♥ Your Heart

Preventing a second heart attack

♥ Your Heart

Each year over 70,000 Canadians suffer a heart attack. For most survivors, this frightening event brings them face to face with their own mortality.

Some describe a heart attack, or myocardial infarction (MI), as a turning point, a chance to change their lifestyle for the better. Others feel betrayed by a body that they’ve cared for over the years, and mending that trust in the self is part of their recovery. For all survivors, a heart attack becomes a significant life landmark from that point forward.

What is a heart attack?

A heart attack happens when the blood supply to a portion of the heart is suddenly cut off. This most often results from atherosclerosis (or hardening of the arteries), where blood flow to the heart is blocked by cholesterol- and calcium-based plaques.

Aside from cholesterol, other factors such as high blood pressure and inactivity increase your risk of having a heart attack. Qualified health care practitioners, such as acupuncturists, physiotherapists, nutritionists, herbalists, and naturopathic doctors (ND), can help you to set and achieve health goals, reducing your risk of another heart attack.

It takes more than an apple a day Research has consistently shown that making the right diet choices can make the difference between life and death for heart attack survivors.

Including soluble whole fibres such as oats and barley helps keep your cholesterol under control. Magnesium-filled leafy greens, beans, and nuts can lower blood pressure, reducing the strain on your heart. Decreasing sodium in all forms, especially processed foods, helps some people reduce blood pressure. The risk of a second heart attack can be greatly reduced by a good diet.

Eat your veggies

Filling your diet with colourful fruits and veggies provides you with an arsenal of heart-helping antioxidants and essential nutrients. If you need some help getting started, the Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension) provide guidelines for heart-healthy eating, encouraging an abundance of whole foods and fibre while limiting saturated and trans fats.

But don’t be afraid of all fats: using “good” unsaturated fats such as olive oil can decrease blood pressure and may reduce the ability of cholesterol to damage the arteries. A daily teaspoon of high-quality fish oil has been shown to decrease the risk of sudden death from a second heart attack.

Heart-loving lifestyle

Good diet and daily exercise go hand in hand, and both in combination will significantly improve your chances of living a long and healthy life. Consult your doctor or physiotherapist for specific exercise prescriptions, but the sooner you can get moving after your recovery the better.

Daily exercise has countless benefits for your heart. Weight loss, healthy cholesterol and blood pressure levels, and stress reduction all have direct, positive effects on your cardiac health, and all can be achieved through exercise. Reduce your stress further with meditation, tai chi, and yoga, and support your whole-body response to stress by getting adequate sleep.

Support groups can help you to make the necessary changes to your diet and exercise regimen. This assistance is especially important if you are quitting smoking as the result of your heart attack, a choice that all survivors must consider very seriously.

Diabetes and heart disease

If you are diabetic, you must be especially careful to control your blood glucose and hemoglobin A1c levels (HbA1c). Diabetes itself can cause damage to arteries, which increases the chance of another heart attack.

Metabolic syndrome, or pre-diabetes, is a constellation of poor blood sugar management, low HDL, high triglycerides, obesity (especially abdominal), and high blood pressure. Sadly, these individuals are three times more likely to have heart disease than healthy people. All of these symptoms can be improved by good diet and exercise, dramatically improving quality of life and survival.

A little extra help

A good diet will more than satisfy your basic nutritional needs. Additional supplementation can further support your heart and circulatory system. Although these nutrients may be available through foods, the levels may not be high enough to be therapeutic after an MI.

Coenzyme Q10

CoQ10, also aptly known as ubiquinone due to its presence throughout the body, has been well studied in reference to cardiac health. It appears to reduce the formation of artery-blocking plaques and to increase energy delivery to the heart muscle. Statin drugs, frequently prescribed post-MI (see sidebar), deplete CoQ10, reducing energy delivery to all muscles, including the heart. Adding CoQ10 to your regime may reverse these side effects, but consult with your ND or MD before taking it.

Vitamin B3

Niacin (vitamin B3), can be extraordinarily beneficial, lowering LDL and triglycerides while increasing high-density lipoproteins (HDL), the good cholesterol. First-time users will experience a skin flush from niacin, but this reaction will diminish over time. Side effects are possible with all treatments, even natural ones, and those taking niacin should have their liver function monitored a few times a year. Even with its potential side effects, this treatment may still be preferable to conventional therapy.

Vitamin D

Our understanding of the vital role of vitamin D continues to evolve, and there is evidence supporting its role in cardiovascular health. Adequate levels of vitamin D may prevent calcium from accumulating in plaques in the arteries, providing yet another excuse to carefully spend more time outside in the sun!

Plant power

Trained herbalists and NDs have many potent botanical therapies at their disposal. Before embarking on any course of herbal therapy, consult with an expert regarding potential interactions with drugs you are already taking.

Crataegus oxyacantha (hawthorn) has a long history of traditional use in congestive heart failure (CHF), a condition that can follow a heart attack. Modern science is finally catching up to entrenched herbal knowledge: CHF sufferers in a recent study were able to exercise with less shortness of breath while taking hawthorn.

Digitalis lanata (Grecian foxglove) has been used traditionally for the same condition, and the drug digoxin is derived from its leaves.

Traditional Chinese wisdom

Traditional Chinese medicine (TCM) diagnosis is an art and science that approaches human illness from a completely different perspective than Western medicine. Heart and other physical symptoms result from derangements in the interconnected organ systems of the body.

A TCM doctor or acupuncturist will evaluate the body’s organs through symptom analysis and assessment of the tongue and pulses. Diagnoses for heart conditions may involve derangements of blood or chi, and treatment normally involves botanical combinations, dietary prescriptions, and acupuncture.

There is some evidence to show that acupuncture improves cholesterol levels, angina, and arrhythmias, and may improve stress and depression, conditions that are known to contribute to a second heart attack down the road.

A heart attack is a life-altering experience for all survivors. Through good diet and lifestyle choices and the appropriate use of supplements, botanicals, and TCM, you can support your recovery and optimize your heart health for many years to come.

Prescriptions for a heart-healthy lifestyle

  • smoking cessation
  • regular exercise as advised by health care practitioner
  • diet high in fresh fruits and vegetables, whole grains, and unprocessed foods
  • elimination of trans fats from diet; reduction of saturated fats
  • healthy oils in raw form (extra-virgin olive oil—2 Tbsp/30 mL per day)
  • weight loss (body mass index <25)
  • good control of blood glucose (check HbA1c every three months)
  • stress reduction

Food-based therapies

  • Amino acids, L-carnitine, and taurine decrease blood pressure.
  • Phytosterols compete with cholesterol for absorption in the body, reducing artery-harming LDL.
  • Red yeast rice, a fermented food used in Chinese cuisine, has statin-like action on cholesterol, reducing LDL and triglycerides.

Consult your health care practitioner before taking any supplement.

Botanical treatments

These herbals have been used traditionally for treatment of cardiovascular risk factors. As with all natural products, consult your health care practitioner before taking any botanicals.

  • mistletoe, rauwolfia, garlic, and onion for hypertension
  • lily-of-the-valley and hawthorn for arrhythmias
  • schisandra, Siberian ginseng, and rhodiola for stress management
  • bilberry, bitter melon, and cinnamon for blood glucose control

Supplements for heart-attack prevention

  • CoQ10 —improves energy delivery to heart
  • niacin—reduces LDL and triglycerides; increases HDL
  • vitamin D—supports arterial health
  • fish oil—reduces inflammation; improves cholesterol levels and survival
  • hawthorn—improves symptoms of heart failure and arrhythmias

Consult your health care practitioner before taking any supplement.

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