“YOU” Can Prevent Heart Disease

“YOU” Can Prevent Heart Disease

Eighty million Americans have cardiovascular disease.  That comes to almost one out of every three people.  According to the American Heart Association’s ‘Heart and Stroke statistical updates,’ all categories of cardiovascular disease have increased by 33% during the years from 2002 to 2009, and currently, 910,000 Americans die of heart disease annually.  Though our pharmacologic/surgical health care model has become very efficient at treating “acute” cardiovascular events, it has a poor track record for preventing these events. 

Dr. Thomas Fuller (1654-1734) said, “Health is not valued ‘till sickness comes.”   Truer words have never been spoken.  Value your health.  Make every effort to prevent disease, and don’t be fooled by the “we all must die of something” mantra.   Unfortunately, today’s “disease-care system” places a premium on treatment.  Research and marketing dollars are funneled into disease management and new drugs rather than prevention.  Nevertheless, modern technology and western science have afforded us a “giant toolbox” of preventive tests which should be part of your ‘health regimen.’ 

Comprehensive blood testing may be the most cost effective preventive measure you can do.  Many biomarkers of cardiovascular disease will    alert you to a problem before symptoms develop. 

Sudden cardiac death is defined as dying within one hour of the onset of symptoms with NO previous history of heart problems.  This accounts for more than 50% of all heart attack deaths.  Think of this, over half of all heart attack deaths occur in people who have no history of a heart problem! 

The ‘Nurses Health Study’ contained data on 121,000 female nurses aged 30 to 55 years old.  Researchers followed 505 women for 25 years to see if there was a relation between blood magnesium levels and sudden cardiac death.  Women with the highest blood magnesium levels were 77% less likely to die suddenly! 

The Journal of the American Medical Association (JAMA) stated in 1995 that the highest risk for sudden cardiac death is an HS-Omega-3 Index of 3.3% or lower.  Do you know your blood magnesium level (a red or white blood cell level is the best marker) and your HS-Omega-3 Index?  With comprehensive blood testing, it is possible to KNOW critical levels of biomarkers that may prevent a sudden cardiac event.

Pulse wave velocity and digital pulse analysis are exciting, non-invasive, FDA cleared, in-office assessments of the physiologic status of the cardiovascular system.  They are backed by more than 25 years of advanced research in medical physics.  In simple terms, it tells us how fast the blood is moving through the arteries.  This in turn indicates how stiff (or flexible) the arteries are.  “Hardening of the arteries” will increase your risk of having a heart attack or stroke.  Though it is necessary to provide invasive assessment and treatment after a heart attack or stroke has occurred, it is wiser to prevent their occurrence.  Pulse wave velocity and digital pulse analysis can help us meet this goal.  Disease begins in the arterial wall.  Do you know the flexibility of your arteries?     

Heart rate variability (HRV) is a measure of the variability of the heart from one normal heartbeat to the next.  This variability is controlled by the autonomic (involuntary) nervous system.  You may have heard the phrase “stress kills.”  Chronic stress will significantly lower one’s HRV which in turn increases the risk of sudden cardiac death.  HRV analysis is a non-invasive, FDA cleared, in-office assessment that provides valuable information of one’s cardiovascular risk.  Knowing this allows one to make appropriate choices that will lead to lower risk and better health.  For example, HRV is increased by exercise, stress reduction, and omega-3 oil intake.  Simple measures like a 20 min walk several times a week, relaxation exercises such as deep breathing or meditation, and a daily supplement of 2-4 grams of omega-3 oils can provide significant health benefits and lower your risk.  Do you know what your heart rate variability is?

Carotid IMT provides a test for detection of atherosclerosis (hardening of the arteries) and risk for a heart attack or stroke at its earliest stages.  It identifies thickness of the various layers in the carotid artery wall called carotid intima-media thickness, which is one of the best methods for detecting the “early” stages of vascular disease.  It can be done in-office, with an FDA cleared, non-invasive ultrasound assessment.  The 2010 American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) Guideline for assessment of Cardiovascular Risk in Asymptomatic Adults recommends carotid intima media thickness (CIMT) for detection of atherosclerosis.   The Mayo clinic summarized the value of CIMT in its March 2009 edition of the Mayo Clinic Proceedings by stating:

“A CIMT evaluation can detect subclinical (no symptoms) vascular disease in young to middle-aged patients with low Framingham Risk Scores and Coronary Artery Calcium Scores of ZERO!”  In other words, CIMT evaluation can detect vascular disease in healthy young adults who have no risk based on the current model of risk assessment. 

There is a great deal of difference between Carotid IMT and conventional carotid ultrasound using Doppler.  Carotid Doppler looks at blood flow; this can be very limiting in that:

-Narrowing of the artery is not considered significant until blockage is 70%

– Patients with 70% blockage can still pass a treadmill stress test

-68% of heart attacks occur in patients with less than 50% blockage

-86% of heart attacks occur in patients with 70% blockage

This means that 86% of patients who have a heart attack are able to pass a treadmill stress test!  This speaks to the issue that many of the cardiovascular tests performed today, though excellent and necessary AFTER a heart attack or stroke has occurred, provide for little in the way of preventing these events. 

Carotid IMT measures the thickness in the arterial wall which can be significant before there is plaque or narrowing detectable on Doppler, and most importantly, before symptoms are present.  The reason this is important is shown below:

Glagov’s Coronary Remodeling Hypothesis
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As plaque accumulates, the arterial wall reacts by ‘remodeling,’ i.e. expanding.  Because the arterial lumen remains constant, if one measures only blood flow with Doppler studies, minimal to moderate coronary artery disease will be missed.  It is necessary to measure the thickness of the arterial wall in order to discover disease at an earlier stage when ‘regression’ of this process is possible.  If one waits until the lumen is narrowed and there is severe coronary artery disease, it may be too late in the disease process to expect regression to occur.

Carotid IMT is a preventive screening test to detect disease before the patient has an event; which could range from a mild event to sudden cardiac death.  Do you know your CIMT?

There is an old saying, “Healthy people are sick people who don’t know it.”  There is some degree of truth to this statement due to the fact that many diseases have long ‘incubation periods.’  Atherosclerosis is a good example of this.  Studies have shown that atherosclerosis can be well advanced by age 25!  Nevertheless, until a vital area of the heart is blocked, this young individual may appear to be in excellent health.   In reality this is a ticking time bomb waiting to be triggered by nutritional deficiencies, emotional turmoil, or the like.  Too often Americans are attentive to preventive maintenance on a new car, or a new home recently bought, but provide little to no prevention when it comes to their most important possession – their health. 

Remember:

“Health is the only form of currency that can make a

rich man poor and a poor man rich.”

Emerson

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