Tag Archive for: heart health

Another Buffalo Bill’s Cardiac Arrest

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I hope that you took 60 seconds to watch the video from Tuesday’s Memo and learn CPR. As I said, it’s simpler than when I taught it, and it may just save someone’s life—someone you love or maybe a stranger.

In the close, I mentioned another Buffalo Bill who suffered a cardiac arrest several months before Damar Hamlin’s on-field experience. The owners of the Bills and Buffalo Sabres and CEO of the Buffalo professional sports teams are Kim Pegula and her husband Terry. One night last June, Terry was awakened by Kim going into cardiac arrest. One of her grown daughters happened to be staying with her parents and performed CPR until emergency services arrived. She saved her mother’s life.

In an open letter in The Players Tribune, Kim’s daughter Jessica, a top-ranked tennis player, told the story of her mom. This time, without the immediate attention from a couple dozen experts, Kim’s brain was without oxygen for longer. While she continues to improve every day, she suffers from expressive aphasia. She can probably understand almost everything, but she sometimes can’t get the correct words to communicate well. No one knows whether she’ll regain lost function, but she’s alive to make that journey because of CPR. It’s a very moving story and I urge you to read it.

Who can do CPR? Almost anyone. The American Heart Association has no minimum age for learning CPR. They say, “The ability to perform CPR is based more on body strength than age. Studies have shown that children as young as nine years old can learn and retain CPR skills.” Now—are you going to take the time to learn CPR in 60 seconds? Just click this link.

Aging with a Vengeance

After the Super Bowl Webinar on Taking Back Your Muscle last Sunday, I had inquiries about the prior Super Bowl Webinar Reclaiming Your Power. I’m happy to let you know you can purchase both replays in the Store at drchet.com. If you order one or both, make sure you use the correct email address; it’s the only way you can get the link to listen to the replay. And if you want to gift the replay to someone, you can; when you’re checking out and get to the billing details page, enter their email address instead of your own.

What are you prepared to do today?

        Dr. Chet

References:
1. https://www.heart.org/en/damar-hamlins-3-for-heart-cpr-challenge
2. https://www.theplayerstribune.com/posts/jessica-pegula-tennis

Happy Heart Health Month!

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Happy Valentine’s Day to everyone! February is American Heart Month; it also has an emphasis on women’s heart health with Go Red for Women. That’s symbolized by wearing red as often as you can during February. I can’t think of a better day to do that than today—Valentine’s Day. There’s a lot that we can do for our hearts with diet, exercise, and more, but that’s not what this memo is about. It’s about responding to a challenge.

Whether you’re a football fan or not, you’ve probably heard about Damar Hamlin, the Buffalo Bills safety who had a cardiac arrest on the field in January. He has recovered and is doing well, and he hopes to get back to playing football. But he’s alive only because the immediate training staff responded by doing CPR on the field.

Damar is part of American Heart Month with #3forHeartTM CPR Challenge. The first part, and probably most important, is to learn how to do CPR in 60 seconds; follow the link to watch the video. Even though I’ve taught CPR, it was a good refresher and, wow, it’s a lot simpler than it used to be. Take a minute today to be prepared in case your Valentine or anyone else has a problem.

There is another part to this story about another Buffalo Bill who had a cardiac arrest. I’ll tell you about her on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.heart.org/en/damar-hamlins-3-for-heart-cpr-challenge

The Secret to Prevention

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Consistency.

I thought I’d lead with the secret to disease prevention instead of making you wait. Whatever you want to accomplish in taking charge of your health, you have to be consistent. The polypill study proved it although the scientists, being conservative in their conclusions, don’t come out and say it—but I will. Here’s why.

Why the Polypill Was the Difference

The subjects taking the polypill were more consistent in taking their medications than the subjects who took the exact same medications as individual pills. They didn’t ask the subjects whether it was easier to remember to take one versus three pills; that could be a factor as the mean age of the subjects was over 75. It’s also easier to keep one medication refilled rather than three. Whatever the reason, the subjects just took their medication on a more regular basis and thus saw a decrease in recurrence of cardiovascular disease events.

While this was a study about medication, it applies to reducing or changing your foods to eat healthier, reducing the risk of cardiovascular disease and diabetes, or any other health goal: we have to be consistent. Even getting a health benefit from taking a supplement requires you to take it regularly for weeks or months to see a benefit.

Weight Loss: A Special Case

Losing weight and maintaining the weight loss is the single most difficult thing humans can do. I know. I’ve been trying for decades. I don’t weigh what I used to weigh, but I’m not where I want to be. I know many of you are in that spot as well.

