Blood Pressure and Cholesterol – The Affect of Personality and Panic Attacks
Lisa Nelson RD: What role does personality play in a person’s heart disease risk? Does temperament have a direct affect on cholesterol levels or blood pressure?
Dr. Shelby-Lane: Temperament and personality have a definite effect on blood pressure and on heart disease. This is a great question and it has been studied by the experts, as you will note in the following excerpts. Heart disease consists of congenital abnormalities, arrhythmias, lipid abnormalities acquired and congenital, functional and physiologic problems, risk factors such as diabetes and metabolic syndrome, structural disease and valvular problems, heart failure, acquired disease such as coronary artery disuse, and infectious diseases along with diseases related to blood vessel structure. Again, anxiety, stress, and stress related disorders can have an effect on major hormones, heart rate and heart health and heart disease. Nutritional abnormalities can also affect heart performance.
New research suggests that people who suffer from panic attacks are at increased risk of developing heart disease.
Dr Kate Walters and colleagues at University College London examined medical records of more than 400,000 people, including 57,615 who had been diagnosed with panic attacks. Results showed that people who were younger than 50 when they were first diagnosed with panic attack were 38% more likely to have a heart attack and 44% more likely to develop heart disease than those without the condition. Those who were older than 50 at the time of diagnosis did not have an increased risk of heart attack, but were 11% more likely to develop heart disease than those without the condition.
Intriguingly, the results also showed that while panic attack sufferers were at increased risk of developing heart disease, they were seemingly less likely to die from it.
Why people who suffer from panic attacks should be at increased risk of developing heart disease is unclear. According to the study, authors put forward several theories, one being that panic disorders might trigger nervous system changes which could promote the clogging of arteries. Another theory is that people may have been misdiagnosed as having panic attacks when they actually have coronary heart disease. “Clinicians should be vigilant for this possibility when diagnosing and treating people presenting with symptoms of panic,” said Dr Walters.
Walters K, Rait G, Petersen I, Williams R, Nazareth I. Panic disorder and risk of new onset coronary heart disease, acute myocardial infarction, and cardiac mortality: cohort study using the general practice research database. European Heart Journal. 2008;29:2981-2988. doi:10.1093/eurheartj/ehn477.
News release: Panic attacks linked to higher risk of heart attacks and heart disease, especially in younger people. European Society of Cardiology. December 10th 2008.
Study results have shown that people with depression are at increased risk of heart attack and heart failure because they are less likely to be active.
Scientists have known for some years that people who are depressed are at increased risk of heart attack and other cardiac events, however the reason why this should be has remained unclear. However, according to results of a study by Mary A Wooley and colleagues, the increased risk is due to behavioral factors.
The researchers analyzed data obtained from 1,017 people with heart disease, 199 of which had symptoms of depression. Results showed that 10% of depressed participants had a cardiac event (e.g. heart attack, heart failure, stroke, transient ischemic attack) during the study period, compared to just 6.7% of non-depressed participants, meaning that depressed participants were 50% more likely to have a cardiac event. However, results also showed that depressed participants were more likely to smoke, were less likely to take their medications as prescribed, and were less physically active. After the researchers factored these behaviors into their calculations the risk of a cardiac event in depressed participants was similar to that in non-depressed participants.
The researchers concluded: “These findings raise the hypothesis that the increased risk of cardiovascular events associated with depression could potentially be preventable with behavior modification, especially exercise.” Adding: “Exercise training can improve both depressive symptoms and markers for cardiovascular risk.”
Whooley MA, de Jonge P, Vittinghoff E, et al. Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA 2008;300:2379-2388.
February is American Heart Month. In recognition of American Heart Month you can access Heart Health Made Easy at a 25% savings. Learn more about this take action guide to lower cholesterol and blood pressure at http://www.hearthealthmadeeasy.com.
All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight
Heart Disease – What is the connection between blood pressure and heart rate?
Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.
Lisa Nelson RD: Please explain the connection between high or low blood pressure and someone’s heart rate? For example, if someone lowers their blood pressure, should they see a corresponding decrease in heart rate? Also, should someone be concerned about a consistently high heart rate, such as 100 bpm?
Dr. Shelby-Lane: Blood pressure and heart rate are interrelated components of the cardiovascular system and therefore, not mutually exclusively. One can affect the other.
Persons with well controlled high blood pressure, with or without medication, can also have a cardiac arrhythmia or irregular heart beat. This heart rhythm problem, if poorly controlled can then affect the blood pressure.
Persons with low blood pressure, due to a variety of reasons, can have a normal or abnormal heart rhythm. Person with a disorder called neurocardiogenic syncope can have low blood pressure and a low or normal heart rate, but this is positional in nature and may involve a severe hormone problem related to the adrenal glands.
