Heart disease continues to be America's leading killer, but unless it strikes close to home, most of us probably don't think about it too much. At the same time, there’s some good news: Deaths from the most common form, plaque build-up (aka coronary artery disease), have been decreasing in the last decade. But there’s a lot more we can do to protect ourselves. Perhaps surprisingly, some of the biggest heart-healthy benefits come from these simple lifestyle changes and heart-smart supplements.
1. Get More Oxygen
It’s no secret that smoking, high blood pressure, unhealthy cholesterol, and diabetes increase the odds of heart disease, but the American Heart Association has concluded that there’s “a potentially stronger predictor.” Called “cardiorespiratory fitness,” it’s all about our ability to use oxygen.
When we breathe air into our lungs, oxygen gets absorbed into blood, transported to the heart, and pumped through arteries to various organs and muscles. How well that process works, and how efficiently the muscles absorb and use oxygen, determines our cardiorespiratory fitness. Exercise that makes the heart pump harder is the chief way to improve and maintain this type of fitness, but as we get older, the process can get sidelined if we aren’t able to produce enough nitric oxide, a gas that dilates blood vessels and enhances blood flow and oxygen transport.
“Nitric oxide is the molecule that controls blood supply to the heart,” says Nathan Bryan, PhD, professor of medicine at Baylor College of Medicine in Houston, a leading nitric oxide researcher, and author of the upcoming book, Functional Nitric Oxide Nutrition. “Heart disease is a slow process where the arteries become stiff and then, over time, plaque builds up and it ruptures, and that’s a heart attack,” he says, adding, “The loss of nitric oxide production in the lining of the blood vessels precedes the structural changes and the plaque development by many years, sometimes decades.”
4 Ways to Make More Nitric Oxide:
- Walk daily or do other moderate exercise such as biking or swimming. The key is to raise your heart rate during the activity. Over time, gradually make it more challenging, for example, by walking faster, longer, or uphill, or by running.
- Make it a daily habit to eat green leafy vegetables, which are a natural source of nitrates, the raw material for nitric oxide production. Beets are one of the richest food sources of nitric oxide.
- Don’t use antibacterial mouthwash. Nitric oxide production begins in the mouth, but antibacterial mouthwash kills beneficial oral bacteria that generate about half of our daily nitric oxide, says Bryan. Switch to an herbal mouthwash instead.
- Avoid antacids and heartburn drugs that suppress stomach acid, which is necessary to break down nitrates in food to produce nitric oxide.
2. Reduce High Blood Pressure
“Silent” because it doesn’t usually produce noticeable symptoms, high blood pressure really is a killer, and it plagues nearly one in two Americans. Healthy levels are below 120/80 mm Hg, but if they’re 10–20 points higher, risk of heart disease doubles, according to Paul Whelton, MD, lead author of the latest medical blood pressure guidelines. “It doesn’t mean you need medication,” he says, “but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.” For accurate readings, blood pressure should be checked on at least two separate occasions, at home and in the doctor’s office.
Lose Weight to Reduce Blood Pressure
Leading integrative cardiologist Stephen Sinatra, MD, author of The Great Cholesterol Myth, recommends setting small, achievable goals to lose some weight, be more active, and cut back on sugars and high-carb foods, which drive up blood pressure and inflammation. “Baby steps are better,” he says, “because you need motivation.” Among his patients, he found that losing 5–10 pounds likely means dropping one clothing size, 4–6 points in the top blood-pressure number, and 2–4 points in the bottom one. And these visible changes help motivate healthier lifestyle habits and further improvements. And, he adds, “A small drop lowers risk substantially.”
3. Understand Cholesterol Markers
Along with blood pressure, there are three other markers that dramatically affect heart health, says Sinatra: HDL “good” cholesterol; triglycerides, which are usually tested along with cholesterol; and blood sugar. At unhealthy levels, the combination of these three factors makes up metabolic syndrome, the big driver of chronic inflammation, the culprit behind heart disease and diabetes. A large waist or belly is the most common outward sign.
“People don’t realize that the fat around the tummy, that’s where the inflammatory mediators live in your fat cells,” he says; “So basically, when you get rid of fat cells, you’re getting rid of inflammation.”
Track Ratio of Triglycerides to HDL
To see where you stand and monitor progress, says Sinatra, cholesterol numbers by themselves don’t tell the whole story. Instead, he recommends tracking the ratio of triglycerides to HDL cholesterol, which should be no higher than 2. For example, triglycerides at 95 and HDL at 55 (95:55) would be a good ratio, below 2, but a 300:30 ratio of 10, often found among type 2 diabetics, is far from healthy. The other key marker is blood sugar: lower is better. Following the steps to lower blood pressure will also improve these markers and lower inflammation and heart risk.
