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sleep-women

Sleep and CVD: What Can Midlife Women Do?

/1 July 2024/ All MFN blog/

It was the scorching summer of ’96 when I received a call that rocked my world—my 60 year old mother had suffered a stroke. This powerful woman’s life changed forever. Years later, my brother, a firefighter whose sleep was frequently interrupted by alarms, tragically lost his life to a heart attack. These personal stories illustrate the profound effects of sleep on heart health, particularly for midlife women.

The Hard-Hitting Stats: Focused on Midlife Women

Let’s dive into the statistics that underscore the importance of this issue specifically for midlife women:

  • Stroke Alert: 20% of midlife women will encounter a stroke by the age of 55. This statistic is drawn from the National Stroke Association, highlighting the elevated risk for this demographic.
  • Death by Stroke: Women account for 57% of stroke deaths, a significant gender disparity in stroke mortality rates reported by the American Heart Association.
  • Race and Risk: Black midlife women face disproportionately higher mortality rates from strokes, pointing to an urgent need for targeted health interventions, as noted by the National Institutes of Health.
  • Heart Disease Dominance: Over 60 million women, many in their middle years, live with heart disease, the leading cause of death for women, outpacing all cancers combined. These figures are supported by data from the Centers for Disease Control and Prevention (CDC).

Research Revelations: The SWAN Study by Rebecca Thurston, PhD

Dr. Rebecca Thurston’s research utilized the Study of Women’s Health Across the Nation (SWAN), a multi-decade study initiated in 1996. Focusing on 2,517 women whose sleep patterns were monitored through midlife for 22 years, the study involved 16 different interviews where participants self-reported their sleep habits. Here’s what they found:

  • Long-term Insomnia Risks: Women with persistent insomnia throughout midlife have a 70% increased risk of developing cardiovascular diseases, revealing the critical impact of sleep quality on heart health.
  • Impact of Sleep Quality: Those with persistent insomnia and short sleep exhibited a 75% increased risk of cardiovascular issues, emphasizing the importance of both sleep quantity and quality.

What Can Midlife Women Do?

So, what actionable steps can midlife women take to mitigate these risks? Here are some effective strategies:

  • CBT-I for Better Sleep: Cognitive Behavioral Therapy for Insomnia (CBT-I) helps develop healthy, drug-free sleep patterns and is endorsed by numerous sleep studies and health organizations as an effective treatment for insomnia.
  • CPAP for Sleep Apnea: For those disrupted by sleep apnea, using a CPAP machine can significantly improve sleep quality.
  • Lifestyle Tweaks: Engaging in morning exercises and avoiding blue light exposure from electronic devices in the evenings can greatly enhance sleep quality and overall heart health.

This isn’t just about discussing sleep; it’s about taking actionable steps to improve heart health for midlife women. By transforming personal loss into proactive health strategies, we aim to advance this conversation together and ensure every moment is lived to its fullest.

Ren Jones is your guide through the health maze, specialized in nutrition, fitness and menopause, dedicated to improving the lives of midlife women since 2014. You can catch more insights on his podcast, “This Podcast Has No Name,” (Apple and Spotify) where he delves deep into these vital health topics.

senior-man-and-trainer-treadmill

Coaching Hardiness of Heart: Buffers vs. Band-Aids

/26 January 2024/ All MFN blog/

Like a leaky roof, do we just patch the hole, and hope for the best?  Or do we replace and restore it, and do the maintenance to optimize it, despite extreme weather conditions?  In ski-speak, we joke about variable conditions, never predictable.  In life, it’s the same thing.  Are we prepped and ready for the curveballs and Murphy-strikes that WILL come our way?  Do we have an ample buffer, a reserve capacity to pull from?  Can we bounce back, repeatedly, take hits and remain solid?  Hardy folks can and do!   Think of a hardy person you know.  What keeps them surviving, and thriving?     

Today, it is well-accepted that cardiovascular disease (CVD), the leading cause of death in the U.S., is rooted in inflammation, insulin-resistance, oxidative stress (rusting), hormonal imbalances and exposure to toxins.  We also know that a lousy diet, long-term micro-nutrient deficiencies, physical INactivity, chronic DIStress, and various toxins, raise cholesterol and blood pressure exacerbating an inflammatory response in our arterial endothelium. Remember that half of the people who experience heart attacks do NOT suffer from hypercholesterolemia. To quote Mark Hyman, M.D., Founder, Cleveland Clinic Center for Functional Medicine, “CVD is not about cholesterol; it is about inflammation in a cholesterol environment.”    