Lisa Nelson RD: Hmmm, not sure you answered the question. Yes, blood pressure and heart rate are connected. If someone lowers there blood pressure via medication or lifestyle changes, should they expect a lower heart rate also?
Dr. Shelby Lane: This is not a straight forward answer. You can have normal blood pressure and an altered heart rate or vice versa. Heart rate and rhythm may be caused by electrical disturbances which may or may not affect blood pressure. Again, there is no one answer and follow up with a specialist is needed since there are multiple causes for high and low blood pressure as well as heart rhythm disturbances. Hope this makes sense.
Lisa Nelson RD: Thanks for the clarification. There is not one set answer for this question.
All the best,
Lisa Nelson RD
7 Natural Ways to Lower Blood Pressure
Heart Health – Do you know the difference between and "organic" and "natural" food?
The hottest label claims right now are “organic” and “natural”. Do you know the difference?
Organic
Organic foods were produced under environmentally friendly conditions with no antibiotics, growth hormones, fertilizers with synthetic ingredients or sewage sledge, pesticides, bioengineering, or ionized radiation.
The label claim “100% Organic” is the highest standard a food can receive and is allowed on single ingredient foods (fruits, vegetables, meat, dairy, and eggs that exclude water and salt).
The label claim “Made with Organic Ingredients” can be used on multiple ingredient foods if the food contains between 70% and 94.9% organic ingredients.
Natural
A food using the “natural” label claim cannot contain any artificial ingredients, added coloring, and must be minimally processed.
“Organic” and “natural” are not interchangeable!
All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight
Physical Activity – How much do you really need?
As I previously mentioned, The Health and Human Services Department sets physical activity guidelines after reviewing a good decades worth of research related to physical activity and health.
This report encompasses everyone from the age of 6 and up. Let’s go into a little more detail on the adult guidelines.
Adult Physical Activity Guidelines
- All adults should avoid inactivity. Any type of activity is better than nothing. Adults who include activity as part of their everyday life gain some form of health benefit.
- To see substantial health benefits, include at least 150 minutes (2 ½ hours) per week of moderate-intensity activity. If times a factor, you can see the same benefits by bumping up the intensity and being vigorously active 75 minutes (1 hr. 15 min.) each week.Yes, it is still okay to break your activity into chunks.For example, if your schedule doesn’t allow 30 minutes at the gym, you can include a 10 minute brisk walk during lunch break to count towards the goal of 150 minutes for the week. However, workout segments less than 10 minutes in length are not as beneficial.
Also, the most benefit is seen by spreading your activity throughout the week. If you’re tempted to hit the gym for a power workout session on a Saturday for 2 ½ hours, that is not as beneficial as 30 minutes of activity 5 days out of the week. But, remember, any form/amount of activity is better than nothing!
- If you want to take things to the next levels, more extensive health benefits are seen when activity is increased to 300 minutes (5 hours) per week of moderate intensity activity or 150 minutes of vigorous intensity aerobic activity.
- Don’t forget strength training! You want to include all major muscle groups on two or more days each week. Especially beneficial as we age and see a decline in metabolism (and corresponding weight gain) if muscle mass is not maintained.
Now, don’t let yourself be overwhelmed and give up without even attempting to meet these guidelines. Activity does not have to be hard or expensive. You can walk your dog, go dancing, climb the stairs at work, mow the lawn, and go to the gym. There are many, many options available to get 2 ½ hours of physical activity every week.
All the best,
Lisa Nelson RD
Heart Health and Weight Loss – Do you need to eat fat to lose belly fat?
I enjoy the show The Biggest Loser. On one of the episodes this season they had an individual from Prevention magazine share some tips based on the “Flat Belly” diet. I was very excited because it sounded like a link had been found between the Mediterranean diet and reduced abdominal obesity. Hence, the reason for this article!
The Mediterranean diet contains an increased level of monounsaturated fat compared to the typical American diet. Monounsaturated fat is a type of heart healthy unsaturated fat. One of the best monounsaturated fat sources is olive oil. I went to work researching to find scientific evidence to support a link between a diet high in monounsaturated fat and reduced belly fat.
Here’s the main study supporting the connection between decreased abdominal obesity and monounsaturated fats.
