Heart Attack and Stroke

C-reactive protein (CRP) is a marker for inflammation that is directly associated with atherosclerotic plaque. It’s a blood protein that, when found in elevated levels, may indicate you could be at risk of heart attack and stroke.

Multiple studies have identified CRP as a potent predictor of future cardiovascular problems—and one that is far more reliable than elevated cholesterol levels.

Biological characteristics that are associated with high CRP levels include trauma, infections, high blood sugar, excess weight, and hypercoagulability of blood (sticky blood). Any one of these situations literally feeds pro-inflammatory mediators, ratcheting up the chances that you’ll develop atherosclerosis.

If you have heart disease concerns, other cardiovascular problems, or you’ve had trauma or an infection that could cause inflammation, you should have your CRP levels tested. Just make sure your doctor uses the high sensitivity test (hs-CRP). This test doesn’t take much time; typically, blood is drawn from a vein located either on the forearm or from inside your elbow. The blood is then analyzed in several tests to determine the level of CRP present.

For more information on heart risk factors or cardiovascular problems, visit www.drsinatra.com.

There has been some controversy about the effectiveness of medicinal footbaths. Dr. Sinatra and I have experienced several of them in exhibit halls at major health expos. You can imagine the numerous venders who propose many health benefits from using their products, particularly detoxification. The concept involves sitting with your feet in a small tub of water. Then, devices and solutions are added to promote detoxification.

Sodium chloride salt is usually sprinkled in the warm water and an electrode added with a positive and negative electronic charge to create a high energy complex in the water. Proponents claim that the color changes noted in the water colors represent different toxins being drawn out of the body through the feet—toxins coming from the liver, lymph glands, joints, fatty tissue, etc.

Now, while it’s true that the water does change color in these footbaths, it would do so even if your feet were not placed in the water. However, those colors do appear darker and thicker when the feet are immersed. So, what could possibly be going on?

Some proponents of the medicinal footbath claim that the highly charged water creates an energy complex that acts on the acupuncture meridians in the feet, reaching multiple systems in the body. Now remember, Dr. Sinatra is from Missouri, so you gotta show him! 

At one such anti-aging conference years back, Dr. Sinatra looked at these foot baths with a very skeptical eye. Although the theory seemed plausible, we were both thinking it a bit of a parlor trick that it could energize the body at the same time, despite positive testimonials from people who feel better after using the bath. Then one distributor offered some science: a live visual of microscopic serum analysis of blood viscosity pre- and post- footbath. 

The pre-treatment blood showed red blood cells stacked on one another like poker chips, known as rouleaux (pronounced rooo- low). Rouleaux formation indicates clumpy, sticky blood and increased blood viscosity, a risk factor for cardiovascular problems, such as heart attack and stroke. The post-foot bath blood analysis revealed red blood cells that were not sticking together; they were flowing freely in the microscopic field.

Mildly impressed, but still skeptical, Dr. Sinatra and I joined two another MD colleagues and tried the footbath for ourselves—and had the same blood results. For my husband, there was even relief of his right hip pain. The intervention had also included drinking a solution called Ioncleanse, a mixture of silver chloride and other minerals. The internalization of the minerals and the external charge are supposed to raise the overall energy field, thus making the detoxification and energetic process even more profound.

Needless to say, we all ordered footbaths for our own homes.

That was back in 2004. Flash forward to today, and many health professionals endorse footbaths and are convinced they may be a vital tool in energizing and detoxifying the body. Even the prestigious Townsend Letter described how the footbath works.

For now, we continue to have an open mind that the footbath may even be a viable intervention to reduce blood viscosity and inflammation—two factors that contribute to developing and worsening of heart disease. And the benefits of detox cannot be underscored; inflammation is the root of many illnesses.

We have the most experience with B. E. S. T. (Bio-Electric Stimulating Technique) footbath, and there are many others in the marketplace. Some companies offer electrodes that can be placed in your own bathtub. Many alternative medicine practitioners offer footbath treatments in their office or clinic if you want to experience one yourself.

For more information on cardiovascular problems, as well as new ways to reduce heart risk factors, visit Dr. Sinatra’s Web site.

