Ask the MD: Men’s Heart Health

By Dr. Brad Jacobs, MD, Chair of Pharmaca’s Integrative Health Advisory Board

Heart disease and related health problems, such as cerebro-vascular accidents (e.g. strokes), comprise the leading cause of death in the United States. I recommend using the Reynolds Risk Score calculator to calculate your risk for developing a heart attack or stroke over the next 10 years.

So how should men think about reducing their risk for heart disease or strokes? First, learn the facts. The major risk factors for heart disease and stroke include age (<55 years in men and <65 years in women), family history (first degree relatives experiencing a heart attack), use of tobacco, elevated blood pressure, poor cholesterol profile (LDL>130, HDL <40), diabetes and an elevated c-reactive protein lab test.

Second, realize that lifestyle changes are the most potent, safest and cheapest “medicine” available—far more potent than any single prescription drug or natural remedy available.

Third, if you are at least 40 years of age, talk to your physician about the possibility of taking a baby aspirin daily (81 mg, enteric coated). Research has shown that low doses of aspirin lower heart disease risk and lower cancer rates by 33 percent.

Risk factors you can influence  

Smoking tobacco triples your risk of heart disease and stroke—quit while you’re ahead!  More smokers die from heart disease than lung cancer, and 30 percent of all heart disease deaths are caused by cigarette smoke. After two years of not smoking tobacco, your risk for heart disease returns to the same risk as someone who never smoked cigarettes.

High blood pressure: A healthy blood pressure is 120 mmHg/80 mmHg.  Check the American Heart Association’s website for an easy-to-use calculator to determine your risks.

Fortunately there are several things you can do to lower high blood pressure. Stopping smoking, decreasing salt and alcohol consumption, managing your stress through mind-body practices such as yoga and meditation, exercise and reducing your weight can all reduce your blood pressure. (Read more about my weight management tips here).

As for supplements, magnesium and calcium are thought to have modest blood pressure-lowering effects, and CoQ10 is thought to lower systolic blood pressure.

Cholesterol: Make sure you have both your HDL and LDL tested, since total cholesterol is less relevant. The LDL should be as low as possible, and the “good stuff,” HDL, as high as possible. The general guidelines are to aim for higher than 45 for HDL, and below 130 for LDL—unless you have diabetes or a history of heart disease, in which case an LDL below 100 is recommended.

To raise your HDL, daily exercise (even 20 minutes daily has large health benefits!), one glass of alcohol per day and supplementary niacin has been shown to increase levels.

Modifying your diet has been shown to dramatically lower LDL levels. I recommend limiting saturated fat intake to less than 5-10 percent total calories, increasing fiber and whole grains to 25 grams or more daily, and increasing low glycemic-load fruits and deeply pigmented vegetables to 5-7 servings daily.

In addition, reconfigure your plate of food so that two-thirds of the plate is filled with vegetables, and the remainder split between non-animal or lean animal protein and whole grain carbohydrates. When you do that, it can dramatically change your overall heart health and cholesterol. (For more information on healthy eating, I recommend the Harvard School of Public Health’s Healthy Eating Pyramid by Dr. Willett.)

I also recommend the following supplements for improving cholesterol:
·     Niacin: Take in small doses several times per day to help increase your HDL levels.
·     Garlic: Research has linked it to modest lowering of cholesterol, and it can be beneficial for overall health.
·     Omega-3s: Strong evidence shows that these reduce your triglycerides, and reduce your risk of dying during a heart attack.
·     Plant sterols can be quite effective in lowering LDL levels, especially beta-sitosterols. You can find them in spreads such as Benacol or in supplements like Natural Factors’ Cholesterol Formula.

Diabetes: Maintaining normalized blood sugars levels is paramount for those with diabetes. If you are at risk for developing diabetes, then the lifestyle program we discussed above should become an essential part of your daily life.

C-reactive protein levels: This lab test is a marker of your overall inflammatory state. We previously thought aspirin was good for heart disease because it thinned the blood, but current research has found its anti-inflammatory effects are likely the true cause (and help explain why it reduces cancer rates as well). For similar reasons, good oral hygiene reduces chronic inflammation and may thereby lower heart disease rates.

The bottom line? Reduce heart disease and stroke risk with simple steps like flossing your teeth, taking a baby aspirin, exercising and drinking alcohol in modest amounts, and eating modest amounts of food, mostly plants.

For more advice about maintain good cardiovascular health, speak with a Pharmaca practitioner today.

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