So, you popped your cholesterol meds then tucked into a juicy steak. The pill can handle a little cholesterol surge, right? “At times, patients don’t think they need to follow a healthy diet since their medications have already lowered their blood pressure and cholesterol—and that is wrong,” says Mahshid Dehghan, Ph.D., study author and nutritionist at McMaster University in Hamilton, Ontario. Eating well offers benefits beyond standard drug therapy.

In fact, researchers found patients taking drugs to prevent recurrent heart attacks and strokes who also ate a heart-healthy diet reduced their risk of cardiovascular death (by 35 percent), congestive heart failure (28 percent), stroke (19 percent), and new heart attacks (14 percent) compared to those with less healthy eating habits.

No License to Binge The Saturday Evening Post

Most study participants used extra-virgin olive oil, which accounts for 98 percent of the olive oil available in France.

The versatile product also appears to protect against cardiovascular risk factors such as diabetes, high blood pressure, high cholesterol, and obesity.

Want to add olive oil to your diet? Go for it! But remember that even healthier fats like olive oil are high in calories, so use it in moderation; choose olive oil instead of butter and stick margarine—not in addition to them.

Here are 3 tips for buying, storing, and enjoying olive oil:

1. If you can, smell (and taste) before you buy. Olive oils encompass a wide range of flavor from fruity to peppery, mild to intensely strong. Don’t buy one you don’t like!
2. Good extra-virgin olive oil lasts about a year when stored out of the light and away from heat.
3. Virgin and extra-virgin oils are best used uncooked or cooked at low to medium temperatures. Try them in marinades, drizzle them over vegetables or bread, and add them at end of cook time for a burst of flavor.

Is Olive Oil Good For You? The Saturday Evening Post

A: Doctors commonly prescribe five types of medicines that lower high blood pressure in different ways. In almost all patients, some combination of drugs (usually at least two, and sometimes more) are tolerated and are effective. As I mentioned in my March 2010 column, a new procedure involves threading a catheter into the renal artery and burning key nerves in the wall of the artery that help regulate blood pressure. Ask your cardiologist about it.

Help for Hypertension The Saturday Evening Post

Common diuretics: hydrochlorothiazide (Microzide and others) and furosemide (Lasix).

When to take: in the morning to limit nighttime 
bathroom trips.

What to watch for: Some people suffer leg cramps when taking water pills. To combat the problem, 
consider getting extra potassium from foods such 
as bananas and orange juice. Before making drastic changes in your diet, however, please consult a 
pharmacist or doctor for specific advice. Too much 
potassium may cause other problems. Do not take 
potassium supplements when taking water pills.

Water Pill Basics The Saturday Evening Post

A: Blood pressure readings are normally the same in both arms. On occasion, an obstruction in the artery that carries blood to one arm can reduce the pressure in that arm. If the sonogram completely ruled out an arterial obstruction and you have no symptoms, then I would probably do nothing further except schedule regular checkups to be sure nothing crops up in the future.

Blood Pressure Paradox The Saturday Evening Post

1. Monounsaturated fats in olive oil are associated with lower rates of heart disease and colon cancer, and reduced risk of diabetes and osteoporosis.

2. Quercetin in onions is one of the most powerful flavonoids (natural plant antioxidants). Studies show it helps prevent cancer.

3. Rich in carotenoids, carrots may help lower cholesterol, regulate blood sugar levels, and protect against coronary heart disease and certain cancers.

4. An excellent source of potassium and manganese, zucchini provides your body with vitamins C, B1, and B6.

5. Several population studies associate an increased intake of garlic with a reduced risk of cancers, including stomach, colon, esophagus, pancreas, and breast.

6. Processing makes the cancer-fighting compounds in tomato paste more available to your body because heat breaks down the plant’s cell walls.

7. The type of soluble, cholesterol-lowering fiber found in chickpeas is not only heart-healthy, but helps stabilize blood sugars—particularly important for people living with diabetes.

8. Fresh basil boasts a healthy dose of blood-clotting vitamin K, and its oils and extracts are said to possess antibacterial and antioxidant properties.

9. Omega-3 fatty acids found in salmon promote heart, skin, and joint health. A study in the British Journal of Ophthalmology suggests omega-3s could also protect against age-related macular degeneration (AMD).

10. Data from a study published in Diabetes Care reported that a dietary pattern incorporating more low-fat dairy products may lower the risk of type 2 diabetes in middle-aged or older women.