So, when 45 year old 2-stent Charlie, husband, father of three, small business owner, with a passion for hunting and fishing comes to me, I need Whole-Charlie coaching.  A Hardiness model fills the bill.

Hardiness Coaching is designed to fortify FIVE structural pillars: 1) Movement, 2) Diet, 3) Rest-Recovery-Regeneration, 4) Stress Resistance and, 5) Purpose-Relevance-Meaning. The Pillars are grounded in a foundation of DAILY habits, patterns and practices, not programs with a start and end date. They are interconnected, and the robustness of one supports the others; if one crumbles, the others bear the brunt. By repairing cracks and leaks within a given pillar, we boost overall resilience, durability, and robustness, not just the CV issue at heart (no pun intended). Hey, what’s good for the heart, is good for the brain is good for the gut is good for the immune system is… 

Our clients come to us with the desire to move better, feel better and get back to living life, even surpassing it, despite their issues. Their current health does NOT define them, nor does their age. It’s our responsibility to meet them where they’re at, know where they have been [for decades], and get them where they want to go. Keeping their hopes and dreams alive is paramount.

As Hippocrates so eloquently stated, “Know the person who has the disease, not just the disease that has the person.” 

So, when we hear ‘cardiac or cardiovascular’, think beyond the heart and vasculature for transport and waste removal. Think integration with the lymph and respiratory systems, and their role in running a well-oiled machine, one where the other six systems [gut microbiome, immune/inflammatory, energy production (mitochondria), waste disposal – detoxification, communication (neurotransmitters, hormones), structural (cells, tissues, organs) synergistically thrive. This is a Functional Medicine model. Check it out. 

Clinical psychologists, physical therapists or medical doctors, we are not. But, we impact lives in a multitude of ways, some measured by hard data, and others, by those intangibles like confidence and joy. Yes, we work within the physical realm, but when we take the integrated pillar approach to coaching Hardiness, we sync and link the pillars, buttressing them to exponentially resist and adapt better to the stresses and strains of life. Buttresses, NOT band-aids! 

Coaching MUST transfer to performing and feeling better, at home, in labor, care-giving, recreation and even competition. For example, with regards to the movement pillar, there are three realms:  1) physical activity, as in walking, stairs, labor and chores, 2) recreation, as in sport, dance, all-seasons GO on snow, ice, sand or water, and 3) TRAINING, exercising with purpose. ALL contribute to the robustness of our movement pillar. Training is only one piece of the movement pie, so yes to targeted training, AND to more movement in labor, hobbies and play.  

When training any adult, there are 7S Buckets that may need to be restored and refilled. The 7th Bucket is Specificity and Specifics. Specificity refers to “we get what we train for; we keep what we do!” Specifics are those things unique to our client; in this case, those CV conditions that propelled the client in our direction in the first place. It may have been a primary care Doc, a referral from cardiac rehab or simply the client’s grit to BE better. Whatever, we are here to fortify all their pillars of hardiness.

Don’t get me wrong. We must know CVD pathologies, physiology, metrics and measurement, and network with relevant healthcare professionals. But more importantly, we must customize and personalize coaching to provide the springboard for Charlie to thrive, as a husband, father, business owner and outdoorsman, to optimize his health-span, and his zest for living life to his fullest.

So, from pacemakers, stents, meds and more, to risk factors, co-morbidities, MSK challenges and all else in store, we practitioners are here to reboot, rebuild, coach, train and restore.  

Specialization for Fit Pros

Join Pat VanGalen in the online course, Cardiac REHAB Fitness Specialist. Learn the nuts and bolts of coaching hardiness within the cardiovascular system. Evidence-based facts, figures, updates AND case studies will tweak your coaching.  Integrate, don’t isolate!

