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52 Foods and Supplements for a Healthy Heart
By Deborah Mitchell St. Martin's Press
Copyright © 2010 Lynn Sonberg Book Associates
All rights reserved.
ISBN: 978-1-4299-5557-7
CHAPTER 1
Everyone Needs This Book: Heart Disease Today
Chances are you or someone you love is at risk for heart disease right now. No, we don't say this to scare you, although we do want to get your attention. Perhaps facts like these will cause you to pause: More than 785,000 Americans will experience a new coronary attack in 2009, and about 470,000 will have a repeat attack. Heart disease is the number one killer in the United States, and it is becoming an increasing problem among younger people.
Perhaps you have already heard some of this information, and maybe that's why you've picked up this book. We're glad you did, because we hope you are ready to take steps to prevent heart disease or, if it is already a presence in your life, incorporate measures to manage it in a healthy, tasty, and enjoyable way, every day of your life.
Before we get into the "how" of taking care of your heart, we begin with a discussion of the nuts and bolts of this vital organ and how it operates — and unfortunately doesn't operate for many people. So let's turn to your heart.
THE HEART OF THE MATTER
The human heart beats approximately 100,000 times each day, 365 days a year. Nearly 2,000 gallons of blood are transported through the heart each day, passing through nearly 100,000 miles of blood vessels. That's an incredible amount of work for one organ to do. For millions of people, the heart has some difficulty performing that work. That difficulty can manifest as different types of heart disease and its complications.
TYPES OF HEART DISEASE AND COMPLICATIONS
Heart disease is a general term used to describe a range of disorders that affect the heart and, in some cases, the blood vessels. Many people use the term "heart disease" interchangeably with "cardiovascular disease," a phrase that usually refers to conditions involving narrowed or blocked blood vessels that can cause a heart attack, stroke, or angina (chest pain).
Types of Heart Disease
Heart disease can refer to damage that occurs to many different structures, including the heart's valves, muscle, arteries, lining, and electrical circuitry. You can be born with a heart condition (inherited or congenital) or develop one — or more — later in life due to risk factors that you can control (e.g., diet, smoking, amount of exercise) or ones you cannot (age, ethnicity, gender). In addition, risk factors also can have an impact on inherited or congenital heart problems.
There are many different types of heart disease, and we give a brief explanation of the more common ones below.
• Aneurysms. When an artery is damaged and loses its elasticity and strength, it can develop a bulge called an aneurysm. The force of blood pushing against the weakened wall can cause the aneurysm to rupture, causing bleeding into and along the artery wall. A ruptured aneurysm is often fatal.
• Angina. This condition is marked by a feeling of pressure in the chest, shortness of breath, and sometimes sweating. Angina is a symptom of myocardial ischemia usually caused by coronary atherosclerosis (hardening of the arteries; see below).
• Arrhythmia. Any abnormal or disturbed heart rhythm is referred to as arrhythmia. This can include abnormally rapid (tachycardia), slow (bradycardia), or irregular rhythms.
• Atherosclerosis. This condition is commonly referred to as "hardening of the arteries" and is caused by an accumulation of cholesterol, fats, and other substances in the arteries. The buildup causes the arteries to become narrow and less flexible. Although loss of elasticity is a part of the aging process, factors such as smoking, diabetes, poor nutrition, and high blood pressure are also risk factors for atherosclerosis.
• Cardiomyopathy. Disease of the heart muscle. There are several types, including dilated cardiomyopathy and hypertrophic cardiomyopathy, which are explained below.
• Congenital heart disease. These conditions develop before birth. The most common types are obstruction of blood flow in the heart or vessels around the heart, an irregular pattern of blood flow through the heart, and various structural problems such as having just one ventricle instead of two. Approximately 36,000 infants are born with congenital heart disease each year.
• Congestive heart failure. If the heart is too damaged or weak to regulate blood flow properly, the blood can become congested in different locations (e.g., feet, lungs, legs) and cause swelling, as well as shortness of breath, paleness, and coolness in the legs and arms. These are symptoms of congestive heart failure.
• Coronary artery disease. This is the number one cause of heart attack. Coronary artery disease is a condition in which the heart muscle cannot get enough oxygen and blood. In addition to heart attack, coronary artery disease can lead to angina and, in severe cases, sudden death.
• Diastolic dysfunction. This is a type of heart failure in which the relaxation portion of the beat (diastolic) is abnormal. This abnormality prohibits the blood from flowing freely between the ventricles and sends it up into the arteries and veins. This action can cause swelling and increased pressure in the blood vessels of the lungs (pulmonary congestion) and/or in the blood vessels that enter the heart (systemic congestion).
• Dilated cardiomyopathy. If you have dilated cardiomyopathy, your heart muscles have become so weak and your heart chambers are so dilated that too much blood is released with every beat. This condition can be caused by coronary artery disease, myocarditis, or excessive alcohol use, or the reasons can be unknown.
