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Heart Health Metabolic

Obesity and Cardiovascular Health

In my practice, I focus on obesity and cardiovascular health only when weight clinically affects heart health. Obesity, in isolation, if all else is optimized, offers only slight improvement if corrected.

Obesity has become a sociopolitical topic rather than a medical one. In my practice, I don’t focus too much on obesity unless it is a unique contributor to my client’s heart health.

Obesity in Healthcare

In western medicine, the patient is considered sick if their BMI is over 25. The patient will always have an ICD-10 code stuck somewhere in their medical chart.

It’s hard to know why conventional medicine manages patient health in such a way. Perhaps it expedites care and makes insurance billing simpler.

It is true that carrying extra weight puts most people at increased risk of insulin resistance, joint problems, sleep apnea, certain cancers, and other metabolic issues. But not everyone.

A person can be obese (BMI > 25) and relatively healthy. They manage their stress well, they are active, and their diet is optimized for their individual needs.

Vice versa, a person can have a normal BMI and not have an ideal metabolic profile. They can still have sleep apnea, hypertension, insulin resistance, and increased cancer risk.

Personal Perspective on Weight and Heart Health

I have clients who carry extra weight but live a good life. They have a diet that fits their individual needs, and they aren’t suffering in any significant way due to their weight.

For such individuals discussing obesity is clinically unnecessary. The minor percentage points of health advantages may not be worth the effort needed to change their weight.

If weight is an important topic, however, affecting their heart health, then we make that a priority. Think of sleep apnea or insulin resistance.

Obesity And Heart Health

I’ve worked with many heart health coaching clients and many of heart risk factors due to their lifestyles. Much more so than due to their body mass index.

We work together to improve their diet, stress, exercise, breathing, chemical exposures, and relationships that change their heart disease risk and improve their heart health.

If my client has the ideal diet, lifestyle, clean environment, sleep, and social support but remains overweight or obese, then we perform calculations to assess their ongoing risk.

This final risk score is how we determine if a weight reduction would add meaningful results; if it would improve this person’s heart health.

The Current Obesity Research

Look, all else equal, it’s potentially better to have a lower BMI – up to a point, of course.

However, we’re talking about an individual and not the population. The current research, just like most research, uses statistics to draw general conclusions. And it generally states a strong correlation between obesity and cardiovascular health.

General conclusions don’t define you and must be carefully applied to individuals. Otherwise, it’s easy to do a lot and not get results.

Most individuals who suffer from obesity also tend to have poor diets. They tend to be sedentary and, therefore, strongly correlate their weight and heart health.

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Diet Heart Health

Heart Rate and Alcohol Use

the resting heart rate and heart rate variability are affected by alcohol consumption

For most individuals, using alcohol will have a negative or neutral effect on their cardiovascular health. The popular belief that alcohol is good for the heart isn’t something we see in clinical practice. It’s not to say that you should stop drinking. Those who are at risk of heart disease should reconsider their alcohol use. Heart rate and alcohol are closely tied, and we know that alcohol decreases heart rate variability.

Heart Rate

The sympathetic and parasympathetic systems regulate the rate of the heart. The goal is to have a low resting heart rate with good heart rate variability (HRV).

For an in-depth discussion of heart-rate variability, I recommend this podcast episode by Dr. Attia. There, he discusses HRV in much more detail. But remember that just because your HRV isn’t optimal doesn’t mean you will suffer ill cardiovascular health.

Back to heart rate. If you are a tech nerd, you know that your heart rate changes whenever you drink alcohol. Commonly you’ll notice that it’ll be higher than usual and you’ll have decreased variability between beats – decreased HRV, which is less favorable.

Alcohol Use

Some of my clients binge drink, and others rarely drink. In this spectrum, there are those who drink moderately and those who drink several drinks per day.

It also matters the type of alcohol you drink, how dehydrated you get when drinking, and the quality of the beverage. So much to consider, no doubt.

I remain convinced that occasional alcohol use isn’t an issue. But binging on weekends or drinking daily is more challenging for the body to handle.

Resting Heart Rate

It’s hard to ignore my patients who enjoy excellent heart health and the association with their low resting heart rate.

