National Nutrition Month

National Nutrition Month

HEART HEALTH

‘Heart Healthy’ Starts With What’s On Your Plate

What is good for your heart is good for your body

National Nutrition Month® is an annual nutrition education and information campaign created by the Academy of Nutrition and Dietetics. The campaign, celebrated each year during March, focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. Over the years, we have been educated on how to eat a balanced diet and how to read nutrition facts labels.

Make smart choices

Do you know what’s really in your food?
How many calories?
How many nutrients?

Over the years, many “fad diets” have arrived, each with a promise to improve health through some ingredient or process. One truth has emerged, a healthy diet that includes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry, and fish that also limits saturated and trans fats, sodium, red meat, and sugars offers long-term benefits to your health and your heart. Dr. Kevin Woods is a cardiologist with a passion for nutrition. He pointed out the popularity of ‘heart healthy’ diets. “Heart-healthy eating does more than reduce your blood pressure or cholesterol, lower your weight or sugar levels; at the end of the day what we are trying to accomplish is lowering your risk of heart disease. It turns out that what is good for your heart is good for the rest of your body too!”

This year, the Academy of Nutrition and Dietetics is promoting cutting down the fat in our meals while savoring the flavor. The propose the following tips:

• Use heart-healthy canola, olive or peanut oil instead of solid fats. • Use sharp, reduced-fat cheese and low-fat milk in your macaroni and cheese • Sweeten your desserts with fruit puree or apple sauce instead of sugar • Use whole wheat flour instead of white flour in muffins • Opt for brown rice instead of white rice in your red beans and rice or jambalaya.

We are what we eat

Dr. Woods noted the challenge in changing how we eat. “If you look at population studies that eat what we call the ‘Standard American Diet’ or SAD Diet, they are at an increased risk of cardiovascular disease. If you start taking items away from that, like red meat or meat in general, and you take away meat and dairy there are progressively lower levels of reported heart disease,” he stated.

Canada recently updated its Food Guide to offer advice on what to eat, what not to eat, and how to eat. “Half of the plate is filled with fruits and vegetables, a quarter of whole grains, the other quarter is protein. They specifically state that plant-based protein is preferred to animal-based proteins. They have also removed dairy as a food group. Instead of having a glass of milk on the side of their plate, there is a glass of water which is certainly the most healthy beverage for a meal,” said Dr. Woods. Canada has also removed the traditional four food groups into three key food groupings: vegetables and fruits; whole grains; and protein foods — foods that should be a regular part of your diet. The photo also represents the proportion of how much of each grouping should be consumed with more fruits and veggies, fewer grains and proteins.

Whether you are looking at the Food Guide Pyramid or Canada’s Food Guide, you will notice that processed foods are not included as part of a heart-healthy or well-balanced meal. Not all processed foods are unhealthy, but some processed foods may contain high levels of salt, sugar, and fat. “Processed foods, in general, are not good for you,” says Dr. Woods. “Whether you are talking about meat or dairy, even processed sugars. They contribute to build up of plaque in your arteries, increase your risk of diabetes, and if you look at cold cuts, bacon, sausage, hot dogs, those are the worst of the worst. When it comes to cancer risk, researchers lump processed meats as cigarette smoke.”

Exercise snacking

Two controllable risk factors in your health are diet and exercise. The Physical Activity Guidelines for Americans, 2nd edition, published by the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion recommends at least 150 minutes (2.5 hours) of physical activity per week. That breaks down to about 20 minutes of activity or exercise PER DAY. For those struggling to find time for a walk on your lunch break, exercise before or after work, or any heart-pumping activity during the day, there is a new trend you can follow, “exercise snacking.”

A study by Canadian researchers found that climbing stairs at short intervals throughout the day can improve cardiovascular health and may even add years to your life. They call it “exercise snacking,” the technical term is sprint interval training (SIT), which can be effective when done as a single session with a few minutes of recovery between each intense burst of exercise, only requiring about 10 minutes of exercise total. “I like this term ‘exercise snacking,’ it’s certainly better than the other snacking we know!”, exclaimed Dr. Woods. “I do encourage my patients to embrace physical activity. One of the things I bring up is that if you don’t have time to exercise or be active in the traditional sense of workouts in the gym if you break it up, time adds up. I encourage them to get a pedometer to count your steps during the day. Every hour you should stand up, walk for a minute, even stretch your legs; do something even if it is just for a few minutes every hour it will add up at the end of the day. Set a goal to reach 10,000 steps a day, it will take some effort but being able to break it up throughout the day and tracking your progress will help motivate you to hit your goal.”