It’s not the losing that’s the problem—it’s the maintaining. When you consider the simplicity of it, why is it so difficult to sustain a way of eating that keeps you at a healthy weight? Scientists and physicians have examined genetics, proteomics, hormones, and more. They have looked at every psychological issue they can think of to try to help people lose the weight and keep it off. No luck so far.

I’ll go out on a limb and predict there won’t be any one answer. It’s really up to each individual to find a way to eat that can sustain a normal body weight. It will probably be slightly different for each of us as to the types of foods and exercise we use, but our solution exists. We just have to find a way to be consistent and in the case of weight loss, it has to be for life.

The Bottom Line

We face plenty of obstacles in our path to health. We may not have the best genes. We may have had a poor lifestyle for many years that we have to compensate for. We may not have all the resources we need. But if we can pick a couple of things at a time and make them our habits for life, we can begin the process. We just have to be consistent, day in, day out. Where we end up may not be perfect, but it can be better than you are right now. That’s what aging with a vengeance is all about.

What are you prepared to do today?

        Dr. Chet

Reference: NEJM. 2022. DOI: 10.1056/NEJMoa2208275

Will the Polypill Reduce Second Heart Attacks?

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One of the issues with prevention is having people stick to a plan, even after an event as serious as a heart attack. Lifestyle changes are challenging to stick with, but so is something as simple as taking medications. Remember, this isn’t to prevent a heart attack; it’s to prevent a second one. That’s serious.

The concept of a polypill has been around for close to 15 years. The idea was to put medications together in one pill as a preventive that would reduce the risk of getting cardiovascular disease. For a long time, that idea never went anywhere, but recently researchers decided to resurrect the concept. This time, the objective was to monitor subjects with recent heart attacks. Would there be a difference in the rate of secondary events between subjects who took the polypill and those who took the same medications as individual pills? The medications used were aspirin, ace-inhibitor, and a statin. After three years of follow-up, the subjects in the polypill experienced significantly fewer secondary events, 9.5% versus 12.7%.

Can you figure out why the subjects who took the polypill did better than the subjects who took the same medications individually? I’ll tell you the secret to disease prevention on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: NEJM. 2022. DOI: 10.1056/NEJMoa2208275

Research on Health and Apple Cider Vinegar

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Watching more television than usual means I’m seeing more commercials than I’m used to seeing. It’s time to take a look at some dietary supplements that make health claims in television commercials. I’m going to focus on the science behind any claims being made on the product label or on the product’s website to see if they pass the FDA regulations. The product claims are worded as the FDA suggests; the question is whether the science is substantial enough to make the type of claims the FDA allows.

The first product is Goli, an apple cider vinegar (ACV) gummy supplement. The website makes claims about weight loss, appetite control, blood sugar control, energy, immune function, detox, gut health, skin, and heart health. I chose to examine heart health.

The company used three studies to support the claim. The first examined the use of 750 and 1,500 mg of ACV in a drink. The results showed no clear pattern of benefit although triglycerides went down. The second study compared a group using ACV plus calorie reduction with a control group that had no intervention; in this case, the restricted calories could explain any benefits. Finally, they used data from the Nurses Health Study that reported better heart outcomes in women who used oil-and-vinegar salad dressing. The focus of that research was on the type of oil, not the type of vinegar.

Based on the FDA Guidelines, claims cannot be made from research that uses an ingredient in food as the substantiation for a benefit from a dietary supplement. I checked the research on several of the other claims they made and the research they used, and I came to the same conclusion. They may be very tasty gummies, but the research does not appear to support the claims they make. But if you want to take a gummy or two to reduce your appetite, our grandson Riley recommends sour gummy worms. Just FYI.

What are you prepared to do today?

        Dr. Chet

References:
1. Guidance for Industry: Substantiation for Dietary Supplement Claims Made Under Section 403(r) (6) of the Federal Food, Drug, and Cosmetic Act. https://bit.ly/2QLDRa2
2. Biosci, Biotechnol, Biochem. 2009; 73(8):1837-1843.
3. https://doi.org/10.1016/j.jff.2018.02.003.
4. Journal of the American College of Nutrition, 2001; 20:1(5-19).

Treating a Woman’s Heart Disease

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The paper I’ve been using as a primary source for this week’s Memos is titled “Sex Differences in Ischemic Heart Disease. Advances, Obstacles, and Next Steps”; the purpose of this paper is to provide the current state of the science to clinicians when it comes to preventing and treating heart disease in women. A team of experts combed the medical literature to let their colleagues know where we stand in treatment and where future research should go, and you could look at it as a roadmap for improving prevention and treatment. You could also look at this as an indictment for less-than-quality care for women with heart disease.

There were seven categories of treatment options for various phases of heart disease, from diagnosing heart disease to mortality. I’m going to talk about just two but understand that even though the mortality from heart disease has decreased over the past 30 years, there are still gaps in treatment between men and women.

The first was a 30-minute delay in restoring the flow of blood to the heart in women who were having a heart attack with ST- segment elevation, a distinct change in the EKG. The time from the onset of symptoms and arrival at the hospital as well as time from arrival at the hospital to needle insertion for a percutaneous coronary intervention was 30 minutes or longer compared to men. That means women don’t get to the hospital early enough, so that’s on them. Ladies, you need to make that 911 call a little quicker. But it also means that once they’re there, it takes longer to get the arteries open again. That creates the possibility of more damage.

One of the problems is getting the correct diagnosis. There are 11 other conditions that can cause ST-segment elevation including takotsubo syndrome also known as broken heart syndrome. Still, 30 minutes seems way too long and needs to be improved.

The second is the one that really stunned me: fewer women are given recommendations for cardiac rehabilitation after a heart attack. Not only that but fewer women register to take part in cardiac rehab. They also attend fewer sessions than men do. When I read that, I was almost apoplectic. The heart is a muscle that can be damaged by a heart attack. When it’s time to rehabilitate that muscle, it’s not like restoring range of motion after knee surgery. If this muscle isn’t rehabbed and then trained for the rest of a women’s life, the death rate increases for those women.

That has to change today. If you have any type of coronary event, from atrial fibrillation to a full blown heart attack, the first question you ask is “When can I begin cardiac rehab?” I understand that every insurance plan may be different but you need to understand any limitations, how to exercise after a heart attack, and how to progress. That’s important, not just for the muscle, but also for the nervous system, the lungs, increasing the number of blood vessels, and even to reduce the depression that occurs after a heart attack.

And then you’re going to do it until you get every session you qualify for and get a plan to take home with you to keep improving. When that’s done, you’re going to get a plan from your physician as to how to progress from that point. These are non-negotiable. This has to change and it has to change today. The quality of your life depends on it.

Next Tuesday I’ll finish American Heart Month with a question I get a lot: does taking my calcium supplements increase calcification in my coronary arteries? I’ll let you know on Tuesday.

What are you prepared to do today?

Dr. Chet

 

Reference: Circ Cardiovasc Qual Outcomes. 2018;11:e004437.

 

Emerging CVD Risk Factors for Women

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The paper I referred to in Tuesday’s Memo provided a list of emerging risk factors for heart disease that apply only to women. But first, I wanted to define exactly what a risk factor is and what it means.

As defined by the World Health Organization, a risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury. The key word is likelihood. It does not mean cause and effect, and that includes genetic tendencies. Lifestyle contributes close to 80% when it comes to raising or lowering risk. You’re not doomed; you just have to be aware and take action.

There were several emerging risk factors for cardiovascular disease (CVD):

  • Gestational diabetes: your risk of getting type 2 diabetes increases four-fold later in life; type 2 diabetes is a risk factor for heart disease.
  • Hypertension during pregnancy: hypertension and preeclampsia increase the risk of heart disease three-fold.
  • Early menopause: women’s hormones are protective against heart disease. When they change during menopause, the risk of heart disease begins to increase; the earlier that happens, the sooner the risk rises.
  • Autoimmune disease: diseases such as rheumatoid arthritis and lupus increase the risk of heart disease. Autoimmune diseases increase inflammation, and that may partially explain this connection.

You can see why these emerging risk factors are primarily associated with women. While depression is also associated with an increased risk in women, it may be that women seek help more than men.

Keep in mind that these conditions don’t make heart disease a given, just a risk. But if that gives you the oomph you need to get to the gym today or skip that sweet roll, I’m okay with that.

What happens after a woman has heart disease or a heart attack? We’ll take a look at that on Saturday including one thing that stunned me and has to change.

What are you prepared to do today?

Dr. Chet

 

Reference: Circ Cardiovasc Qual Outcomes. 2018;11:e004437.

 

It’s American Heart Month

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February was declared American Heart Month by President Lyndon Johnson in December 1963. As I’m searching the recent research in preparing to update the Women’s Heart Health audio, I’ve found new research on women’s hearts. I’m not ignoring men, but the research on women has lagged behind what we know about the risk of heart disease in men, because women’s bodies react differently to heart issues. Now we’re starting to catch up on women’s hearts.

Let’s look at the same risk factors for heart disease and see the differences between men and women. In a paper published this month, researchers looked at the differences in how risk factors for heart disease are managed in women. Here’s what they found:

  • Blood lipids: after menopause, women are less likely to achieve goals in reducing triglycerides and LDL-cholesterol and increasing HDL-cholesterol.
  • Blood pressure: as women get older, those with hypertension are less likely to lower blood pressure; only 29% achieve healthy blood pressures.
  • Exercise: 25% of all women get no regular exercise.
  • Obesity: carrying extra weight impacts the risk of heart disease more in women than men—64% compared to 46%.

There are more risk factors, but what makes these four important is that they can be improved through changes in lifestyle. Eating less. Eating better. Moving more. Even a 10% change can help reduce a women’s risk of getting heart disease.

Some new risk factors are emerging that are unique to women. I’ll cover those on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Circ Cardiovasc Qual Outcomes. 2018;11:e004437.

 

How Long Does Fitness Last?

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Does exercise when you’re young have any impact when you’re older? That’s the question researchers sought to answer in a very unique study. They recruited men who competed in running events in the 1968 Olympics and evaluated fitness variables to see how they had changed since then. The subjects were tested in 1993 and retested in 2013. Did their fitness and cardiovascular measures decline at the same rate as their age would predict?

Maximal heart rate is calculated by subtracting your age from 220. There are formulas that make it a little more precise, but the shortcut is close enough for most purposes. At every retest, the runners measured max heart rate was significantly higher than predicted. The maximal amount of oxygen they used was also higher than would be expected for their age.

What does this mean? The fitness you attain when you’re younger can impact your fitness when you’re older. This study shows that there are some measures related to the cardiovascular system that can be sustained. You may never have trained like an Olympian, but even if you start later, the fitness you gain may yield benefits years later. Improving your fitness now will still pay dividends twenty or thirty years ahead when you may have more physical restrictions than you have now.

That raises another question: will being fit help you live longer? We’ll tackle that on Saturday.

If you want the best way to combine a change in your diet with an exercise program to maximize fat loss, no matter what your current fitness level may be, make sure you sign up for the Super Bowl Webinar.

What are you prepared to do today?

Dr. Chet

 

Reference: Med Sci Sports Exerc. 2018 Jan;50(1):73-78.

 

What to Do After a Bypass

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A family friend recently had a quadruple bypass surgery or CABG for short; CABG stands for coronary artery bypass graft. In case you’re thinking all our friends are old, I have to tell you this man is 47; we met him through our kids.

So what happens now? He’ll go through recovery and rehab. Here are the things that I think he has to do short and long term, including some lifestyle changes:

  1. Be patient. It’s going to take time from having your chest split open, your heart stopped, veins from the leg grafted to bypass the blocked arteries, getting sown back up, and then staying out of commission for a while. This was serious surgery and recovery is going to take time.
  2. Do the cardiac rehabilitation. It’s not just exercise to recover from the surgery—exercise should become a permanent part of life. Ask plenty of questions. Know your limitations and don’t exceed them, especially when it comes to weight training. The bones of the sternum have to heal just like any broken bone. As an aside, always exercise with your cell phone. My daughter-in-law made me promise to carry mine when I’m running after I took a tumble. In this case, always means always.
  3. Eat a better diet. Plants rule because of the benefits they provide, so always begin with those. Less saturated fat and fewer refined carbohydrates are also part of the better diet. This is a time to learn how to do it better.
  4. Take your medications as prescribed; this is not the time to start doing things the “natural” way.
  5. If you haven’t been taking a high-EPA fish-oil supplement, start now. Your daily supplements also should include 100 mg of coenzyme Q10 and a good multivitamin-multimineral to fill in nutritional gaps, all with your doctor’s okay.
  6. Expect to be depressed. Nothing gets into your head more than facing your own mortality. Depression is common after surgery. Keep a support group of friends around and work on getting your attitude right; your fellow rehabbers can be a source of commiseration and encouragement. If you need professional help, get it. Depression doesn’t necessarily mean medication; there’s plenty you can do to help yourself, and talking tops the list.
  7. Enjoy your life without reservation. You cannot live your life listening to your heartbeat or constantly checking your pulse. You already know what it feels like to have a compromised heart. If something is wrong, you’ll know and that means you immediately get it checked out. But you can’t live in fear because that’s not living.

Let me repeat an important point about cardiac rehab: it’s never over. Rehab teaches heart attack survivors how to exercise to stay healthy, and it’s important that they never quit.

For those of us who haven’t had to deal with CABG, what we do related to exercise, diet, and stress may help reduce our risk and may prevent it altogether. It really depends on one thing:

What are you prepared to do today?

Dr. Chet