Heart disease, or heart disorders, are conditions that
affect the heart muscle or the blood vessels of the heart. There are many
different types of heart disease, but the most common is coronary artery
disease (CAD). This condition causes the arteries to narrow, and it may lead to
stroke or heart attack.
High cholesterol and high blood pressure are often
precursors to heart disease. In addition, recent evidence suggests that high
levels of homocysteine in the blood increases a patient's risk of developing coronary
artery disease (CAD). These factors may damage or irritate the blood vessels,
leading to blockages in arteries.
Heart disease is potentially life threatening. In the
United States, heart disease is the leading cause of death in adults. According
to the U.S. Centers for Disease Control and Prevention (CDC), nearly 700,000
Americans die of heart disease each year. This is because the heart is
responsible for pumping blood throughout the body. Blood contains oxygen, which
is necessary for the body to function properly.
Patients with heart disease may have heart attacks
(myocardial infarctions), which may be fatal. A heart attack occurs when the
supply of blood and oxygen to an area of heart muscle is blocked. If treatment
is not started quickly, the affected area of heart muscle begins to die. This
injury to the heart muscle can lead to serious complications, including death.
It is possible to survive a heart attack, but the part of the heart muscle
affected may be damaged, causing shortness of breath and chest pain during
exertion or rest. Patients who have experienced a heart attack have an
increased risk of having another one.
Patients with heart disease also have an increased risk
of developing strokes. This occurs when the blood vessels in the brain become
blocked. As a result, the brain does not receive enough oxygen.
Although some patients may be genetically predisposed to heart
disease, individuals can take steps to reduce their risks. Eating healthfully,
exercising regularly, maintaining a healthy weight, and not smoking lower a
patient's risk of developing heart disease.
Cor pulmonale, also called pulmonary heart disease,
occurs when the right ventricle of the heart becomes enlarged. If left
untreated, the condition may lead to heart failure.
Long-term lung diseases, such as emphysema, chronic
bronchitis, or cystic fibrosis, cause cor pulmonale. It may also be caused by
serious lung infections. These lung diseases increase the blood pressure in the
lungs, causing a condition called pulmonary hypertension (high blood pressure).
As a result of this increased pressure, the right ventricle of the heart has to
work harder to pump blood and it eventually becomes enlarged causing cor
pulmonale. Cor pulmonale may also come on suddenly if the patient's pulmonary
artery is blocked with a blood clot, a condition called a pulmonary embolism.
Symptoms of cor pulmonale are usually similar to the
underlying cause, which is typically a lung disease such as emphysema or
bronchitis. Symptoms often include frequent coughing, wheezing, weakness,
fatigue, difficulty breathing, shortness of breath, and irregular heartbeat.
Fluid may build up in the body tissue and cause swelling (edema). Patients may
feel weak or experience discomfort in the upper chest.
A magnetic resonance imaging (MRI) scan is the standard
diagnostic procedure for cor pulmonale. A machine takes pictures of the patient's
heart. The pulmonary arteries will be enlarged in patients with cor pulmonale.
An electrocardiograph (EKG) may be also performed. During this noninvasive
procedure, electrodes are taped to the patient's chest to measure the
electrical activity of the heart. Patients with the condition will have
frequent premature contractions in the atria or ventricles of the heart because
the heart muscle is overworked. A chest X-ray may show an enlarged right
Even with treatment, many patients with cor pulmonale
develop heart failure. This is because cor pulmonale occurs in the later stages
of serious lung diseases. In general, a low-salt diet and restricted fluids are
recommended for patients who have cor pulmonale or have an increased risk of
developing the condition. Antibiotics may be prescribed if a lung infection is
causing the condition. Blood thinners (anticoagulants) may be prescribed if a
pulmonary embolism caused the condition. Supplemental oxygen may also be used
to increase the amount of oxygen in the blood.
ARTERY DISEASE (CAD)
Coronary artery disease (CAD), also called coronary heart
disease (CHD), occurs when the blood vessels that supply oxygenated blood to
the heart muscle gradually become narrowed or blocked by plaque deposits.
Plaque is a combination of fatty material, calcium, scar tissue, and proteins.