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

Luke Perry Stroke

Luke Perry Stroke

PATIENT EDUCATION

Stroke is no longer
an “old age” risk

Adults as young as
40 are now at risk.

Here’s what you need
to ask your doctor.

Luke Perry’s death, just four days after FOX announced that it would be re-booting “Beverly Hills, 90210”, the TV show that made him 90’s icon, came as a surprise to fans who were hoping he would return as “Dylan McKay.” This role cemented Perry’s iconic image as the standard of cool for the generation who grew up after Jim Stark, the troublemaking teen played by James Dean in the epic 1955 film “Rebel Without A Cause.” The two characters not only shared similar backstories, dangerous loners who lived on the edge; the actors also shared a striking similarity in appearance.

The news report that The Los Angeles Fire Department responded to a “medical assistance” call at Perry’s home on Wednesday, February 27, dominated the headlines. At first, officials say Perry was talking to first responders and was fully conscious. This was just days after TV announcement; fans were shocked to learn that the star, at 52 years old was hospitalized due to a massive stroke. We were all saddened when the news broke the following Monday of his passing.

Redefining stroke

Stroke, as with many other forms of heart disease, is often thought of as an “old person’s” health concern. While there are more than 200,000 stroke cases in the US every year, making it the fifth leading cause of death in our country, the primary age affected is 60 years old and up. However, recent health trends have shown a growth in diagnosis with adults aged 41-60. “People can have strokes at any age,” says Maryellen King, Nurse Practitioner at Capital Cardiology Associates. Ultimately, if you have a concern about your risk of stroke, heart attack, or heart disease make an appointment with your doctor or primary care provider, today.

The traditional factors that put you at risk for stroke are lifestyle, diet, physical activity – which are controllable — tobacco use and smoking double the risk of stroke when compared to a nonsmoker. Smoking increases clot formation, thickens the blood, and increases the amount of plaque buildup in the arteries. Abusing alcohol and drugs (cocaine, amphetamines, and heroin) have been associated with an increased risk of stroke. The uncontrollable risk factors are your family history, age, race, gender, and prior heart health history.

There are also uncommon causes of stroke which are usually congenital (birth disorders) or rare vascular blood vessel diseases.

The recommendations for adults in their 40’s who are concerned about lowering their risk of stroke, heart attack or heart disease are:

• Eat a healthy diet, including reducing salt intake.
• Engage in regular physical activity and maintain a healthy weight.
• Manage stress.
• Avoid tobacco smoke.
• Take your medication as prescribed.
• Limit your alcohol consumption.

What is a stroke?

The National Stroke Association defines a stroke as “a brain attack.” Essentially, you have an instance where you’re losing blood flow to a part of the brain. “There are different types of stroke, hemorrhagic (bleeding in the brain), embolic (a blood clot that travels),” says King. Hemorrhagic strokes are less common; only 15 percent of all strokes are hemorrhagic, but they are responsible for about 40 percent of all stroke deaths. They can occur as a cerebral aneurysm, a congenital malformation of the arteries in the brain that can rupture. “There is no way to know if you have an aneurysm or not. If it ruptures, you can have bleeding on the brain, and people can die from that. They would experience sudden severe headache, the bleeding in the brain, patients will say the worst headache of their life. It’s not a warning sign, that’s a symptom,” stated King.

The other form of stroke is called an ischemic stroke. This can happen when a sticky, fatty material called “plaque” builds up in a blood vessel in your brain. Plaque slows your blood flow. It may cause your blood to clot. This can stop the flow of blood completely. This kind of stroke can also happen when a clot travels to your brain from another part of your body, even if you don’t have plaque buildup in your vessels. The most common cause of this type of stroke is A-Fib (atrial fibrillation) when your heart has an abnormal rhythm that produces the opportunity for a clot to form in the left side of the heart, dislodge and travels up and through to the brain.

A patent foramen ovale (above) is a hole in the heart that didn’t close the way it should after birth. The condition affects about 25% of Americans, but many do not know it.

