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Healthy Heart, Healthy Brain
The Personalized Path to Protect Your Memory, Prevent Heart Attacks and Strokes, and Avoid Chronic Illness
With Lisa Collier Cool
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Did you know that every forty seconds, someone in the US suffers a heart attack or stroke, and every sixty-five seconds someone develops dementia? The culprit is cardiovascular disease—and rates are soaring in younger, seemingly healthy people. Busting every myth we have about cardiovascular health, including that women are less likely to suffer from heart attacks and strokes, world-renowned cardiovascular specialists Bradley Bale, MD, and Amy Doneen, DNP, have pioneered a lifesaving method to prevent these devastating events—and reverse the disease that causes them.
The BaleDoneen Method transcends the medical silos of cardiology, neurology, endocrinology, and others with a holistic approach designed to protect and optimize the health of the heart, brain, and other vital organs, as well as the blood vessels that supply them. With laser-sharp focus, Bale and Doneen provide the latest research on how your oral health is contributing to the decline of your heart. Captivating and revolutionary, Healthy Heart, Healthy Brain is a unique and comprehensive program to prevent chronic diseases and memory loss in people of all ages regardless of their body type, medical history, or genes. Offering a roadmap to lifelong arterial wellness, it includes:
- Precision medical methods to prevent diseases of aging
- The best and worst supplements and foods for your heart
- Ten lifestyle moves that lower dementia risk by 35 percent
- Information about genes that raise cardiovascular risk as much as smoking
- The top ten heart attack prevention tips for women
Healthy Heart, Healthy Brain will equip you with the knowledge you need to approach your healthcare as an empowered and informed patient.
In loving memory of my beloved father, Wally “Butch” Hubbard. During the writing of this book, it has been heartbreaking to witness the devastating effects of dementia claim the life of my strong and loving father. My wish is that this book will prevent other families from suffering this catastrophic illness. To my husband, Daren, your love and support have allowed me to follow my passion for my life’s work in this field of medicine and prevention. This journey would not be possible without you by my side. To our children, you have shaped my life and taught me so many lessons. Sydney: You teach me to keep a steadfast focus on my goals. Devin: You inspire me to grab hold of all life has to offer. Sophie: You motivate me to follow my heart. To each of you I say, “Follow your dreams as you have supported me to follow mine. I love you all.”
—Amy Doneen, DNP
To my husband and best friend, John: Your love, encouragement, wit, and sage advice has nurtured me throughout our life together and during the writing of this book. To our daughters, Alison, Georgia, and Rosalie: I rejoice in your many successes and accomplishments and am proud to be your mom. To our beautiful and brilliant granddaughters, Carson and Alice: you lift my heart and spirit. In loving memory of my father, Oscar Collier, my first agent, editor, and mentor: I shall not look upon your like again. You were gone too soon.
—Lisa Collier Cool
A Plan That Is Guaranteed to Prevent Heart Attacks and Strokes
“Superior doctors prevent the disease. Mediocre doctors treat the disease before it is evident. Inferior doctors treat the full-blown disease.”
—HUANG DEE NAI-CHANG, FROM THE FIRST KNOWN CHINESE MEDICAL TEXT, C. 2600 BCE
New cars, washing machines, and even toasters come with a warranty. Who would purchase one otherwise? We think that healthcare providers should also guarantee that their care is safe and effective. Since 2008, we have offered all our patients a written guarantee stating that if they experience a heart attack or stroke while under our care, we will refund 100 percent of all fees paid during that year.
To date, we have only had to give three refunds, despite treating hundreds of high-risk patients. These include men and women who have survived previous heart attacks or strokes while under the care of different medical providers. Other patients have major risk factors for suffering these events, such as smoking (past or present), high blood pressure, and obesity, including some patients who weigh as much as four hundred pounds. The three patients who received refunds all chose to continue their treatment with us.
