Menstuff® is actively compiling information, books and resources on the issue of the heart. For years I've asked men if they knew the first warning sign of a heart attack. Virtually no one can answer the question correctly. It isn't severe pain in the chest, loss of mobility on one side of the body, etc., etc. The first sign is "Death". One out of three Americans have Hypertension and over 100,000 people will die unnessisaryly this year of Hypertension. Add it up. More people die from sudden cardiac arrest each year than from breast cancer, prostate cancer, AIDS, handguns, house fires, and traffic accidents combined. Don't wait for "symptoms." Change your health habits now before the first warning sign hits!
Your guide to hypertension
Newsbytes - latest news
Over a Third of Americans Have Heart Risk
What Happens During a Heart Attack?
A Heartfelt Warning to Giants, Pats Fans
6 Common Habits That Are Damaging Your Heart
Take Blood Pressure Advice with a Grain of Salt
A Short Fuse Could Be a Time Bomb
Year's Biggest Game Puts Men at Risk
Exercise for a Healthy Heart
Safe Exercise for Heart Disease Patients
Lifestyle Vital to New Heart Diet
How to Reamin Calm When You Want to Explode
How Much Exercise Is Necessary to Keep Your Heart Healthy?
Does Running 5 Minutes A Day Really Protect Your Heart?
Three Who've Learned The Hardest Way
Waiting for a Heart
Heart Attack Quiz
Year's Biggest Game Puts Men at Risk
Gender gap remains for heart attack care
Heart Attack Quiz
Heart Health for Men, Women
A Short Fuse Could Be a Time Bomb
Nothing in particular set off the attack, he recalls; what stands out was that anger had become his reflexive response to stress. By his own account, he would morph into a yeller, a fist-clencher, a vein-popper. "I did more than once throw the phone and pick up a book and throw it against the wall to the point where it scared my employees," he said.
On the other hand, Mr. Seidel said, hospital tests after his attack showed his blood contained high levels of homocysteine, a byproduct of protein that is known to clog arteries. As he rebuilds his health and learns to manage his anger, Mr. Seidel said, he often wonders whether it was chemistry, psychology or some combination thereof that nearly killed him.
A connection between anger and an increased risk of heart disease has been suspected since at least the 1950's, when Meyer Friedman and Ray Rosenman, San Francisco cardiologists, used the term "Type A behavior" to describe their impatient, often hostile patients. These days, in an age of gene-splitting precision, the Type A label is considered too broad, even simplistic. But its underlying assumption is inspiring more research into the links between negative emotions and cardiovascular disease.
Anger has yet to be sanctioned as an established, biologic risk factor, said Dr. Janice E. Williams, a cardiovascular epidemiologist with the Centers for Disease Control and Prevention in Atlanta. But, she said, it is considered an emerging risk factor.
"What we're finding is that the risk of heart attacks associated with anger is comparable with that of smoking and high cholesterol," Dr. Williams said.
Deconstructing anger can be tricky, and remains controversial, partly because anger is harder to measure than conventional risk factors like cholesterol, hypertension and diabetes. One measurement is a standardized, 50-question form known as the Cook-Medley Hostility Scale. But the subject's self-awareness is often so limited that spouses are asked to rate their partner's levels of anger, too.
It is also difficult to separate anger from depression. Some recent research suggests that low levels of serotonin in the brain cause not only sadness but also hostility, and that some heart patients could benefit from drugs used to treat depression. So someone once regarded as hotheaded might now be understood as serotonin-deficient, said Dr. Andrew Littman, a Boston psychiatrist who specializes in preventive cardiology at Massachusetts General Hospital.
"What's striking is that a high proportion of people who have heart disease are people who have something psychologically going on," Dr. Littman said.
What is still unclear is whether anger sets in motion a specific metabolic reaction that clogs the arteries, or whether it makes people smoke and overeat, which in turn affects blood pressure and cholesterol. Either way, more attention and effort to change unhealthy behavior are merited, said Dr. Valentin Fuster, the director of the cardiovascular institute at the Mount Sinai School of Medicine in New York, and a former president of the American Heart Association.
