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Heart Healthy Guide

Heart Healthy Guide. Robert Grimshaw, MD FACP. A Lifetime of Quality Care That’s Convenient & Complete. Did you know?.

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Heart Healthy Guide

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  1. Heart Healthy Guide Robert Grimshaw, MD FACP A Lifetime of Quality Care That’s Convenient & Complete

  2. Did you know? In the next hour, 170 Americans will have a heart attack; 70 will die. That’s one heart attack every 20 seconds, and one heart death every 51 seconds. There are 1.5 million heart attacks each year: total cost $60 billion. How do you avoid this?

  3. Early Detection: We’re getting closer to being able to find who’s going to get heart disease, and much earlier — before their heart attack or stroke. And we can treat earlier, and more effectively.

  4. High Frequency Carotid Ultrasound: A study by Dr. Howard Hudis and colleagues at the University of Southern California (in the Feb 15, 1998 Annals of Internal Medicine) showed this painless, inexpensive study of the arteries in the neck could pick up people with early heart disease. And frankly, if there’s disease in the arteries to the brain, treating helps prevent strokes at least, as well as heart attack! This is available nearby in New York with NYU cardiologist, Dr. Michael Schloss.

  5. Cholesterol Screening: A massive study of 6600 people in Texas concludes we should treat many more people than we have been under the guidelines of the National Cholesterol Education Program (NCEP). The Air Force Texas Coronary Atherosclerosis Prevention Study (AFCAPS/ TexCAPS) looked at men over 45 and women over 55 who had no known heart disease and low or normal “good” high density (HDL) cholesterols. The “lousy” or LDL cholesterols were 130-190. Treatment was with lovasta-tin (Mevacor). Those who were treated had 36% less risk of a first heart attack, angina or sudden death. Women did particularly well, with 54% reduction in first events. This study confirms another one done with pravastatin (Pravachol) in Scotland. Of great interest, the average LDL in the AFCAPS/TexCAPS trial was 150, below the NCEP’s suggested treatment threshold of 160.

  6. Could Germs Help Cause Heart Disease? Enticing reports that Chlamydia pneumon-iae might be involved in atherosc-lerosis are about to be tested. A recent small study showed that giving the antibiotic Zithromax for the common germ reduced the rate of second heart attack 5-fold in 18 months! Is this voodoo? Well, we now cure ulcers with antibiotics...

  7. The Endothelium: Where the Action Is: Imagine the lining of your arteries: the largest organ in your body: 1800 grams, and if spread out, enough to cover 6 football fields!

  8. Preventing Heart Attacks and Strokes: Diet: A “Healthy Heart” diet should approach the diet eaten in the Greek islands. This Mediterranean diet was used in the “Lyon” study and cut the rate of heart attack and other cardiac events by 76% in a 27 month period in a group of patients with known heart disease. In simple terms, the diet means: • twice the seafood • 66% more fresh veggies • 10% more fruit • 2-4 times the whole grains and beans • 4 times the olive oil • 45% less red meat • 16% less eggs • 50% less whole milk and dairy products • 50% less non-olive oils Sadly, the top 6 sources of calories in the usual American diet are: Whole milk, cola, margarine, white bread, rolls (ready to eat) and sugar.

  9. Exercise: Vigorous physical activity can markedly decrease the risk of heart attack. According to Dr. Robert Vogel, Chairman of Cardiology at the University of Maryland, 30 minutes at 75% of your maximum heart rate 1-2 times per week lowers your risk 80%. Doing it 5 or more times a week lowers your risk 50-fold! And in the Northern Manhattan Stroke Study, a walk a day reduced the risk of stroke by 62%.

  10. Vitamins: Homocysteine can lead to athero-sclerosis, and can be brought down by folic acid, B-6 and B-12. It is estimated that 1 mg. folate daily could reduce strokes by 10% and heart attacks by 15% in the U.S. Vitamin A in veggies is good, but beta-carotene in pills has lead to an increased risk of lung cancer in current and former smokers. Vitamin E 400U daily was shown to reduce the risk of 2nd heart attack 77% in the Cambridge CHAOS study. In a small study, Dr. Vogel’s group has shown vitamin E plus 1000 mg vitamin C block the paralyzing effect that fatty meals have on arteries.

  11. Medicines: We now have proof that “statin” drugs (such as Baycol, Lescol, Lipitor, Mevacor, Pravachol, and Zocor) can decrease the risk of heart attack and stroke in men and women, even if they’ve never had symptoms. There are exciting possibilities that these drugs attack the cause of most heart attacks -- the oxidized LDL causing a ruptured arterial plaque. Pravachol also seems to lower platelet counts and stabilizes fibrinogen, elements involved in plaque rupture. Niacin (Niaspan, etc) is very useful in those with dangerous LDL pattern B or elevated Lp(a) (risk factors we can check on with Berkeley HeartLab) Estrogen and similar drugs such as raloxifene (Evista) may help. Several trials are under way studying if medications may be more effective than angioplasty or even bypass surgery — and early indications are that they are!

  12. And Again, Aspirin: Still one of the most effective drugs ever, 325 mg. of aspirin prevented 39% of heart attacks in a study of 22,000 U.S. physicians. And there is evidence 81 mg. should be enough. It’s also useful for preventing second heart attacks (32%) as well as strokes (27%) and total blood vessel disease related death (25%).

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