World Heart Day: the global issue of heart disease

e told my dad for years that he should stop smoking. First it was a pack a day, and then as he got older and the stresses of raising a family got to him, it was two packs and sometimes more. 

Photo courtesy of world-heart-federation.org.
Photo courtesy of world-heart-federation.org.

By age 66, he was having trouble breathing and had to be rushed to the hospital, where he was told he had congestive heart failure and would have to undergo a quadruple bypass operation. He made it through the operation, but never made it out of the hospital. He was gone; another victim of heart disease. 

According to the World Health Organization, more than 17 million people died from cardiovascular diseases in 2008, representing 30 percent of all deaths worldwide. Of these deaths, an estimated 7.3 million were due to coronary artery disease and 6.2 million were due to stroke. More than 80 percent of these deaths take place in low and middle-income countries. The WHO believes the number of cardiovascular disease deaths, mainly from heart disease and stroke, will increase to more than 23 million by the year 2030. The numbers are truly staggering. 

Cardiovascular disease accounts for 30% of all deaths worldwide Click To Tweet

The world has decided something needs to be done. The World Heart Federation, set up in 1970, and composed of heart foundations around the world, with the purpose of supporting international research, professional and public education, as well as community programs, is sponsoring World Heart Day on Sept. 29 as a way to alert the world about this growing health concern.

For the first time, the WHF has joined forces with the United Nations to try and reduce the number of deaths caused by cardiovascular disease. Dr. William Zoghbi, a cardiologist with the Houston Methodist DeBakey Heart & Vascular Center and a WHF Board Member, says for the first time in its history, the United Nations has taken an active role by putting non-communicable disease like cardiovascular disease on its agenda. He believes this will go a long way toward getting countries involved to do something about the world’s number one killer.

“The goal is to reduce this number by one-third by 2030 through prevention and treatment,” said Zoghbi, who currently chairs the WHF Global Task Force for cardiovascular disease. “We want to ensure that every country’s health plan includes an essential package for the prevention and treatment of cardiovascular disease.”

Zoghbi suggests countries must work on agriculture, transport, environmental and fiscal policies as well as international trade agreements that will have a strong impact on a person’s diet, physical inactivity and tobacco use.

“We need to help impress upon people lifestyle changes that will help reduce risk factors like high blood pressure, high cholesterol and smoking” Zoghbi said. “More importantly, we need to hammer home the importance of screening for heart disease. Many people go to the doctor when it’s too late. Our goal is to make sure people have the tools to prevent heart disease and I believe we can make that happen.”

 

Heroes of Houston heart history featured in book

At some point during his long career at Houston Methodist Hospital, Dr. William Winters realized he was working side by side with living heart history. He thought someone should compile a book to tell the stories he experienced, but never thought he’d be the one to eventually do it.

Houston Hearts: A History of Cardiovascular Surgery and Medicine at the Methodist DeBakey Heart & Vascular Center at Houston Methodist Hospital” is the title of Winters’ recently published history book, co-written with Houston writer Betsy Parish.

“Everywhere you looked at (Houston) Methodist Hospital, heart history was being made,” says Winters, who has worked as a cardiologist at the hospital since 1968. “So many breakthroughs, so many discoveries changed medicine around that time … and much of it took place right here in this institution.”

Dr. Winters with his recently-released book, "Houston Hearts."
Dr. Winters with his recently-released book, “Houston Hearts.”

“Houston Hearts”covers the 95-year history of Houston Methodist Hospital, and tells the stories of surgeons and cardiologists who worked here. The chronology kicks into overdrive during the swinging late 1960s, as Dr. Michael DeBakey and his team earned the world’s attention with an unprecedented string of surgical and medical breakthroughs.

“In 1968 we performed nearly one-third of the heart transplants in the country, and nearly one-fifth of the open heart procedures,” Winters says. “DeBakey and his team of surgeons would sometimes perform up to 12 successful surgeries a day. It was a great time to be a new cardiologist in this city.”

Winters and his medical partner Dr. Donald Chapman often marveled at the history that unfolded all around them. Chapman, also a cardiologist, is credited with bringing heart catheterization to Houston, while Winters began the use of echocardiography in Houston. Eventually Chapman would write three books about his own career, and those contained much of the history he experienced after coming to Houston in 1944.

In 1968 Houston Methodist Hospital performed nearly one-third of U.S. heart transplants Click To Tweet

Winters had an idea to create his own unique record by interviewing key physicians on video. He was able to talk with a number of important players in Houston Methodist’s history, including Chapman (who died in 2007) and DeBakey (who died in 2008) as well as other physicians and hospital administrators.

“A few years ago I realized there aren’t many of us left,” Winters recalls. “So I contacted Betsy Parish and we went to work writing this book. It has a lot of history, but it tells my story as well. As I’ve heard it said, the last man standing gets to tell the tale.”

“Houston Hearts” is available now on Amazon.com, and at select bookstores in the Houston area including the River Oaks Bookstore at 3270 Westheimer Ave., and the Houston Methodist Hospital gift shop.

New heart procedure safer for women

Women with a family history of heart disease or other heart disease risk factors should schedule a doctor’s appointment for their annual heart checkup.

Surgeon Inserting Tube Into Patient During Surgery
Radial artery catheterization involves placing a small tube near the thumb side of the wrist. Using X-ray, the physician guides the catheter up to the shoulder and then down to the heart through the radial artery.

At the checkup, some physicians might recommend further testing to rule out or confirm a diagnosis. In the cases where a heart procedure such as a cardiac catheterization is required, women should ask their physicians about using a radial artery approach.

Standard heart catheterization involves inserting a catheter into the femoral artery in the groin and threading it to the heart to perform a variety of tasks, such as measuring the heart, diagnosing conditions, clearing a blockage or placing a stent. A new technique, called a transradial catheterization, inserts the catheter into the radial artery at the wrist.

“The radial artery approach is much safer for women,” said Colin Barker, M.D., cardiologist at the Houston Methodist DeBakey Heart & Vascular Center. “A recent clinical trial of more than 1,700 catheterizations in women showed the rates of bleeding or vascular complications were 59 percent lower when using the radial artery approach.”

The catheterization begins when a small tube is placed in the radial artery, which is located on the thumb side of the wrist. Using X-ray, the physician guides the catheter up to the shoulder and then down to the heart through the radial artery.

Barker says the radial artery catheterization is safer because the radial artery is located closer to the skin’s surface, which allows bleeding complications to be spotted sooner. It is also more comfortable for patients. The femoral approach requires patients to lay flat for four to six hours after the procedure, while radial artery catheterization patients are sitting up and getting out of bed within minutes.

Barker noted the radial artery catheterization is used in approximately five percent of cases in Houston and less than 20 percent of cases in the United States.

Transradial catheterization has a 59% lower risk of complications compared to standard heart catheterization Click To Tweet

Barker said the radial artery catheterization is used in 60 to 80 percent of cases outside the U.S. and has become standard medical practice in Europe. He added that it is not being used as often in the United States because it’s a difficult technique that is tedious to learn. More than 80 percent of patients surveyed prefer the radial artery approach, so Barker believes patient preference will help drive up the use of the procedure.

“I’ve seen the benefits it provides my patients, especially women,” Barker said. “I hope the technique becomes more widely available as doctors and hospitals continue to gain experience and proficiency in the procedure.”