Heart Healthy Living

Heart Healthy Eating

How What You Eat Affects Your Heart

The food that you eat affects many of the important risk factors associated with heart disease for example:

  • Your blood cholesterol
  • Your blood pressure
  • Your glucose levels if you have diabetes
  • Your risk for another event

Diagram of a meal place setting showing an example of a healthy meal, including two kinds of vegetables, a starch, a protein, fruit and milk.

Top 10 Tips for Heart Healthy Eating

Making healthy food choices doesn’t have to be overwhelming. These tips will get you on your way.

  1. Cook at home more often. Cooking at home makes it easier to avoid processed foods. It can be as simple as scrambled eggs, whole grain toast, tomato and cucumber slices.
  2. How you eat is as important as what you eat. Enjoy mealtimes and the food you eat! Don’t multitask. Avoid distractions like your computer or TV while you eat. Sit down and enjoy a meal at the table. If you live with others, make family dinner a priority.
  3. Listen to your body. Eat when you’re hungry and stop when you feel satisfied.
  4. Eat at regular times. Eat breakfast within 1 to 2 hours after waking up. Don’t wait too long between your meals. It’s harder to make healthy choices when you’re hungry.
  5. Plan healthy snacks. Try whole grain crackers and peanut butter or hummus, a piece of fruit and a few unsalted nuts, or frozen berries and plain yogurt.
  6. Eat a variety of vegetables and fruit at every meal. Enjoy brightly coloured whole vegetables and fruit. Fresh or frozen, try them in different ways—raw, roasted, or sautéed.
  7. Eat whole grains more often. Switch to brown rice, whole wheat pasta, dark rye bread or oatmeal. Try something new in your soup, salad or casserole like quinoa, bulgur or barley.
  8. Eat fish at least twice a week. Trout, salmon, tuna and sardines are some tasty options. Try fresh frozen or canned.
  9. Include legumes like beans, chickpeas, lentils, nuts and seeds more often. Add them to salads, soups and grain dishes such as rice, quinoa or couscous. Legumes can replace meat in your meals. Try a vegetarian chili.
  10. Don’t be afraid of fat. You need fat for good health and it adds flavour to your cooking. Use plant-based fats such as olive or canola oil.

 

Cook at Home More Often

What is a home cooked meal?
  • Meals cooked at home should include at least 3 food groups (Vegetables and fruit, Grain Products, Milk and alternatives, Meat and alternates.)
  • Meals cooked at home don’t need to be fancy or time consuming.
  • Meals can be as simple as a peanut butter and banana sandwich and a glass of milk.
  • Use whole, unprocessed foods.
Why should I cook at home?
  • Cooking at home gives you more control over what goes into your food.
  • Cooking at home is cheaper than eating pre-made meals or at restaurants.
  • Food cooked at home is lower in sodium (salt) fat and sugar.
Tips to cook more at home
  • Cook with your family and friends.
  • Try new recipes.
  • Cook large batches of soups, stews and casseroles on the weekend to eat during the week or freeze for another day.
  • Keep ingredients like canned fish, eggs, frozen vegetables and brown rice in your cupboard for fast easy meals.
  • Plan ahead and make a weekly meal plan.

How you eat is as important as what you eat

How should I eat?
  • Sit at the table to eat.
  • Don’t do other activities while eating.
  • Turn off all screens including television, phones, tablets and computers.
  • If you live with others take this opportunity to connect with friends and family.
  • If you live alone set the table nicely and listen to music.
Why should I eat at the table?
  • Eating while doing other things means you pay less attention to what you eat and may end up eating faster and more food.
  • By sitting at the table you will enjoy what you are eating. You will also be more aware of how much and what you are eating.
  • Eating with others is a great opportunity to connect with friends and family.
Tips to start eating at the table
  • Start by eating at the table once or twice each week.
  • If it’s too difficult to eat supper together at the table, start with breakfast.
  • At work eat lunch away from your desk.

