How the shock of prostate cancer diagnosis raises risk of heart attack by up to 11 times

The shock of being diagnosed with prostate cancer greatly increases the likelihood of a fatal heart attack, researchers have warned.

Men are up to 11 times more likely to die from cardiac problems in the week after being told they have the disease, with younger men and those with no history of heart disease at particular risk.

The threat stays high for the first year after diagnosis and the likelihood of suicide is also raised, a Swedish study involving more than four million men found.

Prostate cancer kills 10,000 British men every year and researchers say it is vital doctors are aware of the dangerous effects of the stress of diagnosis.

They said: 'Careful monitoring of the psychological health of newly diagnosed prostate cancer patients is needed.

'It is not unreasonable to believe that similar effects could be observed among women with breast cancer.'

The researchers analysed the medical records of 4.3million men, including 170,000 diagnosed with prostate cancer between 1961 and 2004, the journal PLoS Medicine reports.

In Britain, Dr Sarah Cant, of the Prostate Cancer Charity, urged caution over the findings.

She said: 'The study fails to take into account several well established risk factors for cardiovascular and suicide, such as age, high blood pressure or mental illness.

'It is important to remember that even if further research did prove a strong association between a diagnosis of prostate cancer and cardiovascular disease or suicide, this does not mean that being diagnosed with prostate cancer causes cardiovascular disease or men to commit suicide.

'There is much research still to be done do understand why possible link exists between these two events.'

But she added: 'This research does underline the need for all men diagnosed with prostate cancer to be given information about, and access to, the support services they need to help them cope with impact that the diagnosis and treatment of the disease can have.'


P.S. protect your HEART by eating Vitamin C and Vitamin D rich foods and fruits.



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Suppressing Anger May Cause Heart Problems

When people think they're treated unfairly at work, does the way they deal with their anger affect the health of their heart?

THIS STUDY involved 2,755 male employees, 41 years old on average, who never had suffered a heart attack. About a fourth of them were supervisors. In the next 10 years, 47 had a heart attack or died of heart disease. Men who used avoidance tactics to deal with conflict or unfair treatment at work -- including walking away from the situation or letting things pass without saying anything -- were twice as likely to have had a heart attack or died of heart disease as were men who openly expressed their anger. Risk was highest for those who walked away.

WHO MAY BE AFFECTED? Men who experience job-related stress or anger. Some studies have linked emotionally upsetting events, especially those involving anger, with heart problems. CAVEATS Behavioral data came from the men's responses on a questionnaire. The study did not suggest what might be healthier coping strategies.

FIND THIS STUDY Nov. 24 online issue of the Journal of Epidemiology & Community Health.

P.S. Protect your HEART by eating Vitamin C and Vitamin D rich foods and fruits.

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6 Best Habits for a Healthy Heart

The cardiologist who created the South Beach Diet shares his top advice for living healthy.

I'm 62 and, thankfully, have never been hospitalized, nor can I remember calling in sick. I still work 12-hour days, walk the golf course, hit the heavy bag, and, not too long ago, even played ice hockey. Other than some minor colds, flus, and heartburn, I have been very healthy, and I take no regular medications. How I've managed this isn't a secret. My philosophy is in my books. But for this special issue of Prevention, I want to summarize it for you--what I eat, how I exercise and beat stress, even my own advice that I struggle with. Here's my personal Rx--feel free to make it your own:

Eat three squares and a snack: I start most days with a three-egg omelet (one yolk and whites) and some green tea with a scoop of Benefiber (a natural fiber supplement). For lunch, I usually order baked salmon and grilled veggies from a nearby restaurant. I never eat fast food. And for dinner, my wife, Sari, typically makes fish or chicken with veggies. We eat little starch at home. If I get hungry during the day or when I'm traveling, I'll have a mozzarella stick, fruit, wasabi-coated soy nuts, other nuts, or a high-fiber bar.

Indulge in moderation: I love dark chocolate. I keep a stash in the office and usually eat a piece after lunch. I try to limit myself to that single daily indulgence, although I also have a weakness for rugelach, a rich pastry my wife buys when our boys come home from college. If I'm lucky, they consume most of it before I have the opportunity to yield to temptation.

Exercise early and regularly: On weekdays, I'm up and in my home gym by 6:15 am. Three days a week, I use a machine called the Power Plate, which vibrates as I do various exercises. It helps warm up my old bones, while building balance and core strength. Then I'll do Pilates. This workout normally lasts an hour. The other two weekdays I'll do 20 to 30 minutes of interval training on an elliptical machine. This type of high/ low intensity is great for the heart. On weekends, I golf, play tennis, or occasionally do a boxing workout.

Go easy on the supplements: I believe a good diet will provide most of the essential nutrients I need. So, besides Benefiber, the only supplements I take are fish oil, turmeric, and Cold-Eeze when I travel. The omega-3 fatty acids in fish oil protect the heart, while some doctors I respect believe the curcumin in turmeric helps prevent Alzheimer's disease. Cold-Eeze contains zinc, which may prevent colds or lessen their symptoms.

Prioritize sleep: I get at least 7 hours per night. I also believe in naps. If I have an evening social engagement, I'll nap for 30 minutes before going out.

Cultivate closeness: I've been married for 28 years, and my wife and I have not only a wide circle of friends but also two much-loved sons who come home often. We all try to spend a few weeks vacationing together in the summer. Studies show that a strong social and family network is not only helpful for your general health but also for preventing heart disease.

Good news for your heart
Read Agatston's blog for the latest advice and ask him questions at prevention.com/dragatston.


By Arthur Agatston , Arthur Agatston, MD, is a preventive cardiologist and Prevention's "From the Heart Doc." He is also a member of Prevention's medical advisory board.



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Tall Tales of the Heart

Every day, patients ask my opinion about various treatments and remedies they've found on the Internet. Just as there are stories about mammoth alligators lurking in Manhattan's sewers, urban legends regarding heart disease and what causes it abound. Here are the verdicts on a few I've heard lately:

You can stop a heart attack by coughing. True.

Coughing alternately increases and decreases chest pressure, which can raise a slow heart rate, boost cardiac output, and sometimes even stop an arrhythmia. It's called "cough CPR." If you have coronary disease and feel palpitations and are lightheaded, take deep breaths and cough repeatedly. This may support your circulation a bit longer until help arrives.

Learn how to lower your heart attack risk from the experiences of other patients.

Roller coasters are dangerous for your heart. True.

That's why there are all those warning signs at Walt Disney World. If you have a heart condition, any thrill ride can trigger a rush of adrenaline that could cause an irregular heartbeat and even a coronary. People with heart disease should stick to It's a Small World.

The higher your cholesterol, the greater your chance of heart disease. Sort of true.

Total cholesterol tells us which populations have higher risks of heart attack. For example, Americans' average cholesterol levels are much higher than those of the Chinese, and we have a much higher rate of heart attack. However, if you look at the population of this country alone, total cholesterol is a very poor predictor of heart disease risk. Studies show that total cholesterol levels among people who've had heart attacks are almost the same as those of people who haven't. You have to look at the types of cholesterol (HDL, LDL) and their size. These are the most helpful measurements.

