All about Cardio- How to prevent a Heart Attack

A number of Americans have put their hearts into lowering their cholesterol. Yet a recent American Heart Association survey found that many adults with high cholesterol still don't realize that they have an increased risk of developing heart disease.

According to the survey, 50 percent of respondents with cholesterol levels of 200 or greater, and who had risk factors such as high blood pressure or diabetes, did not perceive themselves to be at high risk for cardiovascular disease. Fifteen percent believed they were at low risk. However, the American Heart Association and National Cholesterol Education Program (NCEP) data indicate that many of these respondents are in danger of having a heart attack within a decade.

Cholesterol guidelines established by both groups show that people with multiple risk factors-smoking, high blood pressure, elevated cholesterol, etc.-and people with coronary heart disease and other conditions are at high risk of having a heart attack within 10 years.

The findings are the focus of this year's American Heart Association's Cholesterol Low Down program, an effort meant to help teach people about their risk of heart disease. Anyone can join the program by calling 1-800-AHA-USA1 or visiting americanheart.org/cld. Participants receive a Healthy Heart Kit, which includes "The Cholesterol Low Down About Your Cholesterol" guide and a "Low-Fat Favorite Recipes" cookbook. The Cholesterol Low Down is sponsored by Pfizer.

"Patients know that cholesterol is important; however, they need to better understand that their high cholesterol and additional risk factors may lead to heart disease or a stroke," said Roger S. Blumenthal, M.D., associate professor of medicine in the Division of Cardiology at Johns Hopkins Hospital and School of Medicine in Baltimore.

Words Of Wisdom

The survey also found that 72 percent of respondents strongly agree that their health care provider is a partner in managing their cholesterol. Those who frequently discuss cholesterol with their health care provider report being well-informed about issues such as setting personal cholesterol goals and the importance of following treatment plans.

"Health care providers are an important and supportive resource for individuals at risk for heart disease and stroke because of their cholesterol and other risk factors, " said Lori Mosca, M.D., Director of Preventive Cardiology at New York-Presbyterian Hospital; Associate Professor of Medicine at Columbia University College of Physicians and Surgeons. "Patients should work with their doctor to learn if their cholesterol levels are healthy and to develop a plan that includes a healthy diet and physical activity to reduce their risk."

Controlling blood pressure is the easiest thing to do, provided you know the fundamentals. It has to do much with your eating and drinking habits.

Look into the mirror. Do not see only your face. Look at your entire figure. There lies your future. How long do you think your body can go on accepting all that you stuff in, without applying any thought, just because your taste-buds like it? Do you know that overweight people have a higher chance of suffering from a stroke? Do you check your weight at regular intervals?

When you saw the weighing machine marking a fat gain of 16 pounds within a period of two months, why did you simply ignore it? It should have shocked you into action. The least you can do is find out what your weight is now and what your weight should be!

You need to be careful about what you eat as it is directly and proportionately related to your blood pressure. I agree that ‘one has to be true to the salt,’ but this does not hold true for you. You have to cut down on your intake of salt drastically, before your doctor tells you - no more salt! Avoid salty, and fried food. Adopt a diet that is low in saturated fat.

Two local remedies well known, to control high blood pressure are butter milk and lemon. Take butter milk regularly. It is good for both - low as well as high blood pressure. Lemon peel is also equally effective in high blood pressure. A shredded lemon peel may be added to soups and stews or sprinkled over your salads.

And tell me, have you stopped drinking or are you still contemplating the decision? If you have already made that decision, then let me congratulate you. But, if you think that you can not do it all at once, reduce the intake of alcohol. Just take a drink a day. If you are already under the watchful care of your family doctor, please follow their instructions sincerely. Let there be no holidays for the medicine and please keep sufficient stock in advance. If your doctor has called you this Sunday for a check up, then make sure that you reach there this Sunday itself and not, the next Monday.

Also, the doctor must have given you certain indications about the schedule of exercise that is necessary for you, such as, morning walk, light stretching exercises or light aerobics. Follow the schedule strictly. Your doctor treats hundreds of patients like you everyday. He has more practical wisdom about high blood pressure, than you. Go as per his advice and understand his treatments.

