Preventing Heart Attacks and Strokes

Heart Health Tips

The word stress is often used to refer to outside events, when actually; stress is not the event itself, but our response to it. This is why it is important to understand how stress affects us and how to deal with it.

What is Stress?

Numerous surveys confirm that adult Americans perceive they are under much more stress than a decade or two ago. A 1996 Prevention magazine survey found that almost 75% feel they have "great stress" one day a week with one out of three indicating they feel this way more than twice a week. In the same 1983 survey only 55% said they felt under great stress on a weekly basis. It has been estimated that 75 - 90 percent of all visits to primary care physicians are for stress related problems.

The body's response to stress is somewhat like a jet getting ready for take-off. Almost all systems (the immune system, the lungs, the blood vessels and heart, the digestive system, the sensory organs, and brain) are modified to meet the perceived danger.

External and Internal Stressors

People can experience either external or internal stressors.

  • External stressors include adverse physical conditions (such as pain or hot or cold temperatures) or stressful psychological environments (such as poor working conditions or abusive relationships). Humans, like animals, can experience external stressors.
  • Internal stressors can also be physical (infections, inflammation) or psychological. An example of an internal psychological stressor is intense worry about a harmful event that may or may not occur. As far as anyone can tell, internal psychological stressors are rare or absent in most animals except humans.

Acute or Chronic Stress

Stress can be short-term (acute) or long-term (chronic). Acute stress is a reaction to an immediate threat or perceived threat.

Acute stress is the reaction to an immediate threat, commonly known as the fight or flight response. The threat can be any situation that is experienced, even subconsciously or falsely, as a danger. First the stress hormone adrenaline is released. Then the heart beats faster, breath quickens and blood pressure rises. The liver increases its output of blood sugar, and blood flow is diverted to the brain and large muscles. The body triggers the production and release of steroid hormones including cortisol, which is very important to the function of the heart, lungs, circulation, metabolism, immune systems, and skin when a stressor is present.

Acute Stressors

  • noise, crowding, isolation, hunger, danger, infection, imagining a threat, remembering a dangerous event

Under most circumstances, once the acute threat has passed, the response becomes inactivated and levels of stress hormones return to normal, a condition called the relaxation response. Frequently, however, modern life poses on-going stressful situations that are not short-lived and the urge to act (to fight or to flee) must be suppressed. Stress, then, becomes chronic.

Chronic Stressors

  • on-going highly pressured work, long-term relationship problem, loneliness, persistent financial worries


A burning cigarette is a health risk to everyone in the same room. The scientific evidence of tobacco hazards is strongest for smokers. However, research reveals that regular exposure to secondhand tobacco smoke also threatens the health of nonsmokers. 37,000 to 40,000 people die from heart and blood vessel disease caused by other people's smoke each year.

Secondhand smoke, also known as environmental tobacco smoke, is a mixture of side stream smoke from the burning end of a cigarette, pipe or cigar and smoke exhaled from the lungs of smokers. About half the smoke generated from a cigarette is sidestream smoke. Sidestream smoke contains essentially the same compounds as does smoke inhaled by the smoker. Secondhand smoke contains substances that irritate the lining of the lung and other tissues. It promotes genetic changes in cells and interferes with cell development, raising the risk of certain cancers.

A 1996 study published in the Journal of the American Medical Association found detectable levels of serum cotinine - a breakdown product of nicotine - in nearly 9 of every 10 nonsmokers in a large, nationally representative sample.

Research has linked secondhand smoke to cardiovascular disease and many other chronic disorders.

Secondhand smoke and cardiovascular disorders

Researchers are gathering evidence of the effect of secondhand smoke on the heart and blood vessels. A small Japanese study looked at the effects of secondhand smoke on circulation in young men. Exposure to secondhand smoke was associated with reduced blood flow through the arteries feeding the heart. One theory behind the finding is that secondhand smoke affects the function of the cells that line the heart and blood vessels.

