February is American Heart Month. And if, like most people, you seldom give thought to your ticker – maybe it’s time to start. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women in the United States, accounting for about 600,000 deaths – or one in every three deaths – in this country each year.
What Causes Coronary Artery Disease (CAD)?
The term “heart disease” encompasses a variety of heart conditions, but the most common is coronary heart disease, also called coronary artery disease (CAD). CAD develops when a waxy cholesterol plaque builds up in your coronary arteries, the major blood vessels to your heart.
Instead of vilifying saturated fats for plaque build-up like we used to do years ago, said Stephen Sinatra, MD, board certified cardiologist and co-author of The Great Cholesterol Myth, we should be focusing on the most important cause of heart disease – systemic inflammation. If you’ve ever had an athletic injury, you’re already familiar with painful inflammation with its redness, swelling and warmth that occurs as a result of immune system response to the injured area. But inflammation that occurs within the entire body, called “chronic systemic inflammation,” can wreak havoc in the body.
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It affects not just one area, but many internal organs and systems, including the blood vessels. And when the blood vessels are inflamed, they allow cholesterol to penetrate through the artery wall to form plaque deposits. Once there, the plaque oxidizes and becomes inflamed, causing a rupture in the artery wall, which leads to the formation of blood clots that may obstruct the flow of blood to the heart and cause a heart attack.
Diet definitely plays a factor in systemic inflammation, acknowledged Sinatra. Fats such as trans fats, for example, found in some margarines, snack foods like cookies or muffins, and fried foods like donuts or French fries – can increase inflammation. Omega 6 oils (found in safflower, sunflower, corn and sesame oils), while important in small amounts in the diet, can also promote inflammation. And sugary foods and drinks are huge players in the inflammatory process.
Certain health conditions are associated with systemic inflammation, too, said Amy L. Doneen, ARNP, medical director of the Heart Attack and Stroke Prevention Center in Spokane, Washington, and co-author of soon to be released book, Beat The Heart Attack Gene. “Numerous pathologies, including insulin resistance, periodontal disease, autoimmune inflammatory diseases such as rheumatoid arthritis and many others, increase inflammation,” she said.
But diet and inflammation are not the only culprits involved in the development of CAD, added Doneen, who explained that there’s a strong genetic component to heart disease, too. According to Doneen, genetic studies and numerous epidemiological studies have identified genetic markers for CAD, including a form of cholesterol that is a subtype of LDL (bad) cholesterol. This type of cholesterol, called Lipoprotein (a), or Lipo (a), is linked to genes on chromosome 6, and is a strong risk factor for CAD and stroke.
How To Reduce Your Risk for CAD (as outlined in Doneen’s book):
1. Know your family history. Family history of cardiovascular disease is one of the most important risks to keep in mind, with studies finding as much as a threefold increase of CAD in those with a first-degree relative with the condition.
2. Get regular medical care, including blood pressure and cholesterol screening, weight checks and testing for insulin resistance. If you have high blood pressure, diabetes or prediabetes, follow the treatment plan your doctor has recommended to keep things under control. And dental care, including cleanings, should be done ideally every three months to prevent periodontal disease.
3. Consider specialized care. If you have chronic conditions that are linked with inflammation, such as hypertension, diabetes, rheumatoid arthritis or periodontal disease, if you have a first-degree relative with CAD – or if you are simply want to lower your risk for CAD – consider a consultation with a physician who specializes in advanced lipid testing, as well as testing for systemic inflammation, blood vessel plaque formation and genetic markers for CAD. Many of these tests are reasonably priced and can help you and your doctor to make a plan to reduce your cardiovascular risk before problems start.
4. Keep your weight down. Obesity is linked with insulin resistance and with inflammation. The best diet for most people is a Mediterranean-style diet that emphasizes plant-based foods, such as fresh fruits and veggies, nuts, whole grains, legumes and olive oil, along with moderate amounts of cheese, yogurt, fish and wine. Adding one or two squares of dark chocolate (at least 72 percent cocoa) daily can help to reduce cholesterol and blood pressure, and stave off insulin resistance.
5. Don’t smoke.
6. Exercise regularly. Workouts don’t have to be strenuous or long to benefit the heart. Even 15-20 minutes of daily walking can do wonders. Better yet, alternate bouts of higher intensity exercise (like jogging) with walking. Interval training helps to lower weight more effectively and improve cholesterol levels, as well as decreases your risk for insulin resistance.
7. Sleep 6-8 hours a night. Research links obesity, diabetes and heart attack risk with sleep deficit.
By Linda Hepler, BSN, RN