Impact of Cardiovascular Health

on Youthful AgingDesmond Ebanks, MD

Founder & Medical Director

Alternity Healthcare, LLC

Youthful Aging = Successful Aging

Low probability of disease and disease related disability

High cognitive and physical functional capacity

Active engagement with life

JW Rowe & RL Kahn, Successful Aging, The Gerantologist, vol 37, no. 4, pg 433-440, 1997

Cardiovascular disease (CVD) > 80 million Americans have CVD Number one killer of Americans Kills more people than the next 5 leading

causes of death; including cancer Sudden death is the first sign of CVD in nearly

a quarter of first-time heart attack cases

American Heart Association, 2009 update

Cardiovascular disease (CVD) Causes over 1 million deaths/ year; more than

half of those deaths are among women

16 million people have coronary artery disease resulting in nearly 500,000 deaths/ year

Ten times more women die from CVD than breast cancer each year

American Heart Association

CVD Risk Factors

Silent Inflammation

“High-sensitivity C-reactive protein (hs-CRP) levels are an independent marker of cardiovascular disease risk”

American Heart Association Scientific Sessions, 2008

Homocysteine Elevated levels are associated with

increased risk for mortality in patients with coronary artery disease (CAD)

“Long term folate-based vitamin therapy lowered all-cause mortality in patients with CAD and elevated homocysteine levels”

The American Journal of Cardiology, Sept. 2009

Recent Study on Cholesterol “Almost 75 percent of heart attack patients fell

within recommended targets for LDL cholesterol…half were at optimal levels”

“HDL cholesterol levels have dropped in patients hospitalized for heart attack over the past few years, possibly due to increasing rates of obesity, insulin resistance and diabetes.”

American Heart Journal, Jan 2009

Promoting Heart Health

Regular Exercise

Stress Reduction

Good Nutrition and high quality supplements

Hormone Optimization

Nutrition Mediterranean diet has consistently been

shown to reduce the incidence of heart disease, cancers and overall mortality

Avoid highly processed carbohydrates, artificial sweeteners and hydrogenated oils

Optimal ratio: 40% carbohydrates, 30% protein and 30% healthy fats

Drink a lot of water

Vitamin D3 62 percent higher risk of a cardiovascular event [was

noted] in participants with low levels of vitamin D compared to those with higher levels.

“Vitamin D deficiency is associated with increased cardiovascular risk, above and beyond established cardiovascular risk factors”  

Framingham Heart Study researchers reported in Circulation: The Journal of The American Heart Association, Jan 2008

Fish Oil

“…tremendous and compelling evidence from very large studies…demonstrate the protective benefits of omega-3 fish oil in multiple aspects of preventive cardiology”

Carl Lavie, MD, Journal of the American College of

Cardiology, August 2009

Co-enzyme Q-10 Powerful antioxidant and free radical

scavenger Essential for muscular energy production Levels found deficient in heart failure Statin drugs cause a depletion Independent predictor of CV mortality

Journal of the American College of Cardiology, Dec. 2008

Exercise Resistance training reduces body fat, increases

bone density and muscle mass, reduces the potential for injuries and falls, and improves body appearance.

Aerobic exercise results in improved endurance and conditioning that is associated with greater life expectancy and lowered health risks.

Greater flexibility reduces the risk of injury, can help alleviate low back pain, reduce stress, improve balance and grace.

Resistance Exercise Prevents Sarcopenia:

insidious, age-related loss of muscle mass and strength in otherwise healthy adults

Largest loss of muscle mass occurs from age 50 to 75

Average American gains 1 lb of fat every year between ages 30 to 60, and loses ½ lb of muscle

Mortality & Muscular Strength

“Men with low muscular strength had a 60% higher cardiovascular risk and mortality rate”

American College of Sports Medicine, 2008

Aerobic Exercise Maximal oxygen intake

decreases 10-15% per decade after age 20

an accumulation of body fat and a decrease in habitual physical activity accounts for about half of the age-related decrease

Mortality & Aerobic Fitness

“Better cardiorespiratory fitness was associated with lower risk of all-cause mortality, coronary heart disease and cardiovascular disease.”

Kodama, S., et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women, JAMA. 2009;301(19):2024-2035.

Assessing Aerobic Capacity Same sophisticated metabolic measuring

equipment used to test professional athletes and NASA astronauts

Measures VO2 max, or oxygen consumption during exercise, to determine:

1. Effect of body weight on energy2. Capacity of lungs to move air (respiratory exchange ratio)3. Ability of the heart to transport oxygen (O2 pulse)4. Ability of muscles to generate work (watts)5. Optimal training heart rate range (anaerobic threshold)

Aerobic Capacity Peak VO2 values during exercise can

stratify prognosis in patients with heart failure and coronary artery disease

O2 pulse (oxygen consumed per heart beat) provides an additional means for determining prognosis in heart disease patients

Can identify sub-clinical heart disease

Fountain of Youth Deterioration in aerobic fitness may result in a loss of

independence in later life A regular, progressive exercise program can slow or

reverse the loss of aerobic power and prolong independence

Effect of excess body fat Weight: 186 lbs or 84.5 kg Ideal weight: 136 lbs or 61.8 kg

VO2 in ml/kg/min: 22.3

Volume of oxygen moved per minute: 1.89L or 1890 ml

Divided by ideal weight, adjusted VO2: 1890/61.8 = 30.6

Current VO2 divided by adjusted or ideal VO2: 22.3/30.6 = 0.73

27% of oxygen consumption is going to support fat that has no ability to use oxygen. Oxygen is only used by muscles and organs. 27% of fuel is wasted.

Effect of excess body fat Heart rate: 80 beats per minute

60 x 80 = 4800 beats per hour

4800 x 24 = 115,200 beats per day

115,200 x 27% = 31,104 wasted heartbeats per day

31,104 x 365 = 11,352,960 wasted heartbeats/ year

Hormone Balance

Mounting scientific evidence favors a balanced endocrine system for optimal heart health, bone health, sexual health, body composition, and cognitive function.

Hormone Balance (men) Low testosterone concentrations were

associated with increased mortality due to cardiovascular disease, cancer and all causes.

Circulation: Journal of the American Heart Association, 2007

Risk of cardiovascular events was double for men

with ED; and in a range similar to current smokers or those with family history of CV disease. Thompson IM, Tangen CM, Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease.

JAMA 2005; 294:2996-3002.

Hormone balance (women) The loss of natural estrogen as women age may

contribute to the higher risk of heart disease after menopause.

American Heart Association

No significant increase in risk due to hormone therapy for any cardiovascular disease outcome in women in the first 10 years of menopause.

Re-analysis of Women’s Health Initiative (WHI) data,

Journal of the American Medical Association, 2007

Summary Good nutrition: eating more fruits and

vegetables reduces mortality risk Exercise capacity: linked to healthy aging

and an opportunity to live out your years with dignity and self-reliance

A balanced endocrine system: restores vitality and reduces risk of disease

www.alternityhealthcare.com

The End