Plaque buildup in the arteries is associated with several
risk factors, including high cholesterol, high levels of low-density
lipoprotein (LDL or "bad cholesterol") in the blood, low levels of
high-density lipoprotein (HDL or "good cholesterol"), high blood
pressure, smoking, diabetes mellitus, obesity, age, family history of heart
disease, sedentary or inactive lifestyle, stress, and male gender. All of these
factors cause the inner lining of the arteries (called the endothelium) to
become injured. When the endothelium is injured, the substances that make up
plaque cannot flow through the artery. As a result, plaque builds up in the
The plaque deposits decrease the space through which
blood can flow. As platelets (disc-shaped particles in the blood that aid
clotting) come to the area, blood clots form around the plaque, causing the
artery to narrow even more.
Sometimes the blood clot in the artery breaks apart, and
blood supply is restored. In other cases, the blood clot may completely block
the blood supply to the heart muscle. This lack of blood flow (called ischemia)
can "starve" some of the heart muscle of oxygen and lead to chest
pain (angina). A heart attack, also known as a myocardial infarction, results
when blood flow is completely blocked. Heart attacks usually happen when a
blood clot forms over a plaque that has ruptured.
Common symptoms of CAD include chest pain, shortness of
breath, irregular or fast heartbeat, weakness or dizziness, nausea, and
The standard diagnostic procedure for CAD is a carotid
ultrasonography. This procedure evaluates blood flow using a wand-like device,
called a transducer. The transducer sends high-frequency sound waves into the
neck to determine if there is any narrowing or clotting in the arteries.
Drugs used that treat CAD include platelet inhibitors
such as aspirin or clogidogrel (Plavix©); beta blockers such as metoprolol
(Lopressor© or Toprol©); calcium channel blockers such as amlodipine (Norvasc©)
or diltiazem (Cardizem©); angiotensin inhibiting drugs or ACE inhibitors such
as lisinopril (Prinivil© or Zestril©) or ramipril (Altace©); statins; or
HMG-CoA reductase inhibitors such as atorvastatin (Lipitor©) or lovastatin
Arteries that are severely blocked may need to be
expanded using balloon angioplasty (also called percutaneous transluminal
coronary angioplasty or PCTA) and stent placement. This procedure involves
using a wire mesh that expands in the blood vessel, allowing more blood to flow
normally. A specialized doctor, called a cardiologist, performs these
procedures at a hospital. A tube, or catheter, is inserted into a blood vessel.
Several types of balloons, stents, and/or catheters are available to treat the
plaque inside the vessel. Some of these surgical tools contain anti-clotting
medications. The physician chooses the type of procedure based on individual
patient needs. Common complications include restinosis (re-narrowing of the
artery), bleeding, and infection.
Patients with significant CAD may undergo a procedure
called coronary artery bypass graft (CABG) surgery. GABG surgery is when one or
more blocked blood vessels is bypassed by a graft (transplant of healthy
arteries or veins) to restore normal blood flow to the heart. These grafts
usually come from the patient's own arteries and veins located in the chest,
leg, or arm. The graft goes around the clogged artery to create new pathways
for oxygen-rich blood to flow to the heart. Some problems associated with CABG
include heart attack, stroke, blood clots, death, and sternal wound infection.
Infection is most often associated with obesity, diabetes, or having had a
previous CABG. Some patients may develop swelling in the tissue around the
heart (a condition called post-pericardiotomy syndrome) a few days to six
months after surgery. Symptoms typically include fever and chest pain. The
incision in the chest or the graft site may be itchy, sore, numb, or bruised
after surgery. Some patients report memory loss or loss of mental clarity after
Endocarditis occurs when the inner lining of the heart is
infected. The infection starts in the bloodstream and spreads to the heart.
Bacteria cause most cases of endocarditis, but viruses,
fungi, and other microorganisms can also lead to the condition. For instance,
dental procedures that have bleeding risks may allow bacteria to enter the
bloodstream. Bacteria may also enter the bloodstream during surgical
procedures. Other medical conditions, such as skin sores, gum diseases, or
intestinal disorders, may also increase a patient's risk of developing a
bacterial infection in the blood.
Common symptoms of endocarditis include fever, chills,
fatigue, weakness, aching muscles and joints, shortness of breath, night
sweats, pale complexion, persistent cough, blood in urine, unexplained weight
loss, tenderness in the spleen, new heart murmur (abnormal sound of the heart
that can be heard with a stethoscope), and swelling in the legs or abdomen.
Some patients may develop tender, red spots under the skin of the fingers
(called Osler's nodes). Some may also experience tiny purple or red spots on
the skin called petechiae. Similar spots may be present in the whites of the
eyes or under the fingernails.
