By Sorcha Clifford
April 6, 2004
The American Heart Association has for the first time confirmed its belief in the link between air pollution and heart diseases, in its Journal this week.
Particulate matter pollution and second hand tobacco smoke are the most damaging air pollutants to the heart, said the Association.
"The increase in relative risk for heart disease due to air pollution for an individual is small compared with the impact of the established cardiovascular risk factors such as high blood pressure or high cholesterol," said DR Robert D Brook, lead author of the statement. "However, this is a serious public health problem due to the enormous number of people affected and because exposure to air pollution occurs over an entire lifetime," he said.
The Association has until now refused to be drawn on the long-term effects of repeated exposure to pollutants on heart disease and stroke. It says its experts have now conducted a comprehensive review of other research on pollution and cardiovascular disease, and concluded the risk is real.
A panel of experts within the Association looked at several recent studies on the subject and drew three conclusions:
Prolonged exposure to elevated levels of particle pollution is a factor in reducing overall life expectancy by a few years;
Short-term exposure to elevated levels of particle pollution is associated with the increased risk of death due to a cardiovascular event;
Hospital admissions for several cardiovascular and pulmonary diseases are increased in response to higher concentrations of particle pollution. The organisation has made a strong recommendation to ban smoking in public places, including bars and restaurants, as eights states in the US and the Republic of Ireland have recently done.
"Protecting individuals from second hand smoke is critical, and fortunately, an area where communities and states are already making a big difference," said M Cass Wheeler, CEO for the AHA. "Eliminating secondhand smoke in workplaces, restaurants and bars should be a priority for every state and community."
Heres something men are good at: dropping dead of heart disease. Every year, cardiovascular problems cause nearly half of U.S. male deathsa third of them by complete surprise.
Dont follow that pack. Every year scientists discover new ways men can protect their heartsfrom steps you can take to avoid problems, to drugs and gadgets that can help if you already have heart disease. We asked heart researchers to boil it down to 10 simple rules men can follow.
1. Get the latest, greatest test. Thats the highly sensitive C-reactive protein test, or HSCRP. A study reported in the New England Journal of Medicine found that this blood test is twice as effective as a standard cholesterol test in predicting heart attacks and strokes. It measures the levels of a specific blood protein that indicates that you have inflamed heart arteriesthe kind that rupture and cause heart failure. When researchers at Brigham and Womens Hospital in Boston monitored 30,000 women for 3 years, they found that those with the highest levels of CRP suffered a much higher rate of heart attacks and strokes. And this result is perfectly applicable to men, says Paul Ridker, M.D., the lead study author.
"Since half of all heart-attack victims have normal cholesterol levels, the HSCRP test is a much better way to figure your true risk", he explains. Ask your doctor to perform the $15 HSCRP test (not the standard CRP test; thats important) along with your regular cholesterol test. "That gives you plenty of time to make some serious lifestyle changes to reduce the risk", concludes Dr. Ridker.
2. Stop gloating about the half-marathon you ran in 1987. Over the past 4 decades, dozens of studies have shown that exercise is good for your heart. But heres the catch, according to a recent survey: Youre only as strong as your last workout.
Doctors from the Framingham Heart Study in Massachusetts compared people whod only recently started exercising with those who used to exercise regularly but stopped. Their finding: The cardiovascular mortality rate was 40 percent lower among the current exercisers.
"The benefits of exercise wear off quickly", says Scott Sherman, MD, of the UCLA school of medicine. Fortunately, the benefits of exercise also show up quickly, so if the only physical activity you ever have is moving pawn to knight six, youre not deadyet. "The study shows that for sedentary patients, its never too late to start being active", says Dr. Sherman.
| Heart Health Resource | Description |
| National Society of Genetic Counselors | Mentioned in story. Analyze family health data to determine risk. |
| LifeScore.com | Mentioned in story. Early detection: Electron Beam CAT scan (EBCT). |
| New England Journal of Medicine on Rampiril | Study mentioned in story. Prevention of heart attacks and strokes. |
| New England Journal of Medicine on the hsCRP test | Study mentioned in story. A test that's effective in predicting heart attacks. |
| The American Heart Association | Resources for fighting heart disease and stroke. |
| The Prevention Magazine His Health Center | Resource for prevention and heart health, male body quiz, etc. |
| The Yale University School of Medicine Heart Book | Extensive and in-depth resource in Adobe Acrobat format. |
| The OnHealth Cardiovascular Center | Detailed information on prevention, symptoms, conditions, tests... |
| Medline | Vast and useful resource by the US National Library of Medicine and the National Institutes of Health |
3. Spend more time in the weight room. Weights can make your biceps look good, but theyre also good for your heart. Why? In addition to lowering cholesterol and blood-pressure levels, stronger muscles make physical exertion, especially lifting or carrying things, less taxing. "Stronger muscles result in a significant reduction in heart rate and blood pressure while youre carrying a heavy object", says Barry Franklin, Ph.D., director of cardiac rehabilitation at the William Beaumont Hospital in Michigan. This may help you avoid straining your heart during exertion, which can cause a heart attack.
