The YOU Docs Blog
Post 14—How to Prevent Out-of-the-Blue Heart Attacks
PAGE 6
And you thought your 401(k) statement was scary. How about the fact that more than half of all heart attacks strike people who seem perfectly healthy—no high LDL cholesterol, no high blood pressure? Don't cue up the menacing music yet: There are other known risk factors, and you can control them relatively easily.
One reason a heart attack happens to a seemingly healthy person like you is that there's a stalker in your arteries: inflammation. And now, the benefit of what we've been doing to combat it at NewYork–Presbyterian and the Cleveland Clinic has been confirmed by a Harvard Medical School study. The study found that if you have this inflammation villain but you're in good shape otherwise, taking a statin drug could slash your risk of a horror-story heart attack by 50 percent.
People in the study had fairly healthy levels of lousy LDL (under 130 mg/dL) but high levels of C-reactive protein (CRP), a sign of chronic inflammation. Those who got the statin drug saw their CRP counts fall 37 percent and their absolute risk of a heart attack drop by 50 percent. And when you control your risk of a heart attack, you also control your risk of stroke, impotence, kidney failure and even wrinkles. A major cause of all of these is arterial aging, and while arterial aging is typical, it is neither normal nor necessary.
Does this mean you need a statin, even if your cholesterol's not high? Maybe. But there's a better take-home message: Don't wait until you need a drug to get serious about inflammation. Here's how to keep it in check, with or without a statin:
Know Your CRP Score
Get a baseline test of your CRP levels in your 20s, again at 35 and annually after your 50th birthday. Get an hs-CRP (short for high-sensitivity) test, which detects CRP in low ranges (cost: $20 to $50). Regular CRP tests are fine for checking high inflammation levels in rheumatoid arthritis and serious infections, but they won't detect the low levels that can threaten your heart.
A CRP under 1.0 mg/L is considered low risk for cardiovascular disease, 1 to 3 is considered average, and over 3 is considered high risk. That's the conventional wisdom; people in the study got treated at levels as low as 2 mg/L.
If Your CRP Is 2 or Higher, Do Something About It
In addition to making inflammation-quenching lifestyle moves (more on those in a minute), talk with your doc about the pros and cons of statin therapy. By the way, the lower dose of statins that Dr. Mike usually prescribes seems to work just as well as the higher dose in the study. There's little doubt that a statin can lower your risk. But, like all drugs, statins can have side effects. If statins don't seem right...
Consider Aspirin
We recommend half of a regular aspirin or two low-dose aspirin (162 milligrams total) every day if you're a man over age 35 or a woman over 40 (drink half a glass of water before and after). It cuts the risk of a heart attack by 36 percent by lowering arterial inflammation and making platelets less likely to form heart-threatening clots. But talk to your doctor first. Aspirin can raise your odds for an ulcer or gastric bleeding, but those odds are reduced by more than 60 percent when you drink that half glass of water before and after.
Make Good Choices
Inflammation in your arteries is fueled by belly fat; inactivity; eating too much saturated fat; too few fruits, vegetables, whole grains and beans; and even by ongoing low-grade infections like sinusitis and gum disease. But you can control it with these steps:
For more from the YOU Docs, visit RealAge.com.
Find time to walk—even if you're too busy to remember!
One reason a heart attack happens to a seemingly healthy person like you is that there's a stalker in your arteries: inflammation. And now, the benefit of what we've been doing to combat it at NewYork–Presbyterian and the Cleveland Clinic has been confirmed by a Harvard Medical School study. The study found that if you have this inflammation villain but you're in good shape otherwise, taking a statin drug could slash your risk of a horror-story heart attack by 50 percent.
People in the study had fairly healthy levels of lousy LDL (under 130 mg/dL) but high levels of C-reactive protein (CRP), a sign of chronic inflammation. Those who got the statin drug saw their CRP counts fall 37 percent and their absolute risk of a heart attack drop by 50 percent. And when you control your risk of a heart attack, you also control your risk of stroke, impotence, kidney failure and even wrinkles. A major cause of all of these is arterial aging, and while arterial aging is typical, it is neither normal nor necessary.
Does this mean you need a statin, even if your cholesterol's not high? Maybe. But there's a better take-home message: Don't wait until you need a drug to get serious about inflammation. Here's how to keep it in check, with or without a statin:
Know Your CRP Score
Get a baseline test of your CRP levels in your 20s, again at 35 and annually after your 50th birthday. Get an hs-CRP (short for high-sensitivity) test, which detects CRP in low ranges (cost: $20 to $50). Regular CRP tests are fine for checking high inflammation levels in rheumatoid arthritis and serious infections, but they won't detect the low levels that can threaten your heart.
A CRP under 1.0 mg/L is considered low risk for cardiovascular disease, 1 to 3 is considered average, and over 3 is considered high risk. That's the conventional wisdom; people in the study got treated at levels as low as 2 mg/L.
If Your CRP Is 2 or Higher, Do Something About It
In addition to making inflammation-quenching lifestyle moves (more on those in a minute), talk with your doc about the pros and cons of statin therapy. By the way, the lower dose of statins that Dr. Mike usually prescribes seems to work just as well as the higher dose in the study. There's little doubt that a statin can lower your risk. But, like all drugs, statins can have side effects. If statins don't seem right...
Consider Aspirin
We recommend half of a regular aspirin or two low-dose aspirin (162 milligrams total) every day if you're a man over age 35 or a woman over 40 (drink half a glass of water before and after). It cuts the risk of a heart attack by 36 percent by lowering arterial inflammation and making platelets less likely to form heart-threatening clots. But talk to your doctor first. Aspirin can raise your odds for an ulcer or gastric bleeding, but those odds are reduced by more than 60 percent when you drink that half glass of water before and after.
Make Good Choices
Inflammation in your arteries is fueled by belly fat; inactivity; eating too much saturated fat; too few fruits, vegetables, whole grains and beans; and even by ongoing low-grade infections like sinusitis and gum disease. But you can control it with these steps:
- If you smoke, for heaven's sake quit!
- Move! Get at least 30 minutes of walking every day.
- Take vitamin D (1000 international units) and omega-3 DHA (600 milligrams of DHA). If you prefer fish oil, take 2 grams every day.
- Put colorful, high-fiber foods, including beans, blueberries and tomatoes, on your plate at every meal. A high-fiber diet can reduce CRP levels. So can the carotenoids in pumpkins and cantaloupes, the lutein in tomatoes, the natural oils in herbs like oregano, and something called oleocanthal in fresh-pressed extra-virgin olive oil.
- Skip Conan, Letterman and Jon Stewart and turn in early. Or just TiVo them or catch them on the Web the next day. In one recent study, sleep-deprived people—especially women—showed a marked increase in proteins associated with inflammation.
- Floss. Plaque buildup in your mouth may provoke inflammation.
- Battle belly fat, even if you're skinny. The higher your percentage of body fat—especially around your middle—the more proinflammatory cytokines are racing around in your blood. To lower your body fat, use the triple threat: aerobic exercise, weight training and a balanced diet.
For more from the YOU Docs, visit RealAge.com.
Find time to walk—even if you're too busy to remember!
As a reminder, always consult your doctor for medical advice and treatment before starting any program.
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