We’ve all heard the so-called “standard” risk factors for heart disease: lack of exercise, excess weight, high blood pressure, and “high” cholesterol.
But how accurate are these factors?
Well, if you’ve been a reader of mine for a while now, then you know cholesterol, for one, really shouldn’t be on that list at all—and the other items can be a little complicated.
Plus, there are a number of important heart disease risk factors you don’t typically hear about from your doctor, such as high homocysteine, low B-vitamin status, and chronic inflammation.
Not to mention, high blood sugar and metabolic syndrome are key risk factors for cardiometabolic heart disease. (You can learn more about this on page 4).
Then, add some well-researched but little-known indicators for cardiovascular disease in general, and it can be hard to keep track of what you really need to pay attention to when it comes to heart health.
That’s why I’m revealing my nine simple, effective steps to significantly lower your risk of heart disease. And I’ll be busting some common myths and misunderstandings along the way.
So, let’s get right to the heart of the matter—starting with the “big three” risk factors for cardiovascular disease. And then I’ll reveal new research on lesser-known—but important—factors that are key to keeping your heart strong and healthy for years to come.
When it comes to blood pressure, don’t be afraid of a little elevation
Truly high blood pressure is always a serious risk for heart disease. But, as you get older, studies show that a moderately “high” systolic (the top number) blood pressure reading of 130 to 150 mmHg can be healthy—and may even be helpful—for optimum blood circulation to the heart and brain.
The real danger is that your doctor may not be familiar with (or may ignore) those studies’ conclusions, and prescribe dangerous drugs to artificially lower your blood pressure instead.
I’ve warned before about blood pressure drugs called angiotensin-converting enzyme (ACE) inhibitors, like lisinopril, benazepril, and other medications ending in “pril.”
These are terrible drugs that often cause a nasty chronic cough and increase the risks of lung diseases and lung cancer. There’s also clinical findings from Europe that ACE inhibitors may worsen respiratory infections like COVID-19 because of their interference with basic lung functions.
Plus, a recent study of 4.9 million men and women in the U.S., Germany, Japan, and South Korea found that the people who took diuretics (old standby drugs used to lower blood pressure) had 15 percent fewer heart attacks and strokes compared to those taking ACE inhibitors.1
Bottom line: If your doctor wants to prescribe drugs to lower your blood pressure, first find out if it really is too high. Then discuss natural approaches like diet, exercise, and dietary supplements to lower your blood pressure—without drugs.
(Modern studies show that a systolic reading of 170 mmHg is too high even in older people—and may increase stroke risk. But at the same time, 120 mmHg may well be too low in older adults to deliver those much-needed nutrients to the brain and around the body. So, the key is to strike a balance between dangerously high and dangerously low blood pressure. As always, it’s a question of moderation.)
Exercise, but don’t overdo it
Regular, moderate exercise is important for a healthy heart—physically, emotionally, and spiritually. But the key word, again, is “moderation.”
As I’ve frequently reported, excess exercise (what I call “excess-ercise”) can be dangerous for the heart and other organs, especially as you get older. Studies show that a total of 120 to 140 minutes per week of light-to-moderate exercises like walking, swimming, gardening, or housework offers the most benefits for most people.
In fact, a recent review of 22 studies that included more than 320,000 adults found that just 15 to 20 minutes per day of moderate walking is beneficial for the heart. And one of those studies found that people who exercised moderately for just 15 minutes a day lived three years longer than their sedentary peers.2
(Interestingly, the study also found that heart-health benefits actually plateau if you walk more than 45 minutes a day.)
Bottom line: Exercise is key for heart health, but don’t overdo it. Exercising for too long or too intensely may actually damage your heart. So, aim for 15 to 20 minutes of light-to-moderate physical activity daily.
Watch your weight, but don’t yo-yo diet
Of course, obesity is unhealthy, but some excess weight as you get older isn’t a death sentence. What many people (and doctors) don’t realize is that it may be better to just leave well enough alone when it comes to a few extra pounds.
