Continuing our strategies to Grow Younger Every Day

19 Ways to Stave Off Heart Disease

HEART DISEASE - more than one in five Americans suffer from some form of it, with more than 2,500 dying from it each day. In many cases, it can be avoided altogether simply by following a healthy lifestyle and adding a supplement or two. Each expert believes that the heart disease factors that he is studying are the most detrimental, but since everyone is different, it's hard to say which is most damaging to you. Be smart and follow the advice of as many experts as you can.

Eat Your Fruits and Veggies

The most effective step you can take to prevent a heart attack is to eat fruits and vegetables every day. So finds a major international study that searched for the strongest protective factors against an attack. The highest daily intake of fruits and veggies cut risk by a whopping 30%, which was more than the reduction attributed to exercise in the 52 countries surveyed. Yet among Americans, only 27% of women and 19% of men eat the minimum of five daily fruit and vegetable servings, shows data from the Centers for Disease Control and Prevention.

Savor Mediterranean Cuisine

Traditional Mediterranean cuisine features luscious fruits and vegetables, hearty grains and nuts, rich olive oil, and naturally low-fat chicken and seafood (plus a daily glass of red wine). These same foods also prevent heart attack and stroke, and now scientists are pinning down exactly why.

Atherosclerosis-causing blood chemicals were lowest in those on a Mediterranean diet, and highest in those on a Western diet, in a new Harvard study of 732 women. High-antioxidant fruits and vegetables and omega-3-rich fish are heart protective, while trans fats in Western-style fast food irritate blood vessels.

Break a Sweat

Exercising for 30 minutes daily, at any time of day, strengthens your heart by lowering "bad" LDL cholesterol, raising "good" HDL cholesterol, and reducing inflammation, a newly discovered risk factor for heart disease. (It will also help you lose weight, another boon for your heart.)

Exercise in the Evening

Working out after noon, when the mercury peaks, may help your heart even more than exercising earlier in the day. In the afternoon, your muscles are warmer and more flexible, so it's easier to work out. If it feels better, you'll be more likely to exercise more vigorously and frequently, two of the keys to a healthy heart. If you can only do a morning walk, warm up by starting out slowly for 10 minutes.

Lose  Belly Fat

Even if your scale says you're healthy, a large middle could mean that you have dangerous abdominal fat, according to a Canadian study of 14,924 men and women.

This is the story of the apple vs. the pear body type: Do you carry your weight around your hips or your waist and upper body? The difference is key, because as your belly measurement increases, so does your risk for heart disease, high cholesterol, high blood pressure, and diabetes-by up to 93%. (Hip fat does not seem to carry the same risk.)

How do you measure up? Current guidelines define high risk as a waist that's greater than 35 inches for women or 40 inches for men.

Drink Tea-Any Tea!

Taiwanese researchers studying 1,000 people found that those who averaged just 2 cups of tea - black, green, or oolong - once a week for 10 years had 20% lower body fat and 2% lower waist-to-hip ratios compared with those who didn't drink tea.

Cut Cholesterol with Black Tea

New research confirms that extracts of black tea - the kind you get in Lipton or Tetley - can help reduce cholesterol. Researchers at Vanderbilt University tested 240  people with mild to moderate high cholesterol who were on a low-fat diet. Half took a daily black tea extract with polyphenols called theaflavins (equal to 7 cups); the other half took a placebo. After 12 weeks, those on tea extract cut total cholesterol by 11% and LDL -  the bad cholesterol - by an amazing 16%, compared with no change in the other group. "Over time, that could translate into a 16 to 24% reduction in risk of heart attack and stroke," says David Maron, M.D., cardiologist and lead researcher.

"Black tea theaflavins may help people who can't lower their LDL enough with diet alone, but whose level isn't high enough for drugs," says Maron. The study extract, which is sold as Teaflavin, has 75 mg of theaflavins and no caffeine. For additional information, go to www.teaflavin.com.

Get Nutty

Recent research from the University of Toronto indicates that eating at least a handful of almonds (about an ounce, or 23 almonds) a day lowers LDL cholesterol, reducing the risk of heart disease. Eating two handfuls lowers it even more. (They're 164 calories per ounce.) The secret: Almonds, like walnuts, pecans, pistachios, and hazelnuts, are high in heart-smart omega-3 fatty acids.

Call Your Pals

Stress is the greatest preventable cause of heart disease says Mehmet Oz, M.D., a professor of surgery at Columbia University College of Physicians and Surgeons. And a landmark UCLA study found that women can counteract stress by hanging with their girlfriends. The research shows that when women face tough times, they have a self-protective response: Their bodies produce oxytocin, a hormone that compels them to nurture their loved ones and be with their friends. Called the "tend-and-befriend response," it not only relieves stress, but it's also a powerful antidote to the better-known fight-or-flight response, which is marked by the production of the heart-damaging stress hormone cortisol.

