What you can do for your heart

THIS BLOG POST, LIKE OTHERS IN THIS SERIES, DOES NOT ATTEMPT TO PROVIDE MEDICAL ADVICE. ALWAYS CONSULT A PHYSICIAN BEFORE MAKING SIGNIFICANT CHANGES TO YOUR HEALTH REGIMEN.

Primary prevention of cardiovascular disease; yep, we're still talking about that. Primary prevention interventions work to reduce or eliminate effects of the risk factors related to, in this instance, impaired function of the heart and blood vessels. Let's apply this basic premise to the recent trivia game this blog posted (1/17/21), about decisions you might make to manage risk to your cardiovascular system. We'll address each question in the game, citing the evidence currently available on each issue, then addressing what you might expect to come in the prevention movement. Here we go. The best answer for each quiz question is underlined.

1. If you divide the total recommended weekly minutes for moderate physical activity, into equal weekday periods, that EXACT time period would replace:

A. Breakfast at Brennan's

B. Licking and applying a Forever stamp

C. Mixing a chocolate cake batter

D. Running a 10K race

E. Watching an episode of "The Conners"

A Brennan's breakfast easily requires one hour. Putting a stamp on an envelope rarely takes longer than a minute. The preparation time for a chocolate cake batter? 20 minutes tops. A 10K race can be run in about 45 minutes by a top - tier runner. The allotted time for a comedy like "The Conners" is 30 minutes, and that is the daily average time a person might expend on moderate physical activity. Thanks to the American Heart Association, and Department of Health and Human Services,  for this recommendation. 

2. To protect your cells and keep your skin healthy, eat plenty of foods high in Vitamin C. 

The Office of Dietary Supplements at the National Institute of Health provides a deep review of Vitamin C's powers. Try to consume the vitamin in uncooked foods, since Vitamin C is water-soluble. Cooking otherwise limits the effectiveness of the vitamin, so that you consume additional nutrients and fiber from uncooked foods, as well get increased nutrition.  And, yes, getting at least your recommended daily allowance of  Vitamin C can be a cardiovascular benefit. 

 3. All cholesterol is bad for your heart and blood vessels.       T       F

The Centers for Disease Control and Prevention point to high - density lipoproteins (HDL), or "good" cholesterol, as a source for production of hormones and cell construction. Keep your HDL to LDL (low density, or "bad cholesterol") high, and manage your LDL through lifestyle changes and your healthcare provider's assistance. 

4. Describe common behavioral methods for managing your triglyceride levels. 

According to the Cleveland Clinic, you may have a significant chance to lower your triglyceride levels in your blood when you get regular aerobic exercise, eat healthy and maintain a weight that is good for you. For example, a diet that may be helpful in lowering triglycerides would include: low amounts of fats, of sugars, and of simple carbohydrates and alcohol. Your healthcare provider might direct you to consider medication (e.g. statins) to manage very high triglyceride levels.

5. Areas on your body that do not allow for reliable blood pressure readings include:

A. Earlobe

B. Finger

C. Toe

D. Upper arm

E. Wrist

 The American Heart Association says that blood pressure cuffs, fitted around the upper arm, provide the most reliable blood pressure readings. Even though wrist cuffs are available in many 'big box' stores, their reliability is suspect. Earlobe and finger readings are not widely accessible outside research or clinical settings.

6. Supplements like ___B vitamins____ and __magnesium_____ help stabilize your blood sugar levels. 

 A 2015 paper in the journal Endocrine, Metabolic and Immune Disorders Drug Targets by Valdes'-Ramos et al., included the conclusions that eating foods containing ample amounts of the nutrients above, among others, is the best approach to increase control of type 2 diabetes. Use of dietary supplements to augment other medical treatments for diabetes, remains an individual decision until further research fills in the blanks about supplements' roles. 

7. Reluctance to eat protein could be a sign of kidney disease.       T       F

A 2018 meta - analysis in PLoS One of 19 randomized controlled trials, on the relationship between protein consumption and chronic kidney disease (CKD), revealed that the rate of decline in kidney function, as well as the risk of kidney failure for persons with CKD, may be slowed by a low - protein diet. Not wanting to eat protein, by itself, indicates you may have kidney disease. There is still limited understanding of how much protein consumption among cohorts is best. 

8. Explain how rheumatoid arthritis can lead to cardiovascular disease. 

Inflammatory processes engaged in the body by rheumatoid arthritis (RA), can lead to buildup of lipoproteins that may bring about cardiovascular disease. Be proactive! Reduce your levels of inflammation. Treat signs of cardiovascular disease. Fight the risk factors hard!

9. Women's health risks that do not trend with cardiovascular disease include: 

A. Hormone replacement therapy

B. Mommy's locked in the bathroom

C. Oral contraceptive use

D. Pre - eclampsia

E. Preterm delivery

Option "B" is a temporary respite from shocks to the heart. 

 10. South Asians will benefit from lower cardiovascular risk, by focusing on their best levels of _HbA1C_, _physical activity_ and _carbohydrates in the diet_ (Cardiology magazine, 5/17/2019). 

11. E - cigarette use is safer for adults than smoking or otherwise using tobacco.        T        F

The U.S. Surgeon General, the Department of Health and Human Services, and Northwestern University Medicine each document on their websites, factors including the ingestion of toxic minerals (e.g. aluminum, tin, nickel), the consumption of high levels of nicotine relative to that in tobacco, and the potential for both injury to the developing brain, and the lungs, which point to e-cigarette use as extremely risky to health.

12. Talk about what habits of yours have most helped you maintain a healthy weight. 

I keep a balance in my life, that helps me keep my weight where I need it to be. I watch the portion sizes of my meals, so I get the nutrition I need. My daily diet allows me opportunities for sufficient protein, fiber, essential nutrients and water. I exercise at the level that affords me at least moderate cardiovascular benefit. Stress I manage through my fitness work, cognitive - behavioral work, and leisure pursuits. I sleep to refresh the brain and body. It's a constant discipline, with pauses inserted to relax and 'cheat'.

13. Takeaways from any discussion of a genetic predisposition for CVD should mention:

A. If you have CVD,  your siblings have a 40% greater risk of developing CVD. 

B. You face a 60 - 75% higher risk of CVD, if your parents presented with CVD. 

C. Nothing you might achieve from lifestyle management can lower your CVD risk. 

D. Your risk for having a heart attack (myocardial infarction) is increased, if one parent had an MI. 

E. The Developmental Origins of Health and Disease framework gives researchers and clinicians, tools for better understanding the transmission of CVD between branches of a family tree. 

Two 2014 studies published in the journal Canadian Family Physician cite statistics for options "A", "B", and "D". A 2018 paper in the Journal of Physiology takes the study of pre- and perinatal effects upon the health of individuals to a mechanistic level,by comparing the fetal developments of humans with those of guinea pigs. 

THERE. I hope you've enjoyed the brief experience in the wide world of cardiovascular disease. It's also my wish that you see there is a place for the SLP clinician, helping her consumers learn to manage risk factors for CVD.