13 Rules for a Healthy Heart
How healthy is your heart? After decades of declining rates of heart attacks, experts from the University of Oxford warned this week that they were on the rise again in England, fuelled partly by obesity and unhealthy lifestyle habits. Researchers tracked adults aged 15 to 84 for more than 40 years, documenting 3.5 million hospital admissions for heart attacks, and found that the groups that experienced the most marked increases were women aged 40 to 49 and men aged 15 to 34. Rates rose by 7 per cent a year for both groups.
A heart attack happens when the coronary arteries become blocked, affecting blood supply to the heart’s muscles. Starved of oxygen, the heart cannot pump properly and can stop beating. According to the British Heart Foundation (BHF), there are 280 hospital admissions each day on average due to heart attacks, and about 1 million men and 380,000 women alive in the UK today have survived one. Attacks can come without any symptoms, but most are caused by underlying risk factors, known as heart disease, an umbrella term to describe a heart that is not functioning properly. About 7.6 million people in the UK have heart and circulatory diseases, according to the BHF.
“Men are more likely to develop heart disease at an earlier age than women but women shouldn’t be complacent or think heart disease doesn’t affect them,” says Joanne Whitmore, a senior cardiac nurse at the BHF. “Every year heart disease and heart attacks kill more than twice as many women in the UK as breast cancer.”
So what can we do to help keep our hearts healthy? Here we ask experts for the latest advice:
Watch your salt intake – most of us have too much
On average British adults consume about 8.4g of salt a day, down from the 9.5g we were consuming two decades ago, but still not low enough to benefit our heart health. Research by Graham MacGregor, the chairman of the scientific campaigning group Action on Salt and professor of cardiovascular medicine at the Wolfson Institute of Preventive Medicine at Queen Mary University of London, has shown that too much salt in the diet is the main factor that increases blood pressure, which can lead to heart attacks. A high intake of salt makes it harder for your kidneys to remove fluid, causing a build-up of fluid in your system that increases blood pressure. MacGregor says this is responsible for many heart attacks every year. “Over time untreated high blood pressure can lead to a thickening of the heart muscle, which can reduce the effectiveness of the heart pumping action,” he says. “We should be aiming for no more than 6g of salt daily, which would have a dramatic effect on cutting the number of heart attacks in the UK.”
Cut down on cheese, red meat and processed meats
A diet that contains too many saturated fats is bad for your heart. “Too much saturated fat from butter, cheese and processed meats can increase the risk of developing high cholesterol, a risk factor for coronary heart disease,” Whitmore says. Processed meats such as bacon and sausage not only contain saturated fats but are often high in salt. This year a study involving more than 19,000 participants showed that a higher intake of red or processed meat was associated with a greater risk of heart problems. The Department of Health advises that we eat no more than 70g a day of processed and red meat.
Eat fatty fish and use nut oils
The BHF advises that you choose seed or nut oils over butter and coconut oil to reduce the saturated fat in your diet and improve your heart health. And eating at least two portions of oily fish such as mackerel and herring each week has been shown to help prevent heart attacks. In an analysis released in May of studies from more than 60 countries, researchers reported that the omega-3 fats in fish oil had a significant protective effect on heart health in those with existing cardiovascular disease. “A Mediterranean style of eating with plenty of fatty fish, vegetables, olive oil and nuts seems to be the best approach for the heart,” Whitmore says.
Up your intake of kale, spinach and beetroot
https://link.springer.com/article/10.1007/s10654-021-00747-3 A Study this year involving 53,150 Danish participants (aged between 52 and 60) showed that eating at least one serving of green leafy vegetables providing 60mg per day of vegetable nitrate could significantly reduce the risk of hospital admissions for heart disease. Those who consumed the most nitrate-rich vegetables, such as kale, rocket, Swiss chard, spinach, romaine lettuce and beetroot, had lower blood pressure and up to a 26 per cent lower risk of heart disease. “Our results have shown that by simply eating one cup of raw — or half a cup of cooked — nitrate-rich vegetables each day, people may be able to significantly reduce their risk of cardiovascular disease,” said Catherine Bondonno from the Institute for Nutrition Research at Edith Cowan University in Australia.
Take up meditating
High levels of stress have been shown to cause a cascade of hormones such as adrenaline and cortisol that narrow the arteries and raise blood pressure over time. “There isn’t enough solid evidence at present to suggest that stress alone causes heart disease, but if you cope with stress by turning to unhealthy habits such as smoking and drinking, your risk of a heart attack increases,” Whitmore says. “Activities such as mindfulness, meditation and yoga can help to modify stress.” A study released in 2012 found that people with heart disease who meditated every day had a 48 per cent lower risk of a heart attack when followed for more than five years compared with those who attended lessons in the importance of reducing stress. The meditators were asked simply to sit with their eyes closed for about 20 minutes twice a day practising the technique, allowing their minds and bodies to rest deeply while remaining alert.
Yoga: excellent for heart health
Downward dogs and tree postures are also thought to be beneficial for heart health. In research presented at the American College of Cardiology’s annual meeting this year, Dr Kenechukwu Mezue suggested that yoga helps by minimising stress signals in the brain that can raise the risk of a heart attack. And a paper in the Journal of the American College of Cardiology in 2013 showed that twice-weekly hour-long gentle yoga classes had a calming effect that helped to prevent the speeding up or slowing down of heartbeat in people with an irregular heart rhythm (atrial fibrillation or AF).
“Atrial fibrillation happens when electrical impulses in the top two chambers of the heart fire chaotically instead of in a steady and regular way, causing them to flutter,” Whitmore says. “It isn’t life-threatening, but it’s considered serious because it could create blood clots in the heart that may lead to a heart attack so you need to get it checked by a medical professional.”