In 2019, we began offering an even more powerful promise of cardiovascular wellness, which is the focus of this book: our new AHA (Arterial Health Assurance) for Life plan, described in depth in chapter two. Drawing on more than twenty years of clinical experience and our landmark research on arterial health and disease reversal, this six-step plan is designed for people who are worried that a heart attack, stroke, dementia, or other devastating complications of cardiovascular disease (CVD) could loom in their future. Rooted in a groundbreaking new medical specialty that we pioneered—called arteriology—as well as the latest peer-reviewed science, our AHA for Life plan provides a proven, easy-to-implement method to protect and enhance your heart and brain health, while also optimizing the wellness of the more than sixty thousand miles of blood vessels that nourish every organ, muscle, and tissue in your body.
We have also observed that patients treated with our holistic approach to arterial wellness have a significantly lower risk for new onset diabetes and chronic diseases of aging, such as AD, Parkinson’s disease, vascular dementia, chronic kidney disease, erectile dysfunction, peripheral artery disease, cancer, heart failure, vision loss, high blood pressure, fatty liver disease, and atrial fibrillation. Practiced by healthcare providers all over the world, the BaleDoneen Method has helped thousands of men and women of all ages lead active, healthy, and pleasurable lives, free from the fear of a heart attack, stroke, or dementia.
How Standard Care Can Fail Patients
When we opened the Heart Attack & Stroke Prevention Center in 2001, it was the first facility of its kind in the United States. Our initial goal was to bridge a deadly gap in our healthcare system: When we looked for experts in preventing heart attacks and strokes, we couldn’t find any, even though more than 1.6 million Americans suffer heart attacks and strokes each year—and of that number, 775,000 die.1,2 Recently, rates of these events have gone up among younger adults (those under fifty-five) for reasons that we will discuss in the next chapter, along with the action steps you need to take—today—to avoid them.
Initially, we thought that preventing these life-threatening events was the job of cardiologists. However, in their training and clinical practices, these specialists have traditionally focused on treating patients who are in the later stages of arterial disease. That’s because patients are rarely referred to these specialists until they have already developed symptoms of CVD. This condition typically progresses silently over many years. The failure to detect and treat this quiet disease explains why the first sign of a problem is frequently a heart attack, stroke, or cardiac arrest. This results in specialists, such as cardiologists, being so overwhelmed with managing these emergencies that they do not have time to prevent them.
Dr. Pierre Leimgruber, a former interventional cardiologist, told us that, “During the years that I was treating people who had advanced coronary artery disease [CAD], there was so much plaque in their arteries that they were either on the brink of having a heart attack or had already had one. I’d often think, ‘What if there was a way to successfully intervene ten or even fifteen years earlier, at the earliest stages of this disease? Would it be possible to prevent heart attacks and strokes, instead of doing multiple procedures inside the arteries of the same patients as their CAD continues to progress?’” Dr. Leimgruber, who has been a patient of ours, has become such a staunch supporter of our holistic approach to wellness that he has switched his focus from intervention to prevention, using his thirty-two years of clinical cardiology experience to focus on CVD prevention with the precision-medicine approach of the BaleDoneen Method. He recently joined our practice as a specialist in heart attack and stroke prevention.
The new medical specialty of arteriology is our answer to Dr. Leimgruber’s question. It’s designed to transcend the traditional medical silos that result in incomplete, fragmented care for people with blood vessel disorders. For example, patients who suffer strokes are typically managed by neurologists, while those who have heart attacks are treated by cardiologists—even though almost all these events stem from the same cause: Plaque that has been growing silently inside an artery wall becomes so inflamed that it ruptures explosively, like a volcano spewing molten lava. In an attempt to heal the breach, the blood vessel forms a clot. If the clot travels to the brain and blocks one of its arteries, the result is a stroke. If the clot obstructs a coronary artery, a heart attack can occur.
