Sunday, 3 April 2011
Monday, 28 March 2011
Sunday, 27 March 2011
Saturday, 12 March 2011
Personal Insurance
InsuranceAgents.com is a consumer website where anyone in the US can compare insurance quotes from local agents and save $100’s on their insurance each year. Our brand is consistently growing and gaining more trust with consumers
Matchmaking
Matchmaker is one of the largest and most successful online dating networks on Commission Junction! With premium online dating websites such as Matchmaker.com, Date.com, Amor.com and GayDating.com- our program consists of top websites that connect singles looking for friendship, love, romance and/or marriage. Our sites include multiple chat room communities, video and audio web messaging, dating advice, and much more. Publishers can earn thousands of dollars a month in commissions, so start driving traffic and promoting today! We are looking for publishers with online community-related websites, affiliates with high traffic sources, social media experts, dating review directories- as well as email and search engine marketers. We have several dating websites in our program with high payouts. • Matchmaker • Date.com • Amor.com (Latin/Hispanic Dating) • Corazon.com (Latin/Hispanic Dating) • GayDating.com (Gay/Lesbian Dating) • MatureSinglesClick (Senior Dating) • SingleParentClick (Single Parent Dating) • BlackDatingClick (African American Dating) • ChristianMatchmaker (Christian Dating) • CatholicSoulmates (Catholic Dating) and Jewcier (Jewish Dating) Our Program Offers: • Premium commission structure and bonus incentives • Extensive banner creative/ text link archive • Monthly affiliate newsletters showcasing our top banners, new creative, promotions, seasonal media, and bonus incentives • By joining our program today you'll also be eligible for special promotional bonuses. Current payouts range from $100 per sale or 200% of the sale amount per action! Sign up today and start earning top commissions with your traffic! If you have any questions, please feel free to contact us at affiliates@matchmaker.com
Personal Loans
PaydayBank is an established payday loan provider in the UK.
PaydayBank offers same day payday loans. We provide an immediate response to our customers, who require quick loans of up to 750 GBP.
Our company operates fully online, which means we can provide fast and convenient solutions to our customers. We are a highly professional and respected company and our site is a market leader with regard to conversion rates.
PaydayBank was established in 2006 and has exceeded its growth targets consistently. We have gained a lot of experience promoting our brand in the online market and we are highly committed in delivering results. We are one of the leading UK payday loan brands.
As a PaydayBank publisher you will be able to monetize your traffic efficiently. We offer 45 GBP per qualified loan. You can expect prompt payments and high conversions which are extremely competitive.
PaydayBank's conversion rates are very high and immediate, over 40% of the applications are accepted; therefore you can expect very high EPC's and revenues.
Lead must be valid, must earn over 750 GBP per month, must be a UK resident, and be over 18.
Please note: PPC Publishers are not allowed to use our url: www.paydaybank.co.uk on any search engine.
Features of the programme : We offer a great variety of banners, text links and content links for you to use.
We have gained a lot of experience promoting our own brand and will help publishers succeed. A dedicated affiliate manager will help you drive sales, so please ask us questions. Our offer has proven results. Brand awareness is high and this helps conversions.
PaydayBank offers same day payday loans. We provide an immediate response to our customers, who require quick loans of up to 750 GBP.
Our company operates fully online, which means we can provide fast and convenient solutions to our customers. We are a highly professional and respected company and our site is a market leader with regard to conversion rates.
PaydayBank was established in 2006 and has exceeded its growth targets consistently. We have gained a lot of experience promoting our brand in the online market and we are highly committed in delivering results. We are one of the leading UK payday loan brands.
As a PaydayBank publisher you will be able to monetize your traffic efficiently. We offer 45 GBP per qualified loan. You can expect prompt payments and high conversions which are extremely competitive.
PaydayBank's conversion rates are very high and immediate, over 40% of the applications are accepted; therefore you can expect very high EPC's and revenues.
Lead must be valid, must earn over 750 GBP per month, must be a UK resident, and be over 18.
Please note: PPC Publishers are not allowed to use our url: www.paydaybank.co.uk on any search engine.
Features of the programme : We offer a great variety of banners, text links and content links for you to use.
We have gained a lot of experience promoting our own brand and will help publishers succeed. A dedicated affiliate manager will help you drive sales, so please ask us questions. Our offer has proven results. Brand awareness is high and this helps conversions.
Credit Reporting and Repair
CreditReport.com is the industry leader in providing free credit scores to consumers in a secure, online environment. Our Credit Monitoring service alerts customers to changes across all 3 of their credit reports while Credit Score Tracking notifies customers to significant changes in their credit score.
Wednesday, 2 March 2011
PURCHASING SAFE TOYS
Toys even though our children love them, can pose as hazardous to our children without use even realizing it. In fact, the U.S. Consumer Product Safety Commission estimates 150,000 toy-related injuries needing hospital emergency treatment occur each year.
Falls are of the most frequented accident, but there are other serious injuries resulting from swallowing small parts or placing tiny toys in noses or ears, exploding gas-powered toys, flammable products, and from sharp edges.
Yearly, some 5,000 new toys get introduced to the market-place. The holiday season alone finds over 150,000 different toys for sale in nearly one million stores. So naturally, despite the many efforts of manufacturers, retailers, safety inspectors, and others, it's just impossible to examine each toy. But remember it is always possible for parents and relatives to thoroughly inspect each toy purchased and every old toy around the house for possible dangers. Here are a few useful tips when shopping for toys and games.
1. Choose cautiously. Look for design and quality construction in the toys you buy.
2. Be aware of toys containing sharp edges, small parts, or sharp points. Avoid toys producing excessively loud noises potentially damaging for the ears, and propelling objects that can injure the eyes.
3. Purchase toys that complement the child's age, interest, and abilities. Avoid complex toys for young children. Be aware that toys have suggested age ranges to aid you in choosing toys that are appealing as well as safe.
4. Learn to read Labels. Look for safety information such as "Not recommended for children under 3 years of age," or "non-toxic" on toys likely to end up in baby's mouth, or "washable/hygienic materials" on stuffed toys and dolls.
5. Always check with parents before acquiring toy's needing supervision - electronic toys, shooting toys and games, chemistry sets, etc.. Remember that younger children may have access to toys intended for older children once the toy has been brought into the home.
6. And lastly you can look for the UL (Underwriters Laboratories) seal on electrical toys. It indicates the electrical parts have been tested for safety.
We all want our children to have safe rewarding experiences with there toys. As parents and relatives taking a few extra steps to ensure proper toy purchases may actually save your child from being one of the 150,000 hospitalized children this year, or any other and I'm certain that your child would be thankful for not having to be one!
Article Source: http://www.ArticleBlast.com
Falls are of the most frequented accident, but there are other serious injuries resulting from swallowing small parts or placing tiny toys in noses or ears, exploding gas-powered toys, flammable products, and from sharp edges.
Yearly, some 5,000 new toys get introduced to the market-place. The holiday season alone finds over 150,000 different toys for sale in nearly one million stores. So naturally, despite the many efforts of manufacturers, retailers, safety inspectors, and others, it's just impossible to examine each toy. But remember it is always possible for parents and relatives to thoroughly inspect each toy purchased and every old toy around the house for possible dangers. Here are a few useful tips when shopping for toys and games.
1. Choose cautiously. Look for design and quality construction in the toys you buy.
2. Be aware of toys containing sharp edges, small parts, or sharp points. Avoid toys producing excessively loud noises potentially damaging for the ears, and propelling objects that can injure the eyes.
3. Purchase toys that complement the child's age, interest, and abilities. Avoid complex toys for young children. Be aware that toys have suggested age ranges to aid you in choosing toys that are appealing as well as safe.
4. Learn to read Labels. Look for safety information such as "Not recommended for children under 3 years of age," or "non-toxic" on toys likely to end up in baby's mouth, or "washable/hygienic materials" on stuffed toys and dolls.
5. Always check with parents before acquiring toy's needing supervision - electronic toys, shooting toys and games, chemistry sets, etc.. Remember that younger children may have access to toys intended for older children once the toy has been brought into the home.
6. And lastly you can look for the UL (Underwriters Laboratories) seal on electrical toys. It indicates the electrical parts have been tested for safety.
We all want our children to have safe rewarding experiences with there toys. As parents and relatives taking a few extra steps to ensure proper toy purchases may actually save your child from being one of the 150,000 hospitalized children this year, or any other and I'm certain that your child would be thankful for not having to be one!
Article Source: http://www.ArticleBlast.com
READING PROBLEM?? BUY TOYS
Reading Problem among children is a common symptom in their stages. Some children are often seen not able to read or write properly. Sometimes this can be due to ineffective eyesight or hearing problem. If your child are unable to read or write like other kids in the school then he may be a victim of dyslexia. Children who have dyslexia fails to read or write as they feel word reversal during reading, they have poor handwritings, difficulty in repeating words, difficulty in comprehending written directions etc. If your child shy away from doing his homework or get angry or frustrated when confronted then do not think he is stubborn. It is the high time to give a serious thought to his problem.
Thus, Reading Problems (læseproblemer) should be addressed early before it is too late. There are various ways of tackling these problems. Primarily, you should interact one to one to your child and suggest the teacher to do so. One to one interaction helps to understand the problem better. However, using toys are also a way of treating Reading Problems. You can easily Buy Toys from the market or from online marketing sites to help your child read properly. There can be a variety of toys available to choose from. The most relevant and effective types of toys are discussed below:
*
There are three set training books available, which helps in developing reading skills and understanding.
*
Then there are gross motor assimilated products, which help in development of creep, crawl, walk, etc.
*
Then there are various puzzles and memory games which helps in developing word sense and reading skills.
*
PC learning games are also available with improved technical content. They are divided into different age group requirements.
*
Then there are Kindergarden reading kits having CDs, books, puzzles, parent's guide and so on.
*
Then you can also go for big magnetic numbers and alphabets, which comes with a board thereby encouraging your child to learn while having fun as well.
These above categories of toys are available and they have high learning content, so, if your child is having a reading problem then you can buy toys (køb legetøj) of these categories to facilitate them to read and write properly. With the increase in number of Reading Problem, systems among children researches are coming up with innovative technique to solve them. So, Buy Toys and help your child to grow in a better manner.
Article Source: http://www.ArticleBlast.com
Thus, Reading Problems (læseproblemer) should be addressed early before it is too late. There are various ways of tackling these problems. Primarily, you should interact one to one to your child and suggest the teacher to do so. One to one interaction helps to understand the problem better. However, using toys are also a way of treating Reading Problems. You can easily Buy Toys from the market or from online marketing sites to help your child read properly. There can be a variety of toys available to choose from. The most relevant and effective types of toys are discussed below:
*
There are three set training books available, which helps in developing reading skills and understanding.
*
Then there are gross motor assimilated products, which help in development of creep, crawl, walk, etc.
*
Then there are various puzzles and memory games which helps in developing word sense and reading skills.
*
PC learning games are also available with improved technical content. They are divided into different age group requirements.
*
Then there are Kindergarden reading kits having CDs, books, puzzles, parent's guide and so on.
*
Then you can also go for big magnetic numbers and alphabets, which comes with a board thereby encouraging your child to learn while having fun as well.
These above categories of toys are available and they have high learning content, so, if your child is having a reading problem then you can buy toys (køb legetøj) of these categories to facilitate them to read and write properly. With the increase in number of Reading Problem, systems among children researches are coming up with innovative technique to solve them. So, Buy Toys and help your child to grow in a better manner.
Article Source: http://www.ArticleBlast.com
Why Chinese children are better at arithmetic than our children.
A friend of mine is Chinese and when he discovered that I produce mathematics educational software, he told me not to try to sell it to the Chinese as there is nothing we can teach them about arithmetic.
This started me thinking. I have heard many times that Chinese children are much better than western children at arithmetic and I couldn't believe it was just that they practised more or were drilled more efficiently. Then one day I discovered what I think is the main reason - the way they describe their numbers is a great deal easier than the way we describe ours and this gives them a great advantage.
(I should point out that I may be mistaken in one or two of the technical details, but that won't make any difference to the argument, so if you are Chinese and you spot a tiny error, please don't worry about it.)
Think of the number 3457, for instance. We say ‘three thousand, four hundred and fifty seven', of course. We say exactly how many thousand there are and exactly how many hundreds there are. But when it comes to the tens, we don't say ‘five tens'. Instead, we say ‘fifty', a word that does not tell us how many tens it contains.
It is even worse if teens are involved. For instance, the number 8413 is read as ‘eight thousand, four hundred and thirteen'. Again the thousands and hundreds are self explanatory, but the word ‘thirteen' does not tell us how many tens it contains. This has to be learnt as a separate concept.
Not so in the Chinese number system! Their system reads the second number as ‘eight thousand, four hundred, one ten and three' and the first as ‘three thousand, four hundred, five tens and seven'.
So, what's the big deal? I hear you ask. Well, the point is that the extra layers of confusion we have in our number system are introduced just at the point when children are learning to add, subtract, multiply and divide small numbers, i.e. those up to about 99, mentally. By the time they get to the hundreds and thousands, they have mastered the four operations.
Let's see how this affects the learning process. Suppose we want to add 57 and 18. The first thing our children have to do is to recognise that 57 is really ‘five tens and 7' and that 18 is ‘one ten and eight'. Then they add the seven and eight, which they will say as ‘fifteen'. They then have to remember that this is one ten and five, so they write down the five and carry the one.
Next comes fifty plus ten, which they have to remember is five tens plus one ten (or they may know that the answer is sixty straight away) and add the carry digit from the previous column. They write this digit down. Lastly they need to read the answer as ‘seventy five', remembering as they do so that seven in the tens column is ‘seventy'.
Now let's try it the Chinese way.
57 + 18. They read this as ‘five tens and seven plus one ten and eight'. Seven plus eight is one ten and five, so write down the five and carry the one. Now five tens plus one ten plus one ten is seven tens. Write seven in the tens column. The answer is ‘seven tens and five'.
Our children have to make about four conversions from the numbers they are given to separate them into tens and units (and vice versa) that Chinese children do not have to do.
So, if we abandoned saying the ‘teen' numbers, calling them ‘one ten and one' etc and stopped using words such as ‘twenty', ‘thirty' etc and called them ‘two tens', ‘three tens' etc, would our children be much better at mental arithmetic? I certainly think so.
What about other languages? Well, these can be even more difficult. In French, for example, ‘seventy eight' is ‘sixty - eighteen' etc. In German they swap the early numbers around, so 28, for example, is ‘eight and twenty'. They must have a lot of trouble too!
Article Source: http://www.ArticleBlast.com
This started me thinking. I have heard many times that Chinese children are much better than western children at arithmetic and I couldn't believe it was just that they practised more or were drilled more efficiently. Then one day I discovered what I think is the main reason - the way they describe their numbers is a great deal easier than the way we describe ours and this gives them a great advantage.
(I should point out that I may be mistaken in one or two of the technical details, but that won't make any difference to the argument, so if you are Chinese and you spot a tiny error, please don't worry about it.)
Think of the number 3457, for instance. We say ‘three thousand, four hundred and fifty seven', of course. We say exactly how many thousand there are and exactly how many hundreds there are. But when it comes to the tens, we don't say ‘five tens'. Instead, we say ‘fifty', a word that does not tell us how many tens it contains.
It is even worse if teens are involved. For instance, the number 8413 is read as ‘eight thousand, four hundred and thirteen'. Again the thousands and hundreds are self explanatory, but the word ‘thirteen' does not tell us how many tens it contains. This has to be learnt as a separate concept.
Not so in the Chinese number system! Their system reads the second number as ‘eight thousand, four hundred, one ten and three' and the first as ‘three thousand, four hundred, five tens and seven'.
So, what's the big deal? I hear you ask. Well, the point is that the extra layers of confusion we have in our number system are introduced just at the point when children are learning to add, subtract, multiply and divide small numbers, i.e. those up to about 99, mentally. By the time they get to the hundreds and thousands, they have mastered the four operations.
Let's see how this affects the learning process. Suppose we want to add 57 and 18. The first thing our children have to do is to recognise that 57 is really ‘five tens and 7' and that 18 is ‘one ten and eight'. Then they add the seven and eight, which they will say as ‘fifteen'. They then have to remember that this is one ten and five, so they write down the five and carry the one.
Next comes fifty plus ten, which they have to remember is five tens plus one ten (or they may know that the answer is sixty straight away) and add the carry digit from the previous column. They write this digit down. Lastly they need to read the answer as ‘seventy five', remembering as they do so that seven in the tens column is ‘seventy'.
Now let's try it the Chinese way.
57 + 18. They read this as ‘five tens and seven plus one ten and eight'. Seven plus eight is one ten and five, so write down the five and carry the one. Now five tens plus one ten plus one ten is seven tens. Write seven in the tens column. The answer is ‘seven tens and five'.
Our children have to make about four conversions from the numbers they are given to separate them into tens and units (and vice versa) that Chinese children do not have to do.
So, if we abandoned saying the ‘teen' numbers, calling them ‘one ten and one' etc and stopped using words such as ‘twenty', ‘thirty' etc and called them ‘two tens', ‘three tens' etc, would our children be much better at mental arithmetic? I certainly think so.
What about other languages? Well, these can be even more difficult. In French, for example, ‘seventy eight' is ‘sixty - eighteen' etc. In German they swap the early numbers around, so 28, for example, is ‘eight and twenty'. They must have a lot of trouble too!
Article Source: http://www.ArticleBlast.com
Do You would like To Take Your Dog To Travel With You`
Just because you've a dog doesn't mean you've got to stay house all of the time. Should you plan ahead and take a little care, it's simple and fun to travel with your dog.
Here are several tips to make the trip less tough on both you and your pet:
1. Get your dog used to riding in the vehicle by taking him on short trips. Go to fun locations like the dog park, the fast food drive by way of (where you can feed him bits of meat from your burger), or to visit buddies. You want him to believe that trips inside the car are enjoyable. You don't want your dog to think that all automobile trips wind up at the vet's workplace.
2. If your dog will get carsick, do not feed him the morning of the trip. Having your dog travel with an empty stomach will support to prevent any car sickness.
3. Bring a lot of water along with a water dish along. You will will need to give your dog periodic drinks of water when you stop for a rest. It'll be less difficult to get your dog to drink if it actually is familiar water from home. Water in different places often smells or tastes differently, and your dog may possibly not wish to swallow it.
4. Be certain to pack your dog's food, treats, favorite bed, toys, and leash.
5. If your dog uses a crate, bring that along too. In the event you don't have a big vehicle, you can buy crates that fold up. Whenever you get to your destination, you can put your dog in his crate although you go somewhere that you can't bring him along.
6. How ought to your dog travel inside the vehicle? Some dogs like to sit or lay on the seat, so bring a blanket to protect the upholstery. Other dogs may need to be kept in a crate within the car. Be positive the crate can't slide around and frighten the dog whilst you're driving. It is attainable to also purchase dog seat belts to keep your dog safe while sitting inside the car.
7. Make a stop every few hours to walk your dog and give him some water. Some dogs are frightened by the noisy trucks driving by, so attempt to walk in a quiet area. Be a great citizen and bring plastic bags along to collect the mess.