11. According to a USDA Human Nutrition Research Center on Aging in Boston report, blueberries may improve motor skills and reverse the short-term memory loss that comes with aging.

12. A limited study at the University of Memphis Exercise and Sports Nutrition Laboratory found honey to be one of the most effective forms of carbohydrate gels to ingest prior to exercise, also functioning well in post-workout recuperation.

Salmon with Chickpea Ragu

Salmon with Chickpea Ragu

(Makes 4 servings)

• 1 tablespoon olive oil
• 1 small onion, chopped
• 1 large carrot, peeled and diced
• 1 large zucchini, diced
• 2 cloves garlic, minced
• 2 tablespoons tomato paste
• 4 cups low-sodium chicken broth
• 1 (15.5-ounce) can low-sodium chickpeas, drained and rinsed
• 1 cup basil leaves, sliced into ribbons, plus more for garnish
• ½ teaspoon salt (optional)
• ½ teaspoon freshly ground black pepper
• 4 (6-ounce) skinless salmon fillets

Heat oil in large skillet over medium-high heat. Add onion and cook until soft, about 3 minutes. Add carrot, zucchini, and garlic and cook, stirring, until carrots are firm-tender, about 4 to 5 minutes. Add tomato paste and stir. Add chicken broth and chickpeas and bring to boil. Reduce heat to low and cook, covered, until liquid thickens, about 10 minutes. Remove skillet from heat, add 1 cup basil and ¼ teaspoon each of salt and pepper. Stir and cover to keep warm.

To cook salmon: preheat broiler. Season with remaining salt and pepper. Broil fillets for 8 to 10 minutes per inch thickness, turning once. Serve with 1 ½ cups chickpea ragu in shallow bowl. Garnish with basil.

Nutrition Facts

Per serving: 1 salmon fillet and 1 1/2 cups chickpea ragu

calories: 460

fat: 17 g (saturated: 2.5 g; monounsaturated: 7 g; polyunsaturated: 5 g)

protein: 46 g

carbohydrate: 30 g

fiber: 6 g

cholesterol: 95 mg

sodium: 550 mg

Ellie’s Blueberry Blast Smoothie

Blueberry Blast Smoothie

(Makes 1 smoothie)

• ½ cup nonfat milk
• ½ cup plain nonfat yogurt
• 1 cup frozen unsweetened blueberries
• 1 teaspoon honey

Put all ingredients into blender and process until smooth.

Nutrition Facts

Per serving: 1 smoothie
calories: 195
fat: 1 g (saturated: 0 g; monounsaturated: 0 g; polyunsaturated: 0 g)
protein: 10g
carbohydrate: 40 g
fiber: 4 g
cholesterol: 5 mg
sodium: 134 mg

Spice Things Up!

Krieger says spices such as turmeric (found in curry) and ginger provide anti-inflammatory effects—an observation especially important for anyone suffering from rheumatoid arthritis or inflammation-related ailments.

Healthier by the Dozen The Saturday Evening Post

When you are at rest in a warm bed, arteries dilate and blood pressure tends to be low. When you stand up, your body elevates blood pressure to be sure your brain is perfused so you don’t black out. Getting out of bed in a cold room could cause an increase in pressure. How high does it get when you stand up? Does it then return to normal? Is your blood pressure cuff accurate? Discuss these questions with your doctor.

High BP in A.M. The Saturday Evening Post

Best to Check The Saturday Evening Post

You have certainly been through a bunch of medications, but there are others you have not tried. For example, carvedilol is a unique type of beta blocker that has alpha and beta blocking actions. Pure alpha blockers like Cardura (doxazosin) might work. Other diuretics might be effective, as can combinations of drugs that have different actions. Finally, you don’t mention lifestyle modifications and they should be considered. These can include a low-salt diet, potassium supplements, moderate alcohol consumption, weight loss, exercise, and relaxation techniques. Check with your cardiologist or hypertensive expert.

Systolic Hypertension The Saturday Evening Post

• The PLAC Test measures blood levels of an enzyme called Lp-PLA2 that, when elevated, may trigger an inflammatory response inside an artery and set the stage for plaque rupture. Clots from ruptured plaque cause more heart at tacks than do narrowed arteries. In clinical testing, having elevated Lp-PLA2 levels doubled one’s risk of heart attack. People with an elevated Lp-PLA2 com bined with high blood pressure were about seven times more likely to have a stroke than those without the risk factors.

