HEART OF THE MAT­TER

Your heart does much more than sim­ply pump blood and miss a beat when your head is turned. In fact, it’s an exquisitely sen­si­tive in­stru­ment that may be more in touch with your emo­tional in­tel­li­gence than you re­alise. Max­imise its po­ten­tial and safe­guard

Men's Health (UK) - - The Body Issue - WORDS BY BILL GIF­FORD – PHO­TOG­RA­PHY BY DAN FORBES

Your brain and heart health are in­ex­orably linked. Here’s how to get smart about both

on an un­con­quered Hi­malayan peak, Con­rad Anker felt an un­usual sen­sa­tion: he was tired. For a typ­i­cal 53-year- old, this would not have been sur­pris­ing. Anker had been climb­ing for seven hours to the 22,621ft sum­mit of a peak called Lu­nag Ri. It was enough to beat any­one. But Anker was not just any­one; as an ac­claimed moun­taineer he was in re­mark­able shape and, four years ear­lier, had be­come one of a hand­ful of peo­ple to sum­mit Ever­est with­out sup­ple­men­tal oxy­gen. In the­ory, the man was nigh on in­de­fati­ga­ble.

But, on 16 Novem­ber 2016, Anker stopped climb­ing and sat down. At first he thought it was al­ti­tude sick­ness. Then it hit him: this was some­thing else. Just a few months ear­lier, be­fore trekking Mount Kil­i­man­jaro, Anker had un­der­gone a bat­tery of heart tests. Ev­ery­thing had checked out per­fectly. So, at 3000ft from the sum­mit of Lu­nag Ri, a sen­sa­tion Anker de­scribed as a “se­vere mus­cle pain in my heart” was cause for deep con­cern.

Anker and his part­ner David Lama rap­pelled the moun­tain back to base camp where 26-year-old Lama made the cru­cial de­ci­sion to call for as­sis­tance. A he­li­copter trans­ported Anker to a Kath­mandu hospi­tal where doc­tors dis­cov­ered the prob­lem: he had ex­pe­ri­enced an acute throm­botic oc­clu­sion of his an­te­rior de­scend­ing coro­nary artery – in other words, a sud­den heart at­tack. The cul­prit was a crumb­sized piece of fatty plaque block­ing one of the main blood ves­sels to his heart. Nine hours af­ter Anker first felt his chest tighten, doc­tors in­serted a stent in the of­fend­ing ves­sel and saved his life.

Ev­ery year around 73,000 peo­ple die from coro­nary heart dis­ease in the UK, with heart com­pli­ca­tions cost­ing the NHS an es­ti­mated £11bn. Few are world-class ath­letes like Anker. His episode could have been caused by ge­netic bad luck, or the com­pound stresses of a life­time of ex­treme de­mands on his most im­por­tant or­gan. But Anker pin­pointed an­other pos­si­ble cause: grief. Five months ear­lier, Anker had trekked up Ti­bet’s 26,335ft Shisha Pangma to re­trieve the body of his best friend, Alex Lowe, who had died in an avalanche. The mission was suc­cess­ful and Anker car­ried his friend’s body down the moun­tain him­self. “Go­ing back up there was very emo­tional,” he said at the time. “I was stressed, and I felt my heart.”

Even be­fore we un­der­stood how it does its pri­mary job of pump­ing blood, the heart was a pow­er­ful sym­bol of emo­tion, from love (“with all my heart”) to con­vic­tion (“I be­lieve in my heart”) and truth (“the heart of the mat­ter”). But meta­phys­i­cal as­so­ci­a­tions aside, stud­ies have proven that our emo­tions can di­rectly af­fect our heart health in tan­gi­ble ways. This may be why, ac­cord­ing to re­search in the Euro­pean Jour­nal of Epi­demi­ol­ogy, 20% more men suf­fer heart at­tacks on Mon­days com­pared to any other day of the week. When Anker said that his friend’s death had touched his heart, it prob­a­bly did.