"I personally believe that coronary artery disease is an acquired disease of modern development," Dr. Fuster said. It's generally accepted by doctors that intense emotion can touch off a heart attack. But in one developing study led by the Beth Israel Deaconess Medical Center in Boston, researchers hope to understand more about anger and sudden death by tracking patients with implanted defibrillators. The participants, who are currently being recruited, will be asked to report on their activities and emotions every time they experience arrhythmia and feel their defibrillators respond.
"The nice thing about these devices is they have a memory, an electrocardiogram recorded inside so we can confirm exactly what the rhythm disturbance was," said Dr. Murray Mittleman, the coordinator of the study and the director of cardiovascular epidemiology at Beth Israel Deaconess.
Anger's long-term effects are another aspect of research. By causing repeated wear and tear on the arteries, chronic rage may contribute to atherosclerosis, said Dr. Ichiro Kawachi, an associate professor at the Harvard School of Public Health.
One landmark study, published last year in the journal Circulation, found that participants with no existing heart disease or hypertension but high anger traits were nearly three times more likely to suffer nonfatal heart attacks, fatal heart attacks or require bypass surgery than counterparts with less anger. The study involved nearly 13,000 men and women, black and white, who were tracked up to six years in four regions of the country, said Dr. Williams, who was the lead author before she joined the C.D.C.
Another recent study in the journal Cardia found that adults age 18 to 30 were more likely to develop calcifications in their arteries if they had high hostility ratings.
"There's been continuing studies that document that the tendency to have a low threshold for anger a short temper is putting people at higher risk for developing coronary disease," said Dr. Redford B. Williams, a professor of psychiatry and the director of the Behavioral Medicine Research Center at Duke University.
Dr. Williams, widely regarded as the guru of anger management, has developed a life- skills training program with his wife, Virginia, that urges people to evaluate their angry reactions. The couple are marketing their techniques, including making a self- help videotape and workbook.
Some doctors remain skeptical, cautioning that the healing power of anger management has yet to be proven.
"It's not whether there are connections between the mind and the body, of course no one questions that," said Dr. Arnold S. Relman, a professor emeritus at the Harvard University School of Medicine and former editor in chief of The New England Journal of Medicine. "The question is, can you show us evidence that by improving your emotional state you can objectively change the natural history of physical illness?"
Results from at least one small study suggest that you can. Dr. Karina Davidson, a clinical psychologist at the Mount Sinai School of Medicine, tested life-skills therapy on two-dozen heart attack survivors from Halifax, Nova Scotia. Half received the therapy and half did not. Those who did emerged with less cynicism and hostility, as well as lower blood pressure.
Dr. Davidson said she has documented similar results within a small set of New York patients. The more recent work involved women and African-Americans, as well as white men. It is promising, Dr. Davidson said, because it suggests that the higher rates of hypertension among blacks may stem from environmental causes like racism, rather than from genetic origins.
One convert to anger management is Mr. Seidel, the lawyer. In his weekly support group at the New York Hospital-Cornell Medical Center, he gently offers hard-won wisdom to newer members. He meditates. He knows he gets an adrenaline rush when he plays basketball, so he recently quit his amateur league. Heeding the advice of his psychotherapist, Dr. Robert Allan, he tries to swim past the hooks of injustice and incompetence that used to lure him into angry waters.
"It's got to be a factor," he said. "Even if it wasn't a solo factor, it has to have exacerbated whatever else was going on."
6 Common Habits That
Are Damaging Your Heart
You know that eating a healthy diet and exercising regularly are important habits for a healthy heart. But did you know that you could still be undermining all your efforts with some surprisingly common bad habits?
A number of activities that people dont think twice about can have a negative impact on heart health, says Kevin R. Campbell, MD, a cardiac electrophysiologist at North Carolina Heart and Vascular, UNC Health Care in Raleigh. Check out this list of heart-damaging habits to see if it's time to make changes to your routine:
1. Sitting All Day
Compared to people with an active lifestyle, those who dont move enough and tend to sit for five hours or more each day have double the risk for heart failure, according to a study published in January 2014 in the American Heart Association (AHA) journal Circulation: Heart Failure.
