Prevent Blood Clots

• 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.

1. Niacin:  Take up to a total daily dose of 1 gram (1 gram=1,000 mg) taken in one or two doses. Start at a dose of 125mg, then double it as tolerated, up to the full amount.
2. Fish or squid oil: Take 2 grams daily of a good quality fish or squid oil (but not krill oil).
3. Nattokinase: 50 mg daily.
4. Bolouke: Boluoke contains the enzyme lumbrokinase, which has been shown to assist with the breakdown of fibrin, a protein involved in blood clotting. It is a Canadian product and can be purchased online. This is the only measure I know of that may actually lower your Lp(a). Take as directed.
5. Delta tocotrienol: Take 100–200 mg of this natural form of vitamin E once a day.
6. Get grounded! Remember, heart disease—like diabetes, cancer, and a host of autoimmune problems—is a disease caused by inflammation. In the case of heart disease, it’s the arterial walls that get inflamed. Once they puff up from inflammation and all kinds of debris that accumulate in the arterial walls, they then get clogged, especially if you have a tendency to clot. Grounding can help to reduce inflammation, and help avoid cardiovascular problems and prevent blood clots.

• Because of its small dense properties, Lp(a) has been shown to contribute to atherosclerosis;
• Your Lp(a) level is often hereditary, with DNA determinants;
• Lp(a) is thought to have something to do with coagulation and clot formation;
• It can help with wound healing because of its ability to turn on inflammatory reactions; and
• At high levels, it can promote excessive inflammation.

• small—it can easily sneak in and permeate the cell wall and wreak havoc;
• dense— like a stone that sinks to the bottom, it can pile up on the walls of your blood vessels; and
• highly inflammatory—it is a provocative little monster.

While exercising, I urge you to learn to listen to your body. Is the exercise you’re doing causing pain? Tight muscles? Does it hurt your posture? Is it affecting your sleep? Is it disturbing your breathing, digestion, vision, or other functions not normally associated with fitness?

If you experience any of the following symptoms, stop immediately.

• Lightheadedness or dizziness
• Palpitations
• Shortness of breath (unable to carry on a conversation)
• Jaw pain
• Arm tingling or numbness
• Tight feeling in the lungs (bronchospasm)

If you have cardiovascular problems or you’ve recently experienced a virus or urinary infection that could cause inflammation, have your doctor check your C-reactive protein (CRP) levels. CRP can be detected when there is inflammation resulting from trauma or infection (including pneumonia, herpes, chlamydia, and possibly even a viral infection that simulates a cold). A simple blood test is as accurate as cholesterol and homocysteine screening in predicting a person’s risk of heart attack and stroke.

Once you have this test done, what should you do?

Some researchers believe you should take antibiotics to inhibit inflammation. I feel that more research is needed on anti-inflammatories before we begin foisting antibiotics on patients. Research shows that estrogen therapy is associated with favorable lipid and oxidation levels, which also seem to assuage inflammation. But if you’re not postmenopausal and want to lower your protein, your best natural approach to combat CRP is to take immune-boosting supplements. My top recommendations are:

• CoQ10 is one of the best nutrients available for promoting the immune system. Take 100–200 mg daily or 2–4 softgels.
• Beta glucan, a yeast-based nutrient, scavenges for free radicals. There is no toxicity or side effects with this nutrient. Take 10–20 mg daily for one month on, one week off, for three months' duration.
• Bromelain. This enzyme from the pineapple plant reduces inflammation and acts as an antibiotic. Take 100–500 mg daily. Note: Allergic reactions, although rare, can occur.
• Ginger root/ginger tea. Ginger promotes an anti-inflammatory response and is a great substitute for aspirin, which many people can’t tolerate.
• Fish oil helps prevent blood clots and combats inflammation. I recommend 1–2 g daily.
• Exercise.
• Lose weight. CRP loves fat cells. Lose weight and you lose inflammation as well. (For great weight loss ideas, see my healthy heart nutrition tips found here in other blog entries.)  For more information on healthy heart nutrition, visit www.drsinatra.com.
   

Grape juice, like red wine, can help prevent blood clots and improve blood circulation.  Resveratrol, commonly found in grapes and other plants, is being studied for its antioxidant properties and its ability to minimize cardiovascular problems.  The “Dr. Sinatra recommended dosage” of Resveratrol is 2–5 mg daily.

