Shape of Your Heart
People may not fear heart disease as much as cancer, but the prognosis is every bit as serious. It is, in fact, the number one cause of death due to illness in this country. And it affects men and women alike, although men generally develop heart disease up to 10 years earlier. For females, the onset often comes after menopause, in part due to the lack of estrogen, which has protective effects.
So when The Lawyer with the three coronary stents announced to the waiter, “I’ll have the steak,” I was understandably upset, even though he asked for a lean filet mignon. Judging by the look of self-satisfaction on his face, he was obviously proud of himself for not ordering what he really wanted—the marbled prime rib.
I couldn’t resist responding, “While you’re at it, dear, why don’t you have cheesecake for dessert, just in case you have any arteries left unclogged.”
I would be remiss not to mention that The Lawyer, dietary deviations aside, is in very good shape for a man his age and is extremely aware of what constitutes a healthy lifestyle. (Thanks to me, naturally.) But that doesn’t always mean he makes the wisest menu choices when it comes to his heart. He, of course, swears that a genetic predisposition—and my constant nagging—are the primary culprits for his prior coronary clogs. Therefore, I frequently remind him (always in calm, constructive tones), that he is just plain wrong.
Dr. Gordon Tomaselli, former president of the American Heart Association (AHA) and chief of the Division of Cardiology at Johns Hopkins University, backs me up on this. One in three Americans has some sort of cardiovascular disease, which can include hypertension (high blood pressure), coronary artery disease, heart failure, or arrhythmias (irregular heartbeat). He attributes a new uptick in coronary crises to a sedentary lifestyle, obesity, diabetes, smoking, and diets rich in processed foods.
Dr. Tomaselli stresses that we must turn our attention from risky to healthy behavior. For a start, that would include what the AHA refers to as Life’s Simple 7:
1. Get Active
2. Eat Better
3. Lose Weight
4. Stop Smoking (smoking damages your entire circulatory system and increases your risk for coronary heart disease, hardened arteries, aneurysm, and blood clots)
5. Control Cholesterol
6. Manage Blood Pressure (normal is less than 120 mm Hg systolic and less than 80 mm Hg diastolic or <120/80)
7. Reduce Blood Sugar
When it comes to getting active, there is a preponderance of evidence that shows exercise can strengthen your heart, lungs, and blood vessels. The AHA recommends 150 minutes of moderate-to-vigorous activity a week, which can be broken down into sessions of as little as 20 to 30 minutes of activity five or six days a week.
Eat better to lose weight, control cholesterol, manage blood pressure, and reduce blood sugar. Fat—especially if a lot of it is around your waist—puts you at higher risk for many health problems and is especially bad for your heart. According to the AHA, if your body mass index (BMI, a measure of body fat based on height and weight) is 25.0 or higher, you will benefit by bringing your number down below 25. If your BMI is 30.0 or higher, you are at significant risk for heart health problems.
“If a person has had a coronary event in the first place, then clearly life changes need to be made,” says Dr. Suzanne Steinbaum, director of Women and Heart Disease at the Heart and Vascular Institute at Lenox Hill Hospital in New York City and a spokesperson for the American Heart Association. “Eighty percent of the time you can prevent a repeat performance by making healthy lifestyle choices. Start by incorporating fruit, vegetables, whole grains, legumes, beans, olive or canola oil, and fish into your diet, and getting rid of all the saturated fats and simple ‘white’ carbohydrates, such as rice, pasta, bagels, and potatoes. Know that exercise is the best medication, and don’t forget to smile and breathe. Believe it or not, perspective is everything, and being pessimistic and hostile can be damaging to your heart. On the other hand, having a positive outlook and a glass-half-full approach can help your heart’s vitality and spirit.”
Studies presented at a recent AHA’s Scientific Session confirmed that women who drank more than two sugar-sweetened drinks a day had increasing waist sizes but weren’t necessarily gaining weight, reports Dr. Christina Shay, lead author of the study and assistant professor at the University of Oklahoma Health Sciences Center. “These women also developed high triglycerides, and women with normal blood glucose levels more frequently went from having a low risk to a high risk for developing diabetes over time.” This put them at higher risk for a heart attack.
Lack of exercise and an unhealthy diet, along with smoking and genetics, are unquestionably the most important risk factors for heart disease. But stress is also a huge factor. So “it is critical to make the connection between your emotional health and the health of your heart,” says Harvard assistant professor of psychiatry Dr. Paul Hammerness. “At its extreme, heart injuries and heart failure can occur during severe emotional stress. This is called stress cardiomyopathy, or ‘broken-heart syndrome.’ Less dramatic but far more common examples,” he claims, “include the well-known impact of anxiety and depression on heart disease and recovery from heart disease.” And as corroborated by a major and well-regarded Danish study, he notes that the relationship between mood/anxiety and heart disease appears to be a “dose-response relationship,” meaning that greater sadness and anxiety lead to greater heart disease and/or worse heart outcomes.
Therefore, one key step in caring for your heart is caring for your emotional health and working diligently to reduce levels of stress in your life (see Rung 2). When all is said and done, a calm, organized life may actually save your life.
Of course, along with these lifestyle changes, it’s important to have your blood pressure, cholesterol levels, and blood sugar tested regularly. If you already suffer from hypertension, high cholesterol, or elevated blood sugar, more frequent monitoring is required.
Bone Up on Your Bones
Arthritis
Less fatal, but considerably more common, is the pain and debilitation of arthritis. About 50 million Americans have been diagnosed with one of the seven common forms. Yes, I am one of them. But it would take another book to tell you the stories about my recent hip replacement!
“Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions, divided into three major categories: osteoarthritis, rheumatoid arthritis, and juvenile arthritis,” says Patience White, M.D., professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences and vice president of public health for the Arthritis Foundation. “Although common belief is that arthritis is a condition affecting the elderly, two-thirds of people with arthritis are under the age of 65, including 300,000 children. Also, arthritis affects people of all ethnicities.”
The vast majority of current sufferers, about 27 million Americans, have osteoarthritis (OA), which is characterized by a breakdown of joint cartilage. The rest of arthritis sufferers have the more severe form: rheumatoid arthritis. Per Dr. White, “rheumatoid arthritis (RA) is characterized by inflammation of the membranes lining the joint. Although it can strike at any age, women are typically diagnosed between the ages of 30 and 60, while male patients usually are older. There are about 1.5 million affected individuals in the United States. Finally, juvenile arthritis (JA) is a term used to describe many autoimmune and inflammatory conditions that can affect children ages
