Where are the 5 Heart-Healthiest Communities?

 

Recently U.S. News & World Report published a list of the overall healthiest communities in the nation. Check out Kristen Fischer’s piece in Verywell Health that summarizes and adds perspective from my colleague Dr. Elizabeth Kodas and me. Both of us serve on the American College of Cardiology Nutrition & Lifestyle Workgroup.

Here are the 5 Heart-Healthiest Communities in the United States
1.   Bethel, Alaska (tie)
1.   Storey County, Nevada (tie)
3.   Daggett County, Utah (tie)
3.   Carter County, Montana (tie)
5.   Slope County, North Dakota

The illustrations above are from Daggett and Storey Counties. As I mentioned to Kristen, I have added these communities to my “bucket list” of places to visit !

What about these communities make them particularly appealing from a heart-health standpoint? For one, overcrowding is certainly not a problem because population rates are very low (3 counties have less than 1000 residents). But they are also beautifully scenic communities with many outdoor activities to choose from. In other words, these folk(s) live away from the hustle and bustle of city dwellers with much less exposure to crime/ air pollutants/ noise and other toxic exposures. The bottom Line: living in a low stress environment contributes to a low risk of heart disease.

What can you do if you live in a high stress environmental region? if you live a healthy lifestyle (don’t smoke, exercise, manage stress, etc) and have a solid social network, you can work to overcome a less environmentally sound living area.  In addition to healthy nutrition habits, consider outdoor activities such as parks/hiking trails outside of your city limits as well as indoor activities such as yoga/meditation to both offset stress and enhance a sense of tranquility.

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His latest book is  “Heal Your Heart: The Positive Emotions Prescription...” published by Penguin Random House.

 

The COVID-19 Heart: Scientific Sense

This past week, I had the pleasure of being a guest on Gill Eapen’s Podcast, “Scientific Sense” where we discussed the latest evidence related to COVID-19 and the heart (and other issues). Click here for the full podcast.

Below are a few highlights of the program.

1. COVID-19 is like no other virus we’ve ever experienced in our lifetime; the virus is highly unpredictable with many different signs/symptoms/presentations and the potential for long-term consequences on the heart.
2. Compared to seasonal flu where the death rate is ~1 per 1000, the death rate for COVID-19 is ~3-5 per hundred; In other words, fatality rates for COVID-19 are 30-50x fold higher than seasonal influenza.
3. The amount of virus (viral load) exposure predicts how sick you may become. Wearing a surgical quality mask and social distancing can reduce the potential viral load to minimal levels.
4. Level 3 masks (surgical quality) are recommended, especially when indoors and interacting with strangers.
5. Vitamin D supplementation may be protective, especially if levels are low (less than 20 ng/ml)

Michael Miller, MD is Professor of Cardiovascular Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His latest book is  “Heal Your Heart“ published by Penguin Random House.

Back To College in the COVID-19 Era

With one of my daughters returning to college over the weekend, I reminded her that she needs to remain diligent both on and off campus, to wear a mask, to socially distance and to not attend parties or social gatherings of more than a handful of people who are also diligent. I know…good luck with that one!

Before she left, I impressed upon her to make every attempt to avoid COVID-19 if at all possible and was delighted to see that she was very well prepared for a safe flight! Even though the vast majority of healthy young men and women stricken with COVID-19 make complete recoveries, some develop longer-term heart related complications. They include myocarditis that was first reported in China and more recently identified in college athletes. Another newly reported heart related complication that may occur weeks to months after being infected with COVID-19 infection is postural orthostatic tachycardia syndrome (POTS). This condition is characterized by inability of the body to respond properly with changes in position, especially when standing, due to pooling of blood in the lower part of the body rather than throughout the body and brain. As a result, the longer you stand, the more likely you are to experience lightheadedness, fatigue and poor concentration. Pulse rate increases 30-40 beats per minute when standing for more than 10 minutes and you can experience premature (skipped) beats and chest discomfort. Expect to hear more about this association in the coming months.

