Drs. Oz & Roizen: Keep Your Heart Strong

Q: I often feel my heart pumping when I’m lifting weights. Does this provide me with adequate cardiovascular exercise?

A: The only way to really tell if your heart is racing fast enough for you to get the cardiovascular benefits you need is to use a heart rate monitor. Let’s remember the minimum physical activity for maximum health benefit: walking 10,000 steps each day, 30 minutes a week of resistance exercise, and 20 minutes three times a week of movement that puts you at 80 percent of your age-adjusted maximum heart rate. (That’s about 220 minus your age for men; 206 minus 88 percent of your age for women.) So if you use a heart rate monitor—the version with a chest strap tends to be more accurate—see that you are indeed getting to that target heart rate for at least 20 continuous minutes, three times a week, and you’ll be golden. If not, for optimum heart health, you might want to hop on a cardio machine or step outside for a brisk walk or jog.

Q: I’ve heard that women and men show different heart disease symptoms. As a woman, what should I be looking out for?

A: You just asked one very important question. Heart disease is the No. 1 killer of women in the U.S. One in two women will die of heart disease or stroke, compared with one in 25 women who will die of breast cancer.

Yet heart problems are still widely regarded as a male problem, despite the fact that of those who have heart attacks, 42 percent of women will die within a year, compared with 24 percent of men. Women receive far less preventive care than men, and, while women are famously intuitive when it comes to looking out for signs, symptoms and discomfort in the men in their lives, they often ignore or fail to recognize warning signs in themselves. Part of the problem: The signals of heart trouble are slightly different in women than they are in men—and many of the ones you’d experience may just feel like stress or fatigue. (And who isn’t stressed or fatigued?)

Men’s heart attack symptoms by and large revolve around the chest—pain, tightness and pressure. One study found that only 10 percent of men experienced a heart attack sans chest-related symptoms.

But while chest pain and discomfort are statistically the most common heart attack symptoms for women as well, women commonly can have heart attacks without chest pressure—or where other symptoms are more prominent. They might experience shortness of breath, tiredness, lightheadedness, or pressure or pain in the neck or upper back, or even nausea and vomiting. Lots of women have chalked up heart attack symptoms to the flu, stress, acid reflux or even just getting older, and as a result don’t get the treatment they need.

Let’s be clear: Don’t procrastinate. If you’re putting off checking out these symptoms because you “don’t have the time,” think of it this way: A couple of doctor’s visits to figure out the source of these symptoms will prevent a whole lot more time in medical offices down the line. (And hey, even if it is just acid reflux, wouldn’t life be nicer if you could fix it instead of just living with it?)

If you’ve experienced a heart attack, please put yourself first. Women often don’t and as a result experience poorer quality of life and more recurring chest pain and physical limitations during heart attack recovery than men do. Why? Because women often play caretakers to their families, so they may not be as good at taking care of themselves when they need it most.

Research has found that women with heart disease are less likely to do cardiac rehab than men, which is a real shame because women respond to heart disease reversal programs even better than men. Get the treatment you need and be there for your loved ones—and yourself—for the long haul.

Q: There are so many numbers I need to keep track of when it comes to potential heart problems—LDL, HDL, triglycerides. Can you explain what they mean and why they’re important?

A: Heart-related stats may seem like alphabet soup, but they’re a useful way to gauge both your risk and how well you’re doing at preventive measures. Let’s take a look at a few of the most important ones:

LDL cholesterol is the bad (“Lousy”) kind—it breaks apart easily and builds up on the walls of your arteries wherever there is a nick or hole. High LDL levels can be the result of eating too many foods laden with simple sugars, simple carbohydrates, and trans and saturated fats. LDL can also be high partly due to genetics. Exercising, losing even 10 pounds of excess weight, avoiding simple carbs, and restricting your intake of trans and saturated fats to fewer than 20 grams a day will all help lower your LDL. You can also add healthy fats such as omega-3s and omega-7s, or medications called statins. The payoff is substantial: A 55-year-old with an LDL of 180 mg/dl who lowers it to 100 will make himself the equivalent of three years younger.

HDL cholesterol is the good (or “Healthy”) kind—something we actually want you to increase in your body (for a change!). You want an HDL level of more than 40, and the higher, the better. You can increase it by consuming healthy fats like those in olive oil, fish and walnuts, or by taking supplements (for example, fish oil, omega-7 and vitamin B5). Walking or any physical activity for 30 minutes a day helps, too. If you aren’t at risk for alcoholism, one drink of alcohol per night (and no, seven on Saturday night doesn’t count) can be beneficial as well.

Lipoprotein-A (LP-A) is genetically mediated, and high levels of it correlate directly with your risk of artery hardening (atherosclerosis), especially in your heart, and predict premature development of heart disease independent of your other risk factors. If you do have increased LP-A, do everything else you can to reduce your risk of heart disease—exercising, eating healthfully, managing stress—and talk to your physician about taking baby aspirin every day.

Triglycerides are a type of fat the liver makes when you eat more calories than you use. Your body converts those extra calories into fatty triglycerides to store in your fat cells. High levels of triglycerides are linked with atherosclerosis, which increases your risk for stroke, heart attack and heart disease. The same things that make you healthy overall—losing weight, eating healthfully (including portion control!) and exercising—can reduce your triglyceride levels.

Design a plan for your body’s best year yet with the docs’ tips for diet, exercise and medical tests. 

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Michael Roizen

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