Pulse

Troubled hearts

Managing life's stresses is critical for a healthy heart; it's just common sense, says bestselling author Joseph Piscatella.

By SUSAN ASCHOFF, Times Staff Writer
© St. Petersburg Times
published February 4, 2003

Bypass surgery at 32 jolted Joseph Piscatella from disinterest about his heart health into a crusader in search of medical answers for Everyman. Soon he had written two bestsellers, Don't Eat Your Heart Out Cookbook and Choices for a Healthy Heart, and found a new career.

Piscatella and co-author Barry A. Franklin, a physiologist specializing in cardiac rehabilitation, have just published Take a Load Off Your Heart (Workman Publishing, $14.95, 379 pages). In Florida for a two-week speaking tour of hospitals and bookstores, a wiser Piscatella, now 58, shared some of his common sense about matters of the heart.

Q: Tell me about your heart troubles.

I had heart bypass surgery 25 years ago. It took a number of months for me to get well. There was no such thing as cardiac rehabilitation then. I remember walking to the mailbox with a little stitch in my side and thinking they'd find me dead with the MasterCard bill in my hand. I started to do research. I had high cholesterol, but it really wasn't explained to me. Three years after the surgery, my numbers were really good and my doctor said, "I don't know what you did, but it's working. Why don't you write it down and I'll share it with my other patients?"

Q: Neither you nor your co-author, Barry Franklin, are medical doctors. But you've written five books on health?

Eight books. I did Don't Eat Your Heart Out in 1982. They give it to patients in 5,500 hospitals.

Q: Your new book's subtitle is "109 Things You can Do to Prevent, Halt and Reverse Heart Disease." What's 109?

We had stopped with 108. The 109th is interesting. When you look at coronary inflammation, inflammation in the arteries, one of the things that causes that is dental plaque (and bacteria). The 109th was brush and floss your teeth.

Q: What is the Piscatella Protocol?

It's four things. The first is get an assessment of where you are. Figure out whether you're at risk. Then you go to stress management. That's the key to doing the third thing, which is exercise, and the fourth thing, diet. We do it in that order for a reason, and that's because diet is the hardest thing to change. If I can get people to manage their stress, you create a relaxation response. It allows you to do those other things.

Q: Why is stress physically dangerous?

In the normal course of living in modern society, you drive by the roses, you don't stop and smell them. We know that stress has a direct impact on health: It will raise your cholesterol no matter what you eat. We know that stress will raise blood pressure levels, particularly in people who are hot reactors. When they get involved in a stressful event, their blood pressure goes up. We have a lot of people in the United States that actually have high blood pressure that has less to do with salt, less to do with weight, than it has to do with their constant stress level.

Q: How does it work against our heart?

In our book, we identify 10 critical cardiac factors. It goes way beyond cholesterol. It includes coronary inflammation. And we're also finding personality -- anger, social isolation, hostility, depression -- are factors. Depression is a straight-line risk for having a heart attack.

Q: So why don't we do what we know will keep us healthy -- and alive?

I could never figure it out: 50 percent of bypass patients, most of them men, are off the low-fat diet within six months of surgery. How could that be? They go back to smoking. For me, it was really a light bulb going on. I was looking at kids who were 6 and 4 and saying, "What are they going to do (if I die)?"

Q: So how do you reach those who live in denial?

I finally figured out piling up sacks of concrete at a construction site doesn't make a skyscraper. We started to experiment with stress management and could see the changes in the way people approached diet and exercise. We really helped them change their habits. If you're an American, how do you want to live for the rest of your life if there's a 50 percent chance that this (heart disease) is going to be in your life?

Q: So stress management should come first?

I think stress management becomes the critical piece. If you don't do that, save the money on the running shoes and save the money on the latest diet book, because you're never going to use them anyway. It's not rocket science. A lot of this stuff is just flat-out common sense that our grandmothers told us: Get enough sleep. Eat your vegetables. Play nice.

Q: But we didn't do what our grandmothers told us, either.

I can give you a 4-inch-thick study on cholesterol done by the National Institutes of Health, but what does it mean to you when you go one-on-one with your refrigerator? My role is to say this is the credible science and this is how you can use that science.

Q: Is there something that really stresses you out?

For me, I still struggle with not enough time in the day. I'd love to get to the point where I could relax without thinking what I'm going to do tomorrow, what I didn't finish on my list today. I've had more success in picking out things I know will help me manage my stress, like go to the gym.

Q: As in your book, do you ever just breathe?

I brought this technique to a large financial institution. They're stressed because of the economy. They rolled their eyes. They said, "What's next? We're all going to hold hands and sing?" But they tried it, and it was so successful the company actually set a room aside that is darkened and with comfortable chairs and people are invited to go in any time they want and do five minutes of deep breathing and then go back to their office.

Q: What do you see as the biggest obstacle to people changing their habits?

You've got to find what works for you.

Q: How can we as a society calm life's stresses?

It's a real interesting question. Type 2 diabetes in kids is at epidemic levels. Very unfairly, we're putting kids on the road to tremendous problems as young adults. I think the stress levels of parents are being taught to children. Children are being taught to live that way. I don't know what the answer is.

Action steps to manage stress:

1.Volunteer.

2.Take time to relax.

3.Breathe deeply.

4.Expect the unexpected.

5.Tranquilize with exercise.

6.Laugh.

7.Meditate.

8.Practice positive self-talk.

9.Develop resiliency.

10.Practice yoga.

-- from Take A Load Off Your Heart (Workman Publishing Co., $14.95)

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