Several tests, including blood tests, echocardiograms,
and a chest X-ray, may be necessary to confirm a diagnosis. Blood tests may
reveal low levels of iron in the blood, called anemia. This is because chronic
infections often interfere with the production of red blood cells and lead to
anemia. Because endocarditis may make it harder for the heart to pump blood, an
X-ray may reveal blood and fluid backed up in the lungs. An echocardiogram uses
sound waves to produce images of the heart. Patients with endocarditis may have
abnormally thick and/or leaky heart valves. Others may have abnormal growths in
the heart that contain collections of the disease-causing bacteria.
Left untreated, endocarditis can damage the heart valves
and permanently damage the lining of the heart. If the heart suffers from
permanent damage, it may lead to heart failure, which is fatal, unless the
patient undergoes a heart transplant. However, most patients who are diagnosed
and treated promptly experience a full recovery.
Patients with endocarditis receive intravenous (IV)
antibiotics to treat the infection. The type of antibiotic and duration of
treatment depends on the type and severity of the infection, as well as the
patient's overall health.
Blood pressure is the force of blood pushing against the
walls of arteries (blood vessels). Each time the heart beats, it pumps blood
through blood vessels, supplying the body's muscles, organs, and tissues with
the oxygen and nutrients that they need to function. Throughout the day, an
individual's blood pressure rises and falls many times in response to various
stimuli. For instance, stress typically increases blood pressure, and patients
generally have lower blood pressure during sleep. Elevated blood pressure over
a sustained period of time is a condition called hypertension (HTN) or high
The cause of 90-95% of the cases of high blood pressure
is unknown. Patients who are obese, sensitive to salt, consume excessive
amounts of alcohol, do not exercise regularly, smoke, eat poor diets, or
experience frequent stress have an increased risk of developing high blood
pressure. In addition, individuals may be genetically predisposed to developing
high blood pressure. Also, blood pressure tends to increase with age.
Hypertension is called the silent killer because an
individual can have it for years without knowing it. High blood pressure rarely
causes symptoms at first, but it is a risk factor for many other conditions,
including kidney disease and CAD, which may lead to heart attack and/or stroke.
Although it rarely happens, high blood pressure that has persisted for many
months to years occasionally causes symptoms, such as dizziness, ringing in the
ears, impaired vision, fatigue, irregular heartbeat, inability of males to achieve
or maintain erection (erectile dysfunction), and fainting. Extremely high blood
pressure can cause a headache upon awakening or, even more rarely, nosebleed,
nausea, or vomiting.
Blood pressure is measured with a stethoscope and an
inflatable arm cuff with a pressure-measuring gauge called a sphygmomanometer.
A blood pressure reading, given in millimeters of mercury (mm Hg), has two
numbers. The first number measures the pressure in the arteries when the heart
beats (systolic pressure). The second number measures the pressure in the
arteries between beats when the chambers of the heart are filling with blood
(diastolic pressure). To get an accurate blood pressure reading, a healthcare
professional should evaluate the readings based on the average of two or more
blood pressure readings.
The latest blood pressure (BP) guidelines, issued in 2003
by the National Heart, Lung, and Blood Institute, divide blood pressure
measurements into four general categories. Normal blood pressure is below
120/80 mmHg. Patients have pre-hypertension if their systolic pressure is
120-139 and their diastolic pressure is 80-89. Patients have stage 1
hypertension when their systolic pressure is140-159 and their diastolic
pressure is 90-99. Patients have stage 2 hypertension when their systolic
pressure is 160 or higher and their diastolic pressure is 100 or higher.
Treating high blood pressure can help prevent serious and
life-threatening complications. Experts recommend using the Dietary Approaches
to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole
grains and low-fat dairy foods. Experts also recommend: getting plenty of
potassium (e.g. bananas and green leafy vegetables such as spinach), which can
help prevent and control high blood pressure; eating less saturated fat (animal
fat) and total fat; and limiting the amount of sodium (salt) in the diet.
Although 2,400 milligrams of sodium a day is the current limit for otherwise
healthy adults, limiting sodium intake to 1,500 milligrams a day will have a
more dramatic effect on blood pressure. Consumers should look at the food
labels to determine sodium content. If cooking at home, individuals should use
less salt or a salt substitute that contains potassium iodide, which does not
increase blood pressure.
Other lifestyle changes, including bodyweight management,
regular exercise, smoking cessation, and stress management, may also help treat
high blood pressure.
