Dr.

Stephen Sinatra’s

A Cardiologist’s Guide to Total Wellness July 2012

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The dictionary definition of mania is “exces-
sive or unreasonable enthusiasm,” and it perfectly In Dr. Sinatra’s Blog
describes what has been going on for years in at drsinatra.com
the medical community when it comes to lower- ■ Sensational Summer Grilling
ing cholesterol with statins. The fact is that ■ Heart-Healthy Ways to Enjoy
about a third of cardiologists take statin drugs the Outdoors
Stephen Sinatra, MD
themselves, many for preventive reasons, believ-
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that these drugs can lead to heart failure when used long term. Still Not Receiving
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equals a ratio of 2, which is fine. The lower the ratio, the lower the Stephen Sinatra, MD, FACC, FACN,
incidence of heart disease. Everybody agrees on this. CNS is a board-certified cardiologist
and certified bioenergetic analyst with
Unfortunately, many people don’t have such a sweet ratio. They more than 30 years of experience in
helping patients prevent and reverse
may have a triglyceride level of 200 (or higher) and HDL of 40 (or heart disease. Dr. Sinatra integrates the
lower). Divide HDL into the triglycerides and you’re in the danger zone best conventional medical treatments
with complementary nutritional and
with a ratio of 5. And there is a mountain of data showing that if your psychological therapies.
triglycerides are high and your HDL is low, you are headed for trouble. Dr. Sinatra is an Assistant Clinical Professor
at the University of Connecticut School of
For those with high triglycerides and low HDL, there isn’t a magi- Medicine and is author of numerous books
cal pill to pop. But the best treatment options are natural, cheap, and including Lower Your Blood Pressure in
Eight Weeks, Heart Sense for Women,
very effective. First you need to lose weight. You also need to cut down on Reverse Heart Disease Now, and Earthing.
sugar and refined carbohydrates. Finally, you need to exercise regularly. He is a Fellow of the American College of
Cardiology; Fellow of the American College
All simple solutions with no side effects—except for positive ones. ■ of Nutrition; board certified in internal
medicine and cardiology; and certified in
anti-aging medicine, clinical nutrition, and
bioenergetic analysis.

