Meeting Your True Heart Stoppers

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The average human heart pumps five liters of blood per minute and works at a rate of 100,000 beats a day or an incredible 2.5 billion beats over a 70 year lifetime without a single interruption.

This is the equivalent of clenching your fist 60-70 times per minute for your entire life without ever taking a break or getting exhausted.

Your heart is designed to last a lifetime, but you have to do your bit to help ensure it stays in good working order. When you exercise, your heart muscle becomes stronger and can pump more blood per heart beat, so that your heart beats only 50-60 times per minute instead of 90-100 times. This increased efficiency makes your heart last much longer. Regular exercise is only one of many steps you can take to help prevent heart disease from developing.

What Is Heart Disease?
Heart disease refers to any illness of the heart; the most common are coronary heart disease, heart failure, heart valve disease, and conduction or rhythm disorders.

Coronary Heart Disease
Coronary heart disease is still the leading cause of premature, permanent disability among working adults.

What is a Heart Attack?
A heart attack occurs when the blood supply to part of the heart muscle (the "myocardium") is severely reduced or stopped. This reduction, or stoppage, happens when one or more of the coronary arteries supplying blood to the heart muscle are blocked. Blockage is usually caused by the buildup of plaque (deposits of fat-like substances). This is a process called "arteriosclerosis” or narrowing of the arteries. The plaque can eventually burst, tear or rupture, creating a snag where a blood clot forms and then suddenly blocks the artery; leading to a heart attack.

Unfortunately, the first sign of coronary heart disease in one third of heart attack patients is sudden death (He or she was in perfect health and then “boom”, they dropped dead). The so called "lucky ones" are those who survive their heart attack. Saved by modern interventions, such as dilation of their arteries using angioplasty or open heart bypass surgery, these individuals are doomed with a dysfunctional heart and resulting physical limitations for the rest of their lives, unless their blockage is reopened within few hours of their heart attack. As cardiologists love to say, “time is muscle”. The truly lucky ones are the ones like me, who get diagnosed and treated before suffering any cardiac attack, which would, otherwise, leave the heart with a large dysfunctional scar on its walls.

Everyone has a 40% chance of dying of heart disease and a 50% chance that his or her quality of life will be damaged by arterial aging disease. Damaged arteries affect your memory, your sex life, and the ability of all your organs to function properly. The real trick is not to get the best treatment after a heart attack, it is to prevent a heart attack altogether!

Here are eight strategies you can adopt today to prevent coronary heart disease:

1. Quit smoking. Millions are quitting every year. No amount of smoking is safe. The nicotine in cigarette smoke makes your heart work harder by constricting blood vessels and increasing your heart rate and blood pressure. The carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply sufficient oxygen. Women who smoke and take birth control pills are at even greater risk of having a heart attack or stroke than are those who don't do either. Worse, this risk increases with age, especially over 35.

The good news though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year, and no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

Teenagers appear to be the tobacco industry’s new promotional target group, especially those in third world countries. The most effective tool in preventing teens from acquiring this dreadful addiction is by increasing the price of cigarettes and, as parents, raising kids with self confidence and healthy egos, and offspring who are not willing to die in order to act out rebellion or prove their independence.

2. Make exercise easy. Most people know that they should exercise but do not have the time or the energy to do it. Exercise is one of the best and most enjoyable ways of lowering your chances of developing heart disease.

Regularly participating in moderately vigorous exercise can reduce your risk of fatal heart disease by half. When you combine exercise with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.

The American Heart Association guidelines recommend that you get at least 30 -60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can't meet those guidelines, don't simply give up on exercise entirely. Remember that things like gardening, housework, taking the stairs and walking the dog, all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3. Eat your way to a healthy heart. Consistently eating a diet rich in fruits, vegetables, whole grains and low-fat dairy products can help protect your heart. Legumes, low-fat sources of protein and certain types of fish can also reduce your risk of heart disease.

