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    Cardiovascular Disease Overview (Holistic)

    Cardiovascular Disease Overview (Holistic)

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    About This Condition

    A heart-to-heart on cardiovascular disease: Make simple changes to help you beat the odds against heart disease, a leading cause of death.
    • Get smoke-free

      Quit smoking and stay clear of cigarette smoke to lower your risk of several types of cardiovascular disease

    • Watch what you eat

      Eat lots of fruits, vegetables, legumes, whole grains, fish, and avoid fats from meat, dairy, and processed foods high in hydrogenated oils

    • Stay active

      Couch potatoes have increased cardiovascular disease risk, so make sure you get regular exercise

    • Get tested

      See your doctor to find out if you have problems with high blood pressure or high blood levels of cholesterol, triglycerides, or glucose

    About

    About This Condition

    Cardiovascular disease encompasses a wide range of conditions, and includes conditions that affect the heart and the blood vessels.

    Cardiovascular disease is the number one cause of death in the United States. Many risk factors are associated with cardiovascular disease and most can be managed with lifestyle and medical interventions, but some cannot. The aging process and genetic factors (hereditary or family predisposition) are risk factors that cannot be changed. Until age 50, men are at greater risk of developing heart disease than women, though menopause increases a woman's risk, up to as much as three times the risk prior to menopause.

    Many people with cardiovascular disease have elevated or high cholesterol levels.1 Low HDL cholesterol (known as the "good" cholesterol) and high LDL cholesterol (known as the "bad" cholesterol) are more specifically linked to cardiovascular disease than total cholesterol.2 A blood test, administered by most healthcare professionals, is used to determine cholesterol levels.

    Atherosclerosis (hardening of the arteries, often affecting those that supply the heart with blood) is the most common cause of heart attacks . Atherosclerosis and high cholesterol usually occur together,3 though cholesterol levels can change quickly and atherosclerosis generally takes decades to develop.

    The link between high triglyceride levels and heart disease is not as well established as the link between high cholesterol and heart disease. According to some studies, having high triglyceride levels is an independent risk factor for heart disease in some people.4

    High homocysteine levels are not consistently associated with cardiovascular disease risk,5 but according to some studies, homocysteine levels have been identified as an independent risk factor for heart disease.6 Homocysteine can be measured by a blood test that must be ordered by a healthcare professional.

    Hypertension (high blood pressure) is a major risk factor for cardiovascular disease, and the risk increases as blood pressure rises.7 Glucose intolerance and diabetes constitute separate risk factors for heart disease. Smoking increases the risk of heart disease caused by hypertension.

    Abdominal fat (central adiposity), or a "beer belly," versus fat that accumulates on the hips, is associated with increased risk of cardiovascular disease and heart attack.8  Overweight individuals are more likely to have additional risk factors related to heart disease, specifically hypertension, high blood sugar levels, high cholesterol, high triglycerides, and diabetes. Per criteria agreed upon by the International Diabetes Federation; NHLBI; AHA; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity, the presence of three or more of the aforementioned symptoms is a diagnosis of metabolic syndrome. Below is the specific criteria for a diagnosis of metabolic syndrome:

    • Central or abdominal obesity (measured by waist circumference):
      • Men - 40 inches or above
      • Women - 35 inches or above
    • Triglycerides greater than or equal to 150 milligrams per deciliter of blood (mg/dL)
    • HDL cholesterol:
      • Men - Less than 40 mg/dL
      • Women - Less than 50 mg/dL
    • Blood pressure greater than or equal to 130/85 millimeters of mercury (mmHg)
    • Fasting glucose greater than or equal to 100 mg/dL

    Symptoms

    People with cardiovascular disease may not have any symptoms, and for many people, the first symptom of cardiovascular disease is a myocardial infarction ("heart attack"). For others with cardiovascular disease, they may experience difficulty in breathing during exertion or when lying down, fatigue, lightheadedness, dizziness, fainting, depression , memory problems, confusion, frequent waking during sleep, chest pain, an awareness of the heartbeat, sensations of fluttering or pounding in the chest, swelling around the ankles, or a large abdomen.

    Healthy Lifestyle Tips

    Both smoking9 and exposure to secondhand smoke10 increase cardiovascular disease risk.

