(For use by New York Times News Service clients)
c.2014 San Antonio Express-News
Chew on This: No vacation for heart trouble
By Richard A. Marini
You go on vacation, shouldn't your diet be able to take a little holiday, too?
Well, to a point. But for those with any number of cardiovascular risk factors -- diabetes, being overweight or obese, high blood pressure -- a holiday may be a heart attack waiting to happen. In fact, heart attacks account for half of all deaths of Americans abroad.
The risk was brought to light this past summer when actor James Gandolfini was felled by an attack while vacationing in Italy with his family.
"Holiday stress is a well-known heart attack trigger," said Dr. Steven R. Bailey, chief of the cardiology department at the University of Texas Medical School here.
Heart attacks are usually the result of coronary artery disease, which is caused by a buildup of fatty plaque along the inside of the arteries to the heart. When an area of plaque ruptures, it can trigger a blood clot that leads to a heart attack.
"You're on vacation, eating and drinking with family and friends, staying out late," he said. "Maybe you forget to take medication. That can all increase your risk, especially for someone who is already at risk."
The stresses of modern-day travel (can you say "flight delay"?), temperature extremes and unusual physical activity ("Sure, I'll hike to the waterfall with you") may also spell trouble for travelers who are out of shape and overweight.
Even if the body sends you warning signs, most people are likely to ignore them and instead order otra margarita, por favor.
"Most people think a heart attack feels like you've got an elephant sitting on your chest," said Bailey. "Sometimes it does, but sometimes it just feels like a bad case of indigestion."
And since nobody wants to go to the ER for a tummy ache -- especially while in a foreign country -- they'll likely ignore the pain until it goes away.
Unless it doesn't.
Best known for playing a mob boss in the groundbreaking HBO series "The Sopranos," the Emmy Award-winning Gandolfini was not in the best of shape, standing 6-foot-1 and reportedly weighing 275 pounds. That would mean he had a body mass index of 36.3, putting him well into the obese category.
While his family denied news reports that his heart attack may have been triggered by a lavish last meal in Rome, he was nonetheless "a walking time bomb," according to Dr. Chauncey Crandall, chief of the cardiac transplant program at Palm Beach Cardiovascular Clinic in an interview with the website NewsmaxHealth. com.
Still, this doesn't mean having to eschew vacations completely. If you have a heart condition or suspect you may be at risk, talk to your doctor to make sure it's safe for you to travel. Also, ask if you should be taking a daily aspirin to reduce heart attack risk, pack a sufficient supply of medications, and check with your health insurance company to make sure you're covered while on the road. While flying, be sure to drink plenty of water, avoid caffeine and move around as much as possible to prevent blood clots.
And no matter how much fun you're having, trust your instincts. If something doesn't seem "right," don't hesitate to seek medical attention.
Finally, don't let everything I've written here scare you away from taking that long-deserved vacation. Not only is time away good for you mentally, it's good for you physically, too. At least two large studies have shown that regular vacations not only increase life expectancy, they can also decrease risk of developing heart disease.
Bottom line? Bon voyage!