Because arterial disease can literally affect the body from head to toe—causing everything from excruciating leg or chest pain to heart failure, vision problems, erectile dysfunction, chronic kidney disease, non-alcoholic fatty liver disease, digestive disorders, and cognitive impairment—we often see patients who are under the care of multiple specialists, yet continue to experience a relentless progression of their disease. In the next chapter, you will meet a fifty-four-year-old patient named Neal who kept getting sicker despite treatment by numerous specialists, all of whom were doing their utmost to help with the part of the body that was their specialty.
Unlike cardiology, which only focuses on the heart and its major arteries, arteriology encompasses the total care of patients with diseased arteries, since our blood vessels nourish every organ and tissue in our bodies. The primary goal is to prevent arterial inflammation—the fire that sparks most chronic diseases—and empower you to fight back before these conditions become manifest. We look at each patient as a unique individual and treat the entire person—not just their cardiovascular disease. Arteriology incorporates the work of many specialists, including family medicine providers (such as nurse practitioners and physician assistants), functional and integrative medicine doctors, sleep specialists, psychologists, nutritionists, cardiologists, neurologists, urologists, geneticists, dental providers, and others who incorporate personalized medicine and genetically guided treatment into their areas of practice.
We use a team approach in which medical and dental providers work together to optimize their patients’ oral-systemic wellness. Large studies have shown that one of the simplest—and most effective—keys to a longer, healthier life is to combine regular dental checkups with excellent self-care. Chapter ten includes a detailed, step-by-step guide to optimizing oral wellness, which in turn can help you avoid heart attacks and strokes. Maintaining gum health also reduces risk for many dangerous diseases and conditions, including type 2 diabetes, rheumatoid arthritis, pregnancy complications, digestive disorders, erectile dysfunction, and certain forms of cancer.3
Very recently, scientists have identified poor oral health as a potentially modifiable risk factor for Alzheimer’s disease and other forms of dementia.4 Drawing on landmark research published in The Lancet by twenty-eight of the world’s leading experts in the prevention of Alzheimer’s disease and dementia—as well as the first guidelines for risk reduction from the World Health Organization and other, even newer science—we have created an evidence-based three-step plan to protect your memory, which is described in chapter twelve.5
Rapid Reversal of Arterial Disease
A recent peer-reviewed study by researchers from the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease found that the BaleDoneen Method rapidly shrinks and stabilizes arterial plaque in the first year of treatment, helping people avoid heart attacks and strokes. It was also proven that our method eradicated lipid-rich arterial plaque (the most dangerous kind) in 100 percent of cases. Our genetically guided approach also significantly reduced blood pressure, LDL (“bad”) cholesterol, and triglycerides in the study participants, while raising their levels of HDL, the “good” cholesterol that helps protect heart health. These trends continued in the second year of treatment and beyond. Published in Archives of Medical Science, the study included 328 patients of the Heart Attack & Stroke Prevention Center, who were tracked for five years.6
An earlier peer-reviewed study of 572 patients treated with the BaleDoneen Method, published in 2014 in Journal of Cardiovascular Nursing, reported dramatic reductions in plaque deposits, fasting blood sugar, LDL cholesterol, blood pressure, and inflammation over an eight-year period.7 As an added bonus, our method also helps prevent type 2 diabetes—a condition that affects about 30 million Americans, one-third of whom are undiagnosed, greatly escalating their cardiovascular danger—and reduces risk for many other conditions linked to arterial disease, including Alzheimer’s and dementia.
These published results explain the success of our original intention: to prevent symptomatic heart attacks and strokes. The findings also help explain an even more exciting revelation that was unintentional. It is now widely recognized that the majority of heart attacks and strokes are silent.8 Although these events don’t cause any obvious symptoms when they occur, they cause hidden damage to tiny arteries (microvessels) that over time can lead to many diseases of aging. Our method extinguishes the chronic inflammation that contributes to these conditions, thus helping to prevent many of the devastating disorders that result in people outliving their health. New research reveals that most people live the final thirteen years of their life in an unhealthy state.9 Perhaps the greatest benefit of the BaleDoneen Method is helping our patients achieve a health span that matches their life span.
