For years cholesterol, a fatty substance produced by the liver, has been blamed as the primary cause of heart disease. Nonetheless, it’s a subject of much debate. The general consensus however is that low density lipoproteins (LDL) — damages the blood vessels. This leads to risk of blood clots, heart attacks and stroke. Interheart study reported in the Lancet, that 45 per cent of deaths from heart disease were caused by high cholesterol.

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The message is clear: avoid foods rich in cholesterol-raising saturated fat such as butter, cream, milk and cheese, and if you’re at risk of heart disease, take cholesterol-busting statins. Nonetheless, it’s time to have a rethought on this two- track approach.

CUTTING FAT IS BAD FOR YOU

A growing number of specialists have rejected the traditional heart health message of cutting cholesterol. ‘The mantra that saturated fat must be removed to reduce the risk of cardiovascular disease has dominated dietary advice and guidelines for decades and led to a Government obsession with levels of total cholesterol,’ says Dr Aseem Malhotra, a cardiologist and medical adviser to the Academy of Medical Royal Colleges. ‘Yet the scientific evidence shows this advice has increased our cardiovascular risks.’

Saturated fat has various subtypes that vary widely in their health effects, says Dr Rajiv Chowdhury, a cardiovascular epidemiologist and a Gates Scholar at Cambridge University. ‘Without considering these, it’s got to be harmful to replace all saturated fats with sugar or refined carbohydrates — as food manufacturers have been doing in the interests of heart health.’

LOW CHOLESTEROL MAY BE RISKY

The general opinion is Statins reduce cholesterol even in healthy people, and prevent heart attacks in those with risk factors. Originally they were targeted at people with a 30 per cent risk of a heart attack in the next ten years – now the threshold is anyone with a 10 per cent risk of developing cardiovascular disease within the next ten years. Today statin is offered to anyone with a 10 per cent risk of developing cardiovascular disease within the next ten years, as per guidelines of National Institute for Health and Care Excellence (NICE).

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Furthermore, your cholesterol falls naturally with age, particularly in older people with chronic health problems. A 20-year study published in the Lancet in 2001 showed long-term low cholesterol increases the risk of premature death — ‘and the earlier that patients start to have lower cholesterol, the greater the risk’.

So Who’s to Blame

According to a new theory, it’s sugar, which is thought to promote inflammation inside the arteries. A study in the Journal of the American Medical Association found adults who have three sugary drinks a day had triple the chance of a heart attack.

‘So far the concerns about sugar largely relate to obesity and diabetes,’ says Susan Jebb, Professor of Diet and Population Health at Nuffield Department of Primary Care Health Sciences. ‘But it’s probably true chronic inflammation is one reason that obesity and some dietary components such as sugar lead to an increased risk of heart disease.’

WAYS TO BEAT HEART DISEASE

HAVE A WEEKLY SAUNA

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A recent Finnish study found that regular saunas could cut the risk of heart disease by as much as 60 per cent.

BREAKFAST ON PORRIDGE

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Oats contain a soluble fibre, beta-glucan, that forms a thick gel like wallpaper paste, which binds to cholesterol in the gut and prevents its absorption into the bloodstream. So have porridge in the morning to reduce bad cholesterol.

MAKE SURE YOU FLOSS REGULARLY

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Gum disease harden arteries leading to heart attacks. Brush regularly and floss religiously.

HAVE SEX TWICE A WEEK

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Men who have sex at least twice a week are 45 per cent less likely to develop heart disease than those who do so once a month or less, says an American Journal of Cardiology study.

WEAR A SLEEP MASK

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A Warwick University study says lack of sleep is linked to a greater risk of heart attack death: fewer than six hours a night raises it by half. Half plenty of sleep.

CUT OUT SUGAR

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U.S. studies published last year suggest that sugar contributes more to high blood pressure than salt.

BOOK A SUNNY HOLIDAY

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Going on holiday regularly cuts the risk of dying from heart disease by a third, say researchers at the University of Pittsburgh. And a holiday somewhere sunny could boost the benefits.