    Moderate exercise protects both lean and obese individuals from cardiovascular disease.11

    Eating Right

    The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

    Recommendation Why
    Eat healthfully
    Plant-based diets that are based on eating lots of vegetables, fruits, legumes (beans, peas, and lentils), nuts and seeds, whole grains, and small amounts of fish and other lean proteins, are linked with a lower risk of heart disease. In people who already have atherosclerosis (plaque build-up in the arteries), a healthy diet is important for maintaining health, and for reducing the risk of more serious complications and progression of disease.
    The 2013 American Heart Association (AHA)/American College of Cardiology (ACC) guidelines give a grade of "A"-indicating strong evidence to support the recommendation-to following a dietary pattern that emphasizes eating vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats. An "A" grade is also given to following a dietary pattern that limits saturated fat to less than 6% of total calories, or no more than about 13 grams of saturated fat per day for a 2,000 calorie diet, and to reducing the amount of calories coming from the trans (hydrogenated) fats found in proccessed and "junk" foods.12
    Keep it trim
    According to heart disease guidelines, addressing obesity and being overweight are important for helping people reduce the risk of heart disease, and better manage the condition if they already have it. Even modest weight loss of just 3%-5% of baseline body weight is likely to result in meaningful improvements in cardiovascular disease risk factors.
    More than 78 million adults in the United States were obese in 2009 and 2010, and obesity raises the risk of heart disease, death due to heart disease, and all other causes of death as well (all-cause mortality). Fortunately, even a small amount of weight loss can bring big rewards. Losing just 3%-5% of baseline body weight-that's only 7.5 to 12.5 pounds for a person currently weighing 250 pounds-is likely to result in meaningful improvements in cardiovascular disease risk factors, including improvements in triglycerides (fat in the blood) and blood sugar levels. If you're uncertain how to get started with a modest weight reduction plan, ask your doctor for a referral to a nutrition professional for counseling; nutritional counseling receives an "A" grade for effectiveness from the American Heart Association.13
    Limit salt
    According to the 2012 American Heart Association Presidential Advisory, "Sodium, Blood Pressure, and Cardiovascular Disease," the evidence supporting recommendations for reduced sodium intake in the general population remains robust and persuasive, and is important for improving the public's health.14
    Recent reports of selected studies have stirred controversy and led to calls to abandon sodium intake recommendations. However, an expert panel convened by the American Heart Association (AHA) concluded these recommendations remain important. The panel's detailed review of these selected studies considered them in the context of other existing research. The conclusion: There is no good rationale to warrant abandoning or reversing sodium-related dietary recommendations, and the AHA still strongly supports implementation of health promotion goals, including the recommendation to reduce dietary sodium intake to less than 1,500 mg per day, to improve the health of all Americans.15 Further, the 2010 Dietary Guidelines for Americans further clarifies which groups of people most need to focus on reducing sodium intake, noting that Americans aged two and up need to reduce sodium intake to less than 2,300 mg per day. People 51 and older, and those of any age who are African American, or who have high blood pressure, diabetes, or chronic kidney disease should aim lower for sodium-getting no more than 1,500 mg per day. Before you think, "that doesn't apply to me," consider that this covers nearly half the US population, and the majority of adults!16

    Supplements

    What Are Star Ratings?

    Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

    3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

    2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    Supplement Why
    2 Stars
    Sea Buckthorn
    10 mg three times daily of a flavonoid extract of sea buckthorn for six weeks
    Sea buckthorn berries, their oil, or flavonoid-rich extracts of the fruit have lowered biochemical indicators of increased cardiovascular risk in some, though not all, preliminary and double-blind human studies.
    Sea buckthorn berries, their oil, or flavonoid-rich extracts of the fruit have lowered biochemical indicators of increased cardiovascular risk in some,17 , 18 , 19 though not all,20 , 21preliminary and double-blind human studies. In a preliminary trial, people with heart disease who took 10 mg three times daily of a flavonoid extract of sea buckthorn for six weeks had less chest pain, lower blood cholesterol, and improved heart function.22 Double-blind research is needed to confirm these findings.
    1 Star
    Hemp Protein
    Refer to label instructions
    Hemp protein may prevent cardiovascular disease by lowering cholesterol levels and through antioxidant activity.

    Researchers have found that small amino acid chains found in hydrolyzed hemp protein can act as antioxidants, and suggested that these same amino acid fragments are likely formed during normal digestion of hemp protein.23 These antioxidants could protect blood vessels and cell membranes from the free radical damage linked to cardiovascular disease progression.

    In animal research, hemp seed meal was found to increase antioxidant activity and reduce cholesterol absorption in the digestive tract.24 Whether hemp protein has antioxidant and cholesterol lowering effects in humans is not yet known.

    1 Star
    Pea Protein
    Refer to label instructions
    Pea protein might help prevent cardiovascular disease by lowering cholesterol and triglyceride levels.
    A pea protein supplement lowered cholesterol and triglyceride levels more than casein protein in rats.25 Whether pea protein has the same effect in humans is not yet known.

    References

    1. Kinosian B, Glick H, Garland G. Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994;121:641-7.

    2. Kwiterovich PO Jr. The antiatherogenic role of high-density lipoprotein cholesterol. Am J Cardiol 1998;82:Q13-21 [review].

    3. National Institutes of Health. National Heart Lung and Blood Institute. High Blood Cholesterol: What You Need to Know. Available: http://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html.