Regular check up of blood pressure is a must. You need to have such an arrangement at your home. Charts of your regular checkups will help your doctor tremendously in treating you. Let all the members of your family, your wife, and your children go for the check up, along with you, even if they do not have this ailment.

If you are taking basic precautions like controlling your diet and doing proper exercises - keep aside all imaginary worries and live a normal, relaxed life!

On 1 December 2002 I had little exposure to heart disease however only 10 days later was at the Pediatric Intensive Care Unit (PICU) bedside of our newborn baby who required lifesaving open heart surgery.

Whilst many diseases are extremely well known, the following are little known facts:
• Heart defects are present in 1 in 100 babies
• Heart disease in children is the leading cause of childhood death in Australia accounting for 30% of all child deaths.
• Nearly twice as many children die of congenital heart disease compared to all childhood cancers
• In 80% of cases the cause is largely unknown.

The amazing thing is how far medicine and surgery has progressed to allow a second chance for many babies like ours that only 20 years ago would not have survived.

Whilst there is a myriad of different abnormalities that can occur, our newborn baby required reconstruction for a coarctation of the aortic arch, reconstruction of both the aortic and mitral valves and closing of a Ventricular Septal Defect (VSD).

The mitral and aortic valves were narrow and the anatomy of the valves was somewhat different to what they should have been. Whilst the aortic valve reconstruction was quite successful, the mitral valve is far more complex and following surgery the gradient across the valve was still high thus leaving our baby with mitral valve stenosis (narrowing of the valve).

This particular surgery took 5.5 hours and the stakes were high – a one in ten or 10% chance that our son would not survive.

Following surgery the next 24 hours is seen as a vital period where if problems are going to be encountered, this is likely to be the period. This is not to say that post 24 hours means everything is fine and dandy. Recovery in our case was slow with a further ten days in the Pediatric Intensive Care Unit for weaning off the ventilator which assists and at times initiates breathing, as well as waiting for the heart to ‘settle’ so that pacemakers and other medications are no longer necessary.

Much of the recovery period is “trial and error” or more like careful monitoring and adjustment as necessary. For example following heart surgery patients are fluid restricted to assist the work the heart has to do thus attempting to prevent the build up of fluids leading to heart failure. On the other side of this coin however is that a patient can then end up dehydrated.

It is hard to know whether advance knowledge of a heart condition in an unborn baby would be better than the shock we experienced with diagnosis two days after the birth of our child. Either way it is an enormously stressful process that in our case did not and has not ended with the surgery following birth. In many instances further surgery is required, for us another reconstruction of the mitral valve at two years of age and further surgery is expected with ultimate replacement of the mitral valve with an artificial valve.

The unknown throughout our process and in many cases is when the next surgery will be required. For these cases, families of babies, toddlers and children go from day to day, week to week, month to month, and sometimes year to year before the next call to surgery comes.

For all those in a similar situation our thoughts and prayers go out to you. For anyone interested, the amazing story in relation to the ongoing saga with our son can be found at http://www.beatinghearts4kids.blogspot.com .

Some of the drugs listed below can affect certain functions of the body, resulting in bad side effects. However, drugs that lower blood pressure have proven effective over the years. The benefits of using them far outweigh the risk of side effects. Most people who’ve taken these drugs haven’t had any problems.

Diuretics — Some of these drugs may decrease your body's supply of a mineral called potassium. Symptoms such as weakness, leg cramps or being tired may result. Eating foods containing potassium may help prevent significant potassium loss. You can prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic, if your doctor recommends it. Diuretics such as amiloride (Midamar), spironolactone (Aldactone) or triamterene (Dyrenium) are called "potassium sparing" agents. They don’t cause the body to lose potassium. They might be prescribed alone but are usually used with another diuretic. Some of these combinations are Aldactazide, Dyazide, Maxzide or Moduretic.

Some people suffer from attacks of gout after prolonged treatment with diuretics. This side effect isn't common and can be managed by other treatment. This is because of hyperurecemia caused by diuretics.

In people with diabetes, diuretic drugs may increase the blood sugar level. A change in drug, diet, insulin or oral antidiabetic dosage corrects this in most cases. Your doctor can change your treatment. Most of the time the degree of increase in blood sugar isn't much. Impotence may also occur in a small percentage of people.

