Q: Heart troubles seem to run in my family -- so I worry about having a heart attack while I exercise and about my 35-year-old son's risks and how to help protect him. Any suggestions? -- Drew R., Santa Barbara, CA
A: It's true that the risk for cardiovascular disease can be genetically passed down in some families -- chronic high cholesterol or cardiomyopathy (there are two kinds, one that causes the heart wall to thicken, the other causes it to become thin and weak), for example. If those conditions appeared in your parents, their close relatives or your siblings, you should be screened and so should your son -- and regular cardio-checkups are wise. Fortunately, there are steps to take, such as improved lifestyle habits and medications and/or surgical procedures, that can reduce -- even eliminate -- the risks associated with genetic predispositions to these conditions. It simply requires that you have frequent interaction with -- and pay attention to the advice of -- an aggressive, preventive internist or cardiologist.
However, families may see heart disease in multiple generations because of a family history of habits and conditions such as sedentary behavior, overweight/obesity, smoking, excessive drinking, and not managing chronic stress responses linked to life circumstances or mental health challenges.
A 2019 study found that the proportion of heart attack in folks younger than 40 increased by 2% annually from 2000 to 2016. That's because obesity, Type 2 diabetes, and high blood pressure are affecting increasingly younger adults -- and those folks aren't tuned into how easy it is to manage such conditions into non-problems.
You and your son need to work with your docs to determine what your risk factors for heart disease are -- and then address them.
As for your worry about the risk of a sudden heart attack when you exercise, a recent study that looked at records of 4,078 sudden cardiac arrest cases in people 65 and older found that just 1.9% happened during or following an activity, such as bicycling, a gym workout, running, or playing golf or tennis.
Q: With mask and vaccination mandates being lifted and the declaration of a COVID-19 emergency scheduled to end in May, do I need to worry about COVID-19 any more or get the more recent bivalent COVID-19 booster? -- Julie P., Iowa City, Iowa
A: There are still over 40,000 COVID-19 cases reported every week in the U.S. So, whether you're fully vaccinated or not, wearing an N95 mask in crowds and enclosed spaces with other folks still makes sense, especially if you have underlying health conditions such as autoimmune disease, cancer, heart issues or diabetes and obesity.
It's less clear cut when it comes to getting another booster shot. If you are under 50, and without comorbidities like obesity, Type 2 diabetes or cancer, then you're probably better off without the third bivalent mRNA booster. For folks over 50, the benefits of that booster after the second monovalent booster and of getting any additional booster within one year of the last one are now being debated in academic circles. In addition, risk-benefit data about additional boosters after two of the original ones and of the newer mRNA booster is now mixed (even if you are at increased risk because of age or other health issues). So, do make sure you have the original vaccine -- and (if possible) the two original boosters. Then, talk with your primary care provider. Non-mRNA vaccine boosters may be safer, so look for those recommendations in the future (we will keep you updated in these columns).
I also urge you to adopt lifestyle choices that help protect you from infection and (if infected) prolonged symptoms. A Harvard study found that if you can stick with five to six healthy lifestyle factors -- a healthy weight, never smoking, a high-quality diet, moderate alcohol intake, regular exercise and adequate sleep -- you slash the risk of long COVID-19 by almost half compared to other women with no healthy lifestyle factors.
Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow." Do you have a topic Dr. Mike should cover in a future column? If so, please email [email protected].
King Features Syndicate