Tuesday, September 10, 2013

How to Prevent a Heart Attack

Stressed? This may be the root cause of your heart disease.
And now for the important part: how to prevent heart disease. In my last post, I made the point that most heart attack victims have normal cholesterol levels. In the study I cited, which analyzed 65,396 patients hospitalized for heart disease, the average cholesterol level was a "healthy" 170 mg/dl. Not exactly what you'd expect to see based on our cholesterol-phobic society. Obviously, there's something else going on in the development of heart disease other than just your cholesterol level. 

Some of these factors are uncontrollable. For instance, just being a man increases my statistical risk for heart disease. So does my family history. There's nothing I can do to change that, unless I decided to become a woman. Something tells me that still wouldn't change my risk, but that's besides the point. Here are the things you CAN control, and some quick tips on just how to take care of it.

1. Stress.
In all honesty, I believe that stress can be the biggest player in the risk of cardiovascular disease. Malcolm Kendrick has written a fantastic book entitled "The Great Cholesterol Con", in which he explores this theory in much more detail than I will go into here. Check it out. Leading a stressful life, one in which there is no security, happiness, relaxation, or peace of mind, can have a huge impact on your health. 

Think of it this way... your body has two "modes". One mode is a stress response, designed to get yourself out of danger, like that posed from a confrontation with a grizzly bear. And the other mode is a rest response, the opposite of the stress response. This is when you relax, recover, digest and assimilate your food, and repair your body. These systems cannot function simultaneously, but you need a balance of both to be at your best. If you're constantly worried and stressed, you're not dipping into rest mode... you won't make full utilization of the food you're eating, regardless of what it is, and you won't allow your body's maintenance system to function correctly. Imagine living in a home in which no one cleans up... the home will accumulate dirt and garbage until 1 of 2 things happens... A) Someone performs some maintenance, or B) Your home deteriorates until it becomes unlivable. Same goes with your body. Let the trash build up, via too much stress and not enough rest, and you'll see plaque build up, high blood pressure, inflammation, and eventually, a heart attack.

Unfortunately, stress isn't easily quantifiable, and that makes it impossible to isolate and study scientifically. There is no proof of this causal connection because it would be impossible to prove it. This is just one of those times when population studies, case studies, an understanding of physiology, everyday observation, and common sense have to come together. It just makes too much sense.

How to fix it? Oh, this is way beyond the space I have left myself here. Rest more, spend more quiet time with yourself, make time for things that you truly enjoy, take time to relax when you eat. If you need to, see a psychologist, for real. Don't let yourself deteriorate. Let yourself help yourself. 

2. HDL and triglycerides.
On to more quantifiable matters. I group these lab values together because they provide an easy ratio to shoot for. Your HDL cholesterol should be as high as possible, preferably over 60, and triglycerides should be low, under 100. If you can get your HDL higher than your triglycerides, that would be your best case scenario. For example, an HDL value of 60 and a triglyceride level of 50 would be just about ideal. In other words, your HDL:triglyceride ratio should be more than 1. As you can see if you look more closely, the average heart disease patient in the referenced study had a disordered HDL:triglyceride ratio...

You can increase your HDL by eating more healthy fats, such as coconut oil, olive oil, butter, eggs, nuts, etc. Reduce your triglycerides by moderating your calorie intake, especially carbohydrates.

3. LDL Particle Number.
I've discussed this at length in a previous post, so I'll only briefly mention it here. The LDL your doctor tests you for is LDL concentration (LDL-C); I'm talking about LDL particle number (LDL-P). Reference my older article for a thorough explanation of just what that means. Suffice it to say, here, that a high LDL-C only sometimes indicates a high risk of heart disease, whereas LDL-P fills in those gaps and provides a clearer picture. You'll be hearing about this test more in the near future, you can bet on it. 

How to lower your particle number? The science is still young on this, but it appears that excess sugar intake can lead to a high particle number (1). So watch your sugar intake. Incidentally, excess sugar increases your triglycerides as well... sounds like a no-brainer to me.

4. Inflammation.
Inflammation may be at the root of all disease in the body, and heart disease is certainly no exception. Thanks in large part to the hideous food most of us eat, chronic inflammation has become the norm. Systemic inflammation can be measured via a lab value called C-Reactive Protein (CRP), which has been shown to predict cardiovascular disease "at least as well as cholesterol levels (2)". Yet I doubt you've EVER heard of it. Figures.

How to reduce inflammation? Eat better food. As a general rule, omega-6 fatty acids are inflammatory and omega-3s are anti-inflammatory. Eat fewer of the omega-6 type, found in refined vegetable oils and certain nuts. Eat more of the omega-3 type, found in fatty fish and pastured animal products. And of course, manage your stress.

5. High Blood Pressure.
High blood pressure, or hypertension, is a huge risk factor for cardiovascular disease. No doubt about it. And about 1 in every 3 adults has been given this diagnosis, so there's a good chance I'm talking about you or someone you know. Luckily, I've already written extensively on how to prevent hypertension, and about the problem with salt restriction. Together, these will explain all you need to know about preventing high blood pressure. In a nutshell: eat more potassium and lose weight. 

