While standard screening and treatment recommendations address the basics, they might also be the reason many people still suffer from heart attacks today, even after 'appropriate screening'. Did you know that 70% of heart attack victims are considered low risk by traditional screening methods? Additionally, 3/4 of these victims only show mild coronary heart artery narrowing, which often goes undetected in common screening tests like stress tests. This suggests that a significant percentage of people have undiagnosed heart conditions. The good news is that we now have a customized approach tailored to each person's unique genetic makeup, going beyond the standard procedures. This approach, rooted in Functional Medicine or Precision Medicine, has recently revolutionized heart health outcomes. Leading institutions like the Cleveland Clinic Center for Functional Medicine, as well as premium private practices, are pioneering this new approach to heart disease prevention. This strategy emphasizes the interconnected systems in the body, ensuring no one is overlooked. Instead of a generalized method, the focus is on the individual, incorporating advanced biomarkers such as DNA, and the Gut microbiome, environmental toxins, and hormonal imbalances. These all play a crucial role in both heart and overall health. To fully grasp this, let's first explore the traditional approach:How to avoid a heart attack and prevent cardiovascular disease: Heart disease is the leading cause of death, but it's preventable. Here are some factors to consider and avoid:
Smoking
Smokers and those exposed to secondhand smoke face the highest risk due to this lifestyle habit. Chemicals in tobacco can damage heart circulation. Smoking not only reduces oxygen levels in the blood but also increases blood pressure and heart rate, as the heart must work harder. The benefits of quitting begin immediately, reducing heart disease risk from the very day one stops smoking. It's crucial to note that secondhand smoke is just as deadly, so addressing living situations with smokers is essential.Exercise
Engaging in regular, daily physical activity can significantly lower heart disease risk. Recent data suggest that the overall mortality reduction from staying active surpasses many other preventive measures. Therefore, maintaining an active lifestyle is paramount for both preventing and potentially reversing heart disease and strokes. Initiatives to prevent a heart attack should prioritize exercise, as it promotes the development of accessory arteries around those that might be compromised.If you've been inactive for some time, it's essential to start slowly and build up endurance. Aim for a minimum of 150 minutes of moderate aerobic exercise per week, starting with activities like brisk walking or jogging. A balanced routine would include half resistance or weight training and half cardiovascular exercises. This combination has proven to enhance blood flow and overall heart health. As you continue your regimen, your exercise tolerance, often referred to as VO2 max, will increase. This indicates that your body is efficiently delivering oxygen to cells, vital for all cellular processes. Ideally, working up to an hour of exercise per day can help ward off heart attacks.
Heart-Healthy Food:
Consume vegetables and fruits, aiming for at least 6 servings, legumes, lean meats and fish, low-fat or fat-free dairy foods, and healthy fats while avoiding excessive saturated fat. Adhere to the DASH diet and the Mediterranean diet, which means limiting salt, sugar, processed carbohydrates, alcohol, saturated fat (found in red meat and full-fat dairy products), and trans fat (found in fried fast food, chips, and baked goods).
Maintaining a Healthy Weight:
Being overweight, especially around the midsection, increases the risk of heart disease. Excess weight can lead to high blood pressure, high cholesterol, and type 2 diabetes. Additionally, it results in fat storage around your visceral or internal organs, which is another risk factor. Liposuction can't remove this internal fat, but lifestyle changes might. The body mass index (BMI) uses height and weight to determine whether a person is overweight or obese. A BMI of 25 or higher is considered overweight, over 30 is obese, and over 35 is morbidly obese. The risk of heart disease is higher if the waist measurement is greater than 40 inches (101.6 centimeters, or cm) for men and 35 inches (88.9 cm) for women.
Stress management:
Stress is one of the most overlooked and under appreciated causes of not only heart disease but overall aging and death in America. Stress creates cortisol a hormone that is the only one to increase with age. It breaks down tissue throughout the body and increases the release of inflammatory cytokines. These cytokines can trigger the immune system to over react leading to inflammation in our arteries. This leads to heart disease. These are all compound problems.