P eriodically I like to get on the phone with a
handful of other integrative cardiology phy-
sicians whom I greatly respect—call them my
heart-health dream team—for updates on new
treatments and tests or just to hear what recom-
mendations are continuing to work well for their
patients. What follows are the highlights from my
most recent round of cardio communications.
Peter Langsjoen, M.D., has more clinical expe-
rience with CoQ10 than any other physician in
the United States. He has written more than 25
published studies on CoQ10.
“CoQ10 powerfully improves cardiac function in
my heart patients,” said Dr Langsjoen. “It has
been a fundamental part of my practice ever
since my father (also a cardiologist) and I first
studied the effect of CoQ10 in heart failure. We
published our initial findings in 1985. At that
time we used 33 mg of CoQ10 three times daily
with meals. Today, I recommend 200 to 600 mg
daily in divided doses to my heart failure patients.
Because of individual absorption differences, the
lower dosage works for some people, while others
need a higher dosage in order to reach a therapeu-
tic blood level of 4 to 5 mcg/mL.”
Dr. Langsjoen also reported on CoQ10’s effect on
cholesterol. “High cholesterol, as we all know, is
regarded by mainstream medicine as a primary
cause of heart disease. Although I believe that
this theory is false, there may be validity to the
potential for oxidized cholesterol to create harm
to our blood vessels. Cholesterol becomes oxidized
from excess free radicals generated by things
like air pollution, smoking, emotional stress, and
heavy metal toxicity. CoQ10 and cholesterol travel
together in lipoproteins, and supplemental CoQ10
has been shown to protect cholesterol from oxida-
tion. This antioxidant role of CoQ10 may be useful
in the prevention of atherosclerosis.”
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2 H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2
Tips From the Top
The Sinatra Spin: I first became excited about
CoQ10 after reading the landmark studies the
Langsjoens wrote back in the 1980s. Since then
I have had consistently great results with CoQ10
and made it a keystone in my metabolic cardiology
strategy. If mainstream cardiologists were to put
their biases against nutritional supplements aside
and give CoQ10 a chance, they would be doing a
great service for their patients.
Stephen Devries, M.D., Executive Director, The
Gaples Institute for Integrative Cardiology, and
Associate Professor at Northwestern University,
weighed in on the crucial importance of diet when
it comes to heart health. “As a foundational strat-
egy, there is no intervention in cardiology as potent
as the time-tested Mediterranean diet. Studies
show it can reduce the risk of heart attack by
70 percent,” he explained. “The basics are simple:
5 daily servings of vegetables; 2 servings of fruit;
whole grains over refined; 2 fish meals/week; mini-
mizing red meat; and a predominant use of olive
oil. If you don’t like fish, a fish oil supplement can
be helpful for prevention.”
Exercise is also critical for Dr. Devries. “As a second
foundational strategy, physical activity is a must.
Unfortunately, most people don’t want to hear about
it, let alone do it. But this is the real fountain of
youth. It is as simple as 30 minutes of daily recre-
ational walking.”
The Sinatra Spin: It is imperative to remember
that while supplements and medications are impor-
tant, diet and exercise are truly foundational to
health. I also recommend adding traditional Asian
dishes to the diet. A Pan Asian Mediterranean diet,
as I call it, gives patients an expanded variety of
great anti-inflammatory foods to choose from.
James Roberts, Jr., M.D., coauthored Reverse
Heart Disease Now (Wiley) with me in 2008. He is
a relentless clinical investigator, constantly search-
ing for new research and techniques to help his
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Directions, LLC. Photocopying, reproduction, or com. He maintains a website with additional
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Heart, Health & Nutrition is dedicated to the Dr. Sinatra is compensated on the sales of the
prevention and treatment of disease. Heart, Health supplements he formulates for Healthy Directions.
& Nutrition cannot offer medical services; Dr. He is not compensated for other companies’ products
Sinatra encourages his readers to seek advice that he recommends in this newsletter.
from competent medical professionals for their
personal health needs. Dr. Sinatra will respond in
the newsletter to questions of general interest, and
urges you to write him at P.O. Box 3264, Lancaster,
patients. “I have been impressed with 2 to 4 g of
L-arginine three times daily for my heart patients,”
said Dr. Roberts, “not so much as an immediate
remedy but as a good idea to reduce further trouble.