Patricia ‘Pat’ VanGalen, M.S. brings a unique blend of education, practical experience, common sense application, science and research to her lecturing, teaching, training and coaching. She launched her professional career 40+ years ago in physical education and coaching, then spent the next 10 years in corporate-industrial fitness, health promotion, cardiac rehab and injury risk reduction programming design, implementation and management. Visit her website, activeandagile.com

Prescription for good health diet and exercise flat lay overhead with copyspace.

Sam: A Case Study

/22 September 2023/ All MFN blog/

Question from Sam, age 84: Hi Pat! Sam, here. I appreciate your ‘real people’ common sense approach to this aging thing. Your 7S Buckets resonated with me, and I would like to report that I am doing my darndest to keep them ALL full and robust.

Senior man in a gym talking to personal trainer

Where to Begin When You Are Working Out With a Health Condition

/11 September 2023/ All MFN blog/

The gym can be a confusing place especially for individuals with health concerns. Many times, these clients are trying to navigate their workouts by themselves because they are unsure of the appropriate questions that they need to ask.

First of all, there are two different types of trainers. There are trainers who have a four year degree and certifications. These trainers are sometimes called Fitness Specialists and have had many hours of study related to a wide variety of diseases and injuries. They are used to modifying exercises and programs based on any specific condition you may have. Fitness Specialists are usually found in a medically based fitness facility affiliated with a hospital. Please note that some Fitness Specialists will specialize in a certain area. Some work with individuals with diseases and disabilities and some don’t. You can search the free MedFit Network directory to find a fitness pro in your area. In their MFN profile, you’ll find information about their condition-specific education and services.

When you finally narrow down who you might like to hire you will want to ask some questions. Please don’t be afraid to ask these questions as they will help you to decide which trainer is right for you. It is also recommended that you observe Fitness Specialists training clients.

First you want to make sure that the trainer has had experience with your condition. If not, they should be willing to research it and or speak with your doctor with your permission. There are exercise guidelines that all Fitness Specialists should follow when working with clients who have health conditions.

You will also want to ask about the trainers background. It is alright to ask about education, certifications, and years of experience. You also want to hire someone who is patient with you. This is extremely important as you figure out which exercises work best for your body. I would also like to add that you need to be patient with yourself as well. Try to relax and enjoy your training session.

Asking the questions from above help to keep you feeling confident. Exercise can seem frustrating in the beginning but you have to keep a positive mindset. In the beginning, set small goals and do the best you can during each training session.

Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

Massage-Therapy-Senior-Client

I have heart disease. Is massage right for me?

/5 August 2022/ All MFN blog/

According to the Heart Foundation.org about 80 million Americans have heart disease or high blood pressure. The 2010 Heart Disease and Stroke Statistics update of the American Heart Association reported that 17.6 million persons in the United States have heart disease, including 8.5 million with a history of heart attack and 10.2 million with chest pain. The prevalence of heart disease increases with age for both women and men.

Heart disease requires a variety of possible treatments, including various medications and procedures. Some people with heart disease may benefit from regular massage, but there are certain types of massage that can possibly cause serious damage. You need to be sure you’re in a knowledgeable practitioner’s hands to make sure you are safe.

Can Massage Help?

A hypothetical example:

Alex is a 59-year old tax preparer who has moderately High Blood Pressure that is easily controlled with a healthy lifestyle and medications. He is married, enjoys golfing, shooting, and watching football. As Alex’s work becomes busier during tax season, he gets headaches that are frequent and intense.  And when he works too much, he doesn’t have time to take care of himself like he should.

Alex’s doctor recommended that massage could help compliment his treatment plan to stabilize his blood pressure. His doctor referred him to a therapist who is experienced in working with cardiovascular patients. The doctor and therapist agreed that a relaxation massage with some trigger point and stretch techniques mixed in would be safe and beneficial for him.

After a few massage sessions, his headaches decreased. The doctor recommended a massage twice every month, but during busy season, Alex likes to go every week. The routine gives him peace of mind in knowing he’s doing everything he can to take good care of himself. For him, massage is a great antidote to the hours at his desk, and he finds himself less “grumpy” when he gets home after a hard day. When work is less busy, and Alex has more time for golf, he finds that massage gives him great relief for his low back tension, which helps his swing. Alex considers massage as part of his prescribed health routine, just like eating carefully and exercising.

What should you be careful of?

