Heart Disease, Stroke, Blood Pressure Tips

Simple Stroke Prevention with This supplement

April 26, 2015 by James Bogash

folic acid for stroke prevention — freshidea / Dollar Photo Club

Any type of damage to the brain scares most people. Imagine a clot in your brain cutting off blood supply, killing brain cells that allow you to function.

While a survey of 100 people would likely yield all 100 of them voting to NOT damage his or her brain, it seems that most of these 100 people don’t opt to make lifestyle choices that will protect the brain.

Just in case this seems to be a little dramatic, I would point out that cardiovascular disease and stroke share almost identical risk factors. In a recent blog article I pointed out that not a single person out of over 7,100 were living a lifestyle that included “Life’s Simple 7.” These are simple lifestyle choices and yet not a single person in the study followed all seven.

Maybe lifestyle changes are just too darn hard to do. All that exercise, eating right, getting sleep and maintaining an ideal body weight is just too much work. And society just does not support a healthy lifestyle.

Aren’t there any simple approaches that can lower your risk of stroke? Keep in mind that I have never been and never will be a “single supplement for a single condition” person. Supplements should always be used as just one tool among a host of lifestyle changes designed to lower your risk of chronic disease.

That being said, sometimes supplements do show up in the medical literature demonstrating strong effects on preventing chronic disease. This particular study is just such a situation. In it, researchers looked at the ability of folic acid to lower the risk of stroke in a group of 20,702 patients with hypertension.

Patients were given either the high blood pressure drug enalapril or enalapril plus 800 mg folic acid. Here’s what they found after the study was stopped early because the benefits were clear:

7% of those in the enalapril–folic acid group had a first stroke.
4% of those in the enalapril alone group had a first stroke.
Overall, those taking the folic acid had a 21% lower risk of having a stroke.
The benefit of taking folic acid was far stronger in those who started the study with lower levels of folate in the blood (<5.6 ng/mL). First stroke of 2.8% vs 4.6%, a reduction of 39%.

The results of this study managed to make it to the top of many of the medical websites despite that fact that the absolute numbers are very small (0.7% and 1.8% in the low blood folate patients). We use the same excitement when we talk about statins and their ability to lower rates of heart attack.

One of the major differences here is that folic acid is a far safer and less expensive approach to protecting your health than the statin class of drugs. Besides this, statin drugs don’t actually fix anything. At all. Folic acid, on the other hand, plays a role in blood vessel health by lowering homocysteine levels, a known irritant to the blood vessels.

The bottom line, however, is not to run out and buy a folic acid supplement. Rather, a good quality multivitamin will contain a broad spectrum of high quality B vitamins including 800 mg of folic acid as well as vitamin B6 and B12 to make sure they all work well together.

One of my personal favorites is Pure Encapsulations’ Ultra Nutrient, which contains solid levels of folic acid and vitamin B12.

Think You’re Not at Risk for Heart Disease? Take This Test and Find Out

April 13, 2015 by James Bogash

Heart disease is not something that we need to educate the public on. Everyone’s got ideas on how to prevent heart disease.

But, apparently, there’s some massive disconnect between what we need to do and what we are doing. A recently study revealed that not a single person out of 1,731 were living a lifestyle that included Life’s Simple 7 established by the American Heart Association. Not a single one.

But I’m confident that not a single person out of the 1,731 actually wanted to have a heart attack or leave his or her family with the untimely death of a loved one.

So why the disconnect? This particular study may help give you some insight as to why YOU haven’t adopted at least the Simple 7.

In it, researchers looked at a group of 5,863 patients and asked about his or her individual perception of risk of heart disease based on established risk factors. The patient’s perceived risk was then compared to his or her ACTUAL risk based on established risk factors.

Individuals were asked to rate his or her heart disease risk for the next years as low, intermediate or high. Based on these responses, they were classified as hypo-perceivers (the patient’s perceived his or her risk of heart disease as lower than it actually was) and normo-perceivers (the patient’s perceived risk was on par with his or her actual risk). Here’s what they found:

Cardiovascular risk was intermediate in 45.7% and high in 54.3% of individuals as estimated by the Lifetime Risk Score (LRS).
Shockingly, 83.9% were hypo-perceivers, thinking that they were at a lower risk than they actually were.
A mere 16.1% estimated their risk correctly.

