One Heart, Five Habits: A Cardiologist's Guide to Lowering Your Blood Pressure Through Healthy Lifestyle Practices

By Sayeh Zielke and Naomi Lewis

As we grow older, blood pressure tends to increase and create strain on the heart and its arteries. Though older people do suffer from hypertension, it is not always a natural result of aging. Hypertension can affect adults of all ages, at times due to excess sodium in our diets, lack of physical activity, and other modifiable risk factors.

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• Language: English
• Publisher: DrZ Media
• Release date: Feb 1, 2019
• ISBN: 9781775342717

Book preview

Praise for One Heart, Five Habits

"The coaching you get in One Heart, Five Habits is rock-solid advice toward a healthy lifestyle."

—Barry Trotz, Stanley Cup–winning coach

As an athlete, I’ve always valued a healthy lifestyle. Dr. Z’s book is a straightforward and reliable guide on good heart-healthy habits.

—Mike Fisher, former NHL player

Learning heart-healthy practices is a priority when I’m spending so much of my life on the road. This book is a profoundly helpful guide to better habits and, in turn, better health.

—Michael W. Smith, Grammy-winning singer-songwriter

Copyright © 2019 by Sayeh Zielke

Foreword © 2019 by Norman Campbell

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All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher.

Published and distributed by DrZ Media

www.drsayehzielke.com

Permission requests should be directed to the Publisher.

This book contains general advice based on research and guidelines available at the time of publication, and is not intended to replace patient-specific recommendations from a physician. The reader should consult their health care provider before making any significant lifestyle changes.

Dr. Sayeh Zielke supports the dissemination of evidence-based medical information. She has received funding from pharmaceutical companies for activities including consultation, medical education, and quality improvement.

This book has not received funding from pharmaceutical companies or the food industry.

Lily is a fictional composite character loosely based on the author’s experiences working with real-life persons.

Additional disclosures can be viewed on www.drsayehzielke.com

ISBN: 978-1-7753427-0-0 (paperback)

ISBN: 978-1-7753427-1-7 (EPUB)

ISBN: 978-1-7753427-2-4 (PDF)

Designer: Paul Dotey

Author photo: Jodi O

Illustrations: Lauren Shipton and DDCo

Printed and bound in Canada

Produced by LifeTree Media

www.LifeTreeMedia.com

To my patients—you are the source of my inspiration.

CONTENTS

Foreword

Introduction

Why High Blood Pressure (Hypertension) Matters

HABIT 1: REDUCE

Clean Out Your Kitchen

HABIT 2: EAT

Stock Your Kitchen

HABIT 3: MOVE

Exercise Regularly—and Maintain a Healthy Weight

HABIT 4: REST

Sleep Well and De-stress

HABIT 5: MONITOR

Know Your Numbers

Conclusion

Glossary

Acknowledgements

Endnotes

Index

About the Authors

Foreword

Dr. Norman Campbell

Chances are, you are holding this book because you or a loved one has learned that your blood pressure is too high. A diagnosis never feels good. Fortunately, however, high blood pressure can be extremely controllable and preventable. I have spent my whole career working to help control and prevent high blood pressure and hypertension, and I am delighted that health-conscious individuals like you are now equipped with Dr. Sayeh Zielke’s straightforward advice to reduce blood pressure through lifestyle practices based on the best available evidence.

Patients today can pay good money for any number of unique diets, exercise programs, and unproven alternative treatments that don’t accomplish much beyond making their purveyors richer. Misinformation is not just confusing but potentially harmful, and the fact is that you cannot reduce your blood pressure immediately with quick solutions or silver bullets. One Heart, Five Habits wades through the studies, debates, and trends to present long-term habits that work.

Dr. Zielke offers a holistic approach to adjusting your lifestyle. Most importantly, her book focuses on diet. Unhealthy eating causes about 80% of high blood pressure, specifically through too much sodium, too little potassium (due to lack of fruits and vegetables), too much saturated fat relative to unsaturated fat, and increased body fat (being overweight). If you have high normal blood pressure, a major change in diet can reduce it, thereby preventing hypertension, and if you already have hypertension, dietary change can reduce the need for medication. One Heart, Five Habits also stresses physical activity, psychological well-being, and good sleep, which go hand in hand with healthy eating. In my experience, people who sleep well and feel good about themselves are better able to exercise and eat well.

I am passionate about curtailing the toll this disease takes on societies worldwide. As we age, blood pressure increases, and more than nine in ten people who live to age 80 are likely to develop hypertension. But the problems begin long before a diagnosis: the damage occurs even at blood pressure levels considered normal by doctors, and people with high normal blood pressure are at much higher risk of disease and death than people with low normal blood pressure. The common diseases caused by increased blood pressure include stroke, heart attack, heart failure, and kidney failure—but no part of the body is spared.

That news may sound depressing, even frightening, but there’s good news, too: adopting healthy habits will help you reduce your blood pressure, and reducing blood pressure helps prevent those same diseases. Even if you have parents and grandparents with high blood pressure, lifestyle practices will help: although some people’s genes make them more susceptible than others, high blood pressure is much less frequent in those who follow a healthy lifestyle and very common in those who do not.

High blood pressure is not a part of normal aging, but is caused by the design of our communities, which surrounds us with unhealthy processed foods, discourages regular activity, and diminishes our well-being. The next step is to become involved in making our communities healthier, and to push for governmental policies that make healthy eating and regular physical activity easy and affordable for all.

Dr. Norman R. C. Campbell is a member of the Order of Canada and of the World Health Organization Nutrient Advisory Group. He is the former Canadian HSFC/CIHR Chair in Hypertension Prevention and Control (2006–2016) and is past president of the World Hypertension League. He is a professor of medicine, community health sciences, and physiology and pharmacology at the University of Calgary.