You're at risk of a heart attack if there's a crease in your earlobe. Perhaps.

This phenomenon is something I look for and have observed in patients. Some studies show that if you have a pronounced crease running diagonally across one or more lobes, your body's level of elastin is low. Elastin is a protein that affects blood vessel function. It's particularly abundant in your largest artery, the aorta.

The balder the man, the greater his heart attack risk. Probably false.

Balding is triggered in a roundabout way by high levels of testosterone. High testosterone levels are good for a man's sex drive and for lean muscles and good bone mass, but low testosterone levels are associated with prediabetes and type 2 diabetes, both risk factors for heart disease. Although some earlier studies have suggested an association between baldness and heart disease, more recent ones refute the notion.

Follow Dr. Agatston's 6 tips for a healthy heart.

You're probably a bit surprised that so many of these supposed urban legends have an element of truth to them. But keep in mind that even though there may be some science there, it's soft science. Cardiologists routinely do so many tests to assess heart disease risk that oddball theories like these, even if partially true, become relatively minor. Now, about those alligators ...

Arthur Agatston, M.D., an associate professor of medicine at the University of Miami Miller School of Medicine, is the author of The South Beach Diet Supercharged: Faster Weight Loss and Better Health for Life. He maintains a cardiology practice and research foundation in Miami Beach, Fla.

Good news for your heart

Read Agatston's blog for the latest advice and ask him questions at prevention.com/dragatston.

Erectile Dysfunction Often a Sign of Heart Disease, Diabetes

Erectile dysfunction, once thought to have primarily psychological causes, is now recognized to often stem from physiological problems such as poor blood flow to the penis. Increasingly, research indicates that ED can be an early warning sign of coronary artery disease, which also results from obstructed blood flow and, if untreated, can lead to heart attacks and stroke. Recent studies—including two published online today—also link sagging erections to diabetes, which has negative effects on cardiovascular health. More than half of American men age 40 to 70 suffer from erectile dysfunction, so that's a lot of men who may be at risk of vascular disease—and may not realize it.

"Symptoms of erectile dysfunction seem to occur three to four years before symptoms of coronary artery disease," says Robert Kloner, a cardiologist at Keck School of Medicine in Los Angeles, Calif. Researchers first started tracking a link between erectile dysfunction and cardiovascular problems in the mid-'90s, and in the last few years they have recognized that erectile dysfunction precedes and is therefore predictive of future cardiovascular problems.

"Patients should not [ignore] the presence of erectile dysfunction. And physicians should always investigate the presence of ED in high-risk patients," notes Carmine Gazzaruso, that study's author and a professor at the University of Pavia in Italy. In 2005, leading physicians published a consensus statement that every man who reports having erectile dysfunction without an obvious cause should be screened for vascular disease.

In diabetics, it turns out, ED may be even more of a red flag than it is in other men. Two new studies published today in the Journal of the American College of Cardiology suggest that men with both diabetes and erectile dysfunction face a greater cardiovascular risk than men with erectile dysfunction alone. "It's a real wake-up call for men with both erectile dysfunction and diabetes," says Allen Seftel, a urologist at Case Western University. In light of the new findings, he says, diabetics who develop ED should be especially prompt about seeking medical attention and getting tested for cardiovascular disease.

One of the studies, led by Gazzaruso, tracked diabetic men with silent (symptomless) coronary artery disease for several years. It found that those who initially had erectile dysfunction were more likely to experience a major cardiac event such as a heart attack than those who didn't. In the ED-affected group, 61.2 percent had a major heart problem during the four-year study. By comparison, 36.4 percent of men who didn't have erectile dysfunction had major heart problems.

The other study, conducted by researchers in Hong Kong, followed 2,306 men with diabetes without cardiovascular problems for an average of four years, finding that men who had erectile dysfunction had about a 60 percent higher risk of developing cardiovascular problems such as heart attack, heart failure, and chest pain. "Even mild symptoms of erectile dysfunction can mean your glucose, blood pressure, and lipid levels are very abnormal," says Peter Tong, a professor at the Chinese University of Hong Kong and the author of the study.

Making some simple changes, experts say, might save a man's life—not just his sex life. Men with erectile dysfunction—especially those who also have diabetes—need to be especially vigilant about finding ways to eat a healthy diet, exercise regularly, and abstain from smoking. A 2004 study found that men who started exercising in midlife had a 70 percent reduced risk of erectile dysfunction relative to men who remained sedentary. In that study, about a third of obese men with erectile dysfunction had regained their sexual function after two years. "Getting off the couch will not only reduce the risk of diabetes and cardiovascular disease, but it can also prevent erectile dysfunction," says Elizabeth Selvin, a Johns Hopkins researcher. Last year, Selvin found men who were physically inactive were much more likely to have ED than men who were active.

The most important thing for men, however, is simply to get to the doctor if they have erectile dysfunction. "A lot of men still don't feel comfortable talking to their doctor about it," says Kloner. Yet avoiding the doctor might mean passing up access to powerful medications that can help counteract flagging erections and clogging arteries. For example, a class of drugs called PDE5 inhibitors—which includes Viagra (which just celebrated its 10th birthday), Levitra, and Cialis—can help men achieve erections by increasing blood flow to the penis, while statins, if used appropriately, can lower LDL cholesterol levels. The Italian study found that the cholesterol-lowering medications could cut the risk of hear problems by a third, and it hinted that PDE5 inhibitors might have a protective effect as well.


P.S. boost your overall health by eating Vitamin C and Vitamin D rich foods and fruits.



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Signs of Heart Attack That Many Patients Don't Know

Nearly half of heart patients don't fully grasp the symptoms of an attack. Make sure you know them.

Monday's news that many people with heart disease may be lacking in their knowledge about the signs of a heart attack led U.S. News to believe the general public might benefit from a refresher, too. In fact, two colleagues recently wrote that both sexes could stand to be a bit more heart aware: Deborah Kotz blogged about how women having heart attacks are often slow to get help, and Adam Voiland noted that a not-so-subtle clue, erectile dysfunction, might be a sign of heart disease or diabetes. Vincent Bufalino, cardiologist and spokesman for the American Heart Association, offers up the must-know information that could save your ticker—and your life—should a heart attack strike.

Signs and symptoms that could indicate a heart attack include:

* Exertion-related discomfort—say, going up the stairs or carrying a heavy box—such as pressure, burning, squeezing, or tightness in the chest

* Radiating pain or pressure into either arm, the neck, or the jaw

* Breathlessness along with profound fatigue or exhaustion. (Women, in particular, tend to experience these more subtle signs.)

If you develop any of these symptoms, it means you should call 9-1-1 right away, says Bufalino. "We don't want people driving in [to the hospital] and having a sudden cardiac event in the car where nothing can be done." That goes for having a worried spouse ferry you to the hospital, too. Significant damage can be avoided the sooner you get medical help.

And don't try to tough it out, either, says Bufalino. "You don't need that elephant standing on your chest to come in." If you're downing antacids because you think you're having heartburn but the burning isn't subsiding, make that call for medical help. It can't hurt to pop an aspirin while you're waiting, he adds. "The paramedics will give you aspirin first thing."



