Heart Attack Self-Defense

You've cut back on dietary fat and cholesterol. You've started exercising and lost weight. If you ever smoked, you've stopped. Perhaps you've even taken to drinking green tea.
What else can you do to reduce your risk of heart disease?
Quite a lot, actually. These nine suggestions come from Dr. Dennis Sprecher, a heart attack specialist at the world-renowned Cleveland Clinic...

• Consume more apples, onions and green beans...and more purple grape juice. These foods are rich in the heart-protective antioxidants called flavonoids.
Flavonoids benefit the heart by inhibiting oxidation of cholesterol—a chemical process that promotes artery blockages.
Flavonoids also help dilate the arteries that supply oxygen-rich blood to the heart.
CAUTION: Unsweetened grape juice—at 154 calories per eight ounces—is too calorie-dense to be consumed every day.
Like purple grape juice, red wine contains flavonoids. But given the risks associated with alcohol, men should have no more than two five-ounce glasses a day...women no more than one five-ounce glass a day.

• Boost your intake of omega-3 fatty acids. Fish oil is a good source of omega-3 fatty acids, which are believed to account for the lower incidence of heart-related deaths among people who eat at least some fish.
Omega-3s boost levels of HDL (good) cholesterol and reduce blood pressure by relaxing arteries...stabilizing heartbeats...and inhibiting formation of artery-clogging blood clots. Try to eat fish high in omega-3s, such as salmon and trout, twice a week.
CAUTION: Fish oil is a highly concentrated source of fat calories. Consuming too much of it raises LDL (bad) cholesterol levels.
If you don't like fish, ground flaxseed—sold in health-food stores—is an alternative source of omega-3s. Add it to cereal.
Another little-known source of omega-3s is arugula lettuce.

• Eat more beans and other low-fat foods—and less meat. One cup of black beans provides as much protein as two ounces of lean ground beef. But the beans contain only 1 g of total fat, compared with 12 g for the meat.
Also, beans contain no saturated fat or cholesterol. The meat contains 4 g of saturated fat and a whopping 43 mg of cholesterol.

• Eat more soy- and oat-based foods. Both protect the heart by encouraging excretion of cholesterol circulating in the bloodstream.
Use soymilk instead of cow's milk on high-fiber bran or oat cereal. Low-fat soy cheese and tofu — found in the dairy section of many supermarkets — are other good sources of soy. Or have oatmeal or oat bread instead of sugary cereals.

• Cut way back on salt. It's well known that sodium — found in table salt and many processed foods—can damage the heart by raising blood pressure. Yet the average American still consumes 6,000 mg a day—far more than the recommended 2,400 mg.
To lower your salt intake, follow the diet developed as part of a landmark study known as Dietary Approaches to Stop Hypertension (DASH). More information: http://dash.bwh.harvard.edu .
The DASH diet consists primarily of fruits, vegetables, whole-grains and low-fat dairy products. People who followed the DASH diet experienced a 15% reduction of atherosclerosis (stiff, clogged arteries), a cause of heart attack.
The DASH diet also reduces blood pressure about as much as medications do.

• Eat six small meals a day. Small, frequent meals make it less likely that the body will turn the calories you consume into fat.
If you plan to eat at a restaurant, have an apple or another low-fat snack beforehand. This takes the edge off your hunger so you are less likely to load up on calorie-laden breads or appetizers.

• Work out more frequently. In addition to burning excess calories, physical activity boosts levels of HDL cholesterol. Although most experts recommend exercising 30 minutes three times a week, new research confirms that daily activity yields the greatest benefits.
Jog, walk, run, dance or do some other moderately vigorous exercise for at least 30 minutes a day. If you cannot manage a 30-minute workout, do three 10-minute sessions.

• Curb psychological stress. In response to a stressful situation — be it a traffic jam or a difficult boss—your body produces two key hormones. Epinephrine increases heart rate. Cortisol raises blood pressure.
If your body constantly generates these hormones, you overwork your heart—and that increases your risk for heart attack. When we are under stress, our breathing becomes rapid and shallow. That deprives the heart of oxygen.
To reverse this oxygen-robbing tendency, inhale deeply through your nose for a count of 10 when you feel stress. Then exhale for a count of 10. Repeat twice more.

• Ask your doctor about heart-protecting medication. A daily aspirin helps reduce the blood's tendency to clot. That makes heart attack less likely.
CAUTION: Do not take aspirin to protect your heart without talking to your doctor first. In some people, regular use can cause internal bleeding.
If your total cholesterol is 200 or higher and/or you have a strong family history of heart disease, you should probably take pravastatin (Pravachol) or another prescription "statin" drug.

source: Dennis Sprecher, MD, director of preventive cardiology and rehabilitation at the Cleveland Clinic Foundation. He is a contributing author of The Cleveland Clinic Heart Book. Hyperion.