YONKERS, NY — Consumer Reports challenges consumers to reconsider a commonly held assumption that the newest drugs on the market and the most-high tech tests are the best treatment for heart disease.   In its May issue, CR puts heart disease prevention and treatment under the microscope, featuring ten tips for a healthy heart and a strong dose of caution about the rising use of CT heart scans.

In its tips for heart disease prevention and treatment, CR urges a “less is more” approach.   “Too much care, or testing, can be harmful to a patient, and the popular CT scan presents a perfect example of this,” says Dr. Orly Avitzur, medical adviser for Consumer Reports.  The new ultrafast CT scanner, which creates a three-dimensional image of coronary arteries, can expose the patient to a much greater amount of radiation than a typical chest X-ray while gleaning information that is rarely useful for people without symptoms, such as angina.  Adds Dr. Avitzur, “The idea that the newest treatment isn’t always the best isn’t the easiest pill to swallow for Americans who have grown accustomed to judging the merit of a product or service based on how far it advances technology.  We want consumers to question that assumption when they seek medical care.”

CR's list of ten tips for a healthy heart includes seven recommendations for prevention and three tips for treatment: 

TIPS FOR HEART DISEASE PREVENTION

1.    Eat Plenty of Fiber and Good Fat
High-fiber foods are more effective when it comes to controlling the damaging inflammation of arteries than the standard low-fat diet.  Good sources of fiber include fruits, legumes, nuts, whole grains, vegetables and, best of all, soluble fiber from barley, beans, and oats.  As for fat, CR recommends high-omega-3 but low mercury fish such as salmon, sardines, and trout, and vegetable oils such as canola, olive, safflower, and soybean.  People should stay away from transfats.

2.   Lay Off Cholesterol and Salt
People diagnosed with high LDL (bad) cholesterol should consume less than 200 milligrams of cholesterol a day. That’s the amount in one egg yolk, 8 ounces of skinless chicken breast, or 10 ounces of lean sirloin.  For people who have high blood pressure or the risk of developing it, cutting back on salt could reduce the risk of heart attack by 25 percent or more.   People should consume less than 2,300 mg of sodium a day, about the equivalent of a teaspoon of salt.    

3.   Lose The Gut
Carrying extra fat around the middle raises blood pressure, adversely affects blood lipids, causes insulin resistance, and produces substances that inflame the arteries.  The critical point is a waist measurement of 40 inches or more for men and 35 inches or more for women, regardless of height.

4.   Huff and Pump
Name a cardiac risk factor and regular aerobic and strength exercise can improve it.  Aim for at least 30 minutes of moderate-intensity aerobic activity, such as brisk walking, five days a week, or 20 minutes of vigorous activity, such as jogging, three days a week.  Strength training improves overall fitness and improves fat-burning capacity.

5.   Calm Down
Negative emotions, such as stress or panic attacks, trigger the release of hormones that can threaten the heart: studies show that people who experience those troubles have more heart attacks and strokes than calmer people. To alleviate stress, try yoga, tai chi, meditation, and measured breathing.  And to ease depression, CR recommends aerobic exercise.

6.   Drink a Little, But Don’t Smoke
Drinking a little bit of alcohol—one drink a day for women, one or two a day for men—can raise HDL (good) cholesterol and reduce inflammation and blood clots.  But more than that can cause heart problems.  As for smoking, don’t.  Cigarette smokers have twice the heart attack risk of nonsmokers.

7.   Know Your CRP Number
Elevated levels of C-reactive protein, or CRP, can serve as a marker for artery inflammation, even if an individual has no other symptoms.  CR recommends that people ask their doctors to include the inexpensive blood test for CRP the next time they have their cholesterol checked. CR also recommends flossing and good dental care (see CR's dental report in the May issue).

TIPS FOR HEART DISEASE TREATMENT

8.    Avoid CT Angiography
As noted above, CR recommends that consumers avoid this high-tech test, also known as a CT scan, which uses an ultrafast CT scanner to create a three-dimensional image of coronary arteries.  The test is rarely useful and can cause harm through excessive radiation exposure, as much as 325 times the radiation of a typical chest-x-ray, according to some estimates.  People with angina are going to require the traditional “gold standard” angiography to measure the number and extent of blockages, regardless of the outcome of a CT test.  So there’s no need to go to the expense of having the test and undergoing radiation exposure in the first place.

9.  Hold Off On Angioplasty
If an angiogram reveals severe narrowing in more than two major coronary arteries, a patient will need bypass surgery.  If blockages are less severe, immediate angioplasty is not a good idea; it triggers a heart attack in 1 to 2 percent of patients.  Research indicates that most people with chest pain (angina) can be treated as effectively through weight-loss, exercise, and smoking cessation, in conjunction with cardiovascular medications.  However, angioplasty is a lifesaver for people who have just had a heart attack.

10. Know Your Symptoms
According to the U.S. Centers for Disease Control and Prevention (CDC), while almost everyone knows that chest pain and shortness of breath are heart attack symptoms, only 48 percent of people surveyed by the government knew that pain or discomfort in the jaw, neck, or back can be a heart attack symptom.  In addition, only 62 percent recognized feeling weak, light-headed, or faint as a symptom.  Eighty-five percent recognized the fifth symptom, discomfort in the arms and shoulders.