Listen to Your Body

Why should I listen to my body?
  • There is no one right way to eat.
  • Don’t diet. Think about making small changes.
  • Choose foods which are nourishing and taste good.
  • Eating is about more than just nutrients.
  • Eating is social and should be enjoyable.
How do I listen to my body?
  • Listen to your body’s cues. Eat when you feel hungry.
  • Stop eating when you feel full.
  • Enjoy the food that you are eating.
  • Use all your senses when eating.
Tips to listen to your body
  • Turn off all distractions, such as the TV, computer or tablet.
  • Don’t rush. Eat slowly and taste the food you are eating.
  • Pause during and after your meal to ask yourself how full you are.

Eat at Regular Times

What are regular meals?
  • Eat breakfast within one to two hours after waking up.
  • Aim to eat every 4 to 6 hours after breakfast.
  • Try not to skip meals.
  • If you know it will be longer than 4 to 6 hours between meals plan a snack.
Why should I eat regular meals?
  • Skipping meals leaves you feeling extra hungry. By the time you get to the next meal you might eat too much.
  • When you are very hungry it’s hard to reach for healthy foods and to eat slowly.
Tips to eat regular meals
  • Start by including breakfast on a daily basis, if you have never eaten breakfast, start by aiming to eat it one or two days/week.
  • Set an alarm to remind yourself to eat.
  • At work book an appointment in your calendar to avoid interruption.
  • Plan your meals in advance; they can be simple.

Plan Healthy Snacks

What is a healthy snack?
  • A healthy snack should include at least two food groups (Vegetables and fruit, Grain Products, Milk and Alternates, Meat and Alternates.)
  • Keep your serving sizes small.
  • See snack handout for easy snack ideas to have on hand.
Why should I plan healthy snacks?
  • Healthy snacking can help you feel full between meals.
  • Healthy snacking can help you to keep your energy level up.
  • Snack when you are hungry, not because you are bored or stressed.
  • Snacking can make it easier to eat enough vegetables and fruits.
Tips for healthy snacking
  • Plan snacks ahead of time.
  • Don’t snack out of the container, portion it into a bowl.
  • Don’t eat while driving.
  • Don’t eat in front of the TV, while reading, while using your phone, computer or tablet.

Eat a Variety of Vegetables and Fruit at Every Meal

Why should I eat more?
  • Eating 7 servings of vegetables and fruit each day may help to reduce your risk of developing heart disease, diabetes, cancer and stroke.
  • Eating enough vegetables and fruit can help reduce cholesterol and blood pressure.
What is a serving of vegetables and fruit?
  • A serving of most raw or cooked vegetables is ½ cup.
  • A serving of most fruit is ½ cup or 1 small piece of fruit (size of a tennis ball).
  • Choose whole vegetables and fruit more often instead of juice.
Tips to include more vegetables and fruit
  • Eat a vegetable or fruit at all meals.
  • Have an apple, orange, banana, kiwi or melon for a snack.
  • Keep raw, cut up vegetables in the fridge for snacking.
  • Move your vegetables and fruit out of the crisper and onto a higher shelf
  • Use fresh or frozen vegetables and fruit more often. If you buy canned make sure to look for No Added Salt canned vegetables.
  • Roast vegetables and eat them leftover all week.

Eat Whole Grains More Often

What are whole grains?
  • Whole grains include the entire seed of the plant.
  • Whole grains are higher in fibre, vitamins and minerals.
  • They include oatmeal, bulgur, brown or wild rice, barley, quinoa and popcorn.
Why should I eat more?
  • Eating whole grains may help to reduce your risk of heart disease, diabetes, cancer and stroke.
  • Oatmeal, barley and psyllium are high in soluble fibre which helps to reduce LDL (lousy) cholesterol.
Tips to include more whole grains
  • Use brown or wild rice instead of white rice.
  • Have oatmeal for breakfast or snack a few times each week.
  • Add quinoa or barley to salads.
  • Use dark rye bread or whole grain bread instead of white bread.
  • Use whole grain pasta instead of white (or try half and half).