If your job requires sitting at a desk all day, get up and take a five-minute walk every hour. This small tweak in your routine can keep your arteries flexible and blood flowing properly, protecting against the negative effects of being sedentary, according to an Indiana University study published in August 2014 in Medicine & Science in Sports & Exercise.
2. Overindulging in Alcohol
Drinking too much alcohol can lead to high blood pressure, stroke, and obesity all of which increase your risk for heart disease. The AHA reports that excessive drinking more than two drinks a day for men and one drink for women can interrupt your normal heart rhythm and cause heart failure. Its okay to enjoy the occasional cocktail or glass of wine, but you can protect your heart by sticking to the AHA guidelines.
3. Stressing Too Much
Stress spurs the body to release adrenaline, which temporarily affects how your body functions your heart rate increases, and your blood pressure may rise. Over time, too much stress can damage blood vessels in the heart and increase your risk for heart attack and stroke, Dr. Campbell says.
To minimize the harmful effects of stress, the AHA recommends the following:
Find a release. Share your feelings by talking with a trusted friend or family member.
Exercise. Relieve mental tension by engaging in physical activity. Aim for about 30 minutes of moderate-intensity exercise on most days of the week.
Plan your day. Prioritize tasks and plan ahead to help prevent rushing to get everything done.
4. Not Flossing
Your dentist is right: Flossing is important but not just for your teeth. A study published in May 2014 in the Journal of Periodontal Research found that people with coronary heart disease who flossed experienced fewer cardiovascular problems. What's the connection? Certain studies, including one published in July 2013 in International Scholarly Research Notices, show that bacteria associated with gum disease promote inflammation in the body, and inflammation has been associated with increased risk for heart disease, Campbell explains.
A variety of flossing tools are available to make the task a little easier in hard-to-reach areas, from flossing picks to threaders that guide the floss.
5. Overdoing It on Salt
Excessive sodium can lead to high blood pressure, a risk factor for heart disease, Campbell says. Avoiding the saltshaker isnt too difficult, but what about hidden sodium? The National Heart, Lung, and Blood Institute (NHLBI) reports that processed foods including canned vegetables and soups, lunch meats, frozen dinners, chips, and other salty snacks account for most of the salt Americans consume. Be sure to read nutrition labels and compare products, choosing the one with the lowest percent daily value for sodium. A rule of thumb to follow: The AHA recommends that most people consume less than 1,500 mg of sodium per day.
6. Not Getting Enough Sleep
Your heart works hard all day, and if you dont get enough sleep, your cardiovascular system doesnt get the rest it needs. Your heart rate and blood pressure dip during the first phase of sleep (the non-REM phase), then rise and fall in response to your dreams during the second phase (REM sleep). These changes throughout the night seem to promote cardiovascular health, according to the NHLBI.
Chronic sleep deprivation can also lead to high resting cortisol and adrenaline levels, similar to levels that you experience in a stressful situation, Campbell explains. He recommends that adults get 7 to 8 hours of sleep each night. Teens and young adults should aim for 9 to 10 hours, he says.
Make Your Heart-Healthy Changes Stick
Lifestyle changes are a process and do not occur quickly, says Frank J. Sileo, PhD, a psychologist at The Center for Psychological Enhancement in Ridgewood, N.J. In fact, according to a study that appeared in the British Journal of General Practice in 2012, it takes about 66 days for a practiced behavior to become a habit. So practice patience and follow these steps to make your heart-healthy changes stick:
Write out a list of the changes you want to make. Putting goals down on paper makes them tangible and creates a guide you can follow, Dr. Sileo says. Just be sure youre as realistic and specific as possible.
Break down your goals into manageable milestones. Dont try to make all the changes at once. Most people run into difficulties and failure when they try to change too much too fast, he says. Make sure each milestone feels attainable.
Gradually add new changes. When a change starts to become second nature, add another goal. Keep doing this until you reach the end of your list.
If you experience a setback, dont give up. Remember that as
changes turn into habits, youll be on your way to the ultimate
goal: maintaining a healthier heart.