Because there are so many different types of cardiovascular conditions, there is no one-size-fits-all approach. The type of massage that you have seen on TV is not the only kind out there, and in fact, may not be right for you. Your complete health history must be considered before making a decision. You must always talk to your doctor before deciding to embark on a personal massage program:

Blood thinning drugs: Cause the body to be more sensitive and in some cases, even fragile. Deep tissue done on someone taking blood thinners can cause inflammation, bruising, and tissue or organ damage.  Like the wise man said, more is not always better.

High Blood Pressure (Hypertension): Massage may be just the thing to help you manage stress and subsequently your high blood pressure (just like the example above). Low blood pressure is also a concern, and because massage lowers one’s blood pressure slightly, it is not uncommon for individuals taking medication to lower their blood pressure.  This would cause them to get a bit lightheaded just after receiving a massage, until the blood pressure returns to normal.

Blood Clot: Individuals with a history of blood clots (aka Thrombosis) should avoid Swedish Massage. Swedish massage techniques on someone who has a risk of blood clotting could possibly dislodge a clot and release it into the blood stream. In a worst-case scenario, this can induce a stroke or heart attack, or a lung blockage.

Pacemaker: If an individual has a pacemaker, stent, or any kind of apparatus implanted into a vein/artery which is superficial (in the neck and leg would be considered superficial, but inside the rib cage is not), the therapist must avoid pressing over that area so as not to dislodge or damage it or surrounding tissues. But massage can usually be safely done on the rest of the body.

Massage can usually be great for someone who has Arrhythmia or a disruption in the heart rate, if that is the only health concern.

An individual with any signs of Congestive Heart Failure should avoid vigorous Swedish massage or limit Swedish massage to less than 15-20 minutes.  Gentle Massage on head, feet and hands is not a problem.

You must find a therapist who is experienced and knows how to keep you safe. If they don’t ask about your medications or medical history, you’re not in the right office. Interview them on the phone before you go, and check their credentials. You probably want to ask your doctor to consult with your therapist so they can discuss your options. You probably CAN have massage, but it may be different from what you imagined, or what you see on TV.

How do you choose a practitioner?

If you are seeing a cardiologist, you should definitely get medical clearance before you have a massage. You should also get guidance on what kind of massage is best, and what the risks are. You should call your therapist before your appointment to make sure they have a good understanding of what it takes to keep you safe and comfortable. Most Certified or Licensed massage therapists get instruction on working with individuals with heart disease as part of their entry level massage education. However, there are additional classes available, and each therapist has varying levels of awareness and experience. Don’t be afraid to ask questions about the therapist qualifications, and what they’re going to do during the massage. While you’re receiving massage, continue to ask questions as they come up. If at any time during the massage it feels worse than a “hurts good” sensation, then it’s too much, and you should speak up. Your therapist should never encourage you to suffer through anything you don’t like during a session.

Kathy Flippin’s passion is to offer excellent therapeutic massage, and educate her clients on how they can take the best care possible of themselves. Kathy is the owner of Dynamic Touch Massage and has been a Sports Massage Therapist since 1997. Her clients include everyone from professional athletes to active grandmothers.

veg in hand

Heart Disease is Preventable and Reversible through Nutritional Intervention

/22 July 2022/ All MFN blog/

Heart disease is devastating to both our health and our economy. It is the number one cause of death in the country. Cardiovascular disease (CVD) accounted for 32.1 percent of deaths in the United States in 2013 – one out of every three deaths is due to this preventable disease.1 A significant number of research studies have documented that heart disease is easily and almost completely preventable (and reversible) through a diet rich in plant produce and lower in processed foods and animal products.6-9

As the prevalence of CVD escalates, medical costs are rising rapidly. The American Heart Association has projected that by 2030, 40.5 percent of the US population will have some form of cardiovascular disease, and the direct medical costs attributed to cardiovascular diseases will triple compared to 2010 costs.2

Risk factors for heart disease are commonplace for U.S. adults:32.6 percent have hypertension, 13.1 percent have total cholesterol above 240 mg/dl,3 9.3 percent of U.S. adults have diabetes,4 and 68.5 percent of U.S. adults are overweight or obese.5 As a result, it has become considered normal in our society to have atherosclerosis, and to die from cardiovascular disease. If you eat the standard western diet that most people eat in the modern world, you will surely develop heart disease and may die from it.

