Eating heart-friendly foods and getting adequate exercise may be all you need to prevent heart disease, but what about people who already have one or more risk factors? Depending on individual circumstances and test scores, the new cardiologists will devise a course of supplements and nutrients to address specific problems. (Note that many of these substances do double or even triple duty on the front lines of heart health.) Very broadly, they can be broken down into two groups: those that help lower cholesterol within healthy norms, and those that have antioxidant properties, and therefore lower levels of inflammation and free radicals, or otherwise protect the heart and coronary arteries.
To help manage cholesterol, the new cardiology turns to one or more of the following:
Niacin, a B3 vitamin, lowers total cholesterol and LDL while raising HDL.
Pantethine, a form of vitamin B5, reduces cholesterol production in the liver.
Policosanol, a mix of essential alcohols derived from sugar cane, damps down the body’s cholesterol production.
Garlic bulb and soy isoflavones reduce bad cholesterol and raise the good.
Grape-seed extract blocks the enzymes that help process dietary cholesterol.
Plant sterols, a form of fat found in nuts, vegetable oils, corn, and rice, also block the absorption of dietary cholesterol because they look like cholesterol to receptor sites in the intestines.
High amounts of inflammation and oxidative stress—detected by tests that measure CRP, Lp(PLA-2), and ferritin levels—call for one or more of the following:
Vitamin C reduces arterial stiffness and raises HDL levels.
Vitamin E protects against the formation of plaque and reduces total cholesterol.
Fish oil reduces inflammation and may reduce plaque, but it also promotes heart health in general.
N acetyl-L-cysteine (NAC) boosts levels of glutathione, a powerful cellular antioxidant.
Alpha lipoic acid (ALA), an antioxidant in its own right, also helps recycle the antioxidant vitamins C and E and glutathione.
Having read this far, it should come as no surprise to learn that heart disease is a complex issue—and that no simple solution exists. “People will grab one thing and say that’s the important thing,” says Devries, “and I think that’s misleading . . . [heart disease] is a metabolic stew, and if you take one thing and say this is what makes the stew, it’s wrong. It’s the whole thing that makes it.”
With that clearly understood, the new cardiology marshals an ever-expanding array of natural and high-tech weapons in the fight against America’s leading cause of death. But it never loses sight of the role each individual plays in maintaining her heart health—and neither should you. “You cannot rely on a drug to make you healthy,” says Goodman. “You’ve got to do it for yourself as well. You’ve got to be part of your team.”
What are you waiting for? Reduce your risk factors
On Your Own:
Stop smoking: Lighting up lowers HDL levels, causes arterial inflammation and high blood pressure, and stimulates the formation of blood clots.
Get more exercise: Thirty minutes of brisk walking a day can lower risk of heart attack by 18 percent; intense aerobic exercise (running) and regular weight lifting lower risk even more.
Control your weight: Losing as little as 5 percent to 10 percent of your body weight can lower your risk.
Eat healthy foods: Try to adopt a Mediterranean-style diet high in whole grains, fish, fruit, vegetables, unsaturated fats, and olive and nut oils.
Drink in moderation: Two drinks a day may raise HDL levels (but possibly increase breast cancer risk too).
Lower your stress levels: Take a break by practicing yoga, meditation, biofeedback, or other forms of relaxation.
With a Healthcare Professional:
Get regular checkups: Ask for a full complement of blood tests, and know your scores.
Manage your cholesterol: If diet and lifestyle changes still leave you with cholesterol problems, look to supplements, other nutrients, and, if your situation warrants, to cholesterol-lowering statins.
Lower your blood pressure: If diet, exercise, and stress reduction don’t get you to normal levels, look to medications—when combined with other risk factors, high blood pressure increases heart disease risk several times.
Treat diabetes: About 65 percent of people with diabetes die of some form of heart or blood vessel disease.
Measure inflammation: A host of new blood tests can keep tabs on this risk factor for heart disease (see “The 7 New Tests” below).