Beta-blockers — Acebutolol (Sectral), atenolol (Tenormin), metoprolol (Lopressor, Mepressor, Merol), nadolol (Corgard), pindolol (Visken), propranolol (Inderal) or timolol (Blocadren) may cause insomnia, cold hands and feet, tiredness or depression, a slow heartbeat or symptoms of asthma. Impotence may occur. If you have diabetes and you’re taking insulin, have your responses to therapy monitored closely.

ACE inhibitors — These drugs, such as captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril or Prinivil), may cause a skin rash; loss of taste; a chronic dry, hacking cough most common side effect; and in rare instances, kidney damage.

Angiotensin II receptor blockers — These drugs may cause occasional dizziness.

Calcium channel blockers — Diltiazem (Cardizem), nicardipine (Cardene), Nifedipine (Procardia) and verapamil (Calan or Isoptin) may cause palpitations, swollen ankles edema, constipation, headache or dizziness. Side effects with each of these drugs differ a great deal.

Alpha blockers — These drugs may cause fast heart rate, dizziness or a drop in blood pressure when you stand up i.e postural hypoteson

Combined alpha and beta blockers — People taking these drugs may experience a drop in blood pressure when they stand up.

Central agonists — Alpha methyldopa (Aldomet) may produce a greater drop in blood pressure when you're in an upright position (standing or walking) and may make you feel weak or faint if the pressure has been lowered too far. This drug may also cause drowsiness or sluggishness, dryness of the mouth, fever or anemia. Male patients may experience impotence. If this side effect persists, your doctor may have to change the drug dosage or use another medication.

Clonidine (Catapres), guanabenz (Wytensin) or guanfacine (Tenex) may produce severe dryness of the mouth, constipation or drowsiness. If you're taking any of these drugs, don’t stop suddenly, because your blood pressure may rise quickly to dangerously high levels.

Peripheral adrenergic inhibitors — Reserpine may cause a stuffy nose, diarrhea or heartburn. These effects aren't severe and no treatment is required other than to change the amount of drugs taken. If you have nightmares or insomnia or get depressed, tell your doctor. You should stop using the drugs.

Guanadrel (Hylorel) or guanethidine (Ismelin) may cause some diarrhea, which may persist in some people. This side effect usually becomes less of a problem if you continue treatment.

These drugs reduce blood pressure more when you stand. Consequently, you may get dizzy and lightheaded and feel weak when you get out of bed in the morning or stand up suddenly. If you notice any of these reactions — and if they persist for more than a minute or two — sit or lie down and either reduce or omit the next dose of the drug. If symptoms continue, contact your doctor.

When you're taking guanethidine, don't keep standing in the hot sun or at a social gathering if you begin to feel faint or weak. These activities cause low blood pressure. Male patients may experience impotence. Contact your doctor if this occurs. These drugs are rarely used unless other medications don’t help.

Blood vessel dilators — Hydralzine (Apresoline) may cause headaches, swelling around the eyes, heart palpitations or aches and pains in the joints. Usually none of these symptoms are severe, and most will go away after a few weeks of treatment. Minoxidil (Loniten) is a potent drug that's usually used only in resistant cases of severe high blood pressure. It may cause fluid retention (marked weight gain) or excessive hair growth.

If you want to know more about Side effects of High Blood Pressure Medicine Visit our website.

Cardio Exercise Machines – Common Cardio Workout Mistakes

Cardio exercise machine workouts are great and fun for burning excess body fat and building good cardiovascular health. These exercises not only help to burn body fat fast it will also strengthen your heart and lungs and thus reducing your chances of getting high blood pressure, stroke and heart diseases. Regular cardio exercises can also reduce bad cholesterol and raise the level of good cholesterol.

However, are you getting the most out of your cardio machine workouts? Are you using the cardio workout machines efficiently to gain maximum benefits of the exercises?

Well, you probably are not if you are an average gym user without any personal trainers to guide you because you will probably commit common cardio machine mistakes when exercising.

We shall now examine the more popular cardio workout machines and the common mistakes people commit when using these machines for their workouts.

