The news is just permeating the sports world this afternoon, that 26 year old Gaines Adams, defensive end for the Chicago Bears, died from cardiac arrest this morning.

Whenever news of a professional athlete dying from heart-related causes hits the breakfast tables and living rooms of people living with various benign or more serious heart conditions, it gives them pause.  And sometimes worry.

If someone that young can die from cardiac arrest, why can’t you?

He was in fantastic physical health and he still died.  You’re in terrible shape.  Who’s to say you won’t drop tomorrow from cardiac arrest, if someone so healthy could?

First, let’s look at a common sense analysis.  NFL offensive and defensive lineman are huge.  Gaines Adams was a defensive end, and while men playing that position are much larger than any normal human, they aren’t usually the largest men on the field.   That distinction is held by the men playing on the interior of the defensive line and all of the offensive line, with most players in those positions weighing in excess of 300 pounds, some as much as 400 pounds - all packed onto frames in the 6′2″ - 6′6″ range.

Any everyday person with a body that large is putting their heart under tremendous stress.   Pushing blood through the miles of fat-clogged veins under higher than normal pressures makes the heart, a muscle like any other, grow in size.  Unfortunately, hearts almost never grow outward, or if they do, it’s a very small percentage of the total growth.  Usually the muscle mass gained in an enlarged heart is gained inside the chambers of the heart, taking up the space and reducing the volume of blood that can be pumped with each contraction of the heart.

This starts a downward spiral where the heart must work even harder to pump sufficient blood volume throughout the body which makes the heart gain even more muscle mass.  And in the bodies of NFL lineman, the stress is that much greater, as they are capable of and do perform physical feats that many amateur athletes 100 pounds lighter can’t perform.  The vicious cycle of enlargement of the heart, if not caught, stopped and reversed, results in what happened this morning.

But let’s even set aside the common sense and anecdotes.  Let’s look at some facts about the life expectancies of NFL players and lineman in particular.

A 1994 study of 7,000 former players by the National Institute of Occupational Safety and Health found linemen had a 52 percent greater risk of dying from heart disease than the general population. While U.S. life expectancy is well over 70 years years, this ‘94 study suggests the average for NFL players is 55.  And worst of all, 52 for linemen.

The stories and statistics abound.

From ESPN: Heavy NFL players twice as likely to die before 50

From the St. Petersburg Times: A huge problem - Strength isn’t enough: NFL linemen have to be so big, their health may be at risk

From MSNBC: Retired NFL players focus of health push - Stars of the past feeling effects of tackle-filled careers

From Time: The NFL’s Huge Linemen: Healthier Than You Think?

While the death of any young person in the prime of their lives is tragic, in this particular case, unless you’re 6′5″ and weigh 290 pounds, there’s no reason the sadness over the loss of a player on your favorite team needs to become anxiety that you’ll suffer the same fate.  The genetics of these NFL linemen coupled with the terrible health habits they learned throughout high school, college and the pros, all in the name of being massive and able to throw their weight around, are the reasons for their early demise - NOT a benign rhythm gone bad.

I know I’ve said this over and over on this site, but it bears repeating. I’m not a doctor. I’d like to think that if I’d have chosen that path when I was much younger, I’d have had a shot at it. But I didn’t. So I’m not. Bygones.

However, like anyone else who lives with arrhythmia, I have a vested interest in finding ways to reduce or eliminate the heart skips, blips and bursts I deal with on a daily basis. Earlier today I was out on the internet doing research like I do every day, and I ran across a post from someone claiming they’d read somewhere on some arrhythmia site that aloe vera gel was getting a very positive response from PVC/PAC sufferers and wondered if anyone else had tried it.

I drink lemon balm tea every day for the same reason, so when it comes to home remedies or natural “cures”, I’m always going to try to learn more in the hopes that I can rid myself of my palpitations, too.

And Aloe Vera has always been good for the skin, right? It’s good on sunburns and it’s among the ingredients in the finest moisturizers. It’s an extract from a plant, so it’s natural, right?

Unfortunately, trying to pin down hard clinical data has been sketchy at best. Just a cursory Google search for aloe vera gel heart pvc pac nets a site from what appears to be a real doctor. Ray Sahelian, M.D, to be exact. You can find my full opinion of him at the bottom of this article, but suffice it to say the advice he provides is on the sketchy side.*

Next, I found quite a few websites and articles referencing a study done by a Dr. O.P. Agarwal, claiming all sorts of cardiac benefits. ** While the study and the doctor appear to be legitimate, the claims made at the conclusion of the study appeared to be magnified when being reported on other sites that had a vested interest in selling aloe vera. But the claims from the study are interesting, including reduction in total serum cholesterol, serum triglycerides, fasting and postprandial (after eating a meal) blood sugar levels in diabetic patients, total lipids and also increase in HDL (good cholesterol). But nothing about palpitations or arrhythmia.

