Heart Health: Sleep, the Importance of Calling 911, and New Blood Pressure Guidelines
Sleep and Your Heart
Medical professionals are finding sleep disorders and deprivation to be linked to serious health conditions such as heart disease. Sleep apnea is a condition that causes breathing to start and stop during sleep and can fall into two categories: obstructive or central sleep apnea. Central sleep apnea involves the brain not sending the right signals to the muscles that control your breathing and is less common in general, but is found in 30-40% of heart failure patients. Obstructive sleep apnea is caused by the repetitive collapse of the muscles of the surrounding upper airway during sleep. This can lead to fragmented sleep, a drop in oxygen levels in the body from reduced airflow that triggers surges of adrenaline, and increases general inflammation in the body overall.
Individuals with sleep apnea are at higher risk of high blood pressure (hypertension), stroke, pulmonary hypertension, glucose intolerance and diabetes, congestive heart failure, heart rhythm abnormalities, heart attack and sudden cardiac death. Symptoms of sleep apnea include:
- Excessive daytime sleepiness (falling asleep driving, falling asleep on the job, feeling like you have not slept all night upon awakening in the am, inability to carry on daily activities due to fatigue)
- Snoring and witnessed apneas (waking up from a snort) are highly sensitive to sleep apnea
- Snoring – usually noted by the bed partner
- Witness apnea or strange breathing noises at night
- Waking up gasping for breath
- Frequent limb movements throughout the night
- Frequent morning headaches
- Lack of concentration
It is extremely important to discuss sleep apnea with your primary care physician, cardiologist or other healthcare professionals if you suspect the disorder within yourself, a friend or family member. By detecting and treating sleep apnea early, a myriad of cardiovascular diseases and conditions can be prevented or decreased.
Dr. Traci Turner is a cardiologist at Cone Health Medical Group HeartCare at Church Street.
The Importance of Calling 9-1-1
Dialing 911 isn't a call most people want to make, but it can mean the difference between life and death in an emergency. Quick treatment can help limit the damage being done to the heart and increase the chance of a full recovery. But, calling 911 instead of driving yourself or a loved one to a nearby emergency department could be the difference between life and death.
Lack of education about symptoms can act as a barrier to calling and getting the quick care a patient needs. Symptoms of a heart attack can include:
- Discomfort in the center of the chest that lasts more than a few minutes or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath.
- Breaking out in a cold sweat, nausea or lightheadedness.
If you experience these symptoms call 911 immediately and wait for paramedics to arrive. If you have a history of heart disease, watch for the symptoms you've experienced in the past and be ready to act. Some individuals have nitroglycerin tablets to take, but if you do not feel better soon, call for help.
Fortunately, there are things we can do to reduce our risk of developing heart disease. A good start is learning about the risk factors for the disease and understanding which ones we can modify, such as smoking, poor diet and inactivity. The main risk factors associated with heart disease include:
- Family history
- High blood pressure
- High cholesterol
Dr. Suresh Koneswaran is a cardiologist at Cone Health Medical Group HeartCare at Annie Penn and Eden.
New Blood Pressure Guidelines
The American College of Cardiology and the American Heart Association recently updated the blood pressure guidelines, lowering the bar for what is considered high blood pressure. Previously, blood pressure readings below 140/90 were considered normal, and anything about 140/90 was considered high. Now, readings above 130/80 are categorized as high blood pressure, pushing many people into the realm of hypertension (high blood pressure) diagnosis.
These new guidelines also outline how readings should be taken for more accurate results and encourage increased monitoring throughout the year. The thought of a doctor’s visit alone can raise a person’s blood pressure, and the rush of getting there on time can also lead to a falsely high reading when they arrive. The ACC and AHA recommend giving the patient time to relax sitting in a chair for at least five minutes before assessing their blood pressure. Patients should use the restroom beforehand and should avoid caffeine, exercise or smoking for at least 30 minutes before the test. A diagnosis requires two high measurements from two careful readings. Patients should also be checking their blood pressure at home periodically to better understand the pattern or detect a change in normal blood pressure between visits.
The new treatment guidelines are based on whether the patient currently has cardiovascular disease and what their risk of a cardiovascular event is within the next 10 years (calculated by a widely used formula). For those who are hypertensive but do not have cardiovascular disease and have less than 10% risk, lifestyle changes such as following a heart-healthy diet and exercise plan are the first line of treatment. The new guidelines recommend medication and lifestyle changes if a patient falls into one of three categories:
- If their risk is less than 10% but their blood pressure is over 140/90
- If a patient has any kind of cardiovascular disease and stage 1 hypertension
- If they have no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years)
Dr. Tiffany Randolph is a non-invasive cardiologist at Cone Health Medical Group HeartCare at Northline Avenue.