Common mistakes when using cardio workout machines are :-

• Step up stair climber – This is perhaps the most common mistake for not getting the most out of the step up stair climber machine. Almost invariably, everyone when exercising with this machine will rest their arms on the railing. By doing so, the railing now becomes sort of like a crutch as it will now support some of your body weight making the exercise less intensive.

• Treadmill – The treadmill is perhaps the most popular cardio workout machine in the gym. A careful observation will show that many treadmill users run with too much up and downs. This mistake will wear out the person’s ankle and knee joints over time. The correct method is to take long, smooth and purposeful strides during the exercise.

• Stationery Bike – When exercising on the stationery bike, do adjust the height of the seat to a comfortable level. I really don’t understand why many stationery bike users adjust their seats to be either too high or too low. I mean, why be uncomfortable when exercising when you can be comfortable.

When the seat is too low, it adds strain to your knees and spine. When too high, your will butt will rock from side to side. So besides not getting the best from your cardio workout on the stationery bike because your body weight will be involved when you peddle, you will also look weird. It is such a silly workout mistake right?

Another common mistake is that I often see stationery bikers reading a book when exercising. That means that they exercise at a very low intensity level. Hey, how can low intensity cardio exercises work your heart and lung effectively?

• Elliptical Trainer – This is also another bewildering common cardio workout mistake. You use the elliptical trainer to tone your body and to exercise for your cardiovascular fitness right? Then why is it I often see people who use the elliptical trainer exercising at a high speed? So what is the mistake? The mistake is that they have set the resistant level too low.

You see, if you do not puff, pant and breakout in sweat, you are not getting the best out of your cardio exercises. Is it any wonder then that people are not losing weight and not improving on their cardiovascular health even when they are doing their cardio exercises regularly?

Now that you know how to avoid these common cardio machine exercise workout mistakes, you can now head for the gym and get the best out of these exercises. In a very short time, you will see your body toning up nicely, improvement on your cardio health being felt and visibly losing excess body fat.

What IS Cholesterol?

Cholesterol is a soft, waxy substance that's stored in the fat (lipid) content of one's blood stream. It's actually important to have a certain amount of "good" cholesterol in one's system.

Cholesterol, and our other body fats, cannot dissolve in our blood. They must be transported by special carriers called lipoproteins. While there are numerous kinds (too many to cover here), the two that are most important are the high-density lipoproteins (HDL) and the low-density lipoproteins (LDL). There is a third kind, which is referred to as Lp(a), which can increase one's risk of heart attack and stroke. We'll cover that one here, as well.

HDL, LDL, & Lp(a)...What ARE These?

High-density lipoproteins (HDL) are known as "good cholesterol". Most experts agree that HDL moves the cholesterol from the arteries to the liver, where it is broken down and leaves the body through the natural evacuation process. A higher HDL level seems to reduce the risk of heart attack or stroke. Keep in mind, though, that a lower HDL level in one's body (-40 mg/dL in men, -50 mg d/L in women) is a warning signal of greater risk of one or both.

HDL seems to remove excess cholesterol from the plaques which build up in one's blood vessels, thereby inhibiting or slowing their growth. This is what makes it so important to the human body. Approximately 1/3 to 1/4 of the cholesterol in our bodies is carried by the HDL.

Low-density lipoproteins (LDL) are the major transporters of cholesterol in our blood. One can experience a build up on the walls of the arteries which supply blood to our hearts and brains, if too much LDL enters the blood stream. When combined with other substances, it forms plaques. Plaques are hard, thick coatings that can clog one's arteries and decrease blood flow to the heart or the brain. Should the blood not move swiftly enough, there is danger of a blood clot forming near the plaques. When this occurs in the arteries leading to the heart, one is at greater risk of a heart attack. If it happens in the arteries which lead to one's brain, there is a higher risk of stroke.

If one's LDL level is 160 mg/dL or higher, this is an indication of a greater risk of heart disease. And if one has already been diagnosed with heart disease, it is strongly recommended that one maintain a level of less than 100 mg/dL.

