Preventive cardiology clinic reaching out to underserved communities, ethnicities

An Illinois child-welfare retiree who lost 35 pounds, weaned herself off of junk food and halved her “bad” cholesterol count in an eight-month span epitomizes the goal of February’s “Heart Month” awareness campaign.

The national campaign encourages people to learn about their heart health and risks, since heart disease kills more Americans than any other ailment — accounting for one in every four deaths each year, according to the American Heart Association.

African Americans have far higher death rates from heart disease than other races, the latest data show. Of 4,774 Chicagoans who died in 2017 due to cardiovascular disease, nearly half — 2,280 — were African Americans, compared with 430 Latinos and 1,911 whites, according to the Chicago Health Atlas.

Black Chicagoans, on average, live an 8.8-year shorter lifespan than white residents, the city’s health data show.

More than one-quarter of that racial life-expectancy gap is driven by heart disease and related conditions, said Dr. Allison Arwady, the commissioner of the Chicago Department of Public Health.

The key is prevention.

“My biggest recommendation is that people keep up with their regular primary-care doctor appointments,” Arwady said. That includes checking weight, cholesterol levels, waist circumference, family history risks, and getting quick help for danger signs such as chest pain, chest tightness, or feeling short of breath.

That’s how Marilyn Giles-Arnold, 65, of Matteson, Illinois, transformed herself into a regular salad eater, a Mediterranean diet advocate and an exercise enthusiast from a self-described “junk food person” who once reveled in eating candy, cookies, ice cream, fried chicken and fried catfish.

She credits a new preventive cardiology clinic at the University of Illinois at Chicago. The clinic sees patients who already have heart disease, as well as those who worry that they might be at risk of heart disease.

The clinic evaluates people for risk factors such as diabetes, smoking, high cholesterol, high blood pressure and a family history of heart disease. Doctors conduct screenings, yet they go beyond the traditional by delving into each patient’s heart-health history, said the clinic’s founder, cardiologist Dr. Noreen T. Nazir.

“In Chicago, where communities are very diverse and where minority communities have higher rates of heart disease, this individualized, specialized approach is really important,” Nazir said.

Tyler LaRiviere/Sun-Times

“I don’t expect all people to respond to the same recommendations, so finding an approach and identifying lifestyle modifications that work within a person’s daily life can really help reduce someone’s risk,” she said. “This is also discussed in the clinic.”

Giles-Arnold’s turnaround started two years ago with a frightening wakeup call: She started having pounding heart palpitations.

“I couldn’t sleep at night, my heart was beating so fast,” said Giles-Arnold, who grew up in Bronzeville. “It was worse at night.”

Her primary doctor referred her to the clinic, where Giles-Arnold got a heart monitor to wear for a prescribed time period, and tests to measure her heart’s electrical activity.

But it wasn’t until she met Nazir that she was inspired to work toward a solution.

“I had elevated cholesterol, but I refused medicine because I didn’t want to go on a statin,” said Giles-Arnold, who retired five years ago from the Illinois Department of Children and Family Services.

She credited Nazir with convincing her that the benefits of the statin outweighed the risks, and that the doctors would monitor her progress.

“[Nazir] explained the test and talked to me about how she wanted to see my cholesterol levels decline,” Giles-Arnold said. “I thought to myself, ‘She’s taking this amount of time to talk with me as an individual patient. I need to listen to her and follow her advice.’”

Nazir said good heart health can be achieved in most cases by following the Mediterranean diet, which requires no special or expensive foods. The diet focuses on eating vegetables, fruit, nuts, beans and whole grains.

Nazir said she also emphasizes small steps.

“I rarely tell people to stop everything right away” when they’re eating too much salt, carbohydrates and other unhealthy foods, she said. “I tell people to change their diet patterns slowly so it will be easier to adjust and maintain for the long term.”

Nazir, who’s an assistant professor of medicine in the UIC division of cardiology, said she was “very appreciative” to be offered the chance to focus on opening the clinic aimed at helping prevent heart disease.

“It’s our job to educate people about their cardiovascular disease risk and to motivate them to work to improve [their health],” said Nazir, who’s working to add a dietitian to the clinic staff.

The clinic focuses on lifestyle modification, and schedules tests such as echocardiograms and stress echocardiograms, electrocardiograms (EKGs) that record the electrical activity of the heart using electrodes placed on the skin, and treadmill EKG stress tests to identify risk factors. Other tests may include those for genetic abnormalities; advanced imaging such as a cardiac MRI, and screening for biomarkers like enzyme or hormone levels.

Nazir’s goal is to keep prevention top of mind.

“It’s important to get screened for risk factors,” she said. “It’s not something to be worried about when going to a preventive cardiologist. We’re trying to prevent heart disease.”

NOTE: People can either be referred by their primary doctor to the heart clinic or make their own appointment by calling (312) 996-6480 and asking for preventive cardiology. The UIC Heart Center Clinic is in the Outpatient Care Center at 1801 W. Taylor St. People who have no primary-care doctor can find a community health center by putting their address into the website https://findahealthcenter.hrsa.gov/. The centers get federal funding to accept patients regardless of insurance status, immigration status or ability to pay.

Sandra Guy is a local freelance writer.