We’re constantly hearing about how heart disease is the nation’s “number 1 killer.” Yet if I took a survey of my patients, I’m sure most of them would say they’re more worried about cancer than having a heart attack. Especially my female patients. So when the subject comes up, I take the time to point out that heart disease kills about 500,000 women each year–more than 10 times the number who die of breast cancer–and half those deaths are from heart attacks. To which I quickly add there are more effective strategies for preventing a heart attack than there are for preventing any other chronic disease.
For men and women who are healthy, there are plenty of steps you can take right now to help reduce your risk of a heart attack. True, you can’t do much about a family history of heart disease, but you can certainly minimize it by getting to work on everything else.
The supplements we recommend at WholeHealth Chicago are very helpful. It’s even more important, though, that you stay active, allow time to relax, avoid smoking, eat the right foods (and skip or reduce the wrong ones)–and yes, see your doctor regularly to have your blood pressure and cholesterol checked.
About Heart Disease Prevention
Heart disease is the result of the narrowing of the arteries that supply the heart with blood, oxygen, and nutrients. This process, called coronary artery disease (CAD), can generally be traced to a condition called atherosclerosis, the build-up of cholesterol-rich fatty deposits, or plaques, on the inside of arterial walls. As these deposits accumulate over time, the coronary arteries narrow to the point that the flow of oxygenated blood to the heart is impeded. (Arterial spasms, triggered by smoking, extreme emotional stress, or exposure to very cold temperatures, may also cause coronary arteries to narrow suddenly and dangerously.) A partial blockage of blood flow in a coronary artery can result in the symptom of angina, a crushing or squeezing pain beneath the breast bone triggered by physical exertion or emotional stress and relieved by rest. On the other hand, a heart attack occurs when any of the coronary arteries becomes completely blocked, usually by a blood clot forming on a plaque-roughened arterial wall. The chest pain of a heart attack is similar to that of angina but it’s not relieved by rest and is often accompanied by excessive sweating, nausea, and shortness of breath.
Heart disease develops gradually, usually with no symptoms in the early stages. High cholesterol levels and high blood pressure are risk factors for increasing your chances of developing heart disease. If these and other risk factors are not controlled, then the atherosclerotic process continues. Ultimately the insufficient supply of blood to the heart will lead first to angina and later to an actual heart attack. Less commonly, a fatal or near-fatal heart attack is the first sign of coronary artery disease. Because of this, everyone should learn if they have risk factors for developing heart disease and start reducing these risk factors as quickly as possible.
Physicians treat heart disease with medications to strengthen the heart, lower blood pressure and cholesterol, control anginal pain, and prevent blood from clotting in a coronary artery. Heart surgeons can either insert a small tube (stent) to open a blocked artery or attach a small piece of vein to bypass an obstruction. However, heart disease is now considered a “lifestyle” illness, meaning it can be prevented and even reversed by changes in diet, increased physical activity, reducing levels of stress, and ceasing to smoke. Nutritional supplements, especially vitamins B, C, and E can also play an important role in preventing and controlling heart disease.
At first, there are usually no symptoms. High cholesterol levels and high blood pressure, found during screenings or physical check-ups, are early indicators of possible heart disease.
In later stages, the main symptom of heart disease is the activity-induced crushing or squeezing chest pain of angina. The pain, which may radiate to the shoulders, neck, jaw, and arms (usually the left one), is generally brought on by physical exertion or emotional stress, and is relieved by rest.
Palpitations, shortness of breath, nausea, sweating, or dizziness may accompany the chest pain of severe angina or an actual heart attack.
The main cause of the atherosclerosis that underlies heart disease is high levels of fats (lipids) in the blood, especially cholesterol. One type of cholesterol, termed “LDL” (low density lipoprotein or “bad” cholesterol) is especially dangerous as it can undergo a chemical alteration (oxidation) that allows it to stick to an arterial wall and gradually form a plaque. Other factors that promote plaque buildup include smoking, high blood pressure, obesity, lack of exercise, and stress. In addition to plaque formation, cigarette smoking and emotional stress can produce arterial spasms that can cause angina attacks.
The risk of developing heart disease increases with age. Before menopause, the risk is significantly lower in women than in men; after menopause, women and men are at equal risk. This is because the female hormone estrogen helps protect against the development of atherosclerosis.
Heart disease, high blood pressure, and high cholesterol also run in families. A genetic track record of early heart attacks is especially dangerous and requires special attention by both patient and physician to reduce as many controllable risk factors (such as cholesterol, smoking, etc.) as possible.
Treatment and Prevention
A healthy lifestyle and good dietary choices can help prevent many diseases, but perhaps none so effectively as heart disease. If you stop smoking, lose weight, exercise regularly, and eat a low-fat, fiber-rich diet, you can prevent the build-up of arterial plaque, and slow, stop, or even reverse the atherosclerotic process once it has started.
It’s important to have your cholesterol levels (especially “LDL”) and blood pressure checked regularly. If any of your levels is out of line, take the medications your doctor prescribes. Lowering your cholesterol and lowering your blood pressure to normal ranges will substantially reduce your risk of heart disease. If you’ve already had a heart attack or are at high risk for developing heart disease, your doctor may recommend a low daily dose of aspirin in order to reduce the blood’s tendency to clot.
In addition to healthy lifestyle changes, certain nutritional supplements are beneficial in preventing heart disease. Scientists believe that altered oxygen molecules, called free radicals, are responsible for the oxidation of the LDL (“bad”) cholesterol, which then precipitates along the lining of blood vessels. The group of supplements called antioxidants literally acts as scavengers of free radicals throughout the body. High levels of antioxidants in the bloodstream definitely protect against atherosclerosis.