Source: Mikel Theobald Reviewed by Farrokh Sohrabi, MD, www.everydayhealth.com/heart-health/common-habits-damaging-heart/?xid=aol_eh-gen_2_20150209_&aolcat=HLT&icid=maing-grid7%7Cmain5%7Cdl26%7Csec1_lnk2%26pLid%3D613896
How to Remain Calm When You Want to
By recognizing hooks for what they are bait for the prey's free- floating hostility you should be able to swim past them.
Similarly, Dr. Redford B. Williams, the director of the Behavioral Medicine Research Center at Duke University, recommends asking four questions whenever the bile starts to rise:
The situation warrants action only if you get four yeses. Otherwise, Dr. Williams said, let it slide.
See our Time Out card.
Source: Leslie Berger
Take Blood Pressure
Advice with a Grain of Salt
Over time, beta-blockers will turn your heart into a fat, lazy, incompetent water balloon. You already had high blood pressure to deal with, now you have a gross de-conditioning of your heart.
How did this happen? Because no one has messed up modern medicine more than cardiologists.
Well most cardiologists are all about the methodology of using heart drugs and technology, but are opposed to the general concept of analyzing your health and how to improve it.
Its a true but sad state of affairs that a cardiologist cant tell you any more about how to improve the health of your heart than the average person you meet on the street. They know virtually nothing about it.
They know how to use drugs. But the drugs are not health enhancing. In fact, there are no categories of cardiac drugs that I dont disagree with. One by one, I ruled all the drugs out.
For example, if you are getting treatment for high blood pressure, you might be on beta blockers. But think of what cardiologists are doing there.
Theyre now giving you a drug that blocks the regulation of your heart, down-regulates your capacity to get your heart rate up, and suppresses your hearts natural ionotropic capacity to beat more firmly.
Initially, beta-blockers sort of work to artificially bring down your blood pressure, and your heart will calm down, but now you can never get the benefit of exercise.
But there are other steps you can take to lower your blood pressure naturally. And when you do, your chance of heart disease, heart attack, and stroke go back to normal. Its as if you never had high blood pressure in the first place.
Step 1 Use Natures Own Blood Pressure Prescription. Im talking about magnesium, your bodys natural blood vessel relaxer. Ive used it in my practice with great results.
It helps balance potassium, sodium and calcium, which all affect blood pressure. There are many studies that show the more magnesium you get the lower your blood pressure will be.
Why take a drug when this overlooked mineral can have the same effect?
New research even finds that if you get enough magnesium you have a lower risk of dying from any cause. The study followed 4,203 people over 10 years, and found that the rate of death from all causes was 10 times higher for people getting the least magnesium.1 And the rate of death from heart problems was more than 50% higher for those with low magnesium.
You can get more magnesium by eating nuts, seeds, dairy products and dark green, leafy vegetables. But modern farming practices have depleted much of the mineral content in our soil, so theres not much magnesium in vegetables any more.
Magnesium used to be in your drinking water but water with high mineral content hard water fell out of favor because most people dont like the taste.
If you cant get enough magnesium through food, you can take a supplement. I recommend between 600 and 1000 mg a day. Take it with vitamin B6. It will increase the amount of magnesium that accumulates in your cells.
Step 2 Toss The Processed Salt. Salt itself isnt bad. We naturally crave salty foods. In fact, when your blood is at its healthiest, its slightly salty.
Unfortunately, the salt you find in most foods today isnt even close to what Mother Nature intended. Its bleached and refined. When theyre done making it into the white stuff that goes into packaged foods and your salt shaker its like franken-salt, with residual chemicals from the processing.
Try to avoid the foods that have the most processed salt. Bottled salad dressing, cured meats (beef jerky, salami), processed cheese, salt-covered snack foods and pickled foods (like olives and dill pickles).
Instead, look for sea salt. Its unrefined, and has all the minerals and co-factors nature meant salt to have, like potassium and magnesium.
Regular salt is almost pure sodium chloride. Natural sea salt has sodium chloride, too, but also has over 50 other minerals (including magnesium) with all the co-factors and trace elements nature intended real salt to have.
