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.

6 Ways to Avoid Dying of a Surprise Heart Attack

The facts are scary: Despite the progress made against heart disease in the past several decades, almost half the people who die suddenly from a heart attack or other cardiac problem have no prior symptoms. Even knowing someone's risk factors for heart disease, it's often tough to pinpoint who will actually go on to get the disease. And once blood flow to the heart muscle is blocked and a heart attack happens, it's not exactly clear why some people experience sudden cardiac arrest, which killed Meet the Press host Tim Russert last week, and others don't.

Those uncertainties, however, don't mean that you are powerless to protect yourself from dying of a heart attack. Here are steps to take to improve your odds:

1. Follow the standard prevention guidelines. The American Heart Association has three basic tips for preventing heart disease, stroke, and heart attack: Don't smoke, be more active, and make good nutritional choices. This is good general health advice, regardless of your heart disease risk.

2. Exercise. Yes, we mentioned it above, but it's worth repeating. "Exercise raises good cholesterol and lowers bad cholesterol," says Rob Michler, director and chairman of heart surgery at the Montefiore-Einstein Heart Center in New York. Worrying that exercise is going to give you a heart attack is not a valid excuse for skipping it; while it's true that exercise raises your odds of a heart attack in the moment, the long-term benefits vastly outstrip this short-term risk. (Still, check with your doctor first if you're obese, have health problems, or haven't exercised in years.)

3. Know your risk. Find out your Framingham risk score, which gives the odds of heart attack or heart disease-related death in the next 10 years. It requires you have certain basic information, like your cholesterol numbers and blood pressure. This score isn't perfect, especially for young people and for women, who can find alternative ways to gauge risk, but it's a good place to start. Talk to your doctor about your risk score, and do something about what is controllable, like your weight or tobacco habits. "Recognize when you have a risk and modify that risk as much as you can," says Steve Owens, a cardiologist at the University of Kansas Hospital in Kansas City, Kan.. If your odds of heart disease are high enough, talk with your doc about the pros and cons of medications like statins or aspirin.

4. Get a family history. "Your genetic profile is the one risk factor we can't modify," says Michler. But if you have a family history of early-onset heart disease, tell your doctor even if you're in perfect health yourself. If your father had a heart attack at 40 (even if he survived it), that's crucial information about your possible genetic risk.

5. Know the symptoms of heart problems. It's not just crushing chest pain. U.S. News wrote recently about how to know if you're having a heart attack and what to do about it and also looked at how women may not be alert to the signs of heart disease.

6. Learn CPR. Clearly, you can't perform it on yourself, but you can help someone around you who is experiencing cardiac arrest. "If people can make it until EMS arrives, then their chances of survival are wonderful," says Judith Hochman, clinical chief of cardiology at New York University, who says she's seen three recent cases of patients saved by CPR. The American Heart Association says it improves survival two to threefold and recently urged laypeople to learn how to do it. And it needn't be complicated: Chest compressions alone can help heart attack victims. Meantime, if you're in a public space like a gym or casino when someone has an attack, look for an automated external defibrillator, Hochman advises.


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



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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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Former WWE wrestler Edward 'Umaga' Fatu dies of heart attack

The wrestling community is reeling today after news that ex-WWE superstar Edward “Umaga” Fatu has died.

Formerly known to World Wrestling Entertainment fans as Umaga, Fatu died Friday after suffering a heart attack, CNN reports. The 36-year-old's wife reportedly found him unconscious with blood coming out of his nose. He was rushed to a hospital in Houston, TX, but was pronounced dead at around 6:00 pm EST.

In 2007, The News reported that Fatu was one of many superstars who bought prescription drugs from an online pharmacy, which violated the WWE "Talent Wellness" program. The wrestler had purchased a growth hormone called somatropin in the months following a WWE rule was instituted stating its fighters could not buy drugs from online sources.

Fatu was the cousin of Dwayne Johnson, aka The Rock, and a member of the Anoa'I wrestling family. He was nicknamed the Samoan Bulldozer for his powerful technique and won the WWE Intercontinental title two times. But despite his stellar performances, Umaga was ultimately fired by the WWE after violating the Wellness Program again by not entering rehab.

On its official website, the WWE expressed "its deepest condolences to Mr. Fatu's family, friends and fans on his tragic passing."

Fatu had just taken part in Hulk Hogan's Hulkmania tour in Australia when he passed away.


P.S. protect your HEART 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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