We normally associate February with the heart, as in heart shaped treats and decorations. But this month is also a time to bring awareness to heart health as we commemorate American Heart Month, to raise awareness of heart disease and reinforce the importance of heart health ensuring people live longer and healthier.
Heart disease remains the leading cause of death for Americans regardless of sex, race or ethnic group, making up 25% of all deaths in this nation. (1) According to the CDC, coronary heart disease, which causes heart attacks, is the most common type of heart disease, killing more than 350,000 on average each year. (2)
These statistics can be scary but they don't have to overwhelm you. The good news is that in more than half of all cardiac events could have been prevented with lifestyle changes. (3),(4) This knowledge is incredibly powerful and can be leveraged to take positive action on the things you can control to reduce your risk.
Often times conventional medicine over emphasize the utility of medications and their ability to reduce the risk of a coronary event, while under utilizing and even minimizing the power of basic lifestyle changes. This mentality needs to be reversed. In functional medicine we understand that lifestyle is really the most powerful medicine when it comes to building health and preventing disease. This is especially true when it comes to heart health.
In one study, examining the link between coronary heart disease prevention and healthy lifestyle adherence among men taking medications for high blood pressure or high cholesterol it was found that 57% of all coronary events may have been prevented with a low-risk lifestyle despite the fact they were also on medication.(4). The good news is as an individual you have a lot of power to positively impact your heart health.
The Heart Healthy Lifestyle
The functional medicine approach focuses on understanding the root cause of disease. Lifestyle impacts all aspects of health and is a primary driver of disease and dysfunction.
So when we talk about improving our health and lowering our risk of a developing heart disease we need take it one habit at a time.
Here are the most important areas of your lifestyle to focus on to build a healthy heart and reduce your risk.
1. Quit smoking. Research shows that 2 years after quitting smoking your risk of having a heart attack is cut in half and the younger you are when you quit, the better chance you have of reversing all risks from smoking. (5)
There are many resources available online to help you quit. There are apps you can download to your phone that can track your progress and provide helpful tips.
Let your your medical provider, friends and family know you intend to quit and enlist their support. Set a quit date and stick to it.
Consider nicotine replacement or medications to lessen cravings. Work with a counselor experienced in addiction or one who offers hypnotherapy.
2. Get moderate-to-vigorous activity most days per week. Physical activity is one of the most powerful lifestyle changes you can make to help prevent a heart attack.
Regular physical activity can:
Raise "good" (HDL) cholesterol levels.
Help you lose weight or stay at a healthy weight.
Lower blood pressure.
Control blood sugar.
Exercise intensity can be classified as moderate or vigorous. Aim for a mix of moderate and vigorous intensity activity throughout the week. To check physical activity intensity, determine whether your pulse or heart rate is within the target zone during physical activity.
Moderate activity includes movement like brisk walking, cycling, or dancing. You can also include activities, like daily chores, if during these activities your heart rate is 64% and 76% of your maximum heart rate. You should be able to carry on a conversation but you will be breathing more heavily and sweating. Aim of moderate activity for 150 minutes total every week. You can choose to be active 30 minutes a day, at least 5 days a week or for 50 minutes a day, 3 days per week.
Vigorous activity includes activities like jogging, fast cycling, or a high intensity aerobics class. You breathe rapidly and your heart beats much faster, with a target heart rate between 77% and 93%, during this kind of activity. Aim for at least 75 minutes a week. This can mean vigorous activity for 25 minutes a day, 3 days a week or 15 minutes a day, 4 days per week.
3. Reduce alcohol consumption. Drinking too much alcohol is linked to a variety of poor health outcomes including obesity, high blood pressure, cardiac arrhythmia and diabetes. Heavy alcohol consumption can raise the levels of triglycerides in the blood which is one factor that has been associated with fatty buildup in the artery walls, which contributes to an increased the risk of heart attack.(7)
If you choose to drink alcohol focus on moderation. Moderate drinking is defined as an average of one drink per day for women and one to two for men. One drink translates to: 12 ounces of beer, 4-5 ounces of wine or 1.5 ounces of 80-proof spirits. (7).
4. Eat a heart healthy diet. An anti-inflammatory, Mediterranean type diet has been shown to reduce and even reverse coronary heart disease. (9) This approach to eating focuses on whole, plant-based foods including vegetables, fruits, nuts, seeds, whole grains, beans and herbs. The diet is lower saturated fat, added meats, and dairy products, but does include monounsaturated fat from olive oil. It also minimizes added sugars, caloric beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.