"The question I always ask my patients is, `Do you have a reason for your heart to keep beating?"' says Oz. So after a particularly stressful day, remember who makes your heart happy: Call your girlfriends and hug your kids.

Let Go of Anger

An angry outlook is your heart's worst enemy. Hostile people often feel more agitated by daily stress, which could keep stress hormone levels high, accelerating the risk of clogged arteries and heart stopping blood clots, suspects researcher Raymond Niaura, Ph.D., of Brown Medical School in Providence, RI. In a 3-year study of 774 Caucasian men, researchers found that hostility was a more powerful predictor of heart disease than killer risk factors such as high cholesterol, smoking, or obesity.

Self-help is a good first step for hostile types, says Niaura. In more extreme cases, it may be a good idea to seek counseling.

Chase Your Multivitamin with Aspirin

"Men over the age of 45 and women over 50 should be taking two low-dose aspirin [81 mg each] a day - in consultation with their health professional," says Oz. "Aspirin's primary benefit is that it blocks the generalized inflammatory response that is a consequence of aging and that can lead to a heart attack."

Consider Coenzyme Q10 _

In studies by the late Karl Folkers, Ph.D., recipient of the National Medal of Science for his work with CoQ10 and other vitamins, people with congestive heart failure and cardiomyopathy - both frequently fatal conditions - recovered more quickly when CoQ10 therapy was added to conventional treatment. In one case, Folkers actually treated 11 patients who were waiting for heart transplants; all improved, some so dramatically that they no longer needed medication.

It's hard to get enough CoQ10 in your diet to achieve the 100 mg or more that have been used in clinical trials. Fish and animals have some, but not much. "If you eat a lot of fish and animal products, you'll get about 15 mg a day," says Stephen Sinatra, M.D., assistant clinical professor of medicine at the University of Connecticut School of Medicine. But before you start popping pills, discuss it with your doctor. If you have heart failure or cardiomyopathy, you should not be self-treating with CoQ10 or any supplement.

If you're not sick, is there any reason to take it? Some supplement experts, including Prevention columnist Andrew Weil, M.D., recommend taking up to 100 mg a day as a treatment for fatigue. Be aware: If you're taking blood-thinning medication such as warfarin and aspirin, CoQ10 can blunt the drugs' effects. But if you're taking statin drugs to lower your cholesterol, your body's stores of CoQ10 may be depleted - a side effect of the drugs - so it's worth asking your doctor if a supplement might help replenish them.

Filet More Fish _

A 12-year Brigham and Women's Hospital study of 4,800 people found that those who ate any fish one to four times a week had a 28% lower risk of atrial fibrillation (AF) than those who avoided fish. AF disrupts your heart's rhythm, causing fatigue and shortness of breath.

Make It Fatty Fish

A Harvard study of 727 women found that those who ate fatty fish almost every day-compared with those who ate them only three times per month-had 7 to 10% lower blood levels of molecules that bind plaque-building cells to artery walls.

Beat Homocysteine with B

Keep your heart healthy with the Bs which include folate and vitamins B6 and B12. They help lower blood levels of homocysteine, an amino acid that is thought to promote atherosclerosis. Meat, poultry, and fish are good sources because they contain both B6 and B12. But make sure to take your daily multivitamin too-it contains a form of B12 that's easier to absorb than the kind found in food. Aim for no more of the Bs than the DV 400 mcg of folic acid, 1.3 to 1.7 mg of vitamin B6, and 6 mcg of vitamin B12.

Note: Stay away from high-dose B products, which are sometimes marketed as cures for such problems as premenstrual syndrome. Extremely high doses of B6 are known to cause nerve damage.

Fiber Up Your Day

For maximum heart disease protection, the FDA says that women need 25 g of fiber per day, but are we there yet? Not even close, according to a Tulane University study of 10,000 people. Those at the very high end of the scale averaged just 21 g of fiber per day; those at the lowest, 6 g. But the same study confirmed that you can lower your risk of heart disease by up to 15% with a diet high in fiber-especially the water-soluble kind found in oats and beans. Soluble fiber turns into a cholesterol magnet in your intestines, binding it up and escorting it out for elimination. Other excellent soluble-fiber sources: peas, barley, and pears.

Grab Some Garlic

Garlic (Allium sativum) cuts bad LDL cholesterol by 11.4%. The best dose is two to four raw cloves a day. Chop them and add them to food at the end of cooking or to salad dressings.

Help Yourself to Artichokes

Artichoke (Cynara scolymus) has been shown to cut bad LDL cholesterol by 22.9%. You can take it as an artichoke leaf tincture (20 drops diluted in water, three times a day) or standardized artichoke supplements (follow label directions). Or you can eat six cooked artichoke hearts per week.

