At the Brain & Heart Research Institute, our goal is to help individuals and health care providers prevent brain and heart disease through education, testing and superior products.
The Silent Killer. Cardio Vascular Disease and Sudden Death. Heart disease is called the silent killer because most people don’t know they have a problem until an artery is clogged by a blood clot. It is silent because the first sign of disease for many sufferers is a heart attack or stroke that hits suddenly, mainly caused by plaque rupture.
The plaque rupture can lead to a sudden cardiac arrest. Ninety-five percent (95%) of all sudden cardiac arrests are fatal (hence the term “sudden death”).
The American Heart Association (AHA) states that eighty-eight percent (88%) of the 383,000 US cases of sudden cardiac arrest, that occur each year outside of a hospital, happen at home. The survival rate for those who experience this condition is less than eight percent (8%).
Worldwide (it is not just a US problem), five million people die annually from cardiac arrest.
Is it a male only problem? Nearly 2/3rds of all fatal strokes occur in women.
“Heart disease and stroke cause 1 in 3 deaths among women each year – more than all cancers combined. Fortunately, we can change that because 80 percent of cardiac and stroke events may be prevented with education and action.” Quote from Go Red For Women.
The most common heart attack symptom in women is some type of pain, pressure or discomfort in the chest. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as discomfort in the neck, jaw, shoulder, upper back or abdominal area and shortness of breath. Symptoms from MedlinePlus.
Image from MedlinePlus
I am too young to have a heart attack. A sad fact is that ninety percent (90%) of Americans mistakenly rate their heart as “healthy” even though less than eight percent (8%) of Americans over the age of 25 are considered at low risk for heart disease.
Each year, approximately 6,300 children younger than 18 years of age experience out-of-hospital cardiac arrest (EMS assessed). Most sudden deaths in athletes are attributable to Cardio Vascular Disease (CVD). Of the cardiovascular deaths that occurred in a study reported by the American Heart Association, 54% were high school students.
Risk Factors: Aging is of course a significant risk factor for heart disease. However, you need not be an elder to succumb to heart disease. In fact, 33% of all strokes occur in in people under the age of 65 and this age group accounts for 45% of all heart attacks.
If you think 65 is getting old (it is not), then consider that the largest at-risk population is males older than 40 years of age who smoke, have high blood pressure, and diabetes (all risk factors for heart attack).
The absence of the three risks factors listed above does not mean you are risk-free. Smoking, high blood pressure, and diabetes are considered modifiable (correctable) lifestyle risk factors. You can stop smoking and you can reduce your blood pressure significantly by exercise and weight loss (magnesium helps). Diabetes can be controlled and often defeated through exercise, a healthy diet, and nutritional support. Sometimes this is easier said than done, particularly without expert guidance and knowledge.
Other factors can lead to a damaged heart, some of which are also modifiable. These include family history, genes, the presence of soft and calcified plaque, stress, insufficient hormones, poor sleep, excess body fat, insulin resistance, poor nutrition, leaky gut, lack of exercise, pre-diabetes (often overlooked) and insufficient quality nutrients.
Environmental. It is not all about just eating the right foods, although this is likely number one on the list for prevention. Environmental issues, genetic make-up, leaky gut, fatty liver, stress, overuse of antibiotics, medications, all can make it difficult to obtain sufficient heart-healthy nutrients from our food supply.
The food supply itself lacks many of the necessary nutrients due to processing, transportation, pesticides, herbicides, etc. See e.g. The End of Food, by Thomas Pawlick and The Meat You Eat: How Corporate Farming Has Endangered America’s Food Supply by Ken Midkiff.
Don’t’ like to take pills? The science supports the position that nutrient supplementation is generally required for prevention of heart disease and for reducing the risks of other chronic disease processes. Fortunately, the number of supplements can be reduced by making informed decisions about your food choices and your lifestyle choices.