EAT A POT OF YOGHURT

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A daily dose of ‘good bacteria’ or probiotics (from a live yoghurt or supplement) lower blood pressure, says a study from the Griffith Health Institute and School of Medicine in Australia.

WATCH A FUNNY FILM WITH FRIENDS

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A good belly laugh boosts blood flow by more than 20 per cent — and studies suggest it can reduce the risk of heart disease.

DON’T DELAY GOING TO THE LOO

Don’t keep bladder over-full – it can cause your heart to beat faster and put unnecessary stress on coronary arteries, triggering them to contract.

GET A SIT-STAND DESK

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Research indicates sitting for eight hours a day raises the risk of cardiovascular disease, cancer and diabetes by 40 per cent. Try a ‘sit-stand’ attachment, which lets you raise or lower your computer.

DOWNLOAD A ‘MINDFULNESS’ APP

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A study by Brown University in the U.S. discovered that people who are ‘mindful’ (they have a heightened sense of what they’re feeling and thinking at any given moment) are 83 per cent more likely to have a healthy heart. Cardiologist Dr Aseem Malhotra suggests Headspace, an app that teaches mindfulness techniques.

CUT BACK ON SALAMI

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Eat less meats and more vegetables. A Harvard study says less meats in diet cuts heart disease risk by 19 per cent.

LOSE HALF A STONE

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Losing 5 to 10 per cent of bodyweight can lower blood pressure, reduce ‘bad’ LDL cholesterol and blood fats, inflammation and blood sugar levels, suggest studies.

GLUG A LITTLE OLIVE OIL EVERY DAY

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A diet rich in fish, vegetables, fruit and olive oil — can protect against heart disease. Specially, olive oil have a potent anti-inflammatory effect.

Operations that could give your heart new life

Percutaneous coronary intervention (PCI) — often called angioplasties, which is designed to open up narrowed or blocked arteries. It’s a keyhole procedure done through a small incision in the groin or arm and takes from 30 minutes to two hours.

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PCI is a a combination of treatments — angioplasty, where a tiny balloon is inserted to ‘squash’ the fatty deposits that have narrowed or blocked the artery, and the insertion of a stent, a short wire-mesh tube to hold the artery open.

Another procedure performed for heart disease is coronary artery bypass graft (CABG). It involves taking sections of a vein from elsewhere — usually the chest, leg or arm — and attaching them to a coronary artery above and below narrowed areas or blockages, diverting blood around them.

TREATING A FAULTY HEARTBEAT

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Heart rhythm problems (arrhythmias) can trigger symptoms such as breathlessness, dizziness and fainting. Ablation is the treatment procedure which is normally carried out by interventional cardiologists. A small wire — a catheter — is passed into a large vein in the leg and up into the chambers of the heart, where it is heated to create a scar to block the abnormal electrical circuits.

Are statins worth the side-effects?

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Dr Aseem Malhotra, a cardiologist at Frimley Park Hospital, Surrey opines that people who have already had a heart attack or who have unstable angina are safer if they take statin. Nonetheless, doctors point to some potential side-effects. According to the evidence-based medicine website, thennt.com, statins carry a 10 per cent risk of debilitating muscle damage and 2 per cent risk of developing diabetes.

Don’t be afraid of sex

Exercise is the key after a diagnosis of heart disease or a heart attack. A recent study by the American Heart Association showed that heart attack patients who undertook exercise-based cardiac rehabilitation were 20 to 25 per cent less likely to die prematurely.

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Moderate exercise like brisk walking, swimming is good for you. Another form of moderate physical activity is sex. Patients can have sex again if they can walk a mile in 20 minutes or two flights of stairs in 20 seconds, says Graham Jackson, honorary consultant cardiologist at Guy’s and St Thomas’ Hospitals and chairman of the Sexual Advice Association. So happily indulge in sex, rather than fearing it.