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What You May Not Know About Preventing Heart Attacks, Strokes, and Diabetes

By Bradley Bale MD and Amy Doneen ARNP with Lisa Collier Cool

Have you ever wondered why someone could feel perfectly fine and then minutes later have a massive heart attack or stroke that either kills the person or causes a life-long disability? Even more challenging is the concept that some people can go in for a full medical exam, including cholesterol and blood pressure check and a stress test, and be told they are fine only to drop dead of a heart attack days or weeks later. 

Here’s what you need to know in order to avoid those tragic scenarios:

What causes a heart attack or an ischemic stroke? The blockage that triggers a heart attack or stroke is actually a blood clot, not cholesterol build-up as many believe. The potentially lethal clot occurs when a cholesterol deposit (plaque) inside an artery wall becomes inflamed and causes a tear in the inner lining of the artery. In an attempt of repair this injury, the body tries to seal the crack by forming a blood clot. If the blood clot, or thrombus, blocks the flow of blood in the heart, it can cause a heart attack. If the clot occurs in the brain, it is called a stroke.   

Because the plaque hides in the artery wall, common tests such as the stress test can’t find this silent disease. We recommend tests that utilize B-mode ultrasound testing, called the carotid intima media thickness test (CIMT) to look for plaque in the wall of the artery. Another test is the coronary calcium test (CACS) that can identify calcified plaque in the vessels around the heart. These tests are not expensive and they are safe, reliable and reproducible.   

Inflammation is the driver of both disease and events (heart attacks and strokes). Chronic low-grade inflammation in the blood vessel lining is linked to the development of vascular disease and vascular events (heart attacks and strokes). People with high levels of inflammatory biomarkers are up to nine times more likely to develop blockages in their arteries compared to people with lower levels. There are cost-effective laboratory tests that should be performed regularly to determine if you have inflammation in your arterial system and to know if your treatment is working.  If treatment such as lifestyle changes and medication are working, the inflammation should be eradicated. If inflammation is treated properly, the body will heal.    

What are some of the root causes of vascular disease and inflammation? Elevated cholesterol is one of many root causes of vascular disease and inflammation and, amazingly, is perhaps one of the weakest culprits. One of the most common root causes is insulin resistance, which is a condition that can also lead to type 2 Diabetes. Insulin resistance marches on silently for often two decades before it is discovered as diabetes. Unfortunately, the arteries are being damaged the entire time. A fasting blood sugar or A1C (3 month average) often misses this condition. We advocate for a very safe test to find this deadly condition that can even given to pregnant women. It’s called the glucose tolerance test. 

Another root cause is periodontal (gum) disease and endodontic disease (tooth decay). Others include obstructive sleep apnea, vitamin D deficiency, autoimmune disorders such as rheumatoid arthritis and lupus, anxiety, depression, and smoking. A lipid abnormality that is genetically inherited and independently causes heart attacks is Lipoprotein (a). This condition effects 25% of the U.S. population and yet it is rarely checked. 

Women are unique and they have some “red flags” that can indicate potential future risk.  Women ARE unique for many reasons. Most important, women are 10 times more likely to die from a heart attack then any form of cancer. Also, symptoms that women experience are often different from those of their male counterparts. When a woman is having a heart attack, she may not have the typical chest pain or arm pain. Rather, she often demonstrates shortness of breath, unexplained anxiety, and nausea. It is important for women to consider heart disease if they are feeling different than they have ever felt in the past. 

Some “red flags” that should trigger a woman to get a full cardiovascular work-up including imaging to determine if disease is present and inflammatory testing are  a history of gestational diabetes, preeclampsia during pregnancy, blood pressure changes during pregnancy, migraine with aura, waist lines over 35 inches, fasting blood sugars above 90, a disruptive sleep pattern, restless leg syndrome, arthritis, or bleeding gums. Any of these issues could be clues that you may be harboring vascular inflammation and potentially vascular disease.   

What are some tips you can do to stay healthy?

*Floss your teeth twice a day

*Use an ultrasonic toothbrush twice a day

*Exercise 22 minutes a day

*Eat a diet rich in vegetables and fruits

*Eat fatty fish 3 times per week

*Laugh every day and eat dark chocolate (just a little bit – every day!)

*Try to get at least 6 hours of sleep 

*Most important, be your best advocate! Ask for testing and listen to your body. You are the expert!

Cardiovascular specialists Bradley Bale, MD and Amy Doneen, ARNPare the founders of theBale/Doneen Method for preventing heart attack and stroke. Learn about warding off these conditions by reading their new book, Beat the Heart Attack Gene: The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes.

Lisa Collier Cool is an award-winning journalist and author who frequently writes about health. Please visit http://www.lisacolliercool.com/Site/Home.html