Secondly, drinking flavonoid-rich green tea is an easy way to avoid cardiovascular problems and encourage resistance against chronic degenerative diseases, including chronic hypertension, heart attack and stroke.

While plain green tea itself has a delicate flavor, try it in one of the many formulas combining it with lemongrass and other herbs. Add a little honey and lemon, and I think you will find that this healthy heart nutrition tip really is quite delicious. If you can break your coffee habit in the process, you’ll be doubly rewarded, as you’ll also be reducing the amount of caffeine you ingest.

For more information on improving blood circulation, visit www.drsinatra.com.

• Age 55 or older
• Heredity/family history
• Men
• History of heart attack and/or stroke
• Medical conditions such as diabetes, high blood pressure levels, vascular disease, atrial fibrillation, and sickle cell anemia
• Drug/alcohol abuse
• Poor diet
• Sedentary lifestyle
• Living in the southeast US (“stroke belt”)
• Low socioeconomic status

Many people trying to prevent blood clots are taking the blood thinner, Coumadin. But…

There’s something about Coumadin and its cousins that elicits an “anything-but-that-Doc” response from about half the folks who are on it. Many of my patients have asked to discontinue Coumadin because, in addition to the side effects and fear of bleeding, they dislike the nature of the drug (it’s rat poison in high quantities), as well as the discomfort and inconvenience of blood tests every 4–6 weeks.

In fact, whenever I lecture, someone in the audience always asks: “Is there some alternative to Coumadin?” So, let’s review anticoagulants like Coumadin and try and allay some of your concerns.

Before I discuss alternatives to Coumadin, let me tell you why this is the most frequently prescribed anticoagulant. In a nutshell, Coumadin has an unparalleled ability to thin the blood and prevent blood clots. More specifically, studies have shown that Coumadin can protect you from a stroke if you have:

• Mechanical heart valves (their surfaces encourage blood platelets to stick to them).
• Suffered an embolic stroke, one of three types of stroke caused by a fragment or clot of blood pumped from the heart to the brain.
• Atrial fibrillation (AF), where atria fail to contract; blood forms pools and becomes sluggish.
• Had an extensive heart attack (scar tissue weakens heart muscle tissue, which in turn weakens contraction of the left ventricle, possibly allowing blood to stagnate and clot).
• Like any drug, Coumadin has side effects. Although the major one is excessive bleeding (bleeding gums, eye hemorrhages, blood in the urine and even a few bleeds in the brain), other rare reactions include weakness, cold sensations, itchy skin, fever and abdominal discomfort.

Indeed, blood thinning is a double-edged sword. While anticoagulants help prevent thrombotic and embolic strokes, I have to bear in mind that the risk of a stroke-induced hemorrhage is higher for those on Coumadin.

So now you can see why people trying to prevent blood clots struggle with this popular anticoagulant and often ask to trade it in for aspirin or other blood-thinning alternatives.

How Yolan Chose To Prevent Blood Clots

Yolan, 78, suffered with cardiovascular problems and, consequently, had a heart attack a few years ago. She began taking Coumadin but reported that she just didn’t feel right. Yolan experienced several unusual body sensations, which she attributed to the drug.

Against her doctor’s wishes, Yolan went off Coumadin and her symptoms abated. She now takes 324 mg of aspirin every other day (more about aspirin in a moment) and says she feels much better.

I’ve gotta tell you, folks, the decision to go off Coumadin can be a very difficult one; patients and their doctors often struggle together for the right answer. So let me offer some guidelines to help make this decision easier for you.

Coumadin is your best therapy—mandatory even—to prevent blood clots if you have mechanical heart valves. Studies show that it’s more effective than aspirin with other anti-platelet drugs. It should also be your first choice if you’ve suffered an embolic stroke.

Coumadin has been shown to protect patients with left ventricular clots and from AF, which can cause thrombotic strokes. Now, if you have AF, a common cardiac condition—you may wonder if you can take aspirin instead of Coumadin. If you have AF, your best bet is still Coumadin. If you’re not on conventional blood thinners like Coumadin, your risk of stroke is at least 5–6 times greater than those who are. This in itself is a disaster! In fact, approximately 75,000 strokes a year are attributed to AF.

Remember, with AF, the upper chambers of the heart may fail to empty completely, creating a perfect breeding ground for blood clots and poor blood circulation. As clots are formed and pumped out from the heart, they can wander around in the bloodstream until they find a vessel too small to get through and then you can have a major log jam in the brain, the leg, the kidney, in fact, anywhere at all. But the carotid artery is the number one spot to worry about because it’s a direct shot to the brain as the blood is pumped out of the left ventricle.

