HEALTH MATTERS: How healthy is your heart?
February is American Heart month so let’s look at that heart of yours.
First, some basic facts. Everybody gets just one heart, so it’s important to take good care of it. The heart is on average an 11-ounce muscle highly specialized to move blood throughout your body. It beats about 100,000 times each day, moving 2,000 gallons of blood through 60,000 miles of blood vessels. Every day your heart uses enough energy to drive a truck 20 miles, and in a lifetime, drive to the moon and back. It will fill 200 train tank cars in a lifetime. And my favorite fun fact: the heart starts beating at four weeks after conception and does not stop until death.
The heart is amazing and critically important. How can we help it work flawlessly? Millennia of experience and scientific observation tell us much. There are recent changes in our understanding of heart health as well.
The American Heart Association and The American College of Cardiology have recently released new guidelines for the treatment of blood cholesterol using statin drugs. They found there was no good evidence to support the current target levels for LDL cholesterol, so they recommend an approach that disregards target levels and is based only on estimated long-term risk level. The study offers a risk calculator to determine level of concern. The AHA and the ACC have taken a step away from treating lab tests, but critics claim they simply want to sell more drugs.
Like many critics, Drs. Paul Ridker and Nancy Cook of Harvard Medical School feel “the new risk calculator dramatically overestimates risk.” The new guidelines advise lifelong statin use to a healthy 60-year-old white male with no risk factors, for example. Critics claim the new guidelines are based on flawed studies, outdated evidence, influenced by conflicts of interest and increase statin drug overuse.
Cholesterol in fact is very necessary to your health. Cholesterol is a major component of cell membranes critical to the function of every cell in your body. The cholesterol-rich insulation around nerves allows them to transmit electrical impulses. Hormones are made with cholesterol.
Increasingly, scientists understand that cholesterol isn’t the initial cause of cardiovascular disease, but part of the body’s attempt to heal. Cholesterol is involved in artery disease and plaque formation, but isn’t the initial cause. Factors that damage arteries and begin the disease process are much more important and include: smoking, high blood sugar, inflammation and stress. The body covers rough, damaged areas with cholesterol so blood can slip by. Early researchers concluded cholesterol was the perpetrator since it was at the scene of the crime, but blaming cholesterol for plaque is like blaming firemen for causing fires.
A more complete assessment than a lipid profile is important. Cholesterol is one of many factors to consider, and not the most important in assessing risk. Better understanding of how our bodies work is changing what tests doctors order. Some doctors feel the standard lipid profiles commonly used are worthless.
For example, the size and density of LDL particles are more important than the amount of LDL. The “Vertical Auto Profile” test provides far more useful information than the standard lipid profile. Elevated CRP, a marker of inflammation, and high blood pressures are better predictors than “non-HDL cholesterol.” Local labs can run these tests, or look at the “comprehensive cardiovascular risk profile” offered by Doctors Data Lab. There is much more to this subject, but the take home message is don’t abandon cholesterol awareness, just put it in context. Inflammation, blood sugar, high blood pressures, oxidation, excess weight, blood viscosity, low vitamin D, MTHFR mutation and vitamin K levels may be more important to you.
To reduce your risk, a comprehensive, systematic approach works best. Assessing factors and testing when indicated will suggest what treatment you need, if any. There are many ways to treat each of these risk factors. Next time we’ll look at the ways to improve these risk factors.
Dr. John Winters is a naturopathic doctor and owns Winters Naturopathic Clinic in La Grande.