Study: Published in the Diabetes Care back in 2007 by J.A. Paniagua, MD, PHD, A. Gallego de la Sacristana, MD, I. Romero, PHD, A. Vidal-Puig, MD, PHD, J.M. Latre, MD, PHD, E. Sanchez, MD, P. Perez-Martinez, MD, PHD, J. Lopez-Miranda, MD, PHD and F. Perez-Jimenez, MD, PHD
Monounsaturated Fat-Rich Diet Prevents Central Body Fat Distribution and Decreases Postprandial Adiponectin Expression Induced by a Carbohydrate-Rich Diet in Insulin-Resistant Subjects
The purpose of this study was to show that central obesity is linked with insulin resistance (when the body does not respond normally to insulin) and studied the effect of three different diets with the same level of calories on fat distribution, insulin sensitivity, and peripheral adiponectin (fat hormone) gene expression. The study included 11 individuals that were considered insulin resistant. Everyone in the study spent 28 days on each of the following diets: 1. diet enriched in saturated fat, 2. diet rich in monounsaturated fat, 3. diet rich in carbohydrates.
The study found weight, body composition, and metabolism unchanged during all three diets. On a high carbohydrate diet, fat tended to be redistributed to the abdominal area versus the high fat diets.
There have been many studies conducted on this theory, but the results are all conflicting.
Expert Opinion
1. Not enough evidence to support a connection.
This was a fairly small study of only eleven individuals. A study on 62 women published in the Journal of Nutrition in 2004 did not find a link between a diet high in monounsaturated fat and changed body fat distribution. There needs to be more large scale studies that conclusively establish a link before we can jump on the bandwagon.
2. Follow a Mediterranean Diet anyway!
Whether or not a Mediterranean Diet targets belly fat or not, the benefits of this type of diet are well known when it comes to heart health and weight loss.
Those that follow a Mediterranean Diet have a reduced risk of developing heart disease and dying from a heart attack. Even those that have survived a heart attack and lived to adopt the Mediterranean Diet significantly reduce their risk of a second heart attack and other complications.
Also, those that follow the Mediterranean diet have increased satiety (feelings of fullness) due to the adequate fat and fiber content. This means a decreased urge to overeat which promotes weight loss.
Characteristics common to a Mediterranean Diet include:
Consume high intake of fruits and vegetables
Select whole grains
Consume healthy fats (canola and olive oil)
Eat nuts in moderation
Low red wine consumption
Limit eggs to less than 4 times per week
Consume little red meat
Eat fish regularly
If you adopt this style of eating now and some conclusive evidence comes out in the future supporting a link with decreased belly fat, it won’t matter. You’ll already be lean with a healthy heart!
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Lower Cholesterol – Is grapefruit juice safe with medications, such as Lipitor?
Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.
Lisa Nelson RD: Is it safe for individuals taking medication for heart disease, such as Lipitor, to eat grapefruit or drink grapefruit juice?
Dr. Shelby-Lane: I am including information that may help answer your question about grapefruit and a variety of nutritionals that affect statin drugs for the lowering of cholesterol.
Zocor (Simvastatin), for example, is a Statin drug, used to lower high cholesterol levels, and also known as HMG-CoA reductase inhibitor. Zocor may affect the absorption or utilization of vitamins E and coenzyme Q10. Tests showed the average concentration of coenzyme Q10 in blood plasma decreased by approximately 50% after statins were used for 30 days. Supplementation is considered beneficial.
Grapefruit and grapefruit juice may increase the effects of HMG-CoA reductase inhibitors and should not be consumed at the same time. It is suggested that these medications be taken with water. Grapefruit contains substances that may inhibit the body’s ability to break down statin drugs increasing the toxicity of the drug. Muscle pain, tenderness, or muscle weakness may be a result. If you begin to notice these symptoms, contact your doctor.
Niacin is the form of vitamin B3 used to lower cholesterol. Large amounts of niacin taken with a statin drug may cause serious muscle disorders (myopathy). Reasonable levels of niacin combined with statin drugs have been shown to enhance the cholesterol lowering effect. For proper dosage, consult your physician before taking niacin.
Pomegranate juice has been shown to inhibit the same enzyme inhibited by grapefruit juice. This may cause reactions similar to grapefruit juice when it is used with statin drug treatments.
A study of 37 people with high cholesterol treated with diet and statin drugs found vitamin A increased in the blood over two years of therapy. People taking statin drugs and vitamin A supplements should have blood levels of vitamin A monitored.
Magnesium and aluminum containing antacids were reported to interfere with statin drug absorption. To avoid this interaction, take statin drugs two hours before or after any aluminum/magnesium containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
It should be noted that doctors often recommend supplementing with 100 mg of coenzyme Q10 per day for maintaining healthy levels. However, those on statin drugs may have a greater need for a higher dose. It further should be noted that the symptoms associated with the combination of grapefruit juice and statin drugs (muscle weakness and discomfort) are commonly reported as symptoms associated with CoQ10 depletions. Supplementation with coenzyme Q10 is strongly recommended.
The herbs Artichoke plant, Garlic and Plantain may decrease blood cholesterol levels, and therefore enhance the effects of Zocor. Consult with your pharmacist or physician before taking them.
All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight
