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Beyond Diet and Exercise: How to Protect Your Heart

If you’re following the South Beach Diet, you already know the heart-health benefits of making nutritious food choices and exercising regularly. But if you have a moderate or high risk of heart disease, lifestyle changes alone may not be enough to ensure a healthy heart. While leading a healthy lifestyle is always recommended, your doctor may also suggest certain medications and/or supplements that will help lower your risk of heart disease. Here's a snapshot of some commonly prescribed medications and supplements that protect your heart.

Statin drugs: Over the past 30 years statin drugs such as Mevacor, Pravachol, Lescol, Zocor, Crestor, and Lipitor have changed the prognosis for tens of millions of people who are at risk for heart disease or who already have it. Not only can statins reduce levels of LDL cholesterol by 20 to 60 percent with few side effects, they can also mildly lower triglycerides and raise good HDL. Furthermore, numerous clinical trials have shown that these drugs may help prevent heart attacks and strokes: When combined with other drugs or with prescription niacin, statins can cause the regression of soft plaque, which is the primary cause of heart disease. Statins can also reduce inflammation and improve the overall health of the blood vessels.

Aspirin: Taking aspirin every day or every other day if you are at risk for heart disease thins the blood slightly and makes the blood less sticky and thus less likely to form clots that typically precipitate heart attacks and strokes. Be aware, however, that aspirin has been shown to have very little effect in those who have no risk factors for heart disease. Consult with your doctor about whether aspirin therapy is right for you.

Fish-oil supplements: Just as Dr. Arthur Agatston, author of The South Beach Diet Supercharged, advises people to eat fish high in beneficial omega-3 oils (such as wild salmon and sardines) at least twice a week, he also follows the current American Heart Association (AHA) guidelines with regard to omega-3 supplements. The AHA recommends combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — the two major types of omega-3 fatty acids — in a dose of approximately 1,000 mg/day in patients with coronary heart disease. For people with high triglycerides, Dr. Agatston agrees with the FDA recommendations for considerably higher doses of omega-3s in the form of four grams of prescription fish oils per day (but Dr. Agatston advises you to be certain your doctor monitors your cholesterol, since prescription fish oils can raise levels of bad LDL in some people).

Niacin: This B vitamin (B3) is available over the counter as a dietary supplement, though Dr. Agatston recommends higher doses, available by prescription only, for those at risk for heart disease. In combination with a statin, niacin can be a very effective agent for slowing or reversing atherosclerosis and preventing recurrent heart attacks and strokes. Niacin can increase HDL (the "good" cholesterol) and it also can lower LDL as well as triglycerides. While certain forms of niacin are associated with flushing and itching of the skin in some people, this unpleasantness generally disappears within an hour. In some people with diabetes, niacin can raise blood-sugar levels; however, this effect is generally mild. If you think niacin could help you, discuss its use with your doctor.

While diet and exercise can go a long way toward improving your health, sometimes medications and/or supplements are also required. Your doctor will help you determine what prevention program is right for you.

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