• Endocarditis. A disease of the heart valves, endocarditis occurs when the endocardium (the membrane that lines the inside of the heart valves) becomes infected. Most cases develop as the result of surgery.
• High blood pressure. The force of blood on the artery walls as it is pumped through the body is blood pressure. If the flow is obstructed, the heart must pump more rapidly or with more force to push the blood through the vessels, causing blood pressure levels to rise. High blood pressure (hypertension) can lead to an aneurysm, an enlarged heart, or heart failure (see above).
• Hypertrophic cardiomyopathy. When the heart muscle becomes so thick that it restricts the amount of blood the ventricles can hold and pump, you have hypertrophic cardiomyopathy. This condition can result in sudden death and arrhythmia.
• Mitral valve prolapse. The mitral valve makes sure the blood flows toward the body during each beat. Mitral valve prolapse is an abnormality in which the valve goes backward as the heart contracts. The condition can progress gradually and the cause is unknown. In severe cases it can lead to congestive heart failure.
• Myocardial ischemia. Sometimes the blood supply to the myocardium (the muscular wall of the heart) is very low, which causes the heart muscle to function abnormally. An inadequate supply of blood is called ischemia. Because the heart muscle must work harder to try to get enough blood and oxygen, it can cause chest pain, shortness of breath, and fatigue. Angina is a symptom of myocardial ischemia.
• Myocarditis. An inflammation of the heart muscle (myocardium) is myocarditis. It is usually caused by a virus and characterized by fever, joint pain, chest pain, and an abnormally rapid heart rate.
• Valve disease. Any one or more of the four valves in the heart (mitral and aortic on the left side; tricuspid and pulmonary on the right) can become diseased. Diseased valves typically obstruct blood flow, become stiff and do not open easily, or fail to close properly, allowing blood to leak. A stiff (stenotic) valve reduces blood flow, causing the blood behind it to accumulate. This backup leads to symptoms of congestive heart failure and angina. Valves that fail to close properly allow blood to leak back in the wrong direction, which may cause the heart chambers to enlarge. Weakened or damaged valves are susceptible to infections, called endocarditis (see above).
Complications of Heart Disease
The presence of heart disease is associated with a variety of complications. Here are the most common ones.
• Heart attack. Coronary artery disease can cause a heart attack. A heart attack, also referred to as a myocardial infarction, usually occurs when a blood clot blocks the flow of blood through a coronary artery. This interruption can damage or destroy a portion of the heart muscle.
• Heart failure. Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs. What happens is this: As time goes on, the ventricles may become stiff and unable to fill with an adequate amount of blood between beats. The ventricles then stretch (dilate) so much that the heart can't pump blood efficiently throughout the body. The heart muscle also may become increasingly weak. Heart failure can result from many forms of heart disease, including cardiovascular disease, heart defects, valvular heart disease, and cardiomyopathy.
• Peripheral artery disease. This disease is typically caused by atherosclerosis. In cases of peripheral artery disease, the extremities — usually the legs — do not receive enough blood to keep up with demand. The most common symptom of peripheral artery disease is severe leg pain when walking. This is known as claudication, and since it often occurs intermittently, it is referred to as intermittent claudication.
• Stroke. A stroke, or cerebrovascular accident (CVA), occurs when the blood supply to the brain is interrupted, which stops the delivery of critical oxygen and glucose. Brain cells begin to die within just a few minutes of a stroke. A stroke most often is caused by a blood clot that travels to the arteries of the brain (ischemic stroke) or by bleeding (hemorrhage) in the brain from ruptured blood vessels.
• Sudden cardiac arrest. The sudden, unexpected loss of heart function, breathing, and consciousness is sudden cardiac arrest. This condition usually occurs when there is an electrical disturbance in the heart that interrupts its ability to pump blood, which abruptly stops blood flow to the body. Sudden cardiac arrest nearly always occurs as part of an underlying heart problem, especially coronary artery disease. Sudden cardiac arrest is fatal if not treated immediately.
WHO GETS HEART DISEASE?
Heart disease is an equal-opportunity condition: It can affect anyone at any age, from newborns to the very old. There was a time when most people assumed that heart disease occurred primarily in older adults, and to a great extent that is still true. However, because of the increasing prevalence of risk factors for heart disease among younger people, including obesity, type 2 diabetes, high cholesterol, and high blood pressure, we are seeing cases of heart disease develop in younger individuals.
Although heart disease is the number one killer of both men and women, and there are many similarities between the sexes when it comes to heart disease, there are also some important differences. We talk about some of those differences in Chapter 2, for example, where we point out the signs and symptoms of heart disease, which can differ between men and women. Knowing those differences could save your life or that of a loved one someday.