The Importance of Sleep:
People who don't get enough sleep have a higher risk of obesity, high blood pressure, heart attack, diabetes, and depression, as indicated in numerous studies. Most individuals require more than 7 hours of sleep per night. Prioritizing sleep is essential. Sleep apnea, characterized by loud snoring and periodic cessation of breathing at night (which may or may not awaken the individual), is associated with morning fatigue and headaches, as well as high blood pressure and a neck size greater than 17” in males. This condition is an independent risk factor for heart disease. Treatments for obstructive sleep apnea primarily focus on weight loss and the use of devices like CPAP (controlled positive airway pressure) to ensure oxygen reaches the lungs, which might otherwise be obstructed by fat tissue. Current innovations in treatment include oral appliances that, although not the gold standard like positive airway devices, aid in improving oxygen delivery by expanding the oral palate, allowing for better airflow.
High Blood Pressure, Diabetes, and High Cholesterol (Metabolic Syndrome):
Together, these conditions can damage the heart and cardiovascular system. Regular screenings can provide insights into your levels and associated risks, which need to be addressed. Blood pressure screenings should begin in childhood, with adults aged 40 and older undergoing annual blood pressure tests. Elevated blood pressure can cause turbulent blood flow in the arteries, potentially damaging vital organs like the heart, brain, and kidneys. If unchecked, this could lead to heart failure, heart attacks, and strokes, while also exacerbating diseases in the heart arteries. This micro-trauma makes it easier for cholesterol to deposit in them.Cholesterol screenings typically start at age 20. However, if a child is obese or presents other risk factors, such as hypothyroidism, screenings might begin earlier. Early detection facilitates prompt intervention. It's important to note that inflammatory cholesterol levels can be influenced by dietary choices, systemic inflammation, and genetic predispositions related to cholesterol processing.Diabetes is another significant risk factor for heart disease. If you're overweight or have a family history of diabetes, your healthcare provider might recommend early diabetes screenings. Otherwise, screenings generally begin at age 45, with follow-up tests every three years. Diabetes complications arise from the breakdown of glucose into advanced glycemic end products, which are highly inflammatory.Now that we've covered the basics, let's explore innovative approaches that offer individualized strategies. These novel methods aim to enhance our ability to prevent heart attacks and heart disease, moving towards making such diseases elective.
Genetics and your DNA:
Examining a panel of genes, now recognized for indicating the risk of developing heart disease, offers insights into potential interventions. If a specific gene isn't functioning optimally, we can assist by enhancing its function, supplementing the end product it might be underproducing, or guiding its function through lifestyle changes, supplements, and even medications. Take the LPa gene, for instance, which aids in breaking down clots in the arterial system. By identifying this genetic variant in individuals, we can understand that certain nutraceuticals might thin the blood, and modulating our omega-3 fatty acid balance could leverage its anti-inflammatory effects. Furthermore, avoiding certain foods can help mitigate risks. Imagine understanding your genetic predisposition, knowing that even if your ancestors had heart-related problems early in life, you can make different choices. If you've already had a cardiovascular event, you can take measures to prevent recurrence and be aware of potential risks your children might inherit. Another notable gene variant is CDKN2A/B, which, among other things, increases arterial calcification. Vitamin K2 has been proven to not only prevent heart and coronary calcification but also to direct calcium more effectively towards bones for better bone health. Insights like these guide us in choosing appropriate screenings, treatments, and dietary choices. This level of knowledge empowers a personalized and precise health approach like never before.