Adding quality and selective nutrients to your daily health regimen can not only help prevent many disease processes but make your heart and brain function more optimally. Other good news: an ever-increasing number of nutrients are available in liquid and even cream form for those who need a change or who do not do well at taking pills.
But I had an annual physical and my doctor said I was fine. Did you know that traditional markers of cardiovascular risk such as cholesterol levels tell physicians very little about the acute risk of stroke or heart attack?
In fact, fifty percent (50%) of all heart attacks occur in individuals with normal cholesterol levels.
The sad fact is that many if not most of the testing done during the annual physical (if you even have an annual physical) are inadequate for early detection of heart disease. See below.
The traditional approach to assess cholesterol, blood sugar and blood pressure that most physicians use to evaluate heart disease does not address what is happening in the biochemistry within your arteries. Quote: The 30-Day HEART TUNE-UP, Steven Masley, MD
Most common markers used for early warning. The most commonly identified risk factors for cardiovascular disease include high cholesterol, high blood pressure, body weight, body mass index and high blood glucose.
The following are recommended by many healthcare professionals and are included on the Go Red For Women website in its Know Your Cardiovascular Risk section.
- Blood pressure – every regular health care visit starting at age 20.
- Cholesterol – every five years starting at age 20. More often if: total cholesterol is above 200; if you are a man older than 45 or a woman older than 50; if you’re a woman whose HDL is less than 50 or a man whose HDL is less than 40; if you have other cardiovascular risk factors.
- Weight/body mass index – every health care visit starting at age 20.
- Waist circumference – as needed starting at age 20.
- Blood glucose – every three years starting at age 45.
Are these tests sufficient? No! While some of these tests are helpful, they do not adequately provide the early detection and warning signs necessary to protect your heart. For example, the Body Mass Index (BMI) tell you nothing about percent body fat or visceral body fat. A person can have a BMI of 22 (supposedly great) yet have a percent body fat of 35 (obese). Obesity is a risk factor for heart disease and it is about body fat, not just height and weight.
Waist circumference is good to know because a large waist can be predictive of heart disease. HINT: Generally accepted unhealthy numbers are: waist size >35 inches for women and >40 inches for men. Measurement should be around the belly button not under the belly. Easy and simple.
The blood glucose test can be helpful but should be used with a fasting insulin test and HgAIC and in some instances with a glucose tolerance test. Type 2 Diabetes starts generally at least 15 to 30 years before a diagnosis and pre-diabetes is generally overlooked. Testing should start as a teenager. With the current upsurge in childhood obesity and diabetes, we maybe should start earlier.
I think we can all agree that the key to prevention is early detection and being pro-active to address any warning signs. Good News: Most disease processes can be treated and prevented if detected in the early stages and followed by informed lifestyle choices.
Most common markers MISSED for early warning. The tests noted above do not mention homocysteine levels or C-reactive protein? Both are key markers in inflammation.
Also, not mentioned were hormone levels of total and free testosterone, free thyroid, TSH, Free T4, estradiol levels (particularly in post-menopausal women), and DHEA levels. There are many studies that show the protective benefits of correctly used hormones.
Missing is fasting insulin and HgAIC (for diabetes, pre-diabetes). Insulin resistance and poorly controlled blood sugar is a leading cause of heart disease (and brain dysfunction).
Also missing from most testing is the PLAC® test, the Carotid Intima Test (CIMT) and the Brachial Test. These are incredibly important for early detection and warning of risk.
Each of these tests is explained in our blog section and each is important for identification of risk factors that can be correctable. However, let’s look at two that are frequently overlooked by most health care professionals or at least not ordered that are very predictive of heart disease (and correctable).
PLAC®. Testing for soft plaque to Identify risk of sudden heart attack or stroke. The PLAC® test measures the function of Lp-PLA2 in the artery wall— a vascular-specific inflammatory marker critical in the formation of rupture-prone plaque.
