Dr. Saul Isserow reminds us that health is not simply the absence of disease – it is also a sense of well-being.

Q: It is almost Valentine’s Day, is it true that red wine and dark chocolate are good for the heart?

A: We will defend the notion that red wine and dark chocolate are good for the heart to the “hilt!”  They are particularly good for the heart when shared with a loved one. Enjoy red wine and dark chocolate and, like everything in life, do it in moderation.

Q: I am admittedly a sleep-deprived workaholic (and I know I am not alone).  How do stress and lack of sleep affect my heart?

A: Stress is, undoubtedly, bad for the heart. Indeed, there is actually a syndrome called the “Broken Heart syndrome” — an individual under profound stress can actually have a heart attack even if the heart arteries are normal. The name of the game is stress management, as stress avoidance is impossible. Finding ways to manage stress in a healthy way is paramount to well being. Getting a decent amount of good sleep is similarly important. Abnormal sleep, whether it is the lack of it or unhealthy sleep, such as having sleep apnea, can negatively affect the heart.

Q: Beyond changing habits like stopping smoking, eating healthier and exercising, how can I make my heart stronger?  Would more vigorous exercise help?

A: Doing an aerobic workout is very good for the heart. It actually does not make the heart stronger but it certainly improves the environment the heart lives in. By that I mean it helps to keep weight reasonable, lowers cholesterol and blood pressure and, in general, makes the heart live in a healthier systemic environment. Dollar for dollar, there is no better preventative measure than stopping smoking and exercising.

Q: Is it possible to exercise too vigorously and overwork my heart?

A: It is possible to workout too vigorously. During exercising, you are at slightly increased risk of having a cardiac event. However, the risk is much lower than if one did not exercise in the first place. Exercising in moderation is, therefore, key.

Q: How much does my family history of heart disease predict my chances of heart disease and stroke?

A: A positive family history of heart disease is an adverse marker for the future development of you having heart disease. However, defining positive family history is important. The actual definition of a positive family history is having: a father or paternal family member having a heart attack before the age of 45; and a mother or maternal family member having a heart attack before the age of 55. A great majority of people who believe they have a positive family history of heart disease actually do not; it is simply that their grandparents or parents may not have had a sufficiently healthy lifestyle and had a cardiac event later than 45 (for men) or 55 (for women).

Q: People often think of heart disease as a concern more for men that women; does it affect women as much as it affects men?

A: Heart disease is the epitome of an equal opportunity disease. A woman, over her entire lifetime, is more likely to die of a heart attack than any other cause. Women are somewhat protected prior to menopause, but after menopause, all bets are off and heart disease clearly affects women as much as men. One of the differences is that women can present different symptoms than men, but the risk factors for heart disease are the same in men as they are in women.

Q: If I encounter someone who appears to be having a heart attack, what should I do to better his/her chances of survival?

A: The most important thing when you see somebody who may be having a heart attack is to call the emergency ambulance personnel (911). It is imperative, though, that we all learn CPR and initiate it when necessary. In addition, public places should have automatic defibrillators, which are devices that will determine if an individual is having a potentially fatal arrhythmia and prompt the potential rescuer to initiate an appropriate shock.

Dr. Saul Isserow is a Vancouver Coastal Health Research Institute (VCHRI) researcher and UBC and VGH-based cardiologist.