Medications may also be prescribed to reduce blood
pressure. Beta-blockers, such as propranolol (Inderal©), metoprolol (Lopressor©
or Toprol©), or atenolol (Tenormin©), may reduce the workload on the heart,
causing the heart to beat slower and with less force. Angiotensin converting
enzyme inhibitors (ACE inhibitors) may be taken to dilate blood vessels and
increase oxygen to the heart. Calcium channel blockers (CCBs), such as
amlodipine (Norvasc©), felodipine (Plendil©), nicardipine (Cardene© or Carden
SR©), and nifedipine (Procardia© or Adalat©), may also be used. These
medications affect the transport of calcium into the cells of the heart and
blood vessels, causing blood vessels to relax. Alpha blockers, such as
doxazosin (Cardura©), prazosin (Minipress©), and terazosin (Hytrin©), may be
taken to help dilate the blood vessels. Alpha-beta blockers, such as carvedilol
(Coreg©) and labetolol (Normodyne© or Trandate©), may be taken to reduce nerve
impulses to blood vessels and slow the heartbeat. This helps reduce the amount
of blood that must be pumped through the vessels. Vasodilators, such as
hydralazine (Apresoline©), may also be taken. These medications work directly
on the muscles in the walls of the arteries, preventing the muscles from
tightening and the arteries from narrowing. Medications should be taken exactly
as prescribed. Taking more or less than recommended may have serious effects on
High cholesterol, or hypercholesterolemia, is a condition
in which there are unhealthy high levels of cholesterol in the blood. It is
less commonly called dyslipidemia, hyperlipidemia, and lipid disorder.
Cholesterol is a soft, waxy, fat-like substance found
within the bloodstream and cells of the body. Cholesterol is naturally produced
in the body and consumed in the diet. Cholesterol is needed to make membranes
for all cells in the body, including those in the brain, nerves, muscles, skin,
liver, intestines, and heart. Cholesterol is also converted into steroid
hormones, such as the male and female sex hormones (androgens and estrogens)
and the adrenal hormones (cortisol, corticosterone, and aldosterone). In the
liver, cholesterol is the precursor to bile acids that aid in the digestion of
food, especially fats. Cholesterol is also used to make vitamin D.
Too much cholesterol in the blood increases a patient's
risk of developing heart disease, which may lead to a heart attack, heart
failure, stroke, and death. Although eating an unhealthy diet may increase
cholesterol, some patients are genetically predisposed to developing high
High cholesterol can cause plaque deposits to form in the
arteries. Plaque is composed of cholesterol, other fatty substances, fibrous
tissue, and calcium. When plaque builds up in the arteries, it causes
atherosclerosis (hardening of the arteries) or coronary heart disease (CHD).
Atherosclerosis can lead to plaque ruptures and blockages in the arteries. If
the blood supply to the heart is blocked, a heart attack may occur. If blood
supply to the brain is blocked, a stroke may occur.
High cholesterol does not lead to specific symptoms
unless it is a long-term condition. If patients have high cholesterol for many
months to years, they may develop thickening of tendons due to accumulation of
cholesterol (xanthoma), yellowish patches around the eyelids (xanthelasma), and
white discoloration of the outer edges of the cornea due to cholesterol
deposits (arcus senilis). A high level of blood cholesterol causes the arteries
to narrow (atherosclerosis) and can slow, or even block, blood flow to the
heart. This reduced blood supply prevents the heart from receiving enough
oxygen. Left untreated, persistent high blood pressure may cause chest pain
(angina), heart attack, transient ischemic attacks (TIAs, or temporary lack of
blood flow and oxygen to the brain), lack of oxygen to the brain (called
cerebrovascular accidents or stroke), and blocked peripheral arteries (called
peripheral artery disease or PAD).
Healthcare providers typically take a sample of the
patient's blood to measure the patient's total cholesterol levels, lipoprotein
levels, and triglyceride levels and diagnose high cholesterol.
Healthy total cholesterol levels are less than 200
milligrams per deciliter of blood. If the total cholesterol is less than 200
milligrams per deciliter of blood, the risk of heart attack risk is relatively
low, unless there are other risk factors, such as smoking, a previous heart
attack, or high blood pressure. Borderline high cholesterol is diagnosed in
patients who have 200-239 milligrams of cholesterol per deciliter of blood.
High cholesterol is diagnosed when patients have 240 milligrams of cholesterol
per deciliter of blood. These patients are twice as likely to develop coronary
artery disease as patients who have cholesterol levels lower than 200
milligrams per deciliter of blood.
