Thursday, August 16, 2018
Health

Sudden celebrity deaths are a wakeup call on heart health for the rest of us

When Dr. Arthur Labovitz sees patients in his cardiology clinic in the coming weeks, he can be certain that several booked their appointments in response to the recent wave of sudden deaths among relatively young celebrities. Star Wars actor Carrie Fisher died last month, as did actor Alan Thicke and pop music star George Michael.

At age 53, Michael was the youngest of the group. Found unresponsive in his bed on Christmas morning, his family has not released a cause of death, though some have speculated it was heart-related. Fisher, 60, died of a heart attack, and Thicke, 69, of a tear to his aorta.

Their deaths are a grim reminder that heart disease is still the nation's No. 1 killer, despite advances in diagnosis and treatment and aggressive prevention education campaigns. Current trends indicate that's not likely to change soon.

Deaths from heart disease fell at a rate of 3.7 percent annually between 2000 and 2011. But a study published last June in the Journal of the American Medical Association found that the annual decline slowed to less than 1 percent after 2011, likely due to increases in obesity and Type 2 diabetes, researchers say.

"People hear about these deaths and realize that they have the same risk factors and heart issues (as celebrities). And it reminds them that they better pay attention to their own health," said Labovitz, a cardiologist and chairman of the Department of Cardiovascular Sciences at the USF Health Morsani College of Medicine in Tampa. "I know I will see patients who came in because of these deaths, or the death of someone they know caused them worry."

Carrie Fisher's mother, Debbie Reynolds, died at age 84, the day after her daughter, and had a history of heart problems and stroke. At least one family member said Reynolds was so grief-stricken after Fisher's death that she died of a broken heart, something that's not as far fetched as it may sound.

Although not confirmed in Reynolds, broken heart syndrome is a real medical condition known as Takotsubo syndrome, brought on by a sudden emotional shock such as the death of a loved one or a heated argument. In that moment, the heart suffers a sudden weakening so it can't pump enough blood to the body, throwing it into an abnormal rhythm.

"These patients have no blockages, no structural disease to explain their symptoms," said Dr. Siva Kumar, an advanced heart failure and cardiac transplant cardiologist at Tampa General Hospital and a researcher who has studied the condition for several years.

"The chemicals released by the body during a time of severe stress temporarily stop the heart," he said, "and without treatment, that's when these patients die."

If treated promptly, most patients recover within a few days. Kumar said broken heart syndrome is most common in postmenopausal women in their 60s and older. Many have a history of depression or treatment for psychiatric illness.

While the recent celebrity deaths may have seemed sudden to fans, the disease process behind them was probably underway for years, possibly decades — very often without symptoms.

"These are the things you can't feel, like high blood pressure, high cholesterol and high blood sugar," said Dr. Angela Turner, a cardiologist at Bayfront Health St. Petersburg and an assistant professor of medicine at USF Health. "That's why you need to see your family doctor and get these checked at least once a year. And if the results aren't normal, address them because these are the risk factors that cause deaths like we saw in the celebrities in the news."

Some risk factors that contribute to heart disease — such as smoking, uncontrolled diabetes, long-term alcohol abuse, drug abuse, a sedentary lifestyle, obesity, a poor diet, high cholesterol and high blood pressure — can be managed with medication or lifestyle changes, making heart disease preventable for many people.

But one important risk factor you can't control is a family history of heart disease. That usually includes heart disease, heart attacks, bypass surgery, stent placement, stroke or death from heart disease, at a young age, in an immediate family member in their 50s or younger.

Labovitz said those are the people who should be in the care of a cardiologist early in life, long before problems develop, to prevent or delay serious complications, including death. "Yes, your family physician can order many of the same tests, but we tend to treat these conditions more aggressively to keep high-risk individuals healthy, longer," he said.

Smokers, especially long-term smokers, and anyone diagnosed with diabetes also should be in the care of a cardiologist, Kumar said. "Diabetes is a major risk factor for heart disease."

Contact Irene Maher at [email protected]

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