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FEATURE STORY
February is Healthy Heart Month

IN THE NEWS
For Lower Blood Pressure, Kids Should Skip the Salt

CHECKLIST
Risk Factors & Lifestyle Changes

COOKING CORNER
Brandied Cherry Scones

VITAMINS & MINERALS
CoQ10 Brings Down Blood Pressure

HERBAL REMEDIES
Guggul Gets At Triglycerides

EVERYDAY ANSWERS
Is There a Diet Specifically Targeted at Hypertension?

Keep heart disease at bay by choosing healthy diet and lifestyle habits
February Is Healthy Heart Month

A heart-to-heart on cardiovascular disease: Make simple changes to helpyou beat the odds against heart disease, a leading cause of death.According to research or other evidence, the following self-care stepsmay be helpful:

  • Get smoke-free. Quit smoking and stay clear of cigarette smoke to lower your risk of several types of cardiovascular disease
  • Watch what you eat. Eat lots of fruits, vegetables, legumes, whole grains, fish, and avoid fats from meat, dairy, and processed foods high in hydrogenated oils
  • Stay active. Couch potatoes have increased cardiovascular disease risk, so make sure you get regular exercise
  • Get tested. See your healthcare provider to find out if you have problems with high blood pressure or high blood levels of cholesterol, triglycerides, or glucose

About cardiovascular disease
Cardiovascular disease is a wide-encompassing category that includesall conditions that affect the heart and the blood vessels.

Cardiovascular disease is the number one cause of death in theUnited States. Many risk factors are associated with cardiovasculardisease; most can be managed, but some cannot. The aging process andhereditary predisposition are risk factors that cannot be altered.Until age 50, men are at greater risk than women of developing heartdisease, though once a woman enters menopause, her risk triples.

Many people with cardiovascular disease have elevated or high cholesterol levels.Low HDL cholesterol (known as the “good” cholesterol) and high LDLcholesterol (known as the “bad” cholesterol) are more specificallylinked to cardiovascular disease than is total cholesterol. A bloodtest, administered by most healthcare professionals, is used todetermine cholesterol levels.

Atherosclerosis (hardening of the arteries) of thevessels that supply the heart with blood is the most common cause ofheart attacks. Atherosclerosis and high cholesterol usually occurtogether, though cholesterol levels can change quickly andatherosclerosis generally takes decades to develop.

The link between high triglyceride levels and heartdisease is not as well established as the link between high cholesteroland heart disease. According to some studies, a high triglyceride levelis an independent risk factor for heart disease in some people.

High homocysteine levels have been identified as anindependent risk factor for heart disease. Homocysteine can be measuredby a blood test that must be ordered by a healthcare professional.

Vitamin B6, folic acid, and vitamin B12 all play a role inconverting homocysteine to other substances within the body. By sodoing, they consistently lower homocysteine levels in research trials,a finding that is now well accepted. Several studies have used (andsome doctors recommend) 400–1,000 mcg of folic acid per day, 10–50 mgof vitamin B6 per day, and 50–300 mcg of vitamin B12 per day.

Hypertension (high blood pressure) is a major risk factor for cardiovascular disease, and the risk increases as blood pressure rises. Glucose intolerance and diabetes constitute separate risk factors for heart disease. Smoking increases the risk of heart disease caused by hypertension.

Both preliminary and double-blind trials have reported thatsupplementation with coenzyme Q10 (CoQ10) leads to a significantdecrease in blood pressure in people with hypertension. Much of thisresearch has used 100 mg of CoQ10 per day for at least ten weeks.

EPA and DHA, the omega-3 fatty acids found in fish oil, lower bloodpressure, according to an analysis of trials. The effect was dependenton the amount of omega-3 oil used, with the best results occurring intrials using unsustainably high levels: 15 grams per day—the amountoften found in 50 grams of fish oil. Although results with lowerintakes were not as impressive, trials using over 3 grams per day ofomega-3 (as typically found in ten 1,000 mg pills of fish oil) alsoreported significant reductions in blood pressure. One double-blindtrial reported that DHA had greater effects on blood pressure than EPAor mixed fish oil supplements. DHA is now available as a supplementseparate from EPA. To find out more about other ways that fish oilhelps prevent heart disease, visit the American Heart Association's website, www.americanheart.org/presenter.jhtml?identifier=4632.

Potassium supplements in the amount of at least 2,400 mg per daylower blood pressure, according to an analysis of trials. However,potassium supplements greater than 100 mg per tablet require aprescription, and the low-dose potassium supplements available withouta prescription can irritate the stomach if taken in large amounts.Moreover, some people, such as those taking potassium-sparingdiuretics, should not take potassium supplements. Therefore, the use ofpotassium supplements for lowering blood pressure should only be doneunder the care of a doctor. Fortunately, a diet high in fruits andvegetables will safely supply the large amounts of potassium known tobe of benefit.

In a double-blind study of postmenopausal women, supplementing with10 grams of soy protein twice a day for six weeks significantly reduceddiastolic blood pressure by an average of 5 mm Hg, compared with a dietnot containing soy protein. In another study, men and women with mildto moderate hypertension consumed 500 ml (approximately 16 ounces) ofsoy milk or cow's milk twice a day for three months. After threemonths, the average systolic blood pressure had decreased by 18.4 mm Hgin the soy group, compared with 1.4 mm Hg in the cow's milk group. Thereductions in diastolic blood pressure were 15.9 mm Hg with soy milkand 3.7 mm Hg with cow's milk.