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Stifled Anger at Work Doubles Men's Risk for Heart Attack

Men who bottle up their anger over unfair treatment at work could be hurting their hearts, a new Swedish study indicates.

Men who consistently failed to express their resentment over conflicts with a fellow worker or supervisor were more than twice as likely to have a heart attack or die of heart disease as those who vented their anger, claims a report in the Nov. 24 online edition of the Journal of Epidemiology and Community Health.

In fact, ignoring an ongoing work-related conflict was associated with a tripled risk of heart attack or coronary death, the study of almost 2,800 Swedish working men found.

"It is not good just to walk away after having such a conflict or to swallow one's feelings," said study co-author Constanze Leineweber, a psychologist at Stockholm University's Stress Research Institute.

The study did not specify good ways of coping with work-related stress -- "We just looked at the bad side of coping," Leineweber explained.

The study doesn't advocate being belligerent at work, Leineweber cautioned. "Shouting out, and so on, is not proper coping," she said.

But venting one's anger outside of the workplace didn't seem to take a cardiovascular toll, at least. "Getting into a bad temper at home" was not associated with an increased risk of heart attack or cardiac death, the study authors found.

The findings echo those from a study published last year in the journal Occupational and Environmental Medicine. That study, also from Sweden and involving more than 3,100 men, found that having an overbearing or incompetent boss boosted workers' odds for angina, heart attack and death.

Leineweber stressed that what is true for men might not be true for female workers. While the study included more than 2,000 women, too few of them had heart attacks or died of heart disease to allow conclusions to be drawn.

"Earlier studies have indicated that women use different coping strategies than men," Leinewaber said. "So for women, strategies such as going away and not saying anything might not be good."

Women in general appear to handle stressful situations better than men, noted Dr. Bruce S. Rabin, director of the Healthy Lifestyle Program at the University of Pittsburgh Medical Center.

"Social interaction, having people to talk to, is extremely important," Rabin said. "If you keep things to yourself, you have high levels of stress hormones. Women are more comfortable in social interactions than men. They talk more, while men tend to keep within themselves."

A study, conducted by the Swedish researchers in 2005, found that women did not have the same levels of cardiovascular risk factors as men, Rabin noted.

There is no one key to handling on-the-job stress, because the level of stress depends on an individual's environment, at work and in the home, he said.

"Work environment is important," Rabin said. "You need interaction between people so that everybody feels they can express their opinions about their work. You shouldn't come to work with a feeling that no one cares."

"And when you go home, it is very important to share your feelings with whomever you are sharing with," Rabin added. "Also, you should understand that children learn from the behavior of parents. You can have a meaningful effect on the long-term health of children by being good role models. The message is that the environment you culture can affect not only your health but also the health of those who are important to you."



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Ginkgo Won't Prevent Heart Attack, Stroke in Elderly

Among people aged 75 and older, the herbal supplement Ginkgo biloba does not prevent heart attacks, stroke or death, a new study finds.

There is some evidence that the popular herbal remedy might help prevent the leg-circulation problem known as peripheral artery disease, however.

Ginkgo contains nutrients called flavonoids, which are also found in fruits, vegetables, dark chocolate and red wine, and are believed to offer some protection against cardiovascular events, the researchers say. The supplement, which is popular in the United States and Europe, has been touted to improve memory, and to prevent dementia, heart disease and stroke.

However, "ginkgo had no benefit in preventing heart attack or stroke," said study lead researcher Dr. Lewis H. Kuller, distinguished university professor of public health and professor of epidemiology at the University of Pittsburgh.

"But, surprising to us, was that the results were consistent with the observations in Europe that ginkgo appeared to have some benefit in preventing peripheral vascular disease," he said.

This could be due to flavonoids acting as both antioxidants and also causing blood vessels to expand, Kuller said.

The report was released online Nov. 24 in advance of publication in an upcoming print issue of the journal Circulation. Last year the same University of Pittsburgh team reported that ginkgo biloba had no effect on preventing dementia.

For their latest study, Kuller's group randomly assigned 3,069 patients to 120 milligrams of highly purified ginkgo biloba or placebo, twice a day as part of the Ginkgo Evaluation of Memory Study.

Over the six years of the trial, 385 participants died, 164 had heart attacks, 151 had strokes, 73 had mini-strokes ("transient ischemic attacks") and 207 had chest pain, the researchers found.

There was no significant difference between those taking ginkgo or placebo for any of these outcomes, Kuller said.

However, among the 35 people who were treated for peripheral artery disease, 23 received placebo and 12 were taking ginkgo -- a statistically significance difference, the researchers noted.

About 8 million Americans have peripheral artery disease, which typically affects the arteries in the pelvis and legs. Symptoms include cramping and pain or tiredness in the hip muscles and legs when walking or climbing stairs, although not everyone who has PAD is symptomatic. The pain usually subsides during rest.

"This study demonstrated that there were absolutely no benefits of ginkgo biloba in reducing cardiovascular events such as heart attack or stroke or in reducing death due to cardiovascular disease," said Dr. Gregg A. Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles.

"Individuals interested in maintaining cardiovascular health should stick to interventions that have been proven to be beneficial, including not smoking, engaging in regular exercise, and maintaining healthy weight, blood pressure and cholesterol levels rather than taking herbal supplements," Fonarow said.

Mark Blumenthal, founder and executive director of the American Botanical Council, an independent non-profit educational organization, pointed to the study's more positive outcome.

"I believe it is important to emphasize that the results of this current exploratory trial do not in any manner reduce or negate the existing positive results of ginkgo biloba as an effective treatment in peripheral artery disease patients, which has been evaluated, confirmed, and approved by government regulatory drug authorities in leading Western European countries like Germany and France," he said.

In addition, Blumenthal said, the trial showed that ginkgo biloba was safe and well-tolerated.

P.S. protect your heart naturally by eating Vitamin C and Vitamin D rich foods and fruits.

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Cholesterol Plays Role in Heart Failure Risk

Abnormal cholesterol levels can significantly increase the risk of heart failure, a new study has found.

U.S. researchers analyzed data on 6,860 participants in the National Heart, Lung, and Blood Institute's Framingham Heart Study. None of the participants, average age 44, had coronary heart disease at the start of the study. After about 26 years of follow-up, 680 people had developed heart failure.


The incidence of heart failure was:

* 12.8 percent in participants with low levels of high-density lipoprotein (HDL, or "good") cholesterol. Low HDL is less than 40 milligrams per deciliter (mg/dL) in men and less than 50 mg/dL in women.

* 6.1 percent among participants with desirable HDL levels (at least 55 mg/dL in men and 65 mg/dL in women).

* 13.8 percent in participants with high levels (at least 190 mg/dL) of non-HDL cholesterol, which includes triglycerides and low-density lipoprotein (LDL, or "bad") cholesterol.

* 7.9 percent in those with desirable levels (less than 160 mg/dL) of non-HDL cholesterol.

When the researchers factored in age, sex, body mass index, blood pressure, diabetes and smoking, the risk of heart failure was 29 percent higher in participants with high non-HDL cholesterol than in those with lower levels, and 40 percent lower in those with high HDL-cholesterol than in those with lower levels.

