Coronary Heart Disease

This month we look at preventing and treating heart disease. Nathan examines ounces of prevention, measured in grams of fat per serving, while Janice discovers the importance of familial connection, measured in speed of returned phone calls.

She Says

My grandfather called last week, and something in the sound of his voice made me call back immediately.

Two months ago, Grandpa, an active 76-year-old, underwent double bypass surgery. He has had angioplasty and vascular stenting on three separate occasions, but his arteries have continued clogging. This summer, surgery became his only option.

He Says

According to the Heart and Stroke Foundation of Canada (heartandstroke.ca), some form of heart disease affects eight million Canadians. A Statistics Canada report, “The Changing Face of Heart Disease and Stroke in Canada 2000” (statcan.ca/english/freepub/82F0076XIE/82F0076XIE.pdf), states that “cardiovascular diseases are the leading cause of death of over one-third of Canadians.”

One of the most common procedures to treat atherosclerosis (hardening of the arteries caused by plaque or scar tissue) is angioplasty, wherein a balloon-tipped tube is inserted into the artery and then inflated to allow the placement of a small wire-mesh ring, called a stent. This mesh becomes permanent scaffolding, holding the artery open to allow blood flow.

She Says

Each time he’s had an angioplasty, my grandfather has felt immediately better. But each time his symptoms slowly return. Since his bypass surgery, he’s finally changed his diet and added an exercise regimen but admits that change has come “a little late.”

He cautions me to watch what I eat and keep exercising. He and my grandmother have become consummate label readers. “We don’t bring fatty foods into the house anymore,” he says. “We just don’t eat them!”

He Says

By 2003, 63 percent of Canadians had at least one major risk factor for heart disease. In response to this frightening statistic, Health Canada devised new nutritional labelling, making Canada the first country to include fat types on food labels.

As a result all packaged food now includes information on saturated fats (bad), trans fats (bad), polyunsaturated (good), and monounsaturated (good). See hc-sc.gc.ca/fn-an/label-etiquet/nutrition/index_e.html.

She Says

Grandpa’s diet has become more colourful. Having been a meat-and-potatoes man all his life, he now eats a (mostly) Mediterranean diet (mediterraneandiet.gr), which includes vegetables, fruits, whole grains, legumes, garlic, nuts, extra-virgin olive oil, and fish rich in omega-3 fatty acids. With his doctor’s permission, he also takes antioxidant supplements like green tea and coenzyme Q₁₀.

He Says

Clinical trials have seen benefits from both dietary supplements and careful nutrition. Antioxidant-rich foods, including most darkly coloured fruits and vegetables and dark chocolate, have been shown to reduce the buildup of plaque on artery walls, slowing and preventing heart disease. The Canadian Heart and Stroke Foundation (heartandstroke.ca) combines the most recent scientific findings with recipes and practical advice.

Supplements shown to aid heart function include the leaves, fruits, and flowers of hawthorn (Crataegus spp.), which also appear to lower cholesterol levels. For more information, see the article “The health-promoting properties of common herbs” at ajcn.org/cgi/reprint/70/3/491S.

Folic acid, in doses as low as 650 mcg daily, seems to lower homocysteine levels up to 42 percent in at-risk men. Homocysteine is a dangerous amino acid that has been linked to premature coronary disease, strokes, and blood clots. See “Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid, and B Vitamins in Cardiovascular and Thrombotic Diseases” online at ehi.at/journal/pdf/2005_05_22_stanger.pdf.

Some of the most compelling research on heart disease shows that social factors like relationships with family and friends, as well as connectedness within one’s community, may be the deciding precursors in avoiding and recovering from heart disease. See “Stress and coronary heart disease: psychosocial risk factors” at mja.com.au/public/issues/178_06_170303/bun10421_fm.pdf.

She Says

If there’s one good thing about heart disease in the family, it’s that it gets you returning phone calls quickly. Perhaps it’s a prescription for calls on a more regular basis, too.