Do two and a half hours of walking, swimming or cycling a week
Cardiorespiratory fitness is a key factor in the prevention of heart attacks because it improves the efficiency of the heart, lungs and arteries. Any regular cardiovascular physical activity, from brisk walking to running and circuit classes to cycling and swimming, will gradually boost heart health. A study from the Norwegian University of Science and Technology’s Cardiac Exercise Research Group that was published in the European Heart Journal found that higher levels of cardiorespiratory fitness halve the risk of a heart attack and poor cardiovascular fitness raises the risk even if no other symptoms are present. “Any form of exercise is going to have an immediate positive impact on your health and protect your heart for the future, whatever your age,” Whitmore says. “We recommended building up to a total of 150 minutes of moderate-intensity aerobic activity each week — such as brisk walking or cycling — or 75 minutes of vigorous activity such as running.”
But don’t push yourself too hard
However, consistently pushing yourself to physical extremes is not good for the heart. The authors of a review published in the British Journal of Sports Medicine this week found that competitive athletes were two and a half times more likely to experience irregular heart rhythms or AF than non-athletes. Athletes aged 55 and under were more likely to develop AF than older athletes, and those who participated in mixed team sports such as rugby, football and netball were at a higher risk than endurance athletes such as cyclists and runners. “If you have an underlying heart condition or any other health issue you should check with your doctor before embarking on a new exercise programme,” Whitmore says.
Stop smoking and vaping
It goes without saying that smoking cigarettes is a big risk factor for heart disease in men and women, with one large international study in The Lancet showing that it tripled the risk of heart attack. Nicotine can quicken heart rate and raise blood pressure. In the long term smoking makes the walls of arteries that carry blood to the heart become sticky, so that fatty materials stick to them, which can lead to a heart attack. Most e-cigarettes contain nicotine and release very similar toxic compounds to tobacco smoking, and a study published last year by Mohinder Vindhyal, an assistant professor at the University of Kansas School of Medicine-Wichita, found that e-cigarette users were 56 per cent more likely to have a heart attack than those who do not use them or any tobacco products. “When we dug deeper we found that regardless of how frequently someone uses e-cigarettes — daily or just on some days — they are still more likely to have a heart attack or coronary artery disease,” Vindhyal said. “I wouldn’t want any of my patients or my family members to vape.”
Measure your waistline
It’s not just how overweight you are but where that excess fat is stored that determines your risk of heart disease, especially if you are a woman. Fat accumulated around the middle is bad news because it builds up around the organs. That is why keeping tabs on your waist measurement using a tape measure is a better indicator of heart attack risk than hopping on the scales or calculating your BMI (body mass index), according to a study in the Journal of the American Heart Association. Using UK Biobank data on more than half a million men and women aged between 40 and 69, none of whom had previous heart disease, researchers at the University of Oxford reported that during a seven-year follow-up 5,710 heart attacks were recorded among the study participants and women had a 15 per cent higher risk than men with a similar waist-to-hip fat distribution. “We found that women with bigger waists and waist-to-hip ratios face a greater excess risk of experiencing a heart attack than men who have a similar ‘apple shape’,” says Sanne Peters, a research fellow at the George Institute for Global Health at the University of Oxford. According to the BHF a waist circumference for men of 94cm-102cm (37in-40in) is high risk and more than 102cm (40in) is very high risk. For women, a measurement of 80cm-88cm (31.5in-34.6in) is high risk and more than 88cm (34.6in) is very high risk.
Don’t ignore chest pain
Chest pain, or angina, is the main symptom of reduced blood flow to the heart (ischaemia), which occurs as a result of an artery having narrowed. It can lead to a heart attack, yet a recent study presented to the European Society of Cardiology found that women with chest pain are more likely than men to wait more than 12 hours before seeking medical help and that this pain is misdiagnosed in women more frequently than in men. Dr Gemma Martinez-Nadal, the study author, says that this “gender gap” is linked to the “low suspicion of heart attack” in women and advises they get any unusual chest pain checked out.
Excessive drinking is bad for your heart
Dr Kenechukwu Mezue, a fellow in nuclear cardiology at Massachusetts General Hospital who has explored the impact of alcohol consumption on the body, says that as well as causing liver disease and cancer, excess boozing means adding extra “empty” calories that can lead to weight gain, a significant risk factor for heart disease. Drinking can cause high blood pressure and affect the functioning of the heart, Whitmore says. “Alcohol can also cause abnormal heart rhythms, high blood pressure and damage to your heart muscle, all of which are risk factors for a heart attack. If you do want to drink alcohol, stick within the recommended limits of no more than 14 units a week and ensure you spread these out, including keeping several alcohol-free days in the week.”
The best foods for your heart
Berries: High in beneficial flavonoids. Studies have shown that people who eat at least three bowls a week of berries were at 32 per cent lower risk of a heart attack than those consuming them once a month or less.
Mushrooms: Rich in heart-protective antioxidants
Pulses: High in fibre that helps to reduce blood cholesterol. One serving a day of beans, peas, chickpeas or lentils was shown to reduce “bad cholesterol” by 5 per cent.
4. Leafy Greens:
Aim for 1-2 daily servings to get a good dose of plant nitrates that improve artery health.
5. Nuts and seeds:
Recommended by the World Health Organisation to reduce the risk of heart disease. A handful (20g) of plain, unsalted nuts every day has been shown to lower risk of heart disease by up to 30 per cent
6. Black and green tea: Both are rich in flavonoids that reduce the risk of heart disease
7. Plain yoghurt: A fermented dairy food that has been shown to be heart protective even in people with hypertension
8.Coffee: 1-3 cups of black coffee daily provides antioxidants that protect the heart
Reference
The Times
July 17th 2021
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