Further analysis showed that the risk of heart attack was 13 percent higher in participants with high non-HDL cholesterol and 25 percent lower in those with high HDL cholesterol.

"This study goes a step further in implicating cholesterol levels (both HDL and non-HDL) in heart failure and suggests that cholesterol-altering therapy may have long-term benefits in preventing heart failure above and beyond its effects on preventing [heart attack]," study senior author Dr. Daniel Levy, director of the Framingham Heart Study, said in a news release from the American Heart Association.


P.S. maintain good cholesterol by eating Vitamin C and Vitamin D rich foods and fruits.



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Birth Control Pills May Cause a Heart Attack or Stroke

Yaz, Yasmin and Ocella are popular birth control pills that have been linked to alarming side-effects such as heart attacks and strokes. Reportedly, Drospirenone, the key ingredient in Yaz, Yasmin and Ocella is responsible for raising the risk of heart attack and stroke. It is important to note that according to some reports, no other birth control pill contains Drospirenone.

Yaz, Yasmin and Ocella can cause strokes and heart attacks by creating abnormal blood clots. Ordinarily, blood clots serve the important function of stopping bleeding from cuts. Within the body, the blood clotting process repairs damage to the skin, blood vessels and other body tissues. It has been reported however, that the use of Yaz, Yasmin and Ocella can result in unnecessary blood clotting within a blood vessel, vein or artery. If the blood clot causes a blockage near the heart, the clot can prevent blood flow from reaching the heart, resulting in a heart attack. If the blood clot creates a blockage in the brain, the blockage can cause a stroke. It has been suggested that the combination of chemicals and hormones in Yaz, Yasmin and Ocella can increase the risk of blood clots by more than 600%.

A leading personal injury law firm, Weitz & Luxenberg is offering free, online case reviews to those who have suffered side-effects from using Yaz, Yasmin or Ocella. For a free case review, send an e-mail to kumarsingh011@gmail.com. In your e-mail, please state the following:

# Your name
# Your date of birth
# The start date and end date of your use of Yaz, Yasmin or Ocella
# A description of the side-effects that you experienced


About Weitz & Luxenberg lawyers


Weitz & Luxenberg is a leading personal injury law firm. The firm has won more than $1 billion in a wide range of personal injury cases. The cases that the firm handles include defective products such as Yaz birth control pills and asbestos cancer cases such as mesothelioma. Weitz & Luxenberg has successfully represented shipyard workers, boilermakers and others who have been diagnosed with mesothelioma from job-related asbestos exposure.

Weitz & Luxenberg has been recognized as the "Best Lawyers of New York" by New York Magazine.

Remember: The law limits your time to file a lawsuit. Don't lose your rights by waiting too long to explore your legal options.



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Abnormal Cholesterol Raises Heart Failure Risk

Abnormal levels of cholesterol have long been associated with an increased risk of heart attacks and stroke, and now you can add heart failure to the list. Results of a new study show, among other findings, that the risk of heart failure is 29 percent higher in individuals who have high LDL (low-density lipoprotein) cholesterol and triglyceride levels than those who have lower levels.

Heart failure, also known as congestive heart failure, is a condition in which the heart is unable to pump a sufficient amount of blood to meet the body’s needs. An estimated 5.7 million Americans have heart failure and experience its symptoms of fatigue, shortness of breath, swelling of the ankles and lower legs, heart palpitations, and cognitive difficulties. The most significant risk factor for heart failure is high blood pressure, while others include coronary artery disease (characterized by narrowed arteries), heart attack, diabetes, and irregular heartbeat.

This latest study, which was led by Dr. Daniel Levy of the National Heart, Lung and Blood Institute, evaluated data from 6,860 individuals who had participated in the Framingham Heart Study and who were free of heart disease when they entered the study. All of the subjects were followed for an average of 26 years.

Dr. Levy and his team found that 680 of the participants had developed heart failure. When the researchers analyzed the data for these patients, they found that 12.8 percent of them had low levels of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol), and only 6.1 percent had desirable levels (defined as 55 mg/dL or greater in men and 65 mg/dL or greater in women). Levels of LDL cholesterol (“bad” cholesterol) and triglycerides were high in 13.8 percent of the patients and desirable (less than 160 mg/dL) in only 7.9 percent.

After the investigators made adjustments for age, sex, body weight, smoking, blood pressure, diabetes, and other factors, they found that patients who had high levels of LDL had a 29 percent greater risk of experiencing heart failure, while patients who had high levels of HDL had a 40 percent reduced risk of heart failure. When heart attacks were factored in, the scientists found that high cholesterol levels were still associated with a statistically significant risk of heart failure.

The results of this study suggest that improving cholesterol levels through use of cholesterol-lowering drugs (mostly statins), instituting dietary changes, getting regular exercise, stopping smoking, and limiting intake of alcohol can not only help prevent heart attack and stroke but heart failure as well.


P.S. protect your heart naturally by eating Vitamin C and Vitamin D rich foods and fruits.




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One heart attack is enough

Too many heart attack victims don’t exercise as instructed, stop smoking, or lose weight to prevent a second heart attack. Many patients fail to follow Doctor's orders.

Ask survivors to describe the impact of their heart attacks, and a common theme is that it was a “wake-up call.”

Unfortunately, many people seem to hit the snooze alarm once the danger has passed. Some ignore advice that can protect the heart; others gradually let it fall by the wayside.

In a study of nearly 2,500 heart attack survivors across the country, researchers looked at the so-called discharge instructions given to these men and women when they left the hospital. These instructions should cover everything from who to call in case of an emergency to what long-term steps to take to prevent another heart attack.

One month after their attacks, more than 90 percent of the participants said they were taking all of the medications on the discharge list. In contrast, less than 50 percent were exercising as instructed, had stopped smoking, or were losing weight. Just one-third had enrolled in a cardiac rehabilitation program, one of the best things you can do to prevent a second heart attack.

Does following discharge instructions make a difference? Participants who followed fewer than half of their discharge instructions were 68 percent more likely to have chest pain with activity or stress (angina) a year after their heart attacks than people who followed all or most of the instructions (American Heart Journal, March 2009). Angina is a sign of active coronary artery disease.

Preventing the next one

On a personal level, a heart attack is an all-too-real sign that you aren’t going to live forever. Healthwise, it is an outward sign that you’re living with atherosclerosis. This disease stiffens and narrows arteries throughout the body. In addition to setting off a heart attack, it can cause a stroke, damage the kidneys and lead to problems in the legs.

Stiff, cholesterol-clogged arteries make your heart work harder. So does the scar tissue that forms in the part of the heart damaged by a heart attack. Keeping atherosclerosis at bay and strengthening the heart muscle will help you feel better, ward off a future heart attack or stroke and lessen the chances that the damage will evolve into heart failure.

There’s no magic wand you, or your doctor, can wave to make atherosclerosis go away. But you can stop it from getting worse, and maybe even reverse it, by exercising more, shifting to a healthier diet, losing weight if needed, quitting smoking, reducing stress and taking medications as needed.