INTRODUCTION

High Blood Pressure: A Common Diagnosis

Not long ago, a friend told me over Sunday breakfast that she’d been diagnosed with hypertension.

My family doctor says it’s a disease, she said incredulously. He wants me to start on medication, change my diet, exercise, and lose weight—but I don’t even feel sick.

Lily is a youthful 42-year-old woman, generally healthy, and married with no kids. She works from home as an editor. When I asked, she admitted that she felt a bit tired sometimes and had put on a few pounds since her 20s. But I’ve never had any serious health problems. I knew she worked long hours at her home business, and she told me that she didn’t have much time to exercise or prepare complicated meals—during the week she often skipped breakfast or had some cereal, and made herself a sandwich for lunch. But she enjoyed cooking, and when she was too busy to make dinner, her husband picked up takeout. On the weekend, they dined out together, or she met up with a friend, as she had with me that morning.

How high is your blood pressure? I asked. What did your doctor say?

I think he said 164 over 98, whatever that means.

I watched my friend sprinkle salt over her eggs and take a bite of the sausage that had come with them. She saw the look on my face as she took a bite.

Uh oh, she said. You’re about to lecture me.

I’m a cardiologist, I reminded her. What do you expect? I told her I was concerned. Hypertension is a serious illness. The patients I see are in bad shape, and I didn’t want my friend to end up having a heart attack or stroke.

But I feel fine, she said.

She was getting annoyed, the way my husband, Dale, does when I stare down his potato chips, hamburgers, and bottles of pop. So I tried not to say anything. I lasted about two minutes before informing Lily that high blood pressure is called the silent killer because while it has no symptoms, it causes more cardiovascular disease than any other risk factor, making it the leading cause of death and disability in the world—even before smoking.¹ Some of the patients who end up in my office, or under my care in the hospital, have suffered from hypertension for years and never managed to get it under control. If they had, some of them would never have needed a cardiologist. And that’s just my patients, in the medium-sized city where I live. Seven and a half million Canadians have hypertension,² and in 2000, 972 million people worldwide were estimated to have the condition.³ That’s 20% of all the humans on earth. Hypertension is a true epidemic, with dire consequences.

So you’re saying I’m going to die? Lily said.

Not at all. I took the shaker from her hand before she could add more salt to her meal, and she laughed, rolling her eyes. Hypertension can be reversible, I said. That’s the point—but you can’t ignore it. You said your doctor talked to you about lifestyle changes? And medication?

Medication, yes. I’m starting it right away. And lifestyle changes, yeah, he talked about it, kind of. Lily sighed. But it’s all too complicated. I need simple, straightforward advice, or I’ll never do it.

My name is Sayeh Zielke, and my patients and colleagues often call me Doctor Z. (Perhaps because they don’t know how to pronounce my name; it’s Sigh-ay Zill-key, in case you’re curious.) My cardiology practice is in Lethbridge, southern Alberta, Canada, and I grew up mostly in Ontario, but I was born in Iran. My parents had me, then another daughter about a year later, and a son ten years after that. We moved when I was young—my parents left the life they knew behind in hopes of a better future for their children. We moved first to France, and then to Thunder Bay, Ontario.

In France, my siblings and I had become fluent in French, but in Canada we had to learn English too. In school, when I told one of my teachers that I wanted to be a doctor, she gently suggested I consider a different career. My family didn’t have the background, the money, or the connections, she pointed out, nor did I have the language skills.

But I remained determined to master my third language and someday become a doctor. I don’t remember ever wanting to do anything other than practise medicine. Although my family didn’t talk about it much, my mother’s sister was diagnosed in the 1960s—at the age of one—with a congenital heart defect called Tetralogy of Fallot. With few definitive treatments available for the disease, and none in Iran, my grandmother found a surgeon in England who might be able to help. Despite lack of fluency in English, my grandmother travelled alone with her daughter all the way from Iran to the Royal Brompton Hospital in London. Although the surgeons fought hard for my aunt’s life, she died on the operating table. My grandmother flew back to Iran with her body.

The story was part of the fabric of my family. Although not necessarily due to this event, I wanted to become a doctor when I grew up so that I could dedicate my life to helping people like the aunt I’d never had a chance to meet. My sister wanted to be a doctor too, and we kept each other on track. She is now a pediatric emergency physician.

I went to Lakehead University in Thunder Bay for undergraduate studies, and then earned my master’s degree and attended medical school in Ottawa. The more I learned about cardiology, the more it appealed to me. The heart is an immensely complex organ, with battery-like cells, blood vessels, and muscles; it has a mechanical component, an electrical component, and a neural-hormonal component. Some of the subspecialties of cardiology include electrophysiology, heart failure, adult congenital heart disease, interventional cardiology, and cardiac imaging—using various methods to examine images of the heart. I specialize in echocardiography, which means I evaluate the structure and function of the heart using ultrasound. Of course, I am biased, but I think the heart is the coolest organ, and I tell other specialists as much (yes, we argue over which organ is the best).

It takes a long time to become a cardiologist: after medical school, I studied internal medicine for three years, followed by cardiology for another three years, in Calgary, Alberta. Then I had the option to specialize further. I’d always dreamed of going to Oxford, in England, and this was my last chance. I completed an echocardiography fellowship at the John Radcliffe Hospital, which is one of Oxford’s teaching hospitals. During my time in the United Kingdom, I had the privilege of finishing my training in cardiac computed tomography (commonly known as CT) at the Royal Brompton Hospital, the same hospital where cardiac