  • A study of Swedish women and men ages 45 to 70 found a higher risk of nonfatal heart attack among those whose spouses smoked 20 or more cigarettes a day than among people who were not exposed to secondhand smoke from their spouses. The risk was higher for women.
  • A study of 32,000 women who were nurses found that regular exposure to secondhand smoke doubled their risk of a heart attack. The study compared outcomes among nurses who reported regular exposure to secondhand smoke at work and home with those who reported no exposure. The study found the association between heart attacks and secondhand smoke after accounting for many other cardiovascular risk factors such as high blood pressure or high cholesterol.
If you smoke, talk to your doctor about quitting. 

Moderation is the Key

Dozens of studies show that moderate alcohol consumption lowers the risk of heart attack for people in middle age by roughly 30 percent to 50 percent. This result seems to hold up even when you consider other factors that may play a role, such as age and tobacco use. Apparently alcohol offers its greatest protection to men older than age 50, especially those who smoke or did smoke.

Moderate alcohol consumption would be an average of one to two of the following per day for men and one per day for women:

  • 12 oz. Beer
  • 4 oz. of wine
  • 1.5 oz. of 80-proof spirits
  • 1 oz. of 100-proof spirits

In some studies alcohol was shown to:

  • Lower your risk of Ischemic Stroke. About 80 percent of strokes are Ischemic, caused by a buildup of cholesterol and fatty deposits or plaques in your arteries. (Aspirin may help reduce blood clotting in a similar way.)
  • Reduce blockages in your leg arteries. Obstructions in your leg arteries can cause Claudication, a symptom of Peripheral Vascular Disease. You may experience cramping, aching, numbness, fatigue or heaviness in the muscles downstream from the blockage after walking a certain distance, especially downhill.
  • Increased anti-oxidants in blood. Antioxidants can also be obtained from many fruits and vegetables, including red grape juice.
  • The best-known effect of alcohol is an increase in HDL cholesterol. However, regular physical activity and weight loss are other effective ways to raise HDL cholesterol.

However, drinking too much alcohol can raise the levels of some fats in the blood and may bring other health dangers, such as alcoholism, high blood pressure, obesity, stroke, etc. Given these and other risks, the American Heart Association cautions people against increasing their alcohol intake or starting to drink if they don't already do so. Other serious problems include Cardiomyopathy, Cardiac Arrhythmia and Sudden Cardiac Death.

Red Wine and Heart Disease

Some studies suggest that wine's health benefits are superior to beer and liquor because of certain compounds in wine, such as Resveratrol. Other studies document the same cardiovascular benefits with all three. Over the past several decades, many studies have been published in science journals about how drinking alcohol may help reduce mortality due to heart disease. Some researchers have suggested that the benefit may be due to wine, especially red wine. Others are examining the potential benefits of components in red wine such as flavonoids (FLAV'oh-noidz) and other antioxidants (an"tih-OK'sih-dants) in reducing heart disease risk. Some of these components may be found in other foods such as grapes or red grape juice. Another area of controversy is that the linkage reported in many of these studies may be due to other lifestyle factors rather than alcohol. Such factors may include increased physical activity and a diet high in fruits and vegetables.

Don't feel pressured to drink. And don't drink every day. Few, if any, medical experts advise nondrinkers to start drinking.

Don't drink alcohol at all if you have:

  • High blood pressure
  • High blood triglycerides
  • Liver disease
  • Ulcers
  • Severe acid reflux
  • Sleep apnea

Caffeine is in coffee, tea, soft drinks, chocolate and some nuts. Whether high caffeine intake increases the risk of coronary heart disease is still under study. Many studies have been done to see if there's a direct link between caffeine, coffee drinking and coronary heart disease. The results are conflicting.

One study finds a strong link between drinking very high concentrations of black tea and healthy arteries in individuals who have heart disease, according to a report in today's Circulation: Journal of the American Heart Association.

