Best Practices: Heart Health

Heart disease is public enemy #1

A silent killer, cardiovascular disease is a threat unlike any other. Because of its silence, it is easily ignored.

But cardiovascular disease -- including stroke -- accounts for 30 percent of deaths worldwide.

Three TEC speakers, whose goal is to enlighten members about their health risks, health opportunities and how to capitalize on those opportunities, share their expertise in this module.

E. Lee Rice, D.O. and Jerry Kornfeld, M.D. contribute their medical knowledge, and David Meinz, a registered dietician, shares his nutrition advice.

The CEO and Heart Health

As a group, CEOs are no different from the general population, according to Dr. Rice, but with one distinction: they have a very strong ability to deny their symptoms. "The biggest danger CEOs face is their own history of being able to push through difficult situations and come out on top," says Dr. Rice. "Therefore, they develop a sense of invulnerability."

But a group of TEC members in Canada who participated in a study to improve their health proved that you can make the choice to change your lifestyle -- even as a busy CEO -- and reap the rewards. They exercised regularly, improved their eating habits, stopped smoking and actively worked on managing their stress. At the end of a year, their health improved by several measures, including a drop in resting heart rates and blood diastolic pressure.

A key to these members' success was the fact that they were tracked by researchers every two weeks, who used diaries and e-mail for follow-up over the 12-month period. A key component of improving your heart health should include a mechanism for ongoing feedback and follow-up. Consider enlisting your TEC Chair and members of your TEC group as partners in helping you meet your heart health goals.

Warning Signs: Do You Have Heart Disease?

Waiting for "a sign" of heart disease before making your heart a priority can be a fatal mistake. For 40 percent of those who die from cardiac arrest, the heart attack itself was the first warning sign. For the rest of the population, warning signs include:

• Chest pain or discomfort.
  
  
• Pain on exertion that goes away with rest
  
  
• Pain or tingling that radiates to the shoulder -- usually on the left side -- and down the left arm or up into the neck
  
  
• Pain that feels like tightness in the throat or neck
  
  
• Lightheadedness, dizziness, irregular heartbeat -- especially brought on by exertion

Your Risk Factors: A Closer Look

Scientific research over the decades has established the following risk factors for cardiovascular disease: age, gender, heredity, high blood pressure, unfavorable cholesterol levels, lack of exercise, being overweight and having diabetes mellitus. A smoker's risk of a heart attack is more than twice that of a non-smoker.

It's important to learn about the risk factors, and weigh their importance in your life. But even if you appear to have none of them, you can't afford to be complacent because risk factors are tricky indicators. "We're seeing an increase in the numbers of people with heart disease who have no risk factors that we know of," says Dr. Rice.

By the Numbers: Cholesterol and Hypertension

You should know your blood pressure and cholesterol readings, and monitor them regularly. (Your physician will tell you how often.) A blood pressure below 140/90 is normal. Optimal is 120/80.

Total cholesterol below 200 mg/dl is desirable. For LDL or "bad" cholesterol, less than 100 mg/dl is optimal and 100-129 mg/dl is OK. For HDL or "good" cholesterol, the higher the reading the better -- 60 mg/dl or higher is heart protective; less than 40 mg/dl represents an increased risk of heart disease.

Check-ups and Tests

Annual check-ups are necessary to determine your heart health. Your physician can tell you the best schedule for your age. There are many tests available, depending upon your situation -- from stress tests to electrocardiograms, blood tests for cholesterol and full-body scans.

Exercise for Heart Health

Exercise is essential for preventing, halting and -- to the extent possible -- reversing heart disease. "Today, most people don't get out of their chairs -- let alone walk or exercise. It used to be that if you wanted to talk to someone, you walked down the hall. Now you send an e-mail,'' says Dr. Kornfeld.

Studies show that 30 minutes of exercise on a daily basis, five to six days a week, may actually prevent heart disease. The average person can raise HDL cholesterol levels five to 10 points with exercise. But you can't "bank" exercise. What you did three weeks ago won't help you today.

Exercising at 60-75 percent of your maximum exertion level is best. For an easy gauge, Australians call this "lightly puffing."

Always check with your doctor first before embarking on a strenuous exercise regimen.

Maintain a Healthy Diet

Nearly two-thirds of Americans are overweight, and therefore at increased risk of heart disease and stroke. If you're in this majority, changing your diet is essential.

The American Heart Association recommends a balanced daily diet, including six or more servings of breads, cereals, pasta and starchy vegetables; five servings of fruits and vegetables; two to four servings of skim milk, or low-fat dairy products and up to six cooked ounces of lean meat, fish or poultry.

The closer the food is to the way it comes in nature, the better. Apples are better than applesauce. Applesauce is better than apple pie.