Abdominal fat, or a “beer belly,” versus fat thataccumulates on the hips, is associated with increased risk ofcardiovascular disease and heart attack. Overweight individuals aremore likely to have additional risk factors related to heart disease,specifically hypertension, high blood sugar levels, high cholesterol,high triglycerides, and diabetes.

What are the symptoms?
People withcardiovascular disease may not have any symptoms, or they mayexperience difficulty in breathing during exertion or when lying down,fatigue, lightheadedness, dizziness, fainting, depression, memoryproblems, confusion, frequent waking during sleep, chest pain, anawareness of the heartbeat, sensations of fluttering or pounding in thechest, swelling around the ankles, or a large abdomen.

Dietary changes that may be helpful
Preliminary evidence has linked high salt consumption with increasedcardiovascular disease incidence and death among overweight, but notnormal weight, people. Among overweight people, an increase in saltconsumption of 2.3 grams per day was associated with a 32% increase instroke incidence, an 89% increase in stroke mortality, a 44% increasein heart disease mortality, a 61% increase in cardiovascular diseasemortality, and a 39% increase in death from all causes.

Moderate alcohol consumption appears protective against heart disease.However, regular, light alcohol consumption in men with establishedcoronary heart disease is not associated with either benefit ordeleterious effect.

A high intake of carotenoids from dietary sources has been shown tobe protective against heart disease in several population-basedstudies. A diet high in fruits and vegetables, fiber, and possibly fishappears to protect against heart disease, while a high intake ofsaturated fat (found in meat and dairy fat) and trans fatty acids (inmargarine and processed foods containing hydrogenated vegetable oils)may contribute to heart disease. In a preliminary study, the totalnumber of deaths from cardiovascular disease was significantly loweramong men with high fruit consumption than among those with low fruitconsumption. A large study of male healthcare professionals found thatthose men eating mostly a “prudent” diet (high in fruits, vegetables,legumes, whole grains, fish, and poultry) had a 30% lower risk of heartattacks compared with men who ate the fewest foods in the “prudent”category. By contrast, men who ate the highest percentage of theirfoods from the “typical American diet” category (high in red meat,processed meat, refined grains, sweets, and desserts) had a 64%increased risk of heart attack, compared with men who ate the fewestfoods in that category. The various risks in this study were derivedafter controlling for all other beneficial or harmful influencingfactors.

A parallel study of female healthcare professionals showed a 15%reduction in cardiovascular risk for those women eating a diet high infruits and vegetables—compared with those eating a diet low in fruitsand vegetables.

Lifestyle changes that may be helpful
Moderate exercise protects both lean and obese people from cardiovascular disease.

Both smoking and exposure to secondhand smoke increase cardiovascular disease risk.

Support is readily available to help you stop smoking and staysmoke-free for life. According to research or other evidence, thefollowing self-care steps may be helpful:

  • Focus on physical fitness. Increase your physical activity after giving up tobacco to prevent weight gain.
  • Participate in a program. Find a smoking-cessation program that holds regular meetings to discuss important topics such as strategies for stopping; factors that increase relapse risk; and problem-solving, stress-reduction, and coping skills.

Smoking cessation often leads to weight gain, which can dissuadesmokers from trying to quit or cause them to resume smoking. Increasingphysical activity after quitting smoking can minimize weight gain, anda controlled trial found that adding exercise to a smoking cessationbehavioral counseling program improved abstinence rates. However,other, smaller studies have not shown that exercise either alone oradded to a comprehensive program helps to maintain abstinence. Addingweight control through dieting to smoking-cessation programs hasresulted in either an increase in smoking relapses or no effect.Changing the diet at the same time as quitting smoking may require morediscipline than most people can achieve.

People who want to quit smoking cigarettes will have better successif they decide on a quit date and change their routines around typicalsmoking cues, such as coffee breaks, meals, boredom, and sexualactivity. Absolute stopping, known as quitting “cold turkey,” isgenerally considered a better method than weaning off.

In 2000, the United States Public Health Service published updatedsmoking-cessation guidelines for doctors. This report identifiedcounseling and behavioral therapies as proven effective components of asmoking-cessation program. Effective components include providing basicinformation about successful quitting, identifying factors that willincrease the risk of relapse, and teaching problem-solving and copingskills. Also effective is social support provided either in ahealthcare setting (for example, being able to talk about the quittingprocess with a doctor) or by strategies that teach the quitter to builda support network among friends, family, and the community.Government-sponsored, free counseling resources in North Americainclude Quitline [800-QUIT-NOW] and SmokeFree (www.smokefree.gov).Group or individual counseling is often a component of successfulsmoking cessation programs offered in schools and the workplace.

People tend to smoke more often under conditions of stress. Thosewho achieve long-term success in quitting smoking have been shown tohave more social support and less stress than people who eventuallyrelapse. Stress-reduction techniques that have been shown in controlledtrials to be effective for assisting smoking cessation includeself-massage, guided relaxation imagery, and exercise.

 


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