Reference:
Walker M, Walker R.  IonCleanse detoxification—getting the issues out of tissues. Townsend Letter for Doctors & Patients. 2004:101-104.

If you’re working hard to prevent heart attack and stroke, as well as the occurrence of other cardiovascular problems, you need to beware of the dangers associated with salt. 

As any decent doctor or holistic practitioner will tell you, having too much salt in your system can make it difficult for you to maintain healthy blood pressure levels, as well as healthy cholesterol levels.  In fact, too much salt can severely compromise your overall health and force you to deal with a myriad of serious heart risk factors you’d do well to avoid.

Here are four things you may not know about salt consumption:

1. Your body requires sodium (a component of salt) to regulate fluid balance and distribution, as well as nerve and muscle cell function. Although you need some sodium, the standard American diet includes way too much. That’s why I urge my patients to try what I often refer to as "the healthiest diet of all." You'll be amazed at how effective it can be.
2. The current recommendation for salt consumption is less than 2,400 mg of sodium a day, which amounts to about one teaspoon of salt. Recent research suggests that people ingesting less than 1,500 mg of sodium a day are better able to keep their blood pressure low. If you have high blood pressure, you should definitely aim for that kind of level. Don’t use salt from the shaker, and read labels to add up the amount you’re taking in.
3. Many items at fast food restaurants are high in salt, so you can easily exceed the recommended level with one serving.
4. You can easily make up for the reduced salt in your diet by cooking with fresh herbs and spices such as basil, garlic, oregano, rosemary, chives, parsley, and onion. What’s more, all of these flavorings contain natural substances that are good for your health. Garlic, in particular, has been shown to have a positive effect on blood pressure when consumed on a daily basis.

I hope you'll share this information with your friends and loved ones. It's just another example of how you can do something simple to help control your cardiovascular health.

For more information on blood pressure levels and other cardiovascular problems, visit www.drsinatra.com.

Dr. Sinatra has long believed in the famous words of Hippocrates, the Greek physician of centuries past who is now recognized as the “Father of Medicine.” Hippocrates employed food to assist his patients in healing their physical ailments. With all our high tech medical approaches and complex pharmaceutical agents, it is amazing how much we have forgotten that simple approach!

After years of applying nutritional solutions to the myriad faces of heart disease—high blood pressure levels; chronic hypertension; high triglycerides; elevated L(p)a; angina; and heart attack and stroke—Dr. Sinatra has finally answered his patients’ many requests for a book that they can have as a reference at home. His research and personal experiences with his family, friends, and cardiac patients has continually impressed my husband that Hippocrates was so right on—and provided the foundation for this effort.     

Dr. Sinatra has collaborated with former pro athlete and health editor Jim Healthy, as well as recipe queen Rebecca Bent to write Bottom Line’s The Healing Kitchen. The Healing Kitchen is a strategic resource for making healthy grocery selections and healing meal planning guidelines, as well as specific recipes to assist you in selecting the right healthy foods to meet your specific health and fitness needs.

Subscribers to Heart, Health, and Nutrition have been reading Dr. Sinatra’s take on which foods, herbs, and supplements can help with their cardiovascular problems (not to mention cancer and other diseases caused by inflammation) for many years. Now all that information and more is the basis for this one reference to help guide you to foods that can heal your body.

For instance, the omega 3 essential fatty acids—especially those found in squid and fish oils—assuage cardiac arrhythmia, lower blood pressure levels, reduce LDL cholesterol levels, and even prevent plaque rupture.

Garlic is a potent blood thinner and, like onions which are rich in quercetin, helps you prevent the oxidation of LDL cholesterol. Garlic and onions are both superb foods for lowering blood pressure levels. And, speaking of hypertension, Dr. Sinatra also recommends sardines and wakame seaweed as natural blood pressure lowering foods.

And that’s just the beginning! Did you know that the right diet can help alleviate your migraines headaches, or that non-inflammatory foods can heal your arthritis?

Foods can also protect women from menopausal symptoms, as well as heal and protect us from cancer. The lutein in tomatoes along with pumpkin seeds and other fine herbs and spices can help men with their prostate concerns. From heart disease and diabetes to sleep and sex, The Healing Kitchen will educate you about natural, tasty remedies for many of the illnesses that afflict the 20th century. 