Talk about a massive disconnect. First of all, EVERYONE in the study had at least an intermediate risk for heart disease. This is a sad reflection on the overall state of health. But how could so many of these patients be so unaware at how great his or her risk is??

The rest of the study may give us some insight into just how much our “take a pill to fix it” society has screwed up our perceptions:

Smokers were 204% more likely to underestimate their risk.
Those with cholesterol problems were 121% more likely to underestimate risk.
Sedentary people were 167% more likely.
Those who took meds? A whopping 350% more likely to underestimate his or her risk.
On the flip side, those with a higher BMI (64%), high blood pressure (43%), depression (54%) and stress (60%) were at a lower risk of hypo-perception.

I have said this time and time and time again. Taking medications to “fix” your problems does no such thing. In almost every situation, medications give you a false sense of security. Even though your blood pressure, cholesterol or blood sugar has gotten better on the meds, it translates very weakly into actually changing your risk of the things you are really worried about like heart attacks, stroke or death.

In other words, you will die with better numbers, but you WILL STILL DIE.

While this is a strong statement, we have seen it play out over and over in the medical literature. This study just reinforces the fact that our drug-oriented medical approach is creating a society that BELIEVES it is at a lower risk for heart disease, when in reality, it is not. There is a very high likelihood that you have some degree of risk for heart disease, unless you have adopted at least Life’s Simple 7 (click here for more info on the Simple 7 and see where you stand….personally I’m at a 9.4/10 because my BMI suggests I should lose 4 pounds, but my actual body fat percentage is where I want it to be).

Take the test yourself and let me know how you scored in the comments section!

Taking Care of Your Heart? 7 Habits You Need NOW

April 8, 2015 by James Bogash

I’m going to go out on a limb and state that death from heart disease is almost 100% preventable. So why is it still the #1 killer in the US and other industrialized nations?

Doesn’t this seems like a contradiction? If it’s so easy to prevent and research has shown what you need to do to protect your heart, so why the disparity? Maybe the researchers are all wrong and heart disease is just genetic. Given how often I hear this in my office, the “genetics” excuse has got to be at least partially correct, right?

Maybe the things you need to do to protect your heart are just too extreme to adopt. A lifestyle along the lines of the Dalai lama hidden in the mountains of Tibet? Running with the Hazda hunter-gatherers in east Africa? Hunting seals with the Inuit Eskimos of Greenland? Spending every waking moment in the gym on the treadmill or chanting a mantra in a yoga class?

Not even close. The American Heart Association have identified 7 key factors for ideal cardiovascular health (termed “Life’s Simple 7”). NONE of these are even remotely impossible to obtain. You just need to make the choice. Here they are:

Being a non-smoker
BMI < 25 (it is actually better to go by body fat percentage or waist-to-hip ratio–any “buff” weightlifter will have a higher BMI than this)
Physical activity at least 150 min/wk moderate intensity or 75 min/wk vigorous intensity or combination (regular readers will know I’m a big fan of short-burst aerobic, which has been shown to have better cardiac benefits)
At least 4-5 components of a Healthy Diet Score (a pretty simple task, actually…details by clicking here)
Total cholesterol less than 200 mg/dl (UNMEDICATED!!!!)
Blood pressure less than 120/80
Fasting blood sugar less than 100 mg/dl

With this in mind, this particular study looked at 1,731 adults (average age 56.8) to see how much these 7 factors had an effect on plaquing of the arteries feeding the heart muscles (specfically measured as coronary artery calcium, or CAC, scores as measure by cardiac CT). The CAC rating goes from 0 to 400, with anyone having a score of 100 or more to be considered as having heart disease. Using this scale, here’s what they found:

The average number of ideal cardiovascular lifestyle factors was 3.
Not a sinlge participant (out of 1,731) met all 7 factors.
Those who had 2 factors were 63% less likely to have a 100 CAC score.
Those who had 3 factors were 62% less likely.
Four or more factors had a 73% lower chance of having a CAC of 100 or more.