Eat Fish at Least Twice a Week

What fish should I eat?
  • Choose fatty fish more often.
  • Try salmon, mackerel, pickerel, sardines or trout.
  • Aim to eat fish at least twice each week.
  • Seafood like oysters, mussels, shrimp, and lobster are also good choices.
Why should I eat fish?
  • Eating fish can help to lower your risk of having more heart problems.
  • Fatty fish are high in omega-3 fats which may help to reduce your risk of heart disease.
  • Fish is a good source of protein.
Tips to eat more fish
  • Use fresh, frozen or canned fish.
  • Use canned salmon to make a sandwich.
  • Add canned fish to salads.
  • Bake frozen fish for a quick easy weeknight meal.
  • Have sardines on toast or whole grain crackers.
  • Add fresh or frozen fish to a curry.

Include Legumes Like Beans, Chickpeas, Lentils, Nuts and Seeds More Often

What are legumes?
  • Legumes include most beans like chickpeas, kidney beans, black beans and white beans.
  • Nuts and seeds will give you many of the same benefits.
  • Nuts and seeds make an excellent snack.
Why should I eat more?
  • Eating nuts, seeds, beans and lentils may help to reduce your risk of developing heart disease, diabetes and other chronic diseases.
  • Nuts, seeds, beans and lentils may help to reduce your cholesterol and blood pressure.
  • Aim to include them at least 4-5 times/week.
Tips to include more nuts, seeds, bean and lentils
  • Add chickpeas to a main course salad.
  • Add kidney beans to chili.
  • Eat one vegetarian meal once a week.
  • Make bean salad and keep it in the fridge for lunches.
  • Eat nuts as a snack.
  • Add nuts or seeds to your salad.

Don’t be Afraid of Fat

Why is fat important?
  • Fats play an important role in your body.
  • Fats give you energy, and some fatty acids that our bodies can’t make.
  • Fats are a part of cell walls, hormones and insulate our bodies
  • Fats make food taste good and keep you full.
Which fats should I eat more often?
  • Choose unsaturated fats more often.
  • Unsaturated fats come from plant sources including nuts, seeds, avocado.
  • When cooking use olive oil, or canola oil, more often.
  • Make your own salad dressing at home using olive oil or canola oil.
  • Eat nuts and seeds as a snack.
Which fats should I eat less often?
  • Trans fats are found mainly in processed foods and cooking more at home will help you to avoid them.
  • Choose saturated fats less often. Saturated fats come from animal based products such as red meat and dairy.
  • Limit your intake of red meat to once or twice/week.
  • Choose lower fat dairy more often.

A Word About Alcohol

Limit alcohol to three servings a day (maximum of 15 servings a week) for men and two servings a day (maximum 10 servings a week) for women.

One serving is:

  • 125 ml (4 oz) wine or
  • 355 ml (12 oz) beer or
  • 45 ml (1.5 oz) liquor

Heart Healthy Eating Resources

NUTRITION WORKSHOPS:

The dietitian at the University of Ottawa Heart Institute offers a series of interactive workshop series

  • The workshops can be attended by patients, families, and members of the public who are interested in learning about heart healthy eating.
  • Workshops are 60 minutes in length and daytime and evening options are available.
  • The workshops are free of charge.
  • Pick up your Workshops Schedule at the Heart Institute or check our Calendar.

Nutrition 101: Learn how to read food labels and get the facts on fat, cholesterol, fibre and salt.
Nutrition 201: Learn about trends in nutrition including super foods, supplements and the Mediterranean diet
Nutrition Tips for Weight Management: Learn to set realistic goals and plan meals for weight management

WEBSITES:

COOKBOOKS

  • Hold the Salt: Tilley, Maureen 2009
  • Hold the Hidden Salt: Tilley, Maureen 2011
  • Nourish: Whole food recipes featuring seeds, nuts, and beans: Nettie Cronish, Cara Rosenbloom, 2016
  • Dietitians of Canada! 275 Recipes: Weisman, Mary Sue, 2012
  • 15 Minute Meals: Oliver, Jamie 2016

 

What are the Key Principles of Obesity Management?

