Your heart - it beats on average 100,000 times a day and pumps the equivalent of 2,000 gallons of blood each day. Imagine what a workhorse our hearts must be! So vital to our life and yet not well taken care of by most of us. Heart disease continues to be the leading cause of death in the United States, claiming close to a million lives each year. Over 30 million Americans live with the burden of heart disease; 60 million Americans have been diagnosed with hypertension, a major risk factor for heart disease. While traditionally considered a “man’s disease,” heart disease has become a serious health challenge for women as well. Cardiovascular disease kills over 500,000 women each year, more than the next seven causes of death combined.
To give you a perspective, 1 in every 2.5 women will die of heart disease and stroke, compared to 1 in every 30 women who will die from breast cancer. What may be the most important information is that heart disease in women presents with different symptoms and physicians tend to under-diagnose the disease in women. In fact, more than half of women who die of coronary heart disease have either had no classic symptoms, or have been misdiagnosed as anxiety, stress or musculoskeletal disorders. Part of the challenge comes from the fact that coronary artery disease in women tends to present with symptoms like shortness of breath or fatigue rather than the classic “crushing” substernal pain that is more typical in men. Research conducted by NIH with 515 women surprisingly revealed that fewer than 30% of women reported having chest pain or discomfort prior to their heart attacks, and 43% reported have no chest pain at all during any phase of the attack.
The most common symptoms they reported were unusual fatigue, sleep disturbances and shortness of breath. So, whether you are male or female, today is the day to put your heart health on the radar screen.
So, let’s talk about what you can do. First of all, let’s assess your risk and then determine what you can do to lower your risks. Yes, there is much you can do to hopefully prevent a catastrophic event from happening to you down the road! The seven major risk factors for coronary artery disease are:
1) family history
4) elevated cholesterol and triglycerides
5) Type 2 Diabetes
7) sedentary lifestyle.
Well, only one of these risk factors is not in your control. You cannot change your family history, but knowledge is good –so, if your family tree includes heart attacks, strokes and diabetes, it behooves you to look at the other 6 risk factors — because these areall modifiable risks that you actually have control over! Knowing your risk factors is the first step in preventing heart disease. Once you know your risk factors, you can begin to take the steps needed to reducing your chances of developing heart disease. Modifiable Risk Factor 1: Being overweight or obese
If you’re like 65% of Americans who are overweight or obese the number one thing you can do to reduce your risk of heart disease is to achieve a healthy weight. Too much body fat, especially around your waist, puts you at higher risk. Being overweight or obese also increase your risk of other conditions like high cholesterol and triglycerides, stroke and Type 2 Diabetes. So by losing weight you can begin to reduce your risk of heart disease. And the good news is you don’t have to lose a lot of weight to start to improve your health. Modest weight loss of even as little as 5-10% can significantly improve your cholesterol, blood pressure and risk of developing Type 2 Diabetes. Modifiable Risk Factor 2: Having High Blood Cholesterol levels
You can have high cholesterol and not know it because in the early phases of accumulation of cholesterol plaque in your arteries, there are no symptoms! This buildup of plaque can narrow your arteries and reduce blood flow ultimately leading to arterial blockage or blood clots in arteries that feed the heart and brain. This in turn can cause a heart attack or stroke. Lifestyle changes like improving your diet and increasing your physical activity can help lower your cholesterol. Consistently eating a diet rich in whole grains, fresh fruit, vegetables, legumes and low fat sources of protein (like soy protein) can help lower cholesterol and protect your heart. The FDA has recognized that the consumption of 25 grams or more of soy protein per day may reduce your risk of heart disease. Choosing healthy sources of fats is also incredibly important. You need to limit your intake of saturated fat (the type found in beef, butter, cheese and regular fat dairy products) and completely avoid trans fats (found in fast foods, bakery products, packaged snack foods and some margarines) as these have been clearly linked to increasing the risk of heart disease. Simultaneously, it is prudent to switch to monounsaturated fats (found in olive oil, avocado, nuts and seeds), as regular consumption of these fats has been shown to decrease your risk of heart disease. Another important heart healthy fat is omega-3 fatty acids, a type of polyunsaturated fat found in foods like fish and flaxseed that may also help protect your heart by decreasing your risk of heart attack, protect against irregular heartbeats and helping to lower triglycerides and blood pressure. Fiber is another important part of a healthy diet. Look for dark breads that contain at least 3 grams of fiber per serving, whole grain cereal that provides at least 6 grams of fiber per serving. Fiber supplements that provide at least 5 grams of fiber, preferably a blend of soluble and insoluble fiber are a prudent addition for anyone dealing with elevated lipids.