That’s because gaining or losing 10 pounds (or more) in a year can actually be dangerous for both your heart and your overall health.
I first studied this type of yo-yo dieting back in the 1980s as a medical consultant to a group called “Diet Watchers,” then based in North Carolina. I discovered that the metabolic disruption caused by up-and-down weight loss is quite damaging to your health.
My findings are backed up by a new study of 485 women: A whopping 73 percent reported they had at least one cycle of losing and gaining weight at some point in their lives. 3
Those women also had poorer cardiovascular health—in part because this type of weight change can cause slight but permanent increases in baseline blood pressure and blood sugar.
Bottom line: If you’re obese, you probably need to lose weight to reduce strain on your heart. But if you’re only somewhat overweight, it may actually be healthier for your heart (and the rest of your body) to live with the extra pounds. Especially if you eat a healthy, balanced diet (like the Mediterranean-style diet) and engage in regular moderate exercise..
Three key tests to ask your doctor about
Some doctors only measure your weight, blood pressure, and cholesterol during a heart-health checkup.
But research is increasingly showing that the following tests are just as critical (and much more important than a cholesterol test).
Homocysteine. This amino acid occurs naturally in your body. But if you have too much homocysteine in your blood, it’s a key indicator of early heart disease risk. Researchers aren’t entirely sure why, but there’s evidence that too much homocysteine can damage the lining of the arteries and also lead to blood clots.
Although no absolutely “safe” level of serum homocysteine has been determined, research suggests that levels should be less than 12 mcmol/L—especially if you have other cardiovascular disease risk factors. Ideally, studies show that homocysteine levels should be kept under 8.5 mcmol/L for “healthy” adults without cardiovascular disease risk factors.
But here’s the kicker: You probably have no idea if your homocysteine levels are too high, because you generally won’t have any symptoms. That’s why a simple homocysteine blood test is important—especially as you get older, because homocysteine levels naturally increase with age.
B vitamins. B6, B9 (folate), and B12 naturally decrease homocysteine in your blood. (So does betaine, an amino acid found in beets or in some dietary supplements.)
I don’t know of any blood tests for betaine, but there are plenty of tests that can measure vitamin levels in your blood. So, start asking your doctor to test your vitamin B levels—especially if you have any of the following signs of B deficiency: dizziness, weakness, fatigue, pale skin, sore tongue or mouth, or tingling in your extremities.
According to my research, a level of 200 picograms per milliliter (pg/mL) or lower of any B vitamin is deficient. Ideally, you want your levels to be above 500 pg/mL.
C-reactive protein (CRP). This substance, which is naturally produced in your liver, is a general marker for chronic inflammation in the body. Specifically, highly sensitive CRP (Hs-CRP) tests evaluate the health of your coronary arteries, and are a much better measure of heart health than cholesterol tests.
Ideally, your CRP level should be less than 1 mg/L. If it’s higher than that, fish oil has been shown to lower the inflammation that can boost your CRP levels. I typically recommend 5 to 6 grams of fish oil a day, unless you eat more than two servings of fish a week.
Plus, as I wrote in the April issue of Insiders’ Cures, one scientific paper that reviewed nearly 100 studies on sleep and inflammation found that getting less than six hours of sleep a day raises your CRP levels. Of course, following a balanced eating plan like the Mediterranean diet can naturally lower your inflammation and CRP levels, too.
Three little-known risk factors for heart disease
Over the years, I’ve discovered some interesting indicators for heart disease that many people, including doctors, don’t know about. The first one is perhaps the most unusual…
A sign from Frank. When I worked at the National Institutes of Health (NIH) during the mid-1980s, I conducted some collaborations with Dr. Nicholas Petrakis. He was studying simple markers like Frank’s sign in men with heart disease.
Frank’s sign is a diagonal crease in the earlobes, extending downward. Research shows that this crease is linked to higher risk of cardiovascular disease and metabolic syndrome.
