Brought to you by Crozer Health

Heart Health’s Overlooked Risk Factors

We know we’re supposed to eat right and exercise, but is there anything else we could be doing to prevent heart disease? Crozer Health’s Jacqueline L. Scheier, DO, shares some of the often-underrated risk factors—from stress to sleep—and offers practical advice for building a healthy routine.

Do you need to see a cardiologist if you’re concerned about preventing cardiac disease? Not always. Starting with a primary care doctor is a good stepping stone for someone looking to improve their cardiac health. Your primary care physician is typically more accessible than a cardiologist and in-tune to your individual needs. As a family physician, I enjoy work-ing with people to try and achieve their health care goals, whatever that may be, and I love coming up with a reasonable plan for patients and then working with them to troubleshoot areas that are causing difficulty to help them find success. And being reasonable is key—I’m not going to try to convince someone who hasn’t once gone to the gym to all of a sud-den run a daily 5K, but what can you do? Can you track your steps, or maybe set aside 10 minutes at lunch to walk around the block?

What’s a common hurdle you see that prevents patients from finding that success? Getting enough sleep is huge. Most heart attacks occur at night because the cortisol levels are so high, and getting poor sleep raises your cortisol levels even more. You can’t meditate or caffeinate out of adequate sleep at night. I encourage my patients to get into a bedtime routine just like you would with one of your kids: Put yourself to bed at a reasonable time, decrease distractions in the bedroom that can keep you up at night, such as your TV or phone, and make it a dark environment. Sleep also plays an important role in regulating stress and anxiety.

You mentioned stress—how does that impact the heart and what can be done to regulate it? Stress can raise your risk of high blood pressure and stroke. I tell patients often that I could medicate them in various ways to decrease various metrics, but if your preventable risk factors like stress aren’t managed, there is only so much we can do. In terms of management, it’s about trying lots of different things to find what works for you—everyone is going to be different. Some people really don’t do well with therapy or meditation, but love running or find prayer to be a good stress reliever. It’s not one-size-fits-all, and it’s important to have a good primary care doctor advocate for you to try to investigate what your best treatment plan is. I recently had a patient come back to me and let me know they quit their job because it was too stressful, and they’re doing so much better now in their new position. It’s rewarding to see patients like them make meaningful changes to live a healthier and less anxious life.

Has the shift to working from home impacted our health at all? Because of the pandemic, many people who work office jobs have become more sedentary, and I’m concerned about the long-term impact of that. We need to try to get back to how we were before being locked down and working from home. Some people now just go from their bed to their desk to the kitchen, but you need to build in habits that replicate walking to work and moving more throughout the day.