Effective Therapies for Heart Health: Revisiting Standard Recommendations

Effective Therapies for Heart Health: Revisiting Standard Recommendations

Heart Health Tips

How do you maintain a healthy heart? Is it enough to follow a low-fat diet, take your Lipitor® and work out on a treadmill every day? The answers may surprise you.

Prevention and treatment of cardiovascular disease has come a long way during the past few decades. Advice once accepted as standard has been expanded and improved. There’s a lot more to a healthy heart than maintaining a low level of low-density lipoprotein (LDL) cholesterol and avoiding dietary fat. And while most types of safe exercise benefit the heart, some forms may be more effective than others.

Learn more about heart health below and listen to the Live Foreverish Podcast with Life Extension’s own Michael A. Smith, MD, as he discusses “The Heart of the Matter.”

How can you improve your heart health? Statins alone may not be enough.

Statin drugs that reduce low-density lipoprotein cholesterol (LDL), such as Lipitor®, are among the most well-studied cardiovascular pharmaceuticals. In “Statins for Prevention of Cardiovascular Disease in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force,” which appeared in the Journal of the American Medical Association in 2016, researchers analyzed 19 trials that compared the effects of statin therapy to a placebo or no statin in a total of 71,344 participants without prior cardiovascular events.1 Statin therapy was associated with a 14% lower risk of all-cause mortality, a 31% lower risk of cardiovascular mortality, a 29% lower risk of stroke, a 36% lower risk of heart attack and a 30% reduction in composite cardiovascular outcomes. However, a recent study that included 165,411 participants who did not have cardiovascular disease prior to statin therapy found that more than half of the subjects failed to achieve optimal reduction of LDL within two years of starting the drugs.2 However, the authors remark that “variations in individual patient genotypes, and probably non-adherence, may be an important explanation for this phenomenon.”

Related Article: Are Standard Lipid Profile Tests Enough? Advanced Cholesterol Testing

“Despite aggressive LDL-cholesterol management with statins, there remains a residual risk for coronary heart disease events in high-risk patients,” write E. Dembowski and M.H. Davidson in a recent view. “Secondary targets have been proposed to decrease this risk, including non–high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and apolipoprotein B, as well as other emerging targets, including LDL particle number and lipoprotein(a). In many high-risk patients, statin monotherapy is unlikely to achieve goals, and combination therapy with other agents is a safe, effective, and optimal therapeutic approach.”3

The secondary targets listed by the authors are among a number of factors that increase the risk of cardiovascular events. In fact, Life Extension® has identified 19 factors associated with cardiovascular disease risk.

If you’ve been prescribed a statin drug by your physician, it is important to take this medication as recommended. Nutritional supplements such as pantethine, red yeast rice extract, Indian gooseberry (amla) and niacin may also help lower LDL.4-8

How to improve heart health naturally

Is the long-recommended low-fat diet best to prevent heart disease?

Research continues to reveal heart-healthy effects for a Mediterranean diet, which includes high amounts of fruits, vegetables, whole grains, legumes, fish, nuts and olive oil, and limits butter and spreadable fats, red and processed meat, and commercial baked goods. A meta-analysis of six trials that compared Mediterranean with low-fat diets concluded that a Mediterranean diet had more favorable changes in systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol and high-sensitivity C-reactive protein, a marker of inflammation, leading the authors to conclude that “Mediterranean diets appear to be more effective than low-fat diets in inducing clinically relevant long-term changes in cardiovascular risk factors and inflammatory markers.”9

While the Mediterranean diet is relatively low in saturated fat compared with the standard American diet, it does provide healthy fats that may be marginalized in a low-fat diet. Additionally, prepackaged low-fat products consumed by many individuals may contain higher amounts of simple sugars, which contribute to inflammation and other health hazards.

What is the best exercise routine for heart health?

Aerobic exercise, like that done on a treadmill or cycle, can help boost cardiovascular health. However, some recent research suggests that circuit training may be more beneficial than the commonly practiced routine consisting of an uninterrupted stretch of “cardio” combined with resistance (weight) training.

Circuit training involves participating in a series of different exercises performed in rotation, with a little rest between them. It can involve exercises using weights or other equipment, or short bursts of aerobic activity. Quickly moving from an exercise involving one body part to that involving another part allows the first exercised area to rest and recover while another area is being trained.

A recent study compared the effects of circuit-based aerobic resistance training with combined resistance training and aerobic exercise in 34 sedentary women. Seventeen women were assigned to a circuit-based whole-body aerobic resistance training group that involved various exercises using only body weight as resistance. The remaining women participated in aerobic exercise plus resistance training that mainly involved the use of weight machines.

How to keep your heart healthy and strong

Pre- and post-training assessments revealed improvement in cardiorespiratory fitness in the circuit-trained group while the aerobic fitness of those who engaged in combined training did not improve. “Our results suggest that a circuit-based whole-body aerobic resistance training program can elicit a greater cardiorespiratory response and similar muscular strength gains with less time commitment compared with a traditional resistance training program combined with aerobic exercise,” Terrence R. Myers and colleagues conclude.10

However, any physical activity is better for heart health than none unless you have a medical condition that requires you to avoid physical activity. If you don’t have access to circuit-training facilities, aim for 150 minutes weekly of moderate-intensity physical activity, such as tennis, brisk walking, water aerobics or leisurely biking. Alternatively, you can target 75 minutes per week of high-intensity activity, such as running, hiking uphill or backpacking, swimming laps or jumping rope.

How to have a healthy heart for life

Standard recommendations for heart health and useful medical knowledge are constantly evolving. By keeping up with the latest findings and putting them into practice, you can ensure your heart will be better able to keep up with the demands of living a longer and fuller life.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!


  1. Chou R et al. JAMA. 2016 Nov 15;316(19):2008-2024.
  2. Akyea RK et al. Heart. 2019 Apr 15. [Epub ahead of print].
  3. Dembowski E et al. J Cardiopulm Rehabil Prev. 2009 Jan-Feb;29(1):2-12.
  4. Evans M et al. Vasc Health Risk Manag. 2014 Feb 27;10:89-100.
  5. Liu J et al. Chin Med. 2006 Nov 23;1:4.
  6. Upadya H et al. BMC Complement Altern Med. 2019 Jan 22;19(1):27.
  7. Kim SH et al. Clin Ther. 2011 Oct;33(10):1357-64.
  8. Elam MB et al. JAMA. 2000 Sep 13;284(10):1263-70.
  9. Nordmann AJ et al. Am J Med. 2011 Sep;124(9):841-51.e2.
  10. Myers TR et al. J Strength Cond Res. 2015 Jun;29(6):1592-600.

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