“Dr. Hyman, my father has heart disease, his father did too, and I’m obviously concerned about my own heart,” writes this week’s house call. “What can I do to prevent heart disease?”
Most importantly, please know while genetics contributes to some degree, many other factors completely within your control can contribute to or reverse heart disease.
Genetics loads the gun, but environment pulls the trigger. The way you eat, how much you exercise, how you manage stress, and your exposure to environmental toxins all contribute to things like high cholesterol, high blood pressure, high blood sugar, and of course, heart disease.
The current way doctors treat heart disease is misguided because they treat the risk factors not the causes. To think we can treat heart disease by lowering cholesterol, lowering blood pressure and lowering blood sugar with medication is like mopping up the floor while the sink overflows.
Instead, we need to ask what causes these risk factors like high blood pressure, high blood sugar or abnormal cholesterol in the first place. Spoiler alert: These are not medication deficiencies! We treat these problems with medication, but studies have increasingly shown that treating these risk factors has only little benefit, or none at all. Research shows changing your lifestyle can be a more powerful intervention to prevent heart disease than any medication.
The “EPIC” study published in the Archives of Internal Medicine studied how 23,000 people adhered to four simple behaviors: Not smoking, exercising 3.5 hours a week, eating a healthy diet and maintaining a healthy weight. Adhering to those four behaviors alone prevented 93 percent of diabetes, 81 percent of heart attacks, 50 percent of strokes, and 36 percent of all cancers.
Likewise, the INTERHEART study, published in the Lancet in 2004, followed 30,000 people in 52 countries. Researchers found changing lifestyle could prevent at least 90 percent of all heart disease.
Other research shows lifestyle intervention becomes more effective than almost any other traditional medical intervention to reduce cardiovascular disease, hypertension, heart failure, stroke, cancer, diabesity and deaths from all causes.
Your environment, in turn, changes gene expression, subsequently modulatinginflammation, oxidative stress and metabolic dysfunction. These are the reasons we get sick and develop heart disease along with other problems.
That’s actually good news. Addressing and fixing the root causes benefits most chronic disease. These modifications will make you feel alive and healthy without the side effects of medication.
Occasionally, I will use medications if I feel a patient shows a strong genetic predisposition for heart disease or if significant heart disease already exists. Under those circumstances, I carefully weigh a medication’s risks and benefits.
At the same time, most patients can achieve the benefits of most medications through lifestyle changes.
Dr. David Jenkins from the University of Toronto compared treatment with statin drugs (the number one cholesterol medication) with a diet rich in viscous fiber, almonds, soy and plant sterols. Researchers in this study found that, while they created almost equal benefits, diet became more effective to lower inflammation and homocysteine (a risk marker for heart disease).
I’ve, likewise, had patients lower their cholesterol (sometimes over 100 points) simply by incorporating positive dietary and lifestyle changes.