L-arginine improves endothelial function and the
ability of the arterial wall to generate nitric oxide
and keep the lining of the blood vessels healthy.
That’s a valuable contribution for dealing with all
forms of cardiovascular disease.”
Dr. Roberts also discussed a new urine test that
measures organic pollutants, such as phthalates,
benzene, and toluene, commonly found in food, air,
and water. “These substances can potentially cause
endocrine disruption and contribute to weight prob-
lems, diabetes, inflammation, and hypothyroidism.
They accumulate in belly fat and seem to impair the
ability to lose weight. I also have a suspicion they
may play a role in the growing epidemic of atrial
fibrillation. US BioTek, a Seattle company, offers
the test to doctors (http://www.usbiotek.com/Services_
Environmental-Pollutants-Panel.php). It measures seven
key pollutants. At a cost of about $125 to a patient,
your doctor can get a good handle on what is a
widespread and underdiagnosed toxicity problem.
I’m finding my sick patients are loaded with these
pollutants. I detoxify them with various treatments
and they get better.”
The Sinatra Spin: I frequently used L-arginine as
a way to improve endothelial health, and, at the dose
levels that Dr. Roberts suggests, it can be also be
used to address erectile dysfunction. I also applaud
his emphasis on detoxification, which is so over-
looked yet critical for health in our modern polluted
environment. If you have any stubborn health
issues, I suggest seeing an integrative physician
who has a detoxification program. Or consult with a
naturopathic physician who typically uses detoxifica-
tion techniques as a main therapeutic tool.
Howard Elkin, M.D., practices in Whittier, CA,
just east of Los Angeles, and brings an emphasis
on fitness and nutrition into his integrative prac-
tice. “D-ribose is an unsung supplement for getting
energy levels up quickly and feeding heart cells
starving for energy,” he said. “This natural sugar
compound is a main energy substrate for cells.
I’ve had many patients with cardiomyopathies and
other types of heart dysfunction who have responded
superbly. I recommend 5 g twice daily, a dosage that
often boosts patients with low energy to feel good
enough to start exercising, which, of course, is so
important for the heart.”
Using magnesium to calm premature ventricu-
lar contractions (PVCs) is another tip Dr. Elkin
passed along, recommending 500 mg of magne-
sium glycinate daily. “And a fish oil supplement
works wonders on so many things, not just for the
heart, blood, and blood vessels, but for the brain,
memory, eyesight, inflammation, and for balancing
neurotransmitters. I recommend 1 to 2 g daily, but
will go up to as much as 6 g for individuals with
high triglycerides.”
The Sinatra Spin: As much as CoQ10, magne-
sium, and fish oil are central supplements for
health, Dr. Elkin has smartly picked up on the
generally overlooked nutrient D-ribose. I discovered
the importance of D-ribose about seven years ago
and added it as one of my main metabolic cardiol-
ogy therapeutic nutrients.
Richard Delany, M.D., is board-certified in inter-
nal medicine, cardiology, critical care, and geriat-
rics. “My goal is to individualize supplements to the
patient’s needs and illness,” he explained. “However,
my main goal, before I choose any supplement, is
to try to understand the inflammatory cause of the
disease process. I then implement a four-step process
that requires different supplements at different
times coupled with some supplements all of the time.
Patients typically end up with five to six supple-
ments when it is all finished.”
Niacin is key to Dr. Delany’s program. “I use niacin
to strategically raise the beneficial large sub-
fraction of HDL, to lower triglycerides, and to shift
small dense LDL to large LDL. I recommend start-
ing with 500 mg and then increasing by the same
amount after three weeks. Most patients take 1,000
to 1,500 mg, usually with a snack like an apple
in the evening to help further reduce the possibil-
ity of an uncomfortable niacin flush. An aspirin
a half-hour before the niacin can also help reduce
any possible flushing. It’s a good idea to check liver
function from time to time if you routinely take
higher doses of niacin, since the vitamin is known
to elevate liver enzymes and stress the liver in
some people.”
The Sinatra Spin: Dr. Delany gets to the real point
of the cholesterol theory, and that is to effectively
use the influence of a nutrient, in this case niacin,
to help reshape LDL cholesterol particles from a
more potentially invasive and inflammatory form
to a larger, more “fluffy” form. Just be sure, as he
suggests, to check your liver function periodically. ■
H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2 3
 Cardiologist in the Kitchen
Fighting Heart Disease—One Recipe at a Time