At least 90 percent of my AF patients take Coumadin; the other 10 percent take aspirin. But aspirin is less effective for preventing clots and strokes, particularly in women and people over 75. The best advice I can give anyone with more than two episodes of AF a year is to take Coumadin. If you have fewer episodes of AF and no other health problems like diabetes, congestive heart failure, leaking heart valves, or an enlarged heart, aspirin is a second choice.

For more information on how to prevent blood clots, visit www.drsinatra.com.
 

I receive lots of questions about a variety of heart conditions. And one of the most common I receive is about arrhythmias. Specifically, I am often asked how to determine if, in fact, you have an arrhythmia.

One of the first things you need to do is see a cardiologist so they can determine a baseline electrocardiogram (EKG) and do a Holter monitor evaluation. These are very basic, noninvasive tests that your insurance will pay for. Your arrhythmia may show up on the EKG, but your doctor will still want to assess how often it’s happening with the Holter monitor.

For the Holter, you will have a few (4) adhesive electrode pads placed on your chest.  Wires attached to those electrodes will be connected to a recorder box that you can wear on your belt (or in a sling if you prefer). You will be asked to keep a diary of your activity and your symptoms for the next 24 hours, including any awareness you have of skipped or fast heartbeats. You should also track and document your blood pressure levels.

The recording is then analyzed by advanced computers that show pictures of your heart’s rhythm so that your doctor can see what kind of arrhythmia you have. Fast heartbeats for long time periods can occur with what we medically refer to as atrial fibrillation (AF) and supraventricular tachycardias (SVTs: supraventricular identifies the source of the problem in the conduction system; tachy=fast, cardia = heart).

In the event that there is no arrhythmia during your EKG and you fail to experience any symptoms during the 24 hours of monitoring, you can use an event monitor for a month—a Holter-type device you connect to when your symptoms arise.

Once your doctor identifies the type of arrhythmia you have, he or she can look for underlying causes that need to be addressed, including enlargement of the upper chambers of the heart, aging, valve issues, and more. Should you have frequent episodes of AF, you may need to prevent blood clots that can form if your upper chambers are not pumping effectively during times of arrhythmia. 

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

Last week was a sad one for the entertainment world. We lost actress Farrah Fawcett, singer Michael Jackson, and pitchman Billy Mays. Fawcett found peace after her anguishing battle with cancer, and Jackson’s cause of death is yet to be determined. But it looks as if Mays most likely fell victim to hypertensive heart disease.

This condition encompasses a number of cardiovascular problems that result from long-standing high blood pressure. Initial autopsy findings showed that Mays had an enlarged left ventricle, an oversized heart weighing more than 500 grams, and plaque buildup in one of his coronary arteries. All are classic side effects of chronic hypertension.

It has not been stated whether Mays knew he had a cardiac problem, or if he was taking steps to address it. But this fact is undeniable: His death is a tragic yet valuable reminder of how important it is to control high blood pressure. Simple changes to your diet, exercise regimen, nutritional supplementation, and stress reduction techniques can often do the trick. They cost very little, don’t require prescription drugs, and are the best way I know to prevent heart attack and cardiovascular disease.

After decades of experience with sudden cardiac death (SCD)—and remember, the grim truth is that 50 percent of the time SCD is the first sign of cardiovascular problems—I would be remiss if I did not also mention that emotional stress may have been a factor. Mays was onboard the U.S. Airways flight that blew out its front tires upon landing in Tampa the day before his death. There have been several firsthand accounts of the terror passengers experienced when this happened. Many understandably feared for their lives.

For someone with chronic hypertension and underlying atherosclerosis, this would have been a dangerous situation. Psychological stress can cause sudden spikes in blood pressure. As blood pressure rises, the amount of "shear force" that blood exerts against arterial walls increases—sometimes to a point where it can disturb areas of plaque buildup and even potentially cleave them off. This in turn can lead to clots, heart attacks, and strokes. I've written about many of my personal experiences with stress-related SCD in my book Heartbreak and Heart Disease.

It is for the families surviving SDC to mindfully put the puzzle pieces together and try to understand what happened to their loved one. But the take-home message for you is that none of us can afford to be casual about high blood pressure.

Take control of yours today.

