Have a Heart!
10 ways to treat your ticker better

Michele Sponagle

Jim Slotek thought he was in good health. But at age 42, the Toronto journalist suffered a heart attack during a pre-work squash game. It was a wake-up call for Jim to make some major lifestyle changes, and he did. Now 30 pounds lighter, he runs 20 to 25 miles a week, has quit smoking and has learned to handle the stress of his deadline-heavy life. Five years later, he and his heart are healthier for it.

In Canada, more than 90% of heart attacks are the result of coronary artery disease, a “plumbing” problem in which the lining of the coronary arteries that serve the heart become narrowed with fatty deposits, made up largely of cholesterol. Called atherosclerosis, this condition blocks the flow of blood, nutrients and oxygen to the heart. The blockage can lead to angina (chest pain) and heart attacks, which may leave the cardiac muscle damaged. These fatty plaques also make it easier for blood clots to become caught in the arteries, further reducing blood flow to the heart—and even causing death.

Fortunately, coronary heart disease (CHD) is the most preventable type, and mounting research backs up the positive impact of adopting healthier habits. A major study by the Canadian Institutes of Health Research found that serious lifestyle changes could reduce the risk of heart attacks by as much as 80%.

CHD was once considered a man’s disease, and while men are more likely to develop cardiac problems earlier in life, women eventually catch up. Their chances of cardiovascular disease increase four times after menopause. And the younger the female patient, the greater the risk of death she faces after a heart attack. So clearly, both genders need to be kind to their hearts. Here are 10 ways to do just that.

1. Live smoke-free

“Stopping smoking is the single most effective thing you can do for your heart,” says Dr. George Honos, spokesperson for the Heart and Stroke Foundation of Canada and director of non-invasive cardiology at Jewish General Hospital in Montreal. Smoking robs the heart of oxygen by accelerating the deposit of plaque in the arteries. To compensate for arteries that are narrower and less elastic, the heart has to work harder and pump faster. Smoking also appears to impair the blood vessels’ ability to produce “non-stick” chemicals that break down blood clots, according to researchers at Scotland’s University of Edinburgh.

2. Exercise your right to health

Being inactive is high on the list of major contributors to heart disease. Compared with sedentary types, physically active people have half the risk of coronary artery disease and are 35% to 50% less likely to develop hypertension, a risk factor for heart disease.

Exercise can reduce LDL (transported by low-density lipoproteins) cholesterol—the lousy kind that clogs arteries—and raise HDL (transported by high-density lipoproteins) cholesterol—the heart-healthy type that sweeps LDL away. It can also make the heart stronger and more efficient at pumping and help maintain a healthier weight and blood pressure, thereby reducing the burden on the heart. The Heart and Stroke Foundation recommends being physically active for 30 to 45 minutes a day on most (preferably all) days of the week.

3. Banish belly fat

We should all strive for a healthy weight, but the number on the scale is not the only consideration. “The thinking now is that where you carry fat may be far more important than weight itself,” says Honos. Those who are apple-shaped (with fat stored at the belly) are at a greater risk for heart disease than those who are pear-shaped (with excess fat around the hips and thighs). Apple shapes store more visceral fat, which lies deep within the body and releases potentially harmful chemicals. And because of its handy abdominal location, belly fat puts toxins into the blood easily. But this fat responds well to efforts to reduce it. In one study, a 15% decrease in total weight cut visceral fat by as much as 41%.

4. Keep tabs on your blood pressure

High blood pressure forces your hard-working heart to work even harder and may cause it to become thick and stiff. It can hurt the lining of the arteries, which already become less elastic as you age and less able to supply blood to the heart. Lowering blood pressure to acceptable levels can reduce heart attacks by an average of 20% to 25%. But, says Dr. Norm Campbell, a University of Calgary professor of medicine, 42% of affected Canadians don’t know they have hypertension. He recommends a blood pressure check for adults every two years at the very least.

