Blog

As we’ve mentioned on numerous occasions, you can’t ignore your heart health throughout your life, then pop a pill and expect everything to be fine. Our concierge doctors in Jupiter regularly dispense the same proven recommendations for keeping your heart—and the rest of your body—in tip-top shape:

• don’t smoke
• reduce stress
• eat right
• exercise regularly
• maintain a healthy weight

These lifestyle habits are the best way to reduce inflammation throughout the body, and to prevent plaque buildup in your arteries.

That doesn’t mean, however, that there aren’t additional ways to benefit your cardiovascular health.

Background

Many factors can affect overall heart health, from genetics to lifestyle to environment. Medical science has been working diligently to address them, because about 610,000 Americans die annually from heart disease, which equates to 25 percent of all deaths in the U.S. It is the leading cause of death in the country for both men and women.

In addition to lifestyle changes, other proven methods for reducing the incidence of illness and mortality due to cardiovascular disease (CVD) include generic furosemide and reduction of high blood pressure, the use of blood thinners in those who have or are at risk for CVD, and the use of statins to control low-density lipoproteins (LDL, or so-called “bad” cholesterol).

Even with all these interventions, however, triglyceride levels can remain stubbornly elevated. Triglycerides are a type of fatty acids known as lipids. When you eat, calories you don’t need are converted to triglycerides and stored in fat cells for later use. If you typically consume more calories than your body needs, these triglycerides eventually begin to thicken the artery walls, leading to “hardening” of the arteries.

Thus, a high triglyceride level (above 200 milligrams per deciliter or 200 mg/dl) increases the risk of CVD.

New weapon

Last month a unanimous opinion by an advisory panel of the U.S. Food and Drug Administration (FDA) endorsed the use of a prescription-strength fish oil-based drug to treat these elevated triglyceride levels in those at high risk for CVD. This includes people ages 55 and older with diabetes who also have another risk factor for CVD.

The drug, called Vascepa, contains a purified form of the Omega-3 fatty acid found in fish. It was tested in a major study last year which found that it was successful in preventing fatal CVD-related events, including fatal heart attacks and strokes. We should mention one caveat, however: This study was sponsored by Amarin, the maker of the drug. Nevertheless, the FDA’s advisory panel found the study results compelling enough to recommend its use.

The FDA already allows the use of Vascepa for those who have extremely high triglyceride levels. Full FDA approval for the drug’s wider application is expected this month, at which point physicians may begin prescribing it for those who haven’t been able to sufficiently lower their triglyceride levels through other means. Amarin’s advertising on Vascepa notes that it would take between 10 and 40 over-the-counter (OTC) capsules to equal the same dose of fish oil concentrated in its daily dose.

Don’t try this at home

Does this mean you should dash to your local supermarket for a couple bottles of fish oil supplements? We would caution against it.

First of all, as we’ve mentioned previously, supplements are largely unregulated in the U.S. The FDA doesn’t test for purity or ingredients, is not required to approve supplements before they are marketed, and is only empowered to act if a particular supplement is shown to cause serious harm once it’s on the market.

Second, even if they contain the ingredients as labeled, supplements can still be dangerous. Some people who megadose with vitamin C, for example, even in the short term to fight colds, develop diarrhea. Hardly life-threatening, but definitely unpleasant.

Other megadoses can have more deadly consequences. Two different studies that involved supplements with beta carotene to help prevent lung cancer found that the substance, which the body converts to vitamin A, actually increased lung cancer rates. Other studies found a similar result with vitamin E supplements, which were shown to increase the rate of lung cancer among smokers. And studies researching the B vitamin niacin showed an increased risk of death with use of this supplement.

Another example was the SELECT study, which tracked 35,000 men for over a decade to see whether vitamin E and selenium supplements could prevent prostate cancer. The study was halted in 2008 when researchers found an increase in prostate cancer among participants, which they attributed to the vitamin E supplements, and a similar increase in the development of diabetes which they ascribed to the selenium supplements.

Finally, it’s always better to obtain nutrients through diet, because isolating a single component from, say, a mackerel, excludes the other micronutrients that are obtained simultaneously along with the whole food.

If you have questions about the best ways to maintain heart health, please let us know. We can help design the best approach for you.