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April 1, 2009 > Helpful Advice for the Not-So-Young at Heart

Helpful Advice for the Not-So-Young at Heart

Unlike the fictional character Benjamin Button, the rest of us start aging the day we're born. It's easy to note the outer signs of aging just by looking in the mirror - a new wrinkle here, a new gray hair there, a little less muscle tone everywhere. Annoying as those outer signs may be, the more important aspects of aging take place inside the body, including your cardiovascular system.

"As you age, there are cumulative changes to the body's small blood vessels that over time can lead to heart disease and strokes," says Washington Hospital cardiologist Dr. Jeffrey Carlson. "That's why doctors always urge their patients to pay attention to the well-known risk factors for cardiovascular disease such as family history, high blood pressure, high cholesterol, diabetes, obesity, physical inactivity and smoking. It all boils down to their impact on the flexibility of the small blood vessels."

In addition to those "traditional" risk factors, cardiologists are now learning more about other factors that play a role in the health of small blood vessels.

"We're starting to refer to some of the effects of aging as 'continuity diseases,' because it's a continuous process that progresses from the blood vessels to other parts of the body, including the heart, lungs, kidneys and other organs," Carlson explains. "One example is 'endothelial dysfunction.' The endothelial cells in the lining of small blood vessels produce a chemical called nitric oxide that helps keep the arteries flexible. As we age, those cells produce less nitric oxide, so the blood vessels become more rigid and constrict the flow of blood throughout the body. Things start rolling downhill from there."

One clear sign of aging in the blood vessels is a changing pattern in your blood pressure. "When we're younger, our blood pressure is lower in the morning and higher in the afternoon and evening," Carlson says. "As we get older, the pattern shifts, and blood pressure is higher in the morning and lower in the evening. That's why, in general, when someone has a heart attack, it happens in the morning."

Fortunately, according to Carlson, it is possible to slow the effects of aging and - in some cases - reverse them.

"It's really a matter of choice," he says. "You can choose to do nothing about your risk factors and let the process continue, or you can choose to take steps to slow or stop the process. You really can lower your blood pressure. You can lower your cholesterol. You can deal with insulin resistance and diabetes. You can protect the endothelial cells in the blood vessels with a diet that is rich in foods such as green leafy vegetables, the Omega-3 fatty acids found in fish oil, and Vitamin D."

To help people learn more about the effects of aging on the heart and cardiovascular system and how to take charge of your risk factors, Dr. Carlson and Washington Hospital registered clinical dietitian Lorie Roffelsen, R.D. will conduct a Health & Wellness seminar on Tuesday, April 7, from 1 to 3 p.m. The seminar will be held in the Conrad E. Anderson, M.D. Auditorium, Rooms A & B, in the Washington West Building located at 2500 Mowry Avenue in Fremont.

"Your diet can make a big difference in the health of your heart as you age," Roffelsen says. "In general, we recommend the Dietary Approaches to Stop Hypertension (DASH) diet developed by the National Institutes of Health. Among other suggestions, the DASH diet calls for eating several servings a day of fruits, vegetables and whole grains. These fresh foods provide calcium, magnesium and potassium, which play an important role in managing blood pressure.

"The DASH diet also calls for limited amounts of foods from animal sources, including milk, eggs and meat, since they are high in saturated fats," she adds. "The American Heart Association recommends eating fish twice a week for the benefits derived from Omega-3 fatty acids and because fish is much lower in saturated fat than red meat."

Roffelsen offers a number of additional recommendations for a heart-healthy diet, including:
* Keeping your total intake of dietary cholesterol below 300 milligrams a day for most people. People with other risk factors, such as a family history of high cholesterol, may need to limit their dietary cholesterol intake to less than 200 milligrams a day.
* Eating a diet that is high in fiber from food sources such as whole grains like wheat, oats, barley and flax.
* Reducing the amount of sodium in your diet to less than 2.4 grams a day, which is equal to about one teaspoon of table salt.
* Limiting your consumption of alcohol, since alcoholic drinks are high in calories and can raise your blood pressure.
* Avoiding packaged foods and meals from fast-food restaurants or other restaurants that serve fried foods. While some restaurants have switched to trans-fat-free cooking oils, fried foods are still high in calories.

At the seminar, Roffelsen will offer practical tips for choosing and preparing heart-healthy foods including a sample one-day menu that meets the American Heart Association dietary guidelines, advice on reading ingredient labels and suggestions for cutting down on the fat and cholesterol in traditional recipes.

Carlson notes that medications may sometimes be necessary to control your risk factors for cardiovascular disease. "Medications certainly can play an important role, but there are no 'instant fixes,' and just throwing pills at the problem is not the whole solution," he says. "When people understand the issues, they are more likely to be involved in their own care. For example, I have had excellent results with some of my older patients, helping them gradually get off medications by working on changes in their exercise patterns and their diets, including the use of Vitamin D and fish oil supplements.

"The process requires patience because it takes a long time - it may be six months before you see the positive effects," he adds. "People can create their own 'insurance program' by making positive lifestyle changes, though. We have actually measured the changes in thickness of the arteries with ultrasound screenings. If we can help people realize what is at stake and keep them engaged in their own health care, this generation can live well into their 90s."

For more information about the Health & Wellness seminar, or to register to attend, please call (800) 963-7070.

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