Reproduced with permission from the Canadian Obesity Network (CON)

  1. Obesity is a chronic condition that requires long-term management.
    Managing excess body weight (obesity) is similar to managing high blood pressure or diabetes—left unmanaged, these conditions get worse and when treatments stop, the problem comes back. This is why weight management strategies have to be realistic and sustainable. Short-term ‘quick-fix’ solutions are not sustainable, which is why weight usually comes back.
  2. Obesity management is more than just reducing numbers on a scale—it’s about improving overall health and well-being over the long term.
    A common belief about obesity is that there is a simple cure (i.e. lose weight).

    The problem with this notion is that it does not account for the fact that obesity is a chronic disease. The overall goal of obesity management is the improvement of your health and well-being. The first step is to prevent further weight gain. In addition, even a modest reduction in body weight can lead to significant improvements in health. It’s important to look past the scale, and focus on the big picture of why a change is being made.

  3. An important part of obesity management is identifying and addressing root causes for weight gain and removing roadblocks.
    In the same way that each and every person is different and unique, the reasons behind each individual’s weight gain can be different. Managing obesity is even more difficult when you do not understand the root cause of your weight gain and your road blocks to weight management. Identifying and removing what is holding you back is key to making positive, successful health improvements.
  4. Every individual defines success differently.
    Understanding the reasons why you decided to address your obesity can help you to assess what is important to you and how you will measure success within your long-term plan.

    Success may mean having more energy to be active with your friends and family, improving your selfesteem, preventing further weight gain or improving overall health. Whatever your ideal “success” may be, use it to help guide and motivate you.

    Take some time to reflect ~ If you or a loved one are thinking about taking steps towards managing obesity, what are the reasons for making this change, and how will you define “success”?

  5. Work towards your “best” weight.
    When setting expectations for a weight management plan, it is important to set realistic and achievable goals that work within a lifestyle that you still enjoy. You shouldn’t stress about counting calories, setting a timeline for specific weight loss, or exercising excessively. Instead, focus on making healthy and enjoyable lifestyle changes that will improve your overall quality of life! Whatever weight you achieve through these changes is considered your “best” weight.

    Using the resources offered by CON is a great first step in helping you achieve your goals!

    Building an enjoyable, healthy lifestyle ~ If you do not like the way you are living when you are managing your weight, it will be much more difficult to keep it off and to keep yourself from going back to the way you were living before you lost it. Work towards building a healthy lifestyle that you truly enjoy!

My Personal Health Goal

My Personal Health Goal form (pdf)

Stress, Depression & Anxiety

Stress

How Stress Affects Your Heart

In situations that are perceived as stressful, your body reacts by releasing stress hormones. In response, your heart rate and blood pressure increase, your breathing becomes faster and more shallow, your skin starts to sweat, and your entire body revs up into high gear.

In the short term, these reactions make you more alert and able to deal with the stressful situation. But if you are under stress for a long time, other changes occur:

  • Fat cells that were released into the bloodstream for extra energy become converted into cholesterol
  • Platelets circulating in the blood become more “sticky”
  • Insulin resistance can occur causing blood glucose levels to rise outside of the normal range
  • Patterns of daily life may change, making it more difficult to eat well, exercise regularly, and get enough rest
How to Manage Your Stress

How we think about an event determines its impact on our health.

