Prevention & Recovery

How you can lower your risk of heart disease

By: Astrid Van Den Broek

Photography by Kevin Wong Author: Canadian Living Credits: Photography by Kevin Wong

Prevention & Recovery

How you can lower your risk of heart disease

By: Astrid Van Den Broek
Sheryl Gill doesn't remember anything about her sudden cardiac arrest seven years ago. She was pounding her way through a 10K when a fellow runner saw Sheryl collapse, go rigid and then fall limp. When she regained consciousness, a paramedic told her that her heart had stopped before the ambulance arrived. "They said I was pretty much dead for those 10 minutes," explains the Oakville, Ont., woman, now 45.

While a stroke was suspected initially, Sheryl was diagnosed with a congenital anomaly—her left coronary artery was essentially in the wrong place. Post-diagnosis, she's taken steps to improve her overall heart health. Sheryl's physicians referred her to a cardiac rehab program, which encouraged activity and healthful eating, and educated her on heart health. But she took things one step further. "I'm cognizant of my stress level, so I try and spread out tasks into more manageable pieces," she says. Sheryl has also embraced a supplement regime including multivitamins and fish oils as part of a general heart health improvement plan.

The heart scare prompted Sheryl to re-examine her overall health—a lesson we can all learn before disaster strikes. After all, someone dies from heart disease or stroke every seven minutes in Canada—not surprising for two of the three leading causes of death. According to Statistics Canada, cardiovascular disease accounts for almost 30 percent of women's deaths—slightly higher than men's deaths. The Heart and Stroke Foundation 2014 Report on the Health of Canadians noted that, annually, about 50,000 new cases of heart failure are diagnosed, 70,000 heart attacks occur, and 50,000 strokes result in emergency room visits. And according to the Ottawa-based  Canadian Institute for Health Information, 20,897 women (and 24,577 men) were hospitalized by a stroke in 2011. In that same time period, 118,455 women (and 186,722 men) were hospitalized due to heart disease.

So what can you do? While a family history of heart disease is a concern, physicians stress that it's the factors you can change (such as your eating and exercise habits) that truly count. "You can't change your genetics, but you can alter your blood pressure, blood sugar, cholesterol levels and lifestyle," says Dr. Eric Cohen, deputy chief of Sunnybrook's Schulich Heart Centre and cardiology division in Toronto. "You can't guarantee that you'll be free of heart disease by doing that, but it certainly raises your best probability."

Eat to beat heart disease
We know, we know...noshing on antioxidant-rich foods and keeping your sodium levels in check helps your heart. But this standby advice has evolved. After all, while the heart's biggest nemesis used to be bacon, now it might be your soda at lunch. That's right: The heart's new enemy appears to be sugar.
A 2014 study published online in The Journal of the American Medical Asso ciation Internal Medicine concluded that people who took in more than 25 percent of their daily calories from added sugar raised their risk of heart disease.

Not only do excessive added sugars and artificial sweeteners lead to weight gain (obesity is a risk factor for heart disease), but the empty calories that come from sugar don't leave room for nutrient intake in the form of fibre and vitamins, says  Dr. Jacob Udell, staff cardiologist at Women's College Hospital in Toronto. (In fact, the Heart and Stroke Foundation just released its new set of sugar guidelines suggesting that your total intake constitute less than 10 percent—and preferably lower than five percent—of total daily calories, which is in line with the draft recommendations released by the World Health Organization in March.)

More less-than-sweet news: Studies continue to tie diabetes—particularly the more common Type 2, which is partially brought on by excessive weight—to poor heart health. Australian researchers recently concluded that diabetes increases women's risk of heart disease by 40 to 50 percent. The American Heart Association also estimates that one in 10 patients with heart disease has undiagnosed diabetes.

And while the heart has a new foe  in sugar, it has also made a new friend: probiotics. This past summer, Australian researchers released a study noting that probiotics, the type of microorganism found in dairy products, helps lower blood pressure.

