Friday, October 2, 2009

Never Have a Heart Attack

3 new surprising ways to help predict—and prevent—a heart attack
1. The sleep test

Answer this question: Do you feel drowsy during the day? If so, you may be harming your heart. Every extra hour of sleep middle-age adults can add to their nightly average reduces their risk of coronary artery calcification by 33 percent, according to a study reported in the Journal of the American Medical Association. When you're even a little sleep deprived, your body releases stress hormones that constrict arteries and cause inflammation. If you routinely wake up feeling tired or need an afternoon nap, then you're probably sleep deprived. Try either changing your sleep habits (darker room, TV off, earplugs) or going to bed 30 minutes earlier until symptoms disappear. If your spouse complains about your snoring or if you often wake up with a headache, get checked for sleep apnea disorder.

2. The vitamin D test

Low levels of vitamin D, found in nearly 80 percent of U.S. adults, can cause a rise in blood pressure and increased arterial inflammation. Fortunately, it's easy to test for and remedy any deficiency. Ask your doctor to order a vitamin-D analysis as part of your next blood test. Optimal levels are 30 to 40 ng/mL, but some doctors contend 50-plus ng/mL is even better. If yours is low, get 10 to 15 more minutes of sunlight per day (without sunblock), eat more vitamin D-rich foods (salmon, tuna, fortified orange juice), or take a D supplement (as recommended by your doctor). It's one of the simplest things you can do to protect your heart.

3. The finger test

Lining all your blood vessels—even those in your index finger—is a single layer of cells, called the endothelium, that produce chemicals that affect the vessels' function, causing dilation, constriction, clotting, etc. Negative changes in the endothelium occur years before any other measurable signs of heart trouble appear, so researchers have believed that if the health of the endothelium could be tested, we just might lick heart disease and stroke.

Now we have that test. The one I use, called Vendys, involves attaching a fingertip-temperature detector to your index finger and wrapping a blood-pressure cuff around your arm. As the cuff is inflated, blood flow to the hand decreases and finger temperature drops. After five minutes, the cuff is deflated and blood flow returns. The faster and more completely finger temperature rebounds, the healthier the endothelium.

The great thing about this test is that I can not only assess your vascular health but also partially monitor how well treatment is working. If a patient loses weight, lowers her blood pressure or begins taking medication, I can detect positive changes in her endothelial function almost instantaneously. With other methods—calcium scoring, for instance—I'd be waiting years. Eventually, this finger test could be an invaluable aid for monitoring heart health.

If you're at risk of heart disease, discuss this and the other tests with your doctor. There's a good chance that if you pay attention to what they tell you, they'll help you keep your heart beating stronger, longer.

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