Limiting your intake of certain fats is also important. Of the four types of fat: saturated, polyunsaturated, monounsaturated and trans-fats, only saturated and trans-fats increase the risk of coronary artery disease. Trans-fats are disguised as hydrogenated or partially hydrogenated fats and are used extensively in packaged food such as crisps and crackers. Saturated fat is the more worrisome offender because foods containing this type of fat are more prevalent in typical western diets. Major sources of saturated fat include beef, butter, cheese, milk, and coconut and palm oils. Heart-healthy eating is not all about cutting back though. Most people for instance, need to add more fruits and vegetables to their diet, with a goal of five to ten servings a day.

French fries are the only vegetable consumed by 68% of American children today. Never mind that potatoes are starchy vegetables that are rich in sugar and loaded with trans-fats once they are deep-fried. These are then dipped in ketchup which has more sugar than tomato paste. No wonder the American Heart Association is now recommending routine cholesterol checkups for children and some physicians are even considering treating them with powerful statin drugs such as Lipitor. Kids pay when parents are too busy or are bad role models.

Omega-3 fatty acids, a type of polyunsaturated fat, may decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure. Some fish are a good natural source of omega-3s. However, pregnant women and women of childbearing age should avoid shark, swordfish and mackerel fish because they contain levels of mercury high enough to pose danger to a developing fetus.

Omega-3s are present in smaller amounts in flaxseed, walnut, soybean and canola oils and can be found as well in oral supplements of fish oil, EPA, and DHA. It is important to insure that you are using pure pharmaceutical grade fish oil. The total dose of EPA and DHA needed for heart protection is 1-4 grams per day. Fish oil is better absorbed after a meal containing some good fats such as olive oil or nuts. Following a heart-healthy diet also means drinking alcohol only in moderation - no more than one drink a day.

4. Control your weight. How do you know if your weight is healthy? Because muscle weighs more than fat, women and men who are very muscular and physically fit can be overweight without added health risks. The best indicator is the percentage of body fat an individual carries on their skeletal frame. Measuring waist circumference is a useful tool to assess abdominal fat. In general, men are considered overweight if their waist measurement is greater than 34 inches, and women, in general, are overweight if their waist measurement is greater than 32 inches.

Even small reductions in weight can be beneficial. Reducing your weight by just 10% can decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes.

5. Get regular screening. High blood pressure and an elevated ratio of bad fats (LDL) to good fats (HDL) can damage your cardiovascular system, including your heart. C-reactive protein - CRP hs is a genetic marker of chronic inflammation also increases heart disease. Increased homocysteine due to lack of sufficient B vitamins is also dangerous. However, without testing for them, you probably won't know whether you have these conditions. Regular blood screening can tell you what your numbers are and whether you need to take action.

• High blood pressure: Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more frequent checks if your numbers are not optimal or if you have other risk factors for cardiovascular disease. Chronic insulin elevation increases blood pressure and damages the inner lining of blood vessels. Control insulin levels by cutting back on food high in simple sugars such as juices, bread, rice, sugar and tropical fruits and by avoiding a “beer belly”. Optimal blood pressure is less than 120/80 millimeters of mercury. 60% of hypertensive patients respond to lowering their salt intake. For help in gradually getting used to less salt in your diet see the chapter “Salt: Sprinkling Insults on Your Wounds” and the chapter on healthy yet delicious recipes.

• The low-down on lipid levels: A person's total cholesterol number is made up of low density lipoproteins (LDL), high density lipoproteins (HDL) and triglycerides, another fatty substance found in the blood. A desirable level of total cholesterol is less than 200.

LDL or Low-Density Lipoproteins break up easily and adhere to the walls of the arteries. The American Heart Association and the National Heart, Lung, and Blood Institute recommend that everyone 20 and older should have their cholesterol measured at least once every five years.

In combination with cardiovascular disease risk factors, such as high blood pressure, diabetes, tobacco smoking and/or family history of heart disease, high levels of LDL put individuals at increased risk for occlusive coronary heart disease.

