10 Steps to Protect Against Hypertrophic Cardiomyopathy

Click on Image for FoxNews.com Posting

By Dr. Robert Tozzi

Published February 11, 2013


As if it were yesterday, I recall the death of 18-year-old Ben Breedlove, who suffered from hypertrophic cardiomyopathy (HCM), an ailment in which I specialize as a pediatric cardiologist.

I have seen it rob too many young people unnecessarily of a long and fulfilling life.

Here are 10 steps to protect your children, family members and anyone you love against the ravages of hypertrophic cardiomyopathy:

1. Remember that statistically if one member of your family has been diagnosed with HCM, then one-half of your family members are at risk for developing this disease. Evaluation of first-degree relatives on a regular, repetitive basis can go a long way towards correct diagnosis and effective treatment. It is imperative to extend this medical information to as many relatives as possible. Try to make the effort to contact others, even if you are estranged from them. Remember to breed love.

2. Always remember that hypertrophic cardiomyopathy is a sneaky disease: It is many times missed or misdiagnosed. Common diseases that are confused with HCM are asthma, mitral valve prolapse, anxiety, coronary artery disease and an athletic heart.

3. Be aware of symptoms that require prompt medical attention:
• Chest pain with exercise or simple activities such as walking.
• Passing out is a very important symptom that requires prompt medical attention.
• Shortness of breath, lightheadedness, and extreme tiredness are other symptoms of HCM.

4. Avoid circumstances that increase your risk:
• Avoid hot weather and dehydration.
• Be aware of the need for vigorous fluid resuscitation during infections or gastroenteritis or exercise.
• Avoid burst of activity.
• Avoid isometric activity.

5. With hypertrophic cardiomyopathy in humans, the lining of the blood vessels in the heart tends to be affected. Unfortunately, this is not just limited to the heart, but also involves the blood vessels networked to other organs throughout the body:
• Foods that improve the lining of your blood vessel include nuts, seeds, dark chocolate, fruits and vegetables.
• Prolonged periods of walking help revitalize the lining of your blood vessels.
• Foods that decrease the function of the lining of blood vessels include sugary drinks (soda), high salt, high fat, high sugar, high fructose corn syrup, and even high protein. Life is about balance and a balanced diet.

6. Beware of diseases or circumstances that can worsen hypertrophic cardiomyopathy, or cause it to progress faster:
• Sleep apnea, diabetes, obesity, hypertension, rapid weight gain and hypercholesterolemia.
• Steroids, including drugs like prednisone, anabolic steroids, and testosterone can aggravate the condition. The use of growth hormones or supplements that increase growth hormone or testosterone levels may also accelerate HCM.

7. Avoid drugs that can increase your risk of having a bad event:
• Avoid stimulants and decongestants.
• Avoid alcohol consumption as its diuretic effect can lead to decreased blood volume.
• If you are on a blood-thinner (e.g., Coumadin), remember to have your blood checked monthly.

• For any abrupt new onset of neurologic symptoms, such as muscle weakness, severe headache, or change in vision, seek prompt, urgent medical attention.

8. Once diagnosed with HCM, you are restricted from competitive sports and extremes of exercise, such as avoiding heavy lifting.

9. If you are on a beta blocker for HCM, it is imperative that it is taken daily. Missing a dose results in a rebound effect that can make your heart rate increase and put you at an increased risk.

10. Enjoy life, keep active and eat healthy. Most people with HCM have a normal life expectancy.

Dr. Robert J. Tozzi is Chief of Pediatric Cardiology and the Founding Medical Director of The Gregory M. Hirsch Hypertrophic Cardiomyopathy Center at the Hackensack University Medical Center in New Jersey. He is the co-author of several papers published in refereed research journals, and he has lectured extensively in his field at numerous professional conferences. To learn more, visit his website at DRTOZ.com.
Read more: http://www.foxnews.com/health/2013/02/08/10-steps-to-protect-against-hypertrophic-cardiomyopathy/#ixzz2KheuMOYG


Are Your Supplements Killing You?

Certain benefits that have been widely publicized for many years regarding dietary supplements may be ill-advised at best, according to a recent study in the Archives of Internal Medicine.

Indeed, one might almost say that confusion abounds. This new study on women’s health reports that dietary supplements are resulting in a higher mortality rate for women. But before we start to panic, let’s look at a few facts.

1) This study was conducted on older women with a mean age of 61 years.

2) Those taking iron supplements showed the greatest risk of earlier mortality.

Excess iron in the bloodstream is associated with increased atherosclerosis and subsequent heart attacks and strokes. It acts as a catalyst that increases the risk of free radical damage to the vascular system and associated tissue, thereby accelerating the aging process.

But back to the study.

When attempting to analyze this study, the most important piece of information is that these women are in a post-menopausal group that would no longer need to take extra iron to maintain health. After loss of menses, the risk of iron-deficiency anemia is low, and the risk of over accumulation increases.

Of course, most women who are trying to stay healthy are probably getting enough iron from fortified foods and dark green vegetables, as well as the occasional intake of red meat.

So here’s the bottom line: Iron supplementation is needed for the iron-deficient person. This is much more common in younger women, especially those who experience a heavy menstrual flow each month.

So, my recommendation for older men and women is to be smart, have blood work to check your iron status. Unless you receive a doctor’s indication that you are iron deficient, it’s best to skip that vitamin that contains iron.

High Cholesterol in Children: To Screen or not to Screen?

When there is a family history of early-onset coronary artery disease, or a family history of high cholesterol, the current recommendation is to screen a child for elevated cholesterol levels. In addition, screening for high cholesterol is required if a child is obese or suffering from childhood forms of hypertension or diabetes. It is currently recommended that this screening should occur between the ages of two and 10 years.