    4. Harchaoui KE, Visser ME, Kastelein JJ, Stroes ES, Dallinga-Thie GM. Triglycerides and cardiovascular risk. Curr Cardiol Rev. 2009;5(3):216-22.

    5. Ntaios G, Savopoulos C, Grekas D, Hatzitolios A. The controversial role of B-vitamins in cardiovascular risk: An update. Arch Cardiovasc Dis. 2009;102(12):847-54.

    6. Seman LJ, McNamara JR, Schaefer EJ. Lipoprotein(a), homocysteine, and remnantlike particles: emerging risk factors. Curr Opin Cardiol 1999;14:186-91.

    7. Kannel WB. Office assessment of coronary candidates and risk factor insights from the Framingham study. J Hypertens Suppl 1991;9:S13-9.

    8. Megnien JL, Denarie N, Cocaul M, et al. Predictive value of waist-to-hip ratio on cardiovascular risk events. Int J Obes Relat Metab Disord 1999;23:90-7.

    9. Freund KM, Belanger AJ, D'Agostino RB, Kannel WB. The health risks of smoking. The Framingham Study: 34 years of follow-up. Ann Epidemiol 1993;3:417-24.

    10. Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ 1997;315:973-80.

    11. Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 1999;69:373-80.

    12. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Miller NH, Hubbard VS, Lee I-M, et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129 S76-S99.

    13. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129:S102-S138.

    14. Whelton PK, Appel LJ, Sacco RL, Anderson, CAM, Antman EM, Campbell N, Dunbar SB, et al. Sodium, Blood Pressure, and Cardiovascular Disease. Circulation. 2012;126:2880-89.

    15. Whelton PK, Appel LJ, Sacco RL, Anderson, CAM, Antman EM, Campbell N, Dunbar SB, et al. Sodium, Blood Pressure, and Cardiovascular Disease. Circulation. 2012;126:2880-89.

    16. The Centers for Disease Control and Prevention. Get the Facts: Sodium and the Dietary Guidelines. Available: http://www.cdc.gov/salt/pdfs/sodium_dietary_guidelines.pdf).

    17. Lehtonen HM, Suomela JP, Tahvonen R, et al. Different berries and berry fractions have various but slightly positive effects on the associated variables of metabolic diseases on overweight and obese women. Eur J ClinNutr 2011;65:394-401.

    18. Natural Medicines Comprehensive Database citation: Zhang MS, et al. Treatment of ischemic heart diseases with flavonoids of Hippophaerhamnoides. Chinese J Cardiol 1987;15:97-9.Pubmed citation: Zhang MS. A control trial of flavonoids of Hippophaerhamnoides L. in treating ischemic heart disease. ZhonghuaXinXue Guan Bing ZaZhi 1987;15:97-9 [in Chinese].

    19. Larmo P, Alin J, Salminen E, et al. Effects of sea buckthorn berries on infections and inflammation: a double-blind, randomized, placebo-controlled trial. Eur J ClinNutr 2008;62:1123-30.

    20. Suomela JP, Ahotupa M, Yang B, et al. Absorption of flavonols derived from sea buckthorn (Hippophaërhamnoides L.) and their effect on emerging risk factors for cardiovascular disease in humans. J Agric Food Chem 2006;54:7364-9.

    21. Eccleston C, Baoru Y, Tahvonen R et al. Effects of an antioxidant-rich juice (sea buckthorn) on risk factors for coronary heart disease in humans. JNutrBiochem 2002;13:346-354.

    22. Natural Medicines Comprehensive Database citation: Zhang MS, et al. Treatment of ischemic heart diseases with flavonoids of Hippophaerhamnoides. Chinese J Cardiol 1987;15:97-9.Pubmed citation: Zhang MS. A control trial of flavonoids of Hippophaerhamnoides L. in treating ischemic heart disease. ZhonghuaXinXue Guan Bing ZaZhi 1987;15:97-9 [in Chinese].

    23. Girgih A, Udenigwe C, Aluko R. Reverse-phase HPLC separation of hemp seed (Cannabis sativa L.) protein hydrolysate produced peptide fractions with enhanced antioxidant capacity. Plant Foods Hum Nutr2013;68:39-46. doi: 10.1007/s11130-013-0340-6.

    24. Lee M, Park S, Han J, et al. The effects of hempseed meal intake and linoleic acid on Drosophila models of neurodegenerative diseases and hypercholesterolemia. Mol Cells2011;31:337-42. doi: 10.1007/s10059-011-0042-6. Epub 2011 Feb 10.

    25. Rigamonti E, Parolini C, Marchesi M, et al. Hypolipidemic effect of dietary pea proteins: Impact on genes regulating hepatic lipid metabolism. Mol Nutr Food Res 2010;54 Suppl 1:S24-30. doi: 10.1002/mnfr.200900251.

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