The other type of embolic stroke would be a patent foramen ovale (PFO) or some different kind of congenital hole in the right and left sides of the heart. “The sides of your heart are supposed to be separate; blood comes from the right side of the heart is pushed to the lungs. It comes to the left side of the heart and gets pushed through the body. When there is a hole between the two sides, clots form and can travel from one side to the other,” said King. Most patients with a PFO do not have any symptoms. However, the condition may play a role in migraine headaches and it increases the risk of stroke, transient ischemic attack and heart attack.

Advances in testing

For patients who present stroke symptoms (Numbness or weakness in your face, arm, or leg, especially on one side. Confusion or trouble understanding other people. Difficulty speaking. Trouble seeing with one or both eyes. Problems walking, staying balanced, or loss of coordination. Dizziness. Severe headaches that come for no reason.) there are testing procedures. “The only way to find the holes in the heart would be with an echocardiogram, an ultrasound of the heart, to evaluate to see if a PFO has formed,” said King. Echo tests are performed by specially trained technicians at Capital Cardiology Associates. The test is painless, has no side effects, and usually takes an hour. “Using an echocardiogram (ECG) we can inject ‘fizz’ essentially, a trace amount of agitated saline that we call a ‘Bubble Study.’ These tiny bubbles can be seen on an ECG moving across the septum,” King explained. An ECG allows a physician to view the heart’s structure and check how the heart functions.

The other test available is the Transcranial Doppler (TCD), a non-invasive ultrasound method used to examine the blood circulation within the brain. A specially trained technician at Capital Cardiology Associates Imaging Suite performs this test to determine the amount of blood flow to specific areas of your brain. “The main reason that we started doing this is to detect a shunt or a hole in the heart,” shared Dr. Jeffrey Uzzilia of Capital Cardiology. “Patients that had a stroke, one of the reasons why they had a stroke that is not obvious at the time, is they can have a hole in their heart where a blood clot can form somewhere in the body and cross through that hole from the right side of the heart to the left. Once that blood clot is on the left side of the body it can travel anywhere in the body, including the brain and cause a stroke. Something like a PFO that everyone is born with, for most people it will close, for about 25% of people it will stay open. The TDP is the most accurate, sensitive test to detect that. It’s a very easy thing to see. There’s a good portion of patients, like Luke Perry, that you are shocked as to how young they are when they have a massive stroke,” said Dr. Uzzilia.

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

The Life of Heart Transplant Survivor

The Life of Heart Transplant Survivor

PATIENT STORY

The Life of Heart
Transplant Survivor

How a new heart changed one man’s life

The phone rang at my desk. It was Dr. Sullenberger. “Mike, you should come upstairs. There is a patient I want you to meet, David Gray. He has a story you need to hear.” I grabbed my recorder and walked upstairs to the 4th floor of our Corporate Woods location, unsure what to expect. This was the first time I had been called to meet a patient. Dr. Sullenberger introduced me to David Gray, a normal looking man wearing a hoodie sweatshirt and blue jeans. He smiled, we sat down, and David started opening up. He shared his remarkable survival story with the passion that makes you sit up and take notice.

David Gray (left) with Dr. Lance Sullenberger (right)

David Gray is a heart transplant survivor. His life changed forever in the summer of 2010, September 23rd to be exact. He speaks with such detail, you feel like you were in the hospital room when he received the diagnosis from Drs. Jeffrey Uzzilia and Lance Sullenberger that, what he thought were allergies, was in fact, viral cardiomyopathy, a disease of the heart muscle that causes it to become enlarged, thick or rigid. When David says cardiomyopathy, it just rolls right off his tongue. “Then I met Dr. Ian Santoro, my injection fraction was at 34%, it was recommended that I get a defibrillator, I got that. Glad I did because it saved my life. I fell on the floor and it shocked me four times, it brought me back to life!”

It was at that point, that I realized that David is going on his ninth year of telling this story. His journey continued after getting an Implantable Cardioverter Defibrillator (ICD). He blinked a few times, and the smile that was on his face cleared as a more serious tone came over his demeanor. He mentally focused as he shared this part of his story. Five years after receiving his implant, David’s ICD saved his life.

