As a heart doctor who emphasizes prevention, I have helped many hundreds of patients avert cardiac crises and the emergency room. Many times, however, I had to treat patients who waited too long and ignored symptoms, or who suffered a heart attack out of the blue.
I saw them in crisis, in life-and-death dramas, in the ER or critical care unit. After years of treating patients and taking detailed medical histories, I figured out the main reasons – the most egregious things people do − that literally create self-inflicted critical cases at the very brink.
Smoking leads the list, no doubt about it. Lung cancer aside, this habit is the most destructive for the heart and nearly every other organ in the body. Each puff carries a toxic payload of chemicals and carcinogens, things like nicotine (used as a natural pesticide for hundreds of years), carbon monoxide, ammonia, arsenic, cadmium, lead, and formaldehyde, just to name a few of the 600 ingredients. According to the Centers for Disease Control, more than 10 times as many Americans have died prematurely from cigarette smoking than have died in all the wars fought by the United States during its history. If a patient continues to smoke after having angioplasty or stents, two procedures that open occluded arteries, chances are you’ll be back with new blockages in six months. Smoking after any intervention is a disaster. My experience was that getting people to stop their smoking addiction, even after a life-threatening heart attack and knowing that they were lucky to be alive, was always a huge challenge. Many couldn’t do it and the endings usually weren’t happy. If you are a smoker trying to stop the habit, I’ve got some recommendations for you here.
2. Having Severe Emotional Stress
This is like handling dynamite. We all have stress, but when it rises to the level of anger and rage, an already short fuse becomes dangerously short. I have seen many people whose emotions dramatically drove up blood pressure to the point of rupturing vulnerable arterial plaques, which in turn triggered a heart attack or stroke. I coached many heart patients in bad marriages to avoid arguments with a spouse at all cost. I would tell them the argument wasn’t worth dying for. I also saw many casualties from lost jobs, primarily men. More than a loss of livelihood and the fear of not being able to pay bills, the big blow to them was loss of self-esteem. They often remained at high risk for more crises unless they were able to get another job. This effect is at the heart of the issue of loss of a vital connection, and can involve a job or a loved one. The inability to establish a new connection is an overlooked factor that leads to heartbreak and to heart disease. For recommendations on defusing your stress, click here. To learn more about the devastating potential of loss, I suggest my book Heartbreak & Heart Disease.
3. Carrying Excess Weight
More than a third of American adults are said to be obese, a frightening statistic. Even more frightening is that the young are following suit: a third of them are overweight or obese. Obesity not only damages quality of life overall, it rises to the level of a national crisis that can decimate healthcare financing. That’s because it contributes to heart disease, hypertension, stroke, type 2 diabetes and certain types of cancer – some of the leading causes of preventable death. A big problem is that people, young and old, eat too many carbohydrates which turn into fat while not getting enough physical activity. Often these individuals feel trapped, unable to break out of their harmful lifestyle habits. I have always tried to motivate such patients by explaining how fat cells produce inflammatory chemicals that put them at grave risk for catastrophic cardiovascular events. If they could lose some weight, they would be taking a big step in reversing their heart disease, diabetes, and inflammation, and lowering the risks. To do so requires reducing refined carbs down to about 10-15 percent of the diet, minimizing sweets, eating healthy fats and protein, and starting some physical activity, anything, even a small daily walk, and building up gradually. If I could get someone started, and they lost 5 or 10 pounds, their blood pressure would often drop significantly, a relatively rapid result that stokes further incentive.
4. Making Poor Food Choices
Poor nutrition often results from ignorance, and I saw this too often among patients who just didn’t know better, didn’t care, or who looked only for convenience. Many were literally eating themselves to death. On a daily basis for years they ate junk food, sugar, soda, and fried foods, an inflammatory diet leading to cardiovascular trouble. Routinely, these individuals guzzled multiple sodas a day, and when I would show them how much sugar each 16-ounce can contained (11 teaspoons), their eyes would open wide. Half of these patients, I found, were willing to be educated and participate in their own health restoration. For those in this willing category, I tried to coach them off sugar, fried foods, and hydrogenated oils (trans fats), and onto healthier choices of protein, fats, vegetables, and fruit. It was this group of patients that inspired me to write The Fast Food Diet, a guide to making healthier choices at restaurants and fast food chains. You can also find plenty of information on healthier choices that satisfy your taste buds here.
5. Abusing Alcohol
Alcohol famously damages the liver, but it has a severely damaging effect on the heart as well. There is actually a condition called alcoholic cardiomyopathy, a weakened heart resulting from long-term heavy drinking, and thus unable to effectively pump blood 24/7. Other organs suffer as a result. Both long-term and binge drinking disturb the heartbeat, jack up blood pressure, and cause arrhythmias – irregular and scary heart rhythms that have the potential to cause lethal clots.
Binge drinking is a common problem during the holiday season, so common in fact that doctors have coined the term “holiday heart syndrome.” Overindulgence, including both food and alcohol, at Christmas and New Year, are associated with the biggest daily spikes in heart attacks and emergency room deaths. I’ve witnessed this phenomenon firsthand, and it includes people of all races, ethnicities, and religions. To stay out of trouble at holiday time, or any time, you must limit your alcohol intake. Easier said than done perhaps when everybody is in party mode, but for some people it is the difference between life and death.
For men, a low-risk drinking level is no more than four drinks on a single day and no more than fourteen in a week. Women should have no more than three drinks daily and seven weekly. My preference is to try to eliminate the risk altogether, meaning no more than two drinks a day for a man and one for a woman. Many of the heavy drinkers I saw also made poor food choices, which undermined their cardiovascular health further. Fully a third of them were depressed and medicating themselves with alcohol. Depression by itself increases the risk of heart problems four-fold, so these people were compounding their problems. Have a drinking problem or indulge in binge drinking? Please seek help. You’ll live longer and healthier. To learn more, including how wine IN MODERATION can be beneficial for the heart, check out my Myth-or-Fact? video and article.
- CDC. “Smoking and Tobacco Use; Fact Sheet; Health Effects of Cigarette Smoking.” Smoking and Tobacco Use. Accessed online on Oct. 13, 2014 at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/.
- American Chemical Society. “Tobacco and its evil cousin nicotine are good as a pesticide.” Accessed online on Oct. 13, 2014 at http://www.acs.org/content/acs/en/pressroom/presspacs/2010/acs-presspac-october-27-2010/tobacco-and-its-evil-cousin-nicotine-are-good-as-a-pesticide.html.
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