If you are looking to use simple, healthy foods, herbs and spices to get your body back on track, and keep it there, you will love this book!

For more information on healthy heart nutrition or some of Dr. Sinatra’s famous recipes, visit his Web site at www.drsinatra.com.

I worry about the fact that so many women still think that cardiovascular problems, like heart disease and stroke, is primarily a problem for men. The truth is that heart disease is a major health risk for women, but many physicians did not realize this until recently, so they’ve done little to encourage their female patients to take steps to protect their heart health.

I also worry because much of our knowledge about heart disease describes how the condition affects men. This leads many physicians, including some holistic practitioners, to diagnose and treat women as if heart disease affected them the same way. Nothing could be further from the truth. Heart disease affects men and women very differently and I’ve written about that here in this in newsletter articles, books, and here in this blog.

For example, if a 45-year-old woman and a 45-year-old man both come into the emergency room with chest pain, most physicians will probably admit the man and tell the woman her symptoms are due to stress and anxiety. Not many physicians realize that the incidence of coronary events among women quadruples as they reach middle age.

What You Can Do About It

I want you to understand that much of this, in both women and men, is related to lifestyle and the choices you make.

• Choose to seek natural ways to lower blood pressure if that’s a problem for you.
• Choose to adhere to good cardiovascular nutrition, which may include increasing the amount of fresh vegetables you consume and lowering the amount of breads and other starches you eat each day.
• Choose to do what you need to do to maintain good cholesterol levels, improve blood circulation, and healthy triglycerides.
• Choose to exercise so that you can more easily prevent blood clots and maintain a healthy weight.

In short, while it may be difficult at the start, choose to live a healthy lifestyle.  Choose life.

For more information on women and cardiovascular problems or tips for good cardiovascular nutrition, visit Dr. Sinatra's Web site.

The dangers of excess refined carbohydrate and sugar consumption are downright endemic in our society. Sugar causes a myriad of health concerns from obesity and diabetes to high blood pressure levels and cardiovascular problems. Excess sugar is even a major culprit in anxiety, depression, fatigue, and pain.

As Dr. Sinatra has warned in lectures, books, newsletters, e-letters, and blogs, elevated blood sugar stokes inflammatory processes that fuel disease. In fact, his concern for the overconsumption of sugar is what led Dr. Sinatra co-author Sugar Shock in 2006 with Connie Bennett.

Dr. Sinatra also recommends Beat Sugar Addiction NOW! (Fair Winds Press, March 2010), the newest book from one of Dr Sinatra’s “top docs,” Jacob Teitelbaum, MD.  In the book, Dr. Teitelbaum reveals four types of sugar habits and their hidden causes. “Understanding your sugar addiction type, you can take steps to beat it and in the same stroke improve your overall health,” says Dr Teitelbaum. “Knowing the type of sugar addict you are also helps to solve many other chronic medical problems.”

By understanding your metabolic makeup, you are more likely to succeed in kicking your sugar habit. See if you recognize yourself as one the types Dr. Teitelbaum describes:

• Type 1. Sugar addiction driven by fatigue. This is characterized by being hooked on so-called “energy drinks,” which are in reality energy loan sharks.
• Type 2. Sugar addiction driven by adrenal exhaustion. This is when your body's stress handlers (the adrenal glands) are exhausted by the stresses of modern life. It is characterized by intermittent feelings of “feed me now or I'll kill you!”
• Type 3. Sugar addiction driven by yeast/Candida overgrowth. In addition to fatigue and sugar cravings, this is often associated with digestive problems (irritable bowel syndrome/spastic colon) and chronic nasal congestion or sinusitis.
• Type 4. Sugar addiction driven by depression and anxiety caused by hormonal shifts. These include PMS, perimenopause and menopause in women, and andropause (testosterone deficiency) in men.

The best part of his down-to-earth approach is that Dr. Teitelbaum doesn’t give you some insurmountable goals to achieve. He doesn’t wasn’t you to obsess about it! Rather, he shows you how to simply make sugar your dessert, instead of the main course!