For more information on lowering your blood pressure naturally and preventing a heart attack, visit www.drsinatra.com. 
 

Recently I’ve been sharing some natural ways to lower blood pressure. It’s all part of my four-week challenge to tackle this problem—which affects up to one in three Americans according to CDC estimates.

If you’re just joining us, let me bring you up to speed. For each of the past two weeks, I’ve asked you to make changes in a part of your life that has been linked to healthy blood pressure. In Week 1, we focused on the impact that food choices can have. In Week 2, I asked you to work up a sweat by adopting a regular exercise routine—an excellent way to not only control high blood pressure, but minimize other heart risk factors as well.

This week I want to talk about nutritional supplements. There are a number of them out there that can be of help, and I’ve seen them work wonders in patients. As you review the options I’ve provided, please be mindful of the fact that you don’t have to take all of them to realize benefits. In fact, I would probably suggest that you start by taking one or two at a time until you find the combination that works best for you.

Keep in mind, too, that supplements won’t necessarily have an immediate effect like a drug can. It may take a while for enough of each nutrient to have maximum effect—so be sure to stick with them for more than just a few days. Many large clinical trials have confirmed the safety and efficacy of this approach.

Here are my recommendations:

CoQ10. This nutrient is a gem when it comes to cardiovascular problems and managing heart risk factors. You probably know it as an essential ingredient for cellular energy production, but it’s also a potent antioxidant. This ability to limit oxidative stress reduces inflammation and enhances blood flow. CoQ10 is one of the supplements that takes a little while to work—about four weeks—but studies have shown that people who stick with it can lower blood pressure by up to 15 systolic points and 10 diastolic points. Take 100–225 mg daily in divided doses.

Magnesium. This mineral is another one of my favorite blood pressure remedies. Magnesium has a direct impact on the ability of arteries to expand and contract, and deficiencies can cause arteries to spasm and constrict—potentially blocking blood flow altogether. To control high blood pressure, take 500–1,000 mg of magnesium daily.

Nattokinase. This supplement helps prevent abnormal thickening of the blood, which is an often overlooked cause of high blood pressure. I’ve seen nattokinase lower blood pressure by 10–20 systolic points and 5–10 diastolic points. Start with 50 mg a day and increase the dose to 100 mg after a week. (Note: If you’re taking any kind of blood thinning drug, such as Coumadin, you should not use nattokinase. The combination could cause your blood to become too thin.)

Fish oil. The omega-3 fats in fish oil have also been shown to also reduce blood viscosity. Take 2–3 grams daily.

B-complex vitamins. Supplementing with these nutrients is helpful on two fronts. First, it helps replace the B vitamins lost in your urine if you’re taking a diuretic to control your blood pressure (all B vitamins are water soluble). Second, specific members of the B-complex family, such as vitamin B6, have antihypertensive effects. Folic acid is also helpful, particularly for women. You should always take B vitamins as a complex, either in a stand-alone product or as part of a high-quality multivitamin. Just be sure that your formula includes at least 100 mg of B6 and 800 mcg of folic acid.

Vitamin C. Not only is vitamin C essential for building and maintaining healthy blood vessels, it’s also a potent supporter of the body’s antioxidant system. It’s especially important for increasing levels of glutathione, a free-radical scavenger. Both of these effects support healthy blood pressure. Take 1,000 mg daily.

L-arginine. This amino acid is the main ingredient that your blood vessels need to make nitric acid, a substance that helps keep them properly dilated. Eating foods or taking supplements that provide 4–10 grams daily has helped lower blood pressure by 6 systolic points and up to 7 diastolic points. Foods rich in L-arginine include peanuts, walnuts, brazil nuts, soy, coconut, diary, meat, and seafood.

Quercetin. Like nattokinase, quercetin—which is found naturally in onions—helps break down blood clots and keep blood flowing. In one study, people with high blood pressure who took 730 mg of quercetin daily for a month experienced a drop of 7 systolic points and 5 diastolic points.

Again, good luck. Be sure to check back next week for my final instructions, which will focus on how to solve a constant problem these days—stress. In the meantime, let me know how things are working for you!

For more information on lowering your blood pressure, visit www.drsinatra.com. 

Earlier this week, research came out saying that anger and other strong emotions can trigger potentially deadly heart rhythms and cardiac arrest. It was another piece of health "news" that's hardly new--I've been seeing this very thing in patients for 30 years--but I'm still glad that this important connection is getting a little bump in media coverage.

