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For years, heart disease has been associated most prominently with middle aged men. However, recent studies have put this myth to rest. Dr. Robert Beaglehole , WHO Director of Chronic Diseases and Health Promotion, states that "the old stereotype of cardiovascular diseases affecting only stressed, overweight, middle-aged men in developed countries no longer applies." In fact the burden has shifted from gender to economics-- men, women, even children are at risk because 80% of those at risk come from low and middle-income families where healthy dietary and lifestyle habits are difficult to maintain. The emphasis in heart disease risk factors has shifted away from genetic disposition to lifestyle and diets. What this means is that no one is immune from heart disease because of gender and age. What it also means is that everyone has the ability to prevent heart disease by initiating active lifestyle changes.

At the bottom of this shift in attitude is a new understanding of the mechanism behind heart disease. Recent research suggests that atherosclerosis resulting from elevated cholesterol levels in the blood is not the major contributor to heart problems as once thought because half of the people who have heart attacks have normal cholesterol levels. Moreover, improved imaging techniques show that plague formation is not as critical in coronary fatalities as once assumed.

The culprit behind coronary events is now understood to be inflammation. Blood tests that measure C-reactive proteins (CPR) as prediction of heart attack are receiving a great deal of attention these days because elevated levels of this protein indicate active inflammation of the arteries. In fact, studies have shown that healthy middle-aged men with the highest CPR levels were 3 times as likely to suffer a heart attack in the next 6 years than those with the lowest CPR levels.

Think of inflammation as a double-edged sword: it enables the body's immune system to defend itself against invading pathogens; if not turned off, it becomes the culprit that turns the body's immune system against itself. The aftereffects of this unnatural chronic inflammation is more and more viewed by researchers to be the underlying cause not only of coronary problems, but of diseases like Alzheimer's, cancer and diabetes.

What does this new shift in thinking mean in terms of prevention?

a) Dr. Andrew Weil In "Healthy Aging" suggests that diet influences inflammation and strongly proposes that we adopt an anti-inflammatory diet that is rich in omega-3, fish, phytonutrients and low in sugar, high-glycemic carbohydrates and red meat. Such a diet would also reduce excess body fat and obesity-both contributing factors towards diabetes and heart disease.

b) Moderate aerobic and strength-training exercises that tone the heart muscle and improve the elasticity of arteries are also recommended as exercise increases mood enhancing endorphins and reduces stress which can cause cardiac arrhythmias.

c) Stop Smoking. The risk of heart attack in smokers is more than double that of non-smokers.

d) Lower blood pressure with breathwork. Dr. David Anderson at the US National Institute of Health suggests that how we breathe may hold the key to how the body regulates blood pressure. Slow breathing not only elicits relaxation response but may also be able to break down the salt we eat. Excess salt is related to hypertension. Meditation and guided imagery visualization are all tools that expand on the use of breathwork.

e) New FDA regulation that requires nutrition labeling to clearly state how much trans fat a product contains will also do much to raise public consciousness of the perils of trans fat. At the same time, public campaigns to identify foods that lower LDL cholesterol are also underway. An example is the new cholesterol-lowering margarines that are fortified with plant sterols that block cholesterol absorption.

Heart disease is no longer the disease of overweight, highly stressed middle-aged men. All of us are empowered to view coronary problems as something we can change through lifestyle and dietary intervention. We can no longer hide behind the myth of "genetic" disposition or family history which unfortunately incapacitates us by indulging our excuse that we are victims of our physiology and that nothing can be done.