8. If your dog is distressed about staying in a hotel or strange house at your destination, he might not eat or drink. You don't want him to get dehydrated, so be certain to get him to drink, at least. You can mix chicken broth or gravy into the dog's water. Which will typically get him to lap it proper up. You'll be able to mix chicken broth or gravy into the food too.
The initial trip will be the most difficult, since your dog won't realize that you can be returning. With the very first trip behind you, if you have taken the time to make sure it is pleasant for your dog, future traveling together with your dog should be a breeze.
Article Source: http://www.ArticleBlast.com
About The Author:
Here are several tips to make the trip less tough on both you and your pet:
1. Get your dog used to riding in the vehicle by taking him on short trips. Go to fun locations like the dog park, the fast food drive by way of (where you can feed him bits of meat from your burger), or to visit buddies. You want him to believe that trips inside the car are enjoyable. You don't want your dog to think that all automobile trips wind up at the vet's workplace.
2. If your dog will get carsick, do not feed him the morning of the trip. Having your dog travel with an empty stomach will support to prevent any car sickness.
3. Bring a lot of water along with a water dish along. You will will need to give your dog periodic drinks of water when you stop for a rest. It'll be less difficult to get your dog to drink if it actually is familiar water from home. Water in different places often smells or tastes differently, and your dog may possibly not wish to swallow it.
4. Be certain to pack your dog's food, treats, favorite bed, toys, and leash.
5. If your dog uses a crate, bring that along too. In the event you don't have a big vehicle, you can buy crates that fold up. Whenever you get to your destination, you can put your dog in his crate although you go somewhere that you can't bring him along.
6. How ought to your dog travel inside the vehicle? Some dogs like to sit or lay on the seat, so bring a blanket to protect the upholstery. Other dogs may need to be kept in a crate within the car. Be positive the crate can't slide around and frighten the dog whilst you're driving. It is attainable to also purchase dog seat belts to keep your dog safe while sitting inside the car.
7. Make a stop every few hours to walk your dog and give him some water. Some dogs are frightened by the noisy trucks driving by, so attempt to walk in a quiet area. Be a great citizen and bring plastic bags along to collect the mess.
8. If your dog is distressed about staying in a hotel or strange house at your destination, he might not eat or drink. You don't want him to get dehydrated, so be certain to get him to drink, at least. You can mix chicken broth or gravy into the dog's water. Which will typically get him to lap it proper up. You'll be able to mix chicken broth or gravy into the food too.
The initial trip will be the most difficult, since your dog won't realize that you can be returning. With the very first trip behind you, if you have taken the time to make sure it is pleasant for your dog, future traveling together with your dog should be a breeze.
Article Source: http://www.ArticleBlast.com
About The Author:
How You Can Avoid Being Trapped in Debt
Being in debt is a fact of life within the global and local economy. There is very good debt and there's bad debt and the key to dealing with debt just isn't to be trapped in it. Here are a few suggestions to assist you to prevent obtaining trapped within the debt pit.
Live within your means. During the Great Depression this was just the way of life. If you can't afford it, do not get it. Or save up for it till you had enough to buy it. Nowadays, this is no longer accurate and many people today who come across themselves deeply in debt with credit card balances, unsecured credit loans, auto loans and house loans have completed so since they're spending far more than they earn. To stay away from acquiring trapped get a clear picture of what your income and expenses are and plan your purchases based on those numbers.
Educate yourself. At the very least you have to be able to track your income and expenses so it is possible to set a realistic budget for your self that will help you plan the way to pay off your unsecured credit loans and other debts. With the abundance of facts online there is merely no excuse for remaining ignorant about interest rates and how they affect your money flows. You do not will need an advanced degree either and putting in some difficult work on educating your self about personal finances, consumer credit and so on will go a lengthy method to helping you prevent the debt trap.
Take control of your debt. If you are carrying a lot of debt inside your personal balance sheet, take steps to bring that debt to manageable levels and eventually get rid of them. Pay off the higher interest debts 1st like credit card balances and unsecured credit loans. From the cash you free up after eliminating those debts you may start paying down other debts or put the additional money to your savings accounts for emergencies and your retirement.
Article Source: http://www.ArticleBlast.com
Live within your means. During the Great Depression this was just the way of life. If you can't afford it, do not get it. Or save up for it till you had enough to buy it. Nowadays, this is no longer accurate and many people today who come across themselves deeply in debt with credit card balances, unsecured credit loans, auto loans and house loans have completed so since they're spending far more than they earn. To stay away from acquiring trapped get a clear picture of what your income and expenses are and plan your purchases based on those numbers.
Educate yourself. At the very least you have to be able to track your income and expenses so it is possible to set a realistic budget for your self that will help you plan the way to pay off your unsecured credit loans and other debts. With the abundance of facts online there is merely no excuse for remaining ignorant about interest rates and how they affect your money flows. You do not will need an advanced degree either and putting in some difficult work on educating your self about personal finances, consumer credit and so on will go a lengthy method to helping you prevent the debt trap.
Take control of your debt. If you are carrying a lot of debt inside your personal balance sheet, take steps to bring that debt to manageable levels and eventually get rid of them. Pay off the higher interest debts 1st like credit card balances and unsecured credit loans. From the cash you free up after eliminating those debts you may start paying down other debts or put the additional money to your savings accounts for emergencies and your retirement.
Article Source: http://www.ArticleBlast.com
Soccer Training Drills: Exercises To Do To Play Better Soccer
Any player who desires to play better soccer should take the time to perform soccer training drills or football training exercises. These exercises/drills help make winning soccer games easier. Read up for more information.
Every soccer team or football team does their best to experience winning soccer games. One of the strategies that can help people play better soccer is to frequently do football training exercises, also known as soccer training drills. Players who don't do these drills/exercises will surely perform poorly as compared to the players of the other team. Here are some examples of recommended drills, warm ups, or routines you can do if you're a football/soccer player who wants to show better performance during the competition:
A. Stretching Routine
Stretching your limbs, legs, and so on, is very important. This should be done before the game so as to prevent getting hurt or injured during the game. Aside from injury prevention, stretch routines can also boost performance. Stretching before the soccer match is one of the most important activities you should do for you'll find winning soccer games really hard if you don't warm-up.
B. Breathing Exercises
To play better soccer, part of the list of football training exercises players should perform religiously is breathing deeply - in other words, breathing in and out deeply for several times. This can relax your body; calm you if you're a bundle of nerves, etc. Breathing activities are included in soccer training drills because they can eliminate nervousness, help make you play more confidently, which means you can expect better playing from your self.
C. Passing Practice
Some players pass well, why others find it difficult. Good passing skills, of course, help your team in winning soccer games. If you feel that you're not a good passer, do not worry. You can still play better soccer, to be specific, you can become a better ball passer, if you practice passing. You have to pass the soccer ball to the wall using your foot (it's up to you whether your outside or inside foot), and be sure to send it right back to the wall if it bounces off the wall. Repeat a number of times and do it several times a week. This is one of the football training exercises that will really give you significant results.
D. ‘Shooting' Practice
A key to winning soccer games is to shoot the ball into the other team's base via your kick. It is best that you practice with another person who'll try to prevent the soccer ball from going into the enemy's base. Practice makes perfect.
Without performing soccer training drills frequently, you won't really be able to play better soccer.
Article Source: http://www.ArticleBlast.com
Every soccer team or football team does their best to experience winning soccer games. One of the strategies that can help people play better soccer is to frequently do football training exercises, also known as soccer training drills. Players who don't do these drills/exercises will surely perform poorly as compared to the players of the other team. Here are some examples of recommended drills, warm ups, or routines you can do if you're a football/soccer player who wants to show better performance during the competition:
A. Stretching Routine
Stretching your limbs, legs, and so on, is very important. This should be done before the game so as to prevent getting hurt or injured during the game. Aside from injury prevention, stretch routines can also boost performance. Stretching before the soccer match is one of the most important activities you should do for you'll find winning soccer games really hard if you don't warm-up.
B. Breathing Exercises
To play better soccer, part of the list of football training exercises players should perform religiously is breathing deeply - in other words, breathing in and out deeply for several times. This can relax your body; calm you if you're a bundle of nerves, etc. Breathing activities are included in soccer training drills because they can eliminate nervousness, help make you play more confidently, which means you can expect better playing from your self.
C. Passing Practice
Some players pass well, why others find it difficult. Good passing skills, of course, help your team in winning soccer games. If you feel that you're not a good passer, do not worry. You can still play better soccer, to be specific, you can become a better ball passer, if you practice passing. You have to pass the soccer ball to the wall using your foot (it's up to you whether your outside or inside foot), and be sure to send it right back to the wall if it bounces off the wall. Repeat a number of times and do it several times a week. This is one of the football training exercises that will really give you significant results.
D. ‘Shooting' Practice
A key to winning soccer games is to shoot the ball into the other team's base via your kick. It is best that you practice with another person who'll try to prevent the soccer ball from going into the enemy's base. Practice makes perfect.
Without performing soccer training drills frequently, you won't really be able to play better soccer.
Article Source: http://www.ArticleBlast.com
How To Find A Good Inspirational Keynote Speaker
Are you in search of motivational speaker for your conference? If you utilize these tips you will be able to find the right presenter that will impress your crowd and you will look like a hero for bringing them in.
Finding the right speaker to motivate your group may be a very difficult task. Not only can it be quite expensive and it is a major reflection on a meeting advisor and the organization. Here are a few tips that will help you in finding a good inspirational keynote speaker.
* Choose an inspirational speaker like they're a brand new, short term worker. When recruiting a new employee you would be very careful. Why would you treat booking a keynote speaker any differently? Look at it this way. When you hire a new employee and he/she works forty hours a week for 50 weeks, the output would be 1,920 hrs of work. But when inspirational speaker talks for 90 minutes and there's attendance of about 1300 individuals, that's the same number of hours. This way you would take into account the speaker's professional successes and credentials. Have a look at speaker's web page and watch some of the sample videos which he or she may present. Can this person hold an audience attention? Will attendees be fired up to hear them speak?
* Look in for an inspirational speaker appropriate to your objectives: If you have a good handle on the end result that you want your attendees to go away with, you can discover a speaker who will be relevant to that end. If you want somebody to motivate and inspire, the subject matter isn't incredibly important. If you want someone who will entertain, any comedian, magician or excellent story-teller will do the trick. If you want your attendees to leave with a set of abilities or particular industry knowledge, you should take it into consideration as well.
* Appreciate inspirational speakers who are easy to work with!
A lot of speakers are divas. They request personal green rooms and create riders with all kinds of ridiculous requests. You have to email and call you way too often with some kind of change. If someone bothers you when you attempt to book them to speak, or if they're not simple to work with, chances are, they're going to be a pain when these folks get to your conference. Your first experience with a speaker is in all probability going to be your best experience with them. Thus you can save yourself a significant aggravation by trusting your instinct.
If you want the best keynote inspirational speaker for your next event, follow these 3 easy steps! If you want an inspirational speaker who has conducted various seminars, inquire about hiring motivational speaker. All these points can help you in finding a motivational speaker. If you have a good handle on the conclusion result that you want your attendees to go away with, you can find out a speaker who will be appropriate to that end.
Article Source: http://www.ArticleBlast.com
Finding the right speaker to motivate your group may be a very difficult task. Not only can it be quite expensive and it is a major reflection on a meeting advisor and the organization. Here are a few tips that will help you in finding a good inspirational keynote speaker.
* Choose an inspirational speaker like they're a brand new, short term worker. When recruiting a new employee you would be very careful. Why would you treat booking a keynote speaker any differently? Look at it this way. When you hire a new employee and he/she works forty hours a week for 50 weeks, the output would be 1,920 hrs of work. But when inspirational speaker talks for 90 minutes and there's attendance of about 1300 individuals, that's the same number of hours. This way you would take into account the speaker's professional successes and credentials. Have a look at speaker's web page and watch some of the sample videos which he or she may present. Can this person hold an audience attention? Will attendees be fired up to hear them speak?
* Look in for an inspirational speaker appropriate to your objectives: If you have a good handle on the end result that you want your attendees to go away with, you can discover a speaker who will be relevant to that end. If you want somebody to motivate and inspire, the subject matter isn't incredibly important. If you want someone who will entertain, any comedian, magician or excellent story-teller will do the trick. If you want your attendees to leave with a set of abilities or particular industry knowledge, you should take it into consideration as well.
* Appreciate inspirational speakers who are easy to work with!
A lot of speakers are divas. They request personal green rooms and create riders with all kinds of ridiculous requests. You have to email and call you way too often with some kind of change. If someone bothers you when you attempt to book them to speak, or if they're not simple to work with, chances are, they're going to be a pain when these folks get to your conference. Your first experience with a speaker is in all probability going to be your best experience with them. Thus you can save yourself a significant aggravation by trusting your instinct.
If you want the best keynote inspirational speaker for your next event, follow these 3 easy steps! If you want an inspirational speaker who has conducted various seminars, inquire about hiring motivational speaker. All these points can help you in finding a motivational speaker. If you have a good handle on the conclusion result that you want your attendees to go away with, you can find out a speaker who will be appropriate to that end.
Article Source: http://www.ArticleBlast.com
Improve Your Confidence
f you want toimprove your confidence, you may be confused because of all of the different advice out there about how to do so. Numerous seminars, books and television shows aim to help increase self confidence, but the tips may not apply to everybody. The method for increasing your self confidence should be unique to who you are.
First of all, remember that you are different from everyone else. Acknowledging this is the first and most important way to improve your self confidence. This accomplishes a few things. First of all, you remove expectations that you have placed on yourself to be like everybody else.
Too often, people want to increase their self confidence, but what that means to them is that they want to project the same kind of self confidence that they see other people having, and they want to act exactly how those people do. When you acknowledge that you are different from others, it takes the pressure off of you to somehow develop something that you do not feel and act a way that is not natural for you.
Many of us have preconceived ideas of what self confidence looks like. We try to make ourselves and everybody else fit a certain profile. For example, we think that confident people are always outgoing. This is simply not true. People become even more frustrated and lose more confidence in themselves when they are made to feel like they just can't manage to feel the way that everybody else does. The truth is that self confidence is all about being comfortable with who you are, regardless of your past and to improve your confidence, you must know how truly amazing you really are.
People get confidence and certain personality traits confused. Outgoing people may be outgoing by nature or may talk a lot to cover up their nervousness, but this does not mean they are confident. Conversely, a person who is naturally introverted may be very confident in who he or she is. So, do not focus on changing yourself to be like others who you perceive to be confident. Instead, focus on figuring out who you are and becoming comfortable with that.
In many cases, people have reasons that they are not confident with themselves. What they may not recognize is that there may be things that need to be changed in their lives, and there is a reason why they cannot feel comfortable with who they are. Maybe there are certain things in your personality that you should work on or certain character traits that you have or do not have that may be holding you back from feeling good. Addressing honest traits that need to be changed is different than wanting to change who you are.
If you are not confident because you are always showing up late to everything, for example, it is not good advice to just accept who you are and not compare yourself to others. In reality, this personality trait needs to be changed, and once you change this you will feel better about yourself. You are not changing who you are, just working on improving who you already are.
The overall lesson to take away from this article is not to change yourself but to be the best version of yourself possible. Too many of us see someone else's confidence and think we need to be exactly like they are to feel good about ourselves - more attractive, more outgoing or whatever the case may be. The truth is that, to improve your confidence, the key is in feeling that good about YOU.
SelfImprovement4Success.com is dedicated to helping you understand better these strategies to help you in your personal development goals.
Click Here:
http://selfimprovement4success.com/
Article Source: http://www.ArticleBlast.com
First of all, remember that you are different from everyone else. Acknowledging this is the first and most important way to improve your self confidence. This accomplishes a few things. First of all, you remove expectations that you have placed on yourself to be like everybody else.
Too often, people want to increase their self confidence, but what that means to them is that they want to project the same kind of self confidence that they see other people having, and they want to act exactly how those people do. When you acknowledge that you are different from others, it takes the pressure off of you to somehow develop something that you do not feel and act a way that is not natural for you.
Many of us have preconceived ideas of what self confidence looks like. We try to make ourselves and everybody else fit a certain profile. For example, we think that confident people are always outgoing. This is simply not true. People become even more frustrated and lose more confidence in themselves when they are made to feel like they just can't manage to feel the way that everybody else does. The truth is that self confidence is all about being comfortable with who you are, regardless of your past and to improve your confidence, you must know how truly amazing you really are.
People get confidence and certain personality traits confused. Outgoing people may be outgoing by nature or may talk a lot to cover up their nervousness, but this does not mean they are confident. Conversely, a person who is naturally introverted may be very confident in who he or she is. So, do not focus on changing yourself to be like others who you perceive to be confident. Instead, focus on figuring out who you are and becoming comfortable with that.
In many cases, people have reasons that they are not confident with themselves. What they may not recognize is that there may be things that need to be changed in their lives, and there is a reason why they cannot feel comfortable with who they are. Maybe there are certain things in your personality that you should work on or certain character traits that you have or do not have that may be holding you back from feeling good. Addressing honest traits that need to be changed is different than wanting to change who you are.
If you are not confident because you are always showing up late to everything, for example, it is not good advice to just accept who you are and not compare yourself to others. In reality, this personality trait needs to be changed, and once you change this you will feel better about yourself. You are not changing who you are, just working on improving who you already are.
The overall lesson to take away from this article is not to change yourself but to be the best version of yourself possible. Too many of us see someone else's confidence and think we need to be exactly like they are to feel good about ourselves - more attractive, more outgoing or whatever the case may be. The truth is that, to improve your confidence, the key is in feeling that good about YOU.
SelfImprovement4Success.com is dedicated to helping you understand better these strategies to help you in your personal development goals.
Click Here:
http://selfimprovement4success.com/
Article Source: http://www.ArticleBlast.com
Is Hair Loss Preventable?
If your Dad is bald, there's a pretty good chance you will be too. Many accept this as just a fact of life, but some don't. For decades now, men have tried to find a cure for hair loss, or baldness. In some cases it is pure vanity but for some, premature hair loss makes them look years older than they are and they try to hang onto their thatch for as long as possible. They aren't alone in this search, hereditary baldness also affects women. This was a very touchy subject at one time, and women resorted to wigs and hair pieces to hide their thinning locks, but nowadays is much more accepted and recognized.
Looking at other member of your family can often determine the age and the pattern with which you will suffer hair loss. This genetic pattern in passed down and the chances of you bucking the trend are remote. The male pattern usually starts with a receding hairline, followed by a small bald patch on the crown. In complete baldness these will eventually join up and the head will be totally devoid of hair. Some only suffer the receding and general thinning, still keeping a reasonable amount of hair. If there is only a small amount of hair remaining, many men choose to shave their heads as this looks better than a few tufts and a bald patch. Women's hair tends to thin all over, and the scalp may become visible. There are many products on the market that claim to stop hair loss in it's tracks, and make amazing claims. The sad fact is many of these are complete scams and a big waste of time and money. There are now prescription medications available, but many will see little or no results.