I also found a guy by the name of George. ^[1] George lives in Ireland and has been a very vocal advocate for aloe vera gel and what it can do to relieve premature ventricular contractions. I get the sense that George is just a regular guy looking for answers, believes he found one and is telling everyone that’ll listen in hopes of helping them. He’s not pushing a product or posting links to other sites. But in the absence of hard medical data and studies, Google can only give me what it can find on aloe vera helping palpitations. And George is what it found.

So what’s the answer? Can aloe vera help stop your PVCs? In a nutshell - I don’t know. Mayo Clinic’s website claims that a part of the aloe plant has been used as an oral laxative, ^[2] but that prolonged use can lead to an increased risk of colorectal cancer, and those with allergies to onions, garlic, chives and tulips should avoid injesting any aloe products (juice, gel, etc). ^[3] Because aloe is a natural laxative, it’s possible that the diarrhea that can result from aloe injestion can lead to an electrolyte imbalace, which defeats the purpose of taking something to stop your palpitations in the first place. ^[3] I found several studies that reported no side effects or adverse reactions of any kind while taking aloe vera, but there even on Mayo Clinic’s own site there is contradictory information. While one page says that even if Aloe Vera doesn’t help, at least it can’t hurt, another page says it can cause all sorts of problems, not the least of which is colon cancer.^[3][4] It seems like the best answer is to just use aloe to moisturize your skin.

* When I first found Dr. Ray Sahelian’s website, ^[5] I was immediately skeptical. Every page on the site is hyper-optimized for search engines, and every page has a product to sell you. I tried to look past the aesthetics of the site because this doctor may be brilliant medically but can’t pick a tie to coordinate with a shirt to save his life. But I wanted to verify that this person was credible. I’ll spare you the blow-by-blow and just provide the highlights. There’s a website called Ripoff Report that included a partial bio of Ray Sahelian and some strong words about his ethics (or lack thereof). ^[6] And on the website Quackwatch, Sahelian is quoted as saying there is potential for harm in using a particular over-the-counter drug, and that it should only be sold in small quantities. And I found this tight rope walking common in Sahelian’s opinions - if a drug is dangerous he’ll say so, but he’ll also provide information about alleged benefits, oh and by the way, here’s a link where you can buy some (from his own company, Physician Formulas, Inc).

I notice he’s produced videos on Youtube. He’s also written quite a few books, some that can be purchased at Amazon.com. He’s got a positive 60,000+ reputation for his identity on eBay. ^[7] Pretty busy for a guy who says he has a busy family practice in Marina Del Ray, California. Since he’s so “well known and respected”, I thought I’d check him out at Healthgrades.com, where patients give reviews on their doctors. He had only 1 review.^[8] Ok, my own doctor didn’t have any reviews, so maybe that’s a bad metric for establishing credibility. But this one isn’t - if you search on the address provided for Dr. Sahelian’s family practice in Google, you find an office complex located right next to a hospital. Except that not one of the offices there has Ray Sahelian listed as being a part of their practice.

Here’s another metric - on his website you can follow a link to send Dr. Sahelian an email, where the site promises he or one of his staff will respond to your query. Odds are the good doctor is the only one reading the email, as the link points you to his personal AOL email account!

One of his other businesses, the creating and selling of herbal nutritional supplements, looks very impressive when you see a picture of the building on his website.

But thanks to Google’s slightly invasive (but useful) drive-by images of most every address on the planet, we see that Suite B of 212 Technology Drive is no more than one office in a business complex. No mirrored glass high-rises or armed security patroling the parking lots. Just a guy that has an office.

So he’s a family practice doctor with a family practice that can’t be found. He’s made tens of thousands of transactions on eBay selling supplements. He has cheesy Youtube videos.^[9] He writes articles about supplements that he has a financial interest in. His reputation has been called into question more than once. Is this who you want to trust your health with?

** Doctor Om Prakesh Agarwal and his study on the use of a aloe vera gel and a traditional Indian remedy together was a tougher nut to crack. I found articles citing Dr. Agarwal’s presentation at a college in Texas, but I could find no such college. Further digging found that many of the third-party articles had the name of the school wrong. By quite a bit. “International College of Heart Diseases” should have been “International College of Angiology.” ^[10]

But once I was able to get clarification on the school and doctor, and looked at the abstract from the study itself, I found the results to be a little suspect. The abstract states that 5,000 patients were followed for a period of five years. ^[11] Pretty much every other large scale, long term study loses some of it’s patients just through job changes, loss of contact, the normal things. But this one had exactly 5,000 patients and was able to follow all of them, without fail, for 5 years? Sounds fishy.

