Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

February is a time when love is in the air. It is also American Heart Month. While you're thinking of hearts this Valentine's Day, do yourself—and your loved ones—a favor: focus on your own heart.

Heart disease is the number one killer in America. Nearly 2,400 Americans die each day from it. About one in three Americans has one or more kinds of heart disease.

One common type is coronary artery disease. This occurs when the arteries that bring blood to your heart muscle become blocked or narrowed. When that happens, it is hard for blood and oxygen to reach your heart.

If you have coronary artery disease, you are at risk for a heart attack, heart failure, and stroke. If you feel chest pain or tightness in your chest when you do any physical activity or exercise, you may have what doctors call angina. This is a warning sign you shouldn't ignore.

There is no cure for coronary artery disease, but some medicines can help protect you from heart attacks and other heart conditions that can be deadly. If you have or are worried that you might have coronary artery disease or another heart problem, it is important to contact your doctor immediately. Together, you can determine how to protect yourself from future problems.

My agency, the Agency for Healthcare Research and Quality (AHRQ), published a guide to help people understand options for treating coronary artery disease. The guide, "ACE Inhibitors" and "ARBs" To Protect Your Heart? A Guide for Patients Being Treated for Stable Coronary Heart Disease, examines medicines prescribed for this condition. These include ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs).

ACE inhibitors and ARBs usually treat high blood pressure but also appear to help people with stable coronary heart disease. The guide lays out the pros and cons of adding ACE inhibitors or ARBs to other medicines. Here are some highlights:

  • Both medicines can reduce the risk for death, heart attacks, and heart failure.
  • Possible side effects of ACE inhibitors include a persistent cough, sudden fainting, and other problems. Risks associated with both ACE inhibitors and ARBs include problems with the heart's beat and sudden swelling of the tongue, lips, throat, hands, or feet.
  • There are several ACE inhibitors and ARBs available. Finding the right one depends on balancing the benefits, side effects, and costs.

You can lower your risk of heart attack, heart failure, and stroke by following familiar advice: lose weight if you are overweight, exercise regularly, eat foods that are low in fat and cholesterol, and do not smoke. As we all know, sometimes the basics are easier said than done. Here are steps you can take for your heart's health:

  • Do regular physical exercise tailored to your abilities, needs, and interests. Exercise doesn't have to involve training for a marathon. Even walking can help. Ask a friend, colleague, or family member to join you in your efforts.
  • Learn about your heart problem, its causes and treatments, and how you can manage it. The resources listed below are good places to start.
  • Get advice on why and how to change your lifestyle to lower your risk of heart disease. Start by asking your doctor or other health care provider.
  • Learn specific skills to help you stop unhealthy behaviors (such as smoking) and begin healthy behaviors, including eating a heart-healthy diet.

February is a great time to think about your heart health and how you can prevent heart disease. Take the first steps for a longer, healthier life.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
High Blood Pressure Medication May Help Treat Stable Ischemic Heart Disease  (Transcript)

Agency for Healthcare Research and Quality

"ACE Inhibitors" and "ARBs" To Protect Your Heart? A Guide for Patients Being Treated for Stable Coronary Heart Disease
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=384

American Heart Association
HealthHub for Patients
http://www.hearthub.org/

Centers for Disease Control and Prevention
About Heart Disease
http://www.cdc.gov/heartdisease/about.htm

National Heart, Blood, Lung Institute
Spread The Heart Truth™ Message
http://www.nhlbi.nih.gov/educational/hearttruth/

Current as of February 2011
Internet Citation: Focus on Heart Health. February 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/020111.html