“I had just gotten done mowing the lawn,” David began. He went to sit in his chair in the garage to watch TV to cool off. “I said to my wife, ‘Hey, do you want anything from Stewart’s? I’m going to play the Lotto.” He looked right at me and stated the exact time and date; it was 5:30 pm on May the 30th. “She was like, ‘Naw, I don’t want anything.’ I told her, ‘Don’t leave, something is wrong.’ Next thing I remember, she’s in my ear saying, ‘I’m calling 911! Are you okay?” David recalls getting up and sitting in the chair but doesn’t remember falling to his garage floor, his forehead narrowly missing the snowblower parked nearby.

His defibrillator saved his life.

He sat in the chair in his garage for 20 minutes before going to the store. That’s when he got a call. “They told me that I was in full cardiac arrest and needed to come in right now. That started my summer off,” said David. “Dr. Sullenberger brought me in July of 2015 and said we needed to have a family meeting. I brought my wife and two kids in, I remember saying, ‘Really? I need a heart transplant evaluation! Are you serious?’ I was perfectly healthy my whole life. I thought I was just getting old.” David’s heart condition was degrading. A heart transplant was needed to save his life. We talked about what happens after you get this kind of diagnosis. How mind-boggling the news, terminology, and explanation can all be. The worst part is when you get home with a head full of questions left unanswered, so you get on the computer. “I googled heart transplant surgery — biggest mistake in my life, I didn’t need to know that. And I googled organ donation,” he said.

David rattled off facts so matter of factly, that after speaking with him, I realized was part of his impeccable memory recall. When it comes to organ donation in the United States, “New York is number 50 in the country. We’re at about 25% of per capita registered, we’re on the bottom of the pile. A New Yorker dies every 18 hours waiting for a transplant,” David stated. At the end of January 2016, an Intra Aortic Balloon Pump was inserted through Dave’s shoulder, another temporary solution until his open-heart surgery to implant a left ventricular assist device (LVAD).

“I knew nothing, absolutely zero about the heart or cardiology. Now I know more than I ever wanted to know in life!”

David Gray

Heart Transplant Survivor, Patient of Capital Cardiology Associates

“I smiled, I stayed strong during the entire process,” he recalls. The implant of an artificial heart made it possible for David walk his daughter down the aisle for her wedding, his major goal for that summer. He was able to return home, live a “normal life”, get back to the things that kept him busy, and most importantly, be with his family. Now David waited for a heart donor. Four months later, he got a phone call in late August that changed his life: a heart had been found for him. The next day he underwent surgery and on September 14th, he was discharged from the Westchester Medical Hospital. His body had accepted the new heart.

Today, David Gray lives like most retirees in the Capital Region. He keeps busy with his projects. David makes beer, cans jam and tends to his five beehives. “This year I have 42 pounds of honey!” he exclaimed. He fishes in the summer and hunts in the fall. But there is one thing that makes David quite unique to men his age: he’s survived heart failure, open-heart surgery, and in his mid-50’s, David is a patient advocate. “I have always helped people, it’s just different now,” David said.

He started small, working with support groups online and in person. He volunteers his time with several organ donor groups, New York State Donate Life, the Center for Donation and Transplant at Albany Med, the American Heart Association, “but my number one priority is with Westchester Medical Hospital”, he said, where he visits on a weekly basis. “My new life is that I visit patients. I talk with patients who come through from Capital Cardiology, I spend twelve hours a day down there.” This year he started visiting area high school students, sharing his story with young people.

David Gray walking with his daughter at her wedding

In a 2012 study, researchers found that the average life expectancy in heart transplant recipients was a little over 9 years, although researchers found a “relatively high quality of life even 10 years after surgery.” For David Gray, it’s obvious to anyone who speaks or meets with him for any amount of time that he is making the most of his new heart. He writes to politicians, celebrities and speaks to anyone who will listen about the need for organ donors. Personally, he has thanked everyone involved with his heart transplant, from the first nurse who saw him at the beginning of his diagnosis to the mother of his heart donor. An estimated 2,000 donor hearts become available in the United States each year. There is a tremendous need for donors across the country. Approximately 3,000 people are on a heart transplant waiting list at any given time, according to the University of Michigan. “We need more heroes, that’s all I can say,” David said. Anyone 16 years old or older can enroll in the New York State Donate Life Registry. Learn more by clicking here.