Fighting heart disease: Superior nutrition versus drugs and surgery

In 2015, I published a scientific article in the American Journal of Lifestyle Medicine demonstrating, with survey data and case histories, the dramatic weight loss and cardiovascular benefits possible with a Nutritarian diet. Respondents who started out obese lost an average of over 50 pounds two years after the switch to a Nutritarian diet. After one year, in those who started out with hypertension, there was a 26 mm Hg average reduction in systolic blood pressure. In respondents who were not taking cholesterol-lowering medication, there was an average 42 mg/dl decrease in LDL cholesterol, and an average decrease in triglycerides of 79.5 mg/dl.10

The surgical interventions commonly used to treat heart disease, such as angioplasty and bypass surgery are futile. The COURAGE trial and additional studies conducted since have documented that patients undergoing those invasive procedures do not live longer or have fewer heart attacks compared to those receiving medical therapy  with modest lifestyle changes.11-12 Surgical interventions are not long-term solutions to heart disease; they merely treat a small portion of a blood vessel, while cardiovascular disease continues to progress throughout the vasculature.

Drugs that treat hypertension and elevated cholesterol carry serious risks and do not stop heart disease from progressing. Cholesterol-lowering statin drugs are known to increase the risk of diabetes, impaired muscle function, cataracts, liver dysfunction and kidney injury. 13 Each different class of blood pressure-lowering medications is associated with its own risks and side effects. ACE inhibitors commonly cause a persistent cough; diuretics are linked to increased risk of diabetes; beta blockers are associated with increased likelihood of stroke; calcium channel blockers may increase risk of heart attack and breast cancer; and ARBs are associated with increased risk of lung cancer.14-20

The risk associated with these treatments is unacceptable when there is a safe, effective alternative —smart nutrition and exercise – that can actually reverse heart disease and obliterate the need for risky and even futile medical care. Atherosclerotic plaque can be reversed, and cholesterol lowered without drugs or surgery.

Success stories (two of numerous)

Ronnie weighed over 300 pounds when he wound up needing emergency quadruple bypass surgery.  Three years later, he was back for an angioplasty and three stents, but his chest pain returned within one month of the surgery. Working with Dr. Fuhrman in the Ask the Doctor Community, Ronnie lost 140 pounds and went off all medications. He runs and plays sports and has served as an inspiration to family members who have also lost weight and begun to live healthier lives. Read his story.

Julia had three heart attacks within three months. After her fifth angioplasty, she still had constant chest pain. She was on 10 different daily medications, suffered migraines, and, at the age of 60, could not walk even one block. Today, Julia has lost 105 pounds, and now enjoys every day pleasures like exercise, gardening, and playing with her grandchildren. She went from a “cardiac cripple” to a healthy, happy woman. Read her story.

Like Ronnie and Julia, over the last 20 years hundreds of my other patients with advanced heart disease have demonstrated that dramatic reversal of advanced disease can even occur in a relatively short time.

Following the lenient recommendations of the American Heart Association and wearing a red dress pin do not form an effective strategy for protecting you or your loved ones against heart disease. Also, drugs and surgery do not cure heart disease. A health-promoting, nutrient-dense (Nutritarian) diet, that I have designed and advanced over the years (coupled with exercise) is dramatically effective and protective for preventing and reversing  high blood pressure, high cholesterol and diabetes — as well as heart disease — because it removes the primary dietary cause of heart disease, while providing the most protective and life-span promoting diet-style. For more information, check out my book, The End of Heart Disease.

Everyone needs to know that heart disease can be avoided; and those who already have heart disease deserve to know that they can reverse their disease. Conventional medical care does NOT protect against heart disease-related death. Only a Nutritarian diet can offer dramatic lifespan-enhancing benefits against both cardiovascular disease and cancer.

Originally printed on DrFuhrman.com. Reprinted with permission.

Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient-dense, plant-rich eating style.