High blood pressure is just one of the many important topics
addressed by The Institute of Natural Healing. This cutting-edge
newsletter publisher goes beyond the limited scope of most health
publications to provide you with medical news and solutions you
wont find elsewhere.
Source: Press release
Safe Exercise for Heart Disease
Here are some things to discuss with the doctor:
General Workout Tips for Heart Disease Patients:
How Much Exercise Is Necessary to Keep
Your Heart Healthy?
A few years ago, the Institute of Medicine (IOM) released a lengthy report recommending that, as part of a routine regimen to maintain our cardiovascular health, ideal body weight, and ideal body composition, we all (that is, each and every one of us) need to engage in 60 minutes of daily moderate physical activity.
Furthermore, the experts over at the IOM made it crystal clear that they are not talking about merely accumulating the equivalent of an hour of exercise during one's routine daily activities (such as climbing stairs or doing the laundry).
What they're talking about is adding 60 minutes of honest-to-goodness sustained moderate intensity exercise (specifically, the equivalent of walking or jogging at least at a 4 to 5 miles per hour pace) to whatever other activities we might perform during the course of a normal day.
There is no doubt that exercise is very good for cardiovascular health. But an hour a day?
How Did They Come Up With an Hour A Day?
The experts who wrote this report for the IOM are scientists. Every word in this report is backed up by references from scientific studies, carefully interpreted in light of the whole body of evidence accumulated by medical science. This report is a comprehensive synthesis of what is known (and not known) today about optimizing our caloric intake (carbohydrates, fat, protein, etc.) and our output (physical activity) in order to maintain an advisable weight, a favorable body composition (i.e., proportion of muscle to fat), and cardiovascular health.
And based on their synthesis of all this data, the authors' conclusions regarding exercise follow as naturally as the night follows the day. These scientists are immersed in grim scientific objectivity, and like good scientists are merely letting the chips fall where they may. To maintain optimal cardiovascular health, a good body weight, and a favorable body composition, they have no choice but to conclude that all of us adults need to engage in at least one hour of moderately intensive exercise (or at least 30 minutes of vigorous exercise) each day.
A Whole Hour? Really?
While an hour a day of exercise may indeed be just the thing for us, the IOM recommendations are (I humbly submit) emblematic of a fundamental flaw with much modern progressive thinking. To wit: it is entirely ridiculous to expect us folks to change our fundamental human natures just because a top expert panel, following the latest high-quality investigational methodologies, has determined that we should.
To actually be useful, any expert recommendations on a healthy lifestyle must remain within the bounds of the possible. And telling us that it's an absolute that we must exercise for at least an hour a day is more than just out of bounds - it is too outlandish for words.
Indeed, this new recommendation is so outlandish that it threatens to completely undermine whatever good might have come so far from more reasonable recommendations that others have made regarding exercise.
My fear is that typical, ordinary Americans, upon learning that all their efforts to fit at least some exercise into their busy schedules are, after all, laughably inadequate, are going to throw up their hands in sheer frustration and disgust and say, "Screw it.
Pass the remote and open a bag of Cheetos." I suspect this is true because that was very nearly my reaction to this report.
How Much Exercise Is Actually Necessary?
Here's a fact: the available data strongly suggests that the more exercise you do, the more you are reducing your cardiovascular risk (and the more calories you burn off). While the IOM is now on record as saying we "need" to do an hour a day of exercise, the fact is that if we did two hours a day we'd be even better off. (To this extent, at least, the IOM experts who wrote this report in fact did maintain some minimal semblance of practicality.)
Those of you who can fit in an hour or two of exercise a day need read no further. But for the rest of us, the real question is: How much exercise do we really need in order to see at least some substantial cardiovascular benefit?
The answer is: More than 40 studies in scientific literature document that cardiac risk can be reduced by 30 - 50% by regular, moderate exercise - exercise averaging far less than one hour per day. If you can exercise at a moderate pace for 20 - 30 minutes at least five days a week, you may not shed a lot of pounds or reach your ideal body composition, and you may not achieve the optimal cardiac benefits which the IOM mandates for us, but you will be doing your heart and your cardiovascular system a lot of good.