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

Inside Open Heart Surgery

Inside Open Heart Surgery

PATIENT EDUCATION

Inside Open
Heart Surgery

The steps leading to one of the most common heart procedures: Coronary Artery Bypass Graft

The Texas Heart Institute reports that, “Thousands of heart surgeries are performed every day in the United States. In fact, in a recent year, surgeons performed 500,000 coronary bypass procedures.” Coronary Artery Bypass Graft (CABG, pronounced “cabbage”) Surgery is the most common procedure performed to bypasses a severely blocked artery in the heart with a healthy blood vessel. This surgery restores vital blood flow to the heart muscle.

Since the late 19th century, surgeons have been performing cardiac surgery. On May 6, 1953, the first successful open-heart operation was performed on an 18-year-old woman in Philadelphia with a heart defect. What was once a new, unknown, scary procedure is now one of the best known, most studied and most effective surgeries of the modern age. Today, more than 95 percent of people who undergo coronary bypass surgery do not experience serious complications, and the risk of death immediately after the procedure is only 1–2 percent. The list of famous bypass recipients includes celebrities like Elizabeth Taylor, David Letterman, and Larry King to former President Bill Clinton and Vice President Dick Cheney.

Even with this reassurance, there are still concerns and questions surrounding bypass surgery. Dr. Lance Sullenberger is board certified in Internal Medicine, Cardiovascular Disease, and Advanced Heart Failure/Transplant Cardiology. He regularly consults his patients on CABG surgeries. “I would say there are two major ways a patient would present the need for an open heart surgery procedure or CABG,” he said. “The first would begin with a visit to your cardiologist.”

Doctors can determine when someone needs open-heart surgery by performing specific tests. This would begin with a patient who presents typical warning signs, chest pain, shortness of breath or palpitations. People with coronary heart disease sometimes experience buildups of plaque — a combination of fat, calcium, cholesterol and other cellular junk — on the insides of their arteries. This can restrict blood flow and cause clots. The most common symptom of a clogged artery is chest pain. In this case, the physician would order a stress test.

Doctors can determine when someone needs open-heart surgery by performing specific tests. This would begin with a patient who presents typical warning signs, chest pain, shortness of breath or palpitations. People with coronary heart disease sometimes experience buildups of plaque — a combination of fat, calcium, cholesterol and other cellular junk — on the insides of their arteries. This can restrict blood flow and cause clots. The most common symptom of a clogged artery is chest pain. In this case, the physician would order a stress test.

Testing

The heart performs differently at rest than it does during exercise. An exercise stress test – also known as a treadmill test – is designed to help your doctor learn how your heart performs during exercise or other activities that would make the heart work harder. For patients that are unable to use a treadmill or to get a deeper look, your doctor could order a nuclear stress test to help in the diagnosis of coronary artery disease or other heart conditions.

If the result of the stress test is abnormal, that patient would then be placed on medication and referred for catheterization, performed by an interventional cardiologist. “They do a diagnostic cardiac catheterization to look at the arteries that supply the heart with blood to see if that stress test was accurate,” noted Dr. Sullenberger. Again, with this test, physicians are looking for buildups that cause blockage of blood flow. Typically, arteries that are not blocked over 60 to 70% would be treated with medical therapy (medications, alterations in diets, changes in sleep habits, increased physical activity, stress reduction and more).

There could be one or maybe two arteries that have a blockage in them. “In that case, the decision would be made whether or not to use medicines or perhaps put stents in,” said Dr. Sullenberger. The stenting procedure could occur at that moment at the time of the catheterization. “When you start dealing with more than two arteries that are blocked or if there are special situations, such as the main artery on the left is blocked then you have to take a step back and ask, ‘Is this somebody who would be better served by stents or by bypass surgery?’ This is when the cardiologist and the cardiac surgeon would meet to discuss the options involved,” he shared.

The other major situation in which the decision has to be made between stenting and bypass is when a patient presents with a heart attack. “They are coming in with chest pain, losing heart muscle, most of those patients end up immediately in the Cath lab where an interventional cardiologist will look to see which artery is blocked and causing the heart attack, at that moment,” says Dr. Sullenberger. Most of those patients will receive a stent at that moment. A stent is a tiny wire mesh tube that is inserted inside a clogged artery through a tube procedure that does not require open-heart surgery. It props open an artery and is left there permanently.