Power of prevention

Simple steps started before middle age could demote heart disease, stroke, and other cardiovascular diseases from the leading cause of death in America to a distant runner- up. Two long-term studies suggest that most cases of high blood pressure and heart failure could be avoided if people made better choices.

In a 14-year study of female nurses, six factors emerged as important ways to keep blood pressure in check: a healthy diet, daily exercise, a healthy body weight, moderate alcohol intake (no more than one drink a day), sparing use of over-the-counter painkillers and taking folic acid every day. The researchers estimated that if all women adopted these six practices, almost 80 percent of cases of high blood pressure would be avoided.

A 22-year study of male physicians found an equally large reduction in heart failure, a common consequence of high blood pressure or heart attack, with maintaining a healthy body weight, not smoking, regular exercise, moderate alcohol intake (one to two drinks a day), having cereal for breakfast and eating plenty of fruits and vegetables.

Getting help

For some people, a heart attack is a true wake-up call. Take Jim Lehrer, the host of PBS’ “NewsHour.” In a cover story in the American Heart Association’s Heart Insight magazine, Lehrer credits his 1983 heart attack with changing the way he lived. He stopped smoking, started exercising and eating better, and he took time to relax.

Many people head the other direction. Let’s face it, a heart attack can be a frightening life changer. It affects your work, your play, your relationships with family and friends. A twinge of chest pain can rev up worries that you’re having another heart attack. And it can be extremely difficult trying to make major changes in diet, exercise, weight, smoking and other choices that are meant to protect you against another heart attack. It’s no wonder that some heart attack survivors slide into the fog of depression.

One reason why cardiac rehabilitation is such a good undertaking is that it helps you cope with all the aspects of life after a heart attack. It offers support, education, encouragement, connections with others who are going through the same thing you are, and help with exercise and diet. Think of it as one-stop shopping for healing the heart.

P.S. protect your heart naturally by eating Vitamin C and Vitamin D rich foods and fruits.

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Less Tobacco Smoke Means Fewer Heart Attacks

Tobacco deaths rarely make headlines, but the World Health Organization says tobacco smoke kills one person every six seconds. Studies have shown that tobacco smoke is not just deadly for tobacco users. Those who breathe in smoke from other people's cigarettes also have an increased risk for heart attacks. A new study shows that smoking bans have significant health benefits for everyone.

Virginia is the latest U.S. state to ban smoking in restaurants and bars. As communities across the country ban smoking in public places, fewer people are dying from heart attacks.

A study earlier this year in Pueblo, Colorado by the Centers for Disease Control showed heart attacks dropped by 40 percent after a law was enacted to ban smoking at work or in public spaces. New research now supports this and similar studies.

Dr. Neil Benowitz is one of the researchers on this latest report. "If you expose someone to second hand smoke, within minutes you see blood platelets and blood clotting increasing," he explains. "We see that the function of the blood vessels is impaired."

And that is when heart attacks can occur. Dr. Lynn Goldman is the report's principal author. "We did conclude a cause and effect relationship between heart disease generally and second hand smoke exposure," she says.

"Even a small amount of exposure of second hand smoke can increase blood clotting, can constrict blood vessels and can cause a heart attack," adds Dr. Benowitz.

The researchers examined data from 11 studies in various countries. They found that smoking bans reduced heart attacks by anywhere from six percent to nearly 50 percent.

"One of the things to understand and appreciate about these smoking bans is that they are all slightly different. Some are enforced consistently, others are not enforced consistently," Dr. Goldman explains. "But despite that, they all show a consistent reduction in acute myocardial infractions and heart attacks after the bans."

Critics say the study is skewed because people who already had heart disease were not screened out. But the researchers say that would have been impossible.

"Most people who are diagnosed with heart disease have their diagnosis when they have their first heart attack," Dr. Benowitz says.

The study was released by the Institute of Medicine, an advisory group for the U.S. government.

As for the Pueblo, Colorado study, 400 people suffered heart attacks before the ban went into effect. In the 18 months after the ban, fewer than 240 people had heart attacks.

Neighboring areas without smoking laws had no change in their heart attack rates.


P.S. reduce heart attack chances by eating Vitamin C and Vitamin D rich foods and fruits.



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Fish Oil Supplements Don't Help Depressed Heart Patients

In a surprise and not very welcome finding, researchers report that fish oil supplements do not ease depression in individuals who suffer from both depression and coronary heart disease.

Participants in the study, which is published in the Oct. 21 issue of the Journal of the American Medical Association, were also taking the antidepressant sertraline (Zoloft). Some studies have suggested that the omega-3 fatty acids found in fish might enhance the effects of Zoloft.

"Unfortunately, it's not where we wanted to be. We were kind of disappointed, to say the least," said study author Robert M. Carney, a professor of psychiatry at Washington University School of Medicine in St. Louis.

The findings leave physicians still facing the problem of how to boost depression recovery rates so as to also lower cardiovascular risk. The question is a pressing one, given that depression can double or even triple the risk of dying in heart patients, Carney said.

"We're not just treating depression, we're treating a risk factor," he said.

Fish oil, or omega-3 fatty acid, supplements have been touted as a potential panacea for a variety of ailments, notably heart disease, but they have been losing their luster as of late.

A study published earlier this year found that patients receiving optimal drug therapy after experiencing a heart attack do not gain any additional benefit from taking supplemental omega-3 fatty acids. There was no difference in rates of heart attack, stroke, sudden cardiac death or death from any cause, regardless of whether they were taking the supplements or not.

That finding contradicted previous studies, which suggested that taking omega-3 fatty acids improved long-term survival.

Studies involving omega-3 fatty acids and depression have shown similarly uneven results.

For this study, 122 patients with major depression and coronary heart disease took 50 milligrams of Zoloft a day, then were randomized to receive either 2 grams a day of omega-3 acid ethyl esters or a corn-oil placebo capsule.

There was no difference in depression scores before and after 10 weeks of treatment, the researchers found.

The study authors noted that tweaking any of the variables in the study -- amount of Zoloft, dose of fish oil, form of fish oil or duration of treatment -- might yield more positive results.

In general, the effects of antidepressants in people with both depression and heart problems are the same as in a normal "healthy" population, Carney said.

"The problem, from our point of view, is that that's just not good enough," he added. "It's definitely better than placebo, better than doing nothing. We're trying to find a treatment or combination of treatments that's going to significantly improve the depression outcome."

Had this study turned out more positively, the next step would have been to see if improvements in depression translate into improvements in heart outcomes.

As it is, scientists are back to the drawing board.

"We're still exploring other possibilities," Carney said.

That includes an increased dose of omega-3, lengthening the study and identifying a subset of patients for whom this protocol might be more effective than antidepressants alone.

But it's not time to stop taking fish oil capsules yet, one expert said.

"The American Heart Association still does have recommendations based on the data we do have," said Dr. John Erwin III, professor of internal medicine at Texas A&M Health Science Center College of Medicine, and senior staff cardiologist with Scott & White Hospital in Temple.

"We also use fish oil to reduce triglyceride levels and it's very effective in that use. I wouldn't encourage people who are taking fish oil caplets to stop it now because of this study. It just means we have a little bit more work to do on the depression side of things," he said.