The bottom line: if you can engage in vigorous exercise for an hour a day without making yourself crazy, disabling yourself with orthopedic issues, losing your job, or instigating a divorce, then by all means do so. But if you are a mere mortal, then at least try to go for a walk every day. Twenty minutes of moderate daily activity won't make the pounds melt off or give you the same body composition as the Williams sisters, but it can make a real impact on your cardiovascular health.
If the authors of the IOM report had allowed as much, the frustration levels they created among those of us trying to lead healthy, but non-obsessive, lifestyles might be a little bit lower.
Panel on Macronutrients, Panel on the Definition of Dietary Fiber, Subcommittee on Upper Reference Levels of Nutrients, Subcommittee on Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes For Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Institute of Medicine; The National Academies Press, Washington, DC, 2005.
Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995 Feb 1;273(5):402-7.
Sesso HD, Paffenbarger RS Jr, Lee IM. Physical activity and coronary heart disease in men: The Harvard Alumni Health Study. Circulation 2000; 102:975.
Manson JE, Greenland P, LaCroix AZ, et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 2002; 347:716.
Fletcher, GF. How to implement physical activity in primary and secondary prevention. A Statement for Healthcare Professionals from the Task Force on Risk Reduction, American Heart Association. Circulation 1997; 96:355.
Does Running 5 Minutes A Day Really Protect
A study was published in July, 2014 reporting that people who ran 5 - 10 minutes a day - even if they ran very slowly - were significantly less likely to die from heart disease (or from other causes) than people who did not run at all. In fact, the reduction in mortality among people who ran briefly and slowly (but regularly) was the same as for people who ran a lot more, and a lot faster. Immediately after the studys publication, newspaper headlines and TV reports across the country loudly proclaimed that A Little Bit of Running Can Save Your Heart and Your Life.
Can This Really Be True?
Lets have a look at the study and see.
This report came from the Aerobics Center Longitudinal Study (ACLS), a long-term study conducted by the Cooper Institute for Aerobics in Dallas. The ACLS enrolled over 55,000 individuals from all age groups, and followed them for 15 years. The ACLS has published numerous papers comparing lifestyle habits to eventual outcomes. As the name of the Cooper Institute for Aerobics implies, the chief interest of the investigators has been to study the effects of exercise and fitness on clinical outcomes.
In the report from July, 2014, the investigators were able to correlate a running habit - even a minimal running habit - with significantly improved outcomes. In fact, subjects who ran just 5 - 10 minutes per day (including those who ran less than 6 miles per week, or slower than 10 minutes per mile) had the same reduction in mortality as more dedicated runners who ran much faster and who averaged over 20 miles of running per week.
And the reduction in mortality was substantial. Over 15 years, the risk of death from cardiac causes was 45% lower, and the risk of death from any cause was 30% lower, than for non-runners. This benefit accrued to all runners, even the ones who ran quite slowly, and only for 5 - 10 minutes per day.
So, the study suggests, if you cant exercise according to current guidelines (at least 30 minutes of moderate to vigorous activity at least 5 days a week), you can still gain very substantial benefit if youll just run for 5 or 10 minutes a day.
How Is This Even Possible?
A tremendous amount of data has accumulated showing that regular exercise is extremely important to cardiac health, and to health in general.
Most of that data has been compiled by comparing the time people spend exercising to their eventual outcomes, and in most cases the measured exercise consisted of any type of moderate activity (typically, walking). The Cooper Institute was uniquely situated, by virtue of the type of person enrolled in the ACLS (see the next section), to evaluate a substantial number of people who run regularly, but only a little bit. So this is the only study available that was even able to ask the question - and then answer it - as to what happens when a person exercises vigorously for a few minutes a day.
Regular exercise places useful stress on the cardiovascular system that, over time, improves the function of the heart and the blood vessels, by improving blood lipid levels, reducing the resting blood pressure and heart rate, and improving carbohydrate metabolism and neurohormonal activity.