Cholesterol in the body originates from two main sources: absorption in the intestine of both biliary and dietary cholesterol, and production in the liver and peripheral tissues. Approximately, two-thirds of intestinal cholesterol comes from biliary sources; only one third comes from dietary sources. Approximately, 50 percent of cholesterol in the intestine is absorbed and re-circulated in the blood; the remainder is excreted.

Cholesterol-lowering agents (statins) reduce cholesterol levels through the partial inhibition of one pathway; that is, by inhibiting the production of cholesterol in the liver. Cholesterol is needed for building cells, forming hormones, and a host of other essential functions. When the liver can't make cholesterol, it draws LDL cholesterol from the blood to use as raw material. The less LDL in the bloodstream, the less there is available to trigger or promote the artery-clogging process known as atherosclerosis. Statins also appear to stabilize cholesterol-filled deposits in artery walls, promote the growth of new blood vessels, and calm inflammation. All of these actions can help steer you away from a heart attack or coronary vessel disease.

High levels of LDL are partially determined by genetics or can result from eating a lot of fatty foods like burgers, simple carbohydrates such as high fructose corn syrup, white sugar, white pasta, white bread and most processed foods which contain trans-fats. Lowering LDL, while desirable is not always a simple matter. Eating a healthier diet, losing weight if needed, exercising more, and reducing stress may shave LDL levels by 5%-10%. That is absolutely worth doing, and these steps yield widespread benefits that go far beyond heart disease. But a 30%-40% reduction requires intensive lifestyle changes plus medications. If you are at high risk of having a heart attack, the benefits of getting serious about cholesterol far outweigh the costs and risks of medications. High risk individuals are those with a family history heart disease or unstable angina, smoking, high blood pressure, diabetes or kidney disease. Things are much murkier if you don't have signs of heart disease or are at low risk for it. Uncertainty over the balance of benefits and risks for people in the low-risk category is reflected in the guidelines, which leave LDL targets for healthy people at 130 or below.

The new 2004 updated LDL recommendations for those at moderately high risk is a goal of 100, compared to the 2001 goal of 130. While the goal for high-risk (heart disease or diabetes) patients is an LDL level of 70 (the goal used to be 100 in this group). Near Optimal levels is an LDL of 100-129 mg/dL. Borderline high is 130-159 mg/dL, high: 160-189 mg/dL, and very high is anything above 190 mg/dL.

Taking large doses of a statin as a single therapy to reduce elevated lipids is likely to invite liver and muscle damage. Increasing statins to the maximum allowable dose, while increasing cost and side effects, may reduce the LDL by 51% instead of 39%.

Eating food rich with fiber or taking fiber capsules as supplements lower the amount of reabsorbed cholesterol thereby; reducing the need for high dosages of statins. HDL is called the "good" cholesterol (remember H for Healthy) because a high HDL level decreases your risk of cardiovascular disease. For women, an HDL of less than 50 and for men, an HDL of less than 40 is considered a risk factor for cardiovascular disease.

A lot of the attention regarding cholesterol has been focused on lowering your low-density lipoprotein (LDL), or "Lousy" cholesterol. That is still an important goal. But as researchers learn more about how cholesterol is used by the body, they're realizing that boosting your HDL level is just as important as lowering your LDL cholesterol. HDL should be increased with exercise, weight loss, and consuming good fat such as olive oil, fatty fish and nuts or taking fish oil. Niacin (B3) may raise the good cholesterol by 15-35% making it the most effective therapy to increase HDL. Triglycerides are best lowered by avoiding everything white; sugar, wheat, ice-cream and alcohol. Fish oil is as effective as statins in lowering elevated numbers. Elevated triglycerides are also a major risk factor especially in women. A key factor to watch is not just how elevated are your LDL but how small are the LDL particles. A key number to monitor is the small Lipoprotein A.