O rganic, free-range chicken is packed with quality protein to help keep your strength up and your
hunger down, both of which are key to staying fit and lean. And tucked inside the chicken breasts
featured in this delicious recipe is one of my favorite Super Foods: spinach. (You can go to drsinatra.
com for a complete list of Sinatra’s Super Foods.) This leafy green nutritional powerhouse is an excellent
source of bone-building and blood pressure–lowering calcium. It’s also brimming with the important anti-
oxidants vitamin C and vitamin E, which reduce the oxidative stress in your body and benefit the cardio-
vascular and pulmonary systems. So make this satiating chicken/spinach combo regularly to benefit your
waistline, muscles, bones, lungs—and your heart.
Parmesan Chicken Breasts Stuffed with Spinach
Two 4-oz. chicken breasts 1 tsp. dried or fresh basil leaves, chopped, to taste
2 Tbsp. extra-virgin olive oil 4 Tbsp. grated Parmesan or Romano cheese
1/2 cup grated or julienned carrots Black pepper to taste
1 cup spinach, thawed or fresh
Preheat the oven to 400 degrees. Slice the chicken breasts halfway through the center lengthwise, form-
ing a pocket. Heat the oil in a skillet over medium-low heat. Stir in the carrots and heat until softened,
about 5 minutes. Add the spinach and basil. Cook about 3 minutes, or until wilted. Remove from heat.
Add the cheese and stir to combine. Divide the mixture and stuff into the chicken pockets. Soak tooth-
picks in water or oil and use them to secure the chicken pockets. Lightly brush the top of the chicken
with oil and sprinkle liberally with pepper. Bake for about 20 minutes, or until the chicken juices run
clear. Remove toothpicks and serve. Makes 2 servings.
Nutrition Facts (per serving): Calories 360, Fat 21 g, Sodium 268 mg, Carbs 4 g, Fiber 3 g, Protein 40 g
For more heart-healthy recipes go to drsinatra.com.

