Putting atherosclerosis in reverse

       All too often, the first signal of coronary heart disease is a heart attack. It’s not surprising, since artery-clogging plaque can accumulate for years, steadily and silently. Fortunately, researchers have been working to develop new methods to detect and treat atherosclerosis, or hardened arteries caused by a buildup of fatty plaque, at an earlier stage. And it appears there’s reason for optimism: Even if your arteries are already clogged, experts say it’s not too late to fix your arterial plumbing. Your physician can help by prescribing cholesterol-lowering therapy, such as medications or surgery. In addition, you can do your part by following a few heart-healthy guidelines:
       • Enjoy whole grains and soluble fiber. Brown rice, corn, oatmeal, bran, wheat germ and some cereals are rich sources of whole grains, while dried beans and peas, vegetables, barley, flaxseed and fruits with pectin, such as apples and cranberries, are storehouses of soluble fiber. Research also indicates that regular use of products that contain soluble fiber from psyllium seeds—such as Metamucil—can lower cholesterol levels by 5 percent to 10 percent when eaten as part of a healthy diet. Ask your doctor if such products are safe for you.
       • Stamp out tobacco. Medical weapons in the fight against tobacco include nicotine nasal spray, nicotine gum and transdermal nicotine patches. Your doctor may prescribe the oral antidepressant bupropion (brand names Zyban and Wellbutrin) or the new drug varenicline (brand name Chantix) that eases nicotine withdrawal symptoms.
       • Get your fats straight. Experts recommend you restrict your intake of artery-clogging saturated fats and trans fats (found in margarine and packaged goods such as cakes). And mounting evidence suggests that replacing harmful fats with healthier ones is key. In contrast to saturated fats and trans fats, unsaturated fats (found in olive oil and fish, for example) can help lower levels of “bad” LDL cholesterol, the type that sticks to artery walls. Remember, however, that eating any kind of fat in excess can contribute to obesity, a major risk factor for heart attack.
       • Take some tea. A study published in the American Journal of Epidemiology suggests that drinking one or more cups of tea a day—with or without caffeine—may reduce the risk of heart attack. In the study, tea drinkers slashed their risk by 50 percent. According to the study’s authors, tea’s benefits may be due to its high flavonoid content. Found in black tea, these nutrients may protect against heart attacks by inhibiting the production of LDL cholesterol, inhibiting clot formation and preventing atherosclerosis in the arteries that supply the heart.
       • Savor soy. Studies have found that eating soy protein leads to a decline in LDL and total cholesterol levels without reducing levels of “good” HDL cholesterol, the type that helps rid the arteries of LDL cholesterol. Researchers point to the phytoestrogen content of soy as the key heart-healthy ingredient. People may need to eat as much as 25 grams to 50 grams a day to gain significant benefits, but studies show that doing so can reduce LDL cholesterol by up to 8 percent. The richest source of soy is powdered soy protein, followed by tempeh, tofu and soy milk. It’s important to note, however, that excessive soy consumption may be detrimental to your health. Ask your doctor if soy can help you, and how much of it you should be eating.
       • Control your weight. Dropping as few as five to 10 pounds can significantly lower blood pressure. Ask your doctor what your ideal weight should be and strive to maintain it.
• Stay active. Regular exercise helps tip the scale in your favor. It improves your heart’s work capacity, it serves as a release from stress, and it can raise HDL cholesterol, which is good news for your arteries. Experts recommend exercising 30 minutes or more on most, or preferably all, days of the week. Make it 60 to 90 minutes if you need to lose weight or maintain weight loss.

Tests for detection
       These tests provide clues to arterial health and can make early intervention possible.
       • Stress test. An ECG is taken while a person is resting to obtain a baseline reading. The test is repeated during exercise to make sure the heart is getting enough oxygen.
       • Coronary angiography. This one- to two-hour procedure—in which a catheter is threaded from an artery in the groin into one of the coronary arteries—can identify affected arteries and determine if surgery is necessary.
       • Thallium scan. Combined with the stress test, this method involves injecting a radioactive dye, thallium, into the bloodstream to locate the site of a blockage.
       • Echocardiography. During this test, ultrasound waves reflecting off the surface of the heart are used to study an image of the organ on a video screen.
       • Electron-beam CT. This noninvasive method takes X-rays of the heart between beats. Although electron-beam CT does not produce images of actual plaque, it picks up calcium deposits in coronary arteries, possibly detecting calcified plaques before they clog arteries. (Other noninvasive techniques can find abnormalities only once blood flow is obstructed.)