The first sign of disease for many people is a heart attack or stroke that is mainly caused by plaque rupture. An elevated level of Lp-PLA2 may signal that an arterial plaque is susceptible to rupture, which could cause a clot to break loose, precipitating a heart attack or stroke.
Unlike CT and other expensive imaging procedures, the PLAC® test is inexpensive, convenient, and involves no risk other than drawing a blood sample.
The PLAC® test may be used to determine and refine cardiovascular risk levels and to monitor response to hormones, diet, natural supplements, statins, and other treatments used for cardiovascular risk management.
Who Should Test? All males and females with any of the following risk factors (plus anyone who wants to monitor their risk of a heart attack/stroke or a subsequent heart attack/stroke and wants to be pro-active).
- A family history of heart disease or personal history of heart disease.
- Pre-diabetic or type 2 diabetes mellitus.
- Fasting blood sugar over 99 (86 is optimal)
- High cholesterol, high LDL, high triglycerides.
- Overweight and/or obese.
- Age 65 or older. Why wait since 45% of all heart attacks and strokes occur under the age of 65??
- Current smoker.
- High blood pressure.
Carotid Intima-Media Thickness (Carotid IMT) Test
CIMT stands for Carotid Intima-Media Thickness. The Carotid IMT test evaluates the thickness of your macrovascular circulation. It is used to precisely calculate arterial plaque growth and reliably estimate arterial age. Several studies have shown that the CMIT test is an excellent and safe predictor of future cardiovascular events. See The 30-Day HEART TUNE-UP, at p. 56, Steven Masley, MD.
An ultrasound is used to measure the size and thickness of the carotid artery (the large artery in your neck that feeds blood to the brain). Your level of thickness is compared to the average thickness of the remainder of the population.
If your carotid artery is thicker than that of other people your age, you are given an adjusted blood vessel age. For instance, if you are 40 years old, but your carotid artery thickness matches a 65-year-old person, your blood vessel age is 65 years old. This would put you at high cardiovascular risk and may change how aggressively you should manage your risk factors. You are as old as your blood vessels are.
The test can also be used to monitor the effectiveness of your treatment to ensure the plaque is shrinking. This test is considered by the Prevention Group of the American Heart Association as a “safe and dependable tool.”
Other Important information
- Family history is the Number 1 red flag for heart attack and stroke.
- Periodontal disease (gum disease) puts you at a higher risk for heart disease and Alzheimer’s disease.
- Women who are depressed suffer more than 2x the rate of sudden cardiac death (SCD) when compared to women who are not depressed. (Columbia University Study following 63,000 women over 12 years).
- Depression is just as dangerous as obesity, high blood pressure, and high cholesterol in causing or contributing to heart attacks. (Study of male twins).
- Men suffering from anxiety had 2x the risk of developing heart disease or a heart attack. (Study of 50,000 men over 37 years. Quoted in Beat the Heart Attack Gene at p 47.)
- Low levels of Vitamin D3 doubles the risk of heart attack and stroke.
- Less than 7 hours of sleep per night increases your risk of heart disease. More than 9 hours of sleep also increased your risk.
- Insulin resistance is a leading cause of heart disease.
- Prediabetes, diabetes, being overweight, obesity and lack of exercise all increase insulin resistance.
- Rheumatoid Arthritis increases heart attack risk by 45%.
- Rheumatoid Arthritis plus high triglycerides or cholesterol increases risk by 700%.
- Erectile Dysfunction is one of the leading warning signs of heart disease in men
Are you having a heart attack? Symptoms you might have:
- Pain or pressure in the chest
- Discomfort spreading to the back, jaw, throat, or arm
- Nausea, indigestion, or heartburn
- Weakness, anxiety, or shortness of breath
- Fast or irregular heartbeats
Symptoms for women may be different.
- Women don’t always feel chest pain.
- Women are more likely to feel tired or weak.
- Have heartburn or heart flutters
- Lose their appetite
Warning: The longer you wait to get treatment, the more damage can be done.
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