Non hereditary hair loss is a whole different ball game. If you start losing your hair there is a reason for it. Far and away the most common reason for this time of hair loss is Alopecia. There are many theories for why you should suddenly have small, ball patches that are tender to the touch. It can be hereditary, it could be caused by stress or lifestyle, but there is still no scientific proof as to the actual cause. It is widely thought to be a malfunction in the autoimmune system, so the body attacks its own hair follicles resulting in hair growth being stunted or stopped altogether. Thankfully there are now a wide range of creams and applications which can stop the Alopecia progressing. Your doctor will advise you on the one(s) that are best for you, and often a combination of medications will be prescribed.
Lifestyle can play a major part in the health of our hair. Many few people now walk around with a natural shine to their hair, this could be due to smoking, alcohol consumption, poor diet or something as seemingly innocent as hair products. Perming, dying, hair spray, gels, mousses, styling aids and extensions can all severely damage our hair in the long run. It is no coincidence that in every drug store there is an array of supplements purely for hair and nails. These are the two areas that first show signs of an unhealthy lifestyle.
Make the most of your crowning glory, no one really knows how long they will have it for, so it makes a lot of sense to take care of our hair while it is at its best.
Article Source: http://www.ArticleBlast.com
Looking at other member of your family can often determine the age and the pattern with which you will suffer hair loss. This genetic pattern in passed down and the chances of you bucking the trend are remote. The male pattern usually starts with a receding hairline, followed by a small bald patch on the crown. In complete baldness these will eventually join up and the head will be totally devoid of hair. Some only suffer the receding and general thinning, still keeping a reasonable amount of hair. If there is only a small amount of hair remaining, many men choose to shave their heads as this looks better than a few tufts and a bald patch. Women's hair tends to thin all over, and the scalp may become visible. There are many products on the market that claim to stop hair loss in it's tracks, and make amazing claims. The sad fact is many of these are complete scams and a big waste of time and money. There are now prescription medications available, but many will see little or no results.
Non hereditary hair loss is a whole different ball game. If you start losing your hair there is a reason for it. Far and away the most common reason for this time of hair loss is Alopecia. There are many theories for why you should suddenly have small, ball patches that are tender to the touch. It can be hereditary, it could be caused by stress or lifestyle, but there is still no scientific proof as to the actual cause. It is widely thought to be a malfunction in the autoimmune system, so the body attacks its own hair follicles resulting in hair growth being stunted or stopped altogether. Thankfully there are now a wide range of creams and applications which can stop the Alopecia progressing. Your doctor will advise you on the one(s) that are best for you, and often a combination of medications will be prescribed.
Lifestyle can play a major part in the health of our hair. Many few people now walk around with a natural shine to their hair, this could be due to smoking, alcohol consumption, poor diet or something as seemingly innocent as hair products. Perming, dying, hair spray, gels, mousses, styling aids and extensions can all severely damage our hair in the long run. It is no coincidence that in every drug store there is an array of supplements purely for hair and nails. These are the two areas that first show signs of an unhealthy lifestyle.
Make the most of your crowning glory, no one really knows how long they will have it for, so it makes a lot of sense to take care of our hair while it is at its best.
Article Source: http://www.ArticleBlast.com
Food With Fiber Is Needed To Lose Weight
Getting rid of excess fat will require modifying a diet plan. Furthermore, whenever dietary habits are modified a person observes a lot more benefits. An appropriate diet plan not only aids in weight loss but in addition helps avoid constipation, decrease cholesterol and control levels of insulin.
Typical eating habits consist of food products full of simple carbohydrates and unhealthy fats. Both those substances contribute to additional pounds. Foods full of simple or monosaccharide carbs are sugary cereals, pastries as well as potato chips. Simple or monosaccharide carbs are absorbed fast in a human body resulting in immediate hungriness after eating these types of foods. Unhealthy fats are used in vegetable oil, shortening and margarine. The human body cannot process these fats. Regularly consuming food products high in unhealthy fat and simple carbohydrates will never lead to losing weight. Moreover, continuously consuming food products having unhealthy fats and simple carbs might lead to other health conditions.
An effective diet plan for dropping pounds involves consuming food items loaded with fiber. Dieters can find two forms of dietary fiber, insoluble and soluble. Soluble fiber joins with cholesterol and fatty acids, eliminating these substances out of a human body. This action helps to reduce LDL cholesterol. Lowering LDL cholesterol lowers possibility of heart problems. Foods high in this type of dietary fiber are potatoes, beans and apples.
An additional benefit of soluble fiber is it will enable carbs to remain in an individual's belly longer. When carbohydrates remain in an individual's belly for more time, they can be digested better. This particular process helps to manage insulin levels better which is beneficial for every person wanting to decrease unwanted fat, particularly those people having sugar Diabetes. Regulating blood sugar levels reduces probability for type 2 Diabetes.
Insoluble fiber passes substances through a person's digestive system. Plus this kind of fiber eliminates pollutants from the body. Those actions assist to avoid constipation, therefore reducing possibility for colon cancer, diverticular disease and hemorrhoids. An effective diet plan will involve consuming foods filled with this type of dietary fiber such as popcorn, almonds and peas.
But, a dieter should understand the majority of foods containing dietary fiber have both soluble and insoluble. For example, most veggies and fruits provide soluble and insoluble dietary fiber. The outer peels from vegetables and fruits have insoluble fiber. When removing peels then individuals are not getting as much insoluble dietary fiber. Thus, eat the peels in order to receive full benefits. If afraid of pollutants in outer peels, consider buying organic fruits and veggies. Incorporate eating habit changes immediately using a healthy diet plan for dropping pounds and experience better overall health.
Article Source: http://www.ArticleBlast.com
Typical eating habits consist of food products full of simple carbohydrates and unhealthy fats. Both those substances contribute to additional pounds. Foods full of simple or monosaccharide carbs are sugary cereals, pastries as well as potato chips. Simple or monosaccharide carbs are absorbed fast in a human body resulting in immediate hungriness after eating these types of foods. Unhealthy fats are used in vegetable oil, shortening and margarine. The human body cannot process these fats. Regularly consuming food products high in unhealthy fat and simple carbohydrates will never lead to losing weight. Moreover, continuously consuming food products having unhealthy fats and simple carbs might lead to other health conditions.
An effective diet plan for dropping pounds involves consuming food items loaded with fiber. Dieters can find two forms of dietary fiber, insoluble and soluble. Soluble fiber joins with cholesterol and fatty acids, eliminating these substances out of a human body. This action helps to reduce LDL cholesterol. Lowering LDL cholesterol lowers possibility of heart problems. Foods high in this type of dietary fiber are potatoes, beans and apples.
An additional benefit of soluble fiber is it will enable carbs to remain in an individual's belly longer. When carbohydrates remain in an individual's belly for more time, they can be digested better. This particular process helps to manage insulin levels better which is beneficial for every person wanting to decrease unwanted fat, particularly those people having sugar Diabetes. Regulating blood sugar levels reduces probability for type 2 Diabetes.
Insoluble fiber passes substances through a person's digestive system. Plus this kind of fiber eliminates pollutants from the body. Those actions assist to avoid constipation, therefore reducing possibility for colon cancer, diverticular disease and hemorrhoids. An effective diet plan will involve consuming foods filled with this type of dietary fiber such as popcorn, almonds and peas.
But, a dieter should understand the majority of foods containing dietary fiber have both soluble and insoluble. For example, most veggies and fruits provide soluble and insoluble dietary fiber. The outer peels from vegetables and fruits have insoluble fiber. When removing peels then individuals are not getting as much insoluble dietary fiber. Thus, eat the peels in order to receive full benefits. If afraid of pollutants in outer peels, consider buying organic fruits and veggies. Incorporate eating habit changes immediately using a healthy diet plan for dropping pounds and experience better overall health.
Article Source: http://www.ArticleBlast.com
Think About Taking A Multivitamin Supplement For Weight Loss
A healthy diet will be extremely vital for reducing unwanted body weight. Even with an ideal weight loss diet system the body might not be acquiring sufficient quantities of nutrients needed. Consequently, dieters should explore using supplements.
Whenever wanting to lose extra fat, number of calories consumed every day is reduced. If just eating 1,500 to 2,000 calories per day, acquiring sufficient quantities of nutrients necessary could be difficult. Therefore, nutritional supplements are a fantastic alternative for obtaining essential nutrition.
Additionally, vegetables and fruits today no longer have as many nutriments as before. As a result eating vegetables and fruits may not provide enough nutrition required for losing weight. Fields have been stripped of important nutriments. Crops are produced in bulk. Genetically modified organisms are being utilized for increasing growth and resistance to pests. Each one of those items result in fruits and veggies providing smaller amounts of nutriments. As a consequence, using multivitamin supplements will be a wonderful way to acquire needed nutrients which are lacking from present day vegetables and fruits.
A person may have a few worries about taking nutritional supplements. In the past, a few nutritional supplements had been challenging to get down. Currently, lots of multivitamins are offered in a powder. All people must do will be include water or another beverage. A number of multivitamin products are even spread on food items and then eaten that way. Moreover, quite a few multivitamin products today are chewable. Lastly, many multivitamin products available these days are available in a liquid. These three developments will make taking multivitamin supplements a lot simpler. Thus, an individual will find these items no longer are difficult to swallow.
Another issue could be nutritional supplements taste bad. In the past these products might have left a terrible after taste. Nonetheless, lots of nutrient supplements today are great tasting. Companies produce these items that taste the same as fruits or chocolate. Who can resist pills that will taste the same as a strawberry?
Many individuals believe nutriments from these products are flushed down the sewer rather than digested in their body. In the past, that might have been the case. But, a lot of multivitamin supplements these days are more potent, which implies these items provide quick benefits and utmost absorption. Moreover, these items available as a chewable, liquid or powder will take a human body fewer hours to process.
A number of people might think an appropriate weight loss diet program involves just taking a multivitamin supplement. This particular assumption is not true. Multivitamin products ought to be used along with healthy diets. Individuals never should rely on these products alone to reduce weight.
Getting rid of excessive fat will be simpler when the human body obtains adequate quantities of nutriments. Many dieters when trying to drop extra fat rely on multivitamin supplements to assist in providing necessary antioxidants, vitamins and minerals. Nevertheless, even using multivitamin products a weight loss diet system involves a healthy diet.
Article Source: http://www.ArticleBlast.com
Whenever wanting to lose extra fat, number of calories consumed every day is reduced. If just eating 1,500 to 2,000 calories per day, acquiring sufficient quantities of nutrients necessary could be difficult. Therefore, nutritional supplements are a fantastic alternative for obtaining essential nutrition.
Additionally, vegetables and fruits today no longer have as many nutriments as before. As a result eating vegetables and fruits may not provide enough nutrition required for losing weight. Fields have been stripped of important nutriments. Crops are produced in bulk. Genetically modified organisms are being utilized for increasing growth and resistance to pests. Each one of those items result in fruits and veggies providing smaller amounts of nutriments. As a consequence, using multivitamin supplements will be a wonderful way to acquire needed nutrients which are lacking from present day vegetables and fruits.
A person may have a few worries about taking nutritional supplements. In the past, a few nutritional supplements had been challenging to get down. Currently, lots of multivitamins are offered in a powder. All people must do will be include water or another beverage. A number of multivitamin products are even spread on food items and then eaten that way. Moreover, quite a few multivitamin products today are chewable. Lastly, many multivitamin products available these days are available in a liquid. These three developments will make taking multivitamin supplements a lot simpler. Thus, an individual will find these items no longer are difficult to swallow.
Another issue could be nutritional supplements taste bad. In the past these products might have left a terrible after taste. Nonetheless, lots of nutrient supplements today are great tasting. Companies produce these items that taste the same as fruits or chocolate. Who can resist pills that will taste the same as a strawberry?
Many individuals believe nutriments from these products are flushed down the sewer rather than digested in their body. In the past, that might have been the case. But, a lot of multivitamin supplements these days are more potent, which implies these items provide quick benefits and utmost absorption. Moreover, these items available as a chewable, liquid or powder will take a human body fewer hours to process.
A number of people might think an appropriate weight loss diet program involves just taking a multivitamin supplement. This particular assumption is not true. Multivitamin products ought to be used along with healthy diets. Individuals never should rely on these products alone to reduce weight.
Getting rid of excessive fat will be simpler when the human body obtains adequate quantities of nutriments. Many dieters when trying to drop extra fat rely on multivitamin supplements to assist in providing necessary antioxidants, vitamins and minerals. Nevertheless, even using multivitamin products a weight loss diet system involves a healthy diet.
Article Source: http://www.ArticleBlast.com
Tuesday, 1 March 2011
Michelin awards star to closed restaurant
A "posthumous" award for excellent cooking has been presented to a restaurant which closed down three months ago.
There were red faces at France's big red book, the Michelin Guide, yesterday when it emerged that the 2011 edition had awarded a coveted star to a restaurant that served its last meal in December.
Max Bichot, chef of Les Hêtres at Ingouville-sur-Mer on the north Normandy coast, was philosophical about his belated promotion to the culinary aristocracy. "I am very happy because this is the recognition that many chefs aspire to," he said. "It's just a pity that it didn't come a little earlier."
Mr Bichot, 52, closed down his fish restaurant on 30 December because of a "lack of customers". With four- course menus ranging in price from €39 to €85 (£33 to £72), Les Hêtres, which translates as "the beeches", had won praise from several other restaurant guides.
"If I had been given the star earlier, it might have made all the difference," he said. "The Michelin guide is, after all, the real consecration for any chef. My cooking was just as good before."
There is no question of the restaurant reopening. The premises have been sold and are being converted into a private house. Mr Bichot has, in any case, other fish to fry. "I had the good fortune to fall in love with a woman who has a seafood restaurant at Yport [a few kilometres away]," he said. "I am going to help her out in her kitchen – with no pressure."
The commercial failure of Mr Bichot's restaurant, despite its quality, is a sign of the times. Many restaurateurs have been moving away from the "haute cuisine" category for something more affordable.
In the 2011 Michelin Guide to France, published on Monday, the 577 three-, two- and one-star restaurants were outnumbered for the first time by restaurants in the "Bib Gourmand" category of good eating for less than €29 a head (or €35 in Paris). There were 117 new restaurants in this category, bringing the total to 601.
Unusually, no restaurant was promoted to three stars. One was demoted to two stars, reducing the number of restaurants in France in the very highest Michelin category to just 25.
There were red faces at France's big red book, the Michelin Guide, yesterday when it emerged that the 2011 edition had awarded a coveted star to a restaurant that served its last meal in December.
Max Bichot, chef of Les Hêtres at Ingouville-sur-Mer on the north Normandy coast, was philosophical about his belated promotion to the culinary aristocracy. "I am very happy because this is the recognition that many chefs aspire to," he said. "It's just a pity that it didn't come a little earlier."
Mr Bichot, 52, closed down his fish restaurant on 30 December because of a "lack of customers". With four- course menus ranging in price from €39 to €85 (£33 to £72), Les Hêtres, which translates as "the beeches", had won praise from several other restaurant guides.
"If I had been given the star earlier, it might have made all the difference," he said. "The Michelin guide is, after all, the real consecration for any chef. My cooking was just as good before."
There is no question of the restaurant reopening. The premises have been sold and are being converted into a private house. Mr Bichot has, in any case, other fish to fry. "I had the good fortune to fall in love with a woman who has a seafood restaurant at Yport [a few kilometres away]," he said. "I am going to help her out in her kitchen – with no pressure."
The commercial failure of Mr Bichot's restaurant, despite its quality, is a sign of the times. Many restaurateurs have been moving away from the "haute cuisine" category for something more affordable.
In the 2011 Michelin Guide to France, published on Monday, the 577 three-, two- and one-star restaurants were outnumbered for the first time by restaurants in the "Bib Gourmand" category of good eating for less than €29 a head (or €35 in Paris). There were 117 new restaurants in this category, bringing the total to 601.
Unusually, no restaurant was promoted to three stars. One was demoted to two stars, reducing the number of restaurants in France in the very highest Michelin category to just 25.
Gold price hits record high on Libya unrest
The price on the London Bullion Market jumped more than $14 to $1,434.50 an ounce, topping the previous mark of $1,431.25, set in December.
Gold is traditionally seen as a haven for investors in times of uncertainty.
Unrest across the Middle East and North Africa fuelled a 6% rise in gold prices during February.
Analysts said that the political problems were pushing oil prices higher and fanning concerns about inflation and slower global economic growth.
"What gold needed was a catalyst, and it found it in the form of tensions that are surfacing in the Middle East and rising oil prices," said Mark Luschini from the brokerage Janney Montgomery Scott.
Mr Luschini added that investors saw gold giving them greater protection from inflationary pressures and political instability.
On the New York Comex exchange, the price of gold reached $1,434.40, a record for that market, before pulling back slightly.
Meanwhile oil prices, which have also been on the up since unrest broke out in North Africa and the Middle East, rose again on Tuesday.
In London, Brent crude rose 4.2% to $116.46, while US light, sweet crude rose 3.7% to $100.52.
Gold is traditionally seen as a haven for investors in times of uncertainty.
Unrest across the Middle East and North Africa fuelled a 6% rise in gold prices during February.
Analysts said that the political problems were pushing oil prices higher and fanning concerns about inflation and slower global economic growth.
"What gold needed was a catalyst, and it found it in the form of tensions that are surfacing in the Middle East and rising oil prices," said Mark Luschini from the brokerage Janney Montgomery Scott.
Mr Luschini added that investors saw gold giving them greater protection from inflationary pressures and political instability.
On the New York Comex exchange, the price of gold reached $1,434.40, a record for that market, before pulling back slightly.
Meanwhile oil prices, which have also been on the up since unrest broke out in North Africa and the Middle East, rose again on Tuesday.
In London, Brent crude rose 4.2% to $116.46, while US light, sweet crude rose 3.7% to $100.52.
Weight loss
Guidelines For Obesity Treatment
Assessment of weight involves evaluating body mass index, waist circumference, and the patient's risk factors.
BMI=weight (kg)/[height (m)]2.
Overweight is defined as a BMI of 25-29.9 kg/m2.
Obesity is defined as a BMI of ≥30 kg/m2.
Waist circumference for men >40 inches or women >35 inches indicates an increased risk for those with a BMI of 25-34.9.
Coronary heart disease or other atherosclerotic diseases, type 2 diabetes, and sleep apnea are factors associated with a very high risk of developing disease complications and mortality.
Weight loss is recommended for those who are overweight or obese or have a high waist circumference and two or more risk factors.
Appetite Suppressants Background
Appetite suppressants are agents that promote weight loss by decreasing appetite or increasing the sensation of fullness. About one-quarter of the U.S. population can be considered obese (BMI of >30). Four million of these people may be classified as morbidly obese (BMI of >40). Obesity is associated with increased risk of hypertension, type 2 diabetes and heart disease. The use ofappetite suppressant medications to treat obesity in combination with physical activity and diet modification is often recommended to lose and maintain weight successfully over the long term.
Appetite Suppressants Theory/Evidence
Several prescription medications are currently approved for treatment of obesity. In general, the effects of these medications are modest, leading to an average initial weight loss of between 5 and 22 pounds; though studies show that weight returns after cessation of the drugs. There is considerable individual difference in response to these medications; some people experience greater weight loss than others.