Unfortunately, these recommendations do not go far enough, and physicians risk missing many cases of significantly elevated levels of cholesterol in children.

How early should parents intervene in order to prevent potential development of coronary artery disease in their baby? The answer is that it is never too early to intervene.

A little known medical fact is that the damage caused by high cholesterol, called dyslipidemia, can begin to occur before a child’s birth, during fetal life. The diet and eating habits of the mother during pregnancy lay the groundwork for blood vessel development in the gestational fetus. After birth, the single most important and protective food a child can consume is its mother’s breast milk. Many studies have shown that breast-fed children develop far fewer chronic diseases as they grow into young adulthood, with fewer incidences of obesity, hypertension, diabetes and heart disease.

When being transitioned away from breast milk or formula, children still need a certain intake of fats, but these need to be healthy fats. Between one and two years of age, low-fat dairy foods are acceptable, and above two years of age, non-fat dairy can be introduced as part of the regular diet. When integrating eggs or meat as part of the daily menu, it is best to be assured that both poultry and cattle were raised as grain-fed livestock. A grain-based diet for these animal sources results in foods that have a higher concentration of healthy fats for the child’s intake.

To screen or not to screen may be the question of the day, but the answer to being healthy lies in what you eat. The following foods and adjustments to diet have been proven to lower serum cholesterol:

  1. Whole citrus (the pulp absorbs cholesterol)
  2. Nuts and seeds (ligands bind cholesterol)
  3. Ground flaxseed (ligands bind cholesterol)
  4. Soy protein
  5. Chick peas (hummus)
  6. Fish or fish oil 2 grams per day
  7. Dark chocolate
  8. Dark green vegetables like spinach (they are the anti-diabetes food and a good source of Omega 3)
  9. Whole grains (even instant oatmeal)
  10. Reduce the simple sugar

Eat the fruits and vegetables that stain your clothes (these tend to come from the more moderate climates like the Mediterranean region). In general, limit the fruits from the more tropical regions. Tropical fruits are healthy, but they tend to have higher free-sugar content, and if consumed to excess, they may increase the level of bad cholesterol.

Finally, do not forget the best exercise: Walking. Walking is the live-longer, anti-diabetes and lower-your-cholesterol sport for all weathers and all ages, starting in early childhood – just as soon as your toddler learns to stand on his or her own two feet.

In fact, in the healthiest cultures, there is a common proverb that sums up the basis of health living: “We have with us at all times two doctors – the right foot, and the left foot.”

Technology & the Natural Approach to Medicine

Cardio TheaterAs recent medical history demonstrates, it is not a question of making a choice between natural approaches to health vs. technology.

What is required is a new synergy that can only come from a greater human respect for nature and the natural needs and responses of the human body, to be followed by the intelligent application of lessons learned.

Man’s technological arrogance has led us down a mistaken path in medicine on more than one occasion, only to reveal the damage that results from a lack of applied wisdom.

In the 1980s, a study was designed to test how we could improve the survival of men who had suffered a heart attack.

The first trial was meant as a study of the efficacy of Drug A. When Drug A caused statistically more deaths when taken by study participants than if no drug had been taken, it was abandoned. A new trial was begun to study the efficacy of Drug B. The result of the tests using Drug B was the same as the tests using Drug A: More men dying. Based on the overall results, the entire study was eventually abandoned.

Some years later, a review of the study revealed that the men who were more likely to survive had one peculiar thing in common: They were frequent dog-walkers.

But was this really an unpredictable revelation? Walking has been perceived as man’s best medicine since it was first proclaimed as such by Hippocrates in 450 BC.

What should we do with this knowledge? Prescribe scooters to overweight post-MI patients? Operate on patients with coronary artery disease who could have been treated, along with obesity, hypertension and diabetes, by regular walking? Perform leg-bypass operations on individuals with claudication who could have been equally well treated with a regimen of walking and a healthy lifestyle?

Or do we come to a realization that spending billions of dollars bailing out the automobile industry only fuels the fire of mass inactivity – regardless of the effects on the manufacturing sector and the broader economy.

Curiously, the relatively new phenomenon of “exergaming” may be one persuasive answer to preventing obesity, diabetes and hypertension in our youth.

Exergaming is the catch-name for video games and technology-based activities that result in calorie burning. One of the more commonly known exergames is Wii Fit. The problem is that “evidence exists that spending time outdoors is the strongest correlate of physical activity among preschool-aged children,” as quoted from the July 2011 Archives of Pediatric & Adolescent Medicine, 2011; 165(7): 667-669.

I have repeatedly cautioned about using technology-based answers to problems that are for the most part a result of technology dependency.

An easy, simplistic example that highlights the unintended consequences of this type of approach is the handicapped scooter. With obesity at the root of so many of our nation’s health and financial problems, we have companies marketing scooters directly to the public as a medically necessary device. At first glance, these scooters may appear as a great solution that enables handicapped people to be mobile indoors and out. But the ultimate effect is that the overweight diabetic person moves less, resulting in more weight gain, worsening diabetes and the deterioration of vascular health. This further results in even poorer blood flow to the legs, further limiting the patient’s mobility.

Which leads me to conclude by reprising another oft-repeated piece of advice that I impart to all of my patients.

Do not forget the best exercise: Walking.

Walking is the live-longer, anti-diabetes and lower-your-cholesterol sport for all weathers and all ages, starting in early childhood – just as soon as your toddler learns to stand on his or her own two feet.

In fact, in the healthiest cultures, there is a common proverb that sums up the basis for healthy living: “We have with us at all times two doctors – the right foot, and the left foot.” Words to live by.

Video: Powerful Associations