• The ArterioVision ultrasound exam measures the thickness of two inner layers of the carotid artery, the major blood vessel that provides blood to the brain. Studies suggest that the carotid intima media thickness (CIMT) test may detect early signs of atherosclerosis and vascular disease not evident on conventional testing.


For more information about the PLAC Test, visit plactest.com . 


For more information about ArterioVision, visit i-mti.com .

Are You As Healthy As You Think? The Saturday Evening Post

VLDL (very low density lipoprotein) is a type of lipid protein in the blood that contains the highest amount of triglycerides. LDL, or low density lipoprotein, contains the highest amount of cholesterol. VLDL is considered one of the “bad” cholesterols but is difficult to measure, and not done so routinely. Reducing the amount of triglycerides in the blood will reduce the VLDL. Lp(a) is another blood lipoprotein that contains an apo(a) component and, when the concentration is very high, has been associated with an increased incidence of stroke and heart disease.

The Women’s Health Study recently showed that hormone use reduced the concentration of Lp(a). Currently, there are no guidelines recommending intervention based on high Lp(a) levels despite findings from some studies suggesting that lowering Lp(a) might be beneficial. But I don’t think doctors are blasé about it. They simply use other values such as LDL, HDL, and total cholesterol. I also don’t think physicians fuss about small deviations in LDL or sodium levels. I rarely measure LDL more than once a year in a patient unless I have changed their statin dose or drug, and rarely measure sodium unless the patient has renal disease, blood pressure problems, or an endocrine abnormality.

Managing Blood Lipid Levels The Saturday Evening Post

Tortuous coronary arteries are usually a normal variant of no concern. Sometimes they can be associated with high blood pressure. There is no need for routine testing of your children or grandchildren unless they have symptoms.

Convoluted Heart Vessels The Saturday Evening Post

An IMT ultrasonic (echo) scan, or an intima-media thickness measurement of the wall of the carotid artery in the neck, is often used as a surrogate marker for the development of atherosclerosis. When cholesterol gets deposited into arteries, the inner (intima) and middle (media) parts of the arterial wall thicken, so that a thicker wall produces a higher IMT score, which indicates the presence of increased cholesterol deposition and, therefore, more advanced atherosclerosis. What happens in the carotid artery in the neck appears to correlate with what is happening to arteries in the heart and head and, therefore, indicates a greater propensity for developing problems like a heart attack or stroke.

However, the IMT score is only one piece of an overall evaluation, and there are no studies showing that such a measurement alone improves patient outcomes. Nevertheless, given your family history and the fact that you have plaque in your carotid arteries (and assuming your lipids are abnormal), treatment with a statin would be indicated. If you were my patient, I would also address other risk factors such as diet, activity, smoking, blood pressure, weight, diabetes, and so on, and not consider a statin in isolation.

IMT Scan vs. Other Factors The Saturday Evening Post

No genetic marker of which I am aware has yet been identified. Diastolic heart failure and congestive heart disease are linked to high blood pressure, so control of your BP would seem to be the most important thing you can do. Genetics load the gun, but environment pulls the trigger. Therefore, you can escape the bullet by changing the environment with adequate BP control.

Dodging DNA Destiny The Saturday Evening Post

Data show that measurements recorded at the same times and place each day are often lower than readings taken in the doctor’s office and closer to the average BP recorded by 24-hour ambulatory monitoring, which is considered the gold standard. Home blood pressure monitoring also helps distinguish between “white coat” (elevated readings in the doctor’s office only), “masked” (elevated readings at home only), and sustained hypertension.

An expert group of cardiovascular physicians and nurses recently published a “Call to Action” for using home blood pressure monitors, including an appeal for insurance providers to cover the cost of the devices. The American Heart Association offers these tips for getting reliable BP readings at home:

• Your healthcare professional should help you select a cuff-style upper arm monitor, make sure it’s accurate, and show you how to use it.
• Cuff size is important. To get the right one, measure around your upper arm and compare to the cuff size indicated on the monitor’s packaging.
• Sit with your back straight and supported on a high-backed dining chair, rather than a sofa. Both feet should be flat on the floor, with arm resting on a flat surface and the upper arm at heart level.
• Each time you measure, take two to three readings one minute apart. Record all the results.

To download and print a blood pressure log from the American Heart Association, visit their website americanheart.org and search for “blood pressure tracker.” For a paper version to copy as needed, send a self-addressed, stamped envelope to BP Tracker, 1100 Waterway Blvd., Indianapolis, IN 46202.

Blood Pressure Monitors Come Home The Saturday Evening Post