The ABCs of heart disease

If you're worried about heart disease, you're wise. In Canada more women and men die of heart-related causes than of anything else. The good news is that you can do a lot to improve your odds for heart health, such as adopting good eating habits, exercising regularly, quitting smoking and staying up-to-date on the latest diagnostic techniques and treatments. The following is an A-to-Z primer on what's new and what you need to know to get -- and stay -- heart healthy.

ASA: Can taking an acetylsalicylic acid (ASA) tablet every day really keep the heart doctor at bay? Yes -- but only for some people. ASA reduces the amount of hormonelike prostaglandins that can cause platelets to stick together and form blood clots. These clots can block coronary arteries, which causes heart attacks. An inexpensive and readily available therapy, ASA can be beneficial for people who have experienced angina (chest pain) or who have had a heart attack or a stroke caused by blocked arteries. For healthy people, however, ingesting regular doses of ASA to prevent a heart attack may not be a good idea. Taking ASA may prevent an initial heart attack but it may also cause bleeding or stomach irritation, so the dose and pattern of use are important. Check with your doctor before embarking on long-term ASA therapy.

Beta-Blockers: This potentially lifesaving therapy blocks the action of the hormones epinephrine and norepinephrine, which are released when you are under stress. Beta-blockers slow the heartbeat, decrease blood pressure, normalize some irregular heartbeats and reduce contraction of the heart muscle. They're a recommended therapy for people who have suffered a heart attack, and although they still aren't prescribed as often as they should be, the number is on the rise. Patients who take this medicine tend to live longer than those who don't, and beta-blockers have also been proven beneficial in even the sickest patients who have congestive heart failure, a condition in which the heart is too weak to pump blood to the rest of the body.

Calcium Channel Blockers: Although there is much less controversy than a few years ago, this class of blood-pressure medication can't shake the controversy completely. Although CCBs are useful for lowering blood pressure, controlling symptoms and treating complications of heart attacks, such as arrhythmias, short-acting calcium channel blockers should be avoided as they may increase the risk of death in some patients. It was once found that CCB users have an increased risk of heart attacks and heart failure compared with those on other medications, but the Heart and Stroke Foundation says that is not the case with the CCBs currently being prescribed.

Defibrillators: These lifesaving devices deliver an electric shock to the heart to restore a normal heartbeat after cardiac arrest or to stabilize an irregular heartbeat. But speed is of the essence: studies show that survival rates after cardiac arrest decline by approximately seven to 10 per cent for each minute before defibrillation. Up to 45,000 Canadians die of sudden cardiac arrest each year. Ambulance workers and firefighters routinely carry defibrillators, but the Heart and Stroke Foundation declares that more should be put in public places, such as shopping malls, office buildings, casinos and sports arenas. Families or close friends of a patient who is at increased risk of sudden death can purchase their own defibrillator, but that decision should first be discussed with their physician.

Exercise: Most people know exercise is good for the heart; it can lower blood pressure and help control blood lipids, which are fats and oils that include triglycerides, phospholipids and cholesterol. Organizations dedicated to heart health recommend 30 minutes or more of moderate exercise most every day. However, research shows that short bursts of vigorous physical activity -- as little as 10 minutes long -- can also be beneficial if done several times a day.

Folic Acid: Folic acid can cut your risk of heart disease. Studies have shown that it reduces the level of the amino acid homocysteine in the body -- and high homocysteine levels have been linked to some heart diseases. In fact, high homocysteine levels are similar in terns of heart-related risk to smoking, elevated cholesterol and high blood pressure. Homocysteine metabolism is partly controlled by folic acid and other dietary B vitamins, including B6 and B12, so adopt a healthy diet to ensure adequate intake of B vitamins.