“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
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Getting a proper amount of sleep is important for maintaining good health. I sometimes have trouble sleeping, probably from that second glass of red wine at dinner and coffee afterwards. I usually fall asleep rapidly and then wake up three hours later and toss and turn, eventually falling back to sleep. My sleep pattern is not a healthy one, as recent evidence indicates.
In a study of 385,292 adult men and women initially free of cardiovascular disease in the United Kingdom, people whose sleep pattern was characterized by five factors below had about a third less risk of heart disease and stroke compared to those who reported none or only one of these healthy sleep patterns:
1) being a “morning person”
2) sleeping 7-8 hours per day
3) never or rarely experiencing insomnia
4) not snoring
5) not experiencing frequent excessive daytime sleepiness
Healthy sleep behavior even reduced the risk of a genetic predisposition to heart disease for participants in this study. The conclusions have limitations, being based on an observational study, but do emphasize the importance of a good night’s sleep.
To ensure better sleep, experts recommend sleeping in a quiet, cool, dark room; increasing bright light exposure during the day and reducing blue light exposure at night; preparing to wake and sleep at consistent times; avoiding caffeine and late-night dinners; and limiting duration of daytime naps and alcohol exposure. I may have to forgo that second glass of red and espresso.
But I may be able to reduce my risk of heart disease by eating chili peppers with my dinner.
Chili peppers are a usual part of the Mediterranean diet but may be more important than previously considered. In a study of almost 23,000 men and women, regular consumption of chili peppers was associated with a lower risk of total death and death from heart disease independent of cardiovascular risk factors or adherence to a Mediterranean diet. The benefits of eating chili peppers have been ascribed to an ingredient called capsaicin, its major pungent compound. Capsaicin can improve cardiovascular function and metabolic regulation and exert anti-inflammatory and analgesic properties, but the exact beneficial action remains unknown, and none of the biological mechanisms tested could explain the health benefits in this study. However, it is not unusual in medicine for the benefits of a substance to precede understanding how it works. For example, the health benefits of penicillin were known long before we understood how it killed bacteria.
Speaking of heart disease, the holiday season increases the risk of heart attack, perhaps by overindulgence of food and drink. I was surprised to learn recently that half of the individuals in the U.S. were unaware of the constellation of common signs and symptoms caused by a heart attack, and nearly six percent were unaware of any one of the symptoms. That is unfortunate, because prompt recognition is critical to seeking emergency care that can be lifesaving. Delay in seeking medical help increases the risk of dying.
So, remember the big five:
1) chest pain or discomfort
2) shortness of breath
3) pain or discomfort in arms or shoulders
4) feeling weak, lightheaded, or faint
5) jaw, neck, or back pain.
If you experience any of them, call 911 and seek medical aid promptly.
As we enter the new year, don’t forget: moderation in all things, including moderation.
My best to all our readers for a great holiday season and 2020.
Featured image: Shutterstock
“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
Order Dr. Zipes’ new book, Damn the Naysayers: A Doctor’s Memoir.
Are you married? Happily? My wife and I have been married 57 years—happily, though we sometimes have our disagreements. (She calls them discussions. I call them fights. She likes them. I don’t.)
According to a recent study of more than 6,000 individuals undergoing heart catheterization for known or suspected coronary (cholesterol-related) artery disease and followed for almost four years, the chances of living longer were greater if they were married.
Unmarried individuals—whether divorced, separated, widowed, or never married—have about a 50% higher rate of cardiovascular death or heart attack compared to married folks. In other heart studies, unmarried people undergoing coronary bypass surgery or stent placement had higher adverse cardiovascular events compared to married people. But you need a happy marriage because unhappy marriages had poorer outcomes compared to happy ones.
What might explain these findings? A host of possibilities exist: unmarried people may experience a lack of social support, lack of caregiving, and emotional or financial stress and a more sedentary lifestyle. Unmarried individuals may have also self-selected because of psychological or socioeconomic problems. Married couples may have better adherence to medical advice and taking medications. Loneliness, which I addressed in a previous column, can play a role. Blood pressure may be important since high marital quality has been shown to be associated with lower blood pressure, lower stress, less depression, better sleep patterns, and greater satisfaction with life.
Note the emphasis on “high marital quality.” Unmarried individuals compared with those in low-quality marriages had lower blood pressure, suggesting that single individuals fare better than their unhappily married counterparts. Happily married couples have reduced inflammatory markers in the blood, reduced neural stress on the heart, and better functioning immune systems, all of which can impact the development of coronary artery disease. The link between marriage quality and cardiovascular risk appears to be greater in older individuals and more pronounced among women than men.
Whatever the reasons—and they are many and complex—marital status and marital quality are consistent predictors of health outcomes, including cardiovascular disease and mortality. What can you do about it? Obviously, be happily married—not so easy for many people. But at least be aware of the fact that being unmarried or unhappily married can detrimentally affect your general and cardiovascular health. Forewarned is forearmed. Try to change that, if you can.
We are pleased to bring you “Your Weekly Checkup,” a regular online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
Diet is important for general health, and in particular, cardiovascular health. The Mediterranean diet — which has been shown to reduce adverse cardiovascular events — emphasizes eating primarily plant-based foods such as fruits and vegetables, whole grains, legumes (like peas and beans), nuts, olive and canola oil, fish and poultry, and (some) red wine. A recent study showed that only around ten percent of Americans eat enough fruits (1.5–2.0 cup equivalents) and vegetables (2.0–3.0 cups) per day. Women and people in higher socioeconomic classes appeared to eat more than the rest of the population.
Several studies have shown that eating nuts reduces cardiovascular risk, in particular by lessening coronary heart disease. In one study, a Mediterranean diet supplemented with hazelnuts, almonds and walnuts resulted in almost a 30 percent reduction in the incidence of major adverse cardiovascular events after five years of follow up. Three large prospective trials showed that a higher consumption of total and specific types of nuts was inversely associated with total cardiovascular disease and coronary heart disease.
This means that the more nuts you eat, the lower your mortality. Tree nuts like almonds, pecans, and walnuts are especially beneficial, because they are loaded with vitamins, minerals, and unsaturated fats.
But even peanuts and peanut butter are beneficial. Technically, peanuts aren’t nuts but are actually legumes, more closely related to soybeans and lentils than to almonds and walnuts. Nevertheless, the evidence shows eating peanuts and peanut butter is still beneficial. I guess all those peanut butter and jelly sandwiches I ate as a kid had some benefit — at least the peanut butter did!
What’s so great about nuts? They contain lots of protein, unsaturated fatty acids like omega-3 (found in fish oil), fiber, minerals, and vitamins. They improve blood lipids (lower “bad” cholesterol), reduce inflammation, generate better blood vessel wall function and reduce insulin resistance. Not bad for something that also tastes good.
What are the downsides? Eighty percent of a nut is fat, albeit healthy fat, but it still carries a lot of calories. So be careful not to overindulge and start gaining weight. That would defeat the benefits. I find that a handful of almonds reduces my appetite way out of proportion to the amount I ingest.
What type of nuts should you eat? Some, like walnuts, have more heart-healthy nutrients such as omega-3 fatty acids, but it probably doesn’t matter that much since most nuts appear to be generally healthy. The American Heart Association recommends eating about four servings of unsalted nuts a week. Choose raw or dry-roasted nuts rather than those cooked in oil, and avoid those covered with chocolate, sugar or salt. If you choose the kind you like, you’re more apt to include them as a regular part of your daily diet.
So, nuts to you! Enjoy!