When it comes to pro­tect­ing our hearts, most men are well versed in clas­sic risk fac­tors such as high blood pres­sure and choles­terol, but we tend to miss the men­tal and emo­tional clues our hearts of­fer up. In ad­di­tion to pump­ing blood, your heart acts as a use­ful in­di­ca­tor of your level of fa­tigue or stress, and the state of your re­la­tion­ships. By do­ing all of this, your heart keeps you alive; but ig­nore its warn­ing signs and it can also kill you. With this in mind, we’ve com­piled a guide to un­der­stand­ing ex­actly what your heart does to keep life tick­ing over, and how best to work with it to safe­guard your health. Af­ter all, the bet­ter you look af­ter it, the bet­ter it will look af­ter you.

01 GET HIGH ON LIFE

“The heart is the only or­gan that is in con­tin­u­ous mo­tion,” says Dr Euan Ash­ley, a car­di­ol­o­gist at Stan­ford Univer­sity. Around 70 times a minute, 100,000 times a day, the four cham­bers of the heart ex­pand and con­tract to cir­cu­late the equiv­a­lent of 8000 litres of oxy­gen-rich blood through your body. De­spite this wear and tear, its valves keep blood flow­ing in the right di­rec­tion with­out break­ing down or stop­ping, even while you sleep.

And – as any good per­sonal trainer will tell you – due to an in­creased de­mand for oxy­gen in the mus­cles, men who ex­er­cise reg­u­larly are able to pump more blood with each heart­beat than those who are less ac­tive. If you re­ally want to gun it, har­ness­ing the power of grav­ity through ‘pul­monary shunt’ train­ing will force your heart to work at its op­ti­mum. By al­ter­nat­ing be­tween up­per- and lower­body ex­er­cises with min­i­mal rest – think bench press to box jump, or squats paired with max pull-ups – you’ll send blood rac­ing in all di­rec­tions, spik­ing your me­tab­o­lism in the process.

Not only this, re­search pub­lished in the jour­nal Medicine & Science in Sports & Ex­er­cise sug­gests the more pun­ish­ing (and painful) your work­out, the greater the amount of mood boost­ing neu­ro­trans­mit­ters, such as en­dor­phins, sero­tonin and anan­damide, your body will pump out. In other words, the perfect chem­i­cal cock­tail to pro­vide that post-work­out men­tal high.

02 DRINK TO THE RHYTHM

Dr Ash­ley is cap­ti­vated by a unique prop­erty of the heart: “If you re­move it from the body and keep it sup­plied with en­ergy and oxy­gen, it will con­tinue to beat on its own,” he says. That’s be­cause the or­gan has its own elec­tri­cal sys­tem, with spe­cial cells that gen­er­ate reg­u­lar, rhyth­mic pulses, stim­u­lat­ing the heart to con­tract and re­lax. And if some of those cells conk out, oth­ers can take over.

But it’s still a vul­ner­a­ble sys­tem and prob­lems with the com­plex nerve net­work can lead to rhyth­mic dis­tur­bances. In the worst case, these cause the heart to sim­ply stop. “In more than 90% of such in­stances the re­sult is death,” says Dr Jef­frey Ardell, di­rec­tor of the Neu­ro­car­di­ol­ogy Cen­ter for Ex­cel­lence at UCLA.

To re­duce your odds of be­com­ing a statis­tic, the Jour­nal of the American

“OUR EMO­TIONS CAN DI­RECTLY AF­FECT OUR HEART HEALTH IN TAN­GI­BLE WAYS”

Col­lege of Car­di­ol­ogy dryly rec­om­mends cut­ting back on the sauce. But re­stric­tive pre­scrip­tions aren’t what we’re in­ter­ested in. Luck­ily, nu­tri­tion­ist Joe Sex­ton has a solution that cov­ers all bases: “Al­co­hol can flush out heart-help­ing B vi­ta­mins, so load up on some­thing high in pro­tein and fi­bre while you drink – call it a beef burger in a whole­meal bun – to pro­vide enough B vits to can­cel out any loss.” Not only that, B vi­ta­mins are a vi­tal com­po­nent of mood-boost­ing sero­tonin. By top­ping up your re­serves dur­ing that af­ter-work pint, you’ll safe­guard your heart­beat. And you might even sur­vive the hang­over, too.

03 SWEAR BY IT

Re­as­sur­ing news for Mor­ris­sey fans: ac­cord­ing to re­search, your lonely heart may ac­tu­ally be grounded in science, rather than your imag­i­na­tion. Sci­en­tists have ob­served that peo­ple who suf­fer sud­den, se­vere trauma of­ten ex­hibit phys­i­cal wounds on their peri­cardium (the outer layer of heart mus­cle), brought about by high lev­els of stress­neu­ro­trans­mit­ters called cat­e­cholamines. Love can hurt, it seems. But men are also at higher risk from an­other, all-toofa­mil­iar emo­tion: anger.

Ac­cord­ing to stud­ies from typ­i­cally mel­low Cana­di­ans, your risk of heart at­tack goes up by 250% in the hour fol­low­ing you flip­ping your lid. The solution comes in the form of a four-let­ter word. While chil­dren cry to ex­press anger or stress, men have evolved to swear. Re­search by Pro­fes­sor Richard Stephens, a se­nior lec­turer in psy­chol­ogy at Keele Univer­sity, found that swearing oc­cu­pies a com­pletely dif­fer­ent sec­tion of the brain to our usual lan­guage skills – the left hemi­sphere, rather than the pari­etal lobe – and its ef­fects are unique com­pared to other lan­guage pro­cesses.

Let­ting fly the odd blue out­burst not only works as an anal­gesic, but in­creases heart rate and re­leases adren­a­line – mak­ing it an ideal way to tear through that last 1km stand­ing be­tween you and a PB (to try it for your­self, see p48). Add some timely NWA to your car­dio playlist.

04 FIGHT THE FLIGHT

Your heart rate is con­stantly chang­ing, even from beat-to-beat. Ac­cord­ing to Dr Regi­nald Ho of the Thomas Jef­fer­son School of Medicine, that’s be­cause the heart is gov­erned by two com­pet­ing halves of your au­to­nomic ner­vous sys­tem. Your sym­pa­thetic sys­tem re­sponds to

threats with the fight- or-flight re­sponse, which speeds up your heart­beat lead­ing to higher blood pres­sure and a greater risk of car­diac events. But when the parasym­pa­thetic ner­vous sys­tem is dom­i­nant, as it is in prac­tised ath­letes, the rate set­tles down and be­comes more vari­able – a marker of good health.

Ac­cord­ing to a re­cent study, it may be pos­si­ble to ac­quire this skill within just one week. Har­vard re­searchers asked par­tic­i­pants to pause and note their heart rate ev­ery three hours through­out the day. When taken to the lab for test­ing a week later, this ‘hy­per-aware­ness’ group were able to sta­bilise their rac­ing hearts sim­ply by fo­cus­ing on drop­ping the beat. An un­prac­tised group strug­gled to do so.

The key to a truly balanced ap­proach for body and mind lies also in em­brac­ing the sym­pa­thetic re­sponse. In a study car­ried out by Dr Kelly Mc­go­ni­gal, a lec­turer at Stan­ford Univer­sity and the au­thor of The Up­side of Stress, the brains of those who saw the body’s fight-or­flight re­ac­tion as pos­i­tive re­leased more of the hor­mone DHEA dur­ing stress­ful sit­u­a­tions, slash­ing their risk of anx­i­ety.

Re­main­ing calm when your boss gives you a 30-minute dead­line, then, will pro­vide an adren­a­line boost with­out lead­ing to ma­jor blood pres­sure spikes that would put ex­tra strain on your heart. And en­gag­ing the parasym­pa­thetic ner­vous sys­tem dur­ing the course of a longer project will crush cor­ti­sol’s harm­ful ef­fects on both body and mind.

05 STICK TO THE BEAT

As an or­gan, your heart is more than purely me­chan­i­cal: its gan­glia (a clus­ter of nerve struc­tures that op­er­ate al­most like a rudi­men­tary brain) re­spond to sen­sory in­put from the world around you. Dr Peter Sleight, a re­tired Ox­ford Univer­sity re­searcher, has stud­ied the ef­fect of mu­sic on our car­diac rhythms and dis­cov­ered that blood pres­sure and heart rate rise and fall to match the vol­ume and pace of mu­sic.

It’s a use­ful train­ing tool, es­pe­cially so when you con­sider that a sec­ond study pub­lished in the Jour­nal of Pain found that mu­sic can re­duce the level of per­ceived phys­i­cal dis­com­fort, lead­ing to a form of “mu­sic-in­duced anal­ge­sia”. In the study, sub­jects were given ei­ther no dis­trac­tion, or mu­sic to lis­ten to while hold­ing their hand against a heated stim­u­lus. Af­ter the ex­per­i­ment, those in the group lis­ten­ing to mu­sic ranked their pain sig­nif­i­cantly lower than the other par­tic­i­pants and, cru­cially, were able to en­dure it for longer. The re­searchers stud­ied the re­sults, find­ing a sup­pres­sion of ac­tiv­ity in the neu­ral struc­tures associated with pain mod­u­la­tion, in­clud­ing a brain re­gion called the so­matosen­sory cor­tex.

What this means is that the right playlist will synch with your heart rate, which in turn will di­rect your brain as to the level of ef­fort it should per­ceive, whether in the of­fice or work­ing out. Beats of 130-140bpm work well for heavy lift­ing, push­ing you to con­tinue with­out let­ting you speed up and break form (think Go­ril­laz’ Feel Good Inc or Iggy Pop’s The Pas­sen­ger). Mean­while, a tempo of 120bpm will help you cool down at the end of the tough ses­sion, or slide back into of­fice mode with­out too much dis­rup­tion. As well as neatly de­scrib­ing your af­ter­noon, Queen and David Bowie’s Un­der Pres­sure hap­pens to be the perfect fit.

06 EASE THE PRES­SURE

The heart is a uniquely durable or­gan with the abil­ity to pro­tect it­self – and your brain – in a way that no other part of your body can. Be­cause heart cells don’t di­vide and re­pro­duce af­ter in­fancy, they are uniquely less sus­cep­ti­ble to de­vel­op­ing tu­mours. And, even when blood flow to the heart be­comes re­stricted, it can still beat. “My doc­tor told me I had ba­si­cally trained my­self to sur­vive,” Anker says of his high-al­ti­tude mishap. “By stay­ing fit and spend­ing so much time at al­ti­tude, my heart un­der­stood the duress it was un­der, and when it failed, other parts [of the mus­cle] were able to take over.”

Re­search from Ger­many sug­gests that peo­ple who ex­er­cise reg­u­larly may heal faster af­ter a heart at­tack than those who don’t – in part be­cause work­ing out re­duces heart at­tack-in­duced scar­ring and in­flam­ma­tion. That was the case for Anker: two months af­ter the in­ci­dent, his ejec­tion frac­tion – a mea­sure of pump­ing ef­fi­ciency – had re­cov­ered, plac­ing it back within the ‘nor­mal’ range. And his heart mus­cle bore no per­ma­nent dam­age. But if run­ning up stairs rather than slog­ging it up the South Col is more your pace, you needn’t worry. A sec­ond study pub­lished in The Jour­nal of Ap­plied Phys­i­ol­ogy looked at for­mer Bri­tish Olympic ath­letes aged 26-50 and found that while none of the ath­letes were suf­fer­ing from ob­vi­ous symp­toms of car­dio­vas­cu­lar is­sues, half of the older bunch did show signs of scar­ring in their hearts – proof that decades of di­alling it up to 11 isn’t the best way to safe­guard your longevity.

As for Anker, daily med­i­ta­tions, track­ing his heart rate with a fit­ness de­vice and at­tempt­ing to avoid stress­ful stim­uli are all play­ing a part in his slow road to re­cov­ery. Even­tu­ally, he plans to ease him­self back into climb­ing, but not all strate­gies for a health­ier heart need to be moun­tain­ous en­deav­ours: “I saw some­thing in the news the other day that spiked my heart rate up to 128,” Anker says. “So last Tues­day I took a day off from so­cial me­dia. It was great.” With in­creas­ing ev­i­dence that stress­ful news can boost cor­ti­sol, crush your im­mune sys­tem and in­hibit the re­lease of growth hor­mones, it ap­pears that where your heart and mind are con­cerned, no news re­ally is good news.

“SUB­JECTS WERE ABLE TO STA­BILISE THEIR HEARTS JUST BY FO­CUS­ING ON THE BEAT”

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