Nick was a strong advocate for epidemiologists understanding the basic biology of the diseases they were studying. (That was before the statisticians took over.) But there was no real interest at NIH in easy, “low-tech” approaches like Frank’s sign to help establish heart disease screening and prevention metrics.
However, lately, we’re seeing some attention being given to simple assessments like Frank’s sign. (Though I’ll always think of it as Nick’s sign!)
So, if you have Frank’s sign, it may be a good heart disease risk indicator that you—and your doctor—should pay closer attention to.
Joint problems. Research shows that people with arthritis have a higher risk of heart disease. This finding fits with the now-recognized role of low-grade, chronic inflammation in heart disease and other common chronic diseases.
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that has long been associated with inflammation diseases of the cardiovascular system. But newer research is showing that the joint inflammation due to degenerative osteoarthritis is also associated with chronic inflammation in the body, including the heart.
This kind of degenerative arthritis is increasingly common—often due to excess-ercise and running on artificial, hard surfaces—leading to an epidemic of joint disease.
That’s why I recommend what I call my ABCs of joint health (ashwaganda, boswellia, and curcumin). And now, new research on arthritis, inflammation, and heart disease indicates that these natural anti-inflammatories may support not only your joints, but also your heart.
I recommend 400 to 500 mg of ashwaganda, 400 to 500 mg of boswellia, and at least 200 mg of curcumin a day. (See the sidebar on this page for my complete supplement guide for heart health.)
Meal timing. To help maintain an optimal weight, it’s generally recommended that you eat most of your calories during daylight hours. And research is increasingly showing that when you eat also influences your risk of heart disease.
A recent scientific statement from the American Heart Association (AHA) linked skipping breakfast with heart disease risk factors such as obesity, high blood pressure, and high blood sugar.4 The statement cited a 16-year study that found that men who didn’t eat breakfast had a 27 percent higher risk of heart disease than those who regularly had a morning meal.
Meanwhile, preliminary research presented at the 2019 AHA Scientific Sessions found that women who consumed more calories after 6 p.m. had poorer heart health compared with those who ate nothing during the evening hours.5 For each 1 percent increment in calories consumed after 6 p.m., the women had increases in blood pressure, blood sugar, and body weight.
Of course, eating and drinking later in the day is also one of the factors that can contribute to poor sleep quality, which, as I mentioned earlier, is a key risk factor for heart disease. (This reminds me of what my French grandparents used to say: qui dort dîne, or “who sleeps dines.” Meaning that you don’t need to be consuming calories when it’s time to sleep).
So, there you have it…nine simple, effective ways to help keep your heart strong and healthy for years to come. (For more about the risk factors I’ve mentioned above—and all of the natural ways you can help prevent heart disease—check out my Heart Attack Prevention and Repair Protocol. To learn more about this innovative online learning tool, click here—or call 1-866-747-9421 and ask for order code GOV3W900.)
My top recommended heart-health supplements
Ashwaganda 400-500 mg/daily
Vitamin B6 30 mg/daily
Vitamin B9 (folate) 800 mcg/daily
Vitamin B12 1,000 mcg/daily
Vitamin D3 10,000 IU/daily
Vitamin K2 150 mcg/daily
Betaine 500 mg/daily
Boswellia 400-500 mg/daily
Coenzyme Q10 500 mg
Curcumin 200 mg/daily
Fish oil 5-6 g/daily
L-carnitine 500 mg/daily
Magnesium citrate 150 mg/daily
1“Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis.” Lancet. 2019;394(10211):1816-1826.
2“Exercise and Health: Dose and Response, Considering Both Ends of the Curve.” Am J Med. 2015;128(11):1171-1177.
3“Associations of weight cycling with cardiovascular health using American Heart Association’s Life’s Simple 7 in a diverse sample of women.” Prev Med Rep. 2019 Dec; 16: 100991.
4“Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association. “Circulation. 2017;135(9):e96-e121.