It is so easy to go a day, a week, even a year and never think about the fact that it is a friggin’ miracle that a muscle the size of a fist is pumping gallons of blood daily.
I was taught in medical school that coronary artery disease (CAD) progresses from minor “fatty streaks” in youth, to plaques in early adulthood, to complicated plaques causing heart attacks and death later in life.
Stress is often the “elephant in the room” when I discuss why my patients missed their goals for proper exercise, nutrition, abstinence from smoking, and proper sleep. Physicians aren't routinely taught how to advise others on stress-management techniques, and may do no better than the rest in terms of dealing with stress themselves. I've just completed a series of lectures to the public on stress-management tips, and list them here in the hopes they may help others.
1. Adaptogens for Adrenal Support
When I talk to patients about stress, I begin by describing adaptogens, or herbs that appear useful in stabilizing physiology and improving anxiety and stress. These are often called adrenal support herbs as the appear to be a remedy for “adrenal fatigue” or burnout. I use adaptogenic herbs to avoid needing to use Rx medications like Xanax and Ativan.
Frankly, substituting one pill for another is something most patients accept faster than any other technique. I've had success in many patients using ashwagandha. Even elderly patients report they feel less stressed and more functional. Rhodiola is another adaptogen I like because it has been studied in heart patients and shows benefits for their symptoms. Finally, cordyceps has been shown to improve exercise performance and may provide a sense of calm as an additional benefit.
If you're new to adaptogens, incorporating them into recipes is a great way to start. Such as this Adrenal Balancing Smoothie with Adaptogens, this Raw Fudge with Ashwagandha, and this Ashwagandha-infused "Moon Milk" recipe.
2. Breathwork
There are many styles of breathwork, but I find I can teach my patients the 4-7-8 breathing practice in the office in just a few minutes, and they use it right away. I refer them to an online video created for children, and ask them to practice this at home and use it in their daily routine.
3. Meditation
Teaching meditation is a longer process than the first two techniques, but has been shown to benefit heart patients and should be taught routinely. I ask them to study the Kirtan Kriya taught by Dr. Khalsa because it's only 12 minutes and is supported by great research results at UCLA. When I tell them they may slow aging and improve their memory while dealing with their stress, they're eager to use it in their lives.
4. Yoga
Different styles of yoga have been studied in a variety of serious stress disorders including cancer, post-trauma, and addictions. Yoga has been found beneficial even when tested using rigorous scientific study design. Yoga can be adapted for the elderly using only a chair; it provides a sense of community, and offers some cardio benefit as well.
I remind my patients of a story about a man speaking to a religious leader, repeating over and over that he was frustrated with the stresses in life. The leader suggested they take a walk, and stopped in front of a cemetery. The man asked why they stopped there and the leader replied, "There lay the only people who have no worries and stress"; for the rest of us, we need to manage and work out the issues.
I hope you share strategies you use for managing stresses in your life.
Sincerely,
Dr. Kahn
About the author
Dr. Joel Kahn is one of the world's top holistic cardiologists. He has treated thousands of acute heart attacks during his career, and would like to put a stop to ALL future heart attacks by educating and inspiring people to embrace a holistic lifestyle. America’s Healthy Heart Doctor has been featured on The Doctors and Dr. Phil television shows, and is one of the few doctors that posts consistently for Mind Body Green.
Preventing heart disease in patients is my main goal, but early detection is the next best thing if you cannot totally block its development. Changes in lifestyle and medical therapies can delay or deny the onset of a heart attack and almost 80 percent of heart disease is preventable with lifestyle changes. My patients are surprised to learn that the following list may give clues to underlying silent heart disease years before a heart attack.
Erectile Dysfunction (ED) Could Mean Clogged Arteries
Men have a built-in warning system for silent CHD. When achieving an erection is difficult or impossible, it can be a sign of clogged arteries in the pelvis that presents before a heart attack hits. There are, on average, three to five years between the onset of ED and the finding of CHD, which is plenty of time to detect and work on preventing heart issues. If you and your partner are worried about sexual performance, look for and treat root causes of diseased arteries before just popping a blue pill.
Baldness Could Indicate Clogged Arteries
In a comprehensive study of almost 37,000 men, severe baldness at the crown of the head strongly predicted the presence of silent CHD at any age. In a separate study of more than 7,000 people (including over 4,000 women), moderate to severe baldness doubled the risk of dying from heart disease in both sexes.
Gray Hair Is A Clue To Blocked Arteries
A new study presented in Europe at EuroPrevent 2017 found a high amount of gray hair is a risk factor for silent heart atherosclerosis. A total of 545 adult men without known heart disease had a CT angiogram of their heart arteries, a very accurate way to identify silent problems. Having equal amounts of gray and dark hair, or mainly gray and white hair, correlated with finding silent heart blockages. The researches commented that “atherosclerosis and hair graying occur through similar biological pathways”.