5. Eat heart-smart

In terms of managing cholesterol levels, body weight and high blood pressure, all roads lead back to good nutrition. This means eating high-fibre, cholesterol-lowering foods such as whole grains, legumes, nuts and seeds. Deep-coloured fish such as salmon and sardines contain heart-protective marine omega-3 fatty acids, says Montreal registered dietitian Louise Lambert-Lagacé. Limit foods that contain lots of LDL-raising saturated fat (e.g., butter, cream, fatty red meat, hot dogs, side bacon, cheese). Avoid foods with harmful trans fats (hydrogenated margarine, commercial french fries, baked goods, snack foods and processed battered fish and chicken). Trans fats not only raise LDL, they also lower HDL. Eat plenty of fruit and vegetables, rich not only in crucial vitamins and minerals but in heart-healthy fibre and antioxidant compounds that protect against damaging rogue molecules called oxygen free radicals. Only 25% of us eat the recommended five to 10 servings a day.

Go easy on the salt: sodium causes the body to retain fluid, thereby upping blood volume and making the heart work harder to pump it. And watch the booze: have no more than one or two drinks a day. Too much alcohol can contribute to an increase in blood pressure, weight and fatty acids in the blood known as triglycerides, which may elevate the risk of coronary heart disease.

6. Deal with diabetes

Up to 80% of people with diabetes die as a result of a heart attack or stroke, and diabetic women face a threefold risk of heart attack. The persistent high blood sugar levels of diabetes damage arteries and small blood vessels and accelerate artery-plugging atherosclerosis.

If you already have diabetes, modify your other cardiac risk factors: smoking, lack of exercise, high blood pressure, excess weight and high cholesterol. Have a diabetes checkup every three months and a full evaluation once a year. If you don’t have diabetes but are 40 or older, get your blood sugar levels checked soon, and thereafter every three years—especially if you have a high body mass index, high blood pressure, elevated cholesterol or a family history of diabetes.

7. Manage stress and depression

People with high levels of stress may have higher cholesterol and blood pressure levels,” says Honos. They may also have more platelet cells in their blood, which can promote the formation of obstructive clots. “Stress is hard to avoid, but how you handle it is key,” he adds. To alleviate stress, Honos suggests exercise, meditation and low-key hobbies such as gardening. Pets have been shown to help people cope with stress and even lower blood pressure.

Depression needs to be addressed, too. Studies of heart attack patients report that 30% to 40% show symptoms of major or minor depression. And patients who are depressed after a heart attack have three to four times the risk of experiencing additional heart problems. It’s also a wise idea to keep your temper in check. In one study, the risk of having a heart attack more than doubled in the two hours following an episode of moderate or intense anger.

8. Get your shut-eye

During sleep, the heart takes the opportunity to do repair and maintenance work that readies it for optimal performance, according to studies by Toronto cardiologist Dr. Michael Sole. Sleep-deprived people have a higher rate of heart failure and an increase in levels of an inflammatory substance called C-reactive protein, which may elevate the risk of heart disease. Experts recommend seven to eight hours of sleep a night for men and six to seven for women.

9. Aspirin for those at risk

If your family history and other health factors place you squarely in the high-risk category, a daily dose of acetylsalicylic acid (ASA: brand name Aspirin) might help prevent a heart attack. A recent study reported a 32% reduction in heart attacks among men taking ASA. While ASA did not show a significant heart effect in women, strokes dropped by 17%. For some people, however, ASA has harmful effects, such as stomach irritation and bleeding in the GI tract, so consult your doctor first.

10. Brush up on your oral hygiene

Two of the cheapest defensive weapons are your toothbrush and dental floss. One study of Canadians (aged 36 to 69) found that those with severe gum disease (known also as periodontal disease) were at three to seven times more risk for fatal heart disease. Bacteria entering the bloodstream from the mouth can invade the heart. These microbes may promote artery-damaging inflammation as well as contribute to clot formation by binding to the fatty deposits in arteries.