Nutrient
For more heart-healthy Science
recipes —Grape
go to drsinatra.com
B ack in the 1990s I became quite enthusiastic
about grape seed extract and have recom-
mended it and used it myself ever since. As I first
learned from the research literature and then
confirmed in my cardiology practice, grape seed
extract can definitely help lower blood pressure.
Grape seed extract has a high concentration of proan-
thocyanidin, a plant-based compound with substantial
antioxidant potency. So it helps protect the sensitive
endothelial lining of the arteries against oxidative
stress. And research has also shown that grape seed
extract increases the nitric oxide level that relaxes
vascular tissue and helps facilitate blood flow and
maintain healthy blood pressure. In addition to all
these impressive findings, grape seed extract can
be much less expensive than another highly touted
proanthocyanidin product, pycnogenol. Both are defi-
nitely stars in this antioxidant class, but I’ve more
often opted for grape seed extract since it was more
affordable for my patients.
I often used grape seed extract with garlic and
Seed Extract
hawthorn berry, a combination that worked well
to frequently drop blood pressure as much as 5 to
10 points. And I recently found a new source of
grape seed, extracted from white varietal and other
grapes, that has been found to have a particularly
potent antioxidant effect and reduce blood pressure
in patients with prediabetic metabolic syndrome.
In 27 subjects, this proprietary extract reduced
systolic blood pressure by 11 points on average and
diastolic by 6 points after four weeks.
I am constantly combing the nutritional research in
order to update and upgrade the nutritional supple-
ments I formulate. So the new evidence about the
advanced grape seed extract led me to include it
in my new and improved Advanced BP Support
formula—making a good product even better. ■
References
Sivaprakasapillai B, et al. Effect of grape seed extract on blood pressure in subjects
with the metabolic syndrome. Metabolism. 2009;58(12):1743–1746.
Lu B, et al. Effect of a grape seed extract in subjects with pre-hypertension. 13th
World Congress on Heart Disease. Vancouver, B.C., Canada, July 28–31, 2007.
Fitzpatrick DF, et al. Isolation and characterization of endothelium-depen-
dent vasorelaxing compounds from grape seeds. J Agric Food Chem.
2000;48(12):6384–6390.

4 H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2
 Sinatra’s Super Foods: Blueberries

B elieve it or not, beautiful blueberries are benefi-

cial for your blood pressure, your brain, and your
baby blues! And all of these health-enhancing effects
to prevent macular degeneration. And other
research on aging rats showed that those consum-
ing blueberries in their feed had a lower rate of
appear to stem from the berries’ high flavonoid con- memory decline. The blueberry diet also reversed
tent and powerful antioxidant properties. memory loss. It was speculated that the flavonoids
in the blueberries probably helped brain cells
In particular, blueberries are extraordinarily rich communicate better.
in anthocyanins, which are flavonoid pigments that
provide color to many fruits and vegetables and Blueberry Basics
have been shown to reduce the risk of cardiovascu-
Eating blueberries several times a week is simple
lar disease. In one study, British researchers found
to do, since you can work them into just about any
that those with the highest intake of anthocyanins
meal. Take breakfast, for instance. Try a morn-
(predominantly from blueberries and strawberries)
ing shake of blueberries with organic yogurt and
had an 8 percent lower blood pressure than those
crushed flax. Throw a heaping handful of blue-
with the lowest intake. Researchers think that the
berries into your cereal bowl. Eat them alongside
anthocyanins protect against high blood pressure
your omelet. Or include them in your waffles or
by promoting the release of nitric oxide, the chemi-
pancakes as in the recipe below.
cal in arterial walls that keeps the blood vessels
relaxed and dilated. Organic wild blueberries are best because they are
cultivated without toxic chemicals, so try to get
Those blood pressure–friendly flavonoids also
them whenever you can. And don’t discount dried
appear to protect your aging eyes and brain. At
blueberries in a pinch—especially for a snack.
one anti-aging conference I attended, a research
Dried fruit, in general, is an excellent source
ophthalmologist proclaimed that, when it comes to
of fiber, minerals, antioxidants, and complex
protecting your retina, blueberry pigments have
carbohydrates.
even more antioxidant potential than the more
common resource—marigold flower (lutein)—used
Buckwheat Blueberry Pancakes
1 cup buckwheat flour 2 cups soy milk or water 1 Tbsp. honey
1 cup other whole-grain flour 2 egg whites ½ cup blueberries
1 tsp. baking powder 1 Tbsp. light olive oil
Stir the dry ingredients together. Add the soy milk, egg whites, oil, and honey. Mix briefly. Add the blue-
berries and stir gently. Cook on a hot griddle, lightly oiled with olive oil. Makes 14 servings
Nutrition Facts (per serving): Calories 90, Total Fat 2 g, Sodium 30 mg, Carbs 14 g, Fiber 2 g,
Protein 4 g
For more Sinatra’s Super Foods go to drsinatra.com