Short-term use of appetite suppressant medications has been shown to modestly reduce health risks for obese individuals. Studies have found that these medications can lower blood pressure, blood cholesterol, blood fats (triglycerides), and decrease insulin resistance (the body's ability to utilize blood sugar). Long-term studies need to be conducted to determine if weight loss assisted byappetite suppressant medications can improve health long-term.
Weight loss tends to be greatest during the first few weeks or months of treatment, leveling off after about six months. Research suggests that if a patient does not lose at least four pounds during the first four weeks on a particular medication, that medication is unlikely to be effective over the long run.
Short-term use (few weeks to few months): Examples include diethylpropion (Tenuate®), and phentermine (Adipex-P®).
The mechanism of action of diethylpropion and phentermine appears to be secondary to CNS (central nervous system) effects, specifically stimulation of the hypothalamus to release catecholamines into the central nervous system. Appetite suppressing effects are mediated via norepinephrine and dopamine metabolism.
Long-term use (up to one year or more): Examples include orlistat (Xenical®) and sibutramine (Meridia®).
Orlistat is the first prescription treatment for obesity that does not act as an appetite suppressant. It works by interfering with the action of gastrointestinal (GI) lipase in the GI tract. As a result of this mechanism of action, 30% of ingested dietary fat is not absorbed.
Sibutramine and its two primary metabolites also appear to be secondary to CNS effects by blocking the neuronal uptake of norepinephrine, serotonin, and dopamine.
OTC (over-the-counter): It is believed that "P57" molecule in Hoodia mimics the effect that glucose has on your brain, telling part of your brain (the hypothalamus) that you feel full. Consequently, you have no desire to eat. However current available evidence on hoodia's effectiveness and safety is lacking.
Dietrine Carb Blocker with Phase 2®: An ingredient extracted from white kidney beans is thought toneutralize the digestive enzyme alpha amylase before it can convert starch into glucose and then fat.
Safety Of Appetite Suppressants
Ephedrine: Since March 2004, the sale of all products containing ephedra in the United States has been banned. Other names of ephedrine are ephedra, ephedrinum, and ma huang.
A study published in the February 2003 issue of the Annals of Internal Medicine found that ephedra supplements make up only one percent of all dietary supplement sales, but account for 64 percent of adverse effects associated with dietary supplements.
A case-control study published in a 1993 issue of Neurology concluded that the rate of hemorrhagic (bleeding) strokes among ephedra-users was significantly higher than among nonusers, for people taking doses above 32 milligrams a day. According to the FDA, many ephedra-containing dietary supplement labels recommend that users take up to 100mg of ephedra daily.
Fenfluramine (Pondimin) and dexfenfluramine (Redux) were voluntarily removed from the market in 1997. These two medications were shown to be associated with a rare but very serious and potentially fatal disorder known as primary pulmonary hypertension (PPH), a disease of the lungs. Forty-five percent of patients with PPH die within four years of diagnosis.
Phenylpropanolamine (PPA) is a synthetic sympathomimetic amine structurally similar to pressor amines (i.e., epinephrine, phenylephrine, and ephedrine) and central nervous system stimulants (i.e., ephedrine, amphetamine). It is a common ingredient in cough-cold remedies and appetite suppressants. A study reports that taking PPA increases the risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk but no data's available. Although the risk of hemorrhagic stroke is very low, FDA recommends that consumer should not use any products that contain PPA, and also manufacturer either reformulated or recalled all the medications that contain PPA.
General safety concerns: Most side effects of the medications that are approved by FDA are mild and diminish as treatment continues. Rarely, serious and even fatal outcomes have been reported. Medications that affect catecholamine levels, such as phentermine and dietylpropion may cause symptoms of sleeplessness, nervousness.
Gastric Bypass Surgery Background
Gastric bypass surgery is the most common weight loss surgery which uses bands or staples to create food intake restriction. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and you also feel full for a longer time.
This surgery is often performed in those who have a BMI ≥40 (extremely obese) or BMI between 35 and 39.9 and with weight related health problems such as diabetes or high blood pressure.
Surgical candidates go through an extensive screening process. Not everyone who meets the criteria for the surgery is psychologically or medically ready for the surgical procedure. A team of professionals, including a physician, dietitian, psychologist and surgeon, evaluate whether the surgery is appropriate. Following surgery, physical, nutritional and metabolic counseling are given to prevent nutritional deficiencies. Lifelong use of nutritional supplements such as multivitamins, vitamin B12, vitamin D and calcium is recommended.
Researchers have found greater weight loss in gastric bypass (93.3 pounds) compared to gastroplasty (67 pounds) after one year. Over two years, gastric bypass surgery patients have been shown to lose two-thirds of excess weight. The success rate for weight loss for RGB is 68 to 72% of excess body weight over a three-year period, and 75% for BPD. After five years, the average excess weight loss fromgastric bypass surgery ranges from 48 to 74%.
The improvements observed in type 2 diabetes, high blood pressure and high blood cholesterol may significantly decrease the risk of cardiovascular events in individuals who have undergone gastric bypass surgery compared with those treated through other means. Gastric bypass surgery has also shown to improve mobility and quality of life for people who are severely overweight.
Risks Of Gastric Bypass Surgery
A risk of death has been associated with gastric bypass surgery. The risk varies depending on age, general health and other medical conditions. Talk to your doctor about the exact level of risk gastric bypass surgery may pose for you.
Blood clots in the legs are more likely to occur in very overweight people. Blood clots can be dangerous. In some cases, they travel to the lungs and lodge in the lungs' arteries causing a pulmonary embolism, a serious condition that damages lung tissue and can lead to death. Walking and using leg wraps that apply intermittent pressure to the leg can help reduce this risk of blood clots in the legs.
Leaking at one of the staple lines in the stomach has occurred and can be treated with antibiotics. Most cases heal with time. Sometimes, the leak can be serious enough to require emergency surgery.
Excess weight places extra stress on the chest cavity and lungs. This means a higher risk of developing pneumonia after the surgery.
Narrowing of the opening between the stomach and small intestine has occurred. This rare complication may require either an outpatient procedure to pass a tube through your mouth to widen (dilate) the narrowed opening or corrective surgery.
Gastric bypass can also cause dumping syndrome, a condition where stomach contents move too quickly through the small intestine causing nausea, vomiting, diarrhea, dizziness and sweating.
Other common complications include vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcer, hernia at the incision site, and intolerance to certain foods.
Other Types Of Weight Loss Surgery
Adjustable gastric banding: The surgeon uses an inflatable band to partition the stomach into two parts. He or she then wraps the band around the upper part of your stomach and pulls it tight, like a belt, creating a tiny channel between the two pouches. The band keeps the opening from expanding and is designed to stay in place indefinitely. But it can be adjusted or surgically removed if necessary. Most surgeons perform this operation using a laparoscope.
Biliopancreatic diversion: In this procedure, a portion of your stomach is removed. The remaining pouch is connected directly to your small intestine, but completely bypasses your duodenum and jejunum where most nutrient absorption takes place. This weight-loss surgery offers sustained weight loss, but it presents a greater risk of malnutrition and vitamin deficiencies and requires close monitoring.
Jaw wiring: This is a form of food intake restriction for temporary use in patients without respiratory problems. It can be effective for short-term weight loss. However, weight regain occurs soon after the wires are removed.
Liposuction: This is the most frequent cosmetic operation in the United States in which fat tissue is removed. Relatively small amounts of total body fat can be removed safely, however, and little weight is lost.
Vertical banded gastroplasty: This operation divides the stomach into two parts - limiting space for food and forcing you to eat less. There is no bypass. Using a surgical stapler, the surgeon divides your stomach into upper and lower sections. The upper pouch is small and empties into the lower pouch (the rest of the stomach). Surgeons use this procedure less commonly than gastric bypass, partly because it does not lead to adequate long-term weight loss.
Author Information
This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Bibliography
American Obesity Association (AOA). www.obesity.org Ioannides-Demos L, Proietto J, et al. Safety of drug therapies used for weight loss and treatment of obesity. Drug Saf. 2006;29(4):277-302. View Abstract Kral, J.G. Surgical Treatment of Obesity. In Handbook of Obesity, ed. Bray, G.A., Bouchard, C., James, W.P.T. New York. Marcel Dekker, Inc., 1998. National Heart, Lung, and Blood Institute. www.nhlbi.nih.gov National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov Shekelle P, Morton, S., Maglione M, et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76, Southern California Evidence-based Practice Center, RAND. U. S. Food and Drug Administration (FDA). www.fda.gov
Natural Standard Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
Copyright © 2011 Natural Standard (www.naturalstandard.com)
Guidelines For Obesity Treatment
Assessment of weight involves evaluating body mass index, waist circumference, and the patient's risk factors.
BMI=weight (kg)/[height (m)]2.
Overweight is defined as a BMI of 25-29.9 kg/m2.
Obesity is defined as a BMI of ≥30 kg/m2.
Waist circumference for men >40 inches or women >35 inches indicates an increased risk for those with a BMI of 25-34.9.
Coronary heart disease or other atherosclerotic diseases, type 2 diabetes, and sleep apnea are factors associated with a very high risk of developing disease complications and mortality.
Weight loss is recommended for those who are overweight or obese or have a high waist circumference and two or more risk factors.
Appetite Suppressants Background
Appetite suppressants are agents that promote weight loss by decreasing appetite or increasing the sensation of fullness. About one-quarter of the U.S. population can be considered obese (BMI of >30). Four million of these people may be classified as morbidly obese (BMI of >40). Obesity is associated with increased risk of hypertension, type 2 diabetes and heart disease. The use of appetite suppressant medications to treat obesity in combination with physical activity and diet modification is often recommended to lose and maintain weight successfully over the long term.
Appetite Suppressants Theory/Evidence
Several prescription medications are currently approved for treatment of obesity. In general, the effects of these medications are modest, leading to an average initial weight loss of between 5 and 22 pounds; though studies show that weight returns after cessation of the drugs. There is considerable individual difference in response to these medications; some people experience greater weight loss than others.
Short-term use of appetite suppressant medications has been shown to modestly reduce health risks for obese individuals. Studies have found that these medications can lower blood pressure, blood cholesterol, blood fats (triglycerides), and decrease insulin resistance (the body's ability to utilize blood sugar). Long-term studies need to be conducted to determine if weight loss assisted by appetite suppressant medications can improve health long-term.
Weight loss tends to be greatest during the first few weeks or months of treatment, leveling off after about six months. Research suggests that if a patient does not lose at least four pounds during the first four weeks on a particular medication, that medication is unlikely to be effective over the long run.
Short-term use (few weeks to few months): Examples include diethylpropion (Tenuate®), and phentermine (Adipex-P®).
The mechanism of action of diethylpropion and phentermine appears to be secondary to CNS (central nervous system) effects, specifically stimulation of the hypothalamus to release catecholamines into the central nervous system. Appetite suppressing effects are mediated via norepinephrine and dopamine metabolism.
Long-term use (up to one year or more): Examples include orlistat (Xenical®) and sibutramine (Meridia®).
Orlistat is the first prescription treatment for obesity that does not act as an appetite suppressant. It works by interfering with the action of gastrointestinal (GI) lipase in the GI tract. As a result of this mechanism of action, 30% of ingested dietary fat is not absorbed.
Sibutramine and its two primary metabolites also appear to be secondary to CNS effects by blocking the neuronal uptake of norepinephrine, serotonin, and dopamine.
OTC (over-the-counter): It is believed that "P57" molecule in Hoodia mimics the effect that glucose has on your brain, telling part of your brain (the hypothalamus) that you feel full. Consequently, you have no desire to eat. However current available evidence on hoodia's effectiveness and safety is lacking.
Dietrine Carb Blocker with Phase 2®: An ingredient extracted from white kidney beans is thought toneutralize the digestive enzyme alpha amylase before it can convert starch into glucose and then fat.
Safety Of Appetite Suppressants
Ephedrine: Since March 2004, the sale of all products containing ephedra in the United States has been banned. Other names of ephedrine are ephedra, ephedrinum, and ma huang.
A study published in the February 2003 issue of the Annals of Internal Medicine found that ephedra supplements make up only one percent of all dietary supplement sales, but account for 64 percent of adverse effects associated with dietary supplements.
A case-control study published in a 1993 issue of Neurology concluded that the rate of hemorrhagic (bleeding) strokes among ephedra-users was significantly higher than among nonusers, for people taking doses above 32 milligrams a day. According to the FDA, many ephedra-containing dietary supplement labels recommend that users take up to 100mg of ephedra daily.
Fenfluramine (Pondimin) and dexfenfluramine (Redux) were voluntarily removed from the market in 1997. These two medications were shown to be associated with a rare but very serious and potentially fatal disorder known as primary pulmonary hypertension (PPH), a disease of the lungs. Forty-five percent of patients with PPH die within four years of diagnosis.
Phenylpropanolamine (PPA) is a synthetic sympathomimetic amine structurally similar to pressor amines (i.e., epinephrine, phenylephrine, and ephedrine) and central nervous system stimulants (i.e., ephedrine, amphetamine). It is a common ingredient in cough-cold remedies and appetite suppressants. A study reports that taking PPA increases the risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk but no data's available. Although the risk of hemorrhagic stroke is very low, FDA recommends that consumer should not use any products that contain PPA, and also manufacturer either reformulated or recalled all the medications that contain PPA.
General safety concerns: Most side effects of the medications that are approved by FDA are mild and diminish as treatment continues. Rarely, serious and even fatal outcomes have been reported. Medications that affect catecholamine levels, such as phentermine and dietylpropion may cause symptoms of sleeplessness, nervousness.
Gastric Bypass Surgery Background
Gastric bypass surgery is the most common weight loss surgery which uses bands or staples to create food intake restriction. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and you also feel full for a longer time.
This surgery is often performed in those who have a BMI ≥40 (extremely obese) or BMI between 35 and 39.9 and with weight related health problems such as diabetes or high blood pressure.
Surgical candidates go through an extensive screening process. Not everyone who meets the criteria for the surgery is psychologically or medically ready for the surgical procedure. A team of professionals, including a physician, dietitian, psychologist and surgeon, evaluate whether the surgery is appropriate. Following surgery, physical, nutritional and metabolic counseling are given to prevent nutritional deficiencies. Lifelong use of nutritional supplements such as multivitamins, vitamin B12, vitamin D and calcium is recommended.
Researchers have found greater weight loss in gastric bypass (93.3 pounds) compared to gastroplasty (67 pounds) after one year. Over two years, gastric bypass surgery patients have been shown to lose two-thirds of excess weight. The success rate for weight loss for RGB is 68 to 72% of excess body weight over a three-year period, and 75% for BPD. After five years, the average excess weight loss from gastric bypass surgery ranges from 48 to 74%.
The improvements observed in type 2 diabetes, high blood pressure and high blood cholesterol may significantly decrease the risk of cardiovascular events in individuals who have undergone gastric bypass surgery compared with those treated through other means. Gastric bypass surgery has also shown to improve mobility and quality of life for people who are severely overweight.
Risks Of Gastric Bypass Surgery
A risk of death has been associated with gastric bypass surgery. The risk varies depending on age, general health and other medical conditions. Talk to your doctor about the exact level of risk gastric bypass surgery may pose for you.
Blood clots in the legs are more likely to occur in very overweight people. Blood clots can be dangerous. In some cases, they travel to the lungs and lodge in the lungs' arteries causing a pulmonary embolism, a serious condition that damages lung tissue and can lead to death. Walking and using leg wraps that apply intermittent pressure to the leg can help reduce this risk of blood clots in the legs.
Leaking at one of the staple lines in the stomach has occurred and can be treated with antibiotics. Most cases heal with time. Sometimes, the leak can be serious enough to require emergency surgery.
Excess weight places extra stress on the chest cavity and lungs. This means a higher risk of developing pneumonia after the surgery.
Narrowing of the opening between the stomach and small intestine has occurred. This rare complication may require either an outpatient procedure to pass a tube through your mouth to widen (dilate) the narrowed opening or corrective surgery.
Gastric bypass can also cause dumping syndrome, a condition where stomach contents move too quickly through the small intestine causing nausea, vomiting, diarrhea, dizziness and sweating.
Other common complications include vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcer, hernia at the incision site, and intolerance to certain foods.
Other Types Of Weight Loss Surgery
Adjustable gastric banding: The surgeon uses an inflatable band to partition the stomach into two parts. He or she then wraps the band around the upper part of your stomach and pulls it tight, like a belt, creating a tiny channel between the two pouches. The band keeps the opening from expanding and is designed to stay in place indefinitely. But it can be adjusted or surgically removed if necessary. Most surgeons perform this operation using a laparoscope.
Biliopancreatic diversion: In this procedure, a portion of your stomach is removed. The remaining pouch is connected directly to your small intestine, but completely bypasses your duodenum and jejunum where most nutrient absorption takes place. This weight-loss surgery offers sustained weight loss, but it presents a greater risk of malnutrition and vitamin deficiencies and requires close monitoring.
Jaw wiring: This is a form of food intake restriction for temporary use in patients without respiratory problems. It can be effective for short-term weight loss. However, weight regain occurs soon after the wires are removed.
Liposuction: This is the most frequent cosmetic operation in the United States in which fat tissue is removed. Relatively small amounts of total body fat can be removed safely, however, and little weight is lost.
Vertical banded gastroplasty: This operation divides the stomach into two parts - limiting space for food and forcing you to eat less. There is no bypass. Using a surgical stapler, the surgeon divides your stomach into upper and lower sections. The upper pouch is small and empties into the lower pouch (the rest of the stomach). Surgeons use this procedure less commonly than gastric bypass, partly because it does not lead to adequate long-term weight loss.
Author Information
This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Bibliography
American Obesity Association (AOA). www.obesity.org Ioannides-Demos L, Proietto J, et al. Safety of drug therapies used for weight loss and treatment of obesity. Drug Saf. 2006;29(4):277-302. View Abstract Kral, J.G. Surgical Treatment of Obesity. In Handbook of Obesity, ed. Bray, G.A., Bouchard, C., James, W.P.T. New York. Marcel Dekker, Inc., 1998. National Heart, Lung, and Blood Institute. www.nhlbi.nih.gov National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov Shekelle P, Morton, S., Maglione M, et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76, Southern California Evidence-based Practice Center, RAND. U. S. Food and Drug Administration (FDA). www.fda.gov
Read more: http://www.righthealth.com/topic/weight_loss/overview/NaturalStandard20#ixzz1FOfbwsw9
Assessment of weight involves evaluating body mass index, waist circumference, and the patient's risk factors.
BMI=weight (kg)/[height (m)]2.
Overweight is defined as a BMI of 25-29.9 kg/m2.
Obesity is defined as a BMI of ≥30 kg/m2.
Waist circumference for men >40 inches or women >35 inches indicates an increased risk for those with a BMI of 25-34.9.
Coronary heart disease or other atherosclerotic diseases, type 2 diabetes, and sleep apnea are factors associated with a very high risk of developing disease complications and mortality.
Weight loss is recommended for those who are overweight or obese or have a high waist circumference and two or more risk factors.