A little known (by the general population) lipoprotein that can also cause a greater risk is the Lp(a) cholesterol lipoprotein. This is a generic variation of plasma (the "fluid" which carries the blood cells through one's blood stream) LDL. When one's Lp(a) level is higher, one can more quickly develop the plaque build up which physicians and specialists refer to as "arthersclerosis". Although there has been no conclusive evidence drawn as to WHY Lp(a) contributes to the increased risk of heart disease, it is commonly believed that the natural lesions which occur in our artery walls may contain substances that interact with it. This may lead to the build up of the fatty deposits.

From Where Do We Get Cholesterol?

The general consensus is that the human body is capable of producing the cholesterol that one needs to remain healthy. The body - most especially the liver - produces roughly 1,000 mg per day. Therefore the cholesterol consumed (by the average person eating the typical foods such as whole milk dairy products, eggs, meat, poultry, fish and seafood) is not really necessary to maintain the healthy level which one needs.

Two of the biggest culprits which contribute to the excessive consumption of cholesterol are transfats and saturated fats. But other fats consumed in foods can also raise blood cholesterol. While some of the excess fat is removed from the body by the liver, most heart specialists recommend that the average person limit himself/herself to less than 300 mg daily. And if one has been diagnosed with heart disease, that level should be less than 200 mg daily. If one has been diagnosed with extremely high cholesterol, even more drastic measures may be necessary to bring it under control.

How Do I Control My Intake?

A proven and accepted measure of control is to limit one's intake to no more that 6 ounces of lean meat/fish/poultry daily, and to consume only low fat/no fat dairy products. Effective substitutes for the protein necessary for good health can be found in beans and vegetables with high protein content. Two excellent sources for determining which foods have high protein content can be found at:

http://www.vegsoc.org/info/protein.htm and

http://www.vegparadise.com/protein.html#Charts

It is also recommended that one adopt a regular exercise regimen. Even a moderate amount of daily activity can help to increase the movement of blood through one's body. Physical activities such as leisurely walking, gardening, light yard work, housework and slow dancing are often prescribed as ideally suited for those who need a daily routine to help control the cholesterol levels.

A more intense regimen can include brisk walking, jogging, swimming and weight-lifting. Aerobic exercising is an excellent way to increase one's breathing and heart rates.

Side benefits of a regularly scheduled exercise program can include weight control, reducing one's risk of developing diabetes, and helping to keep one's blood pressure at a healthy level. Regular moderate to intense exercise can also help to strengthen one's heart and lungs.

To Smoke or Not to Smoke...

Most physicians and specialists recommend that no one smoke. And it has been proven that tobacco smoking increases the risk of heart disease. One's intake of oxygen, which is a necessary component for good vascular circulation and health, is drastically reduced. Plus, smoking is detrimental to HDL cholesterol levels and increases the possibility of blood clots, not to mention the risks of causing cancer in one's body.

The Effects of Alcohol on Cholesterol Levels

The moderate consumption of alcohol has shown, in some studies, to actually promote higher HDL cholesterol levels. With that said one must weigh the risks of alcoholism, obesity, stroke, high blood pressure, some forms of cancer, and sometimes depression. Exercise moderation (not more than 1-2 drinks daily for men, not more than 1 drink daily for women). And if you don't drink, don't start. There are better and safer alternatives for controlling one's cholesterol.

Synopsis:

- HDL is "good" cholesterol
- LDL is "bad" cholesterol
- An exercise regimen can help in lowering LDL and increasing HDL
- Cholesterol can be controlled with a sensible diet, for many people
- Smoking can increase the risks of lower HDL levels and the possibility of blood clots

Consult your physician or health care provider before embarking on any exercise regimen, or the consumption of alcohol, as a method to control one's cholesterol. He or she can direct you to what steps you need to take in order to ensure the best results for your efforts.

Have an annual screening (usually a blood drawing) to determine your cholesterol levels. Be sure to discuss family history and other issues which your doctor may want to know before deciding whether or not you should be checked for the Lp(a) lipoproteins. He or she can better determine your risks, the diagnosis, and possible treatment (which may include prescription medication) when fully informed.

The most important factor for improving cardiorespiratory fitness (cardio or CR) is the intensity of the workout. Changes in CR fitness are directly related to how "hard" an aerobic exercise is performed. The more energy expended per unit of time, the greater the intensity of the exercise, the greater the effect on cardiorespiratory fitness.