Now, I’m not saying that a 73% lower chance means heart disease has been prevented. There are other ways to check for heart disease besides CAC. But it sure has to be a good thing. Keep in mind that these 7 factors are really the low hanging fruit of prevention. When you get into more specific heart-healthy lifestyles (avoiding chemical exposures like BPA and Teflon, short-burst aerobic, a good night’s rest, etc…) these numbers will skyrocket. For those really interested in learning more, you can check out my Heart Disease eBook on Amazon by clicking here.

To me, though, the sickening part is that NONE out of 1,731 adults were meeting all 7 factors for heart disease prevention. NONE. As in ZERO. Is our society that incredibly sick that making lifestyle choices to protect our heart is out of the question?

Until we wake up as a society, stand up and say “enough is enough,” heart disease, a completely preventable condition, will continue to top the charts as the #1 killer.

Cholesterol Lowering Drugs and Nerve Damage

April 2, 2015 by James Bogash

statins and nerve damage — decade3d / Dollar Photo Club

Ok. I’ll admit it. I am completely stumped as to why drugs to lower cholesterol are among the most successful drugs that drug companies manufacture.

The evidence for their effectiveness pretty much sucks. Out of 100 people who are prescribed statins over the course of 5 years, only a single person will actually benefit. Not quite as rare as winning the lottery, but very few people have side effects from buying a lottery ticket.

Not so with statins. The list of side effects in far longer than you probably realize. At the top of the known list is muscle problems. From microscopic damage all the way up to fatal reactions from muscles literally melting (fatal rhabdomyolysis). It would not be unreasonable to say that almost everyone who takes a statin drug to lower cholesterol will suffer some type of muscle damage, even if it’s only on the microscopic level.

But what about your nervous system? Could your brain and the nerves going into your feet and hands be affected just as much as the muscles? And if so, why didn’t your doctor mention this side effect potential?

Here’s a little tidbit. When it comes to clinical studies on statins, the odds are stacked against you and your doctor for finding out just how common many of the side effects are. In both the muscle and nervous system lists of side effects, there are some 10-11 separate categories. So, when the reports of a study done on drugs that lower cholesterol are released, the risks are deemed “uncommon.” However, if you grouped all of the “nervous system” or “muscle” side effects into a single category, the rates of these side effects for EACH CATEGORY approached that 10% or higher level.

Considering that only 1 in 100 will benefit from the drug, 1 in 10 having significant side effects is a BIG deal.

As for just how common nerve damage may be, I’d like to point out this particular study. Normally, I review current research that has been published in the past month or so, but this one of those “oldie but a goody” studies from 2002. It is even more important in the context of recent recommendations to give practically every living being over 5 years of age who knew someone who had chest pains or lived in the same zip code as someone with heart disease a statin.

These researchers looked at cases of nerve damage (polyneuropathy) to see how likely statin use was related to the nerve damage. Because of the way that the data was retrieved, the diagnosis of polyneuropathy was limited to definitive, probable or possible. (Definitive = tested for all previously listed exclusion diagnoses and conditions, and where no apparent cause for the neuropathy had been established. Probable = only sufficient information existed to rule out alcohol over-use, diabetes, and renal insufficiency. Possible = information available was not sufficient to ascertain the presence or absence of any of the above-mentioned exclusion criteria.)

Here’s the specifics of this study:

Overall, statin users had a 370% higher risk of suffering from polyneuropathy.
However, for those who had definitive nerve damage, this risk skyrocketed to 1,420%.
When looking at current statin users, these were 460% for any diagnosis of polyneuropathy and 1610% for the definite cases.
If patients had been taking statins for 2+ years the risk of a diagnosis of definite idiopathic polyneuropathy topped the charts at 2,640%.

These aren’t exactly small relationships. If the drug manufacturers get their way and there is a massive increase in prescriptions for statin drugs, the number of cases of permanent nerve damage caused by statins are going to go through the roof.

And for what? So a single patient out of a hundred suffer one less heart attack?

