Heart Health
Education

Should I take fish oil supplements?

For years, the American Heart Association has recommended that healthy adults eat at least two servings of fish each week. That's because fish is high in omega-3 fatty acids. It might sound funny for your doctor to recommend that you eat foods high in fat, but the fats found in fish are special. Fatty fish contain two kinds of omega-3 fatty acids called EPA and DHA. We know from studies that these fats actually protect the heart. They make the blood less likely to form clots that can cause heart attacks, and they provide some protection against irregular rhythms that cause sudden cardiac death. Sometimes, if your triglyceride levels are especially high, your doctor might recommend a supplement. But for other people, adding fat in the form of a supplement to a diet already high in fat is not a good idea. The best way to have more omega-3 fats in your diet is to enjoy more fish! Fish especially high in omega-3 fatty acids are salmon, tuna, trout, mackerel, herring, and sardines. If you have trouble doing that, discuss the proper dose of supplementation with your doctor, as high doses can cause excessive bleeding in some people.

Can I eat as many nuts as I want?

Nuts are high in fat and calories. The fat in nuts however, is "good fat". Nuts contain omega-3 fatty acids called alpha-linolenic acid (less potent than the kind found in fish) and a nice mix of monounsaturates with some polyunsaturates. These fats are better for your heart than trans-fats found in baked goods and highly processed foods or the saturated fats found in fatty dairy or meat products. Nuts can be part of heart-healthy diet. I fact, some studies have found that almonds can help lower cholesterol. It's best to use nuts as a replacement for other less healthy fats in your diet. It's important to watch portion size, because nuts are very high in calories. It's very easy to add a lot of fat and calories to your diet by eating nuts on a regular basis, and most Americans do not need to add fat and calories to their diets! The bottom line is that nuts, in moderation, and in combination with whole grains, low fat dairy foods, lean fish and meats, and plenty of fruits and vegetables can fit into a heart-healthy diet.

Should I drink red wine with dinner?

Many studies have examined the effect of drinking red wine on heart disease. Some researchers think that drinking wine reduces mortality, others think that it is a component of the red wine (like flavonoids or other antioxidants) that is responsible for lowering risk. Other people believe that it is it due to some other lifestyle factor altogether. Maybe red wine drinkers eat more vegetables and exercise more often, for example. To date, no direct comparison trials have been done to determine the specific effect of wine or other alcohol on the risk of developing heart disease or stroke. If you do not drink, do not start. Drinking too much alcohol can raise triglycerides and lead to high blood pressure. There are serious problems associated with drinking too much alcohol, including obesity (alcohol is high in calories), diabetes, stroke, breast cancer, suicide, accidents, cardiomyopathy, arrhythmia and even sudden cardiac death. Of course pregnant women should not drink alcohol since it puts babies at risk for fetal alcohol syndrome. If you do drink, do so in moderation. That means no more than one drink per day for women and no more than two drinks per day for men.

Should I take a multi-vitamin?

The American Heart Association recommends that Americans get adequate vitamins and minerals by eating a variety of foods in moderation instead of taking supplements. Sometimes, prescription medications can interact with dietary supplements. Remember that almost any nutrient can be toxic if taken in large quantities over a long period of time. For example, too much iron can increase the risk of chronic disease, and too much vitamin A can cause birth defects. The Recommended Dietary Allowances (RDAs) published by the National Research Council are the best available estimates of safe and adequate dietary intakes. To date, there are no good studies that prove that healthy people achieve any health benefit by taking supplements in excess of the RDAs. Particularly, there has been a lot of research done on antioxidant vitamins (A, C, & E). The evidence to date does not suggest any benefit on heart disease. If you are particularly concerned about a deficiency in your diet, consult your doctor who might suggest you review a food diary with a Registered Dietician.

Will garlic lower my cholesterol?

Garlic contains naturally occurring sulfur compounds. Some studies have proven small, but statistically significant reductions in the cholesterol levels of people who take garlic consistently. Some studies show no change. Some studies demonstrate small reductions in blood pressure and platelet aggregation (platelets are the things that make blood clot). So, if you can stand the side effects (namely "smelly" breath) of garlic and you like the taste of it, use it. Garlic is a great flavor substitute for salt, which should be reduced in a heart-healthy diet. Be careful about using garlic as a replacement for high cholesterol or high blood pressure medications. There's nothing wrong with experimenting with garlic in combination with other therapeutic lifestyle changes like weight loss, increased physical activity, smoking cessation and a heart-healthy diet when you have a borderline condition. If you have a serious case of high blood pressure or high cholesterol and you have other risk factors for coronary artery disease, you're better off sticking to the tried and true: prescription medication to bring down your high cholesterol and blood pressure in a reliable and time sensitive manner.

Should I eat more soy?

Foods rich in soy protein offer a good alternative to meat products, which can be high in saturated fat. In recent years, the health benefits of soy and its perceived relationship to a healthy heart have encouraged more then vegetarian consumers to try soy products. Soy comes from the plant kingdom and contains flavonoids. That doesn't make it a "magic food", however. As part of a heart-healthy diet based on variety and moderation, soy is a good fat-and-calorie conscious protein choice. The controversy comes from the fact that isoflavones (flavonoids) are phytoestrogens (estrogen) - a very weak form of estrogen that could have a drug-like effect in the body. This may be pronounced in postmenopausal women, and some studies suggest that high isoflavone levels might increase the risk of breast cancer. The studies are far from conclusive, and some studies show exactly the opposite; that soy helps prevent breast cancer. In this kind of situation, you have to be careful. The truth is, you'd probably have to eat truckloads of soy to cause breast cancer, but if you are a woman with a history of breast cancer, you will want to use soy products (and never supplements) judiciously just to be on the safe side.

