By Carrie Demers, MD, Yoga+
My father and uncle both had heart attacks in their 40s. I just turned 40. Am I destined to have the same fate?
It is true that heart disease tends to run in the family, but that doesn’t necessarily mean that it has to happen to you. In my experience, it’s not so much a question of what is genetic as it is one of what is learned. When we are young, we unconsciously model our parents—their gestures; their patterns of walking, speaking, breathing; how they communicate; and how they manage their stress. So if you’re doing the same thing your father did, then it is likely you’re going to end up with the same disease he had. But if you make significant lifestyle changes to alter your risk factors—if you eat, exercise, breathe, think, and communicate differently—you can improve your chances of overcoming your family’s patterns of illness. It’s up to you.
What causes heart disease?
Heart disease is a broad label that includes coronary artery disease (CAD), high blood pressure, heart failure, and arrhythmia. We’ll focus on CAD, the most common of these conditions, which is often used interchangeably with the term “heart disease.”
CAD refers to atherosclerosis, or the blocking of the arteries that feed your heart muscle. Arteries bring nourishing oxygen-rich blood to all of your organs. The coronary arteries bring blood flow to the heart muscle itself. If they get blocked, then the heart muscle doesn’t get enough oxygen and you experience heart pain, or angina. Severe blockages cause heart attacks and death. Seventeen million people have coronary artery disease in the United States. With half a million deaths a year, it is the leading killer of both men and women in the country.
In the last 20 years, there has been a lot of attention on lowering cholesterol as a primary way of reducing CAD. And while high cholesterol is a risk factor for heart disease, it is not the only cause. Research from the last decade is showing that inflammation is often the underlying factor in the creation of arterial plaque leading to blockages.
According to ayurveda, inflammation is a sign of excessive pitta, or fiery energy. If pitta is your dominant constitution, you are likely to be driven, efficient, and successful. But if this energy is out of balance, you may have problems with impatience, anger, and inflammation (such as heartburn or ulcers). Ayurveda also says that diseases are caused by the accumulation of ama, or toxins. Blockages in the arteries are a sign of ama. That is why this ancient science places so much emphasis on detoxing. (Visit yogaplus.org/detox to learn more.)
How can I keep my heart healthy?
When I was in medical school 20 years ago, we were taught that heart disease was a progressive chronic disease with no prevention or cure. But in 1990, Dean Ornish—a student of Swami Satchidananda—conducted a study which showed that not only is heart disease preventable, it is also reversible—all through lifestyle changes. That was a novel idea.
A holistic approach—one in which you take care of both your body and your mind—works best. Eat whole foods: whole grains, fruits, vegetables, nuts and seeds, beans, and maybe fresh dairy. Make sure that your food comes from the earth, with minimal processing and as few chemicals as possible; buy local and organic if you can. Eat according to your capacity to digest; if you have symptoms such as heartburn, gas, or discomfort in your belly, you may need to adjust your diet.
Our hearts also need good-quality fats and oils to stay healthy. Most experts agree now that consuming fats isn’t the problem. Rather, it is the quality of the fat that matters: avoid hydrogenated and commercially refined oils, and use organic butter and organic olive, coconut, sesame, and peanut oils instead. Despite our conventional medical system’s bias against saturated fats, there is no good evidence linking saturated fat with coronary artery disease. Historically, few people developed CAD prior to the 1930s, before margarine, Crisco, and refined oils became popular. That was back when butter and lard were favored for cooking.
Balancing omega-3 and omega-6 fatty acids in your diet is also important. Our diets tend to be rich in omega-6 and deficient in omega-3. Try taking fish oils (1–2 grams daily), which provide omega-3 and have been shown to decrease the risk of CAD and death from heart disease, since they lower cholesterol and are anti-inflammatory.
So first you need to eat high-quality foods and then you have to digest the food that you take in. That is why exercise is so important. It kindles your digestive fire and helps burn up the toxins in your body. Conditioning your heart muscle through aerobic exercise increases blood flow throughout the body. A clogged artery is like a river with chunks of debris in it. You need to flush the arteries of toxins—to wash those rivers clean. Any amount of exercise is better than none. If you walk for 10 minutes at a time, three times a day, it has the same effect as walking for 30 minutes all at once. Try to balance aerobic exercise with yoga every day.
Stress causes blood pressure, blood sugar, and cholesterol to rise. It also causes platelets—the small disks in the blood that help with clotting—to become stickier. All of these factors are increased risks for developing CAD. Therefore, a stress management strategy is essential for treating or preventing heart disease. A breath-centered yoga practice can be very effective in relieving stress. It shifts your nervous system from the sympathetic fight-or-flight mode into the parasympathetic rest-and-digest, feel-safe mode. This pattern shift is pivotal to your overall health and can only be achieved when you focus on the breath. Start with a simple yoga routine that you can maintain every day, about 20 to 30 minutes long (see page 24 for a gentle sequence). It’s better to do a few poses and a relaxation practice every day than a 90-minute class once a week. Also consider including a systematic relaxation with your bedtime routine.
So all I have to do is eat right and exercise?
In addition to taking care of your body, you need to take care of your mind and emotions. The Yoga Sutras say that our thoughts, speech, and actions ought to be congruent. This is one of the pillars of health.
When we are afraid, we protect ourselves by closing our hearts. With my patients, I look at what is going on in their relationships, what is going on in their emotional world. Are they being nurtured? Are they nurturing somebody else? Is there an inward and outward flow of heart energy in their lives?
It can be difficult at first to open up and to cultivate healthy emotional relationships with others and with the world. It takes time, practice, and constant awareness. Meditation, contemplation, and journaling are helpful. Feel your fear but don’t let it stop you from doing what you want to do. Examine yourself and see how much you hold back, where you can be more honest and free. Do you have a tendency to remain stoic and aloof, finding it difficult to show your feelings? Or perhaps your tendency is to take care of everyone around you without nurturing yourself? Finding the balance between giving and receiving is essential to reclaiming a healthy and happy heart.
Board-certified in internal medicine, Carrie Demers, MD, is the director of the Himalayan Institute Total Health Center.
Tip: Learn how to lower your cholesterol naturally at yogaplus.org/healthyheart. Plus, read ayurvedic tips on how to open your heart.