What you need to know about Heart Disease

Heart DiseaseDespite continued advances in medicine, heart disease remains the leading cause of death for men and women in the United States.1 Each February marks the campaign to increase awareness of heart disease, and to focus on what each of us can do to decrease our own individual risk.


So what exactly is “heart disease”? Heart disease encompasses any condition that affects the heart. The heart is the main organ of the body that works as a pump; taking old blood from the body, pumping that blood into the lungs where it is replenished with oxygen, and then pumped back to the body to feed and nourish our organs. In order to work, the heart itself relies on blood too, which is supplied by coronary arteries.


According to the American Heart Association, the most common form of heart disease is coronary artery disease, which is when cholesterol-filled plaques build up within the arteries supplying blood to the heart. When the blockage reaches a certain level, blood flow to the heart becomes compromised, and a heart attack can occur. Some risk factors for developing coronary artery disease include other components of heart disease such as high blood pressure (hypertension), diabetes, high cholesterol (hyperlipidemia), and tobacco use.


Although genetics certainly play a role in the development of heart disease, there are easy ways to help decrease your risk. And now that it is officially February, why don’t you get started with these easy tips?


1. Exercise, exercise, exercise: I know, it’s the New Year, and you have thought about losing weight and joining a gym for quite some time now. And whether it has been the cold weather, or your hectic work and home life, something has gotten in the way. However regular physical activity has been well-established way to reduce your risk of heart disease and stroke, while also increasing your good cholesterol, or HDL. What about finding a way to do something a little extra for just 10 minutes a day: a walk after work, parking your car a bit further in the parking lot, or taking the stairs instead of the elevator. After 10 minutes, slowly start to build up to 12, then 15, then 20 and before you know it, you will be up to the recommended 30 minutes of activity a day! Another option is to join a gym and take a group class a few times a week. As you start to notice the pounds melting away, you will only be motivated to exercise even more! Decreasing your weight also decreases the demands on your heart, resulting in improved blood pressure, cholesterol, and diabetes control. Small caveat: for those of you who already have heart disease, be sure to check with your doctor before starting an exercise program.


2. Stay away from the S’s! That means salt, sugar, starches, and saturated fats. Let’s break this down a little bit further…


• Salts: Salt is literally everywhere, especially in processed foods, cured meats, canned goods, and is one of the reasons why eating out tastes so good. A lot of my patients tell me that they “never add salt” to their meals, and are upset when their blood pressure remains high despite multiple medications. Sodium functions in the body to retain fluid, and as a result, raises blood pressure, which increases the demand on the heart. High blood pressure can lead to stroke and heart failure, in addition to increasing your risk for kidney disease, diabetes, and heart attacks. Eating at home and preparing your own food is an easy way to control exactly how much salt you are eating. Also, look at the nutritional content on the back of each food item, and see how much sodium there is per serving. If you already have high blood pressure or heart failure, try to limit your to salt intake to 1500 milligrams (1.5 grams) daily. For everyone else, the USDA recommends 2300 milligrams (2.3 grams) daily.


• Sugars: A recent study found that US adults consume much more added sugar than what is recommended by the American Dietary Association guidelines, and this has dramatic effects on the risk of death from heart disease.2 There are different types of sugar – added sugar and natural sugar. For example, fruits have natural sugar and are part of our daily-recommended diet. However, a quick weight-loss tip is to concentrate your fruit intake to early in the morning so that you have all day to burn off those calories. Added sugar, on the other hand, are found in sweetened beverages such as those fancy lattes and frappucinos, juices, soft drinks, and mixed drinks. Be very careful of drinking sugar because these are empty calories that may taste good, but do nothing in terms of satisfying your appetite and may be placing you at increased risk for heart disease and diabetes.


• Starches: The American diet is filled with starches and carbohydrates such as pasta, bagels, cereal, rice, French fries, mashed potatoes, pizza, and bread, and studies have shown that most US adults obtain more than 50% of their diet from these foods.3 Starches cause quick rises in your blood sugar, followed by a sudden drop which leads to hunger right after eating a meal. Starches are largely responsible for the obesity epidemic in this country, and increase your risk for diabetes and hypertension. Limiting your intake on simple starches and carbohydrates is incredibly helpful for weight loss, but also for lowering your risk for heart disease. Instead of white rice with dinner, try substituting a baked sweet potato (not the kind with brown sugar and butter!), cauliflower, greens such as spinach or kale, or chose a complex grain like quinoa.


• Saturated Fats: These fats are extremely dangerous because not only do they increase your risk for heart disease, they have also been linked to breast, colon, prostate, and pancreatic cancers! The ADA recommends that less than 10% of our daily caloric intake should come from saturated fats. Chose lean meats such as chicken breast (not fried), fish such as salmon or tuna, and pork (not bacon!) as healthy alternatives. Limit your use of butter, oils, and try to use small amounts of canola oil, corn oil, olive oil, sunflower oil, or soybean oil instead. Also try to avoid heavy cream, cheese, and milks and substitute with reduced or fat-free daily products. Remember that much of the baked and processed foods that are out there are filled with saturated fats, and with salts, sugars, and starches as mentioned above.


3. Let them eat chocolate! Yes, small amounts of dark chocolate may actually improve your heart health. In fact, the flavonoids found in chocolate, red wine, and coffee may actually decrease blood pressure and have important effects on the vascular system by making blood platelets less able to clump together causing heart attack or stroke.4 Of course this does not mean that its ok to eat chocolate cakes or sweets, filled with other sugary ingredients such as caramel and whipped crèmes. However small amounts of dark chocolate such as a 1-ounce portion size may be a sweet part of your new resolution to be heart healthy!


1. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6-e245.
2. Yang Q, Zhang Z, Gregg EW, et al. Added sugar intake and cardiovascular disease mortality among US adults. JAMA Intern Med 2014: doi:10.1001/jamainternmed.2013.13563
3. Brown IL, Elliott P, Robertson CE, et al. Dietary starch intake of individuals and their blood pressure: the INTERMAP Study. J Hypertension 2009;27(2):231-6.
4. Buitrago-Lopez A, Sanderson J, Johnson L, et al. Chocolate consumption and cardiometabolic disorders: A systematic review and meta-analysis. BMJ 2011;343:d4488. doi: 10.1136/bmj.d4488

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