The other major situation in which the decision has to be made between stenting and bypass is when a patient presents with a heart attack. “They are coming in with chest pain, losing heart muscle, most of those patients end up immediately in the Cath lab where an interventional cardiologist will look to see which artery is blocked and causing the heart attack, at that moment,” says Dr. Sullenberger. Most of those patients will receive a stent at that moment. A stent is a tiny wire mesh tube that is inserted inside a clogged artery through a tube procedure that does not require open-heart surgery. It props open an artery and is left there permanently.

For patients who present blocked arteries that cannot be corrected with stenting, Sullenberger states that the patient is stabilized in the coronary care unit while the cardiologist and surgeon meet to discuss the next best step. “Most good cardiologists have an idea beforehand if this person is going to end up needing a bypass or if they have valve disease,” he says. The timeline on when to operate depends on the patient’s condition. For an out-patient, surgery is performed within weeks. For heart attack patients, those decisions are made in a day, 48-hours at the most.

Surgical Procedure

According to the Agency for Healthcare Research and Quality statistical brief, published in March 2014, about 213,700 Americans have a CABG procedure every year. When someone has bypass surgery, they are in the operating room for several hours, on average about six hours. Most of that time is spent prepping the patient and getting them ready. The actual bypass surgery itself is about a two-hour procedure which can go longer or shorter based on what needs to be done.

In a typical procedure, the surgeon harvests a healthy blood vessel from a donor site. This is called a graft. The graft is commonly taken from the patient’s leg or arm. The surgeon opens the patient’s chest to expose the heart. The patient’s blood flow is diverted to a heart-lung machine. This machine temporarily takes over the lung’s function of oxygenating the blood and the heart’s function of pumping blood to the body. Medication is administered to stop the patient’s heart and preserve it during the surgery. After the bypass is complete, the surgeon removes the clamp from the aorta and allows the heart to resume beating on its own. The surgeon may insert a temporary pacing wire. This wire can be connected to a pacemaker if needed.

The patient then goes to a surgical ICU for recovery, made especially for cardiothoracic patients that receive specialized nursing care. That’s when cardiologists would see the patient. “In a best-case scenario,” Sullenberger begins, “you stay in the ICU about 48-hours after surgery, then you go to a step-down floor for another five days or so. Expect about a week in the hospital. Then you are discharged to go home and will follow up with your cardiologist within a week, and the cardiothoracic surgeon within a week or two, then you don’t see your surgeon anymore.” Unless there is a problem, you won’t see your surgeon again, but you will continue to see your cardiologist on a regular appointment basis.

Prevention

The need for CABG surgeries is expected to expand by just over 5% in the seven years due to stress, obesity, sedentary lifestyle, and unhealthy habits. “For everyone [reading this] now, you never want to have to see a cardiologist or a cardiothoracic surgeon. The way you avoid that is doing everything you can to keep a healthy lifestyle,” advises Dr. Sullenberger. The American Heart Association strongly recommends eating a balanced diet, maintain reasonable body weight, stay at least moderately physically active (within your limits), and to check your cholesterol level regularly, especially if your family has a history of heart disease. Additionally, quitting smoking significantly reduces your risk of developing heart disease, heart attack, and stroke.

Prevention

The need for CABG surgeries is expected to expand by just over 5% in the seven years due to stress, obesity, sedentary lifestyle, and unhealthy habits. “For everyone [reading this] now, you never want to have to see a cardiologist or a cardiothoracic surgeon. The way you avoid that is doing everything you can to keep a healthy lifestyle,” advises Dr. Sullenberger. The American Heart Association strongly recommends eating a balanced diet, maintain reasonable body weight, stay at least moderately physically active (within your limits), and to check your cholesterol level regularly, especially if your family has a history of heart disease. Additionally, quitting smoking significantly reduces your risk of developing heart disease, heart attack, and stroke.

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Alcohol and Heart Disease

Alcohol and Heart Disease

Heart Health

Alcohol and Heart Disease

Are there safe levels of alcohol consumptions for heart patients?

In August, a study published in The Lancet, suggested there is no safe level of alcohol as beneficial effects against ischemic heart disease. Researchers stated, “Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions.” One of the most common questions heart patients are asked by their doctor is, “How much alcohol do you consume?Dr. Robert Benton, Chief of Cardiology at Samaritan Hospital and Director of the Capital Cardiology Associates, Division of Clinical Research stated, “The alcohol question is always in the initial history of a patient. I often counsel a patient on what’s appropriate for their disease or condition. We have to look at everything, blood pressure, pulse, not having arrhythmia… it’s a big story to put together.”