References

  1.  Xu J, Murphy SL, Kochanek KD, et al: Deaths: Final Data for 2013. Natl Vital Stat Rep 2016;64:1-119.
  2. Heidenreich PA, Trogdon JG, Khavjou OA, et al: Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement From the American Heart Association. Circulation 2011.
  3. Mozaffarian D, Benjamin EJ, Go AS, et al: Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016;133:e38-e360.
  4. American Diabetes Association: Diabetes statistics [http://www.diabetes.org/diabetes-basics/statistics/]
  5. Ogden CL, Carroll MD, Kit BK, et al: Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-814.
  6. Ornish D, Brown SE, Scherwitz LW, et al: Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133.
  7. Ornish D, Scherwitz LW, Billings JH, et al: Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998;280:2001-2007.
  8. Esselstyn CB, Jr.: Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol 1999;84:339-341, A338.
  9. Esselstyn CB, Jr., Ellis SG, Medendorp SV, et al: A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. J Fam Pract 1995;41:560-568.
  10. Fuhrman J, Singer M: Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
  11. Boden WE, O’Rourke RA, Teo KK, et al: Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503-1516.
  12. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, et al: Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet 2009;373:911-918.
  13. Hippisley-Cox J, Coupland C: Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010;340:c2197.
  14. Simon SR, Black HR, Moser M, et al: Cough and ACE inhibitors. Arch Intern Med 1992;152:1698-1700.
  15. Bangalore S, Messerli FH, Kostis JB, et al: Cardiovascular protection using beta-blockers: a critical review of the evidence. J Am Coll Cardiol 2007;50:563-572.
  16. Gupta AK, Dahlof B, Dobson J, et al: Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. Diabetes Care 2008;31:982-988.
  17. Wassertheil-Smoller S, Psaty B, Greenland P, et al: Association between cardiovascular outcomes and antihypertensive drug treatment in older women. JAMA 2004;292:2849-2859.
  18. Group PS, Devereaux PJ, Yang H, et al: Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008;371:1839-1847.
  19. Li CI, Daling JR, Tang MT, et al: Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years. JAMA Intern Med 2013.
  20. Sipahi I, Debanne SM, Rowland DY, et al: Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials. Lancet Oncol 2010;11:627-636.
Paper-Heart

Are You At Risk? The Link Between Autoimmune Disease & Heart Health

/17 June 2022/ All MFN blog/

Severe RA Doubles the Risk of Heart Disease1

In the last few decades, researchers discovered that the burden autoimmune diseases like rheumatoid arthritis (RA) puts on the joints during the first year of diagnosis is a strong predictor of heart disease.2 In fact, it is recommended that doctors who diagnose patients with RA should also be addressing potential heart risks.

There have been several new studies from the Mayo Clinic that show a strong connection between inflammation and heart health. Therefore, it is important to address both conditions at the same time.

Dr. Eric Matteson, chair of rheumatology at the Mayo Clinic, says that people with rheumatoid arthritis and other chronic inflammatory conditions are at a much higher risk of heart disease. In fact, people with severe RA are twice as likely to develop heart disease. Matteson believes that the inflammatory process of arthritis plays a key role in maintaining a healthy heart.

Therefore, if you have been diagnosed with an autoimmune disease such as rheumatoid arthritis, it is imperative that you meet with a cardiologist. Autoimmune diseases are known to not only affect the joints in your body by causing painful stiffness and inflammation, but also negatively affect major organs such as the heart.

One symptom that can develop from an autoimmune disease diagnosis such as RA is vasculitis, or inflammation of the blood vessels that move blood throughout the body. “As the blood vessels become inflamed, their walls thicken, limiting how much blood can pass through them. As a result, if blood flow is restricted, this could cause significant damage to tissues and organs.” 3

Because rheumatoid vasculitis (RV) is a non-joint-related inflammatory complication of RA, it can affect anyone.4 If you or a loved one have been suffering with RA for many years and developed severe joint damage and deformity, it is important to make an appointment to get your heart checked.

What causes vasculitis?

Researchers are not sure exactly what causes rheumatoid vasculitis. Like RA itself, most cases of RV can be considered autoimmune diseases. An autoimmune disorder occurs when the body’s immune system mistakenly attacks healthy tissues.