Here are a few tips to help jump start your heart healthy eating plan.
Add a variety of colorful vegetables and fruits with each meal.
Avoid bad fats. Reduce saturated fats - no more than 11 to 13g daily. Avoid trans fats which are found in processed foods.
Boost good fats found in nuts, seeds, fish, avocados and olive oil.
Choose low fat protein sources including beans, whole soy, nuts, skinless poultry, fish, and eggs.
Keep sodium less than 1500 mg daily.
Be mindful of your portion size. Use a smaller plate and eat slowly.
Find swaps for your favorite desserts or junk food.
5. Maintain a social network. Social isolation and loneliness were associated with a 29% increased risk of heart attack. The risk was similar to that of light smoking or obesity, according to researchers.
We are social creatures that truly thrive when we are safely connected with others. Currently, with the global pandemic still in full swing, this potentially poses a significant challenge. So how do we stay connected while still staying safely distanced? Here are some creative ideas to keep you connected.
Create a call schedule to stay in touch with the most important people in your life.
Write a letter to a loved one.
Call someone you haven't spoken to in over a month.
Join an online book group.
Text someone close to you and share with them how much they mean to you.
Meet up with others in person, maintaining social distance, wearing a mask. Outdoor meet ups are safer than indoor ones.
When making a lifestyle change join an online support group.
Ask for support when you need it. We all do better together.
What other steps can I take to assess my risk of cardiovascular disease?
At Elevate Functional Medicine we don't just manage disease. Instead we focus on detecting issues before disease develops and work with our patients to reverse the disease process. This is accomplished by utilizing the latest in medical testing and technology. Here are a few of the most important heart health assessment tools you should know about.
Advanced Lipid Screening - Providing a more accurate picture of cardiovascular risk than the standard lipid panel, advanced lipid testing directly measures LDL particle number and size of LDL particles. The true culprit in heart disease is not just LDL cholesterol, but LDL particle number and size which is missed with the conventional lipid panel.
Inflammation Markers - High sensitivity C-Reactive Protein (hs-CRP) is one of the most well known tests for inflammation. We go beyond hs-CRP to assess a variety of inflammatory markers including homocysteine, myeloperoxidase, and LpPLA2. Read more about the link between inflammation and heart disease.
Genetic Testing - Experience true personalization of your prevention and treatment strategy using genetic testing. By assessing your genes we can identify your risk of developing heart disease, develop the optimal diet for you, customize your supplement regimen and predict how you may respond to medications.
Multifunction Cardiogram® - The Multifunction Cardiogram® (MCG) is a non-invasive screening test that can assess several aspects of heart function in just a few minutes. This test is so sensitive that it can identify heart ischemia (reduced blood flow) before it can be seen on a stress test allowing time to reduce heart disease severity. It can also rule out false positive results that would normally lead to unnecessary surgical interventions. Locally, this test is available at EMSITE Preventative Health Services.
When identified early, heart disease can be reversed.
Heart disease is common, but it's not inevitable. The team at Elevate Functional Medicine is here to support you, step by step, on your journey to optimal health. Remember how powerful you are when you consistently take action on behaviors that align with health. Focus on why you want to change and the impact better health would have on your life. The wellness journey is about progress, not perfection. Continue choosing to commit to your wellbeing one moment at a time. We have your back. To schedule a visit call 470-266-1380.
Rabia Vaughns, MMS, PA-C is a certified physician assistant who specializes in helping people overcome chronic illness using a functional medicine approach to healing the mind, body, spirit. She is a co-owner of Elevate Functional Medicine.
References
Centers for Disease Control and Prevention. Underlying Cause of Death, 1999–2018. CDC WONDER Online Database. Atlanta, GA: Centers for Disease Control and Prevention; 2018. Accessed March 12, 2020.
Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56–528.
Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy Lifestyle Factors in the Primary Prevention of Coronary Heart Disease Among Men: Benefits Among Users and Nonusers of Lipid-Lowering and Antihypertensive Medications. Circulation. 2006; 144: 160-167. https://doi.org/10.1161/CIRCULATIONAHA.106.621417
National Guideline Clearinghouse (2001, revised 2013). Guideline synthesis: Treatment of tobacco dependence. http://www.guideline.gov/syntheses/synthesis.aspx?id=43817.
U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx
American Heart Association. Is drinking alcohol part of a healthy lifestyle? https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/alcohol-and-heart-health
Mayo Clinic. Heart-healthy diet: 8 steps to prevent heart disease. https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-healthy-diet/art-20047702
Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circulation Research. 2019;124:779–798 https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313348