  • Attend a stress management program (see below) and learn how to:
    • Identify what causes you stress and how it affects you
    • Learn stress management skills like breathing and relaxation exercises
  • Be physically active every day to help reduce the effects of stress
  • Identify and use your support networks (e.g., friends and family)
  • If you feel overwhelmed or if you are having difficulty functioning in your daily activities, speak to your doctor or nurse about options available to help you (e.g., books, websites or a referral to counselling services).
10 Tips for Managing Stress
  1. Exercise regularly. Physical activity helps to relax and condition your body and mind. Exercising three to five times a week for 30 minutes is a great place to start.
  2. Breathe deeply. When we feel stress, we often breathe in a shallow way. Take a moment and take a few deep breaths. Notice how it changes how you feel.
  3. Eat well. Eat at regular times and a variety of foods. Stay away from processed foods high in salt and sugar. Decrease use of alcohol and drugs during stressful times.
  4. Notice your thoughts. Reflect on how you think about what is causing you stress. Sometimes talking with someone you trust or a professional counsellor can help you see things in a new and different way.
  5. Relax the muscles in your body. When we are stressed, the body becomes tense. Notice when your body is tense and try to relax the particular areas where you carry the most stress.
  6. Recognize what you can’t control. Take time to reflect on what you can control, and work at letting go of things that are beyond your control and cannot be changed.
  7. Take a break in your day. Give yourself permission to take time out by having a nap, listening to music, reading a book, meditating, praying, journaling or just having some quiet reflective time.
  8. Make time for things that you enjoy. Set time aside for hobbies or learning something new. It’s never too late to learn something new and enjoyable.
  9. Avoid exposure to stress. It may not always be possible to avoid things which are stressful, but some things may be avoidable, such as distressing news programs or TV shows.
  10. Evaluate your commitments. Take a look at how you spend your time. Consider letting go of commitments that are no longer meaningful or useful to you.

More Information About Stress

Stress Management Program

The University of Ottawa Heart Institute Minto Prevention and Rehabilitation Centre provides a skills-oriented Stress Management Program that offers a variety of techniques to better manage stress. There are six 90-minute sessions in a group format and each of the sessions covers different topics including:

  • Deep breathing and mindfulness stress management techniques
  • Effective communication strategies to reduce stress
  • Improving our interpersonal communication
  • Uncovering and changing negative thoughts
  • Using humour as a coping strategy
  • Ways to improve our sleep

 

  • Location: University of Ottawa Heart Institute, 40 Ruskin St., Ottawa
  • To Register: Call 613-696-7399
  • Material Cost: $25.00
  • Family members can access the Stress Management Program through the Heart Health Education Centre after a cardiac risk assessment
Stress and the Heart

This is a one hour workshop offered to patients and family members through the Cardiac Rehabilitation program. During this session we discuss coping strategies and the physical, psychological and emotional impact of stress on the heart.

There is no cost to attend. See workshop schedule in the Cardiac Rehabilitation program or on-line.

You can also call the Cardiac Rehabilitation program at 613-696-7070.

Books
  • Don’t Sweat the Small Stuff…and It’s All Small Stuff, R. Carlson
  • Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness, J. Kabat-Zinn
  • Stress, Sanity and Survival, R.Woolfolk, FC Richardson
  • The Relaxation & Stress Reduction Workbook, M. Davis, M. McKay and E. Robbins- Eshelman

Emotions Associated with Heart Disease

Heart patients may experience a variety of emotions after being diagnosed or treated for heart disease. For example, over two-thirds of patients may experience anxiety, depression, confusion, memory problems, irritability and/or anger in the weeks or months after bypass surgery. Emotional reactions are influenced by a number of factors (e.g., work or family stress, type of heart problem or treatment, medication side effects, poor sleep, one’s emotional health before being hospitalized). Understanding one’s health condition and treatment, participating in cardiac rehabilitation, engaging in exercise and speaking about one’s experience with peers, significant others, and/or health professionals help recovery. Please call the UOHI Cardiac Rehabilitation Centre (613-696-7070) for information on programs that might help (e.g. Stress Management, Managing Emotions, Women at Heart, Yoga, and ‘Sleep to Your Heart’s Content’ programs).

The good news is that, for most patients, these overwhelming emotions resolve over time. For some, however, emotions such as depression and anxiety persist.

Depression

Depression is an understandable and common reaction among people with heart problems. About one in five patients (20%) experience clinical (or major) depression. If you are feeling at least five of the symptoms listed below for a two-week period or more, you may be developing depression and you may need to speak to your doctor, nurse or mental health professional.