Several factors are thought to play a role in whether a person with RA will go on to develop RV, including whether you have:

  • Severe, long-standing RA for 10 or more years
  • Seropositive RA (a high concentration of rheumatoid factor antibodies and certain proteins in the blood)
  • A history of smoking cigarettes, which can damage the blood vessels’ lining
  • Felty syndrome, a complication of rheumatoid arthritis that results in low white blood cell levels and an enlarged spleen
  • Rheumatoid nodules, firm lumps under the skin that form around the joints

The Facts

According to the CDC:

  • One out of every four people in the United States dies from heart disease.
  • Heart disease is the leading cause of death for men, women and people of most racial and ethnic.
  • One person dies every 36 seconds in the United States from cardiovascular disease.
  • People with autoimmune diseases are at a much greater risk for heart disease.
  • Making lifestyle changes to your diet, exercise, sleep and stress greatly reduces risk.
  • In some cases, medicine reduces risk.5

Therefore, if you or a loved one suffer from an autoimmune disease, be sure to schedule an appointment with a trusted cardiologist for a check-up. The most important step you can take to reduce your risk for developing heart disease is taking action.

Christine M. Conti, M.Ed, BA is and international fitness educator and presenter. She currently sits on the MedFit Education Advisory Board and has been nominated to be the 2020 MedFit Network Professional of the Year. She is the author of the MedFit Classroom Arthritis Fitness Specialist Course and is the CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation. Christine is also the co-host of Two Fit Crazies & A Microphone Podcast and the co-owner of TFC Podcast Production Co.

References

  1. Krans, B. (2013, October 27). Mayo Clinic: Ra can drastically impact heart health. Healthline. Retrieved June 6, 2022, from https://www.healthline.com/health-news/arthritis-ra-raises-your-risk-of-heart-disease-102713
  2. Krans, B. (2013, October 27). Mayo Clinic: Ra can drastically impact heart health. Healthline. Retrieved June 6, 2022, from https://www.healthline.com/health-news/arthritis-ra-raises-your-risk-of-heart-disease-102713
  3. Menard, V., & Teitel, A. D. (2021, May 6). Vasculitis: The risks of ra inflammation. myRAteam. Retrieved June 6, 2022, from https://www.myrateam.com/resources/vasculitis-the-risks-of-ra-inflammation
  4. Menard, V., & Teitel, A. D. (2021, May 6). Vasculitis: The risks of ra inflammation. myRAteam. Retrieved June 6, 2022, from https://www.myrateam.com/resources/vasculitis-the-risks-of-ra-inflammation
  5. Centers for Disease Control and Prevention. (2022, February 7). Heart disease facts. Centers for Disease Control and Prevention. Retrieved June 6, 2022, from https://www.cdc.gov/heartdisease/facts.htm
senior-man-and-trainer-treadmill

Exercise and Cardiovascular Disease

/20 May 2022/ All MFN blog/

Regular exercise has a favorable effect on many of the established risk factors for cardiovascular disease. For example, exercise promotes weight reduction and can help reduce blood pressure. Exercise can reduce “bad” cholesterol levels in the blood (the low-density lipoprotein [LDL] level), as well as total cholesterol, and can raise the “good” cholesterol (the high-density lipoprotein level [HDL]). In diabetic patients, regular activity favorably affects the body’s ability to use insulin to control glucose levels in the blood. Although the effect of an exercise program on any single risk factor may generally be small, the effect of continued, moderate exercise on overall cardiovascular risk, when combined with other lifestyle modifications (such as proper nutrition, smoking cessation, and medication use), can be dramatic.

Benefits of Regular Exercise

  • Increase in aerobic capacity
  • Decrease in blood pressure at rest
  • Decrease in blood pressure while exercising
  • Reduction in weight and body fat
  • Reduction in total cholesterol
  • Reduction in LDL (bad) cholesterol
  • Increase in HDL (good) cholesterol
  • Increased insulin sensitivity (lower blood glucose)
  • Improved self-esteem

Physiological Effects of Exercise

There are a number of physiological benefits of exercise. Regular aerobic exercise causes improvements in muscular function and strength and improvement in the body’s ability to take in and use oxygen (maximal oxygen consumption or aerobic capacity). As one’s ability to transport and use oxygen improves, regular daily activities can be performed with less fatigue. This is particularly important for patients with cardiovascular disease, whose exercise capacity is typically lower than that of healthy individuals. There is also evidence that exercise training improves the capacity of the blood vessels to dilate in response to exercise or hormones, consistent with better vascular wall function and an improved ability to provide oxygen to the muscles during exercise. Studies measuring muscular strength and flexibility before and after exercise programs suggest that there are improvements in bone health and ability to perform daily activities, as well as a lower likelihood of developing back pain and of disability, particularly in older age groups.