For a good chuckle, and an introduction to the four sugar addiction types defined in the book, check out the animation promo on YouTube.

And for more information on proper nutrition or other health concerns, visit Dr. Sinatra's Web site.

C-reactive protein (CRP) is a marker for inflammation that is directly associated with atherosclerotic plaque.

It’s a blood protein that, when found in elevated levels, may indicate risk of heart attack and stroke.  Multiple studies have identified CRP as a potent predictor of future cardiovascular problems—and one that is far more reliable than elevated cholesterol levels.

Biological characteristics that are associated with high CRP levels include trauma, infections, high blood sugar, excess weight, and hypercoagulability of blood (sticky blood). Any one of these situations literally feeds pro-inflammatory mediators, ratcheting up the chances that you’ll develop atherosclerosis.

If you currently have cardiovascular problems or you’ve had trauma or an infection that could cause inflammation, you should have your CRP levels tested. Just make sure your doctor or holistic health practitioner requests the high sensitivity test (hs-CRP). This test doesn’t take much time; typically, blood is drawn from a vein located either on the forearm or from inside your elbow. The blood is then analyzed in several tests to determine the level of CRP present.

For more information on heart risk factors and cardiovascular problems, visit Dr. Sinatra's Web site.

The leading causes of high blood pressure levels include stress, genetics, being overweight, a high-sugar diet, heavy metal toxicity, and lack of exercise. 

This blog is loaded with posts that can help you manage all of these.  And once you have them under control, you’ll be well on your way to avoiding a host of cardiovascular problems, including heart attack and stroke.

Obviously, it’s better to prevent high blood pressure levels than to treat them.  That’s why I work so hard to educate my readers.  I want you all to know that there are natural ways to lower blood pressure, including:

• reducing stress,
• losing weight  (you can get great tips for doing this here),
• controlling your sugar intake, and
• exercising more.

You also want to adhere to good cardiovascular nutrition and following my PAMM diet makes that easy.  You’ll never go hungry, but will enjoy delicious foods filled with the nutrients you need to maintain good health.

For more information on blood pressure levels and healthy blood pressure, visit Dr. Sinatra's Web site.

If you’re unaware of your blood pressure levels, you put yourself at great risk.  That’s because uncontrolled high blood pressure (or hypertension) is a leading risk factor for heart disease and stroke.

Often, there are no symptoms to alert you of the need to better control high blood pressure, which is why hypertension is called the “silent killer.” You may not know you have it unless you have your blood pressure levels checked regularly.

Your blood pressure levels reflect how hard your heart has to work to pump adequate blood through your arteries. Each contraction of your heart pumps out a wave of oxygen-rich blood that causes the flexible arterial walls to expand. After the wave passes, the walls deflate. The intensity of this sequence is your blood pressure.

The first number is your systolic reading (the pressure of the blood against arterial walls at the wave’s peak), and the second number is the diastolic reading (the pressure when the wave passes).

Years ago, we thought a reading of 140/88 was the upper limit of normal. These days, a reading that high is unacceptable. Research shows that you want your systolic pressure to be in the 120s and your diastolic pressure to be in the high 70s or low 80s.

For more information on blood pressure levels or healthy blood pressure, visit Dr. Sinatra's Web site.

Coronary artery disease (CAD) is by far the most common cardiovascular problem.

You may have heard of the term atherosclerosis, which refers to the buildup of plaque in the blood vessels. Essentially, coronary artery disease is a form of atherosclerosis that affects the arteries leading to the heart. As plaque in the coronary arteries builds up and blockages grow, the level of oxygen and nutrients provided to the heart decreases, limiting the heart’s effectiveness. Should an artery become blocked completely—due to plaque buildup or the inability of a clot to pass through the narrowed opening—a heart attack results.

Informing a patient that he or she has coronary artery disease is never pleasant for me. But what the patient says to me in the next few minutes can make all the difference in that individual’s course of recovery. In over 35 years of practice, I have found that the single most important question that can come from a patient is: “Dr. Sinatra, what can I do to help myself?”

I tell them that, in almost every case, coronary artery disease is a story about an unhealthy lifestyle. I probably don’t have to remind you traditional heart risk factors can predispose you to it, including:

• cigarette smoking,
• high blood pressure levels,
• diabetes,
• physical inactivity,
• obesity,
• unhealthy cholesterol levels, and
• emotional stress.

