The Hamilton Spectator - - GO - LESLIE BARKER

We’re a na­tion of trou­bled hearts.

We’re talk­ing about our phys­i­cal tick­ers to­day.

Heart disease kills more Amer­i­cans than any other disease. Ev­ery 25 sec­onds, an Amer­i­can will have a “coro­nary event,” ac­cord­ing to the Cen­ters for Disease Con­trol and Preven­tion. Ev­ery 30 sec­onds, an Amer­i­can will die from heart disease, the Amer­i­can Heart As­so­ci­a­tion tells us.

As much as 70 per cent of heart disease can be pre­vented by con­trol­ling ma­jor risk fac­tors, says Parin Parikh, an in­ter­ven­tional car­di­ol­o­gist with Texas Health Pres­by­te­rian Hos­pi­tal Dal­las.

We asked Parikh and other ex­perts what they would like nor­mal, ev­ery­day peo­ple to know about heart disease and how to pre­vent it. Here’s what they said:

1. Know your risk fac­tors. They may seem ba­sic, but bear re­peat­ing: smok­ing, di­a­betes, high blood pres­sure, high choles­terol, poor diet, obe­sity and seden­tary life­style, Parikh says. In ad­di­tion, “other dis­eases seem to in­crease your risk of heart disease.” These in­clude chronic kid­ney disease, HIV and such auto-im­mune dis­eases as rheuma­toid arthri­tis, lu­pus, or pso­ri­a­sis. Which leads to this:

2. Pso­ri­a­sis patients have the same heart disease risk as peo­ple with di­a­betes.

Pso­ri­a­sis, with its tell­tale signs of rough, red, itchy patches of skin, goes far deeper than cos­met­ics. It’s an in­flam­ma­tory disease, and thus, can af­fect your en­tire body — in­clud­ing your heart.

“We know with peo­ple at any given age what coro­nary cal­cium you’re sup­posed to see or not see,” says Bay­lor Univer­sity Med­i­cal Cen­ter car­di­ol­o­gist Jef­frey Schus­sler, who led a re­cent study on this. “A 40-year-old woman shouldn’t have any coro­nary artery cal­cium. Al­most ev­ery 90-year-old man has a lit­tle or more.”

But in their re­search, “Mid­dleaged to younger ages who shouldn’t have a whole lot of plaque seemed to have more than their fair share,” he says. What made those stand out? They all had pso­ri­a­sis. Says Bay­lor der­ma­tol­o­gist and pso­ri­a­sis ex­pert Alan Men­ter: “What I’m telling patients now is ‘I want to get your skin bet­ter. I want to get your joints bet­ter. Im­prov­ing your skin and joints hope­fully will re­duce the risk of car­diac artery disease.’ It’s a very sen­si­tive is­sue.”

Chad McMinn, one of Dr. Men­ter’s patients, finds the pso­ri­a­sis/ heart disease link “scary,” but is fac­ing his con­cern in a pos­i­tive way.

“When I left Dr. Men­ter’s of­fice, I called my wife and said I’m go­ing to sched­ule an appointment with a nu­tri­tion­ist,” says McMinn, 38.

3. Re­mem­ber that no or­gan is an is­land.

That’s what Cooper Clinic car­di­ol­o­gist Nina Rad­ford stresses to her patients and any­one else.

“I have been in so­cial set­tings where the topic of what I do — pre­vent­ing heart disease — comes up,” she says. “I’ve had peo­ple re­spond that they are re­ally not wor­ried about heart disease be­cause can­cer runs in their fam­ily.”

But, she says, what they do to pre­vent heart disease can also help pre­vent can­cer and other dis­eases. Win-win, eh?

4. Many risk fac­tors can be re­duced.

We can’t change our fam­ily his­tory, Parikh says. But we can con­trol what we put into our mouths (cig­a­rettes, no; fruits and veg­eta­bles, yes). We can con­trol how much we move our bod­ies. We can con­trol how we deal with stress.

5. Pay at­ten­tion to (but don’t ob­sess over) what you eat.

Obe­sity is a ma­jor con­trib­u­tor to heart disease. But de­spite con­flict­ing and some­times con­fus­ing ad­vice out there on ev­ery­thing from choles­terol to gluten to sugar and salt, Parikh of­fers some ba­sics on eat­ing healthily: Limit red meat and sat­u­rated fats. Opt for more fish. Up your fruit and veg­etable in­take.

Also, just about ev­ery ex­pert will tell you to limit pro­cessed foods; the more in­gre­di­ents you see on a la­bel, the more you should steer clear of it. Watch your por­tion sizes. Many restau­rant serv­ings (think spaghetti) are at least twice what’s con­sid­ered a “nor­mal” serv­ing. Swap out soda for wa­ter; if you need the fizz, go for sugar-free car­bon­ated wa­ter.

6. Choose food, not sup­ple­ments.

“Our bod­ies are de­signed to use food in its orig­i­nal, beau­ti­fully bal­anced form,” says Sarah Sa­maan, a car­di­ol­o­gist with Le­gacy Heart Cen­ter in Plano. “When you think about it, nat­u­ral foods such as fruits, veg­eta­bles, grains, and olive and nut oils are re­ally quite mirac­u­lous. When we take sup­ple­ments, we are miss­ing out on all the com­ple­men­tary nu­tri­ents, fi­bre, min­er­als, and an­tiox­i­dants that make up the whole food.”