Black tea can offer some of the same benefits as other foods rich in the antioxidants known as flavonoids, such as purple grape juice, onions and red wine. Flavonoids, the major antioxidants found in tea, have been shown to prevent the oxidation of low-density lipoproteins or "bad" cholesterol that leads to the formation of plaque in artery walls. The new study shows that flavonoids improve the function of the vascular endothelium, which forms the inner lining of cells in all blood vessels. It responds to minute to minute changes in the body's oxygen and blood flow needs, by causing blood vessels to expand (dilate) or contract. The vessels expand when the need for blood flow is higher, as occurs during exercise, and the vessels return to original size when the individual is at rest. Black tea also inhibits the formation of blood clots and the development of inflammation in the vessel wall, which can help prevent heart attacks and stroke.

Researchers measured the immediate and longer-term effects of black tea vs. water consumption on the arteries of 50 individuals who had coronary artery disease. They found that tea improved endothelial-dependent dilation in their arteries, while water had no effect.

Some people think that caffeine can help them lose weight. Caffeine is a diuretic so it increases water loss from the body via urine. Water loss decreases body weight, but the weight lost is not body fat .Caffeine can suppress appetite, but these effects don't last long enough to cause significant weight loss. A few studies have indicated that for people who exercise and maintain a low-fat diet, consuming large amounts of caffeine and other stimulants may slightly enhance weight loss. However , large amounts of caffeine can also cause jitters, irritability, insomnia and elevated blood pressure. It stimulates the central nervous system by increasing heart rate and releasing free fatty acids from fatty tissue, although it doesn't seem to boost the metabolic rate or promote loss of body fat. On the contrary, many caffeinated beverages contain sugar, which can add calories.

Moderate coffee drinking (1-2 cups per day) doesn't seem to be harmful. However, caffeine-habituated individuals can experience "caffeine withdrawal" 12 to 24 hours after the last dose of caffeine. It resolves within 24-48 hours. The most prominent symptom is headache. They can also feel anxiety, fatigue, drowsiness and depression.

Preventing Heart Attacks and Strokes – the Million Hearts® Initiative

CHI St. Vincent was the only organization from Arkansas selected to participate in the Million Hearts® CVD Risk Reduction Model. Our heart doctors will be working with healthcare practitioners around the country to reduce heart attacks and strokes. The MH Model is a program to help people cut their risk for heart attacks and strokes. This model supports the broader Million Hearts® Initiative, a national health initiative launched in 2012 whose goal is to prevent one million heart attacks and strokes by 2017. Lessons from the MH Model will help Medicare take better care of future patients.

Participating in the Million Hearts® Initiative

If you are asked to participate in the MH Model, your doctor or nurse will screen will screen you for your 10-year risk of a heart attack or stroke using the American College of Cardiology/American Heart Association (ACC/AHA) 10-year Atherosclerotic Cardiovascular Disease (ASCVD) calculator. This risk calculator uses several pieces of information about your health—including your age, gender, blood pressure, cholesterol level, and smoking status. Your healthcare team will work with you to understand your risk and discuss ways you can cut your risk for having a heart attack and stroke during the next 10 years. We’ll share with Medicare the information we collect to put together your risk score. There will be no cost for you aside from your normal copay and we will not share personal identification information.

Developing Treatment Guidelines Based on Individual Risk

Each heart is different and so is the risk for heart disease. With information gathered from CHI St. Vincent patients and from patients across the country, Medicare will be able develop treatment guidelines for people based on their individual risk. The CVD Risk Reduction Model is expected to reach over 3.3 million Medicare beneficiaries and involve nearly 20,000 health care practitioners over a five-year period beginning in September 2016 and running through August 2021.

CHI St. Vincent Cardiology Clinics Participating in the Million Hearts initiative.

NameAddressPhone Number
CHI St. Vincent Heart Clinic Arkansas - Kanis 10100 Kanis Road , Little Rock AR
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CHI St. Vincent Heart Clinic Arkansas - North Little Rock 4000 Richards Road, Suite A , North Little Rock AR
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CHI St. Vincent Heart Clinic Arkansas - North University 415 North University Avenue , Little Rock AR
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