Lipoprotein levels are also measured. A high level of low
density lipoprotein (LDL), also called "bad" cholesterol, is a major
risk factor for atherosclerosis and coronary artery disease. LDL levels are
reported in several categories. An LDL level below 100 milligrams per deciliter
of blood is best for people at risk for heart disease. If an individual is at
very high risk for heart disease, such as having a previous heart attack, an
LDL level less than 70 milligrams per deciliter of blood is optimal. LDL levels
can also be near optimal (100-129 milligrams per deciliter of blood),
borderline high (130-159 milligrams per deciliter of blood), high (160-189
milligrams per deciliter of blood), and very high (190 or more milligrams per
deciliter of blood). When LDL levels are high, the condition is sometimes
HDL ("good") cholesterol protects against heart
disease, so for HDL, higher numbers are better. A level less than 40 milligrams
per deciliter of blood is low and is considered a major risk factor for
developing heart disease. HDL levels of 60 milligrams per deciliter of blood or
more help to lower the risk for developing heart disease.
High levels of triglycerides also indicate an increased
risk of heart disease risk. Patients that have levels that are borderline high
(150-199 milligrams per deciliter of blood) or high (200 milligrams or more per
deciliter of blood) may need treatment.
The main goal of cholesterol-lowering treatment is to
lower LDL levels enough to reduce the risk of developing heart disease or
having a heart attack. There are two main ways to lower cholesterol:
therapeutic lifestyle changes (TLC) and drug therapy. TLC includes a
cholesterol-lowering diet (called the TLC diet), physical activity, and weight
management. TLC is for anyone whose LDL is more than their target number and
goal. Drug treatment with cholesterol-lowering drugs can be used together with
TLC treatment to help lower LDL. Prevention of elevated cholesterol with TLC
and possibly drug therapy is started if the individual is at risk for high
cholesterol level or heart disease, or if the patient has suffered from a heart
attack or stroke in the past.
Hyperhomocysteinemia is a medical condition that is
characterized by high levels of an amino acid, called homocysteine, in the
blood. Patients with hyperhomocysteinemia have an increased risk of developing
coronary artery disease (CAD). This is because high levels of homocysteine may
irritate blood vessels, leading to blockages in arteries.
Deficiencies in folic acid (folate), vitamin B6, or
vitamin B12 may lead to hyperhomocysteinemia. Patients with kidney failure who
are undergoing dialysis also have an increased risk of developing
hyperhomocysteinemia. However, researchers have not discovered exactly why this
condition may develop in dialysis patients.
Hyperhomocysteinemia does not cause any symptoms.
Therefore, the American Heart Association recommends regular homocysteine
testing in patients who have high risks of developing heart disease.
Hyperhomocysteinemia is diagnosed after a blood test,
called a homocysteine test. Patients who have 14 or more micromoles of
homocysteine per liter of blood are diagnosed with the condition.
Patients with hyperhomocysteinemia receive folate,
vitamin B6, or vitamin b12 supplements until homocysteine levels are normal.
Pericarditis occurs when the sac-like membrane that
surrounds the heart (called the pericardium) becomes inflamed.
Pericarditis is usually caused by an infection, such as
staphylococcus, tuberculosis, or herpes simplex, which spreads to the heart
through the blood. It may also occur after a traumatic injury to the heart or
after heart surgery. Some patients may develop pericarditis after a severe
heart attack. Pericarditis may occur as a result of inflammatory conditions,
such as systemic lupus erythematosus or rheumatoid arthritis.
Symptoms of pericarditis may include chest pain, shortness
of breath, fever, fatigue, dry cough, and swollen legs and/or abdomen.
Patients with pericarditis may also have pleural
effusions, which occur when the membrane that surrounds the heart fills with
During a physical examination, a healthcare provider
listens to the patient's heart. When the sac around the heart is inflamed, it
will make a distinct noise when it rubs against the outer layer of the heart.
If abnormal sounds are present, a chest X-ray is warranted. Pericarditis is
diagnosed after a chest X-ray reveals inflammation around the heart.
Treatment of pericarditis depends on the underlying
cause. If an infection is causing the inflammation, patients will receive
antibiotics. The specific medication and duration of treatment depends on the type
and severity of the infection, as well as the patient's overall health.
