• Keep the Beat: Heart Disease: Consider Your Risks
• Stress Less: Find a Healthy Balance to Enhance Your Quality of Life
• Got Health?: All About Caffeine and Better Banana Bread
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As Sandy Barnes, 53, entered middle age, she began to suspect that she was a prime candidate for a heart attack.

The signs were there. Her maternal grandfather died of a heart attack years ago. Her mother had a heart attack and emergency bypass surgery when she was 64. Then, in 2000, a younger brother died suddenly of a heart attack. He was just 40 years old and was found to have had significant coronary artery disease.

Barnes also noticed her cholesterol had been creeping up since her 30s. By the time she was in her late 40s, it was up to 240.

Yet, none of this information seemed to concern her doctors. After all, she had not experienced symptoms and an EKG had shown nothing out of the ordinary.

Growing alarm

Barnes grew even more alarmed when she learned that another brother, who is 10 years younger, had gotten a totally different reaction when he asked his doctors about heart disease. “They lined him up with blood tests, stress tests, an EKG – yet they barely batted an eye at me,” said Barnes.

One night in 2005, she experienced chest pain, nausea and a cold sweat. Tests did not indicate she was having a heart attack and a stress test was normal. But it scared her. “I felt that the universe was trying to tell me something,” she said.

Barnes decided to have a test that measures the amount of calcium in the coronary arteries (Electron Beam CT). The test helps to predict the likelihood of cardiac events in people with no symptoms. Meanwhile, a friend suggested she see Norma Thiessen, MD, a cardiologist with the Women’s Heart Health Program.

The scan showed calcification in several areas. It also showed that Barnes had more calcification than 97 percent of women her age. That information, combined with Barnes’ other risk factors, convinced Thiessen to prescribe a daily aspirin and a medicine to reduce cholesterol.

Heart disease without symptoms

“Stress tests pick up significant blockages but not having significant blockages doesn’t mean that coronary artery disease isn’t present,” said Thiessen. “The HeartScan can be helpful for people like Sandy, who have multiple risk factors but are asymptomatic.

“These results really changed the nature of her medical management,” she added. For example, the goal for LDL cholesterol is lower in people who are known to have calcification, so Thiessen has worked with Barnes to further reduce her cholesterol.

Unfortunately, Thiessen said it is not uncommon for women’s concerns about heart disease to initially be ignored by doctors, as Barnes experienced. She also noted that people with heart disease don’t necessarily have symptoms. “That’s why it’s so important for women to know their risk factors, and get a second opinion if they feel they are not being heard.”

But Barnes didn’t stop there. She also resolved to lose weight and get regular exercise. Since December 2007, she has lost 50 pounds. She began walking once a week and now gets three to four hours of exercise a week with walking and strength training. “I’ve probably never been as fit as I am right now,” she said.

While Barnes admits that her diet occasionally slips, she doesn’t let it derail her overall goal to eat wisely and get plenty of exercise. “I sometimes splurge, but I plan ahead and make sure it’s a day when I’ve walked and possibly even biked as well.

“I know that for me to be in good health and active when I’m in my 70s and 80s, I need to put in the time now.”

Can’t start the day without a cup of coffee? You are not alone. According to the National Coffee Association, 55 percent of American adults drink coffee every day, with the average consumption at 3.1 cups.

Coffee is the chief source of caffeine in our diets. But it is not the sole source, as a variety of other beverages and even over-the-counter medications, may contain caffeine.

Caffeine wakes us up, keeps us alert and is one of the fastest acting drugs known. When we consume it, almost every cell in the body, including those in the brain, absorbs it within minutes.

How caffeine works

Caffeine works by blocking adenosine, a neurotransmitter in our body and an important regulator of sleep. In our brain, adenosine slows the activity between nerve cells and dilates blood vessels to increase the flow of oxygen to cause drowsiness. Receptors on the brain’s cells cannot tell the difference between adenosine and caffeine. So when you consume caffeine, it binds to the receptors thereby blocking adenosine. The result is increased alertness.

Good or bad?

Caffeine has many effects on the body’s metabolism including stimulating the central nervous system. Latest research hints that caffeine, in moderation, may be more good than bad.

In studies of athletes and non-athletes, physical endurance is improved if they have 200 to 600 mg of caffeine before running, jogging, bicycling or swimming. Caffeine can also block the perception of pain and this may also increase endurance.

Headache sufferers may find also find pain relief from caffeine. With a headache, the blood vessels in the brain dilate. Caffeine constricts those vessels and can ease headache discomfort.

In clinical studies, caffeine may help protect against gallstones, type 2 diabetes and Parkinson’s disease. However, more research is needed before caffeine can be proclaimed as preventing disease.

Moderation is key

Of course, too much caffeine can cause restlessness, anxiety, irritability, sleeplessness, stomach distress and abnormal heart rhythms. In some individuals, caffeine can increase blood pressure. Some people are extra sensitive to even slight amounts of caffeine.

One thing is clear – despite the findings, most doctors still recommend moderation in regard to caffeine intake. For most healthy people, it appears that a moderate daily intake of coffee – two to three cups – or 200 to 300 milligrams of caffeine does not seem to hurt and may help.

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