While these benefits are obtainable with moderate, sustained exertion (such as walking briskly for 30 minutes a day), it is entirely possible - and the ACLS study suggests it is true - that just a few minutes of somewhat more vigorous exercise may be able to induce enough of this useful cardiovascular stress to achieve the same result.
What Are the Limitations of This Study?
There are several limitatations. As with any epidemiological study (that is, a study that examines outcomes in a large population of individuals), we cannot draw any cause-and-effect conclusions from this one. That is, while the study showed convincingly that minimal running was associated with improved mortality in the enrolled population, it does not (and cannot) prove that running caused the improved mortality.
Also, the population enrolled at the Cooper Institute was hardly representative of all Americans. Up to 95% of the people enrolled in the ACLS were white, and 80% were college gradutates. And the very fact they agreed to be enrolled in a study run by the Cooper Institute suggests that, on average, these individuals may have been more likely than the typical American to pay attention to their health habits. Indeed, it turns out that ACLS enrollees were less likely to be smokers, and were more fit, than the population in general. And even among these healthier than average enrollees, those who were sufficiently motivated to run regularly (even if only for a few minutes and at a slow pace) may have been more likely to attempt a healthier lifestyle in general than non-running enrollees. The investigators took steps to adjust for such confounding variables in their study, but no such statistical adjustments can ever be perfect.
Still, the stark difference in mortality between runners (even very slow runners) and non-runners in the ACLS is very impressive, and is difficult to dismiss out of hand. And as we consider our options in reducing our own cardiovascular risk, we have little to lose by accepting these results as likely representing the truth.
The Bottom Line
We know from numerous studies in the medical literature that getting enough exercise - and staying fit - is an extremely important factor in living a long, healthy life. The Surgeon General, the CDC, and the National Institutes of Health all agree that we each should try to get at least 30 minutes a day of modest activity. (Modest activity is defined as the equivalent of walking briskly, that is, at 3 - 4 miles per hour.)
The report from the ACLS suggests that we can get the same benefit in a substantially shorter period of time, if we just pick up the pace a bit. If we shift from a brisk walk to a slow run (that is, increase our pace to 5 or 6 miles per hour), it is entirely possible that 5 - 10 minutes of exercise would suffice. Since lack of time is the most frequent excuse doctors hear from their patients for not following exercise guidelines, this new study should give us a lot to think about. Almost anyone can find a spare 5-10 minutes in their day.
In fact, if we simply jog to our parked car or to the bus stop instead of walk, we can get in our lifesaving exercise - and at the same time we can even save ourselves a few minutes.
Lee DC, Pate RR, Lavie JR, et al. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol 2014; DOI: 10.1016./j.jacc.2014.04.058.
Wen CP, Wai JP, Tsai MK, Chen CH. Minimal amount of exercise to prolong life. J Am Coll Cardiol 2014; DOI: 10.1016./j.jacc.2014.05.026.
Three Who've Learned The Hardest Way
RICHARD BROWN, 54, was a playground legend with a taste for the high life. Now, after losing a leg to diabetes and receiving a diagnosis of an enlarged heart, he takes better care of himself, and works to help youngsters.
AMIT, 36, with his wife and son, fears that divulging his last name will affect his insurance coverage. He suffered a mild heart attack last year despite exercising and eating sensibly. It only made him more determined to lower his high cholesterol count. ``If I think something is not good,'' he says, ``I will disallow it.''
N a cramped room at the Mount Sinai Hospital's Cardiac Care Center, time is marked by the loud, mechanical beating of Louis Fantauzzi's artificial heart. It is the sound of a tethered life, a life in suspension.
Now in his fifth month of waiting for a real heart, Mr. Fantauzzi embraces distraction. He loses himself in books. He soars with the voice of Celine Dion on his headset. Twice a day he attaches a battery-operated power pack to his stand-in heart and takes 15-minute walks through the antiseptic corridors. Most of all, he longs for his doctor to stride into the room and say: we have a match.
It would mean that a healthy heart had become available to replace the scarred, useless muscle in his chest. It would mean walking with confidence, climbing stairs without pause and sleeping in his own bed beside his wife of 30 years, Zaida. These are the modest hopes of one 56-year-old man, and despite the formidable obstacles before Mr. Fantauzzi they are well within reach.