Appetite Suppressants Background
Appetite suppressants are agents that promote weight loss by decreasing appetite or increasing the sensation of fullness. About one-quarter of the U.S. population can be considered obese (BMI of >30). Four million of these people may be classified as morbidly obese (BMI of >40). Obesity is associated with increased risk of hypertension, type 2 diabetes and heart disease. The use ofappetite suppressant medications to treat obesity in combination with physical activity and diet modification is often recommended to lose and maintain weight successfully over the long term.
Appetite Suppressants Theory/Evidence
Several prescription medications are currently approved for treatment of obesity. In general, the effects of these medications are modest, leading to an average initial weight loss of between 5 and 22 pounds; though studies show that weight returns after cessation of the drugs. There is considerable individual difference in response to these medications; some people experience greater weight loss than others.
Short-term use of appetite suppressant medications has been shown to modestly reduce health risks for obese individuals. Studies have found that these medications can lower blood pressure, blood cholesterol, blood fats (triglycerides), and decrease insulin resistance (the body's ability to utilize blood sugar). Long-term studies need to be conducted to determine if weight loss assisted byappetite suppressant medications can improve health long-term.
Weight loss tends to be greatest during the first few weeks or months of treatment, leveling off after about six months. Research suggests that if a patient does not lose at least four pounds during the first four weeks on a particular medication, that medication is unlikely to be effective over the long run.
Short-term use (few weeks to few months): Examples include diethylpropion (Tenuate®), and phentermine (Adipex-P®).
The mechanism of action of diethylpropion and phentermine appears to be secondary to CNS (central nervous system) effects, specifically stimulation of the hypothalamus to release catecholamines into the central nervous system. Appetite suppressing effects are mediated via norepinephrine and dopamine metabolism.
Long-term use (up to one year or more): Examples include orlistat (Xenical®) and sibutramine (Meridia®).
Orlistat is the first prescription treatment for obesity that does not act as an appetite suppressant. It works by interfering with the action of gastrointestinal (GI) lipase in the GI tract. As a result of this mechanism of action, 30% of ingested dietary fat is not absorbed.
Sibutramine and its two primary metabolites also appear to be secondary to CNS effects by blocking the neuronal uptake of norepinephrine, serotonin, and dopamine.
OTC (over-the-counter): It is believed that "P57" molecule in Hoodia mimics the effect that glucose has on your brain, telling part of your brain (the hypothalamus) that you feel full. Consequently, you have no desire to eat. However current available evidence on hoodia's effectiveness and safety is lacking.
Dietrine Carb Blocker with Phase 2®: An ingredient extracted from white kidney beans is thought toneutralize the digestive enzyme alpha amylase before it can convert starch into glucose and then fat.
Safety Of Appetite Suppressants
Ephedrine: Since March 2004, the sale of all products containing ephedra in the United States has been banned. Other names of ephedrine are ephedra, ephedrinum, and ma huang.
A study published in the February 2003 issue of the Annals of Internal Medicine found that ephedra supplements make up only one percent of all dietary supplement sales, but account for 64 percent of adverse effects associated with dietary supplements.
A case-control study published in a 1993 issue of Neurology concluded that the rate of hemorrhagic (bleeding) strokes among ephedra-users was significantly higher than among nonusers, for people taking doses above 32 milligrams a day. According to the FDA, many ephedra-containing dietary supplement labels recommend that users take up to 100mg of ephedra daily.
Fenfluramine (Pondimin) and dexfenfluramine (Redux) were voluntarily removed from the market in 1997. These two medications were shown to be associated with a rare but very serious and potentially fatal disorder known as primary pulmonary hypertension (PPH), a disease of the lungs. Forty-five percent of patients with PPH die within four years of diagnosis.
Phenylpropanolamine (PPA) is a synthetic sympathomimetic amine structurally similar to pressor amines (i.e., epinephrine, phenylephrine, and ephedrine) and central nervous system stimulants (i.e., ephedrine, amphetamine). It is a common ingredient in cough-cold remedies and appetite suppressants. A study reports that taking PPA increases the risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk but no data's available. Although the risk of hemorrhagic stroke is very low, FDA recommends that consumer should not use any products that contain PPA, and also manufacturer either reformulated or recalled all the medications that contain PPA.
General safety concerns: Most side effects of the medications that are approved by FDA are mild and diminish as treatment continues. Rarely, serious and even fatal outcomes have been reported. Medications that affect catecholamine levels, such as phentermine and dietylpropion may cause symptoms of sleeplessness, nervousness.
Gastric Bypass Surgery Background
Gastric bypass surgery is the most common weight loss surgery which uses bands or staples to create food intake restriction. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and you also feel full for a longer time.
This surgery is often performed in those who have a BMI ≥40 (extremely obese) or BMI between 35 and 39.9 and with weight related health problems such as diabetes or high blood pressure.
Surgical candidates go through an extensive screening process. Not everyone who meets the criteria for the surgery is psychologically or medically ready for the surgical procedure. A team of professionals, including a physician, dietitian, psychologist and surgeon, evaluate whether the surgery is appropriate. Following surgery, physical, nutritional and metabolic counseling are given to prevent nutritional deficiencies. Lifelong use of nutritional supplements such as multivitamins, vitamin B12, vitamin D and calcium is recommended.
Researchers have found greater weight loss in gastric bypass (93.3 pounds) compared to gastroplasty (67 pounds) after one year. Over two years, gastric bypass surgery patients have been shown to lose two-thirds of excess weight. The success rate for weight loss for RGB is 68 to 72% of excess body weight over a three-year period, and 75% for BPD. After five years, the average excess weight loss fromgastric bypass surgery ranges from 48 to 74%.
The improvements observed in type 2 diabetes, high blood pressure and high blood cholesterol may significantly decrease the risk of cardiovascular events in individuals who have undergone gastric bypass surgery compared with those treated through other means. Gastric bypass surgery has also shown to improve mobility and quality of life for people who are severely overweight.
Risks Of Gastric Bypass Surgery
A risk of death has been associated with gastric bypass surgery. The risk varies depending on age, general health and other medical conditions. Talk to your doctor about the exact level of risk gastric bypass surgery may pose for you.
Blood clots in the legs are more likely to occur in very overweight people. Blood clots can be dangerous. In some cases, they travel to the lungs and lodge in the lungs' arteries causing a pulmonary embolism, a serious condition that damages lung tissue and can lead to death. Walking and using leg wraps that apply intermittent pressure to the leg can help reduce this risk of blood clots in the legs.
Leaking at one of the staple lines in the stomach has occurred and can be treated with antibiotics. Most cases heal with time. Sometimes, the leak can be serious enough to require emergency surgery.
Excess weight places extra stress on the chest cavity and lungs. This means a higher risk of developing pneumonia after the surgery.
Narrowing of the opening between the stomach and small intestine has occurred. This rare complication may require either an outpatient procedure to pass a tube through your mouth to widen (dilate) the narrowed opening or corrective surgery.
Gastric bypass can also cause dumping syndrome, a condition where stomach contents move too quickly through the small intestine causing nausea, vomiting, diarrhea, dizziness and sweating.
Other common complications include vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcer, hernia at the incision site, and intolerance to certain foods.
Other Types Of Weight Loss Surgery
Adjustable gastric banding: The surgeon uses an inflatable band to partition the stomach into two parts. He or she then wraps the band around the upper part of your stomach and pulls it tight, like a belt, creating a tiny channel between the two pouches. The band keeps the opening from expanding and is designed to stay in place indefinitely. But it can be adjusted or surgically removed if necessary. Most surgeons perform this operation using a laparoscope.
Biliopancreatic diversion: In this procedure, a portion of your stomach is removed. The remaining pouch is connected directly to your small intestine, but completely bypasses your duodenum and jejunum where most nutrient absorption takes place. This weight-loss surgery offers sustained weight loss, but it presents a greater risk of malnutrition and vitamin deficiencies and requires close monitoring.
Jaw wiring: This is a form of food intake restriction for temporary use in patients without respiratory problems. It can be effective for short-term weight loss. However, weight regain occurs soon after the wires are removed.
Liposuction: This is the most frequent cosmetic operation in the United States in which fat tissue is removed. Relatively small amounts of total body fat can be removed safely, however, and little weight is lost.
Vertical banded gastroplasty: This operation divides the stomach into two parts - limiting space for food and forcing you to eat less. There is no bypass. Using a surgical stapler, the surgeon divides your stomach into upper and lower sections. The upper pouch is small and empties into the lower pouch (the rest of the stomach). Surgeons use this procedure less commonly than gastric bypass, partly because it does not lead to adequate long-term weight loss.
Author Information
This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Bibliography
American Obesity Association (AOA). www.obesity.org Ioannides-Demos L, Proietto J, et al. Safety of drug therapies used for weight loss and treatment of obesity. Drug Saf. 2006;29(4):277-302. View Abstract Kral, J.G. Surgical Treatment of Obesity. In Handbook of Obesity, ed. Bray, G.A., Bouchard, C., James, W.P.T. New York. Marcel Dekker, Inc., 1998. National Heart, Lung, and Blood Institute. www.nhlbi.nih.gov National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov Shekelle P, Morton, S., Maglione M, et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76, Southern California Evidence-based Practice Center, RAND. U. S. Food and Drug Administration (FDA). www.fda.gov
Natural Standard Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
Copyright © 2011 Natural Standard (www.naturalstandard.com)
Guidelines For Obesity Treatment
Assessment of weight involves evaluating body mass index, waist circumference, and the patient's risk factors.
BMI=weight (kg)/[height (m)]2.
Overweight is defined as a BMI of 25-29.9 kg/m2.
Obesity is defined as a BMI of ≥30 kg/m2.
Waist circumference for men >40 inches or women >35 inches indicates an increased risk for those with a BMI of 25-34.9.
Coronary heart disease or other atherosclerotic diseases, type 2 diabetes, and sleep apnea are factors associated with a very high risk of developing disease complications and mortality.
Weight loss is recommended for those who are overweight or obese or have a high waist circumference and two or more risk factors.
Appetite Suppressants Background
Appetite suppressants are agents that promote weight loss by decreasing appetite or increasing the sensation of fullness. About one-quarter of the U.S. population can be considered obese (BMI of >30). Four million of these people may be classified as morbidly obese (BMI of >40). Obesity is associated with increased risk of hypertension, type 2 diabetes and heart disease. The use of appetite suppressant medications to treat obesity in combination with physical activity and diet modification is often recommended to lose and maintain weight successfully over the long term.
Appetite Suppressants Theory/Evidence
Several prescription medications are currently approved for treatment of obesity. In general, the effects of these medications are modest, leading to an average initial weight loss of between 5 and 22 pounds; though studies show that weight returns after cessation of the drugs. There is considerable individual difference in response to these medications; some people experience greater weight loss than others.
Short-term use of appetite suppressant medications has been shown to modestly reduce health risks for obese individuals. Studies have found that these medications can lower blood pressure, blood cholesterol, blood fats (triglycerides), and decrease insulin resistance (the body's ability to utilize blood sugar). Long-term studies need to be conducted to determine if weight loss assisted by appetite suppressant medications can improve health long-term.
Weight loss tends to be greatest during the first few weeks or months of treatment, leveling off after about six months. Research suggests that if a patient does not lose at least four pounds during the first four weeks on a particular medication, that medication is unlikely to be effective over the long run.
Short-term use (few weeks to few months): Examples include diethylpropion (Tenuate®), and phentermine (Adipex-P®).
The mechanism of action of diethylpropion and phentermine appears to be secondary to CNS (central nervous system) effects, specifically stimulation of the hypothalamus to release catecholamines into the central nervous system. Appetite suppressing effects are mediated via norepinephrine and dopamine metabolism.
Long-term use (up to one year or more): Examples include orlistat (Xenical®) and sibutramine (Meridia®).
Orlistat is the first prescription treatment for obesity that does not act as an appetite suppressant. It works by interfering with the action of gastrointestinal (GI) lipase in the GI tract. As a result of this mechanism of action, 30% of ingested dietary fat is not absorbed.
Sibutramine and its two primary metabolites also appear to be secondary to CNS effects by blocking the neuronal uptake of norepinephrine, serotonin, and dopamine.
OTC (over-the-counter): It is believed that "P57" molecule in Hoodia mimics the effect that glucose has on your brain, telling part of your brain (the hypothalamus) that you feel full. Consequently, you have no desire to eat. However current available evidence on hoodia's effectiveness and safety is lacking.
Dietrine Carb Blocker with Phase 2®: An ingredient extracted from white kidney beans is thought toneutralize the digestive enzyme alpha amylase before it can convert starch into glucose and then fat.
Safety Of Appetite Suppressants
Ephedrine: Since March 2004, the sale of all products containing ephedra in the United States has been banned. Other names of ephedrine are ephedra, ephedrinum, and ma huang.
A study published in the February 2003 issue of the Annals of Internal Medicine found that ephedra supplements make up only one percent of all dietary supplement sales, but account for 64 percent of adverse effects associated with dietary supplements.
A case-control study published in a 1993 issue of Neurology concluded that the rate of hemorrhagic (bleeding) strokes among ephedra-users was significantly higher than among nonusers, for people taking doses above 32 milligrams a day. According to the FDA, many ephedra-containing dietary supplement labels recommend that users take up to 100mg of ephedra daily.
Fenfluramine (Pondimin) and dexfenfluramine (Redux) were voluntarily removed from the market in 1997. These two medications were shown to be associated with a rare but very serious and potentially fatal disorder known as primary pulmonary hypertension (PPH), a disease of the lungs. Forty-five percent of patients with PPH die within four years of diagnosis.
Phenylpropanolamine (PPA) is a synthetic sympathomimetic amine structurally similar to pressor amines (i.e., epinephrine, phenylephrine, and ephedrine) and central nervous system stimulants (i.e., ephedrine, amphetamine). It is a common ingredient in cough-cold remedies and appetite suppressants. A study reports that taking PPA increases the risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk but no data's available. Although the risk of hemorrhagic stroke is very low, FDA recommends that consumer should not use any products that contain PPA, and also manufacturer either reformulated or recalled all the medications that contain PPA.
General safety concerns: Most side effects of the medications that are approved by FDA are mild and diminish as treatment continues. Rarely, serious and even fatal outcomes have been reported. Medications that affect catecholamine levels, such as phentermine and dietylpropion may cause symptoms of sleeplessness, nervousness.
Gastric Bypass Surgery Background
Gastric bypass surgery is the most common weight loss surgery which uses bands or staples to create food intake restriction. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and you also feel full for a longer time.
This surgery is often performed in those who have a BMI ≥40 (extremely obese) or BMI between 35 and 39.9 and with weight related health problems such as diabetes or high blood pressure.
Surgical candidates go through an extensive screening process. Not everyone who meets the criteria for the surgery is psychologically or medically ready for the surgical procedure. A team of professionals, including a physician, dietitian, psychologist and surgeon, evaluate whether the surgery is appropriate. Following surgery, physical, nutritional and metabolic counseling are given to prevent nutritional deficiencies. Lifelong use of nutritional supplements such as multivitamins, vitamin B12, vitamin D and calcium is recommended.
Researchers have found greater weight loss in gastric bypass (93.3 pounds) compared to gastroplasty (67 pounds) after one year. Over two years, gastric bypass surgery patients have been shown to lose two-thirds of excess weight. The success rate for weight loss for RGB is 68 to 72% of excess body weight over a three-year period, and 75% for BPD. After five years, the average excess weight loss from gastric bypass surgery ranges from 48 to 74%.
The improvements observed in type 2 diabetes, high blood pressure and high blood cholesterol may significantly decrease the risk of cardiovascular events in individuals who have undergone gastric bypass surgery compared with those treated through other means. Gastric bypass surgery has also shown to improve mobility and quality of life for people who are severely overweight.
Risks Of Gastric Bypass Surgery
A risk of death has been associated with gastric bypass surgery. The risk varies depending on age, general health and other medical conditions. Talk to your doctor about the exact level of risk gastric bypass surgery may pose for you.
Blood clots in the legs are more likely to occur in very overweight people. Blood clots can be dangerous. In some cases, they travel to the lungs and lodge in the lungs' arteries causing a pulmonary embolism, a serious condition that damages lung tissue and can lead to death. Walking and using leg wraps that apply intermittent pressure to the leg can help reduce this risk of blood clots in the legs.
Leaking at one of the staple lines in the stomach has occurred and can be treated with antibiotics. Most cases heal with time. Sometimes, the leak can be serious enough to require emergency surgery.
Excess weight places extra stress on the chest cavity and lungs. This means a higher risk of developing pneumonia after the surgery.
Narrowing of the opening between the stomach and small intestine has occurred. This rare complication may require either an outpatient procedure to pass a tube through your mouth to widen (dilate) the narrowed opening or corrective surgery.
Gastric bypass can also cause dumping syndrome, a condition where stomach contents move too quickly through the small intestine causing nausea, vomiting, diarrhea, dizziness and sweating.
Other common complications include vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcer, hernia at the incision site, and intolerance to certain foods.
Other Types Of Weight Loss Surgery
Adjustable gastric banding: The surgeon uses an inflatable band to partition the stomach into two parts. He or she then wraps the band around the upper part of your stomach and pulls it tight, like a belt, creating a tiny channel between the two pouches. The band keeps the opening from expanding and is designed to stay in place indefinitely. But it can be adjusted or surgically removed if necessary. Most surgeons perform this operation using a laparoscope.
Biliopancreatic diversion: In this procedure, a portion of your stomach is removed. The remaining pouch is connected directly to your small intestine, but completely bypasses your duodenum and jejunum where most nutrient absorption takes place. This weight-loss surgery offers sustained weight loss, but it presents a greater risk of malnutrition and vitamin deficiencies and requires close monitoring.
Jaw wiring: This is a form of food intake restriction for temporary use in patients without respiratory problems. It can be effective for short-term weight loss. However, weight regain occurs soon after the wires are removed.
Liposuction: This is the most frequent cosmetic operation in the United States in which fat tissue is removed. Relatively small amounts of total body fat can be removed safely, however, and little weight is lost.
Vertical banded gastroplasty: This operation divides the stomach into two parts - limiting space for food and forcing you to eat less. There is no bypass. Using a surgical stapler, the surgeon divides your stomach into upper and lower sections. The upper pouch is small and empties into the lower pouch (the rest of the stomach). Surgeons use this procedure less commonly than gastric bypass, partly because it does not lead to adequate long-term weight loss.
Author Information
This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Bibliography
American Obesity Association (AOA). www.obesity.org Ioannides-Demos L, Proietto J, et al. Safety of drug therapies used for weight loss and treatment of obesity. Drug Saf. 2006;29(4):277-302. View Abstract Kral, J.G. Surgical Treatment of Obesity. In Handbook of Obesity, ed. Bray, G.A., Bouchard, C., James, W.P.T. New York. Marcel Dekker, Inc., 1998. National Heart, Lung, and Blood Institute. www.nhlbi.nih.gov National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov Shekelle P, Morton, S., Maglione M, et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76, Southern California Evidence-based Practice Center, RAND. U. S. Food and Drug Administration (FDA). www.fda.gov
Read more: http://www.righthealth.com/topic/weight_loss/overview/NaturalStandard20#ixzz1FOfbwsw9
High blood pressure
Definition
Heart disease refers to one of several conditions that affect the heart. One in three Americans has some type of heart disease, which is also the leading cause of death. But even for those with a family history of the condition, heart disease and heart attacks are not inevitable. A healthy diet, regular exercise, cholesterol-lowering drugs, and lifesaving surgeries can reduce your risk of having—or dying from—a heart attack.