Some of the study authors, including Carney, declared financial ties with different pharmaceutical companies including Pfizer Inc., which makes Zoloft. The study was funded by the U.S. National Heart, Lung, and Blood Institute. GlaxoSmithKline Inc. provided both omega-3 and placebo capsules, while Pfizer supplied the Zoloft.



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Blood Protein May Predict Heart Attack But Not Stroke

More study needed into how CRP levels influence risk

High blood levels of C-reactive protein (CRP) may increase a person's risk for heart attack and death, but not for stroke, a new study has found.

The study included 2,240 people in New York City who were 40 or older and stroke-free. At the start of the study, the participants' blood was checked for levels of CRP (a marker for inflammation) and their heart attack and stroke risk factors were evaluated by researchers.

During an average follow-up of eight years, there were 198 strokes, 156 heart-related events and 586 deaths. People with CRP levels greater than 3 milligrams per liter of blood were 70 percent more likely to have a heart attack and 55 percent more likely to die than those with CRP levels of 1 milligram per liter or less, the researchers reported in the Oct. 20 print issue of Neurology.

After they took other risk factors into account, the study authors concluded that CRP levels didn't influence stroke risk.

"The role of this protein in predicting risk of stroke has been controversial, although prior studies have found it to be a marker for predicting risk of heart disease," study author Dr. Mitchell Elkind, of Columbia University Medical Center in New York City, said in a news release from the American Academy of Neurology. "However, in our large, multiethnic population, CRP levels did not play a role in predicting stroke, though they may still help determine whether someone is at risk of heart attack or early death."

CRP levels are influenced by factors such as physical activity, smoking, alcohol consumption and diabetes.

"It appears that by living a healthy lifestyle, one may be able to lower these protein levels, thus lowering the risk of cardiac events and possibly early death," Elkind said.

"It may be that the failure of CRP to predict stroke in our study, unlike in some other populations, reflects the fact that our population is older and has more of these risk factors. While CRP may be predictive in generally young healthy people, it may be less useful among older, sicker people. More research needs to be done on why the protein wasn't able to predict stroke in the same manner as heart disease," he said.



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Ingredients for the Faint of Heart ( Part 2 )

Bradley West, Nordic Naturals research advisor said Nordic Natural combines fish oil with red yeast rice in its Omega LDL. “Numerous scientific studies have shown that red yeast rice, a natural red-pigmented yeast grown on rice, helps support healthy cholesterol levels that are already within the normal range,” West said. Red yeast rice is a fermented product of rice on which red yeast (Monascus purpureus) is grown. A Mayo Clinic study found lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL in proportions similar to standard therapy with the statin therapy drug Simvastatin.18

A heart-healthy ingredient also grown, but this one from the soil, is hawthorn berries. “Hawthorn has been used for decades as a cardiovascular tonic, as it has been shown to improve the efficiency of the pumping action of the heart by increasing blood flow in the coronary arteries,” said Eileen Sheets, managing director, Bioforce USA. “And, improvement in the heart’s ability to pump blood more effectively has a positive impact on blood pressure.”

Keri Marshall, M.D., medical director at Gaia Herbs, added, “Hawthorn is profoundly important for increasing blood flow and the integrity of the vessels. Hawthorn berries are known to help connective tissue integrity, and blood vessels are all connective tissues, as well as help increase the integrity of blood flow within the body.”

A New York Heart Association study concluded patients who ingested standardized hawthorn berry extract, “may expect an improvement in their heart failure condition under long-term therapy.”19 And, a review of 14 randomized, double blind, placebo-controlled studies suggested hawthorn extract has significant benefits in the treatment for chronic heart failure.20

Folic acid, aka vitamin B9, is becoming more known as an ingredient that reduces the risk of heart disease. In the IFIC survey, 70 percent of responders said they were aware of folic acid’s heart-health abilities, compared to 55 percent in 2007. A recent study showed supplementation of folic acid may improve cardiovascular health and reduce the prevalence of peripheral arterial disease (PAD).21 And in an earlier study, the same group of researchers found 5 mg/d of folic acid over a three-week period reduced pulse pressure compared with a placebo.22

Niacin, also part of the B vitamins, has also been shown to improve heart health via raising HDL cholesterol.23 When used in combination with cholesterol-lowering drugs, it enhanced the cholesterol-managing effect.24 According to Lonza’s Web site, its niacin ingredient lowers LDL cholesterol, elevates high-density lipoprotein (HDL) cholesterol and reduces the level of triglycerides in the blood.

Sometimes, a lack of an ingredient can pose problems. In a George Washington University study, magnesium deficiency caused inflammatory, oxidative and nitrosative events, which promoted cardiomyopathy, cardiac dysfunction and myocardial intolerance to secondary stresses.24 In addition, the level of magnesium in the body has a direct effect upon the relaxation capability of vascular smooth muscle cells, blood pressure and hypertension.25 However, adding magnesium to the diet can improve blood pressure. A study examined the effect of magnesium, potassium and dietary fiber on incidence of high blood pressure in more than 30,000 men.26 After four years, researchers noted dietary fiber, potassium and magnesium were each significantly associated with lower risk of hypertension.

Some consumers want more than one or two ingredients in their heart-health supplements. Proprietary Nutritionals Inc. offers Sytrinol, with polymethoxylated flavones (PMFs), a group of compounds derived from the peels of citrus fruits including the bioflavonoids tangeretin and nobiletin; and palm tocotrienols, members of the vitamin E family extracted from the fruit of the palm tree.

Vitalah’s Oxylent contains magnesium, selenium, arginine, CoQ10, SOD, catalase , vitamin D and B vitamins; and Get Well Natural’s heart health supplement Cardio Well Classic includes the herbs Morinda citrifolia (noni fruit), prunella, salvia, notoginseng, eucomia and lycium fruit.

to be continued............

P.S. Pamper your heart with Vitamin C and Vitamin D rich foods and fruits.



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Walking The Best Exercise

If a daily fitness walk could be put in a pill, it would be one of the most popular prescriptions in the world. It has so many health benefits. Walking can reduce the risk of many diseases — from heart attack and stroke to hip fracture and glaucoma. These may sound like claims on a bottle of snake oil, but they're backed by major research. Walking requires no prescription, the risk of side effects is very low, and the benefits are numerous:

Managing your weight. Combined with healthy eating, physical activity is key to any plan for long-lasting weight control. Keeping your weight within healthy limits can lower your risks of type 2 diabetes, heart disease, stroke, cancer, sleep apnea, and osteoarthritis.

Controlling your blood pressure. Physical activity strengthens the heart so it can pump more blood with less effort and with less pressure on the arteries. Staying fit is just as effective as some medications in keeping down blood pressure levels.

Decreasing your risk of heart attack. Exercise such as brisk walking for three hours a week — or just half an hour a day — is associated with a 30% to 40% lower risk of heart disease in women. (Based on the 20-year Nurses' Health Study of 72,000 female nurses.)

Boosting "good" cholesterol – the level of high-density lipoproteins (HDL). Physical activity helps reduce low-density lipoproteins (LDL or "bad" cholesterol) in the blood, which can cause plaque buildup along the artery walls — a major cause of heart attacks.