4. Quit smoking dope. The only thing more pathetic than a 43-year-old guy who still gets high is a 43-year-old guy who gets high then drops dead of a heart attack. Unfortunately, if youre still smoking pot, that could be where youre heading. A new study from Beth Israel Deaconess Medical Center in Boston shows that inhaling marijuana quintuples your risk of a heart attack for 1 hour after lighting up. Trust us on this: Dropping dead in a 7-Eleven with a bag of Cheetos in one hand and a Big Gulp in the other is no way to leave this world. Put down the weed.
5. Buy extra-virgin olive oil. Spend the extra buckit could cut your risk of heart disease. In a recent Spanish study, subjects who ate meals drizzled with extra-virgin olive oil lowered their LDL (bad) cholesterol levels by 4 percent more and raised their HDL (good) cholesterol by 2 percent more than the people who ate refined olive oil, which has fewer antioxidants than extra-virgin oil. Thats impressive. Even more impressive? Nowhere in the study did doctors make fun of the phrase "extra-virgin".
6. Talk to a genetic counselor. In spite of the time-sucking questionnaire he gives you, your doctor probably knows next to nothing about your family health history. Thats bad, because its the most important medical information you have. The solution: See someone trained to give your background the attention it deserves. Genetic counselors analyze your family health data (going back to your great-grandparents, if possible) and determine your risk of heart disease, cancer, and other problems. "We determine if an individual is at risk for disease and then target therapies to reduce that risk", says Helen Hixon, of the GenRisk program at Cedars-Sinai Medical Center in Los Angeles. Most major hospitals now have genetic counselors. To find one near you, call the National Society of Genetic Counselors at (610) 872-7608. Yes, most insurance carriers pay for this service.
7. Take a picture of your heart. The problem with heart disease? You may not know you have it until youre clutching your chest and hearing harp music. A new procedure called an electron-beam cat scan (EBCT) could be a solution. Aimed at men over 40, the EBCT gives your doctor a 3-D image of your heart and blood vessels and can show blockage in its early stagesbefore it causes problems.
"The key benefit of this is early detection", says Douglas Triffon, MD, of the Scripps Clinic and Research Foundation in La Jolla, California. An EBCT takes only 5 minutes, costs $495, and doesnt even require you to take off your clothes. For more information on the test, check the Web at www.lifescore.com.
8. Get on the treadmill. Its not new technology, but according to a study from the University of Maryland school of medicine, the traditional treadmill stress test is the single best predictor of heart troublebetter than age or blood pressure.
The catch, of course, is that you cant ignore the results if they suggest a problem. "We do sometimes see false positives in the stress test, and there has been a tendency for people to ignore their results. But this study shows its not smart to do that", says Leslie Katzel, MD, of the University of Maryland. Dr. Katzel says its not necessary to undergo a treadmill test every year, but its a good idea to have one when you turn 40, especially if youre starting an exercise program.
9. Pop a pill, not a balloon. Every year nearly 500,000 men undergo angioplasty. A doctor inflates a balloon inside a patients coronary artery to clear out blockage and start blood flowing again. Problem is, the procedure can be dangerous, and in up to 30 percent of cases the artery clogs again within 6 months.
Fortunately, there may now be a better alternative: taking high doses of cholesterol-reducing statin drugs. In a study last year of patients with coronary-artery disease, half underwent angioplasty and half were treated with the statin drug atorvastatin. The atorvastatin group had fewer heart attacks within the next 18 months. "Statins are proving that blood vessels arent just plumbing that needs to be reamed out", says James Froehlich, M.D., director of vascular medicine at Beth Israel Deaconess Medical Center in Boston. Dr. Froehlich says statins do more than clear blood vesselsthey actually help the vessels become larger to accommodate greater blood flow.
10. Weak heart? Ask your doctor about Ramipril. For 30 years, Ramipril has been used as a hypertension drug. But a study from McMaster University in Ontario shows that it actually helps prevent heart attacks and strokes, and even makes you less likely to need bypass surgery. In the study, which included nearly 10,000 patients (80 percent of whom had coronary artery disease), vitamin E and Ramipril were tested against placebos. The subjects taking vitamin E showed no benefit, but those taking Ramipril had a 25 percent reduction in death rate.
Note: Your heart rate rises when the oxygen level in your blood is too low. Avoiding Air Pollution will help to keep your lungs healthy enough to provide adequate oxygen so that your heart will not have to pump too hard.