4. Use Supplements
While there are many nutrients that can contribute to a healthy heart, these are Sinatra’s favorites:
- CoQ10 is an essential nutrient for the heart. After age 40, take 100 mg daily to maintain heart health, but if blood pressure is high or there’s any chronic disease, take 150–200 mg daily. For heart failure, take 300 mg daily.
- Fish oil reduces inflammation. Take 1,000–2,000 mg of an EPA-DHA combination, and up to 3,000 mg if there is chronic disease.
- Magnesium performs hundreds of functions that help keep us alive, including relaxing blood vessels, producing energy, and lowering blood pressure and blood sugar. Start with 100–200 mg daily and gradually increase to 400–600 mg. If loose stools become a problem, reduce the dose or split the daily amount into several smaller doses.
- Astaxanthin improves triglyceride-cholesterol ratios and reduces inflammation. Take 6–12 mg daily.
- Vitamin K (MK-7 form) takes calcium out of blood vessels and into bones. Take 150–300 mcg daily.
- Ribose drives energy production, eases muscle cramps, and improves recovery from exercise. Take 1 scoop of ribose powder daily, in juice or added to food.
- B vitamins are essential for healthy metabolism. Take a B complex with up to 750 mcg of the methylcobalamin form of B, 100–400 mcg of folic acid, and up to 30 mg of B.
- Vitamin D helps protect against heart disease and diabetes at adequate levels. Take 1,000–2,000 IU daily.
- Vitamin C strengthens artery walls, protects against plaque deposits, and increases the availability of nitric oxide, which helps to dilate blood vessels and improve blood flow. Take at least 1,000 mg daily.
- Delta tocotrienol, one of the natural forms of vitamin E, reduces dangerous, inflammatory cholesterol. Take 50–100 mg daily.
Heart Healthy Recipes
5. Take 5-Minute Breaks
Even for people who get some regular exercise, sitting for prolonged periods is bad for the heart. To see what it takes to reverse damage, the American Council on Exercise sponsored a study at Western State Colorado University in Gunnison. Seven middle-aged men and six women, who did some regular exercise but also spent at least six hours per day sitting, all had unhealthy markers of heart health. Taking a 5-minute movement break, once every hour of sitting, for one week, produced these improvements:
- HDL cholesterol increased by 21.2%
- Triglycerides decreased by 24.6%
- Blood glucose decreased by 6.1%
- Blood pressure dropped 6–12 points
But there’s a catch: When those in the study stopped taking breaks for a week, the benefits reversed.
3 Innovative Heart-Healthy Tips
Healthy habits can be surprisingly simple. Here are three from researchers who presented their latest findings at the American Heart Association's Scientific Sessions 2017.
1. Savor Food Slowly
"Eating more slowly may be a crucial lifestyle change to help prevent metabolic syndrome," said Takayuki Yamaji, MD, author of a study showing that slow eaters are less likely to gain weight and develop metabolic syndrome. "When people eat fast,” he said, “they tend not to feel full and are more likely to overeat.”
2. Be a Smart TV Viewer
"Watching TV itself isn't likely bad, but we tend to snack and sit still for prolonged periods while watching," said Mary Cushman, MD, author of a study showing that avid TV watchers were nearly twice as likely to develop a dangerous blood clot, compared to people who rarely watch TV. “You could put a treadmill or stationary bike in front of your TV and move while watching,” she suggests. Or, record your favorite show while you’re out for a walk, and watch it later, minus the ads.
3 Keep Gums Healthy
Where there’s gum disease, getting it treated significantly lowers blood pressure. One study found that after intensive dental treatment, blood pressure began to gradually drop and within six months, systolic pressure (the top number) was 13 points lower and diastolic pressure (the bottom number) dropped by nearly 10 points.
Ubiquinol CoQ10 = Better Absorption
CoQ10 provides energy to cells, especially the cells in the heart, and low levels of this critical nutrient are linked to nearly every form of cardiovascular disease, including angina, hypertension, cardiomyopathy, and congestive heart failure. CoQ10 supplements can be hard to absorb, particularly the ubiquinone form. But studies show that a more bioavailable form of CoQ10—ubiquinol—provides 60 percent better absorption than standard CoQ10 supplements. Studies have demonstrated that ubiquinol effectively inhibits LDL oxidation and may have a direct effect on the progression of atherosclerotic lesions. Ubiquinol has also been found to improve the symptoms of congestive heart failure.
Ubiquinol supplements are generally labeled as “CoQ10 Ubiquinol,” “Super Ubiquinol CoQ10,” and “Ubiquinol QH.” To be sure you're getting ubiquinol and not ubiquinone, look for the word “ubiquinol” on the Supplement Facts panel.—Kim Erickson