6. Blood sugar regulation.
Diabeetus. Don't get it. Diabetics have a much higher likelihood of developing cardiovascular problems than the average person. What causes diabetes is not really known, but I can make a great guess, thanks to Chris Masterjohn's presentation at last year's Ancestral Health Symposium... overconsumption of calories, coupled with a lack of antioxidant capacity. In other words, too much oxidative stress for the body to handle. 

Advice? Eat more fruits and vegetables, don't eat junk food that causes you to overeat, and lose weight if you can.

7, 8, and 9. Obesity, Smoking, and Lack of Physical Activity.
Okay, come on people. Everyone knows this. Get your weight under control, stop smoking, and move your body. This should go without saying and needs no explanation.

It's not that having high total cholesterol doesn't matter; I want to make this clear. But it's a sort of like measuring your body weight... Say you're a 5'5" woman, and your doctor weighs you in at 160 pounds. Knowing nothing else about you, he can't determine whether that's good or bad. He would have to look at your muscle mass, bone structure, body fat percentage, and the location of your body fat. In other words, your body weight may or may not indicate a problem. The same goes with cholesterol; having high cholesterol is an indicator that there may be a problem, but you need to be more thorough than that to know for sure.

Phew, there it is. That's nine things you can work on to prevent a heart attack. Nine! I think it's time to get to work. Overall advice? Eat more fruits and vegetables, eat healthy fats, don't eat too much sugar, lose weight, don't smoke, move your body... and most importantly, let yourself relax once in a while! 


  1. http://www.cobblescorner.com/wp-content/uploads/2011/01/Get-With-The-Guidelines_AHJ-Jan.2009.pdf

    Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines

    Of 231,986 hospitalizations from 541 hospitals, admission lipid levels were documented in 136,905 (59.0%). Mean lipid levels were LDL 104.9 ± 39.8, HDL 39.7 ± 13.2, and triglyceride 161 ± 128 mg/dL. Low-density lipoprotein cholesterol <70 mg/dL was observed in 17.6% and ideal levels (LDL <70 with HDL≥60 mg/dL) in only 1.4%.

    1. An even better study, thank you for that!

    2. This I think is the key point from the study

      ideal levels (LDL <70 with HDL≥60 mg/dL) in only 1.4%.

      What are your thoughts on ldl <70 thru diet and/or statins?

    3. I think having both of those things simultaneously is nearly impossible, and also unnecessary. Having an LDL that low alone would be impossible for many people, and I am definitely one of them. A moderate LDL in the low 100s is fine in my opinion, provided the other numbers like HDL and triglycerides are good.

      As far as statins go, I think they're very overrated. Yes, they lower cholesterol and they reduce cardiovascular mortality, but they only reduce all-cause death in a small segment of the population, namely those with preexisting heart disease or those whose cholesterol is extremely high.

    4. http://www.sciencedaily.com/releases/2013/08/130829112854.htm

      Statins May Slow Human Aging by Protecting Against Telomere Shortening: A Feature of Senescent Cells

      Not only do statins extend lives by lowering cholesterol levels and reducing the risks of cardiovascular disease, but new research in the September 2013 issue of The FASEB Journal suggests that they may extend lifespans as well. Specifically, statins may reduce the rate at which telomeres shorten, a key factor in the natural aging process. This opens the door for using statins, or derivatives of statins, as an anti-aging therapy.

      "By telomerase activation, statins may represent a new molecular switch able to slow down senescent cells in our tissues and be able to lead healthy lifespan extension," said Giuseppe Paolisso, M.D., Ph.D., a researcher involved in the work from the Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine at Second University of Naples in Naples, Italy.

      To make this discovery, Paolisso and colleagues worked with two groups of subjects. The first group was under chronic statin therapy, and the second group (control), did not use statins. When researchers measured telomerase activity in both groups, those undergoing statin treatment had higher telomerase activity in their white blood cells, which was associated with lower telomeres shortening along with aging as compared to the control group. This strongly highlights the role of telomerase activation in preventing the excessive accumulation of short telomeres.

      "The great thing about statins is that they reduce risks for cardiovascular disease significantly and are generally safe for most people. The bad thing is that statins do have side effects, like muscle injury," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "But if it is confirmed that statins might actually slow aging itself -- and not just the symptoms of aging -- then statins are much more powerful drugs than we ever thought."

    5. That's interesting for sure. But none of the statin trials I'm aware of have shown that people may live longer on them, unless you're a man who already has heart disease. I suspect there's more going on here than just telomerase activation.

  2. Your article is fantastic and you have provided the depth sight about the heart attack symptoms . Knowing and understanding that heart attack health issue is serious and potentially deadly can help to save your life or the life of someone you love. Shortness of breath that occurs especially without activity during sleep or rest could be a sign of a serious heart failure. Thank you for this nice article.

  3. Heart attack is a big problem these days. Last week my close neighborhood had died although he is young about 35 year old. I asked the reason and his brother tell about the heart attack. The heart failure or heart attack is symptoms are very common so Prevent heart attack symptoms by simple care and save your life and your loves one. Thank you for this nice article!!!