A Diagonal Ear Lobe Crease Might Indicate Clogged Arteries
One of the stranger markers, a crease in your earlobe (specifically, an angled crease in the ear that runs diagonally from the canal to the lower edge of the earlobe) has been mentioned in medical research reports as a sign of silent CHD for decades. The ear crease may result from poor circulation, including in arteries in the heart. Although some medical professionals have argued that a crease is just a general sign of aging, researchers last year used the most sophisticated CT scan method to measure silent CHD and found that ear crease predicted heart disease even after the authors accounted for other risk factors, such as age and smoking.
Calf Pain When You Walk Might Mean Clogged Arteries
This is known as claudication (from the Latin for “to limp”). Atherosclerosis can block leg arteries, particularly in smokers, before CHD is diagnosed. This symptom requires an evaluation without delay. Your doctor will examine the pulses in your legs and perform simple measurements of leg blood pressure and blood flow to confirm a diagnosis of poor circulation.
It is critical that heart disease be diagnosed as early as possible because there are many dietary and medical treatments that can help reverse the issue. Some of my patients took these early clues to heart. Anyone with any of the above clues to silent heart issues should know his or her numbers (blood pressure, cholesterol, fasting glucose). Asking your doctor for an EKG or a coronary calcium CT imaging is wise, whether you are a woman or man. Changing your lifestyle right away to ban smoking, walking, managing stress, and adding a plant-based diet can reverse problems before they attack your health or life. To borrow from Ben Franklin, an ounce of prevention (plus a bowl of kale) is worth a pound of cure.
Sincerely,
Dr. Kahn
About the author
Dr. Joel Kahn is one of the world's top holistic cardiologists. He has treated thousands of acute heart attacks during his career, and would like to put a stop to ALL future heart attacks by educating and inspiring people to embrace a holistic lifestyle. America’s Healthy Heart Doctor has been featured on The Doctors and Dr. Phil television shows, and is one of the few doctors that posts consistently for Mind Body Green.
Jack and Jill, both non -smokers, walk out of their health care providers office satisfied that an annual check-up indicated a blood pressure under 140/90 and a blood sugar under 125. They were told they were low risk for heart disease and their LDL cholesterol of 150 mg/dl was therefore not of much concern. They were satisfied as they had heard somewhere in the news or maybe on a podcast that cholesterol no longer matter like in the old days. Well, those old days are back with new data from a prospective study from Spain, the PESA trial.
The PESA study is following over 4,000 bank workers in Madrid, free of known heart disease, and assessing them for silent artery damage using heart artery calcium CT scans and ultrasounds of the carotid and femoral arteries.
In a new report, researchers identified 1,779 of the study subjects that were like Jack and Jill and had total cholesterols under 240 mg/dl. A group of 740 participants had even better results with blood pressures under 120/80 and blood sugars under 100 mg/dl and were reported on too.
How frequently was silent hardening of arteries, called subclinical atherosclerosis, identified in the group of 1,779 subjects? A whopping 50% had aging arteries that raise the risk of heart attack, stroke, vascular problems of the legs, and shorten lifespan. In the 740 superstars, the rate of silent vessel disease was still 38%. These numbers are striking but match test results I see in my advanced preventive cardiology clinic where I routinely do similar vascular assessments.
Should Jack and Jill be tested for silent heart and vascular artery disease? Yes, they should and I have written repeatedly about the role of coronary artery calcium scans using CT as a cost effective way to assess individual risk. These scans are under $100 in my hospital and take under 5 minutes.
Should Jack and Jill be concerned about their LDL-cholesterol levels? They should. In the PESA study, LDL cholesterol was an independent predictor of atherosclerosis in the overall group and the picture above shows how the higher the LDL cholesterol was in the study group, the greater the chance of disease in one or more artery systems. The authors of the study indicated "LDL cholesterol, even at levels currently considered normal, is independently associated with the presence and extent of early systemic atherosclerosis in the absence of major cardiovascular risk factors. These findings support more effective LDL cholesterol lowering for primordial prevention, even in individuals conventionally considered at optimal risk".
How Low Should Jack and Jill Want Their LDL Cholesterol?
Even the nine study participants in PESA who had LDL cholesterol levels of 60-70 mg/dL range still had a 11% rate of subclinical plaques, leading the investigators to suggest that atherosclerosis develops when LDL cholesterol exceeds a threshold of approximately 50-60 mg/dL. The authors wisely recommended intensive lifestyle efforts for primordial prevention of artery damage starting as young as possible.
The Bottom Line: Do not walk out of your physical or workplace wellness exam satisfied that your LDL cholesterol is the only lab elevated beyond optimal. It might be a clue to progressive aging and damage of your heart and arteries. Ask for advanced testing and work with an experience practitioner to bring your numbers into the optimal range. As 2017 closes and 2018 approaches, LDL cholesterol is back, in fact it never went away, as an important measure of cardiovascular health to focus on.
Sincerely,
Dr. Kahn
About the author
Dr. Joel Kahn is one of the world's top holistic cardiologists. He has treated thousands of acute heart attacks during his career, and would like to put a stop to ALL future heart attacks by educating and inspiring people to embrace a holistic lifestyle. America’s Healthy Heart Doctor has been featured on The Doctors and Dr. Phil television shows, and is one of the few doctors that posts consistently for Mind Body Green.