Throughout this book, you will find the scientific evidence to support each test and treatment we recommend, so you can show it to your healthcare provider and ask for optimal, personalized care. We’ll share the stories of several of our patients, including their challenges and the strategies they used to address them. Our goal is to empower you to take charge of your medical destiny by identifying your true risks and what’s really causing them. You’ll also find a guide to the best treatments, including how to lift your lifestyle to the next level, in part three of this book to help you overcome and avoid cardiovascular dangers.
If you are one of the more than 12 million Americans who have had home genetic tests to check for health threats in your DNA, we will also show you how to decode genetic information you may already have and use it to guide the right lifestyle to protect you from those risks, including the diet and exercise plan based on your DNA presented in chapter thirteen. As you will discover, our comprehensive, precision-medicine prevention plan uses inexpensive, noninvasive tests, as well as information that may already be in your medical chart, to answer important questions about your cardiovascular health. Learning the answers—and acting on them—could save your life.
Action Step: Assess Your Heart Attack, Stroke, and Dementia Risk
More than 108 million Americans—nearly half of the adult population—have one or more major risk factors for cardiovascular disease.10 To find out if you could be at risk for CVD and its devastating conditions, we suggest that you take a few minutes to answer the following questions, which are similar to those we ask our patients during their initial evaluation. The answers will help you identify potential threats to your cardiovascular health and areas you need to work on to prevent a heart attack, stroke, or dementia.
How old are you?
Male younger than 55 years old 1 point
Female younger than 65 years old 1 point
Male at least 55 years old 4 points
Female at least 65 years old 4 points
Do you have a family history of heart attack, stroke, Alzheimer’s disease, or dementia?
No 0 points
Yes 4 points
What is your waist circumference, as measured by wrapping a tape measure all the way around your body, level with your belly button? (Note: Do NOT use your pants size, which often provides an inaccurate waist measurement.)
If you’re a woman: Less than 35 inches 0 points
If you’re male: Less than 40 inches 0 points
If you’re a woman: 35 inches or more 4 points
If you’re a man: 40 inches or more 4 points
What’s your weight range according to BMI? (Check your BMI at https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm?)
Underweight 2 points
Average 1 point
Overweight 3 points
Obese 4 points
What is your resting pulse?
Less than 60 beats per minute 0 points
Less than 75 beats per minute 1 point
More than 75 beats per minute 2 points
Don’t know 2 points
What is your blood pressure?
Less than 120/80 0 points
120/80 to 139/89 3 points
140/90 or higher 4 points
Don’t know 4 points
If taking blood pressure medication, your total count is 3 points.
What is your total cholesterol level?
Less than 160 mg/dL 0 points
Less than 200 mg/dL 1 points
Greater than 200 mg/dL 3 points
Don’t know 3 points
If taking cholesterol medication, your total count is 2 points.
What is your HDL (good) cholesterol level?
If you’re a woman: Less than 60 mg/dL 0 points
If you’re a man: Less than 50 mg/dL 0 points
If you’re a woman: 60 mg/dL or higher 3 points
If you’re a man: 50 mg/dL or higher 3 points
Don’t know 3 points
What is your LDL (bad) cholesterol level?
Less than 70 mg/dL 0 points
70 to 99 mg/dL 1 point
100 to 130 mg/dL 3 points
More than 130 mg/dL 4 points
Don’t know 4 points
Which of the following best describes your triglyceride level?
Less than 100 mg/dL 0 points
101 to 150 mg/dL 1 point
More than 150 mg/dL 3 points
Don’t know 3 points
Do you have diabetes or high blood sugar?
No 0 points
Yes, I’m prediabetic 3 points
Yes, I’m diabetic 4 points
I haven’t had my blood sugar tested 4 points
Do you have bleeding gums? (Check all answers that apply.)
No 0 points
Yes 2 points
Which of the following best describes your sleep patterns?