Just as poets continue to plumb the symbolic possibilities of the heart, so too do medical researchers continue to learn about an organ at once so basic and so complex: the heart remains a central riddle of life. After years of being overshadowed by cancer, AIDS and other public-health matters, diseases of the heart have returned to the spotlight thanks in part to two men who might have preferred other ways to contribute to the public good.
Early last year, David Letterman, the late-night talk- show host, underwent quintuple bypass surgery, after a test that indicated an artery leading to his heart was severely constricted. Mr. Letterman was only 52 at the time, but he knew that he had high cholesterol and that heart disease ran in his family.
And last November, Dick Cheney, the future vice president, suffered a heart attack at age 60. It was his fourth, and his travails were not over. In March, the vice president returned briefly to the hospital because a blockage had developed around a wire-meshed stent that had been implanted in a coronary artery after his heart attack.
Some cardiologists welcome the renewed attention prompted by the Letterman and Cheney cases, given that heart disease is the nation's leading cause of death. Although more women than men have died of cardiovascular disease since 1984, men appear to be particularly susceptible to certain manifestations of the disease. According to the American Heart Association, more men undergo angioplasty and bypass surgery, and they account for 74 percent of all heart transplants in the United States.
"I think it's been taken for granted by some professionals and by the public that things are going well, and that we have it under control," said Dr. George Sopko, a cardiologist at the National Heart, Lung and Blood Institute in Bethesda, Md. "Not necessarily. There's still room for a lot of education" for researchers and the public.
Still, for all the sobering statistics, Dr. Sopko and other cardiologists stress that remarkable advances in preventing and treating heart disease have been made in just the last 15 years or so from realizing the blood-thinning benefits of aspirin to decoding the complex relationship between heart disease and genetics.
Stents, which are essentially interior scaffolding for clogged blood vessels, have become common hardware for cardiology. Statins, a class of drugs, not only lower cholesterol, they also stabilize vessel walls, have anti-inflammatory properties and are tolerated well. Even heart transplants, once considered the most extreme of surgical procedures, have become almost standard.
For Mr. Fantauzzi, the clinical details are mundane. It is the
specific details, of his case and those of two other men, that make
it personal and therefore unique.
Waiting for a Heart
The discomfort intensified. After some internal debate, Mr. Fantauzzi left the subway platform, returned home and was admitted to a neighborhood hospital. That evening he had a massive heart attack, delivering a pain so intense that his voice lowers with respect as he talks about it today. Two months later he had a double bypass operation, then returned to his normal routine only this time he watched his diet and rode an exercise bicycle every evening after work.
By now, though, the best of intentions could not overcome the damage done to the heart. Dr. Alan Gass, the director of transplant cardiology at Mount Sinai, said the scarring caused by Mr. Fantauzzi's heart attack was so extensive that coupled with his genetic makeup "he was already destined to need a heart transplant."
In 1995, Mr. Fantauzzi suffered an aneurysm of the heart, a result of his earlier heart attack. He tried to return to his job, but he was too weak. "It was like picking up that bed," he said, motioning to his hospital bed. "It was too much." And when his family moved from the apartment to a house in Queens, he could do nothing more than watch everyone pack and unpack.
As his strength flagged, so much so that driving his wife to the store became a private marathon, Mr. Fantauzzi began to attribute his condition to age. "You're 55 years old, you've got a bum heart, this is the way it is," he said. "That's how I was rationalizing it."
That changed one day in January, when he began to perspire profusely and could not summon the strength to climb the stairs into his house. As one of his sons carried him to the sofa, his wife called 911. Mr. Fantauzzi has been in hospital care ever since.
"It's the extreme end of heart disease," Dr. Gass explained. "He
was in cardiogenic shock. Because of the heart attack, there is not
enough blood going to his vital organs, and his kidneys were
beginning to shut down."
Over a Third of
Americans Have Heart Risk Factors
The bad news is that according to new research, over a third of
Americans have metabolic syndrome, and the rate increases
dramatically with age: Almost half of people over 60 have metabolic