Alternate Names
Heart Disease
Cardiovascular Disease
Coronary Artery Disease
Coronary Heart Disease
Acute Coronary Syndrome
Angina Pectoris
Congenital Cardiovascular Defects
Heart Attack
Heart Failure
Arrhythmia
High Blood Pressure
High Cholesterol
Stroke
Symptoms
Pain
If your arteries start collecting plaque, your heart may have trouble getting enough blood. And if blood flow runs low, the heart complains—with pain. This is often one of the first symptoms of coronary artery disease (CAD).
You may notice a sharp pain in your chest, known as angina. The pain—often described as pressure, heaviness, tightness, squeezing, burning, or a dull ache—will likely last a few minutes before fading.
The pain is hard to pinpoint, although some people describe it by holding a clenched fist to their chest. (Note: Burning chest pain following a meal is more likely to be acid reflux than angina. If an antacid eases the pain, it's heartburn.)
Chest pain can be a sign of a heart attack. At first, you're only likely to notice angina when you're exercising. The pain should ease quickly as you rest.
But if plaque continues to build, your heart may start complaining any time of day in any situation. It may even wake you up in the middle of the night. Unpredictable or unstable angina is a powerful predictor of a heart attack.
Breathlessness and fatigue
A heart that isn't getting enough blood is also not getting enough oxygen. For that reason, people with coronary artery disease may feel breathless and unusually tired. But you should be concerned if you suddenly lack the strength or the breath to do something that usually comes easily.
Male CAD risk
Men have another early warning system. Erectile dysfunction (ED)—trouble achieving or keeping erections—is extremely common in men with coronary artery disease. The arteries feeding the penis can clog just as surely as the arteries around the heart.
Stroke and other problems
In addition to ED, you could also have clogging in other arteries (a process known as atherosclerosis). For example, blockages in the carotid artery of the neck can lead to strokes.
Atherosclerosis can play a role in kidney failure and cause peripheral arterial disease, an insufficiency of blood supply to the legs that can lead to pain and difficulty walking.
Causes
These are the leading factors that put you at risk for coronary artery disease or a heart attack:
• Age: More than 83% of people who die from coronary heart disease are 65 or older. Older women are more likely to die of heart attacks within a few weeks of the attack than older men.
• Being male: Men have a greater risk of heart attack than women, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, women's risk of heart attack is not as great as men's.
• Family history: Those with parents or close relatives with heart disease are more likely to develop it themselves.
• Race: Compared with Caucasians, heart disease risk is higher among African-Americans, Mexican-Americans, American Indians, native Hawaiians, and some Asian-Americans.
• Smoking: Cigarette smoking increases your risk of developing heart disease by two to four times.
• High cholesterol: High levels of “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol, in the blood drive up your risk of coronary heart disease.
• High blood pressure: High blood pressure, or hypertension, puts a strain on the heart, causing it to thicken and become stiffer. Additional risk factors of hypertension are stroke, heart attack, kidney failure, and congestive heart failure. Obesity, smoking, high blood cholesterol levels, or diabetes, in combination with high blood pressure, increase the risk of heart attack or stroke several times.
• Sedentary lifestyle: Inactivity is a risk factor for coronary heart disease.
• Excess weight: People who have excess body fat—especially abdominal body fat—face an increased likelihood of developing heart disease and stroke even if they have no other risk factors.
• Diabetes: Having diabetes dramatically raises your risk of developing cardiovascular disease. Approximately three-quarters of diabetics die from some form of heart or blood vessel disease.
Drugs
ACE inhibitors: These are a class of drugs that relax and dilate blood vessels, reducing blood pressure. They include:
• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Vasotec)
• fosinopril (Monopril),
• lisinopril (Prinivil, Zestril)
• moexipril (Univasc)
• perindopril (Aceon)
• quinapril (Accupril)
• ramipril (Altace)
• trandolapril (Mavik)
Aspirin: Taken daily, aspirin can help prevent blood clots by keeping platelets from sticking together. It's a potential lifesaver for anyone at risk for a heart attack. And when taken during or immediately after a heart attack, aspirin can help to break up a clot and restore blood flow to the heart.
Beta-blockers: These are a class of drugs that slow the heart rate, lessening blood pressure and the risk of heart attack.
Calcium channel blockers: These drugs dilate or open blood vessels, releasing blood pressure.
Diuretics: This class of drugs, such as Lasix and Diuril, works by flushing extra salt and water out of the body.
Statins: These drugs can dramatically lower the levels of artery-clogging cholesterol in the blood. After a heart attack, taking a statin can prevent the risk of death within one year by 25%. Among patients who don't even have cardiovascular disease, taking a statin preventively can reduce the risk of a major coronary event, like a heart attack, by about 30%. Statins include:
• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)
• pitavastatin (Livalo)
Angioplasty
Angioplasty is a procedure in which a narrowed section of the coronary artery is widened. Angioplasties are often an essential treatment for heart attack patients. As with all parts of heart attack care, timing is crucial. Up to 20% of all angioplasty patients who have a stent inserted during the procedure will have blocked arteries again within six months.
Bypass Surgery
If you have blockages in three or more coronary arteries, your doctor is likely to recommend bypass surgery. This is an invasive procedure whereby doctors route new vessels around blocked arteries, usually taken from the leg or groin. Patients with serious coronary artery disease who undergobypass surgery are nearly 50% more likely to be alive in five years than patients who receive drug treatment alone.
Cardiac Rehabilitation
Cardiac rehab is an organized lifestyle, diet, and exercise program, usually administered by a team of cardiac medical specialists, for people with coronary artery disease, or those who have had a heart attack or bypass surgery. Cardiac rehab teaches lifestyle modification, such as exercise, dietary changes, smoking cessation, and medication compliance, designed to reduce the risk of another cardiac event such as a heart attack. Heart patients who attend cardiac rehabilitation tend to recover faster and more completely than people who don't.
Prevention
To reduce your risk of heart disease:
Don't smoke. Smokers are two to four times more likely to develop coronary artery disease (CAD) than nonsmokers. Cardiovascular disease—including CAD, heart failure, and heart attack—is the leading killer in the U.S., claiming more than 860,000 lives in 2005. Smoking ups your risk for heart disease by decreasing the flow of oxygen to the heart and raises your risk for atherosclerosis, or hardening of the arteries. Lighting up also damages the cells that line the coronary arteries and increases your likelihood of blood clots. In fact, heart-related complications are one of the main reasons cigarettes can take so much time off a smoker's lifespan.
Keep blood pressure at 120/80 or below.
Drink at least half a glass of wine, or equivalent alcohol, each day (but not more than a full glass, experts say).
Get at least 30 minutes of moderate or vigorous physical activity daily. Exercise has been shown to slash the risk of heart disease and add years to one's life, even among obese people and other high-risk populations. Moderate-to-vigorous exercise is defined as reaching and maintaining 50% to 85% of your maximum heart rate on most days of the week. A brisk walk, a bike ride, and light weight training all count.
Maintain a healthy weight. Obesity is a risk factor in cardiovascular disease, especially for young men. But where you carry fat on your body can also be a good predictor of heart health. Being “apple shaped,” with extra fat on the belly, can put you at a higher risk than someone with the fat distributed around the hips and thighs. Extra fat cells can also lead to type 2 diabetes, itself a risk factor for heart disease. Even if you don't reach your ideal weight, every little bit can help. According to the National Institutes of Health, losing just 10% of your total body weight can lower your risk of heart disease and other conditions associated with obesity.
Eat a healthy diet. Your diet should be rich in fruits, vegetables, and other plant foods and low in saturated fat, which comes from animal products. It should be low in trans fats but high in fiber, omega-3 fatty acids, and folate. It should also have a lower glycemic load and a higher polyunsaturated-to-saturated fat ratio.
Minimize stress. Stress triggers an increase of cortisol, a “stress hormone,” which can raise blood sugar levels and blood pressure. The overproduction of cortisol can lead to a constant state of chemical arousal, which can eventually cause a heart attack.
Tests
Angiogram
Coronary angiograms involve inserting a catheter (a thin tube) through a blood vessel in the arm or leg to the heart. The procedure is usually performed in a hospital, in a cardiac catheterization lab (commonly called a “cath” lab). Angiograms test for blockages in the coronary arteries in addition to other cardiovascular ailments. The test is often used to diagnose coronary artery disease (CAD) or to track the success of heart treatments. It's also commonly performed on heart attack patients.
Electrocardiogram (ECG or EKG)
An exercise electrocardiogram (EKG or ECG), sometimes called a stress test, checks and records changes in your heart while you walk or run on a treadmill with electrodes on your arms, legs, and chest. Some heart abnormalities can be seen only during exercise or while symptoms are present. Because they don't use radiation, they can be safe for women who may be pregnant.
Cardiac MRI
Magnetic resonance imaging (MRI) has been around for decades, but it's only within the past several years that physicians have begun using the technology on a regular basis to examine the heart.
For years the ultrasound-based echocardiogram was the standard option for capturing an image of the heart at work. It remains the go-to procedure, but a cardiac MRI is an increasingly common and often more accurate alternative.
Nearly identical to a traditional MRI, a cardiac MRI is a noninvasive procedure that entails lying on a bed scanner for 45 to 90 minutes. The magnetic fields and radio waves used in cardiac MRI are harmless, although the procedure can disrupt the functioning of pacemakers and implantable defibrillators and is therefore off-limits to patients with those devices.
Computed tomography (CT) scan
This is a full-body X-ray that detects calcified plaque in the arteries of the heart. Calcified plaque is an indicator of heart disease.
MUGA
Another alternative to the echocardiogram is the multiple gated acquisition (or MUGA) scan, a form of cardiac blood pool scan. In a MUGA scan a patient is injected with a small amount of radioactive liquid, which is detected by a special camera as the liquid passes through the bloodstream. This procedure generates a stop-motion image of the beating heart and measures the amount of blood ejected by the left ventricle with each beat—a good indicator of overall heart health.
Coping And Support
Getting emotional and psychological help is a key factor in recovering from heart disease. By some estimates, people who suffer from depression are about 65% more likely to develop heart disease, and up to one in five people with heart disease will develop depression.
Depression can affect the heart in many ways, both before and after heart disease. It can disrupt the heart's rhythm, encourage inflammation and blood clots, and bathe the body in stress hormones that can raise blood pressure and harden arteries.
People with blocked coronary arteries have reduced blood flow to the heart, but they can also have blockage in the arteries in their brain, making them vulnerable to strokes. Studies show that heart attack survivors who spend less time alone and reach out for help have an easier time recovering from depression.
Doctors don't yet know if treating depression can prevent heart disease, but they do know that if you have heart disease and you're depressed, treating depression is critical to your recovery and your quality of life.
Patient Experiences
Coronary artery disease (CAD) can sneak up on you. You may learn that you have it after months of experiencing symptoms such as chest pain, jaw pain, fatigue, or even heartburn. Or you may find out you have CAD after surviving a heart attack. Either way, once you've got it, you have to learn how to live with it, because even though CAD is treatable, there is no cure.
Karen Sanson, a thin, fit 60-year-old, of Cleveland, struggled with fear and anxiety after her heart attack and diagnosis of coronary artery disease. “I had to come to terms with trying to have a relationship with my heart where I don't panic,” she says.
“You think you're never going to be the same and you have to tiptoe around everything,” says Jim Hayes, 77, of Solon, Iowa, who found solace by volunteering with other people living with heart disease.
Heart attacks, in particular, can be life changing and terrifying, but they sometimes sneak up on you. Kevin Ambrose, 52, of Washington Grove, Md., has had three heart attacks but was never in physical agony. “They were all mild—I didn't fall to my knees,” he says. “Instead I got a bad headache or blurred vision.” During one heart attack, he recalls, he felt well enough to drive himself to the hospital, even though he knew he should call 911. Joe Marzan, of Prineville, Ore., who had a heart attack at 31, says he felt his whole chest move with every heartbeat, and then he started vomiting.
Lori Kupetz, 41, of Sherman Oaks, Calif., was hiking with a friend when she felt a blinding chest pain that quickly went away. Soon she was consumed by fatigue. “After six or seven months I couldn't carry groceries, I couldn't have sex, I couldn't dance with my daughters without feeling chest pain,” says Kupetz.
Sanson started to wake up in the middle of the night unable to breathe. “I also felt very fatigued,” she says, “even though I usually have mounds of energy and go till I drop.”
Although neither Sanson nor Kupetz seemed at risk for heart disease, they both ended up having (and surviving!) heart attacks and were diagnosed with coronary artery disease.
It's been more than 10 years since 65-year-old John Maiorana, of Virginia Beach, Va., suffered daily bouts of chest pain. And after an emergency bypass surgery restored blood flow to his heart, he has spent the time getting stronger and feeling better, but one thing has remained constant. As a volunteer with Mended Hearts, Maiorana often visits CAD patients in the hospital. Whether they're recovering from a heart attack or bypass surgery or both, he has the same message: It's possible to live with heart disease. And he's proof.
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Definition
Heart disease refers to one of several conditions that affect the heart. One in three Americans has some type of heart disease, which is also the leading cause of death. But even for those with a family history of the condition, heart disease and heart attacks are not inevitable. A healthy diet, regular exercise, cholesterol-lowering drugs, and lifesaving surgeries can reduce your risk of having—or dying from—a heart attack.
Alternate Names
Heart Disease
Cardiovascular Disease
Coronary Artery Disease
Coronary Heart Disease
Acute Coronary Syndrome
Angina Pectoris
Congenital Cardiovascular Defects
Heart Attack
Heart Failure
Arrhythmia
High Blood Pressure
High Cholesterol
Stroke
Symptoms
Pain
If your arteries start collecting plaque, your heart may have trouble getting enough blood. And if blood flow runs low, the heart complains—with pain. This is often one of the first symptoms of coronary artery disease (CAD).
You may notice a sharp pain in your chest, known as angina. The pain—often described as pressure, heaviness, tightness, squeezing, burning, or a dull ache—will likely last a few minutes before fading.
The pain is hard to pinpoint, although some people describe it by holding a clenched fist to their chest. (Note: Burning chest pain following a meal is more likely to be acid reflux than angina. If an antacid eases the pain, it's heartburn.)
Chest pain can be a sign of a heart attack. At first, you're only likely to notice angina when you're exercising. The pain should ease quickly as you rest.
But if plaque continues to build, your heart may start complaining any time of day in any situation. It may even wake you up in the middle of the night. Unpredictable or unstable angina is a powerful predictor of a heart attack.
Breathlessness and fatigue
A heart that isn't getting enough blood is also not getting enough oxygen. For that reason, people with coronary artery disease may feel breathless and unusually tired. But you should be concerned if you suddenly lack the strength or the breath to do something that usually comes easily.
Male CAD risk
Men have another early warning system. Erectile dysfunction (ED)—trouble achieving or keeping erections—is extremely common in men with coronary artery disease. The arteries feeding the penis can clog just as surely as the arteries around the heart.
Stroke and other problems
In addition to ED, you could also have clogging in other arteries (a process known as atherosclerosis). For example, blockages in the carotid artery of the neck can lead to strokes.
Atherosclerosis can play a role in kidney failure and cause peripheral arterial disease, an insufficiency of blood supply to the legs that can lead to pain and difficulty walking.
Causes
These are the leading factors that put you at risk for coronary artery disease or a heart attack:
• Age: More than 83% of people who die from coronary heart disease are 65 or older. Older women are more likely to die of heart attacks within a few weeks of the attack than older men.
• Being male: Men have a greater risk of heart attack than women, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, women's risk of heart attack is not as great as men's.
• Family history: Those with parents or close relatives with heart disease are more likely to develop it themselves.
• Race: Compared with Caucasians, heart disease risk is higher among African-Americans, Mexican-Americans, American Indians, native Hawaiians, and some Asian-Americans.
• Smoking: Cigarette smoking increases your risk of developing heart disease by two to four times.
• High cholesterol: High levels of “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol, in the blood drive up your risk of coronary heart disease.
• High blood pressure: High blood pressure, or hypertension, puts a strain on the heart, causing it to thicken and become stiffer. Additional risk factors of hypertension are stroke, heart attack, kidney failure, and congestive heart failure. Obesity, smoking, high blood cholesterol levels, or diabetes, in combination with high blood pressure, increase the risk of heart attack or stroke several times.
• Sedentary lifestyle: Inactivity is a risk factor for coronary heart disease.
• Excess weight: People who have excess body fat—especially abdominal body fat—face an increased likelihood of developing heart disease and stroke even if they have no other risk factors.
• Diabetes: Having diabetes dramatically raises your risk of developing cardiovascular disease. Approximately three-quarters of diabetics die from some form of heart or blood vessel disease.
Drugs
ACE inhibitors: These are a class of drugs that relax and dilate blood vessels, reducing blood pressure. They include:
• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Vasotec)
• fosinopril (Monopril),
• lisinopril (Prinivil, Zestril)
• moexipril (Univasc)
• perindopril (Aceon)
• quinapril (Accupril)
• ramipril (Altace)
• trandolapril (Mavik)
Aspirin: Taken daily, aspirin can help prevent blood clots by keeping platelets from sticking together. It's a potential lifesaver for anyone at risk for a heart attack. And when taken during or immediately after a heart attack, aspirin can help to break up a clot and restore blood flow to the heart.
Beta-blockers: These are a class of drugs that slow the heart rate, lessening blood pressure and the risk of heart attack.
Calcium channel blockers: These drugs dilate or open blood vessels, releasing blood pressure.
Diuretics: This class of drugs, such as Lasix and Diuril, works by flushing extra salt and water out of the body.
Statins: These drugs can dramatically lower the levels of artery-clogging cholesterol in the blood. After a heart attack, taking a statin can prevent the risk of death within one year by 25%. Among patients who don't even have cardiovascular disease, taking a statin preventively can reduce the risk of a major coronary event, like a heart attack, by about 30%. Statins include:
• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)
• pitavastatin (Livalo)
Angioplasty
Angioplasty is a procedure in which a narrowed section of the coronary artery is widened. Angioplasties are often an essential treatment for heart attack patients. As with all parts of heart attack care, timing is crucial. Up to 20% of all angioplasty patients who have a stent inserted during the procedure will have blocked arteries again within six months.
Bypass Surgery
If you have blockages in three or more coronary arteries, your doctor is likely to recommend bypass surgery. This is an invasive procedure whereby doctors route new vessels around blocked arteries, usually taken from the leg or groin. Patients with serious coronary artery disease who undergo bypass surgery are nearly 50% more likely to be alive in five years than patients who receive drug treatment alone.