If your physi­cian recommends a sup­ple­ment, pay at­ten­tion, of course, she adds. But re­mem­ber that some sup­ple­ments can be harm­ful in high doses. And along those lines ...

7. Sup­ple­ments alone can­not im­prove heart health.

That’s the word from Dr. Christie Bal­lan­tyne, pro­fes­sor of medicine and chief of the sec­tion of car­di­ol­ogy at Bay­lor Col­lege of Medicine, who says over-the-counter nu­traceu­ti­cals or vi­ta­mins alone won’t do the trick.

8. Pre­scribed med­i­ca­tion doesn’t elim­i­nate risk of a heart at­tack.

This, too from Bal­lan­tyne, who says that tak­ing pre­scrip­tions for your heart only means you’re work­ing to lower your risk; heart at­tacks can still hap­pen. Talk to your doc­tor to make sure you’re do­ing ev­ery­thing pos­si­ble to guard against that.

9. Don’t be afraid of statins. Un­for­tu­nately, Parikh says, this med­i­ca­tion has “re­ceived a lot of neg­a­tive at­ten­tion in the press be­cause of not very com­mon side-ef­fects. How­ever, statins re­main very im­por­tant in pre­vent­ing and treat­ing heart disease.”

10. Move. That’s what ex­er­cise means, so don’t think run­ning marathons — or run­ning at all — is your only op­tion. Ex­er­cise is what­ever YOU want to do, not what­ever is the hot class at the gym or what your best friend swears by. So dance! Ride your uni­cy­cle! Leap onto a pogo stick! Walk!

“The ev­i­dence is over­whelm­ing that ex­er­cise re­duces the risk of heart at­tack, stroke, con­ges­tive heart fail­ure and other types of heart con­di­tions,” says James de Le­mos, a se­nior car­di­ol­o­gist at Park­land Health & Hos­pi­tal Sys­tem. “Even if the in­di­vid­ual is over­weight or obese, im­prov­ing your fit­ness level markedly im­proves the prog­no­sis and out­comes for peo­ple with heart disease.”

Strive for 30 min­utes a day, five days a week. You can even break it up into three 10-minute seg­ments.

11. Re­mem­ber that heart at­tack symp­toms are wide-rang­ing.

Most heart at­tacks be­gin with slow symp­toms that in­crease grad­u­ally. Chest pain, for in­stance, may spread to the neck, jaw, or arm and be ac­com­pa­nies by nau­sea, short­ness of breath or vom­it­ing.

12. If you’re a woman, symp­toms may also in­clude the fol­low­ing:

Se­vere, un­ex­plained fa­tigue; pain or burn­ing in the back, arm or even wrist; jaw pain, Sa­maan says. “Even the sen­sa­tion of a tight bra band may be a symp­tom of a blocked artery.”

Parikh also cau­tions peo­ple with di­a­betes to watch for such symp­toms.

13. Don’t hes­i­tate to call 911. The Amer­i­can Heart As­so­ci­a­tion feels so strongly about this that they fo­cused an en­tire ad cam­paign on the im­por­tance of seek­ing im­me­di­ate help if you or a loved one are ex­pe­ri­enc­ing symp­toms.

14. Fol­low through with re­hab.

If you’ve had a heart at­tack, by all means do what you’re sup­posed to do af­ter­ward. That may sound ob­vi­ous, but in the last 30 years, 80 per cent of women didn’t, ac­cord­ing to a study pub­lished in the jour­nal Cir­cu­la­tion and led by Laxmi Me­hta, direc­tor of the Women’s Car­dio­vas­cu­lar Health Pro­gram at the Ohio State Univer­sity Wexner Med­i­cal Cen­ter. The re­sult? In­creased rates of hos­pi­tal read­mis­sion and in­creased deaths dur­ing the year af­ter the car­diac episode.

15. Re­duce stress. Not al­ways (or ever) easy, but stress can af­fect be­hav­iours that can lead to heart disease, ac­cord­ing to the Amer­i­can Heart As­so­ci­a­tion. Maybe stress makes you overeat, drink too much or col­lapse on the couch. What to do when you’re feel­ing stressed? Go for a walk. Med­i­tate. Call a friend. Take care of your­self.

16. You can pass a stress test and still have coro­nary artery disease.

“The test gen­er­ally de­tects a heart block­age only when it is se­ri­ous enough to limit the flow of blood through an artery,” Sa­maan says. “That usu­ally means a 70 per cent block­age or worse. So a nor­mal stress test will not get you off the hook if you are won­der­ing whether or not you are at fu­ture risk for heart disease.”

That’s why pay­ing at­ten­tion to your body and your symp­toms, and let­ting your doc­tor know what’s hap­pen­ing, is im­per­a­tive, she says.

17. Even if you think you’re healthy, you still need a phys­i­cal.

We’ve all heard of peo­ple who ate right and ex­er­cised reg­u­larly but who ended up drop­ping dead of a heart at­tack. An­nual check­ups should in­clude blood work, blood pres­sure tests and a ba­sic dis­cus­sion with your doc­tor about your fam­ily his­tory and life­style to make ab­so­lutely cer­tain your risk is as low as pos­si­ble.


When we take sup­ple­ments, we are miss­ing out on all the com­ple­men­tary nu­tri­ents, fi­bre, min­er­als, and an­tiox­i­dants that make up the whole food.

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