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Diet, exercise the magic pills for heart health

April 30, 2008

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Think the best treatment for heart disease includes the newest drugs on the market and the most high-tech tests? Think again. Consumer Reports recently put heart-disease prevention and treatment under the microscope and offered these 10 low-drug or no-drug tips for a healthy heart:

1. Eat plenty of fiber and good fat. New research suggests inflammation of the arteries may be as big a risk factor for heart disease as clogging with cholesterol deposits. According to CR, a high-fiber diet featuring plenty of beneficial fats proved better at controlling that damaging inflammation than the standard low-fat diet in a recent clinical trial. Good sources of fiber include fruits, legumes, nuts, whole grains and vegetables.

2. Avoid cholesterol and salt. Anyone diagnosed with an elevated level of LDL (bad) cholesterol should consume less than 200 milligrams of cholesterol a day, the amount in one egg yolk, 8 ounces of skinless chicken breast or 10 ounces of lean sirloin.

3. Lose the gut. Even for individuals who are not significantly overweight, carrying extra fat around their middle is bad, bad, bad. It raises blood pressure, adversely affects blood lipids, causes insulin resistance and produces substances that inflame the arteries. CR health experts advise that the critical point is a waist measurement of 40 inches or more for men, or 35 inches for women, regardless of height.

4. Huff and pump. Name a cardiac risk factor, and regular aerobic and strength exercise can improve it - including arterial inflammation. Updated recommendations from the American Heart Association and the American College of Sports Medicine call for at least 30 minutes of moderate-intensity aerobic activity, such as brisk walking, five days a week, or 20 minutes of vigorous activity, such as jogging, three days a week. According to CR, strength training, in addition to improving overall fitness, improves fat-burning capacity by increasing muscle mass.

5. Calm down. Negative emotions, such as stress or panic attacks, trigger the release of hormones that can threaten the heart; studies show that people who experience those troubles have more heart attacks and strokes than calmer, more cheerful types.

6. Drink a little, but don't smoke. Drinking a little bit of alcohol - one drink a day for women, one or two a day for men - can raise HDL (good) cholesterol and reduce inflammation and blood clots. But more than that can cause heart problems. As for smoking, don't. Cigarette smokers have twice the heart-attack risk of nonsmokers.

7. Ask about CRP numbers. Elevated levels of C-reactive protein, or CRP, serve as a marker for artery inflammation, even for those who have no other symptoms. Ask a doctor for the inexpensive blood test for CRP when cholesterol is checked.

8. When being treated, avoid CT angiography. CR reports that this high-tech test uses an ultrafast CT scanner to create a three-dimensional image of coronary arteries. However, it rarely provides any useful information for people without symptoms such as angina, while exposing them to as much as 325 times the radiation of a regular chest X-ray.

9. Hold off on angioplasty. If an angiogram reveals severe narrowing in more than two major coronary arteries, bypass surgery will be required. With less severe blockages, immediate angioplasty is not a good idea. It triggers a heart attack in 1 to 2 percent of patients. Instead, treat the angina with weight loss, exercise and stopping smoking, and with cardiovascular medications.

10. Know all the symptoms. Almost everyone knows that chest pain and shortness of breath are symptoms of heart attacks, but so is pain or discomfort in the jaw, neck or back. Other symptoms include feeling weak or lightheaded and discomfort in the arms or shoulders. Upon experiencing any of these symptoms, CR recommends calling 911 for an ambulance to the emergency room; getting treatment within an hour can greatly increase the chances of a good recovery.

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