Alcohol and resting heart rate have been studied in detail in the literature. Consuming alcohol regularly seems to increase the resting heart rate.

We work to decrease their consumption for my clients who are at risk of atrial fibrillation or heart failure. And for those who cannot cut down, we develop a strategy to consume alcohol in more ideal circumstances.

Cardiovascular Health

What is heart health or cardiovascular health? Well, it’s how well your heart and blood vessels function. And it depends on how well you want them to perform. Health, after all, is a personal journey.

When I consider my client’s heart health, I think of the following:

Heart health and alcohol are closely linked to HRV. Furthermore, the rhythm of the heart is closely tied to alcohol usage.

Specific individuals are far more susceptible to this, while others can drink alcohol without changing their cardiovascular health.

The best way to find out is to use devices like the Polar to determine your HRV and experiment with how late-night eating or alcohol impacts your values.

Timing Alcohol Usage

The time of day when you drink alcohol matters. Also, how hydrated you are and your stomach content are important factors.

Whenever possible, I recommend drinking alcohol with a meal and heavily hydrating after alcohol consumption. This helps with the clearance of this compound from the system.

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Heart Health Treatment

Cardiovascular Biofeedback

cardiovascular biofeedback for heart health

Biofeedback is time intensive and requires you to work with an expert to understand or “feel” your body better. It’s a potent tool that can improve the functional capacity of your heart or other cardiovascular symptoms.

Biofeedback

I explain biofeedback to my patients as a method of interpreting and understanding the physiological functions of the body. It’s a method of becoming in tune with the body.

In the age of modern medicine, it’s a common false belief that only a heart rate monitor or EKG can tell us about the heart’s function. Though these are great tools, they also improve our sense of well-being regarding the cardiovascular system.

I use biofeedback in my private practice with low back pain patients. Especially for those who have an exaggerated pain sensation, musculoskeletal biofeedback can help them better overcome the pain.

Biomechanical Biofeedback

In this article, I don’t want to focus too much on the technical side of biofeedback. There are incredible tools, from virtual reality to implantable sensors. But let’s start with the basics because it’s the most achievable for most of us.

Biofeedback can be broken down into biomechanical and physiologic ones. In biomechanical feedback, I might measure how much range of motion someone achieves with their low back injury.

Sometimes biomechanical feedback utilizes technology to determine how much pelvic pressure someone can exert with their kegel exercises.

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Physiological Biofeedback

Physiological feedback might require some measurement techniques. Neuromuscular feedback may require EEG measurements or gait assessment.

I measure heart rate, respiratory rate, and even cardiac perfusion when providing cardiovascular biofeedback.

Cardiovascular Biofeedback

The common conditions I treat with heart biofeedback include the following:

  • hypertension
  • palpitations
  • shortness of breath
  • exercise capacity
  • chest pain

Individuals with a history of a heart attack want to get back into an exercise routine. Often angina gets in the way. The pain creates a cycle of fear and emotional dissonance, which worsens cardiovascular capacity.

I can show my client on a heart rate monitor what their heart is doing as they increase their activity level. We review this together and dive deep into what they are feeling in their chest, arms, back, etc.

Patient Empowerment

It’s one thing to diagnose a patient using advanced technology, and it’s another to empower a person to manage their own body. Biofeedback methods can empower a person to self-regulate their physiologic processes.

The goal is to work on a particular medical condition or symptoms afflict you. A feedback expert will sit with you and help you recognize signals in the body which you can manipulate to achieve the desired outcomes.

This is powerful in that you can do this yourself moving forward. For most heart-related issues you need a heart rate monitor and an oxygen monitor.

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Heart Health Hypertension

The Basics of Hypertension

An overview of high blood pressure should get you on the same page as your doctor. Managing this condition is a team approach and needs to happen slowly.

Pharmacologic Treatment

If you treat your hypertension, you will manage it through lifestyle means or by taking prescription medications. You might also try herbal treatments, of which there are a few good options out there—more on that in another article.

There are reversible causes that are addressed before assuming the diagnosis is essential hypertension, aka idiopathic hypertension.