Lowering your risk of stroke. Regular, moderate exercise equivalent to brisk walking for an hour a day, five days a week, can cut the risk of stroke in half, according to a Harvard study of more than 11,000 men.

Reducing your risk of breast cancer and type 2 diabetes. The Nurses' Health Study also links regular activity to risk reductions for both these diseases. In another study, people at high risk of diabetes cut their risk in half by combining consistent exercise like walking with lower fat intake and a 5% to 7% weight loss.

Avoiding your need for gallstone surgery. Regular walking or other physical activity lowers the risk of needing gallstone surgery by 20% to 31%, found a Harvard study of more than 60,000 women ages 40 to 65.

Protecting against hip fracture. Consistent activity diminishes the risk of hip fracture, concludes a study of more than 30,000 men and women ages 20 to 93.

The list goes on and on. Many other studies indicate a daily brisk walk also can help:

• Prevent depression, colon cancer, constipation, osteoporosis, and impotence
• Lengthen lifespan
• Lower stress levels
• Relieve arthritis and back pain
• Strengthen muscles, bones, and joints
• Improve sleep
• Elevate overall mood and sense of well-being.

Keep it Steady

A steady routine is the most important factor in getting the most out of your exercise program. Walking for at least 30 minutes a day, 5 or more days a week is recommended.

Use these tips to keep you on track:

• During your walks, you should be able to maintain a conversation. If you're breathing too lightly, increase your pace. If you can't catch your breath, slow it down.
• Walk around the local area after lunch or dedicate 15 minutes to walking up and down stairs. Climbing is an excellent way to strengthen your heart.
• At night, trade a half hour of TV for a brisk stroll around the block. Take a friend with you for company or get the whole family involved.

The Best Medicine

Any amount of walking is good, but for the best health results, set a brisk pace and walk for 30 minutes at least 5 times a week. Be sure to check with your doctor on the level of exercise that's best for you.



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A Woman’s Heart, Anxiety vs. Heart Attack

There is no doubt that women today are under more stress than ever. One of the “gifts” left to us by the women’s liberation movement is that we not only get to fry-the-bacon-up-in-a-pan at night, but we are also frequently out there in the workforce bringing-home-the-bacon as well.

Add to that the demands of children, homework, soccer practice, PTA, church and other civic activities, our cup truly RUNS over! Super Girl has nothing on us! It’s no wonder that heart disease is the number one killer of women. Sisters, we have STRESS in our lives!

Just how bad our stress level really is was recently brought home in a very real way to me. One of my best girlfriends just had the “pleasure” of a one-night stay at the local heart “hotel” (hospital). This definitely wasn’t her destination when she left for work that morning. She’s a single-parent of two small preschool children. She’s a widow and has no backup at home. (Are we getting the stress level picture yet?) In addition, she works for a company that’s been laying off workers for months and outsourcing jobs overseas. She’s been working 70-80 hour work weeks for months in an effort to ensure her job stays in the good old USA. (Bingo! Stress level gets a 120%!)

As she recalls it, her chest began pounding and hurting unbearably. She was short of breath and couldn’t breathe - sick to her stomach, sweating, dizzy and lightheaded. The pain radiated down her left arm. She tried to ignore it for a while but as the day progressed, the symptoms only increased in intensity. Finally, she phoned the nurse on call with her insurance company who promptly sent her straight to the hospital for evaluation.

Fortunately, this hospital visit had a happy ending. She was diagnosed with a panic or anxiety attack. Some of the symptoms of a panic attack are similar to those of a heart attack. Panic attack symptoms include: chest pain, sweating, shortness of breath, rapid heartbeat, hyperventilation (very rapid breathing), and dizziness/faintness. In addition, a panic attack may also be accompanied by a sense of fear or impending disaster. Other panic attack symptoms may also include trembling, headache, chills, hot flashes, stomach cramps, or tightness in the throat and trouble swallowing.

Panic attack symptoms generally last about a half an hour. However, there are exceptions and they can last for hours. In addition, there are instances, such as my girlfriend's experienced, where the symptoms can last up to a day.

Symptoms of a heart attack also include chest pain (described as a “fullness or a crushing” type of pain which may radiate to your left arm, back, neck, jaw and shoulders), sweating, shortness of breath, nausea and an “impending sense of doom.” (Sound familiar?) In addition, symptoms in women can be somewhat different than those experienced by men. Women may also experience heartburn, severe/unexplained fatigue, sleep disturbances, dizziness and clammy skin. The Women’s Heart Foundation also reports that approximately 1/3 of all women do not experience any chest pain at all during a heart attack. In addition, 71% of women report that they experienced flu-like in the weeks leading up to the heart attack.

Since some of the symptoms are similar, you may not be able to easily tell whether you are experiencing a panic attack or a heart attack. While a panic attack is not life threatening, a heart attack certainly can be. When in doubt, seek treatment. It is always better to err on the side of safety than to leave a potential heart attack untreated until it’s too late.

Until next time, here’s wishing you a healthy heart.



P.S. take care of your heart. Eat vitamin C rich fruits and foods.


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Predicting A Heart Attack

In the past, doctors believed that most heart attacks occurred when the arteries become blocked by plaque. However, scientists have learned that a significant number of heart attacks are caused when the cap, or crust on top of the plaque, is weak. This type of plaque is known as vulnerable, or soft, plaque. If the cap ruptures or cracks, the cholesterol, fats and other chemicals inside the plaque deposit are released into the bloodstream. The body senses an “injury” and sends platelets to seal the site. The platelets adhere to the sticky plaque cells, causing clumps of cells and the formation of a clot. That clot can become large enough to block the artery, leading to a heart attack.

The American Heart Association estimates 16.8 million Americans have coronary artery disease. It’s the leading cause of disease-related death in the U.S. This year, 1.25 million men and women in this country will have a heart attack.

Vulnerable plaque often lies hidden on the walls of the artery. Often, the deposits don’t bulge out, so they may not be detected with standard imaging or diagnostic tests. And since they are so small, patients often don’t have any symptoms until the plaque ruptures, causing a sudden, unexpected heart attack.

Vulnerable plaque appears to be associated with inflammation. Researchers at Beth Israel Deaconess Medical Center in Boston have been studying the combined use of PET/CT scans to screen patients for these areas of “hot” plaque. Prior to a scan, the patient is given an injection of glucose with a radioactive tracer (called 18F-FDG). The glucose is taken up by active cells (like areas of inflammation), carrying the tracer with it. The CT part of the imaging shows the anatomy of the heart. The PET portion detects the location and concentration of the radioactive tracer. But the scientists found the active heart muscle cells took in so much of the radioactive glucose plaque “hot spots” could not be seen.

To overcome the imaging obstacle, the researchers give patients a high-fat drink three hours before the scan. The radioactive glucose injection is given two hours later (one hour before the scan). Nuclear Medicine Specialist, Gerald Kolodny, M.D., explains the heart muscle takes up the fat for its energy needs rather than the glucose. This enables the inflammatory cells in vulnerable plaque to take up more of the radioactive glucose, creating a better picture of those “hot spots.”