After a heart attack, cardiac event, or diagnosis of heart disease, heart patients can sometimes be overwhelmed with a list of new rules they must live by. There are new medications to take, lifestyle changes like dieting or exercise, along with doctors appointments and other tests/checkups to schedule. As part of returning to a new normal life, patients will often ask their doctor when and if it’s safe to drink alcohol. Every year, there can be conflicting research on the benefits and risks of alcohol and heart disease. “This paper was in The Lancet and offered a retrospective look at countries around the world to see if there were any safe levels of alcohol,” said Dr. Benton.

Wine being poured into a glass

Dr. Benton summarized The Lancet article as a comprehensive, detailed analysis of “safe levels” in retrospective trials. “This study looked worldwide at the huge health burden related to alcohol use even at very low levels which would be less than one drink a day,” he said. The definition for “one drink” is one five ounce glass of wine, 12 ounces of beer (which in the US has 5% alcohol), and or one and a half ounces of 80 proof alcohol or just one shot. “The upside is that if you looked at the study in totality, you would find cancer, self-harm, and tuberculosis, as the three areas of increased events of the middle age range. Within that, there are going to be people, I would adhere to this opinion myself, who are moderate alcohol drinkers using the definitions I just gave you, who have some health benefits to drinking moderate amounts of alcohol.”

“Let me be clear on this point,” began Dr. Benton. “I would never tell or suggest to anyone to start drinking alcohol for any perceived health benefits.” But the discussion comes up frequently. “I usually have it with people who are new to me, new for primary prevention, or a patient in the hospital after having a cardiac event like a heart attack or stroke or surgery,” he said. “I often counsel a patient on what’s appropriate for their disease or condition.”

Alcohol in moderation

“I think for people who safely consume moderate levels (as outlined) there are some benefits to mildly lowering blood pressure, cholesterol, and preventing ischemic stroke (a dry stroke),” shared Dr. Benton. The Lancet study (funded by the Bill and Melinda Gates Foundation) was not the first to explore alcohol’s complex association with health. The authors of this study estimate that, for one year, in people aged 15-95 years, drinking one alcoholic drink a day increases the risk of developing one of the 23 alcohol-related health problems by 0.5%, compared with not drinking at all. So far, the strongest evidence with heart health has shown that alcohol can increase levels of HDL (good) cholesterol. The Mediterranean Diet (endorsed by the Mayo Clinic)  says one standard 5 oz. glass of red wine at dinner is okay. 

Here are some findings from other studies:
• Agavins, the natural sugar in tequila, is shown to help lower cholesterol and can help you lose weight.
• The active compounds in red wine (polyphenols, resveratrol, and quercetin) have been proven to improve overall heart health.
• Whiskey also contains ellagic acid, which known for fighting off cancer by absorbing rogue cells.
• The polyphenols in rosé have been shown to prevent atherosclerosis, a major contributor to heart disease.

Couple on wine tasting tour

The health risks of drinking alcohol vary widely from person to person

“But as you know we have a lot of problems with the downside and damage caused by overconsumption,” cautioned Dr. Benton. “Too much alcohol can also raise your blood pressure, leading to hemorrhagic stroke, referred to as a bleeding stroke in your brain. Alcohol also has toxicity on the electoral system in your heart which can lead to atrial fibrillation. I certainly have a stable full of people with cardiomyopathy and A-fib related to alcohol and they are still drinking. That is not good. That is the opposite conversation!” Dr. Benton points out that even healthy people can have problems processing alcohol which is why the American Heart Association recommends no more than one drink per day for women and two for men. “There is evidence that heavy alcohol use can cause cardiomyopathy (weakened heart). Even healthy people can develop A-fib or as we call it “holiday heart”, we see that in young people who binge drink at parties or are over served,” he said.

But in terms of moderate alcohol use, for a person who has been drinking, had an event or is being treated for primary prevention, “My own opinion, and I think you’d find the opinion would be pretty solid amongst most cardiologists, that person is safe,” shared Dr. Benton. “That doesn’t mean I’m talking to everybody but I’m talking to probably, most people.” Most importantly, Dr. Benton urges people to talk with their doctor or health care provider. “This whole alcohol issue has many different sides to it.” At best he says, “This is a personal decision, advice is individualized for each patient.”

Written by: Michael Arce, Media Specialist
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