Modifiable Risk Factor 3: Having High Blood Pressure
Many woman have high blood pressure or hypertension and don’t know it. With elevated blood pressure, your heart is working harder than normal, pushing your blood with too much pressure against your artery walls. This in turn may enlarge your heart and damage your arteries and significantly increase your risk of having a heart attack or stroke. What can you do? Well, if you are overweight, losing weight can make a significant difference in your blood pressure. Eating a heart healthy diet rich in plant foods and heart healthy fats can also help. And make sure to get adequate amounts of potassium, calcium and magnesium but watch your sodium intake. Studies indicate that populations who consume diets rich in potassium, calcium and magnesium, but limit sodium intake have lower blood pressure. Regular physical exercise also tends to strengthen the cardiovascular system and lower blood pressure. And, again, omega-3 fatty acids have been shown to support healthy blood pressure and help to maintain healthy heart rhythm.
Modifiable Risk Factor 4: Having Type 2 Diabetes
Type 2 Diabetes is a serious and increasingly common disease in which the body doesn’t properly use insulin, the hormone produced by the pancreas that is responsible for transporting sugar in the blood into cells of the body where it can be metabolized. Left untreated, blood sugar levels increase and will damage blood vessels, thus increasing the risk of having a heart attack or stroke. Being overweight and sedentary are two big risk factors for developing Type 2 Diabetes, and once again, modest weight loss can help prevent diabetes from developing in the first place. If you already have diabetes, weight loss, improvements in your diet and the addition of fiber can help to naturally improve your blood sugar control. Regular visits to your health care provider are critical if you already have diabetes. If you have a family member with diabetes or you are overweight, have your doctor screen you for diabetes, which can often be without symptoms until it is advanced. Modifiable Risk Factor 5: Being Physically Inactive
Being a couch potato increases your likelihood of developing heart disease. And increasing your physical activity can make a big difference. If you’re overweight it will help you burn calories, it will also help lower your blood pressure and improve your cholesterol. The American Heart Association recommends 30 minutes a day, most days of the week. If you don’t have time to do all 30 minutes at once, no worries, breaking it up into shorter periods of exercise is fine just be sure it all adds up to 30 minutes a day. In addition to vigorous activities like walking, running, or swimming, simple day to day activities count too. Activities like gardening, housework, mowing the lawn are all activities that can help improve your heart health. Modifiable Risk Factor 6: Smoking
Smoking is the most preventable cause of death in the United States. Even second hand smoke, constantly breathing in smoke from someone else’s cigarette or cigar also increases your risk of developing heart disease and other serious conditions like cancer. If you smoke the best thing you can do for your health and the health of others around you is to quit. Discuss quitting with your doctor. He or she can help direct you to a smoking cessation program that’s right for you.
So in honor of February – Heart Health Month - we want to be sure you are taking special care of your most prized possession, your heart. Learn if you have any risk factors and take the necessary action outlined in this bulletin to modify your risk – starting today. Start by following a heart healthy weight and inch loss plan and increasing your physical activity level. In addition, consider the use of heart-smart dietary supplements as added nutritional support. Incorporate soy protein and soluble fiber into your diet. Eat a diet rich in plant foods like whole grains, fresh fruits and vegetables, other lean protein and heart healthy fats. Be sure you are consuming adequate amounts of homocysteine lowering folic acid, Vitamins B6 and B12. Make sure to get plenty of omega-3 fatty acids. If you are concerned about contaminants in fresh fish, consider a pharmaceutical grade fish oil supplement that will bring you a full spectrum of omega-3 fatty acids including EPA for hearth health and DHA to support brain function. And don’t forget about Coenzyme Q10 ( ours is now triple it’s dosage, for almost the same price!) , to prevent the oxidation of LDL cholesterol, the form of cholesterol that makes up the plaque that builds up inside artery walls. Those on statin type drugs may be depleted in coenzyme Q10.
So, perhaps you enjoyed a few bites of mouth-watering dark chocolate on Valentine’s Day (for its heart healthy polyphenols, of course) but also be sure then to go for a walk with your “honey.” Talk about your excitement about incorporating exercise, healthy eating and wise supplementation into your daily routine so that you can enjoy the coming year with energy and vitality–and the confidence that you are taking care of your heart.
Be well. Dr. Jamie McManus MD, FAAFPChairman, Medical Affairs, Health Sciences and Education