The relationship between the mind and body is grossly overlooked in conventional medicine, and we would all benefit from being more mindful about its impact on our well-being. Just as emotions can help us heal, they can also harm us. And when it comes to our hearts, they are exceptionally powerful.

Early in my career, I noticed a common behavior pattern in many acute heart attack patients. They had the typical hard-driving, overachieving Type A personality that was quick to anger. This observation ultimately motivated me to study psychotherapy, and it didn't take long for me to realize that anger is the Achilles' heel of the cardiovascular system. When you become angry, your blood vessels constrict and your blood pressure rises as your body is flooded with stress hormones. The electrical currents to your heart become unstable. And if you have arterial plaque, anger is like throwing a match into a can of gasoline. The plaque can rupture, and the resulting clots can kill you.

With all of my patients, I talk about the standard heart risk factors and the importance of maintaining healthy blood pressure, homocysteine, C-reactive protein, Lp(a), and insuling sensitivity, and, when appropriate, we discuss reducing cholesterol. But I also talk to them about their emotions, particularly how they were feeling just before an angina episode or heart attack. Many have told me that they had an outbreak of anger before the event. One patient, an attorney, had his new car scratched with a key from one end to the other by a teenager. When he first saw the damage, the man got so angry that he had a heart attack on the spot.

Obviously, there's no way to avoid anger or stress--they are as much a part of life as breathing. But I do want to encourage you to think about how you react to frustration, pressure, and other types of adversity. Then, the next time you feel yourself losing control, ask yourself this very simple question: Is this worth dying for?

This is a question I learned from Dr. Robert Eliot, a fellow cardiologist who wrote a book by the same title. Dr. Eliot suffered a heart attack at age 44 and realized that the cause was stress. He also realized he would die if he didn't change his attitude toward life. He did--and so should we.

It's important to remember that even though we all get angry, we have a choice about how to express those feelings. We can go into a potentially fatal fit of rage, or we can defuse the anger and go back to the situation later on and deal with it after the emotional charge has passed.

If you have a difficult time controlling your anger, please seek the advice of a trusted friend, clergyman, or therapist. This may be a sign of long-term repressed anger, which can also lead to cardiovascular problems such as high blood pressure, atherosclerosis, and increased risk of heart attakc and stroke. 

For more information on heart risk factors and how to prevent them, visit www.drsinatra.com. 

• Decreases triglycerides
• Reduces arterial wall inflammation
• Makes blood less sticky and less likely to form clots
• Stabilizes plaque and prevents plaque rupture
• Soothes and nurtures heart rate variability, actions that counteract arrhythmias
• Contributes to the bioenergy of the heart muscle

There is new scientific evidence to support your desire to listen to your favorite music every day...

Yes, Dr. Michael Miller, director of preventive cardiology at the University of Maryland Medical Center in Baltimore, Maryland studied the effect of music on your heart and presented his findings at a recent meeting of the American Heart Association.

His research found that when people listen to music they like, their blood vessels dilate much as they do when laughing, exercising, or even when taking prescribed medications. 

This is great news because, as you may know, when your blood vessels dilate, they open up to allow your blood to flow more smoothly.  When your blood is allowed to flow smoothly, its less likely clot and you're at a much lower risk of having a heart attack, stroke, or other cardiovascular problems.    

While this is not reason enough to stop taking your medications (please don't do that), it is "music to the ears" of a cardiologist and holistic health practitioner like me because it provides scientific evidence of yet another natural way to reduce your risk of cardiovascular problems. 

For years I’ve been telling my patients suffering with high blood pressure to listen to music and the results have been quite successful. 

Many of them choose to listen to classical scores like Brandenburg Concerto and compositions of Maurice Ravel and Mahler Gustav and some have commented that they don’t really know why they’re drawn to these pieces.  Research suggests that this attraction is because those songs have a beat that’s in the 60 to 140 range, which is a cadence similar to that of a heart beat and is, therefore, quite soothing to the listener.

It’s also interesting to note that we’re often drawn to the type of music we heard while in our mother’s womb, as it brings back pleasant memories.

I've written extensively about the effects of music and how it can help you prevent heart attack and stroke in my printed newsletter, Heart, Health&Nutrition.  I firmly believe that a half hour each day spent listening to your favorite tunes is not only relaxing, but also reduces heart risk factors and is good for your overall health.  To read more about avoiding heart risk factors, visit www.drsinatra.com.