You have to know how hard is "hard" to determine if an aerobic exercise like running is producing a CR training effect or if it's just burning a few calories. The heart rate during work or exercise is an excellent indicator of how much effort you are exerting. Only by keeping track of your heart rate during a workout can you be sure that the intensity is enough to improve your CR fitness level. In other words, your ability to monitor your heart rate is the single most important key to success in CR training.

Training Heart Rate (THR) = Desired Intensity of the Workout

THR is the heart rate at which you need to exercise to get a training effect. The U.S. Army fitness gurus have given us two methods to determine THR. The first method, percent maximum heart rate (%MHR) is simpler to use, while the second method, percent heart rate reserve (%HRR) is more accurate.

%MHR Method

With this method the THR is figured using the estimated maximal heart rate. You can estimate your maximum heart rate (MHR) by subtracting your age from 220. Thus, a 20 year old would have an estimated maximum heart rate (MHR) of 200 beats per minute (220 - 20 = 200).

A person who is in poor shape should exercise at 70 percent of his MHR; if he is in relatively good shape, at 80 percent MHR; and, if he is in excellent shape, at 90 percent MHR.

Examples:

A 20 year old in good physical condition would have a THR of 160 beats per minute (BPM). 220 - 20 = 200 * .80 = 160 BPM.

A 30 year old in good physical condition would have a THR of 152 beats per minute (BPM). 220 - 30 = 190 * .80 = 152 BPM.

A 40 year old in poor physical condition would have a THR of 126 beats per minute (BPM). 220 - 40 = 180 * .70 = 126 BPM.

%HRR Method

A more accurate way to calculate THR is the %HRR method. The range from 60 to 90 %HRR is the THR range in which people should exercise to improve their CR fitness levels. If you know your general level of CR fitness, you can determine which percentage of HRR is a good starting point

for you. For example, a person in excellent physical condition could start at 85 percent of his HRR; if he is in reasonably good shape, at 70 percent HRR; and, if he is in poor shape, at 60 percent HRR.

Most CR workouts should be conducted with the heart rate between 70 to 75 percent HRR to attain, or maintain, an adequate level of fitness. A person who has reached a high level of fitness may derive more benefit from working at a higher percentage of HRR, particularly if he cannot find more than 20 minutes for CR exercise.

Exercising at any lower percentage of HRR than 60 does not give the heart, muscles, and lungs an adequate training stimulus. Exercising at more than 90 percent can be dangerous. Before anyone begins aerobic training, he should know his THR (the heart rate at which he needs to exercise to get a training effect).

The example below shows how to figure the THR by using the resting heart rate (RHR) and age to estimate heart rate reserve (HRR). A 20 year old in reasonably good physical shape is the example.

STEP 1: Determine the MHR by subtracting your age from 220. i.e. MHR = 220 - 20 = 200.

STEP 2: Determine the resting heart rate (RHR) in beats per minute (BPM) by counting the resting pulse for 30 seconds, and multiply the count by two. A shorter period can be used, but a 30 second count is more accurate. This count should be taken while you are completely relaxed and rested. For this example we use a RHR of 69 BPM.

STEP 3: Determine the heart rate reserve (HRR) by subtracting the RHR from the estimate MHR. i.e. HRR = 200 - 69 = 131 BPM

STEP 4: Calculate THR by (1) multiplying HRR by the relative fitness level as a percentage and (2) adding the result to the HRR. For example, our 20 year old in good physical condition will exercise at 70% HRR.

(1) .70 * 131 = 91.7
(2) 91.7 + 69 = 160.7

In summary, a reasonably fit 20-year-old with a resting heart rate (RHR) of 69 BPM has a training heart rate (THR) goal of 161 BPM.

During aerobic exercise, the body will usually have reached a "Steady State" after five minutes of exercise, and the heart rate will have leveled off. At this time and, immediately after exercising, is when you should monitor your heart rate to see if you are within your desired THR range.

If your pulse rate is below the THR, you must exercise harder to increase your pulse to the THR. If your pulse is above the THR, you should reduce the intensity to reduce the pulse rate to the THR goal.