The Bottom Line: COVID-19 is not going away anytime soon, so best to listen to and heed the advice of qualified health care experts, like Dr. Anthony Fauci. I met Tony when I was a medical student and researcher at the National Institutes of Health during the early stages of the AIDS epidemic and have the highest regard for him. I also had the opportunity to work with Dr. Phil Pizzo, who was also at NIH during that time. Like Dr. Fauci, Dr. Pizzo is of the highest integrity and aims for the promotion of honesty and truth in science.

Michael Miller, MD, is a Professor of Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine in Baltimore. Check out his twitter handle: @mmillermd1

Back To College in the COVID Era

With one of my daughters returning to college over the weekend, I reminded her that she needs to remain diligent both on and off campus, to wear a mask, to socially distance and to not attend parties or social gatherings of more than a handful of people who are also diligent. I know…good luck with that one!

Before she left, I impressed upon her to make every attempt to avoid COVID-19 if at all possible and was delighted to see that she was very well prepared for a safe flight! Even though the vast majority of healthy young men and women stricken with COVID-19 make complete recoveries, some develop longer-term heart related complications. They include myocarditis that was first reported in China and more recently identified in college athletes. Another newly reported heart related complication that may occur weeks to months after being infected with COVID-19 infection is postural orthostatic tachycardia syndrome (POTS). This condition is characterized by inability of the body to respond properly with changes in position, especially when standing, due to pooling of blood in the lower part of the body rather than throughout the body and brain. As a result, the longer you stand, the more likely you are to experience lightheadedness, fatigue and poor concentration. Pulse rate increases 30-40 beats per minute when standing for more than 10 minutes and you can experience premature (skipped) beats and chest discomfort. Expect to hear more about this association in the coming months.

The Bottom Line: COVID-19 is not going away anytime soon, so best to listen to and heed the advice of qualified health care experts, like Dr. Anthony Fauci. I met Tony when I was a medical student and researcher at the National Institutes of Health during the early stages of the AIDS epidemic and have the highest regard for him. I also had the opportunity to work with Dr. Phil Pizzo, who was also at NIH during that time. Like Dr. Fauci, Dr. Pizzo is of the highest integrity and aims for the promotion of honesty and truth in science.

Michael Miller, MD, is a Professor of Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine in Baltimore. Check out his twitter handle: @mmillermd1

5 Surprising Signs/Symptoms Your Heart Might be in Trouble

At the international European Society of Cardiology meetings last week, a new study revealed that many “sudden” heart related events were actually not so sudden. You can find this story as well as my comment under “Reader Picks” in the New York Times . Listed below are 5 signs/symptoms that are important to recognize as they might indicate that your heart is in trouble.

1. Chest discomfort: Discomfort in the chest area that feels like “tightness”, “pressure”, “heaviness”, etc, occurs with activities such as that walking up a hill or emotional stress should be promptly evaluated as these symptoms may indicate a blockage in a heart (coronary) artery.
2. Shortness of Breath: Activities that cause you to become short of breath or easily winded when that was not the case days or weeks earlier, also raises the possibility that you may have a heart-related problem.
3. Excessive Fatigue: If you become overly tired while conducting your daily activities, that might indicate weakness of heart function that should be checked out.
4. Radiation to the neck, jaw and down the left arm: Sometimes the only symptom is discomfort that travels up to the neck, jaw or down the inner portion of the left arm. If this occurs with activity or stress (with or without chest discomfort) , you need immediate evaluation.
5. Discomfort just below the chest. On occasion, discomfort occurs below the chest or in the upper central part of the abdomen (epigastric region). When these symptoms occur with activity or stress, they may also indicate blockage in a heart artery and requires swift attention.

Michael Miller, MD is Professor of Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His latest book is  “Heal Your Heart“ published by Penguin Random House.