This is one of the most diagnosed health issues in both men and women over the age of 45; but the problem starts way before this age – in the routines of our lifestyle. In our first two blogs in this series, we talked about how the mind and emotions (part 1) played an important role in cardiovascular disease (CVD), then continued onto health in the arteries (part 2). In this blog we are going to concentrate on the heart; but the heart of the issue is not the organ – it is lifestyle! Even though this is one of the most prominent causes of deaths in the world, it is one of the most preventable. This presents us with great hope of preventing CVD and for a full recovery, with reduced risks in the future. We will get into lifestyle issues after we learn some background information. So let get started with understanding what heart failure is.
Heart failure (HF) is a generalized term that describes a dysfunction in the pumping mechanism of the heart, it does not mean your heart has failed or stopped beating. It means the heart cannot adequately maintain the circulation of blood to all parts of the body. In most cases it refers to a progressive but gradual loss of the efficiency of the heart. A myocardial infarction or heart attack is usually a lack of blood supply to the heart tissue, and while it may cause sudden death, it may also lead to progressive heart failure, often with repeated incidents.
Anything that causes the heart to increase its workload for prolonged periods of time can result in heart failure. Heart failure can occur for several reasons, some of which are due the health of the heart itself (intrinsic), but most are not due to the heart (extrinsic). Intrinsic causes include a loss of the contractile force of the heart muscle (myocardium), or a failure of the heart valves to regulate the flow of blood through the heart (e.g. rheumatic fever). A common extrinsic cause of heart failure is high blood pressure (hyper-tension, possibly secondary to atherosclerosis), which increases pressure inside the heart and promotes changes in the pumping mechanism of the heart. Again stress and lifestyle issues can slowly increase the load on the heart to cause problems. Up to 80% of all cases of heart failure relate to a process by which the coronary arteries become progressively clogged with less blood supply producing a heart attack. Of course lifestyle and diet play a big role here.
The term congestive heart failure (CHF) describes a pathological process that results in a buildup of fluid in the lungs and other tissues. It is specifically related to a failure of the ventricles to sufficiently eject blood from the heart, increasing the volume of blood in the ventricles, causing a dilatation of the heart chambers, and elevating the internal heart pressure. Overtime the increase in pressure promotes “enlarged heart” (mycocardial hypertrophy), a compensatory mechanism that allows the patient to tolerate this state for years.
The focus of medical treatment in CHF is three-fold: to decrease water and thus pressure in the lungs; reduce congestion in the arteries; provide support to the heart muscle. Typical therapies used to reduce lung congestion and edema include nitroglycerin (mostly for angina), diuretics (e.g. furosemide, bumetanide, torsemide and metolazone) and vasodilators (e.g ACE inhibitors, angiotensin II receptor blockers). Medications used to reduce systemic vascular resistance are mostly comprised of the same vasodilators mentioned above. The most important medications used to provide heart muscle and heart beat support is digoxin. Digoxin (from Digitalis, a botanical) increases the force of heart muscle contractions (positively ionotropic) but decreases the heart rate (negatively chronotropic). Beta-adrenergic blockers (e.g. metoprolol, carvedilo) control the heart beat, and are also used to control the rhythm of the heart, particularly in diastolic heart failure, such as amiodarone and flecainide.
There are many botanical and other supplements that can reduce problems with heart failure as well as other cardiac problems. It is important to know that you cannot get yourself out of heart health issues by just taking supplements alone. As alluded to before, it has taken many years of lifestyle abuse to create problems in the cardiovascular system and there is no magic bullet or supplement that can fix it, even though there are many supplements that will assist with the job.
The two things that should be avoided are:
Alcohol: reduce consumption to 2 drinks a day for men and one for women (size being the biggest factor here)
The three most important things to address in one’s lifestyle are:
Stress: We all know that stress is bad for us, but most of use thrive on it and almost wear it like a badge of honor. I know I have certainly been guilty of this myself. Certainly some of the supplements we will mention deal with this, but again this is not really enough. One of the best way to productively reduce stress in one’s life is to meditate. Many studies have shown that 20 min, one to two times daily can really help reduce the stress load. These can be sitting meditations with a mantra or active meditation like Tai chi or Qi Gong. The more mindful and heart based the meditation can be, the better it is. Creative release like a hobby without perfectionism can also help. This could be knitting, doodling, keeping a journal, walks in nature or whatever suits you. But it has to be part of your daily routine.
Relaxation techniques include practices such as progressive relaxation, guided imagery, biofeedback, self-hypnosis, and deep-breathing exercises can be useful. The goal of these techniques is to consciously produce the body’s natural relaxation response, characterized by slower breathing, lower blood pressure and oxygen consumption, and a feeling of calm and well-being.
Diet: We have been told for years that the Western Diet or Standard American Diet (SAD) is going to kill us. Well this is starting to catch up with many people. The four biggest things to consider reducing are dairy, flour, sweets and foods you are allergic to. Notice that salt, fat and alcohol are not on this list. Yes, their reduction can matter, but not as much as the first four. There have been many studies that show that 70 – 80% of cardiovascular health issues are related to sugar problem such as metabolic syndrome, or diabetes. Reducing sugar consumption can be the most important nutritional practice that can be done.