Treatments for hypertension decrease the pressure exerted on the heart and the vascular system. Some medications work by removing the amount of water in the vascular system (diuretics); others decrease the tightness of the vessels (vascular dilators). Some medications also reduce the output from the heart (beta-blockers).

The downside to medications is that they have side effects and need to be monitored. There is also no way to know which medication will work immediately for you.

The other downside to managing hypertension with pharmacology alone is that we don’t focus on the underlying causes which led to hypertension in the first place. For some, it’s an aging heart. For others, it’s genetic, yet it’s an issue with vascular resistance.

Lifestyle Treatment

Lifestyle management of hypertension would include focused activity for the individual. It’ll need to be cardiovascular training; for others, it’s resistance training.

Dietary treatments, such as salt and alcohol intake, can also make a difference, but not for everyone. When going down the diet, you must be okay with a trial and error factor. 

I prefer lifestyle treatment options because it puts the individual at the helm. One learns a lot about their body when experimenting with their lifestyle to see how their health is affected. 

I will add meditation and breathing and general stress and sleep management. These can be significant factors for some while minimally effective for others. 

Diseases Associated with Hypertension

We forget that continued high blood pressure can lead to various diseases, from heart failure to heart attacks and strokes. It can cause erectile dysfunction and kidney disease. And it can hasten dementia or other cognitive issues. 

It is also among the leading accuses of eye problems and circulation issues such as peripheral vascular disease. 

I mention all of these because treating a single condition such as hypertension can improve your health immensely. You get a significant return on effort investment. 

Diagnosing Hypertension

The easiest way to diagnose hypertension is to slap a cuff on your arm. The problem is that this will miss several hypertensive individuals and overdiagnose some.

A 24-hour blood pressure monitor is probably the best thing to invest in. This can be done by wearing a blood pressure cuff that auto-inflates every couple of hours or by having your doctor order the proper 24-hour blood pressure monitoring device.

A person with a few elevated readings does not mean they have a hypertensive disease. And just because you happen to see regular readings when you check, it doesn’t mean your blood pressure doesn’t get unbelievably high during specific episodes in your life, such as when you first wake up or after or during stressful events.

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Heart Health

What is Heart Health

achieving heart health to delay the onset of chronic diseases

It’s important that my clients understand the definition of heart health. This concept can allow you to live a rather comfortable and disease-free life. Or your poor cardiovascular health can get you stuck in the revolving door of healthcare. So, what is heart health? How will it affect you?

Importance of Heart Health

I first encountered the phrase heart health when consulting for a healthcare startup. They focused on managing high blood pressure, which alone was one of the leading causes of heart disease.

#hearthealth fascinates me because the heart plays a central role in overall health. With most pediatric diseases wiped out and antibiotics readily available most of us will make it well into our forties.

With heart-healthy choices, it’s quite likely to make it well into your 80s. A healthy heart can even help prevent other chronic diseases such as cancers or diabetes.

It’s in our forties that poor cardiovascular health can have major health effects. For example, high blood pressure can cause heart failure, kidney disease, or heart attacks.

If you managed to dodge hypertension, you might still face blood vessel diseases such as a heart attack from atherosclerosis or peripheral vascular disease.

Women are at risk of strokes as they age and men at risk of myocardial infarctions and erectile dysfunction.

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A Healthy Heart

The heart is at the center of the cardiovascular system and therefore controls everything downstream. This includes the blood vessels and the organs it supplies.

Living with a healthy heart is mostly about prevention; preventing extra strain on the heart and preventing poor cardiac output.

Starting our 40s with a healthy heart means that we can live longer and live a better life. Which is a life with less disease, fewer medications, and fewer visits to the doctor.

Measuring Heart Health

In our modern age of data, it’s common to want to know metrics. So my clients look for a way to quantify the health of their hearts.

There are heart scores we can calculate based on your family history and current cardiovascular health. But achieving a healthy heart requires strong preventative strategies.

Prevention

Fortunately, it’s never too late to start on prevention. Regardless of where you are in your #hearthealth journey, it’s always possible for things to improve or worsen.

Our lifestyle choices strongly impact our heart performance. These choices can be modified one step at a time resulting in a cumulative positive effect on the cardiovascular system.