I sleep soundly 6–8 hours a night 0 points
I sleep restlessly for 6–8 hours a night 2 points
I sleep less than 6 hours or more than 9 3 points
Do you snore?
No 0 points
Yes, occasionally 1 point
Yes, frequently and loudly 3 points
Yes, and I have sleep apnea 4 points
Do you have rheumatoid arthritis or any other inflammatory disease such as psoriasis or lupus?
No 0 points
Yes 4 points
What is your vitamin D level?
At least 50 ng/ml 0 points
30 to 49 ng/ml 1 point
Less than 30 ng/ml 3 points
I do not know my vitamin D level 3 points
Do you have a history of migraines?
No 0 points
Yes, with no migraine aura 2 points
Yes, with a migraine aura 3 points
How would you characterize your ability to cope with stress?
I’m usually pretty laid back 0 points
I have healthy ways to cope with stress 1 point
Sometimes people say that I seem stressed 2 points
I feel stressed and anxious most of the time 4 points
Do you spend 11 or more hours a day sitting?
No 0 points
Yes 4 points
How much exercise do you get?
At least 30 minutes, 5 to 7 days per week 0 points
At least 30 minutes, 2 to 4 times per week 1 point
30 minutes, once a week or less 2 points
I do not exercise 4 points
Do you use nicotine in any manner? This would include chewing, cigarettes, cigars, e-cigarettes, nicotine gum, and vaping if nicotine is in the product.
No 0 points
Yes, but have quit for at least 5 years 1 point
Yes, but quit less than 5 years ago 2 points
- “Healthy Heart, Healthy Brain will help you change your body, heart and mind. I can’t recommend this groundbreaking book from Bale and Doneen enough. Fascinating and filled with so much actionable information, you’ll want to read every page.” —Daniel G. Amen, MD, author of Change Your Brain, Change Your Life and You, Happier
- "Healthy Heart, Healthy Brain summons us to reclaim our health. With simple screening tests and diagnostics, it revolutionizes our idea of preventative medicine as well our concepts about holistic health. No longer do you need to go to a different specialist for every body part when you take Drs. Bale and Doneen’s approach. If you care about your health and longevity, you’re going to want to read this book.”—Edward Mylett, author of #MaxOut Your Life
- “Based in the most cutting-edge and formative science, Healthy Heart, Healthy Brain unravels cardiovascular disease in a holistic and personalized manner. [It has] practical advice and simple tricks based upon their revolutionary BaleDoneen Method, which has been meticulously developed over the past two decades–– you won’t regret getting your hands on this book!” —Robert G. Darling, MD, FACEP, FFSEM, White House Physician, ‘96-’99, Founder & Chief Medical Officer of Patronus Medical
- "Healthy Heart, Healthy Brain is a life-saving book! I would know –– I am alive today because of Bale and Doneen’s extraordinary work. Providing me with top-notch medical advice and treatments for over a decade, they continue to open our eyes to the insidious ways cardiovascular disease can creep into our lives by examining everything from oral health, diets, and sleep patterns to provide precise, extensive, and approachable advice for anyone who picks this book up.”—Dr. Jeff Life, author of The Life Plan Diet
- “I’ve not only used the BaleDoneen method, but I’ve seen it work with my former patients. A comprehensive yet personalized approach to identifying and eliminating inflammation, Healthy Heart, Healthy Brain is a roadmap to the future of cardiovascular disease management. A true practice changer, this is sure to be one of the most compelling books you’ve read in years!” —Sean Conley, DO, FACEP, White House Physician, ‘2016-21’,
- “Dentists have a significant role in managing oral infections and the airway. The principles outlined in Healthy Heart, Healthy Brain recognize the critical role of oral healthcare providers in cardiovascular wellness. Everyone who wants to be as healthy as they can be should read this book.”—John C. Kois, D.M.D, M.S.D, Founder and Director of Kois Center, LLC
- On Sale
- Mar 15, 2022
- Page Count
- 288 pages
- Little Brown Spark