Research has clearly demonstrated that the more heart risk factors you have, the greater your chances of developing serious coronary artery disease.

I challenge my patients, as I’m challenging you now, to become proactive and do what it takes to reduce your heart risk factors and take control of your health. You must realize that all of the advice, medicine, and technology in the world won’t help you if you continue to abuse your body and live an unhealthy lifestyle.

For more information on coronary artery disease or other cardiovascular problems, visit www.drsinatra.com.

As you may know, there’s an email that periodically floats around the Internet regarding what is supposedly an easy test for whether someone is having a stroke. And I often have concerned patients come into my office and ask, “Dr. Sinatra, is there any truth to it?”

Well, I checked it out, and I’m happy to report the information there is correct. Hopefully you never need to apply it, but in case you do, the simplicity of it can perhaps make a difference in saving someone’s life or minimizing their symptoms.

Note the key words in each of these first three steps. Smile. Talk. Raise. The words start with the first three letters of the word stroke: s, t, r.

• Step No. 1: Ask the individual to smile.
• Step No. 2: Ask the person to talk. Try a simple sentence, like “it’s rainy (or cloudy or sunny) outside.” Look for coherence in how the person speaks.
• Step No. 3: Ask the person to raise both arms.
• Step No. 4: Ask the person to stick out his or her tongue. A “crooked” tongue that curves outward to one side or the other is another easy-to-recognize indication of a stroke.

If the person has trouble with ANY ONE of these tasks, then seek immediate medical attention.

Again, my hope is that you’ll never need to apply this.  I hope you’re adhering to good cardiovascular nutrition, exercising daily, and trying to maintain healthy blood pressure levels.  Doing this will go a long way toward helping you to avoid a stroke, as well as other cardiovascular problems.

For more information on strokes or other cardiovascular problems, visit www.drsinatra.com.

I love summertime dining, farm stand meals, and harvesting my own crops from my container garden. (This week, I even cut and zip locked our own fresh basil, oregano, mint, and chives to take on vacation with us!)

But, I was recently perusing a friends gardening eLetter when I came across an important tip. If you reside in an older home that was ever painted with lead paint—even if those painted wood, shingles, trim, stucco, brick, or what-have-you was covered over with some kind of siding—never plant any edibles in beds next to the house. That means never plant fruit, veggies, herbs, or fruit-bearing trees in the soil near the house known—or suspected—to have been painted with lead-based paint.

Lead can leach out of weathered paint and remain in the soil for a long time. The lead is then absorbed by the plants, which is very dangerous.  We should be especially aware of this exposure for pregnant women and children.  Of course, all of us must avoid lead contamination!

When I shared this info with Dr. Sinatra, he was reminded of a famous French vineyard that was planted close to a highway. Leaded gas fumes penetrated the soils, and the wine was contaminated with lead when it was tested.

In the cardiology world, higher levels of lead in the body are associated with high blood pressure levels and an increased risk for heart attack in men. Excess lead in the body can cause also renal failure, and for our children, behavioral problems and more.

So, if you have an older home that may have been painted with a lead-based product, just don’t take any chances. Plant colorful flowers and shrubs for display close to the house, but nothing that could end up on your plate and/or in your body.

For more great information on cardiovascular nutrition or ways to lower blood pressure levels, visit Dr. Sinatra's Web site.

The following eight tips can help you improve blood circulation and even reduce your risk of stroke:

• Address any lifestyle-related or heart risk factors you have with your doctor.
• Follow a good cardiovascular nutrition eating program, such as the PAMM diet.
• Take 1–3 grams of fish oil daily.
• For women over 65, take 100 mg of aspirin (equivalent to 1.25 baby aspirin) a day. (Beware of stomach bleeding, though, which is always a possibility with long-term aspirin use.)
• Drink 1 to 3 cups of green tea and 2 ounces of pomegranate juice daily.
• Take a 500–1,000 mg garlic supplement or eat one crushed clove daily. (Avoid this tip if you’re taking Coumadin.)
• Be aware of your high inflammation marker scores: CRP, homocysteine, fibrinogen, and Lp(a).
• Maintain good cholesterol levels, including an HDL less than 40.

