Live Well Ohio: Jan./Feb. 2021
Dr. Steven Bruhl offers health numbers to keep an eye on, and Katie Gascho shares how life-saving cancer therapies affected her heart health.
Help your heart in the new year and beyond by keeping track of these vital health figures.
Your heart health depends on a combination of family history — risk factors like heart disease and stroke — as well as lifestyle choices.
“The reality is we have risk factors that are controllable and some that are not,” says Dr. Steven Bruhl, cardiologist and chief medical officer at Mercy Health — Tiffin Hospital. “The things we can change are smoking, cholesterol, blood pressure, staying active … Do it for tomorrow, for next year, for five years from now so you can age in home, remain independent and live your life doing what you want to do.”
When it comes to protecting your heart, these are the numbers that matter.
Blood Pressure: Bruhl says he likes to see blood pressure levels of 120 to 130/80. “For every 20 points you are above 140 systolic, you double your stroke risk,” he explains. “If you go from 140 to 120, you cut the risk of stroke in half.”
Body Mass Index: A BMI of more than 25 is considered overweight and 30 or higher is considered obese. Bruhl says those in the morbidly obese category (40 or higher) can reduce their risk of stroke and heart attack by 45 percent by getting out of the category. “If you are overweight, even losing 10 to 15 pounds can reduce your risk of cardiovascular disease by 7 to 10 percent,” he adds.
Cholesterol (Good vs. Bad Fat): The general total target number is 200 for those at low risk for heart disease. But Bruhl says he looks more closely at the “bad cholesterol” or low-density lipoprotein (LDL). It should be less than 130 if you do not have diabetes, a previous heart attack or stroke, or a family history of heart issues. He prefers to see LDL levels of 100 and ideally less than 70.
A Heart Reality
Life-saving cancer therapies can compromise heart function, but careful monitoring allows doctors to respond right away.
Heart health has been a hum in the background of Katie Gascho’s life ever since she began radiation treatments for Hodgkin’s lymphoma at age 20. She was studying special education at Purdue University, and while her prognosis was positive, she knew the radiation exposure to her body put her heart at risk.
“They create blocks to protect your vital organs, but they were concerned that the lining around my heart on the right side could start to harden over time because there was a possibility it would get some radiation,” says Gascho, 43, who lives in Troy with her husband, Sam, and two boys, ages 13 and 11.
Gascho went into remission. Then in 2010, her sister was diagnosed with Stage III breast cancer and encouraged Gascho to get tested to see if she had the breast cancer gene.
“The gene I had was 84%,” Gascho recalls. “Combining that with the high risk from the radiation, I decided to get a prophylactic double mastectomy and have reconstruction.”
All the while, she was consulting with her doctor to monitor her heart for any damage. Another sharp turn occurred in 2019 when Gascho found a small lump in her breast. It was Stage I breast cancer, requiring surgery followed by chemotherapy and radiation that she received at The James at The Ohio State University Comprehensive Cancer Center. Gascho voiced concerns about her heart, but doctors assured her the treatment was necessary and that she would be closely monitored. Following abnormal results from a routine echocardiogram, she was enrolled in the cardio-oncology program.
“Chemotherapy is lifesaving, but it affects the heart,” says Dr. Ragavendra R. Baliga, inaugural director of the Cardio-Oncology Center of Excellence at The Ohio State University Wexner Medical Center. Up to 45 percent of breast cancer survivors later succumb to heart disease, he adds. “There’s a complex interplay between these two conditions.”
Heart monitoring and care is tailored to the individual. For example, a patient in the midst of chemotherapy treatments might experience compromised heart function.
“We have thresholds where we stop the therapy, give medication to help the heart and wait for the heart to recover,” Baliga says.
Gascho completed treatment without immediate heart issues, but after a follow-up, the medical team noticed higher pressure on the right side of her heart, a situation they will continue to monitor. Gascho says the care she receives gives her peace of mind, and she also takes matters into her own hands.
“I have to take care of my heart by monitoring it and also with diet and exercise,” she says. “I try to keep my body really healthy so it can function at its best.”