The 28 amino acids in the body serve as building blocks of protein. Scientists have recently discovered, however, that when one of these, methionine, undergoes a chemical change in the body, it produces a substance called homocysteine. When it is found in unusually high levels, homocysteine brings the same degree of risk as having high cholesterol does. Fortunately, the B vitamins, especially folic acid and B12, will drive elevated homocysteine levels down to normal, often without the need of any prescription medication.
The good news is that all of these vitamins can be taken with conventional medicines for heart disease, high blood pressure, and high cholesterol. The only exception is if you’re taking a blood thinner (anticoagulants, such as Coumadin). In that case, don’t use either vitamin E or fish oils because these supplements may intensify the blood-thinning effect of your medication.
Just a reminder: If you have a serious medical condition, it’s always a wise idea to talk with your doctor before beginning a supplement program.
How Supplements Can Help
The antioxidant vitamins C, E, and carotenoids all prevent the oxidation of LDL cholesterol. Vitamin C has the added advantage of enhancing tissue repair and keeping arteries supple. Grapeseed extract does double duty: Not only is it an extraordinarily potent antioxidant (some 50 times more powerful than vitamin E), but it works as a bioflavonoid, a “helper” of vitamin C, to keep the arteries in a healthy state. A pill combining a number of these protective compounds–an antioxidant complex–is an efficient, cost-effective way to get the nutrients you need.
The B vitamins, especially B6, B12, and folic acid (also called folate) are involved in hundreds of reactions throughout the body. One of the most important is to lower levels of homocysteine, an amino acid-like substance that is associated with an increased risk of heart disease.
Many studies have shown that a diet rich in omega-3 fatty acids lowers your heart disease risk. Although eating fresh fish is the ideal way to get fish oils, adding flaxseed and fish oils to your supplement regimen can provide added protection.
Studies are also finding that the nutritional supplement coenzyme Q10, when taken in conjunction with conventional medications and therapies, shows great promise for protecting against heart disease. Key to the body’s energy production, this compound is especially plentiful in the heart. In addition, it also acts as a powerful antioxidant. Recent findings suggest that CoQ10 can help protect against blood clots, lower high blood pressure, diminish irregular heartbeats, and relieve both congestive heart failure and angina.
Some nutritionally oriented physicians believe that Americans often don’t get sufficient amounts of magnesium in their diets. Normal levels of this mineral can definitely protect against both heart attacks and heart-rhythm abnormalities. Magnesium will also help to lower elevated blood pressure.
Get supplement dosages and tips in our WholeHealth Chicago Supplement Recommendations for Heart Disease Prevention.
Quit smoking and avoid smoke-filled places (secondhand smoke significantly increases your risk for heart disease).
Make sure your diet is low in saturated fat, cholesterol, and salt, and high in fiber. Use canola or olive oil instead of butter. Eat at least five servings of fruits and vegetables a day and plenty of soluble fiber (contained, for example, in beans, oats, and citrus fruits).
Have fatty fish, such as salmon, tuna, or sardines, twice a week.
Lose weight if you are overweight.
Start and stay with a program of regular, moderate aerobic exercise for at least 30 minutes a day, three days a week. If you are a man over age 45, or a woman over age 55, and you haven’t been active in a while, consult your doctor before you take up exercise.
When to Call a Doctor
- If you experience any of the symptoms of heart disease
- If you have frequent heartbeat irregularities, such as skipped or extra beats
- If you become dizzy, weak, or faint for no obvious reason
- If you know you have angina but your attacks become more frequent, intense, or longer lasting, or are brought about by less exertion. (Changes in the pattern of angina attacks could be warning signs of an impending heart attack.)
- If an angina attack lasts more than 15 minutes, or if it’s accompanied by dizziness, nausea, vomiting, profuse sweating, clamminess, or shortness of breath, or if it’s not relieved by nitroglycerin. (These are signs of a heart attack. Get immediate medical attention.)
- If you are healthy and have seemingly normal heart function, you should see your doctor every two years to have your blood pressure checked, and every five years to get your cholesterol checked.
From David Edelberg, M.D. at WholeHealth Chicago: Based on the experience of the physicians at WholeHealth Chicago, the supplements listed in the chart have proved to be very useful in helping to prevent heart disease. They include individual vitamins, minerals, and herbs, as well as special combination supplements that include two or more heart-healthy components. Some of them are antioxidants, which hunt down and mop up cell-damaging free radicals. Others help combat chemical substances that contribute to the buildup of plaque on artery walls.
How to Take the Supplements
If your health is basically excellent, your blood cholesterol is under control, you exercise regularly, don’t smoke, and you’re eating a healthy low-fat diet, then you’re already 90% there when it comes to heart disease prevention. And, simply by taking a daily high-potency multiple vitamin and an antioxidant complex, you’ve taken major steps in the nutritional supplement aspects of prevention. The multi should already include sufficient B vitamins to keep your homocysteine level in check; and your antioxidant complex gets you off to a strong start.
If heart disease runs in your family, however, then in addition to all the lifestyle changes you know you need to make, I’d suggest increasing your antioxidants even further by adding separate antioxidants for vitamins C and E, carotenoids, coenzyme Q10, and grape seed extract. And definitely add magnesium and essential fatty acid supplementation (flaxseed oil, and fish oilcapsules if you don’t eat fish at least three times a week).
If you think you might have some form of heart disease, add carnitine and hawthorn, even if the condition is not apparent–for example, if you have a history of a cardiac arrhythmia, an abnormal EKG, or pre-existing, but controlled high blood pressure or high cholesterol.
If you feel you are under stress, consider adding the herb kava. Although not directly helpful for heart disease prevention, kava does reduce the body’s response to stress, which is well established as a contributing factor to heart disease.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
David Edelberg, MD