Cardiac Rehabilitation
Cardiac rehab is an organized lifestyle, diet, and exercise program, usually administered by a team of cardiac medical specialists, for people with coronary artery disease, or those who have had a heart attack or bypass surgery. Cardiac rehab teaches lifestyle modification, such as exercise, dietary changes, smoking cessation, and medication compliance, designed to reduce the risk of another cardiac event such as a heart attack. Heart patients who attend cardiac rehabilitation tend to recover faster and more completely than people who don't.
Prevention
To reduce your risk of heart disease:
Don't smoke. Smokers are two to four times more likely to develop coronary artery disease (CAD) than nonsmokers. Cardiovascular disease—including CAD, heart failure, and heart attack—is the leading killer in the U.S., claiming more than 860,000 lives in 2005. Smoking ups your risk for heart disease by decreasing the flow of oxygen to the heart and raises your risk for atherosclerosis, or hardening of the arteries. Lighting up also damages the cells that line the coronary arteries and increases your likelihood of blood clots. In fact, heart-related complications are one of the main reasons cigarettes can take so much time off a smoker's lifespan.
Keep blood pressure at 120/80 or below.
Drink at least half a glass of wine, or equivalent alcohol, each day (but not more than a full glass, experts say).
Get at least 30 minutes of moderate or vigorous physical activity daily. Exercise has been shown to slash the risk of heart disease and add years to one's life, even among obese people and other high-risk populations. Moderate-to-vigorous exercise is defined as reaching and maintaining 50% to 85% of your maximum heart rate on most days of the week. A brisk walk, a bike ride, and light weight training all count.
Maintain a healthy weight. Obesity is a risk factor in cardiovascular disease, especially for young men. But where you carry fat on your body can also be a good predictor of heart health. Being “apple shaped,” with extra fat on the belly, can put you at a higher risk than someone with the fat distributed around the hips and thighs. Extra fat cells can also lead to type 2 diabetes, itself a risk factor for heart disease. Even if you don't reach your ideal weight, every little bit can help. According to the National Institutes of Health, losing just 10% of your total body weight can lower your risk of heart disease and other conditions associated with obesity.
Eat a healthy diet. Your diet should be rich in fruits, vegetables, and other plant foods and low in saturated fat, which comes from animal products. It should be low in trans fats but high in fiber, omega-3 fatty acids, and folate. It should also have a lower glycemic load and a higher polyunsaturated-to-saturated fat ratio.
Minimize stress. Stress triggers an increase of cortisol, a “stress hormone,” which can raise blood sugar levels and blood pressure. The overproduction of cortisol can lead to a constant state of chemical arousal, which can eventually cause a heart attack.
Tests
Angiogram
Coronary angiograms involve inserting a catheter (a thin tube) through a blood vessel in the arm or leg to the heart. The procedure is usually performed in a hospital, in a cardiac catheterization lab (commonly called a “cath” lab). Angiograms test for blockages in the coronary arteries in addition to other cardiovascular ailments. The test is often used to diagnose coronary artery disease (CAD) or to track the success of heart treatments. It's also commonly performed on heart attack patients.
Electrocardiogram (ECG or EKG)
An exercise electrocardiogram (EKG or ECG), sometimes called a stress test, checks and records changes in your heart while you walk or run on a treadmill with electrodes on your arms, legs, and chest. Some heart abnormalities can be seen only during exercise or while symptoms are present. Because they don't use radiation, they can be safe for women who may be pregnant.
Cardiac MRI
Magnetic resonance imaging (MRI) has been around for decades, but it's only within the past several years that physicians have begun using the technology on a regular basis to examine the heart.
For years the ultrasound-based echocardiogram was the standard option for capturing an image of the heart at work. It remains the go-to procedure, but a cardiac MRI is an increasingly common and often more accurate alternative.
Nearly identical to a traditional MRI, a cardiac MRI is a noninvasive procedure that entails lying on a bed scanner for 45 to 90 minutes. The magnetic fields and radio waves used in cardiac MRI are harmless, although the procedure can disrupt the functioning of pacemakers and implantable defibrillators and is therefore off-limits to patients with those devices.
Computed tomography (CT) scan
This is a full-body X-ray that detects calcified plaque in the arteries of the heart. Calcified plaque is an indicator of heart disease.
MUGA
Another alternative to the echocardiogram is the multiple gated acquisition (or MUGA) scan, a form of cardiac blood pool scan. In a MUGA scan a patient is injected with a small amount of radioactive liquid, which is detected by a special camera as the liquid passes through the bloodstream. This procedure generates a stop-motion image of the beating heart and measures the amount of blood ejected by the left ventricle with each beat—a good indicator of overall heart health.
Coping And Support
Getting emotional and psychological help is a key factor in recovering from heart disease. By some estimates, people who suffer from depression are about 65% more likely to develop heart disease, and up to one in five people with heart disease will develop depression.
Depression can affect the heart in many ways, both before and after heart disease. It can disrupt the heart's rhythm, encourage inflammation and blood clots, and bathe the body in stress hormones that can raise blood pressure and harden arteries.
People with blocked coronary arteries have reduced blood flow to the heart, but they can also have blockage in the arteries in their brain, making them vulnerable to strokes. Studies show that heart attack survivors who spend less time alone and reach out for help have an easier time recovering from depression.
Doctors don't yet know if treating depression can prevent heart disease, but they do know that if you have heart disease and you're depressed, treating depression is critical to your recovery and your quality of life.
Patient Experiences
Coronary artery disease (CAD) can sneak up on you. You may learn that you have it after months of experiencing symptoms such as chest pain, jaw pain, fatigue, or even heartburn. Or you may find out you have CAD after surviving a heart attack. Either way, once you've got it, you have to learn how to live with it, because even though CAD is treatable, there is no cure.
Karen Sanson, a thin, fit 60-year-old, of Cleveland, struggled with fear and anxiety after her heart attack and diagnosis of coronary artery disease. “I had to come to terms with trying to have a relationship with my heart where I don't panic,” she says.
“You think you're never going to be the same and you have to tiptoe around everything,” says Jim Hayes, 77, of Solon, Iowa, who found solace by volunteering with other people living with heart disease.
Heart attacks, in particular, can be life changing and terrifying, but they sometimes sneak up on you. Kevin Ambrose, 52, of Washington Grove, Md., has had three heart attacks but was never in physical agony. “They were all mild—I didn't fall to my knees,” he says. “Instead I got a bad headache or blurred vision.” During one heart attack, he recalls, he felt well enough to drive himself to the hospital, even though he knew he should call 911. Joe Marzan, of Prineville, Ore., who had a heart attack at 31, says he felt his whole chest move with every heartbeat, and then he started vomiting.
Lori Kupetz, 41, of Sherman Oaks, Calif., was hiking with a friend when she felt a blinding chest pain that quickly went away. Soon she was consumed by fatigue. “After six or seven months I couldn't carry groceries, I couldn't have sex, I couldn't dance with my daughters without feeling chest pain,” says Kupetz.
Sanson started to wake up in the middle of the night unable to breathe. “I also felt very fatigued,” she says, “even though I usually have mounds of energy and go till I drop.”
Although neither Sanson nor Kupetz seemed at risk for heart disease, they both ended up having (and surviving!) heart attacks and were diagnosed with coronary artery disease.
It's been more than 10 years since 65-year-old John Maiorana, of Virginia Beach, Va., suffered daily bouts of chest pain. And after an emergency bypass surgery restored blood flow to his heart, he has spent the time getting stronger and feeling better, but one thing has remained constant. As a volunteer with Mended Hearts, Maiorana often visits CAD patients in the hospital. Whether they're recovering from a heart attack or bypass surgery or both, he has the same message: It's possible to live with heart disease. And he's proof.
http://www.americanheart.org/presenter.jhtml?identifier=4726
http://www.mayoclinic.com/health/daily-aspirin-therapy/hb00073;
http://www.americanheart.org/presenter.jhtml?identifier=4456
http://www.americanheart.org/presenter.jhtml?identifier=118
http://www.medterms.com/script/main/art.asp?articlekey=26009
http://www.americanheart.org/presenter.jhtml?identifier=118#calcium_channel
http://www.health.com/health/condition-video/0,,20193723,00.html
http://www.americanheart.org/presenter.jhtml?identifier=163
http://www.theheart.org/article/990121.do
http://www.mayoclinic.com/health/angioplasty/my00352
http://www.health.com/health/condition-article/0,,20189575,00.html
http://www.webmd.com/heart-disease/heart-disease-bypass-surgery
http://www.health.com/health/condition-article/0,,20189555,00.html
http://www.americanheart.org/presenter.jhtml?identifier=4473
american_heart_association_meeting_report_light_wine_intake_is_associated/index.html
http://www.americanheart.org/presenter.jhtml?identifier=3039571
http://www.health.com/health/condition-article/0,,20187994,00.html
http://www.health.com/health/condition-article/0,,20188391,00.html
http://www.americanheart.org/downloadable/heart/119619923016841%20WhatIsaCoronaryAngiogram_9-07.pdf
http://www.americanheart.org/presenter.jhtml?identifier=11222
http://www.nhlbi.nih.gov/health/dci/Diseases/ca/ca_whatis.htmlhttp://www.ehealthmd.com/library/heartattack/HA_tests.html
http://emedicine.medscape.com/article/811577-overview
https://www.americanheart.org/presenter.jhtml?identifier=3005172
http://www.mayoclinic.com/health/electrocardiogram/MY00086/DSECTION=what%2Dyou%2Dcan%2Dexpect
http://emedicine.medscape.com/article/811577-overview
http://www.nia.nih.gov/HealthInformation/Publications/AgingHeartsandArteries/chapter02.htm
http://www.health.com/health/condition-article/0,,20188551,00.html
http://www.mayoclinic.com/health/mri/MY00227/DSECTION=what%2Dyou%2Dcan%2Dexpect
http://www.americanheart.org/presenter.jhtml?identifier=3005170
http://www.scandirectory.com/content/heart_scan.asp
http://medical-dictionary.thefreedictionary.com/Multiple-Gated+Acquisition+(MUGA)+Scan
http://www.health.com/health/condition-article/0,,20189122,00.html
http://www.health.com/health/condition-article/0,,20189121,00.html
http://www.annals.org/content/140/12/1054.full
http://www.health.com/health/condition-article/0,,20206872,00.html
http://www.health.com/health/condition-article/0,,20188894,00.html
http://www.health.com/health/condition-article/0,,20188868,00.html
Read more: http://www.righthealth.com/topic/high_blood_pressure/overview/healthcomunique#ixzz1FOefppal
Heart disease refers to one of several conditions that affect the heart. One in three Americans has some type of heart disease, which is also the leading cause of death. But even for those with a family history of the condition, heart disease and heart attacks are not inevitable. A healthy diet, regular exercise, cholesterol-lowering drugs, and lifesaving surgeries can reduce your risk of having—or dying from—a heart attack.
Alternate Names
Heart Disease
Cardiovascular Disease
Coronary Artery Disease
Coronary Heart Disease
Acute Coronary Syndrome
Angina Pectoris
Congenital Cardiovascular Defects
Heart Attack
Heart Failure
Arrhythmia
High Blood Pressure
High Cholesterol
Stroke
Symptoms
Pain
If your arteries start collecting plaque, your heart may have trouble getting enough blood. And if blood flow runs low, the heart complains—with pain. This is often one of the first symptoms of coronary artery disease (CAD).
You may notice a sharp pain in your chest, known as angina. The pain—often described as pressure, heaviness, tightness, squeezing, burning, or a dull ache—will likely last a few minutes before fading.
The pain is hard to pinpoint, although some people describe it by holding a clenched fist to their chest. (Note: Burning chest pain following a meal is more likely to be acid reflux than angina. If an antacid eases the pain, it's heartburn.)
Chest pain can be a sign of a heart attack. At first, you're only likely to notice angina when you're exercising. The pain should ease quickly as you rest.
But if plaque continues to build, your heart may start complaining any time of day in any situation. It may even wake you up in the middle of the night. Unpredictable or unstable angina is a powerful predictor of a heart attack.
Breathlessness and fatigue
A heart that isn't getting enough blood is also not getting enough oxygen. For that reason, people with coronary artery disease may feel breathless and unusually tired. But you should be concerned if you suddenly lack the strength or the breath to do something that usually comes easily.
Male CAD risk
Men have another early warning system. Erectile dysfunction (ED)—trouble achieving or keeping erections—is extremely common in men with coronary artery disease. The arteries feeding the penis can clog just as surely as the arteries around the heart.
Stroke and other problems
In addition to ED, you could also have clogging in other arteries (a process known as atherosclerosis). For example, blockages in the carotid artery of the neck can lead to strokes.
Atherosclerosis can play a role in kidney failure and cause peripheral arterial disease, an insufficiency of blood supply to the legs that can lead to pain and difficulty walking.
Causes
These are the leading factors that put you at risk for coronary artery disease or a heart attack:
• Age: More than 83% of people who die from coronary heart disease are 65 or older. Older women are more likely to die of heart attacks within a few weeks of the attack than older men.
• Being male: Men have a greater risk of heart attack than women, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, women's risk of heart attack is not as great as men's.
• Family history: Those with parents or close relatives with heart disease are more likely to develop it themselves.
• Race: Compared with Caucasians, heart disease risk is higher among African-Americans, Mexican-Americans, American Indians, native Hawaiians, and some Asian-Americans.
• Smoking: Cigarette smoking increases your risk of developing heart disease by two to four times.
• High cholesterol: High levels of “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol, in the blood drive up your risk of coronary heart disease.
• High blood pressure: High blood pressure, or hypertension, puts a strain on the heart, causing it to thicken and become stiffer. Additional risk factors of hypertension are stroke, heart attack, kidney failure, and congestive heart failure. Obesity, smoking, high blood cholesterol levels, or diabetes, in combination with high blood pressure, increase the risk of heart attack or stroke several times.
• Sedentary lifestyle: Inactivity is a risk factor for coronary heart disease.
• Excess weight: People who have excess body fat—especially abdominal body fat—face an increased likelihood of developing heart disease and stroke even if they have no other risk factors.
• Diabetes: Having diabetes dramatically raises your risk of developing cardiovascular disease. Approximately three-quarters of diabetics die from some form of heart or blood vessel disease.
Drugs
ACE inhibitors: These are a class of drugs that relax and dilate blood vessels, reducing blood pressure. They include:
• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Vasotec)
• fosinopril (Monopril),
• lisinopril (Prinivil, Zestril)
• moexipril (Univasc)
• perindopril (Aceon)
• quinapril (Accupril)
• ramipril (Altace)
• trandolapril (Mavik)
Aspirin: Taken daily, aspirin can help prevent blood clots by keeping platelets from sticking together. It's a potential lifesaver for anyone at risk for a heart attack. And when taken during or immediately after a heart attack, aspirin can help to break up a clot and restore blood flow to the heart.
Beta-blockers: These are a class of drugs that slow the heart rate, lessening blood pressure and the risk of heart attack.
Calcium channel blockers: These drugs dilate or open blood vessels, releasing blood pressure.
Diuretics: This class of drugs, such as Lasix and Diuril, works by flushing extra salt and water out of the body.
Statins: These drugs can dramatically lower the levels of artery-clogging cholesterol in the blood. After a heart attack, taking a statin can prevent the risk of death within one year by 25%. Among patients who don't even have cardiovascular disease, taking a statin preventively can reduce the risk of a major coronary event, like a heart attack, by about 30%. Statins include:
• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)
• pitavastatin (Livalo)
Angioplasty
Angioplasty is a procedure in which a narrowed section of the coronary artery is widened. Angioplasties are often an essential treatment for heart attack patients. As with all parts of heart attack care, timing is crucial. Up to 20% of all angioplasty patients who have a stent inserted during the procedure will have blocked arteries again within six months.
Bypass Surgery
If you have blockages in three or more coronary arteries, your doctor is likely to recommend bypass surgery. This is an invasive procedure whereby doctors route new vessels around blocked arteries, usually taken from the leg or groin. Patients with serious coronary artery disease who undergobypass surgery are nearly 50% more likely to be alive in five years than patients who receive drug treatment alone.
Cardiac Rehabilitation
Cardiac rehab is an organized lifestyle, diet, and exercise program, usually administered by a team of cardiac medical specialists, for people with coronary artery disease, or those who have had a heart attack or bypass surgery. Cardiac rehab teaches lifestyle modification, such as exercise, dietary changes, smoking cessation, and medication compliance, designed to reduce the risk of another cardiac event such as a heart attack. Heart patients who attend cardiac rehabilitation tend to recover faster and more completely than people who don't.
Prevention
To reduce your risk of heart disease:
Don't smoke. Smokers are two to four times more likely to develop coronary artery disease (CAD) than nonsmokers. Cardiovascular disease—including CAD, heart failure, and heart attack—is the leading killer in the U.S., claiming more than 860,000 lives in 2005. Smoking ups your risk for heart disease by decreasing the flow of oxygen to the heart and raises your risk for atherosclerosis, or hardening of the arteries. Lighting up also damages the cells that line the coronary arteries and increases your likelihood of blood clots. In fact, heart-related complications are one of the main reasons cigarettes can take so much time off a smoker's lifespan.
Keep blood pressure at 120/80 or below.
Drink at least half a glass of wine, or equivalent alcohol, each day (but not more than a full glass, experts say).
Get at least 30 minutes of moderate or vigorous physical activity daily. Exercise has been shown to slash the risk of heart disease and add years to one's life, even among obese people and other high-risk populations. Moderate-to-vigorous exercise is defined as reaching and maintaining 50% to 85% of your maximum heart rate on most days of the week. A brisk walk, a bike ride, and light weight training all count.
Maintain a healthy weight. Obesity is a risk factor in cardiovascular disease, especially for young men. But where you carry fat on your body can also be a good predictor of heart health. Being “apple shaped,” with extra fat on the belly, can put you at a higher risk than someone with the fat distributed around the hips and thighs. Extra fat cells can also lead to type 2 diabetes, itself a risk factor for heart disease. Even if you don't reach your ideal weight, every little bit can help. According to the National Institutes of Health, losing just 10% of your total body weight can lower your risk of heart disease and other conditions associated with obesity.
Eat a healthy diet. Your diet should be rich in fruits, vegetables, and other plant foods and low in saturated fat, which comes from animal products. It should be low in trans fats but high in fiber, omega-3 fatty acids, and folate. It should also have a lower glycemic load and a higher polyunsaturated-to-saturated fat ratio.
Minimize stress. Stress triggers an increase of cortisol, a “stress hormone,” which can raise blood sugar levels and blood pressure. The overproduction of cortisol can lead to a constant state of chemical arousal, which can eventually cause a heart attack.
Tests
Angiogram
Coronary angiograms involve inserting a catheter (a thin tube) through a blood vessel in the arm or leg to the heart. The procedure is usually performed in a hospital, in a cardiac catheterization lab (commonly called a “cath” lab). Angiograms test for blockages in the coronary arteries in addition to other cardiovascular ailments. The test is often used to diagnose coronary artery disease (CAD) or to track the success of heart treatments. It's also commonly performed on heart attack patients.
Electrocardiogram (ECG or EKG)
An exercise electrocardiogram (EKG or ECG), sometimes called a stress test, checks and records changes in your heart while you walk or run on a treadmill with electrodes on your arms, legs, and chest. Some heart abnormalities can be seen only during exercise or while symptoms are present. Because they don't use radiation, they can be safe for women who may be pregnant.
