A Balanced Heart Is A Healthy Heart
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By Dr. Suzanne Steinbaum | Posted Dec 10, 2024
Are you living from the heart? Find out. Take our brief quiz to get your own #LiveFromTheHeart tip sheet.
Take the quiz!
Plaque in the arteries for men and women are different. In women’s arteries disease is diffused throughout the artery and in men’s arteries it happens in one location. This is super interesting because this is when testing gets a little wacky.
You take a picture at rest and then you exercise or are on the bicycle, and then you take a picture after. With this ‘picture’ the Doctors are looking for is the concept of supply and demand.
When you exercise, your body needs more oxygen. So your demand for oxygen goes up, and if there’s a blockage in the artery, your supply goes down. If those blockages are 70% or greater, meaning that hole, that artery, that tube is blocked 70%, then there’s a problem with the whole supply.
But guess what? Most heart attacks happen when those blockages are 30 to 50%. Therefore, it doesn’t make sense to me to do this sort of stress test. So I do something a little differently. I do something called a cardiopulmonary exercise test. It’s called a cpe, CPET, cardiopulmonary exercise test.
Now, this is super interesting because you get on a bike and you have a mask, and that mask tells me how much carbon dioxide you’re blowing out, which means you only blow out carbon dioxide when you take oxygen in, so I can know how much oxygen is happening.
This test also can tell me how healthy the lining of the arteries are. It can tell me if there’s diffuse disease, if there’s a problem with the endothelial, the lining of the artery, that protects our arteries from all the risk factors.
It’s the lining of the artery, the endothelium that actually protects us from heart disease, from plaque buildup. If you have plaque buildup, microvascular disease, we call it endothelial dysfunction. Or if you’re a woman and there’s a problem, we can actually figure that out. That is a great way to find out if there’s a problem with the lining of the arteries in women.
How do they get stiff? Comes right down to the basics, the blood pressure, the cholesterol and the sugars. Are you eating right? Are you exercising? How’s your stress? Are you sleeping? All of the stuff. You can actually prevent yourself from getting endothelial dysfunction and you can actually make it better.
The other test that I recommend is a screening test called a coronary artery calcium score. It’s a CAT scan, no dye, no contrast. You lie down on a table, take a picture of your heart with the goal of looking for calcium. Calcium is super bright so we can see it. Calcium in the heart could only be one thing, and that’s plaque. So if you have a calcium score that’s greater than zero, we know that there’s the beginning of plaque formation in the artery. What happens with plaque in the beginning is when the endothelium is stiff, like I talked about, and there’s damage to the lining of the artery, inflammatory cells go in and plaque starts developing.
When we start seeing calcium, we know the progression of atherosclerosis has begun and we have to know that it’s really time to do something about it. If you have diabetes, it’s almost a given over time that you are going to develop plaque in the arteries. So you will have a greater potential of having a heart attack. The greatest thing is that if you have type two diabetes, this one that occurs later in life from maybe how you’re eating or not exercising, you can reverse it. You just need to get it checked. The blood pressure thing too, that one is interesting because everyone’s talking about numbers, this, that, the other thing. I’m just going to tell you the basics. Systolic is the top number. It’s the force against the arteries when the heart’s beating and that bottom number, it’s the diastolic number, it’s the force against the arteries.
When the heart’s relaxing and it’s actually trying to fill with blood, if the heart’s stiff, that pressure is greater. And you know when that heart gets stiff, when you don’t exercise, when you sit a lot, when you have too much weight, when your blood pressure’s up, the heart gets stiff. That’s the bottom number. So when everyone’s wondering what my top, what’s my bottom, what matters, it all matters. But just know if that top is greater than one 30, that bottom is greater than 85, it’s not great, and when you get to one 40, you might just need medication. So watch what you eat. Stay away from the fats, get rid of the salt, keep an eye on your weight. All of that, that is going to help you and maybe prevent you from needing medication or having a heart attack. And then of course, the cholesterol, which is a whole big story.
I’m just going to break it down. The cholesterol numbers are the big number. There are a couple parts to it. The LDLL, I say L is the lousy one, the lower the better. H, D, L. I always say H is the happy one. The higher the better.
Then there are the triglycerides, which are often associated with your diet because those go up with carbohydrates, simple carbohydrates and sugars. We want that number to be less than 150 to make sure it’s in check. Now, the next one, makes me angry, infuriated, bananas- nuts -crazy! Because this one’s been around for decades, but it wasn’t until recently that we’ve really understood this. In fact, it’s called a novel risk factor. It’s not new. It’s been here, but now we’re understanding the importance of it. It’s calledLipoprotein little A (LP little A). That’s kind of hard to understand, but it looks like this LP with a little A.
Now this is genetic. This little genetic marker is kind of an LDL, but it has this clotting piece to it, and genetically this clotting part of this LP little A causes the cholesterol to stick together and leads to heart attacks and strokes. When there is a family history, a lipoprotein little A might be the reason.
The interesting thing is we don’t exactly have the medication to fix it, but we’re getting there and we know how to manage it. We know and understand what kind of medications and what to do. For somebody who does have an LP, little A, we have to screen harder. We have to look for heart disease, we have to figure it out, but I’m telling you, there is something that we can do.
So make sure to be proactive and advocate for yourself, for your heart and for all areas of your life. And those big three, get them checked, blood pressure, cholesterol, sugars, 80% of the time, heart disease is preventable. And all three of these, they’re up to you. They’re in your control, and there is something you can do about it. The time is now.
In case you’ve missed it, Step 1 taught us how to Live From the Heart, In Step 2 we discussed how to get moving. Step 3 was all about nourishing your heart and body with foods that taste good and are good for you. If you missed it, you can read it here, Nourish Your Food And Your Heart.
In Step 4, we discussed something very close to my heart and something we all deal with on a daily basis, Stress, Anxiety, Depression And Purpose. The past few years have been a really, really rough time. It’s been a time of stress in ways that we never even knew were possible. We all can deal with stress in like a day or a week or a month even, but years and years of chronic stress, it’s hard.
Step 5, People, Pleasure and Purpose was all the effects of relationships on our heart. Last week, Step 6, Know Your Heart was all about, well, the heart and how well do we know it.
We are almost to the end of this year, stay with us as we continue this journey of heart health.
