Preventing Heart Attack
By Dr. L. William Lauro
As you probably know, heart attack is the number one cause of death in the industrialized countries of the west (which of course includes the U.S.). Heart attacks kill more people each year than cancer, traffic accidents, AIDS, and suicide, even though this latter group seems to get more publicity. With this in mind, I wanted to illuminate the various things we can do to reduce our risk of developing coronary heart disease (heart attack).
Now, I know we can’t eliminate heart attack as a cause of death. But what I would like to see is the rate of premature death from heart attack decrease. I mean, who wouldn’t mind dying in their sleep from a heart attack on their 90th birthday. But I am concerned about the patient who has his first heart attack at age 64. We have far too many premature deaths from coronary disease, deaths which I believe can be prevented, or at least post-poned for many years.
If you have been reading the health articles in this magazine through the years you have noticed that several of the medical authors have offered, in bits and pieces, advice on eating habits, exercise, vitamins, etc. But today I would like to collect for you, in one article, the facts, as we currently know them, for recommendations to reduce your risk of coronary heart disease.
Reducing Your Risk
First of all, the most important thing you can do to reduce your risk of coronary vascular disease (and cancer for that matter) is to avoid smoking, either directly or indirectly (i.e. through second-hand smoke). Smoking is the number one health issue in this country! The incredible damage that smoking does to our bodies is irrefutable. I believe that good LDS people do not need to be lectured on this issue, but this article could not be complete without at least mentioning smoking. And be careful with second-hand smoke, that which originates from external sources such as spouses who smoke, adult children who may live with you who smoke, and public areas which allow smoking such as restaurants and clubs, airports, bus stations, etc.
And don’t be mislead by the “street culture” which teaches our children that marijuana smoking is not as bad for your heart as tobacco smoke. It is just as bad, if not worse.
Next, we must address being overweight. I know, I have harped on this before in other articles, but I must again point out how detrimental excess body weight is to our blood vessels and heart. Being just twenty pounds over your ideal body weight starts you on the road to the metabolic syndrome which causes adult-type diabetes and premature cardiovascular disease.
The industrialized countries have food aplenty-what a blessing. But what a curse as well-we humans have a difficult time saying “no” to tasty foods that are so readily available. But it is time for us to “just say no” to all the excess food we consume. The studies are irrefutable: less food intake equals lower body weight equals longer and healthier life. Period.
What Types of Food Should We Eat?
Just look at the different diets popular in our culture and you will see there is a wide difference of opinion regarding the answer to this question. We have the Atkins, South Beach, Carb Busters, Weight Watchers, Jenny Craig, and LA Weight Loss Clinics Diet-you have seen the ads. If you want to review what I consider to be a healthy diet, then see my previous article in Meridian on the subject.
Here is a quick review of that article: less carbohydrates-yes. But you don’t have to eliminate them completely and forever. You can safely eat starches if they have good fiber (usually represented by a color other than white) or even white starches in small (and infrequent) amounts. And no, chocolate ice cream is not a brown high-fiber starch!
Proteins? Yes! But don’t get sucked into the Atkins frenzy, which says you can have any protein you want (bacon, sausage, fatty red meats, butter, etc). I would implore those of you who are on a low carb, high protein diet to watch your saturated fat intake by selecting high-quality proteins (i.e. lean proteins such as chicken, fish, lean pork, low-fat cheese, roasted nuts, low-fat milk, etc). Enough said.
Try Some Exercise
The next big contributor to good cardiovascular health is exercise. Oh what a cure-all. If I could just convince you to take 30 minutes out of your busy day and go for a brisk walk my mission would be complete. Walk every day if you can-consistency counts, and I do not believe taking a walk with your spouse on Sunday breaks the Sabbath. But the minimum effective routine is four times a week-that is the minimum folks.
If you would like to do even more, carry some weights in your hands (2.5 lbs) and wave a lot to your neighbors!
Next, consider taking a baby aspirin a day. Just 81 mg, the dose which is contained in St. Joseph’s baby aspirin, is enough. The latest studies confirm that aspirin is not just for those who already have proven cardiovascular disease-it can be used in primary prevention. Of course it is always best to ask your doctor if you can safely do this-some of you may have stomach or other problems prohibiting the use of aspirin. Always take aspirin with food on your stomach and with plenty of liquid. And no, Motrin (ibuprophen) and Tylenol (acetaminophen) do not work like aspirin in cardiovascular disease prevention.
Next, eat more foods with omega-3 fatty acids. This is the health-promoting ingredient in fish. And if you do not like fish, go buy some fish oil capsules containing 1000 mg of omega-3 fatty acids and take them once a day.
What about vitamins? I know, many of you were ready to hang me last month for pooh-poohing vitamins, but let me say once again that the studies at this time do not seem to indicate that taking supplemental vitamins or anti-oxidants helps reduce the risk of heart attack. At one time we thought vitamin E was promising, but the studies have been somewhat disappointing. I do believe in folic acid though (a B vitamin)-take 400 to 800 mcg a day. And if your are taking a vitamin supplement, and believe in it, that is fine, but please do not take too much. More is not better, maybe even harmful.
Do not use hormone replacement to lessen cardiovascular risk! It is well established at this point that hormones do more harm than good. Very few women should be on hormone replacement except for short periods of time to help with the initial symptoms of menopause.
Watch your blood pressure. Hypertension is a huge risk factor for heart attack. Elevated blood pressure stresses the blood vessel wall, causing it to thicken and harden to protect itself against damage. But in this process the vessel ends up hurting itself anyway, thus reducing blood flow to the heart and other organs. Hardening of the arteries is a direct result of high blood pressure and elevated blood fats.
Blood Fats
This leads me to the next suggestion: watch your blood fats. Check your cholesterol and triglycerides at your doctor’s office every one to three years, depending on your age and your results. Eat the healthy diet we discussed earlier. And do not be afraid to take the “statin” medications if your cholesterol does not come down with diet alone. They are safe! They have been proven to not only reduce the risk of heart attack but also stroke and Alzheimer’s Dementia as well.
Have your C-reactive protein (CRP) checked. This is a measure of the total inflammation in your body, which is a risk factor for coronary heart disease. What happens is this: the body attacks its own diseased coronary arteries just like it would an invading intruder, because it has been fooled. This accelerates the coronary disease by laying down a lot of scar tissue in the vessel. This process is reflected in the CRP level.
Check your homocystine levels. This natural-occurring chemical in the body is detrimental to the coronary arteries and thus is an indicator of increased risk of coronary disease. Folic acid lowers homocystine and therefore helps reduce the risk of coronary disease. Homocystine levels can be checked by your doctor with a blood test (just like your cholesterol).
Treat chronic stress, anxiety, and depression. These emotional disorders increase your risk for heart disease and can be detrimental just as if you had high blood pressure or were overweight. There are many ways of reducing stress and improving one’s mood. Exercise can be very relaxing (another plug for that). Recreational activities that you enjoy and that help you unwind are very important; reading and meditating on the scriptures really helps me, but you should do whatever calms and soothes you. Contact a mental health professional if you do not feel you are able to get a handle on these disorders–many of the newer anti-anxiety and anti-depressant medications are helpful for many patients. But getting a handle on stress, anxiety, and depression can be as important as therapies prescribed to lower your cholesterol or your blood pressure.
Let me conclude by saying that if you or someone you know ever has symptoms of a heart attack, do two things: 1) call the paramedics; and 2) have the person chew one adult-strength 325 mg aspirin tablet and swallow with some water. Of course if the patient is unresponsive do not force aspirin down his throat! (do CPR instead).
Good luck to you and your coronaries.
P. S. While I have your attention may I clear up something up that has been troubling me? Many readers have written to me regarding my articles. Some comments are positive, and some are quite negative. Regarding the latter, I want to clear up some accusations that often appear in the critical letters. 1) I am not a “puppet” of the “powerful” AMA (American Medical Association). I am not even a member of the AMA, and never have been. I have nothing against this organization, I just never felt it was worth my money to join (the fee is quite steep and I am a pretty frugal guy).
2) I am not a “puppet” of the drug companies. As you may have noticed form my bio, I am not practicing medicine currently (because of health issues) and therefore I do not even see drug representatives or partake of their free gifts and inducements. I haven’t talked to a drug rep for over two years.
I am only writing these articles in hope of being informative and helpful. I truly do not have an agenda nor am I trying to convert you to any particular way of thinking. Thank you for you sympathetic ear.