In a study published in the April 2009 issue of The Journal of Nuclear Medicine, the researchers report the technique can effectively detect vulnerable plaque in coronary arteries. Further research needs to be done to confirm the efficacy of the technique and determine who may benefit most from the testing. Kolodny says if 18F-FDG PET/CT proves to correctly identify areas of vulnerable plaque, the technique may be useful for screening high-risk patients and monitoring the effects of therapy.

P.S. reduce your risk of a heart attack by loading yourself with Vitamin C rich fruits.

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Are You Having A HEART ATTACK?

In the movies, heart attacks are easy to recognize. The victim, sweaty and pale, suddenly clutches his chest and complains of terrible pain just before he drops to the floor. "That’s the typical textbook definition of what it should look like," says noted cardiologist Dr. Benjamin Alimurung, head of the Cardiac Catheterization Unit and medical director of Makati Medical Center. "But if you’re older, female or diabetic, you’re less likely to experience the classic symptoms of a heart attack."

Heart disease is one of the leading causes of death in the Philippines. Every year, thousands of people have heart attacks and about a third of these are fatal. Almost half of heart attack deaths occur within one hour after symptoms appear and often before the person even gets to a hospital. Thus, it is very important that you know its symptoms and act quickly when these appear — it may save your life. It is equally important that one realizes that some symptoms are atypical, some you might not even think are related to the heart.

Warning Signs

A heart attack occurs when blood flow to a part of the heart suddenly becomes obstructed, usually by blood clots that form at the site of a damaged artery (see illustration). The heart cells that are deprived of fresh blood and oxygen die over a period of a few hours. A heart attack may develop gradually or begin with only mild chest discomfort that may not seem alarming at first. In some patients, symptoms may come and go.

The typical signs that may indicate a heart attack include chest pain, breathlessness, nausea, and vomiting. One telltale serious sign, Dr. Alimurung warns, is the combination of any heart attack symptom with shortness of breath. "Difficulty of breathing is bad, particularly when breathlessness is not because of normal physical exertion. If one who usually can walk up five flights of stairs without breathlessness can suddenly only climb one or two, that’s a problem."

Missed Signals

Sometimes, symptoms may not fit the typical pattern. The pain may not be in the chest, but rather along the left arm, in the stomach area, or even the jaw. The reason for the unusual pain locations is because the heart lacks the type of sensory nerves found in the fingers and in other pain-sensitive parts of the body. "The heart tries to send pain messages, but it does not have the right nerves to send them correctly so it sends a jumbled message over the wrong cable," Dr. Alimurung explains.

Pain is not the only sign of a heart attack that one easily mistakes. Other symptoms can easily be mistaken for other much more benign problems such as heartburns. Although there may be other explanations for your symptoms, it is best to get to a hospital quickly and let a doctor examine you to make sure you are not having a heart attack.

Women, the elderly, and people with diabetes are most likely to have the kinds of unusual symptoms that are easily missed. Women (and their doctors) sometimes overlook symptoms because they mistakenly assume that heart attacks more commonly afflict men; in fact 64 percent of all women who die suddenly of coronary heart disease have no previously recognized symptoms. Seniors often mistake the signs of a heart attack for symptoms of other diseases or even of the aging process itself, even though they have a higher rate of heart disease than any other age group. Diabetics may have no symptoms at all, even though they’re at higher risk for heart attacks. High blood pressure and high cholesterol, conditions that increase the risk for diabetes and heart disease, are often symptom-free, so many people don’t realize they have these important risk factors.

What To Do

It often is not possible to self-diagnose a heart attack. The old adage is true: It’s better to be safe than sorry. When you develop a heart attack, every minute counts. Emergency department staff will work quickly to determine if a full-blown heart attack is in progress or whether you need hospital confinement for further close observation and additional tests before the diagnosis of a heart attack is confirmed or ruled out.

Once you’ve called for emergency help, it is generally recommended that you immediately chew and swallow an aspirin — unless you’re allergic to this medicine or have a stomach ulcer that bled recently — to help thin your blood. When you arrive at the hospital, you can expect a flurry of activity. It may seem as though your blood pressure levels, heart rate, and temperature are being checked all at once, even as a brief medical history is taken. Blood tests may be done, and you may be hooked up to a heart monitor. An electrocardiogram (ECG) test helps to determine whether a heart attack is occurring. Other accurate indicators of a heart attack are revealed from the initial blood tests. An elevation in certain markers may appear in the blood as a result of damaged heart muscle. However, these blood test markers may not become abnormal until a few hours after a heart attack.

Heart Attack!

If markers indicate you may be having a heart attack and you have access to a medical center, you may be sent immediately to the cardiac catheterization laboratory — commonly called a cath lab. There, a doctor quickly performs coronary catheterization or angiogram. If the angiogram detects a blockage, the same catheter may be used to open the blocked vessel with a tiny balloon (coronary angioplasty) and most often, will place within the artery a tiny expandable steel mesh-like slotted tube device called a stent. The procedure immediately restores blood flow to the heart muscle, effectively limiting or preventing the heart attack. Studies in the Philippines and other countries show that coronary angioplasty can cut a patient’s risk of dying by 40 percent if done promptly and within less than two hours of heart attack onset. Doctors typically call this important critical time frame as the "golden window of opportunity."

If you don’t have ready access to a medical center with a cath lab, the next best therapy is with intravenous (IV) clot-buster medications, called thrombolytics. These dissolve blood clots that form and block the coronary arteries. Thrombolytics are most effective when given during the first two hours after the symptoms appear and usually not later than 12 hours after. If multiple blocked or narrowed coronary arteries are detected, coronary artery bypass surgery may be recommended. The surgery will likely be scheduled several days to weeks after a heart attack. The delay allows your heart to stabilize.

Hospital Time

If you have had a heart attack, you can expect to spend several days in the hospital. During your hospital stay, tests such as chest x-rays and echocardiograms may be done to determine how well your heart is functioning and if you have any evidence of fluid buildup in the lungs that could indicate congestive heart failure due to poor pumping capacity of the heart. Before discharge, a treadmill or other stress tests may be done to determine if more areas of the heart are at risk from blocked vessels and to see how well your heart functions with physical exertion.

Certain well-known drugs have been shown to be of clear benefit to people who have had a heart attack. These include drugs such as aspirin and clopidogrel (Plavix), which are used to help reduce the risk of blood vessel clotting. Statin-type cholesterol-lowering drugs may be used both to rapidly improve cholesterol to target levels and for their ability to stabilize blood vessel walls, which may also help stop future clots from forming. In addition, most people who have had a heart attack will be advised to take angiotensin converting enzyme (ACE) inhibitors and beta blocker class drugs. These prescription medications have been shown to improve long-term outcomes for people who have had a heart attack.

Time Is Muscle

If you experience chest pains that persist for 15 minutes or have any other reason to believe you may be having a heart attack, don’t delay. Call for emergency help. Time is critical when a heart attack is under way because the heart muscle is dying. What should you do if you’re not sure? Make the call anyway or rush to the hospital and get emergency help. When it comes to heart attacks, the earlier you are treated, the more heart muscles will be saved, and the faster, better, and more complete your recovery will be.

Save this article and read it again. What you learn now may save your life later!

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