Patients with newly diagnosed heart disease who participate in an exercise program report an earlier return to work and improvements in other measures of quality of life, such as more self-confidence, lower stress, and less anxiety. Importantly, by combining controlled studies, researchers have found that for heart attack patients who participated in a formal exercise program, the death rate is reduced by 20% to 25%. This is strong evidence in support of physical activity for patients with heart disease.

How Much Exercise is Enough?

Unfortunately, most Americans do not meet the minimum recommended guidelines for daily exercise. In 1996, the release of the Surgeon General’s Report on Physical Activity and Health provided a springboard for the largest government effort to date to promote physical activity among Americans. This redefined exercise as a key component to health promotion and disease prevention, and on the basis of this report, the Federal government mounted a multi-year educational campaign. The Surgeon General’s Report, a joint CDC/ACSM consensus statement, and a National Institutes of Health report agreed that the benefits mentioned above will generally occur by engaging in at least 30 minutes of modest activity on most, if not all, days of the week. Modest activity is defined as any activity that is similar in intensity to brisk walking at a rate of about 3 to 4 miles per hour.

These activities can include any other form of occupational or recreational activity that is dynamic in nature and of similar intensity, such as cycling, yard work, and swimming. This amount of exercise equates to approximately five to seven 30-minute sessions per week at an intensity equivalent to 3 to 6 METs (multiples of the resting metabolic rate*), or approximately 600 to 1200 calories expended per week.

How Can a Personal Trainer Help?

If you have cardiovascular disease or are at risk for developing disease, you may be apprehensive at starting an exercise program. You may have questions such as:

  • Is exercise safe for me?
  • How long should I exercise?
  • How frequently should I exercise?
  • Do I stretch before or after exercise?
  • Can I do strength training and lift weights?
  • How do I know if I’m exercising at the right intensity?
  •  What if I develop symptoms such as dizziness, light-headedness, or nausea?

A personal trainer or exercise professional can answer all of these questions for you and establish a well-rounded exercise program that is safe and effective.

A personal trainer will tell you what types of aerobic exercise are most appropriate for you and devise an exercise program tailored towards your needs. This will include guidelines for frequency (how many times per week), intensity (how hard you should exercise), and duration (how long each exercise session should last). A well-designed exercise routine will start with a warm-up that includes dynamic movements designed to raise the heart rate, increase core temperature, mobilize the major joints in the body, and prepare the body for more intense exercise. Warm-up can be followed by either aerobic exercise or weight training. Your trainer can monitor your heart rate and blood pressure during both activities to make sure you are exercising at the proper intensity. If heart rate and blood pressure get too high, your trainer will have you decrease the intensity of exercise or stop. If you develop any symptoms while exercising, your trainer will be right there to advise you and check your vital signs. Weight training is very safe as long as it is performed with proper supervision. Your trainer will recommend the most appropriate exercises for you to do and emphasize proper breathing and technique. Under the guidance of an exercise professional, you can help to improve aerobic capacity, decrease blood pressure and cholesterol, improve good cholesterol, lower blood glucose, improve muscular strength, increase joint range of motion, and lower weight and body fat. All of these will result in a lower risk for developing cardiovascular disease or if you already have disease, it will decrease the chances of subsequent cardiovascular events. Most importantly, working with an exercise professional will extend your lifespan and greatly improve the quality of your life.

Eric Lemkin is a certified personal trainer, strength & conditioning specialist, corrective exercise specialist and founder of Functionally Active Fitness. Lemkin has been a certified personal trainer for 17 years and has helped people ages 8-80 reach their fitness goals through customized personal training – specializing in exercise for the elderly or handicapped. 

References

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  • Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association . Circulation. 2012;125(1):e2–220.
  • Heron M. Deaths: Leading causes for 2008 [PDF-2.7M]. National vital statistics reports. 2012;60(6).
  • Heidenriech PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.
  • CDC. Million Hearts™: strategies to reduce the prevalence of leading cardiovascular disease risk factors. United States, 2011. MMWR 2011;60(36):1248–51.