These symptoms may include:

  • Sad feelings
  • Loss of interest in activities that you usually enjoy
  • Changes in appetite
  • Significant unplanned weight loss or weight gain
  • Sleep problems
  • Loss of energy
  • Difficulties with concentration or memory
  • Decrease in your normal social activities or withdrawing from friends and family
  • Feelings of worthlessness, helplessness, or hopelessness
  • Changes in sexual desire
  • Thoughts about death or suicide
How Depression Affects Your Heart

Depression may affect your heart in two ways: directly and indirectly. Depression affects your heart directly by increasing the risk of blood clotting, plaque build up and atherosclerosis. Depression also negatively affects your immune system, so you are less able to fight off germs and viruses.

Depression may affect your heart indirectly by influencing some of the decisions you make. People with depression often find it difficult to make healthy choices about quitting smoking, exercising, eating, or taking medications as prescribed. They find it difficult to find the drive or energy to make healthy lifestyle changes.

Anxiety

Anxiety is one of the most distressing emotions that people feel. At some point in time, most cardiac patients will experience varying degrees of fear or nervousness related to their health condition.

Anxiety describes a number of problems including generalized anxiety (a mixture of worries experienced most of the time), panic attacks (intense feelings of anxiety where people often feel like they are going to die), and posttraumatic stress disorder (repeated memories of terrible experiences with high levels of fear).

Like depression, about one in five cardiac patients experience significant anxiety symptoms. These symptoms may include:

  • Uncontrollable worry
  • Feeling “on edge” or restless
  • Feeling irritable
  • Muscle tension
  • Light-headedness
  • Sleep problems
  • Being easily fatigued
  • Difficulty breathing
  • Increased heart rate
  • Headaches
  • Sweating
  • Gastrointestinal (stomach) problems
How Anxiety Affects Your Heart

Anxiety may play a role in cardiac problems by increasing the risk of an irregular heart beat and triggering spasms; both of these responses may lead to cardiac complications. Anxiety may also lead to unhealthy behaviours such as: smoking, overeating, poor sleep and decreased physical activity.

What you can do if you are Feeling Depressed or Anxious
  • Talk to your doctor or a mental health professional (social worker, psychologist, or psychiatrist) about proven treatments for depression and/or anxiety
  • Participating in Cardiac Rehabilitation Program has proven benefits for both physical and mental health.
  • Check out The Beat for the Top 10 sleep tips; getting a good night’s sleep helps you manage your emotions.
10 Tips for Emotional Health
  1. Practice deep breathing. Deep breathing relaxes your body and lowers your blood pressure and heart rate.
  2. Name your emotions. Naming your emotions helps you be more aware and decide how you will react.
  3. Try not to judge your emotions. Judging our emotions can make them seem worse.
  4. Know your emotional triggers. Knowing what makes you angry, sad or anxious will help you be better prepared.
  5. Be more mindful. Be aware of what is around you and try to notice your thoughts and feelings.
  6. Move your body. Physical activity decreases anxiety and improves mood and self-esteem.
  7. Talk to someone you care about. Humans are social! Make time to talk and connect with others.
  8. Sleep well. Sleep is important for your mind and body.
  9. Stop “shoulds” in their tracks. Don’t put too much pressure on yourself about what you “should” or “shouldn’t” be doing.
  10. Do the things that make you happy. Identify the things that make you happy and make time for them.

More Information About Depression and Anxiety

Books
  • Feeling Good: The New Mood Therapy, Burns, D. (1990)
  • Mind Over Mood: Change How You Feel by Changing the Way You Think, Greenberger & Padesky (1995)
  • The Anxiety and Phobia Workbook (4th Ed.), Bourne, E. (2005)
  • The Anti-anxiety Workbook, Antony & Norton (2009)
Web Sites

 

 

Sexual Health and Heart Disease

Sexual activity is an important part of quality of life and is often a great concern for both patients and their partners after a cardiac event. Fears and concerns may temporarily interfere with sexual spontaneity and response. Feel free to talk about your questions and concerns with your health provider. He or she is used to discussing these matters and will answer your questions in a professional and understanding way.

A few factors may interfere with your sexual health after your discharge from the hospital. You might temporarily suffer from mild depression which will affect your sexual desire. Some medications may also impact sexual function. You might fear that sexual activity will cause another heart attack or your spouse might silently think the same. For the majority of patients, this will last a short period of time and life will pick up where it left you before you had a cardiac event.