In addition to antibiotics, patients with pleural
effusions will also need to have the fluid drained at a hospital. During the
procedure, called pericardiocentesis, a healthcare provider administers a local
anesthetic to numb the patient's chest. Then, a thin needle is inserted into
the pericardium and fluid is removed. This treatment may last several days
during the course of the patient's hospitalization.
High blood pressure (hypertension) control: One of the
most important things that can be done to prevent coronary artery disease (CAD)
and heart attack is to reduce high blood pressure. Blood pressure should be a
systolic reading of 120 and a diastolic reading of 80 (120/80 millimeters of
mercury). Exercising, managing stress, maintaining a healthy weight, and
limiting sodium and alcohol intake are all ways to keep blood pressure in
check. Medications to treat hypertension, such as diuretics,
angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor
blockers, may also be used.
Cholesterol and saturated fat intake reduction: Eating
less cholesterol and fat, especially saturated fat, may reduce the amount of
plaque in the arteries. Most people should aim for a low density lipoprotein
(LDL) level below 130 milligrams per deciliter of blood. If there are other
risk factors for heart disease, the target LDL may be below 100 milligrams per
deciliter of blood. If the individual is at a very high risk for heart disease,
such as having a previous heart attack, an LDL level below 70 milligrams per
deciliter of blood may be optimal. Statin drugs (HMG-CoA reductase inhibitors)
can be prescribed to help maintain healthy cholesterol levels.
Platelet inhibitors: In otherwise healthy men who are
older than 50 years, 325 milligrams of aspirin every other day helps prevent
heart attack (at a rate of two men per 1,000), but not stroke. In otherwise
healthy women older than 45 years, a 100 milligram dose of aspirin every other
day prevents ischemic stroke (at a rate of three women per 1,000) but not heart
attack (myocardial infarction). Platelet inhibitors, or antiaggregants (prevent
platelet clumping), such as aspirin may increase the risk of gastrointestinal
bleeding. Other platelet inhibitors include dipyridamole (Persantine©),
ticlopidine (Ticlid©), and clopidogrel (Plavix©). A 15% relative risk reduction
in vascular events (stroke, death, and heart attack) has been documented for
aspirin compared with placebo.
Smoking cessation: Smoking is a major risk factor for
coronary artery disease. Nicotine constricts blood vessels and forces the heart
to pump harder. A buildup of carbon monoxide (CO) reduces oxygen in the blood
and damages the lining of the blood vessels. Therefore, individuals can
decrease their risk of heart disease by not smoking.
Flu shots: Flu shots for patients with chronic
cardiovascular disease are now used routinely. This is because patients with
cardiovascular disease have an increased risk of dying from the flu.
Weight control: Being overweight contributes to other
risk factors for stroke, such as high blood pressure, cardiovascular disease,
and diabetes. Weight loss of as little as 10 pounds may lower blood pressure
and improve cholesterol levels.
Exercise: Exercise can lower blood pressure, increase the
level of HDL cholesterol (good cholesterol), and improve the overall health of
blood vessels and heart. It also helps control weight, control diabetes and
reduce stress. Thirty minutes daily of exercise is normally recommended.
Stress management: Stress can cause an increase in blood
pressure along with increasing the blood's tendency to clot. Chronic stress can
lead to an increase in the release of the stress hormone cortisol from the
adrenal glands. Researchers believe that this increase in cortisol leads to
increased blood pressure. Managing stress can be vital to keeping a heart
Diet: Eat healthy foods. A healthy diet should include
five or more daily servings of fruits and vegetables, foods rich in soluble
fiber (such as oatmeal and beans), foods rich in calcium (dairy products,
spinach), soy products (such as tempeh, miso, tofu, and soy milk), and foods
rich in omega-3 fatty acids, including cold-water fish, such as salmon,
mackerel, and tuna. Pregnant women and women who plan to become pregnant in the
next several years should limit their weekly intake of cold-water fish because
of the potential for mercury contamination. The U.S. Food and Drug
Administration (FDA) has announced that whole grain barley and
barley-containing products are allowed to claim that they reduce the risk of
coronary artery disease.
Alcohol consumption: In some studies, moderate use of
alcohol (particularly red wine) has been linked with increasing levels of HDL
cholesterol. No more than two glasses of red wine (four ounces each) should be
consumed daily for heart protection. Excessive drinking can have a negative
impact on cholesterol levels, actually raising triglyceride levels and
increasing blood pressure.
Cholesterol screenings: Everyone age 20 and older should
have their cholesterol measured at least once every five years.
© 2011 Natural Standard (www.naturalstandard.com)