• AA/EPA Ratio: This unique test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body’s eicosanoid balance. This is an excellent way for managing heart disease and other chronic and inflammatory processes by adjusting your intake of fish oil until you reach your optimum level. Some people need one gram and some need five! It all depends on your diet, genes and life style. The NEJM reported in 2006 that people taking fish oil had 21% less heart attacks compared to patients not taking fish oil while both groups had the same LDL numbers.

A lower AA/EPA ratio indicates a better balance of "good" and "bad" eicosanoids in your body. An AA/EPA ratio of 1.5 is considered to be ideal, since this is the ratio found in the Japanese population having the greatest longevity and the lowest incidence of cardiovascular disease. The average AA/EPA of Americans is approximately 11, and for patients with inflammatory conditions and neurological disorders, the AA/EPA ratio will be in excess of 20. We need to cut down on the yummy trans-fats and increase our fish oil intake!

• Homocysteine: Check your blood levels. A high level of homocysteine, a byproduct of the body’s digestion of proteins, can damage arterial walls, increase blood clots, and increase the risk of Alzheimer’s disease. Taking B vitamins and a much higher dose of folate can easily reduce homocysteine levels. The effective folate dose is as high as 1000-3000 micrograms per day. Folate is found in leafy green vegetables, but you would need to eat huge amounts in order to get such a dose.

• C- reactive protein (CRP hs): measures the level of inflammation in your body. Chronic sinusitis, urinary tract infections and gum disease increases cardiovascular death three fold. A course of antibiotics, flossing your teeth, regular dental cleaning and checkups, and taking two baby aspirin per day or aged garlic can reduce your CRP. The Honolulu-Asia Study revealed that elevated CRP predicts Alzheimer’s 25 years earlier. Strive to keep CRP less than three. The ideal number is below one.

• Fasting insulin blood levels: Insulin resistance increases with aging and with bulging abdomens resulting in inflammatory fire in your brain (Alzheimer’s) and in the inner lining of your arteries (high blood pressure) and in oxidation of the small lipid particles circulating in your blood. The ideal number is below five. The average is below ten. Anything above 15 is of great concern requiring a serious reduction in bread, rice, pasta, alcohol, fizzy drinks and juices and more exercise.

6. Reduce your stress level. Come to terms with anger and hostility. Use the stress management techniques that I discussed in the chapter on stress, to help dissolve negative feelings, self-talk and emotions and better manage self-destructive negativity. Learning and regularly practicing stress management and rapid stress reduction can help with many afflictions that are often exacerbated by stress, such as: high blood pressure, heart disease, ulcers, high cholesterol, and suppressed immune function and anxiety attacks.

Excessive stress does not have to be a part of your life any longer. Find stress relief and stress reduction in a healthy manner, without the use of tranquilizers or drugs. When you vigorously pursue a stress management program, you begin to put yourself on the road to improved mental and physical health. Laughing and meditating reduce anxiety, tension and stress. Regular exercise is an essential part of any stress reduction program. Decrease caffeine, quit smoking, get plenty of sleep, live below your financial means, and avoid long commutes, difficult people, too much sugar and too much TV!

7. Consider taking Hormone Replacement Therapy: Compared to conventional estrogen replacement derived from the urine of pregnant horses, Bio-identical Hormone Replacement Therapy (BHRT) in the first ten years after menopause has a definite advantage in terms of lowering the risk of heart attacks, osteoporosis and Alzheimer’s, with much lower risk of inducing cancer. Testosterone replacement for men is recently proven in few studies to reduce the risk of the metabolic syndrome (abdominal obesity, insulin resistance, and high blood pressure), osteoporosis and dementia. Published data in the Cardiology journal proves its effectiveness in patients with heart failure. It is also protective against stroke and heart disease (gel or injections but not pills).