Heart Beat: What’s Good, What’s Not, in Cardiology

Cut Down on Meat—and
Heart‑Health Risks
Epidemiological studies indicate that a meat-heavy
diet, and particularly red meat, raises your risk of
coronary heart disease, stroke, colorectal cancer,
and diabetes. Researchers from Harvard have now
published an analysis of two health databases with
more than 110,000 men and women showing that
red meat actually increases the risk of dying from
cardiovascular causes by 16 percent and cancer by
10 percent.
The analysis, published in the Archives of Internal
Medicine, found that nearly one in 10 deaths in men
and one in 7.6 deaths in women could be prevented
if people ate fewer than 0.5 servings of red meat per
day. The researchers estimated that substitutions of

H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2 5
one serving a day of other foods, including fish, poul-
try, nuts, legumes, low-fat dairy, and whole grains,
for one daily serving of red meat could reduce the
mortality rate anywhere from 7 to 19 percent.
I follow the 80/20 diet rule where only 20 percent
of the diet is from animal sources, including fish,
chicken, lamb, and even buffalo. The best diets in the
world, eaten in Asia and the Mediterranean, simply
don’t include big chunks of meat.
Reference
Pan A, et al. Red meat consumption and mortality: results from 2 prospective cohort
studies. Arch Intern Med. 2012;172(7):555–563.
Another Reason to Take
Magnesium
As you know, magnesium is one of my “awesome
foursome” supplements, which are so vital for
enhancing cellular energy production. Thus, a recent
review on magnesium in the European Journal
of Clinical Nutrition caught my attention. It was
conducted by British medical statisticians who
combed through previous published studies to assess
how much of an effect magnesium supplementation
exerts on lowering blood pressure.
Based on 22 trials involving 1,173 subjects with 3
to 24 weeks of follow-up, they found a small, but
clinically significant average drop of 3 to 4 mmHg
systolic and 2 to 3 mmHg diastolic. Magnesium
dosage in these studies ranged from 120 to 973 mg
(mean dose 410 mg), with the largest reductions in
blood pressure generated by an intake over 370 mg
a day. One of the explanations for this effect is that
magnesium protects the sensitive endothelial linings
of blood vessels and acts like a vasodilator, which is
important for relaxed arterial function.
Magnesium is one of my must-take supplements. It
contributes to hundreds of enzymatic reactions in
the body and promotes healthy bowel movements.
I generally recommend 200 to 400 mg daily. Just
be cautious with magnesium if you have kidney
disease, which can impair the body’s ability to clear
magnesium from the body.
Reference
Kass L, et al. Effect of magnesium supplementation on blood pressure: a meta-
analysis. Eur J Clin Nutr. 2012;66(4):411–418.
Check Your Uric Acid Level
You’ve no doubt heard the term gout in refer-
ence to a hot, tender, and painful big toe. Although
this arthritic-like condition most commonly affects the
base of the big toe, it can also involve the ankle, knee,
wrist, finger, and elbow joints.
6 H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2
The cause of gout is an overload of uric acid that
leads to the deposition of crystals in the joints and
other tissues. Contemporary research says the prob-
lem is often related to a genetic inability to properly
process uric acid, a breakdown product of purines,
compounds found in many foods, most notably
red meat, game meats (pheasant, rabbit, venison),
seafoods like shellfish, anchovies, herring, and
sardines, mushrooms, asparagus, soy, and yeast-
containing foods and beer.
The reason I bring all of this up is that for
decades, high uric acid has also been associated
with an increased incidence of cardiovascular
disease, and recently several studies presented at
the European Society of Hypertension in London
further incriminated uric acid’s involvement with
hypertension, diabetes, and other cardiovascular
risk factors.
One of the studies, based on an analysis of a large
Israeli database of more than 100,000 individuals,
suggests that even a so-called normal level of uric
acid poses an almost twofold risk of diabetes and
kidney disease over a decade of follow-up compared
to a low level. A normal level is considered to be 3.1
to 6.8 mg/dL and low is less than 3.
Another study, this one from Japan, linked a uric
acid level over 8 to hypertrophy, which is a thick-
ening of the left ventricular section of the heart
muscle, and a significant symptom of weaken-
ing cardiac function. Other studies reported an
elevated uric acid level was associated with meta-
bolic syndrome as well as arterial stiffness and fatty
deposits in the carotid arteries.
These reports suggest to me that elevated uric
acid may be related to dysfunctional metabolism of
adenosine triphosphate, the basic cellular fuel in the
body. I strongly recommend that you have your doctor
pay attention to your uric acid level the next time you
get a blood test. While it is part of regular blood tests,
doctors may not pay much attention to it if it shows
up in the normal range. The normal range could
mean you’re off the hook for gout but may still be at
an increased risk for cardiovascular problems.
References
Culleton BF, et al. Serum uric acid and risk for cardiovascular disease and death:
the Framingham Heart Study. Ann Intern Med. 1999;131(1):7–13.
Leiba A, et al. Healthy subjects with low uric acid levels followed up for 10 years,
have a decreased incidence of diabetes and hypertension. J Hypertens. 2012.
[Epub ahead of print.]
Yoshimura A, et al. Serum uric acid is strongly associated with the left ventricular
mass index in the general population. J Hypertens. 2012. [Epub ahead of print.]
Papavasileiou MV, et al. Uric acid blood levels and relationship with components of
metabolic syndrome of hypertensive patients. J Hypertens. 2012. [Epub ahead of
print.]
 Carotid Stenting—A
Safe Option Dr. Sinatra’s
The carotid arteries in the neck are
the critical channels through which Healthy Heart Blog
blood flows up into the brain. A