Moderation is the key. For instance, consuming alcohol in small amounts (two drinks or less per day for men and one drink or less per day for women) has been shown to have heart healthy benefits, but over-indulgence can have major implications.

Actively Pursue Stress Reduction

All stress is not the same. Positive stress -- so-called "eustress" -- is energizing, motivating and can be fun. It is healthy and allows us to be more productive. Eustress adds spice to life. When we have chronic, unrelenting distress, it results in the depletion of our reserves.

Symptoms of stress may include a wide variety of general complaints, including insomnia, headache, GI problems, muscle aches, back pain, increased irritability, high blood pressure, skin rashes, anxiety, and a general feeling of not being in good health.

The most dangerous symptoms in terms of their association with heart disease are anger, hostility, and feelings of constant time constraints.

Consider Lifestyle Changes

But you can significantly reduce the levels of stress you feel. The following strategies have been proven to help: early recognition of stress; a monitoring system, which includes encouraging your spouse, children, friends, peers and employees to tell you when they see signs of stress; exercise, one of the best ways to immediately reduce stress; nutrition and supplements, meditation, relationships, music and the arts; and anger management.

Too many CEOs overlook play, solitude and significant relationships, which provide connectedness and perspective.

Five of the worst wellness behavioral choices are: isolation; fear-based decision-making; sedentary lifestyle mixed with constant "busyness;" addictive behaviors; and poor food choices. Five great wellness choices are : regular exercise; good nutrition; plenty of sleep; stress reduction; and positive attitude.

Reversing Heart Disease

Following the Dr. Dean Ornish Plan to Reverse Heart Damage is a proven route to reversing heart damage -- but it should only be started under the supervision of a physician. Dr. Ornish prescribes a dramatic reduction in fat consumption -- no more than 10 percent of daily caloric intake from fat, as well as creating a lifestyle that integrates regular exercise, balance of work-play, meditation and strong, healthy relationships.

Don't wait for a crisis to force you to make the decision to change. Remember: You can reverse heart disease if you do it carefully. True lifestyle changes can dramatically improve health into your 80s, 90s and perhaps beyond.

Contributing Experts:

Dr. Jerry Kornfeld

A family physician for more than 30 years, Dr. Jerry Kornfeld has treated hundreds of patients and spent years of study trying to understand such "mysteries of life" as, "Why do some people run marathons at age 86, while others half their age have problems walking around the block?" and "Why have some people died in the prime of their lives from illnesses and disease that others, twice their age, have survived?" Through study and observation, Dr. Kornfeld has developed his own concepts of wellness and longevity, which he shares with TEC groups in a program called "Surviving the Corporate World: A Physician's Gameplan for Wellness and Longevity."

David Meinz

David L. Meinz, MS, RD, FADA, CSP, is the director of Personal Health Strategies, Inc., specializing in consultations and workshops that challenge and enable people to improve their health. He is author of "Survival of the Fittest: How to Lose Weight, Lower Cholesterol, Prevent Cancer, Eat More, Get Fit, and Feel Great!" (Gilbert Press) Meinz earned a Master's degree in Human Nutrition in 1981. He is also a registered dietician and Fellow in the American Dietetic Association (FADA), an honor held by less than 1 percent of all dieticians. Meinz has been a consultant and professional speaker since 1991. He has taught at Norfolk State University and Hampton University, worked in human nutrition research through the University of Missouri, practiced hospital clinical dietetics, and was director of a hospital health promotion program. A speaker internationally to businesses and associations, Meinz has earned the Certified Speaking Professional (CSP) designation from the National Speakers Association. Only 325 people in the world have earned this prestigious title. The topic of his presentation to TEC groups is "Survival of the Fittest."

Dr. E. Lee Rice

E. Lee Rice, D.O. founded the San Diego Sports Medicine Center in 1980, and has more than 20 years of experience in the practice of primary care sports medicine. Dr. Rice has served as team physician for many professional, Olympic and university teams including the San Diego Chargers, San Diego Clippers, San Diego Gulls, San Diego State University, and the Men's and Women's USA Volleyball Teams. An internationally known authority on sports medicine, wellness and preventative medicine, Dr. Rice is a clinical professor at the University of California, San Diego, School of Medicine and at the Western University of Health Sciences. He is past president of the American Osteopathic Academy of Sports Medicine, a Fellow of the American Academy of Family Physicians, a Fellow of the American College of Sports Medicine, co-founder and past president of the American Medical Society for Sports Medicine, and is chairman of the Medical Advisory Committee to the California Governor's Council on Physical Fitness and Sports. Dr. Rice addresses TEC groups on "Health and Fitness" and "Drugs in the Workplace."

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