Get to Know Guggul

The supplement called guggul (Commiphora mukul) can cut LDL cholesterol by 12.5%. Take one 25-mg capsule three times a day and cut back to one daily capsule once cholesterol is normal. Note: Talk to your doctor first because guggul interacts with other drugs.

Improve Your Sex Life with Arginine

Arginine seems to boost flagging sexual function in both men and women. In a 6-week study of 50 men, 5,000 mg of arginine daily relieved erectile dysfunction. A 4-week study of 77 women taking 2,500 mg of arginine daily found increased sexual desire, orgasm frequency, and clitoral sensation.

How does it work? Arginine helps synthesize nitric oxide, which increases bloodflow to the genitals, promoting sexual arousal - erection in men and enlarged clitoris in women. And there are no significant side effects although some people experience mild blood pressure drop. Try a daily dose of 1,500 to 5,000 mg.

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Continuing our strategies to Stay Young and Healthy,

11 Strategies To Lower Blood Pressure

A report from the famed Framingham Heart Study warns that middle-aged and older persons face a 90% chance of developing high blood pressure sometime in their lives. No small thing, since high blood pressure,while it causes no symptoms, boosts the risks of leading killers such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure.

So, if you have normal blood pressure, following these steps can help lower those 90% odds that your numbers will rise. If you already have high blood pressure, they'll help you control it, possibly with a lower dose of medication, or none at all. What follows is your to-do list.

Carry Less Excess

"When we're talking about preventing high blood pressure, by far the most important lifestyle factor to consider is weight," says Curtis Ellison, M.D., chief of preventive medicine and epidemiology at Boston University School of Medicine.

Among other things, obesity is associated with abnormalities in glucose and calcium metabolism and with certain hormonal changes that may be linked to high blood pressure, notes Ellison. "Almost everybody, if they lose a few pounds, is going to bring their blood pressure down," he says. In some cases, very few pounds will do the trick. In one study, people who lost an average of just 7.7 pounds and kept it off were half as likely to have high blood pressure as those who hadn't lost weight. The best way to lose weight? Exercise more, and eat less.

Sweat It

Exercise helps lower blood pressure in a number of ways. It helps you shed excess pounds and manage stress. Regular aerobic exercise also strengthens your heart so it can pump blood more efficiently. That, in turn, lowers your resting heart rate, which is helpful because a slower heart rate translates into lower blood pressure. Regular aerobic workouts also help make your blood vessels more flexible, so they give more when your heart pumps blood, and that also translates into lower pressure.

Prevention recommends 30 minutes of moderate-intensity activity (such as walking, jogging, or cycling) at least 5 days a week.

"Moderate-intensity exercise appears to lower blood pressure as much as vigorous exercise," says Deborah Young, Ph.D., associate professor in the department of kinesiology at the University of Maryland.

Do the DASH

Incorporating little fat, cholesterol, red meat, or sweets, but lots of fruits, vegetables, whole grains, and low-fat or fat-free dairy products, this diet takes its name from the comprehensive "Dietary Approaches to Stop Hypertension" study. The study followed more than 450 adults, about one-third of whom had high blood pressure, as they ate one of three diets: standard American fare, a similar diet that was higher in fruits and vegetables, and the DASH diet. While both the plan rich in fruits and vegetables and the DASH diet cut blood pressure, the DASH diet had the greatest effect, and after just 2 weeks.

Why does DASH work? "While the diet is rich in vitamins and minerals that have been linked to lower blood pressure, it's not these nutrients alone but the whole dietary package that works," explains Eva Obarzanek, Ph.D., a research nutritionist at the National Heart, Lung, and Blood Institute and a project officer for the DASH study. For more information, go to National Heart, Lung, and Blood Institute; www.nhlbi.nih.gov.

Shake Off Sodium

To get even better results, follow the~ DASH diet and cut back on sodium, Obarzanek suggests. A follow-up to the DASH study, called "DASH-Sodium," found that doing both lowered blood pressure more than following the diet alone. In the study, even people with normal blood pressure lowered their blood pressure when they cut back on sodium.

Certain groups of people - the elderly, African-Americans, and those with a family history of high blood pressure are more likely than others to have blood pressure that's particularly salt (or sodium) sensitive. But everyone should lower his sodium intake, says Obarzanek. How far? To 1,500 mg daily, about half the average American intake, she says. (Half a teaspoon of salt contains about 1,200 mg of sodium.)

Cutting sodium means more than going easy on the saltshaker, which contributes just 15% of the sodium in the typical American diet. In addition to seasoning the foods you cook with spices, herbs, lemon, and salt-free seasoning blends, watch for sodium in processed foods. Most of the sodium in your diet comes from processed foods, says Obarzanek.