Eat lots of roughage, greens and other vegetables in your diet, and try to keep fast food and commercial snacks to a minimum. Eat as much real food as possible, and as little processes food as you can achieve is the goal. In other words – a “Low Crap Diet”.
As you might have noticed in other blogs, I strongly suggest eating fermented food at least 5 times a week. Interestingly being involved in the preparation of the food can help your health a lot too.
Exercise: Again most of us know we should do more of this, but it doesn’t have to be heavy ‘cardio-vascular’ exercise to dramatically loses weight. Walking has been shown to be the best and most reliable exercise to do. We suggest getting an exercise band to record your steps. A person over 45 years should walk at least 3-5,000 steps a day, with 10,000 steps at least three times a week. Too much sitting is also important. Sitting to much is the new smoking! Getting up for 1 – 2 minutes every hour, at least 12 times a day, can be just as important for heart health as aerobic exercise. Since this is hard to enroll into one’s lifestyle, again a wrist application can nudge you into doing this. The use of stationary bikes, or tread mills can be quite functional, but by saving the money on these by walking instead, you can get an electronic assistant to remind you to exercise, and take your medication and supplements, which is often better and cheaper in the long run.
Stretching exercises can be particularly beneficial. Things like Yoga, Tai chi, Qi Chong can be physiologically and psychosocially valuable and appear to be safe and effective in promoting balance, control, flexibility, and cardiovascular fitness in older populations. This may represent an important complement to standard medical care in the treatment of deconditioned patients with systolic heart failure.
Supplements: All of the following supplements are safe to take along with the generally prescribed pharmaceuticals and there are thousands of practitioners in North America and Europe prescribing them.
- Hawthorn (Crataegus ): rich in flavonoids and are well-known tonic agents, particularly indicated in hearts, helping to strengthen the heart beat while regulating its rhythm. The dose for either Hawthorn tincture is 1-5 mL; 2 – 3 times daily or as a powder (2-3 g ; 2 – 3 times daily) or as an aqueous extract (100-150 mL ; 2 – 3 times daily) .
- Queen of the night Cactus (Selenicereus grandifloras) is described as having a digitalis-like effect, and in small doses is an excellent heart tonic, increasing the force and regulating the rhythm of ventricular contraction. Dose of the fresh plant tincture (1:2) is 10-20 drops 2 – 3 times daily.
- Motherwort (Leonorus cardiac): is an important antispasmodic herb that is particularly useful to relax anxiety and nervousness. Dose of the tincture is 1-4 mL 2 – 3 times daily (fresh plant 1:2, dry plant 1:5), or it may be taken as an infusion, 100-150 mL 2 – 3 times daily.
- Reishi (Ganoderma spp.) and Cordyceps both have cardiac tonic, blood pressure reducing, lung congestion reducing and qi increasing ability (Reishi/Cordyceps formula 2 – 3 capsules, twice daily)
- UBIQUINONE: Q10 is necessary for certain metabolic reactions, including oxidative respiration, and its concentration is increased in the heart, liver and pancreas. Two well-researched meta-analyses have shown improved ejection fractions, stroke volume, cardiac output, cardiac index and end diastolic volume in patients taking Q10 supplement; each also suggested that Q10 may have a role in the treatment of CHF.
- Carnitine: is essential in the transport of fatty acids into the heart muscle and mitochondria for energy production. Carnitine appears to have beneficial effects on CHF. If the heart does not have a good oxygen supply, then carnitine levels decline quickly. Several double-blind clinical studies have shown that carnitine improves cardiac function in CHF patients. The longer carnitine was used, the more dramatic the improvement. After six months of use, patients’ ejection fraction increased by 12.1% and 13.6%, respectively. Chronic administration of carnitine has been shown to improve ventricular function, reduce systemic vascular resistance, and increase exercise tolerance. The dosage used in most studies is 1-3 grams daily.
- Magnesium: plays an important role in the functioning of the cardiovascular system. A decrease in magnesium has been linked with tachydysrhythmias (fast, irregular heartbeats) and increased mortality in CHF patients. The research shows that use of magnesium supplements in these situations may be beneficial for treating and preventing life-threatening conditions. Magnesium supplements can be administered orally of 300 mg of oral magnesium citrate daily.
- Alpha Lipoic Acid: CHF patients should supplement with at least 250 mg of alpha lipoic acid each day.
- Essential fatty acids: Fish oils or as I prefer Krill of 500 – 2000 mg daily
The following guidelines should also be adhered to:
- Roughage should always be present.
- Meals should be small and fairly frequent; avoid large meals.
- Food should be chewed extremely well.
Breakfast: A grain with 1 tablespoon of Hemp seed, Magnesium (300 mg), Hawthorn (2-3 g 2 – 3 times daily), Motherwort (1 – 2 ml; 2 – 3 times daily), Cayenne (1-2 capsules), Reishi/Cordyceps (3 capsules; twice daily), Essential Fatty Acids (1 – 2,000mg), Coenzyme Q10 (150mg), Alpha Lipoic Acid ( 200 500 mg daily), Carnitine (1 – 3 gram daily) .
Lunch: Salad or soup.
Supper: Salad with grains, lightly cooked vegetables and/or some fish or lean poultry. Supplements: same as at breakfast.