At the same time, researchers in Western Canada are experimenting with flaxseed's effects on blood pressure. In a one-year study of patients with hypertension at St. Boniface Hospital in Winnipeg, researchers found that consuming 30 grams of ground flaxseed daily lowered patients' systolic blood pressure (the pressure in the arteries when your heart beats) by 15 millimetres of mercury, and diastolic blood pressure (the pressure between heart beats) by seven millimetres of mercury. Grant Pierce, executive director of research at the hospital, notes that the team hasn't determined what exactly is helping the numbers drop—or whether the numbers will be sustained over time—but the research looks promising.

The latest on medications
What continue to be scrutinized—in Canada at least—are standard blood pressure guidelines. In a report published in The Journal of the American Medical Association this past January, an expert panel introduced revised guidelines for blood pressure ranges, raising it to a 150/90 reading from 140/90 for people over the age of 60, noting that there didn't seem to be any benefit to staying at the 140/90 guidelines. While Canada continues to follow the Canadian Hypertension Education Program Guidelines (endorsed by the Heart and Stroke Foundation), doctors remain watchful of the new U.S. numbers. Why? "It's been a controversial move," says Dr. Udell. Some health experts have publicly decried the new numbers, claiming a lack of sufficient evidence to raise the figures.

What's worse for your heart: smoking or sitting?
Physicians continue to stress that exercise is another critical factor people can control in shaping the future of their heart health—even for weekend warriors.  A recent study by the Mayo Clinic concluded that two hours of sitting cancels out the effects of 20 minutes of exercise. The good news is that it's easy to turn that around. "Even if you just get up for regular breaks and are active recreationally, this has the best association with lower risk of heart disease in the future," says Dr. Udell.

Know your risk

Dr. Udell stresses that women should focus on modifiable risk factors. "When you identify a risk—such as obesity—is there something you can do about it?" he asks. "There are a lot of things in life that we can't do anything about. Though it's important to note those, the Holy Grail is finding out if we can do something about risk factors."

Drink more milk
The next time you're thirsty, reach for a cold glass of milk—it just may help your heart. Multiple studies have shown that milk consumption and a dietary intake of dairy proteins may be related to a lowered risk of hypertension. Increasing your fruits and veggies and adding more dairy  to your diet may help you manage your blood pressure.

How women's hearts are different from men
Women's hearts weigh about two ounces less than men's— that's just one of the differences that influence how women are  diagnosed. A recent Mayo Clinic study discovered that exercise —specifically treadmill heart tests—affected women's hearts differently. (Women's peak heart rates dropped more slowly.)

This could influence recommended heart rate peaks for women  in exercise and stress tests. And according to Statistics Canada,  more women die of stroke, possibly because they are prone to risk factors such as migraines, or they may have had preeclampsia,  used oral contraceptives or had hormone replacement therapy.

The latest heart health news you need to know about: New injectable cholesterol drugs
In the late stages of clinical development, these biological therapy injectables are part of a new group of treatments called PCSK9 inhibitors, which help to lower cholesterol. "There are still ongoing studies, but it looks very promising," says Dr. Jacob Udell. Injections would regularly be prescribed and administered to those with high cholesterol.

Nix the niacin?
"A study in The New England Journal of Medicine showed that vitamin B3 niacin, combined with laropiprant, has no benefits and actually has harmful effects on patients," says Dr. Jean-Claude Tardif, director of the Montreal Heart Institute Research Centre. Niacin has long been prescribed as a cholesterol-lowering supplement, but the study found niacin has harmful side effects, including increased blood sugar levels in diabetics, bleeding, infections and more.

Feeling low hurts
An American Heart Association study noted that women under  55 are more likely to have a heart attack if they're moderately or severely depressed. A study from the Harvard School of Public Health, along with Beth Israel Deaconess Medical Centre and New York Presbyterian Hospital researchers, also confirmed the movie cliché: The risk of heart attack or stroke increases after  an angry outburst.

To learn how you can take steps to lower your risk of heart disease with these quick and easy activities for a healthy heart.

This content is vetted by medical experts

This story was originally titled "The Heart of Your Health" in the November 2014 issue.

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Prevention & Recovery

How you can lower your risk of heart disease