I
stroke can occur when they become have written things you are most grateful
significantly blocked. For decades, about the for and internalize how each
vascular surgeons have cleaned power of makes your life better.
up blocked carotids with surgical positive thinking for years
carotid endarterectomies. They ■ Reframe your frustra-
because I’ve long subscribed to
open the affected vessel, scrape the tions. Whenever things
the theory that our emotions
lining to remove plaque and debris, have a profound impact on our don’t go your way, reevalu-
and sometimes put in a graft. ate the situation in a light
health. That’s why I recently
Carotid artery stenting is an alter- blogged about a study that that casts it in a positive
native to endarterectomies. In this confirmed my heartfelt belief: perspective. For instance, if
procedure, a stent (a small wire you step on the scale only to
mesh tube) is maneuvered into I wasn’t surprised to read find out that your diet has
the carotid artery via a catheter new findings from a team
not produced any weight
inserted through an incision in the of Harvard researchers who
loss, reframe your thoughts
groin. When the site is reached, found that optimism and
to focus on the fact that you
a balloon is inflated to widen the joy can protect your heart—
artery, then the stent is laid in actually lowering the risk of did not gain any weight.
place to keep the artery open. strokes and heart attacks. ■ Remember a happier
In a yet-to-be-published In this study, the research- time. When you feel your
study, researchers at Thomas ers reviewed the outcomes pulse begin to rise in the
Jefferson University Hospital in of more than 200 previous face of a stressor, short-
Philadelphia, along with investi- studies. What they found is circuit the stress response
gators from several other medi- that in those studies, people by concentrating on a past
cal centers, found that carotid with the most optimistic atti- moment of intense joy, like
artery stenting is safe and effec- tudes had a 50% reduced the birth of a child, an
tive for patients over 70. There risk of having a cardiac event engagement or marriage,
is an increased risk of stroke
than those who were less or being recognized for an
and heart attack with age, they
optimistic. accomplishment.
said, but the overall risk remains
“extremely low” at 6 percent, Additional Thoughts ■ Focus only on what you
even in those over 85. Their can change. Don’t encour-
conclusion was based on a review To harness the healing power
of optimism and cultivate a age pessimism by wrestling
of 5,000 high-risk patients who
happier, healthier attitude, I with problems that are
had undergone stenting.
suggest the following strategies: beyond your control or that
The researchers said they were you can’t change in any
encouraged by their findings. ■ Begin the day grate-
ful. When you first get up, constructive way. Instead,
I am as well. Both endarterecto-
perhaps as you take your focus your positive energy
mies and stenting are potentially
life-saving procedures. The results morning walk, make a on issues that you can actu-
here add to the confidence with mental list of some of the ally do something about.
which surgeons can pursue these
options for patients at risk. ■ Join the Conversation…
Reference You and your fellow readers are a never-ending source of inspiration
www.jeffersonhospital.org/News/2012/March/carotid-
artery-stenting-found-to-be-safe-in-the-elderly.aspx. to me and to each other. I encourage you to read more of my blogs,
Accessed June 8, 2012.
ask me a question, or post your thoughts at drsinatra.com.

H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2 7
 Dr. Stephen Sinatra’s
P.O. Box 3264
Lancaster, PA 17604-9915
Address Service Requested
Here’s your July issue!
Volume 18, Number 7
Inside this issue:
■ Dear Reader: Managing
Triglycerides Is a Must. . . 1
■ Tips From the Top. . . . . . . 2
■ Cardiologist in the
Kitchen: Parmesan Chicken
Breasts Stuffed with
Spinach . . . . . . . . . . . . . . . . . 4
■ Nutrient Science—Grape
Seed Extract. . . . . . . . . . . . . 4
■ Sinatra’s Super Foods:
Blueberries. . . . . . . . . . . . . . 5
■ Heart Beat: Cut Down
on Meat; Magnificent
Magnesium; Uric Acid
Levels; Carotid Stenting. . 5
■ Dr. Sinatra’s Healthy Heart
Blog: The Healing Power of
Positive Thinking. . . . . . . . 7
“
T reat the patient, not
the X-ray.”
—James M. Hunter
8 H e a rt, H e a lt h & N u t r i t i o n • J u ly 2 0 1 2
Periodicals
postage
paid at
Rockville, MD
and at additional
mailing offices
Q & A Session
Keep those questions coming! Send an email to feedback@drsinatra.com,
or write to me at Dr. Sinatra Feedback, P.O. Box 3264, Lancaster,
PA 17604-9915.
Diuretics for High Blood Pressure
My doctor wants to prescribe a diuretic for me to help lower my
blood pressure. I am a 70-year-old woman. Are diuretics a good
option?
Dr. Sinatra replies: In my newsletter series on cardiology drugs last
year, I dedicated a whole article to diuretics (August 2011). I am very
wary of diuretics, particularly for long-term use, because they can de-
plete the body of many key minerals, such as potassium, magnesium,
calcium, and zinc, along with the fluid loss that is promoted. It’s kind of
like throwing the baby out with the bath water.
High blood pressure is a significant heart-health risk factor for both
men and women. A diuretic may help in the short term. You could ask
your doctor specifically about thiazide diuretics, which may decrease
the risk of hip fracture. If you do start on a diuretic, be sure to take
a good multinutrient supplement as well to help offset any possible
loss of key nutrients. It is also possible, however, that by supplement-
ing with the “awesome foursome” (CoQ10, L-carnitine, magnesium,
and D-ribose) and omega-3 fatty acids, you may be able to bypass
the need for a diuretic at all. Talk to your doctor to see if your situa-
tion allows you to try these natural options.
See more Q & As online at drsinatra.com
in the Q & A Archive.