Prevention of Heart Disease

PREVENTION OF HEART DISEASE  Anti-inflammatory (?)

INTERVENTIONS FOR THE PREVENTION ACE INHIBITOR OF HEART DISEASE Benefit SMOKING CESSATION  30% reduction of risk for future cardiac events

Benefit Mechanism  50-70% lower risk in 5 years  Decreases work load on heart  Prevents remodeling of left ventricle Mechanism  Improves blood pressure  Reverses clotting abnormalities  Direct effect on atherosclerotic plaque  Returns normal vessel ability to dilate  Raises HDL DEAN ORNISH REVERSAL PROGRAM

CHOLESTEROL REDUCTION Benefit Benefit  57% reduction in cardiac events  2% decrease in risk for each 1% reduction in cholesterol Mechanism  30% average reduction in risk  Reversal of atherosclerotic plaque Mechanism  Stabilization of plaque  Decreases LDL & total cholesterol  Stress reduction  May decrease triglycerides  Improvement in lipid profile  May raise HDL  Improvement in clotting parameters  Decrease clotting BETA BLOCKERS ACHIEVE BLOOD PRESSURE GOAL (135/85) Benefit Benefit  40% reduction in risk of another cardiac event  2-3% reduction in risk for each 1 mm. drop in following a myocardial infarction diastolic blood pressure  20-40% average reduction in risk Mechanism  Decreases blood pressure Mechanism  Decreases cardiovascular response to emotional  Improves arterial tone or physical stress  Decrease end organ damage  Anti-arrhythmic

ASPIRIN (81 mg. daily) STRESS REDUCTION/ANTIDEPRESSANTS

Benefit Benefit  50% reduction of risk of future cardiac events  Anticipated benefit - depression increases risk following a heart attack of cardiac events by 2-5 times  Chronic stress increases most risk factors for atherosclerosis and sudden cardiac death Mechanism  Anti-clotting Mechanism  Reduce oxidation of LDL  Decreases catecholamines  Improve insulin resistance  Decreases blood pressure  Olive oil is highest in anti-oxidants  Decreases clotting  Improves blood sugar VITAMIN E

ATTAIN IDEAL BODY WEIGHT Benefits  40% reduction of risk of heart disease with 200 Benefit International Units per day in the Nurses  35-55% lower risk of heart disease than if Cooperative Study greater than 20% overweight  Vitamin E is not recommended with “statin” drugs.

Mechanism Mechanisms  Decreases blood pressure  Improves blood sugar  Anti-oxidant  Improves cholesterol  Anti-clotting  General health benefits and life style NUTS FISH OIL/OMEGA-3 POLY UNSATURATED Benefits FAT  20-25% decreased risk of coronary artery Benefits disease.  50% reduction in the risk of sudden cardiac  In the Male Physicians Study there is a death - consume fish one time per week reduction in sudden cardiac death with a direct  70% reduction in the risk of sudden cardiac linear relationship to the quantity of nuts eaten death - consume fish 3-4 times per week Mechanism  High fiber Mechanism  Mono unsaturated fats  Lower triglycerides by 30%  High in magnesium  Anti-clotting  Highest in mono unsaturated fats are walnuts,  Reduce inflammation in plaque (and joints) almonds, filberts, macadamias, pecans, pistachios  Increase HDL  Decrease LDL WHOLE GRAIN  Anti-diabetic, obesity, carcinogenic effect Benefits MONO UNSATURATED FATS  30% reduction in risk of coronary artery disease Benefits  42% reduction in risk of coronary artery disease Mechanism by switching 5% of energy from saturated fats to mono unsaturated fats  Healthy lifestyle may be contributory  53% reduction by switching 2% of energy from  Fiber trans fatty acids  Plant chemicals  Anti-oxidants

Mechanism DIETERY FIBER Benefits  Reduce LDL cholesterol Reduction in all cause mortality  Raise HDL   30% reduction in cardiac risk from whole grains Mechanism with atherosclerotic heart disease  Theoretical dilution of the blood and clotting  Recommended dose is 20 grams per day factors  Increased mineral content of water

Mechanism GRAPE JUICE  Fiber itself may play a role, but a greater effect may be what is associated with the fiber coming Benefit from plant sources such as anti-oxidants, folic  Intuitive benefit is anticipated acid, and plant chemicals

TEA Mechanism  Reduce clotting Benefits  Reduce anti-oxidant effect  45% less risk for myocardial infarction in the  Normalizes function of arterial wall Boston Health Study with 1 cup per day  70% less risk of stroke with 4.5 cups per day MEDITERRANEAN DIET

Benefit Mechanism  70% fewer heart attacks  Anti-oxidant  50% fewer overall deaths  Lowers homocysteine  61% fewer cancers  The above is based on the Lyon France Study ALCOHOL  Reduces the risk of cardiovascular events by Benefit 50%  Reduces adult onset diabetes by 300%  30-50% reduction in risk of developing atherosclerotic heart disease with 1-2 drinks per day Mechanism  Anti-oxidants Mechanisms  Mono-unsaturated fats  Raised HDL (50% of the benefit) REGULAR EXERCISE  Decreasing clotting especially if alcohol is taken with meals (30% of the benefit) Benefit  Anti-oxidant (20% of the benefit)  50% reduction of cardiac events  Reduces insulin resistance  Note: 80% of the benefit of alcoholic beverages is due to the alcohol itself Mechanism  Decreases blood sugar WATER Benefit  Decreases clotting Decreases blood pressure  51% lower risk of heart disease in men with five  or more glasses per day 7th Adventist Study  Decreases catecholamines  35% lower risk in women  Increase fitness  44% lower risk of stroke  Increased arterial collaterals  Swedish Study – 38% lower risk of fatal myocardial infarction