8. Fight depression. Depressed people are four times more likely to suffer heart attacks. Depression seems to weaken the immune system and increases platelet stickiness which invites arterial clotting. Regular exercise is one of the most effective anti-depressants. Food supplements such as 5 HTP or SAMe are much better to use for mild and moderate depression than anti-depressant drugs such as Prozac. These drugs should be reserved for severe depression. Avoid toxic people and watch comedies instead of depressing news programs. Excessive alcohol worsens depression and increases triglycerides; both are risk factors for heart disease.

Chronic Heart Failure
Is an irreversible decrease in the pumping activity of the heart, ranking it as the only cardiovascular problem that continues to rise among the general population. Heart failure results in swelling of the ankles, fatigue and shortness of breath with the slightest exercise.

After surviving a heart attack, parts of the cardiac muscle are replaced with scar tissue which does not contribute anymore to the pumping function of the heart, resulting in a weaker pump. It is also seen after years of heavy smoking, as smokers develop lung disease or emphysema which places heavy resistance against the cardiac pump. Hypertensive heart failure is seen when the heart is forced to pump against the resistance of an elevated blood pressure which, for lack of symptoms, remains undiscovered and untreated for a long period of time. Co Q10, an essential vitamin needed for the heart muscle, may be depleted when using cholesterol lowering drugs or certain diabetes drugs such as Metformin (Glucophage). Take CoQ10 supplements if you are on these drugs or you may risk serious atrophy and damage to your muscles, particularly your heart. Many CoQ10 formulas are poorly absorbed. Ribose –a new sugar substitute- is a great source of energy to the failing heart. L-Carnitine 600 mg twice a day is a food supplement that help the metochondria better utilize the available CoQ10.

Irregular Heart Beat
About half the people with coronary heart disease also end up developing the biological equivalent of electrical problems that affect the heart’s rhythm. This can be controlled with medications such as digitalis and potassium supplements. A battery operated pacemaker may also be inserted for certain conditions. Magnesium especially magnesium torate is a strong anti-arrhythmia mineral that also lowers your blood pressure, reduces migraine attacks, constipation, restless leg syndrome and muscle cramps. Magnesium is now depleted in our over-cultivated soil which helps to explain why optimal levels were found to be low in 70% of all Americans

Other common reasons for irregular heart beat or palpitations are:

• Drinking too much coffee and smoking;
• Mitral valve prolapsed, a congenital condition affecting 15% of women;
• Anxiety or panic attacks.

There is a popular myth that risk factors such as smoking, obesity, high blood pressure, high lipid levels and increased inflammation markers, such as CRP, are absent in 50% of heart attack victims. While it is true that cholesterol is normal in 70% of heart victims the facts remain that 90% of heart attacks occur in people who have at least one of the above risk factors.

Heart disease is often avoidable. We say in medicine that your age is the age of your heart and your arteries. Just look at all the cardiovascular poisons around you – cigarettes, stress, your computer chair, or the couch in front of the TV. Following a heart-healthy lifestyle doesn't have to be complicated and it doesn't mean you need to live a life of self-deprivation. Instead, find ways to incorporate heart-healthy habits into your lifestyle.

A word about angioplasties.
Angioplasties frequently offer a less invasive alternative to address arterial restriction of the vessels that feed the heart than open heart bypass surgery. A wire in a plastic tube is introduced through a tiny cut in the groin all the way to the heart under x-ray guidance and a spring or a stent is placed to open up the narrowing in the artery.

A study published in 2008 revealed that patients with stable angina or chest pain that were given medications did, as well as, patients who underwent the $40,000 (U.S.) angioplasty procedure in terms of survival or life expectancy. It is important to keep in mind that patients deprived of the benefit of angioplasty may equally survive on medications alone but they will be restricted in their physical activity and lifestyle choices.

Star foods for circulation:
Garlic, ginger, green beans, leeks, lemon, lettuce, lime, oily fish, olive oil, onions, orange, parsley, potato, pulse, onions, spinach.

Heart friendly food supplements: Fish oil- aged garlic- ribose- CoQ10- alpha lipoic acid- folic acid, niacin, L-Carnetine and magnesium.

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