Balance It with Potassium

The best formula for controlling blood pressure is to eat at least 1.5 times as much potassium as sodium, a new Australian study shows. Most of us do just the opposite. In 100 people -15% with and 85% without high blood pressure - a diet with a 1.5 – to - 1 ratio of potassium to sodium lowered systolic blood pressure (the top number) by 2.4 points in just 4 weeks.

To balance out a moderate - sodium diet, eat two or three servings of high - potassium fruit (apricots, peaches, nectarines, cantaloupes, honeydews, bananas) and four or five of almost any vegetable every day.

Choose Olive Oil

Olive oil lowered blood pressure in a study of 20,000 people by Harvard and University of Athens researchers. Those with healthy pressure averaged 3 ounces of olive oil a day. Blood pressure protection starts with just 1 ounce a day, the experts say.

Serve Fatty Fish

Northwestern University scientists analyzed eight studies, involving 200^,575 people, and concluded that eating fatty fish (such as salmon, mackerel, and herring) just once a week cut the risk of clot-caused strokes by 13%, though it had no effect on strokes from burst blood vessels.

Flag Yourself at One or Two Drinks

According to a recent analysis of 15 studies, the less alcohol you drink, the lower your blood pressure will drop - to a point. A study of women at Boston's Brigham and Women's Hospital, for example, found that light drinking - defined as one-quarter to one-half a drink per day for a woman - may actually reduce blood pressure more than no drinks per day. One "drink" is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits.

Other studies have also found that moderate drinking - up to one drink a day for a woman, two for a man - can lower risks of heart disease. "High levels of alcohol are clearly detrimental," says Obarzanek. "But moderate alcohol is protective of the heart. If you are going to drink, drink moderately."

Stay Out of Cafe Nervosa

Scientists have long debated the effects of caffeine on blood pressure. Some studies have shown no effect, but a recent study at the Duke University Medical Center found that caffeine consumption of 500 mg - roughly three 8-ounce cups of coffee - increased blood pressure by 4 mm/Hg, and that effect lasted until bedtime. For reference, 8 ounces of drip coffee contains 100 to 125 mg; the same amount of tea, 50 mg; an equal quantity of cola, about 40 mg.

Caffeine can raise blood pressure by tightening blood vessels and by magnifying the effects of stress, says Jim Lane, Ph.D., associate research professor at Duke and the lead author of the study. "When you re under stress, your heart starts pumping a lot more blood, boosting blood pressure, and caffeine exaggerates that effect," he says. Can't live without your morning cup? Look for decaf versions.

Switch to Tea?

Australian researchers who studied 218 women found that for each 1-cup increase in tea drunk daily (up to 4 cups), systolic (top number) blood pressure dropped 2 points and diastolic (bottom number) pressure dropped 1 point.

Learn to Chill _

Meditation and other relaxation techniques such as yoga and tai chi can help lower blood pressure significantly, says Richard Liebowitz, M.D., medical director of the Duke Center for Integrative Medicine. In a study of 62 sedentary seniors, in fact, those who started doing tai chi saw their blood pressure drop nearly as much as those who began a moderate-intensity aerobic exercise program.

Relaxation techniques trigger what Herbert Benson, M.D., of Harvard Medical School, has dubbed the "relaxation response," a calming of the nervous system that can lower blood pressure and slow breathing rate.

While you can learn yoga and tai chi from videos, says David Shapiro, Ph.D., many people find it easier to learn from an instructor and regular classes. To find out more about yoga and how to select an instructor, contact the American Yoga Association, PO Box 19986, Sarasota, FL 34276, or visit www.americanyogaassociation.org. To find out more about tai chi, go to www. thetaichisite.com.

For more information on high blood pressure, visit the National Heart, Lung, and Blood Institute at www.nhlbi.nih.gov.

What Is High Blood Pressure?

Your blood pressure readings - always two numbers, one over the other - gauge the force your circulating blood exerts against the walls of your blood vessels. Systolic pressure, the top number in a reading, indicates the pressure as your heart beats or contracts. The bottom number, your diastolic reading, indicates the pressure between contractions. You have high blood pressure when you have a systolic Blood pressure of 130 millimeters of mercury (mm/Hg) or higher and a diastolic blood pressure of 85 mm/Hg or higher, or 130/85. But most experts now agree that your optimal pressure is 120/80 or lower, as low as you can go without fainting when you stand up.

GOOD.NEWS, NO MATTER YOUR READINGS: Just a tiny drop in blood pressure, 2 mm/Hg, could reduce strokes by 14% and heart disease by 6%, potentially saving 70,000 lives a year.

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