Cardiac MRI
Magnetic resonance imaging (MRI) has been around for decades, but it's only within the past several years that physicians have begun using the technology on a regular basis to examine the heart.
For years the ultrasound-based echocardiogram was the standard option for capturing an image of the heart at work. It remains the go-to procedure, but a cardiac MRI is an increasingly common and often more accurate alternative.
Nearly identical to a traditional MRI, a cardiac MRI is a noninvasive procedure that entails lying on a bed scanner for 45 to 90 minutes. The magnetic fields and radio waves used in cardiac MRI are harmless, although the procedure can disrupt the functioning of pacemakers and implantable defibrillators and is therefore off-limits to patients with those devices.
Computed tomography (CT) scan
This is a full-body X-ray that detects calcified plaque in the arteries of the heart. Calcified plaque is an indicator of heart disease.
MUGA
Another alternative to the echocardiogram is the multiple gated acquisition (or MUGA) scan, a form of cardiac blood pool scan. In a MUGA scan a patient is injected with a small amount of radioactive liquid, which is detected by a special camera as the liquid passes through the bloodstream. This procedure generates a stop-motion image of the beating heart and measures the amount of blood ejected by the left ventricle with each beat—a good indicator of overall heart health.
Coping And Support
Getting emotional and psychological help is a key factor in recovering from heart disease. By some estimates, people who suffer from depression are about 65% more likely to develop heart disease, and up to one in five people with heart disease will develop depression.
Depression can affect the heart in many ways, both before and after heart disease. It can disrupt the heart's rhythm, encourage inflammation and blood clots, and bathe the body in stress hormones that can raise blood pressure and harden arteries.
People with blocked coronary arteries have reduced blood flow to the heart, but they can also have blockage in the arteries in their brain, making them vulnerable to strokes. Studies show that heart attack survivors who spend less time alone and reach out for help have an easier time recovering from depression.
Doctors don't yet know if treating depression can prevent heart disease, but they do know that if you have heart disease and you're depressed, treating depression is critical to your recovery and your quality of life.
Patient Experiences
Coronary artery disease (CAD) can sneak up on you. You may learn that you have it after months of experiencing symptoms such as chest pain, jaw pain, fatigue, or even heartburn. Or you may find out you have CAD after surviving a heart attack. Either way, once you've got it, you have to learn how to live with it, because even though CAD is treatable, there is no cure.
Karen Sanson, a thin, fit 60-year-old, of Cleveland, struggled with fear and anxiety after her heart attack and diagnosis of coronary artery disease. “I had to come to terms with trying to have a relationship with my heart where I don't panic,” she says.
“You think you're never going to be the same and you have to tiptoe around everything,” says Jim Hayes, 77, of Solon, Iowa, who found solace by volunteering with other people living with heart disease.
Heart attacks, in particular, can be life changing and terrifying, but they sometimes sneak up on you. Kevin Ambrose, 52, of Washington Grove, Md., has had three heart attacks but was never in physical agony. “They were all mild—I didn't fall to my knees,” he says. “Instead I got a bad headache or blurred vision.” During one heart attack, he recalls, he felt well enough to drive himself to the hospital, even though he knew he should call 911. Joe Marzan, of Prineville, Ore., who had a heart attack at 31, says he felt his whole chest move with every heartbeat, and then he started vomiting.
Lori Kupetz, 41, of Sherman Oaks, Calif., was hiking with a friend when she felt a blinding chest pain that quickly went away. Soon she was consumed by fatigue. “After six or seven months I couldn't carry groceries, I couldn't have sex, I couldn't dance with my daughters without feeling chest pain,” says Kupetz.
Sanson started to wake up in the middle of the night unable to breathe. “I also felt very fatigued,” she says, “even though I usually have mounds of energy and go till I drop.”
Although neither Sanson nor Kupetz seemed at risk for heart disease, they both ended up having (and surviving!) heart attacks and were diagnosed with coronary artery disease.
It's been more than 10 years since 65-year-old John Maiorana, of Virginia Beach, Va., suffered daily bouts of chest pain. And after an emergency bypass surgery restored blood flow to his heart, he has spent the time getting stronger and feeling better, but one thing has remained constant. As a volunteer with Mended Hearts, Maiorana often visits CAD patients in the hospital. Whether they're recovering from a heart attack or bypass surgery or both, he has the same message: It's possible to live with heart disease. And he's proof.
http://www.americanheart.org/presenter.jhtml?identifier=4726
http://www.mayoclinic.com/health/daily-aspirin-therapy/hb00073;
http://www.americanheart.org/presenter.jhtml?identifier=4456
http://www.americanheart.org/presenter.jhtml?identifier=118
http://www.medterms.com/script/main/art.asp?articlekey=26009
http://www.americanheart.org/presenter.jhtml?identifier=118#calcium_channel
http://www.health.com/health/condition-video/0,,20193723,00.html
http://www.americanheart.org/presenter.jhtml?identifier=163
http://www.theheart.org/article/990121.do
http://www.mayoclinic.com/health/angioplasty/my00352
http://www.health.com/health/condition-article/0,,20189575,00.html
http://www.webmd.com/heart-disease/heart-disease-bypass-surgery
http://www.health.com/health/condition-article/0,,20189555,00.html
http://www.americanheart.org/presenter.jhtml?identifier=4473
american_heart_association_meeting_report_light_wine_intake_is_associated/index.html
http://www.americanheart.org/presenter.jhtml?identifier=3039571
http://www.health.com/health/condition-article/0,,20187994,00.html
http://www.health.com/health/condition-article/0,,20188391,00.html
http://www.americanheart.org/downloadable/heart/119619923016841%20WhatIsaCoronaryAngiogram_9-07.pdf
http://www.americanheart.org/presenter.jhtml?identifier=11222
http://www.nhlbi.nih.gov/health/dci/Diseases/ca/ca_whatis.htmlhttp://www.ehealthmd.com/library/heartattack/HA_tests.html
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Definition
Heart disease refers to one of several conditions that affect the heart. One in three Americans has some type of heart disease, which is also the leading cause of death. But even for those with a family history of the condition, heart disease and heart attacks are not inevitable. A healthy diet, regular exercise, cholesterol-lowering drugs, and lifesaving surgeries can reduce your risk of having—or dying from—a heart attack.
Alternate Names
Heart Disease
Cardiovascular Disease
Coronary Artery Disease
Coronary Heart Disease
Acute Coronary Syndrome
Angina Pectoris
Congenital Cardiovascular Defects
Heart Attack
Heart Failure
Arrhythmia
High Blood Pressure
High Cholesterol
Stroke
Symptoms
Pain
If your arteries start collecting plaque, your heart may have trouble getting enough blood. And if blood flow runs low, the heart complains—with pain. This is often one of the first symptoms of coronary artery disease (CAD).
You may notice a sharp pain in your chest, known as angina. The pain—often described as pressure, heaviness, tightness, squeezing, burning, or a dull ache—will likely last a few minutes before fading.
The pain is hard to pinpoint, although some people describe it by holding a clenched fist to their chest. (Note: Burning chest pain following a meal is more likely to be acid reflux than angina. If an antacid eases the pain, it's heartburn.)
Chest pain can be a sign of a heart attack. At first, you're only likely to notice angina when you're exercising. The pain should ease quickly as you rest.
But if plaque continues to build, your heart may start complaining any time of day in any situation. It may even wake you up in the middle of the night. Unpredictable or unstable angina is a powerful predictor of a heart attack.
Breathlessness and fatigue
A heart that isn't getting enough blood is also not getting enough oxygen. For that reason, people with coronary artery disease may feel breathless and unusually tired. But you should be concerned if you suddenly lack the strength or the breath to do something that usually comes easily.
Male CAD risk
Men have another early warning system. Erectile dysfunction (ED)—trouble achieving or keeping erections—is extremely common in men with coronary artery disease. The arteries feeding the penis can clog just as surely as the arteries around the heart.
Stroke and other problems
In addition to ED, you could also have clogging in other arteries (a process known as atherosclerosis). For example, blockages in the carotid artery of the neck can lead to strokes.
Atherosclerosis can play a role in kidney failure and cause peripheral arterial disease, an insufficiency of blood supply to the legs that can lead to pain and difficulty walking.
Causes
These are the leading factors that put you at risk for coronary artery disease or a heart attack:
• Age: More than 83% of people who die from coronary heart disease are 65 or older. Older women are more likely to die of heart attacks within a few weeks of the attack than older men.
• Being male: Men have a greater risk of heart attack than women, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, women's risk of heart attack is not as great as men's.
• Family history: Those with parents or close relatives with heart disease are more likely to develop it themselves.
• Race: Compared with Caucasians, heart disease risk is higher among African-Americans, Mexican-Americans, American Indians, native Hawaiians, and some Asian-Americans.
• Smoking: Cigarette smoking increases your risk of developing heart disease by two to four times.
• High cholesterol: High levels of “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol, in the blood drive up your risk of coronary heart disease.
• High blood pressure: High blood pressure, or hypertension, puts a strain on the heart, causing it to thicken and become stiffer. Additional risk factors of hypertension are stroke, heart attack, kidney failure, and congestive heart failure. Obesity, smoking, high blood cholesterol levels, or diabetes, in combination with high blood pressure, increase the risk of heart attack or stroke several times.
• Sedentary lifestyle: Inactivity is a risk factor for coronary heart disease.
• Excess weight: People who have excess body fat—especially abdominal body fat—face an increased likelihood of developing heart disease and stroke even if they have no other risk factors.
• Diabetes: Having diabetes dramatically raises your risk of developing cardiovascular disease. Approximately three-quarters of diabetics die from some form of heart or blood vessel disease.
Drugs
ACE inhibitors: These are a class of drugs that relax and dilate blood vessels, reducing blood pressure. They include:
• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Vasotec)
• fosinopril (Monopril),
• lisinopril (Prinivil, Zestril)
• moexipril (Univasc)
• perindopril (Aceon)
• quinapril (Accupril)
• ramipril (Altace)
• trandolapril (Mavik)
Aspirin: Taken daily, aspirin can help prevent blood clots by keeping platelets from sticking together. It's a potential lifesaver for anyone at risk for a heart attack. And when taken during or immediately after a heart attack, aspirin can help to break up a clot and restore blood flow to the heart.
Beta-blockers: These are a class of drugs that slow the heart rate, lessening blood pressure and the risk of heart attack.
Calcium channel blockers: These drugs dilate or open blood vessels, releasing blood pressure.
Diuretics: This class of drugs, such as Lasix and Diuril, works by flushing extra salt and water out of the body.
Statins: These drugs can dramatically lower the levels of artery-clogging cholesterol in the blood. After a heart attack, taking a statin can prevent the risk of death within one year by 25%. Among patients who don't even have cardiovascular disease, taking a statin preventively can reduce the risk of a major coronary event, like a heart attack, by about 30%. Statins include:
• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)
• pitavastatin (Livalo)
Angioplasty
Angioplasty is a procedure in which a narrowed section of the coronary artery is widened. Angioplasties are often an essential treatment for heart attack patients. As with all parts of heart attack care, timing is crucial. Up to 20% of all angioplasty patients who have a stent inserted during the procedure will have blocked arteries again within six months.
Bypass Surgery
If you have blockages in three or more coronary arteries, your doctor is likely to recommend bypass surgery. This is an invasive procedure whereby doctors route new vessels around blocked arteries, usually taken from the leg or groin. Patients with serious coronary artery disease who undergo bypass surgery are nearly 50% more likely to be alive in five years than patients who receive drug treatment alone.
Cardiac Rehabilitation
Cardiac rehab is an organized lifestyle, diet, and exercise program, usually administered by a team of cardiac medical specialists, for people with coronary artery disease, or those who have had a heart attack or bypass surgery. Cardiac rehab teaches lifestyle modification, such as exercise, dietary changes, smoking cessation, and medication compliance, designed to reduce the risk of another cardiac event such as a heart attack. Heart patients who attend cardiac rehabilitation tend to recover faster and more completely than people who don't.
Prevention
To reduce your risk of heart disease:
Don't smoke. Smokers are two to four times more likely to develop coronary artery disease (CAD) than nonsmokers. Cardiovascular disease—including CAD, heart failure, and heart attack—is the leading killer in the U.S., claiming more than 860,000 lives in 2005. Smoking ups your risk for heart disease by decreasing the flow of oxygen to the heart and raises your risk for atherosclerosis, or hardening of the arteries. Lighting up also damages the cells that line the coronary arteries and increases your likelihood of blood clots. In fact, heart-related complications are one of the main reasons cigarettes can take so much time off a smoker's lifespan.
Keep blood pressure at 120/80 or below.
Drink at least half a glass of wine, or equivalent alcohol, each day (but not more than a full glass, experts say).
Get at least 30 minutes of moderate or vigorous physical activity daily. Exercise has been shown to slash the risk of heart disease and add years to one's life, even among obese people and other high-risk populations. Moderate-to-vigorous exercise is defined as reaching and maintaining 50% to 85% of your maximum heart rate on most days of the week. A brisk walk, a bike ride, and light weight training all count.
Maintain a healthy weight. Obesity is a risk factor in cardiovascular disease, especially for young men. But where you carry fat on your body can also be a good predictor of heart health. Being “apple shaped,” with extra fat on the belly, can put you at a higher risk than someone with the fat distributed around the hips and thighs. Extra fat cells can also lead to type 2 diabetes, itself a risk factor for heart disease. Even if you don't reach your ideal weight, every little bit can help. According to the National Institutes of Health, losing just 10% of your total body weight can lower your risk of heart disease and other conditions associated with obesity.
Eat a healthy diet. Your diet should be rich in fruits, vegetables, and other plant foods and low in saturated fat, which comes from animal products. It should be low in trans fats but high in fiber, omega-3 fatty acids, and folate. It should also have a lower glycemic load and a higher polyunsaturated-to-saturated fat ratio.
Minimize stress. Stress triggers an increase of cortisol, a “stress hormone,” which can raise blood sugar levels and blood pressure. The overproduction of cortisol can lead to a constant state of chemical arousal, which can eventually cause a heart attack.
Tests
Angiogram
Coronary angiograms involve inserting a catheter (a thin tube) through a blood vessel in the arm or leg to the heart. The procedure is usually performed in a hospital, in a cardiac catheterization lab (commonly called a “cath” lab). Angiograms test for blockages in the coronary arteries in addition to other cardiovascular ailments. The test is often used to diagnose coronary artery disease (CAD) or to track the success of heart treatments. It's also commonly performed on heart attack patients.
Electrocardiogram (ECG or EKG)
An exercise electrocardiogram (EKG or ECG), sometimes called a stress test, checks and records changes in your heart while you walk or run on a treadmill with electrodes on your arms, legs, and chest. Some heart abnormalities can be seen only during exercise or while symptoms are present. Because they don't use radiation, they can be safe for women who may be pregnant.
Cardiac MRI
Magnetic resonance imaging (MRI) has been around for decades, but it's only within the past several years that physicians have begun using the technology on a regular basis to examine the heart.
For years the ultrasound-based echocardiogram was the standard option for capturing an image of the heart at work. It remains the go-to procedure, but a cardiac MRI is an increasingly common and often more accurate alternative.
Nearly identical to a traditional MRI, a cardiac MRI is a noninvasive procedure that entails lying on a bed scanner for 45 to 90 minutes. The magnetic fields and radio waves used in cardiac MRI are harmless, although the procedure can disrupt the functioning of pacemakers and implantable defibrillators and is therefore off-limits to patients with those devices.
Computed tomography (CT) scan
This is a full-body X-ray that detects calcified plaque in the arteries of the heart. Calcified plaque is an indicator of heart disease.
MUGA
Another alternative to the echocardiogram is the multiple gated acquisition (or MUGA) scan, a form of cardiac blood pool scan. In a MUGA scan a patient is injected with a small amount of radioactive liquid, which is detected by a special camera as the liquid passes through the bloodstream. This procedure generates a stop-motion image of the beating heart and measures the amount of blood ejected by the left ventricle with each beat—a good indicator of overall heart health.
Coping And Support
Getting emotional and psychological help is a key factor in recovering from heart disease. By some estimates, people who suffer from depression are about 65% more likely to develop heart disease, and up to one in five people with heart disease will develop depression.
Depression can affect the heart in many ways, both before and after heart disease. It can disrupt the heart's rhythm, encourage inflammation and blood clots, and bathe the body in stress hormones that can raise blood pressure and harden arteries.
People with blocked coronary arteries have reduced blood flow to the heart, but they can also have blockage in the arteries in their brain, making them vulnerable to strokes. Studies show that heart attack survivors who spend less time alone and reach out for help have an easier time recovering from depression.
Doctors don't yet know if treating depression can prevent heart disease, but they do know that if you have heart disease and you're depressed, treating depression is critical to your recovery and your quality of life.
Patient Experiences
Coronary artery disease (CAD) can sneak up on you. You may learn that you have it after months of experiencing symptoms such as chest pain, jaw pain, fatigue, or even heartburn. Or you may find out you have CAD after surviving a heart attack. Either way, once you've got it, you have to learn how to live with it, because even though CAD is treatable, there is no cure.
Karen Sanson, a thin, fit 60-year-old, of Cleveland, struggled with fear and anxiety after her heart attack and diagnosis of coronary artery disease. “I had to come to terms with trying to have a relationship with my heart where I don't panic,” she says.
“You think you're never going to be the same and you have to tiptoe around everything,” says Jim Hayes, 77, of Solon, Iowa, who found solace by volunteering with other people living with heart disease.
Heart attacks, in particular, can be life changing and terrifying, but they sometimes sneak up on you. Kevin Ambrose, 52, of Washington Grove, Md., has had three heart attacks but was never in physical agony. “They were all mild—I didn't fall to my knees,” he says. “Instead I got a bad headache or blurred vision.” During one heart attack, he recalls, he felt well enough to drive himself to the hospital, even though he knew he should call 911. Joe Marzan, of Prineville, Ore., who had a heart attack at 31, says he felt his whole chest move with every heartbeat, and then he started vomiting.
Lori Kupetz, 41, of Sherman Oaks, Calif., was hiking with a friend when she felt a blinding chest pain that quickly went away. Soon she was consumed by fatigue. “After six or seven months I couldn't carry groceries, I couldn't have sex, I couldn't dance with my daughters without feeling chest pain,” says Kupetz.
Sanson started to wake up in the middle of the night unable to breathe. “I also felt very fatigued,” she says, “even though I usually have mounds of energy and go till I drop.”
Although neither Sanson nor Kupetz seemed at risk for heart disease, they both ended up having (and surviving!) heart attacks and were diagnosed with coronary artery disease.
It's been more than 10 years since 65-year-old John Maiorana, of Virginia Beach, Va., suffered daily bouts of chest pain. And after an emergency bypass surgery restored blood flow to his heart, he has spent the time getting stronger and feeling better, but one thing has remained constant. As a volunteer with Mended Hearts, Maiorana often visits CAD patients in the hospital. Whether they're recovering from a heart attack or bypass surgery or both, he has the same message: It's possible to live with heart disease. And he's proof.
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