Tag Archives: risk factors

Does Running Really Help your Heart . . . . and Your Spouse’s Too?

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IMG_8348rt5x7bwIt is commonly accepted that regular physical activity, such as running, can improve your overall health and reduce the risk of chronic disease. But can more extreme exercise, such as marathon running, actually increase our risk of heart problems, perhaps by ‘straining’ or ‘overtraining’ our heart and circulation (fortunately, the actual risk of a cardiac event during extreme exertion such as a marathon is very low)?   Recently, researchers in Hartford reported on a very interesting study- they recruited Boston Marathon participants to undergo a vascular ultrasound and physical prior to the marathon, in order to compare the plaque buildup in their carotid arteries to average non-runners. But what was most interesting was that they also recruited the runner’s spouses for the same checkup – and noted if they were runners or non-runners. Their theory was that the spouses would have the same “heart healthy” lifestyle as their running mates, minus the endurance training.

RunningSo what did they find? This article from the New York Times has the details (and this link is to the original research article) . . . .essentially they showed that the runners were indeed  healthy overall, with generally better body weight, blood pressure, and cholesterol than non-runners. . . but many still had significant plaque buildup in their hearts, especially if they were older or had ongoing risk factors such as high blood pressure or high cholesterol.  So running did not cancel out the effects of other risk factors, but did not increase heart risk either. What can we conclude from this research? Running, or other high level fitness, improves health and reduces risk – but does not excuse us from monitoring our blood pressure, our weight, our diet, or our cholesterol levels.

The most intriguing conclusion? It turns out the spouses of the runners, even if not runners themselves, had better than expected risk profiles and plaque buildup, probably from the same heart healthy lifestyle that most runners employ. The article quotes the lead researcher as saying:  If you want improved heart health but can’t be a runner, marry one!   Hopefully my wife finds that advice reassuring!

Here is more information of the benefits of exercise on the heart and the benefits of exercise on delaying dementia.

Is your Heart older than You? Find out your “Heart Age”

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Grewal Kanny MD 2x3 webI decided to spend my birthday figuring out my age. Not my actual age, which is painfully obvious, but my “Heart Age”. This is a new online calculator (featured in the Wall Street Journal this week) created by researchers in the UK, which uses existing data regarding the prediction of future cardiovascular risk (from the Framingham database, which is the most comprehensive set of data available). It has been reformatted into an algorithm that compares your true age with your estimated cardiovascular age, as a general way to look at your overall cardiovascular health.   To use the calculator, you need to know:

– your true age, sex, height and weight

-a recent total cholesterol and HDL if available

-a recent blood pressure reading

-your family medical history

Of course, there are several limitations to a simple calculator like this – it doesn’t take into account any symptoms you may have, or the duration or severity of risk factors. And the database from which it is drawn was created predominantly from Caucasian Americans, so it may not directly predict risk for other ethnic groups (for example South Asians, whose risk may be higher, or based on different weighting of factors). But it is a nice snapshot of your CV health in a format that is easy to understand.

So how did I do? Well, fortunately my Heart Age came out less than my actual age – but not by much. (Luckily, I have 365 days to make some progress!) Give it a try yourself:

Here is a link to the Heart Age calculator.

If your heart age is older than your real age, don’t dismay (the average result is 6 years older than real age!), but do look back at the questions – and notice how dropping your blood pressure, cholesterol, or waist size has a positive impact. We can’t change our age or family history (and generally not our sex), but lifestyle changes can go a long way to reduce our risk. So click here to learn about the best medication for heart disease – a therapy that reduces blood pressure and cholesterol and shrinks our waist size as well!

For more information see our articles on heart healthly diet and heart prevention in women.

Here is an informative video interview with the creator, from the WSJ: http://live.wsj.com/video/how-old-is-your-heart/A280BEEC-4649-4472-8223-65856B0FB3A5.html

The New Cholesterol Guidelines: What do they mean for you?

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Kanny S Grewal MD 5x7 (4)As you may of heard, some experts created new guidelines for clinicians to treat high cholesterol, and they have generated quite a bit of controversy, since they are a big departure from prior guidelines. The big new difference is that they no longer emphasize having “target” levels of cholesterol, LDL, etc and rather focus on just using statins at low, moderate, or high doses based on the patients level of “risk”, which is calculated from a formula based on age, sex, and various risk factors. This could be a sound approach, since some experts feel that simply being on a statin will reduce heart risk, regardless of how much a patients “numbers” actually change. They also conclude that most other types of cholesterol medications, besides statins, don’t have much impact on heart disease and are not generally recommended. The controversy is that the recommended formula to calculate an individual’s long-tern risk has not been thoroughly tested, and it seems to overestimate risk in many groups of patients.

What messages can we “take home” from these new guidelines? Here are a few:

1. The best treatment for high cholesterol remains lifestyle – diet and exercise.

2. The decision to start medication therapy should be individualized and come from the patient, after a thorough discussion with their clinician about risk.

3. Patients with established heart disease clearly benefit from statin therapy, which clearly reduces future risk of heart attack and stroke.

4. For patients without a history of heart disease or stroke,the benefit may be very negligible, unless they fall in a “high risk” group based on other risk factors such as diabetes. These patients should discuss the pros and cons of medication therapy with their doctor.

4. One way to think of statin therapy: it reduces future risk of heart attack and stroke by one-third in everyone. That means a 300 lbs diabetic who just had a heart attack, and a 30 year old fitness fanatic in perfect shape. The difference is the baseline risk. If you start with a risk of 1 in 100 of a heart attack the next 5 years, is that 1/3 reduction really worth taking a potentially toxic pill every day? Probably not. But 1 in 10, or 1 in 5? Probably yes.

So if you have been recommended therapy, or already on therapy, for high cholesterol, ask your doctor about your cardiovascular risk both with and without medication. And more importantly, stay active, maintain your weight, and focus on your diet!

Here is an some excellent summaries of the debate about the new cholesterol guidelines:

Dr. Krumholtz discussion in New York Times

Experts Reshape Treatment Guide for Cholesterol