Peripheral Vascular Disease

PVD develops as a result of atherosclerosis or "hardening of the arteries". It affects 10 million Americans, and is commonly diagnosed after the age of 50. When the arteries outside of the heart become narrowed by plaque, cholesterol and scar tissue, blood flow decreases. These "clogged" arteries and the decreased blood flow inside of them cause a pain called claudication. It's mostly experienced when walking and it's important to pay attention. PVD which is untreated can result in gangrene and even amputation. People at highest risk for PVD include those with diabetes, those who smoke, those who are obese, those who are physically inactive, have a family history of PVD and those with high blood pressure and high cholesterol. Your doctor can order a very simple test called the ankle brachial index to screen for PVD. This simple, painless test compares the blood pressure in the arms to the blood pressure in the legs to determine how well the blood is flowing. People with a positive ABI can be sent for more tests, such as ultrasounds and angiograms. Possible treatment for PVD includes lifestyle changes, medication, angioplasty and stenting.

Carotid Artery Stenting

The carotid arteries supply blood and oxygen to the brain. A stroke can be the consequence of carotid arteries clogged with plaque and cholesterol, a process called atherosclerosis. Until recently, the most common intervention for people with carotid stenosis was a surgical procedure called carotid endarterectomy. The procedure involves a surgeon cutting into the artery in the neck to clean out the plaque. An estimated 200,000 Americans a year undergo this procedure. Now there is an alternative to surgery. Interventional Cardiologists can now put stents into the carotid arteries. A stent is a small mesh tube which sits inside of the artery to keep it open and keep blood flowing through it. Stents are usually threaded up to the carotid artery through a small catheter inserted in a blood vessel in the groin area. People who have had symptoms of a stroke or whose carotid artery is 80% blocked and who are not good surgical candidates might be candidates for this new procedure. The procedure takes place in the catheterization lab and usually requires only local anesthesia.

Heart Failure

Heart Failure is a condition where the heart cannot pump enough blood to meet the needs of the body. Because the heart muscle changes, the heart either cannot fill with enough blood, or cannot pump with enough force (or sometimes both). Heart failure develops over time. It can affect the left side of the heart, so that the heart cannot pump oxygen-rich blood to the body. It can also affect the right side of the heart, so that the heart cannot pump blood efficiently through the lungs where it can pick up oxygen. This gradual weakening of the heart causes blood and fluid to back up into the lungs, the build up of fluid in the feet, ankles and legs, and causes people to feel tired and short of breath. Heart failure affects 5 million people in the United States. Each year, another half a million people are diagnosed with heart failure for the first time. Heart failure treatment is geared to treat the underlying cause, improve symptoms and quality of life, stop the heart from growing worse, and prolong life. Treatments include lifestyle changes, medications, and specialized clinical care. The major cause of heart failure is coronary artery disease and high blood pressure, so anything that reduces your risk for heart disease also reduces your risk for heart failure.

The MAZE Procedure

Heart surgeons at the Heart Hospital of New Mexico perform the MAZE procedure on patients with atrial fibrillation. Atrial fibrillation is an abnormality of the electrical system of the heart that causes an irregular heart beat. This incoordination or irregularity creates an inefficiency in pumping and can be associated with stroke. Most people with atrial fibrillation do not need open heart surgery, but in some cases it is necessary. This usually restores a normal heart rhythm which reduces the risk of stroke. The surgeon creates a number of small incisions in the atrium (top walls of the heart) which restores normal electrical activity. The incisions in the heart look a little like a children's maze in which there is only one path that the electrical impulse can take. This restores normal rhythm to the heart and helps to prevent stroke.

Theraputic Lifestyle Therapy

Cardiovascular disease remains the number one killer of Americans. Over the last few years, we have actually noticed a decrease in the number of deaths and disability that can be attributed to heart disease. This is largely due to the lifestyle changes being made by millions of people across the country. Heart disease has been called a "lifestyle disease" and the good news about that is that people can do something about it. Adopting heart-healthy lifestyle habits can prevent and in some cases, even reverse heart disease. The therapeutic lifestyle changes most often prescribed by doctors are as follows:

• If you are a smoker, stop smoking. Your risk for having a heart attack decreases in the first 24 hours.
• Maintain a healthy blood sugar level and HgA1C level. These are markers for diabetes. If you have diabetes, keep careful control over your blood sugar levels.
• Monitor your blood pressure and keep it below 120/80. Eat a low-salt, high fiber diet with lots of fruits and vegetables and get regular exercise.
• Monitor your blood cholesterol level and eat a low fat diet. Stay within your cholesterol goals.
• Build regular physical activity into your lifestyle. Just thirty minutes of exercise, most days of the week keeps your heart healthy and helps you to control weight.
• Maintain a healthy body mass index (between 18 & 25). Lose weight if you have to - your heart will thank you for it.

ICD

An Implantable Cardioverter-Defibrillator (ICD) is a small electronic device installed under the skin in the upper chest with wire(s) passed through the vein into the heart chamber(s). An ICD prevents sudden death from cardiac arrest due to life-threatening, abnormally fast heart rhythms. The ICD is capable of monitoring the heart rhythm. When the heart is beating normally, the device remains inactive. If the heart develops a life-threatening fast heart rate, the ICD delivers an electrical shock to the heart to terminate the abnormal rhythm and restore normal rhythm. ICDs are implanted in the catheterization or electrophysiology laboratory by electrophysiologists (cardiologists with special training in the electrical system of the heart). People who have significant heart muscle damage or have survived a cardiac arrest are candidates for an ICD. Other people who are considered high risk for having cardiac arrest are also eligible for an ICD.