Environmental toxins:
In 2020, the American Heart Association (AHA) identified fine particulate matter as one of the most significant threats to cardiovascular health. Sources of exposure include fossil fuel emissions, flame retardants, and solvents. People living near industrial plants or in certain neighborhoods might face higher risks. Moreover, some foods, especially when processed, might introduce these toxins. For instance, certain fish, even if caught locally, are sometimes processed in countries like China, as highlighted in a recent TED talk about food quality.Mercury exposure from amalgam dental fillings is another environmental concern. Consuming a lot of sushi, especially larger fish varieties, can increase mercury levels in the body, elevating the risk of cardiovascular issues, including high blood pressure. We've identified individuals with these exposure histories, and after undergoing chelation detoxification, not only did their symptoms of chronic toxin exposure improve, but so did their blood pressure. Dietary choices matter too. Consuming vegetables like cilantro and parsley might help bind and remove these toxins. Additionally, nutrients like selenium, found in plant-based foods such as nuts, can aid in mercury excretion. These foods also have antioxidants, combating inflammation and providing multiple health benefits.
Gut microbiome:
The gut microbiome refers to the ecosystem of organisms residing in our digestive tracts. It's associated with various health conditions, including cardiovascular disease. Gut health is paramount for a heart-healthy lifestyle, especially considering certain metabolites produced from the consumption of inflammatory foods. For instance, a substance named TMAO, prevalent in individuals with diets high in eggs, milk, and meats, is linked not just to cardiovascular disease but also heart failure. Diets rich in saturated fats, as opposed to more plant-based diets, can lead to an increase in gram-negative bacteria in the gut, impacting our health differently. Recent studies highlight that the gut microbiomes of children differ significantly from older adults, an observation tied to aging and inflammation processes. A particular concern is LPS (an intensely inflammatory cell wall protein) which can permeate the gut and enter our system when the number of gram-negative bacteria rises due to certain foods. LPS has been implicated in causing ALS (a neurodegenerative disease) in animal models and has been associated with significant inflammation across many species, often linked to the 'leaky gut' syndrome. LPS is also correlated with autoimmune conditions. These findings underscore the importance of diet. In our practice, several patients have seemingly cured their autoimmune conditions by shifting from carb-heavy/processed foods to more plant-based, anti-inflammatory organic diets.
Hormone imbalances:
Did you know that women are three times more likely to die from a heart attack than men after the age of 65? The reason? After menopause, women's production of protective hormones—Estrogen, Progesterone, and Testosterone—dwindles. A decline in these hormones is not only linked to heart disease but also to deteriorating bone health, osteoporosis, and a shift in muscle-to-fat ratio. The metabolic syndrome, characterized by increased fat content, cholesterol, and waist size, heightens the risk for heart disease. This syndrome can be attributed to hormonal decline in both women and some men. Hormone replacement has been clinically associated with improvements in these parameters and reduced menopausal symptoms. Women have not only reported feeling better but have also showcased clinical health improvements. Current literature highlights the efficacy of these hormones in enhancing bone density, heart health, stem cell secretion, and cognitive health. Some women with specific genetic predispositions related to estrogen receptors or hormone production respond exceptionally well to post-menopausal hormone therapy. There were concerns about hormones leading to cancer, but recent studies, especially on bioidentical topical hormones, have dismissed these fears. Some studies, including those from the American Cancer Society, even indicate a reduction in certain female cancers, as thoroughly discussed in the book "Estrogen Matters." Men, too, can benefit from hormone therapy. Testosterone therapy, known for its muscle-building effects, prevention of muscle loss with aging, and benefits for bone health, has recently been recognized for heart disease prevention. Recent findings even suggest its potential in cardiac repair post heart attack. While these therapies offer expansive benefits, they aren't as commonly recommended for women as they are for men.When considering such treatments, remember that quality is paramount. Just as we tend to value what costs us more, it's essential to invest wisely in your health. Avoid choosing health services based solely on discounts or deals. Such decisions might be acceptable when purchasing electronics, for instance, but not for comprehensive healthcare. Ensure you consult well-trained Functional Medicine or Age Management physicians with a solid grounding in endocrinology to achieve the best results.
Learn more about Dr. Dinetz's approach to heart health.