Here are a few answers to common concerns about sexual activity:

Sexual Activity after a Heart Attack

If you have recently had a heart attack, your doctor might ask you to wait up to 6 weeks before resuming sexual activity. After this healing period, the risk of having a heart attack during sex is actually quite low. The risk is comparable to that of getting angry and is reduced if you exercise regularly and take your medication.

From a cardiac standpoint, sexual intercourse is like any other physical activity; your heart rate and your blood pressure increase. The activity is often compared to walking at three to six kilometres per hour on a level surface.

Recommendations for Engaging in Sexual Activity

  • These past few weeks have been very stressful on your partner and yourself. Both of you might still be tired. Plan sexual activity for the time of day when you have the most energy and are least bothered by other issues.
  • Avoid having sex after a large meal. Give yourself a few hours to digest.
  • The effort on your heart is about the same regardless of your position.
  • Limit the amount of alcohol you drink and avoid using tobacco as both of these may affect sexual function.
  • If you have chest pain or shortness of breath, speak to your doctor.

If You Had Erectile Dysfunction before Your Heart Attack

Erectile dysfunction (ED) is often associated with heart disease. The same factors that contributed to blocking the arteries of your heart can block arteries elsewhere in your body. Some medications may also contribute to ED. A healthy lifestyle that incorporates a heart healthy diet, exercise and reaching a healthy weight will correct ED in 30% of obese patients.

Speak to you doctor if you suspect your medications are a contributing factor.

Use of ED Medication after a Heart Attack

Check with your doctor before starting or resuming ED medications (Viagra®, Cialis® or Levitra®). These medications are usually safe but can be devastating on your blood pressure if taken with any form of nitroglycerin (spray under the tongue, pills or the patches).

You should not take any form of nitroglycerin within 24 hours after taking Viagra® or Levitra®, or within 48 hours if you take Cialis®.

If you do experience chest pain within 24 hours of taking any of the above medications please call 911 and let the paramedics and emergency physician know you have taken these drugs.

ED Treatment Options for Nitroglycerin Users Not Eligible for ED Medication

If you have been told you are not a candidate for ED medication, there are other options. These involve treating the penis by inserting or injecting medications or using vacuums devices. Finally, penile prosthesis may be surgically implanted. These more specialized approaches require a referral to a urologist.

Hormone Replacement Therapy for Postmenopausal Women

For years, women were prescribed HRT (estrogen and progesterone) to relieve postmenopausal symptoms. Several studies have shown no protective effect on the heart, and one study reported an increase in the risk of heart disease. In women taking HRT for menopausal symptoms, treatment should be discontinued if they experience angina or a heart attack. There is also evidence that HRT may increase the risk of stroke, blood clots and breast cancer.

Treatments for Sexual Dysfunction in Women with Heart Disease

There are a few options for women but the problem is often more complicated than with men. Women respond more to touch and verbal stimuli and will present with sexual dysfunction involving several of the sexual response cycles (desire, arousal and orgasm).

Certain medications may improve low sexual desire in women taking antidepressants and there is a small category of woman that will benefit from Viagra. A clitoral suction vacuum device, EROS CTDT, is FDA approved for female sexual dysfunction. Its mechanism is similar to vacuum devices used for male erectile dysfunction. It may improve local arousal and response and is safe to use. Speak to your doctor about your concerns.

Suggestions for Maintaining Your Sex Life

  • Sex is not always about intercourse. Explore your senses: hold hands, hug and touch your partner.
  • Create a bit of romance with music, candles and special scents.
  • Agree to have honest discussions. Tell each other what you like and don’t like.

Sleep and the Heart 101 - an introduction for patients with cardiovascular disease

This video reviews insomnia and the normal sleep cycle. It provides tips for basic sleep hygiene and an overview of cognitive and behavioural strategies to reduce insomnia.

Reference:  “Sink into Sleep” by Judith Davidson; Sleep to your heart’s content program at UOHI.