Following these tips will minimizes your chances of having a stroke and will also help to keep other cardiovascular problems at bay. For more information on stroke, heart risk factors, cardiovascular problems and overall heart health, visit www.drsinatra.com.

I’ll never forget a patient I treated a few years ago who was living with chronic hypertension.  One Easter Sunday, he ate his fill of canned ham (packed with salt) and found himself in the hospital emergency room the next day.  He was in a hypertensive crisis and suffering with acute heart failure. His heart just couldn’t handle the large amount of salt he had consumed.

His was an extraordinary situation, but it underscores the need to be careful with salt intake. So please let his story be a lesson to you.   And please share it with family and friends who may be dealing with cardiovascular problems.

Here are some things you need to know about salt consumption:

• Your body requires sodium (a component of salt) to regulate fluid balance and distribution, as well as nerve and muscle cell function. Although you need some sodium, the standard diet includes way too much.
• “Salt sensitivity” is a key factor in determining the response to dietary salt intake. Cardiovascular problems, including heart attack and stroke, are more common in “salt sensitive” patients than in “salt resistant” ones.
• The current recommendation for salt consumption is less than 2,400 mg of sodium a day, which amounts to about one teaspoon of salt. Recent research suggests that people ingesting less than 1,500 mg of sodium a day are better able to control high blood pressure. If you have high blood pressure, you should definitely aim for that kind of level. Don’t use salt from the shaker, and read labels to add up the amount you’re taking in.
• Many items at fast food restaurants are high in salt, so you can easily exceed the recommended level with one serving.
• You can easily make up for the reduced salt in your diet by cooking with fresh herbs and spices such as basil, garlic, oregano, rosemary, chives, parsley, and onion. What’s more, all of these flavorings contain natural substances that are good for your health. Garlic, in particular, has been shown to have a positive effect on blood pressure when consumed on a daily basis.
• Beware of cutting your salt consumption too much. You need a minimum amount of sodium in your system to maintain proper electrolyte balance, regardless of your blood pressure status. For that reason, don’t let your daily salt intake fall below about 500 mg.

Managing your salt intake is just one of the natural ways to lower blood pressure that are highlighted here. For even more information on reducing hypertension visit www.drsinatra.com. While there, sign up for FREE e-letters or subscribe to Dr. Sinatra’s monthly newsletter, Heart, Health & Nutrition.

Uncontrolled blood pressure levels (or hypertension) are a leading risk factor for heart attack and stroke. Often, there are no symptoms, which is why hypertension is called the “silent killer.” You may not know you have it unless you have your blood pressure checked regularly.

Your blood pressure reflects how hard your heart has to work to pump adequate blood through your arteries. Each contraction of your heart pumps out a wave of oxygen-rich blood that causes the flexible arterial walls to expand. After the wave passes, the walls deflate. The intensity of this sequence is your blood pressure. The first number is your systolic reading (the pressure of the blood against arterial walls at the wave’s peak), and the second number is the diastolic reading (the pressure when the wave passes).

Years ago, we thought a reading of 140/88 was the upper limit of normal. These days, a reading that high is unacceptable. Research shows that you want your systolic pressure to be in the 120s and your diastolic pressure to be in the high 70s or low 80s.

Unfortunately, our arteries become more rigid and calcified as we age, making it harder to attain these optimum blood pressure levels. Think of your arteries as rivers full of twists and turns. Just as the force of rushing high water can eat away at the bank of a river, high blood pressure has a potentially damaging effect on the inner layer of the arterial wall. The arteries are especially vulnerable where they bend or form branches.

The leading causes of high blood pressure include stress, genetics, being overweight, a high-sugar diet, heavy metal toxicity, and lack of exercise. Stress-related hormones, for instance, cause the peripheral vessels to constrict. This forces the heart to pump harder in order to move blood through the narrowed channels, and leads to more pressure at the bends.

Obviously, it’s better to prevent hypertension than to have to treat it. For more information on natural ways to lower blood pressure, visit www.drsinatra.com. While there, sign up for FREE e-letters or subscribe to Dr. Sinatra’s monthly newsletter, Heart, Health & Nutrition.