Here we want to mention that women tend to experience heart disease ten years later than men, which is believed to be associated with the heart-protective effect of estrogen, and that they also tend to have a worse prognosis once they enter the hospital, which may be related to the fact that they tend to be older and/or have a more severe case by the time they are hospitalized. More women than men die of heart disease each year, and women are six times as likely to die of heart disease as of breast cancer. Heart disease kills more women older than 65 than do all types of cancer.
Heart Disease Statistics
According to the latest figures from the American Heart Association (the 2009 Heart Disease and Stroke Statistics, which gives statistics for the latest years available, 2005–2006), these are the facts on the prevalence of heart disease and some of its risk factors and complications.
• Coronary heart disease. 16.8 million adults, or 7.6 percent of the adult population in the United States. This includes 8.7 million men and 8.1 million women
• Heart attack (myocardial infarction). 7.9 million adults, including 4.7 million men and 3.2 million women
• Heart failure. 5.7 million adults, including 3.2 million men and 2.5 million women
• High blood pressure. 73.6 million adults, including 35.3 million men and 38.3 million women
• High cholesterol (200 mg/dL or higher). 98.6 million adults, including 45.0 million men and 53.6 million women
• Obesity/overweight. 145 million adults, including 76.9 million males and 68.1 million females
• Stroke. 6.5 million adults, including 2.6 million men and 3.9 million women
The website for this and more information is www.americanheart.org.
The risk of heart disease and its risk factors is not the same for each ethnic group. According to the HCHS NHSI 2007, the prevalence estimates for people age 18 and older are:
• Among whites, 11.4 percent have heart disease, 6.1 percent have coronary heart disease, 22.2 percent have hypertension, and 2.2 percent have had a stroke
• Among blacks or African Americans, 10.2 percent have heart disease, 6.0 percent have coronary heart disease, 31.7 percent have hypertension, and 3.7 percent have had a stroke
• Among Hispanics or Latinos, 8.8 percent have heart disease, 5.7 percent have coronary heart disease, 20.6 percent have hypertension, and 3.7 percent have had a stroke
• Among Asians, 6.9 percent have heart disease, 4.3 percent have coronary heart disease, 19.5 percent have hypertension, and 2.6 percent have had a stroke
Heart Disease in Children
Two types of heart disease are seen in children: congenital and acquired. Congenital heart disease, or congenital heart defect, is a condition that is present at birth. Each year, about 36,000 children in the United States are born with a heart defect. Examples include structural defects such as atrial septal defects, ventrical septal defects, and patent ductus arteriosis. Heart disease that develops during childhood (acquired heart disease) includes rheumatic fever, infective endocarditis, and Kawasaki disease.
High cholesterol in children is associated with three factors: heredity, obesity, and diet. Most children who have high cholesterol have a parent who also has hypercholesterolemia.
Higher than normal blood pressure is seen in about 20 percent of children, although less than 1 percent of children have significant hypertension (240 mg/dL or higher). In most cases, no cause can be identified. If hypertension becomes severe in children, it is usually a warning that there is a serious underlying problem, such as kidney disease, or abnormalities of the heart, endocrine (gland), or nervous system. If hypertension is not addressed or grows worse over the years, it can lead to heart failure or damage to the kidneys, eyes, and other organs.
RISK FACTORS FOR HEART DISEASE
When it comes to risk factors for heart disease, there are traditional factors that affect women and men about equally, and then there are those that tend to play a bigger role in the development of heart disease in women. We look at the risk factors for both sexes and note which ones tend to impact women more.
Overall in this section, however, we answer questions you, whether you are male or female, may have asked yourself about heart disease, namely:
• What are the chances that I will develop heart disease?
• What are the risk factors for heart disease?
• Are some risk factors more important than others?
• How many risk factors do I need to have before I should worry about getting heart disease?
Let's answer these important questions by looking at the types of risk factors for heart disease and how they can impact your health.
Major Risk Factors
Researchers have identified some factors as "major" because they significantly increase the risk of heart and blood vessel disease. Generally, the more risk factors you have, the greater your chance of developing coronary heart disease. In addition, the more severe level of each risk factor, the more that factor impacts your overall chances of getting cardiovascular disease.
Some major risk factors can't be changed. These include:
• Increasing age. Approximately 82 percent of people who die of coronary heart disease are 65 years or older. As people age, women who have a heart attack are more likely than men to die from them within a few weeks.
• Gender. Men are at greater risk of heart attacks than women, and they tend to have them at a younger age. Although women's rate of death from heart disease increases after menopause, it does not reach the level of men's.
(Continues...)
Excerpted from 52 Foods and Supplements for a Healthy Heart by Deborah Mitchell. Copyright © 2010 Lynn Sonberg Book Associates. Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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