Cholesterol Lowering Drug (Jupiter) Trial Shenanigans

March 17, 2015 by James Bogash

ARE THE DATA FROM ASTRAZENICA, CRESTOR JUPITER TRIAL ON STATINS LOOKING FISHY?

Wow. I really think if most of the American public knew the real story of what goes behind some of these trials we’d all be sickened. In it’s essence, the Jupiter trial looked at the prevention of heart disease in patients who had NORMAL cholesterol, but elevated inflammation. Essential understanding that the “cholesterol blame game” was going away and they needed to find a new lab value that they could use the drug for.

The study was stopped early and declared a rousing success. Much fanfare was heard and the medical journals and editorials sung it’s praise. Oops. A little too soon. A closer look at the data raises some serious suspicions. Basically, the trial was stopped early when predetermined events occurred just 2 yrs into the trial.

Furthermore, when you look at a population, certain statistics are expected. Here’s the quick details:

The study found that statin drugs did NOT protect against deaths from heart attack and stroke.
In the general population, cardiovascular deaths account for about 40% of the total number of deaths. Of these heart attacks, around 50% of these are fatal.

But in the Jupiter trial? Apparently miracles occurred. Cardiovascular mortality accounted for under 20% (instead of 50%) of the deaths, and the fatality rate of these heart attacks was very low (instead of the expected 50%). This raises serious questions about the validity of the data and suggests that funding of the trial may have had a strong influence on the interpretation of the data.

Calcium Channel Blockers Increase Heart Failure Risk

March 14, 2015 by James Bogash

ANOTHER DRUG FOR HIGH BLOOD PRESSURE INCREASES RISK OF DEATH??

Seriously. First we see a meta analysis several years back of 95,000 patients on beta blockers that had increased risk of diabetes and stroke and no lowered risk of death. Now, in a review of almost 157,000 patients (that’s a big review, by the way) we see another large class of drugs used to treat HTN that actually increase the risk of heart failure18% higher risk), especially in diabetics (a substantial 71% increased risk)?? These are the times that I think I read TOO much medical literature. The reality is, with drugs, it is a race to see whether side effects kill you before the disease you’re trying to prevent does.

The bottom line? Lifestyle is the ONLY answer. So many times I hear patients tell me that their blood pressure is “controlled.” This is a false sense of security because the “numbers” look better. Rarely is their risk truly reduced without making the right lifestyle choices.

Statins and Your First Heart Attack

March 10, 2015 by James Bogash

IS THIS THE BEGINNING OF THE END OF STATINS (LIPITOR, CRESTOR, ZOCOR, VYTORIN, etc…)?

It should come as no surprise to regular readers of my posts that the research just does not support the use of statins to prevent a first heart attack. The data is very, very weak. Which would be fine if it didn’t cost the US alone some $20 BILLION per year. Talk about money wasted. And not a shred of evidence to suggest that they help prevent a heart attack, and plenty to suggest they harm. But, despite the evidence, our country and medical system is absolutely convinced that statins are the savior for heart disease.

This meta analysis, reviewing over 65,000 patients over 11 studies with patients at a HIGH RISK of heart disease (forget those with only elevated cholesterol…), found NO EVIDENCE FOR THEIR USE IN PREVENTING THAT FIRST HEART ATTACK!!! Seriously. What more information do we need? Any why do I have to spend hours educating patients that the drug they are taking is worthless to them? Help!!

Worried About Your Heart? Did Your Cardiologist Check This?

March 9, 2015 by James Bogash

YOU MUST ADD THIS TO YOUR LABWORK!!

I personally do not check this lab value, but these numbers are very strong. Troponin T (cTnT) is a protein that helps cardiac muscles contract. Any level of heart damage can increase the level of this compound in the blood stream. In this particular study, those with the highest levels of cTnT had almost an 800% increased risk of dying from a fatal heart attack!!! 800%!! Even those with mild elevations had increases in risk of dying. It is becoming more and more frequent to hear of people suffering fatal heart attacks that “had no history of heart disease.” This is actually very misleading as I’ve said that someone can drop dead of a heart attack leaving a perfect stress test and cardiac screen. Maybe if these now deceased patients had their cTnT levels checked it would’ve be a wake up call for the path they were on.