As for the study itself - maybe there are some studies published in India on the effects of the husk of Isabgol (a plant native to India and Afghanistan), ^[12] making this study’s results more meaningful, but it appears to me that these two unrelated ingredients, Isabgol husk and Aloe Vera gel, were given to patients over the period of the study. Were there no control groups? Were there no subgroups of patients receiving only Isabgol husk or only Aloe Vera gel? If not, then how can it be stated with any authority that was not one or the other ingredient alone that improved patient’s conditions? The findings of the study were very interesting, but the abstract lacked much of the technical jargon that normally accompanies text, like confidence intervals and hazard ratios. And with such an exact number of subjects in the study and the inability to assign credit to Isabgol or Aloe due to poor study design, I have to say that I’m skeptical of the results.

Jeff

References

by Jeff

We’ve had a rash of untimely deaths among celebrities lately.  While Michael Jackson’s death was shocking at first, as the details of his life and drug use during the last twelve months are being made public, his death seems less surprising.

But immediately on the heels of Jackson’s death came word that television infomercial star Billy Mays had also died.  Initially there was speculation that the luggage that hit Mays in the head during a rough airplane landing hours before his death was somehow responsible, but the initial autopsy findings showed no head trauma and that his heart was likely to blame for his death.

Dr. Vernard Adams, Hillsborough County Medical Examiner, said that the autopsy did reveal hypertensive and arteriosclerotic heart disease, and that either one of these would be capable of producing a sudden disturbance in the electrical systems of the heart and cause death.

Hypertensive heart disease is what results from having high blood pressure for an extended period of time. ^[1]

Why Is High Blood Pressure Bad?

The term “high blood pressure” is quite literal.  Like a garden hose being fed by a fire hydrant, it means that the pressure of the volume of blood coursing through a patient’s arteries and veins is greater than it should be.  If this overpressure of a patient’s circulatory system goes on for years, those arteries and veins become scarred, hardened and less elastic. ^[2]

Worse, the heart has to work that much harder to push against that pressure to deliver life-giving oxygen and nutrients to the rest of your body.  Because it’s the heart’s left ventricle that does the work of pushing blood throughout the body, that ventricle is the one you often hear referred to when a doctor describes a thickening of the ventricle wall.  Like a weight lifter pumping iron, the left ventricle is getting disproportionately large because it has to work harder than the right ventricle (which sends oxygen-depleted blood to the lungs for a recharge) to do it’s job.  At autopsy Billy Mays heart weighed over 500 grams, while a normal male heart weighs about 300 grams. ^[3]

This imbalance and thickening of the left ventricle wall can lead to several problems, one of which is what Dr. Adams mentioned, a sudden disturbance in the electrical system of the heart capable of causing death.

What Causes High Blood Pressure?

Believe it or not, in 90-95% of cases, the cause is unknown.^[4] This is called essential or primary hypertension.  For the remaining cases, the cause can be traced back to either a kidney abnormality, aortic abnormality or a narrowing of certain arteries, meaning more force (or pressure) is required to push blood through and beyond those narrow passages.

How Can I Lower My Blood Pressure?

Though the cause of most cases of high blood pressure is unknown, what is known is how you can lower your high blood pressure:

• Eat a healthy diet high in fruits and vegetables.
• Exercise regularly.
• If you’re overweight, lose the extra pounds.^[5]
• If you use tobacco products, stop.
• Cut back on your sodium, caffeine and alcohol intake.  Each of these add millimeters of mercury to your blood pressure reading.
• Relax.  Meditation, soothing activities can help to reduce blood pressure.

I Can’t Relax.  In Fact, I Suffer From Anxiety.  Can Anxiety Make My Blood Pressure Worse?

According to Mayo Clinic emeritus hypertension specialist Sheldon G. Sheps, MD, it can.  ^[6] Anxiety can cause temporary spikes in blood pressure that taken alone don’t harm the heart or circulatory system.  But if anxiety strikes daily or on most days, the long-term effect on the heart and arteries is much like that of someone who has chronic high blood pressure.  What makes the problem of anxiety (as it relates to blood pressure) worse is one of the more popular classes of drugs used to treat anxiety, SSRIs, can also cause blood pressure to go up.

What Is Ateriosclerotic Heart Disease?

Also known as Coronary Heart Disease (CHD) and Coronary Artery Disease (CAD), it is the narrowing and hardening of blood vessels from the buildup of fatty materials and plaque on blood vessel walls.  It is the leading cause of death in the United States.

So to help avoid a fate like Billy Mays, manage your weight, diet and activity level, check your blood pressure often, and get any new arrhythmias checked out by your physician.

References