Many of you have probably been hearing and reading about the ongoing Avandia controversy. Anyone with diabetes—especially those who taking this drug that’s been designed to keep blood sugar at bay—have reason to be concerned. Those of you who subscribe to my newsletter have gotten my take on Avandia, as well as alternative solutions to treat diabetes, over the years.

But the drug is back in the news this week, so let’s update you all on the subject. After years of discussion regarding the safety of the drug, our FDA is poised to decide the fate of Avandia, and it looks like there are three possible outcomes: they will demand even more warnings on the Avandia label; only specific MDs will be allowed to prescribe it; or it will be taken off the market.

When folks ask me what I think, my answer is that as long as there is any whiff of danger—and there is question about an increased risk for both heart attack and heart failure in those taking Avandia—then the potential risks out-trump the benefits. It’s just a no-brainer. Why put yourself in harm’s way if there is even a slight doubt?

My Recommendation

If you have mild diabetes, are 20 to 30 pounds overweight, and your MD wants to put you on an oral hypoglycemic, you should know about intriguing research I mentioned in my Heart, Health & Nutrition newsletter.

In a stellar study published in the prestigious New England Journal of Medicine, researchers compared people taking Metformin—a oral hypoglycemic mainstay preferred by many MDs—with a group of folks who made serious shows lifestyle changes.  The lifestylers exercised, follow a sound low glycemic diet, and lost weight. AND they lifestylers had a more significant reduction in their blood sugar levels than the people taking Metformin!

For those of you who do need to rely on medication to control your diabetes, talk with your physician about using a pharmaceutical with a tried and true track record like Metformin, and start making the lifestyle changes (i.e. low glycemic diet, increased exercise, etc.), so that you can eventually lose weight and possibly take a lower dose, or even wean off the drug. 

Lp(a) cholesterol has been of great interest to many of you, and we’ve had many comments posted on the topic. I’d like to take the opportunity to answer a sound question from a concerned mom, because it is exemplary of what folks often ask us in the office that all of you can benefit from it.

Like many of you looking at the results of your cholesterol profiles, she reports that she is not sure what constitutes an alarming abnormal Lp(a) value. In her 50-year-old daughter’s case, the blood work read as follows:

• Total Cholesterol:  173
• HDL:   74
• LDL:   87
• LDL cholesterol-C:  90
• Lp(a) : 12

In this particular case, there is no family history of cardiovascular disease, and the lipid panel results were within normal limits.

As with other blood level parameters, there may be some variation in normal ranges for Lp(a) as reported by different labs. I have seen some labs where up to 30 was within the normal range for the equipment and reagents they use. Our concerned mom reports that, for her daughter’s lab, anything over 10 is out of the normal range; hence her concern.

Her question is a good one. In the absence of any family history of cardiovascular problems and good cholesterol levels, how much should one be concerned about slightly elevated Lp(a)?

In this particular case, Dr. Sinatra and I would like to reassure her not worry about this finding. First of all, her daughter’s Lp(a) is only elevated two points (or  20 percent above the limit). Secondly, her high HDL “good” cholesterol levels of 74  (HDL > 60 for a woman,  and > 45 for men is considered desirable) is a very protective component. And, thirdly, there is no family or personal history of heart disease.
 
When do we get concerned? Dr. Sinatra takes action when he sees Lp(a) levels that are twice the normal limit (he sees some that are even four times higher or more!). In those cases, he recommends fish oil (a total of 2 grams/day in divided doses) and nattokinase (50 mg twice daily).

Even if your Lp(a) levels are normal, borderline, or even slightly elevated and you want to be more aggressive in your preventive medicine efforts, then just be sure that omega 3s are part of your daily vitamin and mineral plan. About one to two grams of a high quality fish oil—or squid oil—should do the trick.

Lp(a) may still be a new blood component to know about for many of you. Be sure to watch for an upcoming newsletter article on the seriousness of this risk factor. For other tips on healthy cholesterol levels, visit Dr. Sinatra's Web site. While there, don't forget to sign up for his FREE eLetters!