美国整体护理协会/美国整体医学会年会

　　 
　
American Holistic Nurses Association (AHNA)/American Holistic Medical Association (AHMA) Annual Conference

　　2006年6月7－10日

　　美国明尼苏达州

　　June 7 - 10, 2006, St. Paul, Minnesota
Lessons of the Heart -- Cardiovascular Disease: A Mind, Body, and Spirit Approach
Veda Andrus, EdD, MSN, RN, HN-BC　　
Introduction: The Heart Speaks
Medical schools do a superb job of teaching about the physical heart: a 4-chambered, fist-size organ functioning as a mechanical pump beating an average of 72 beats per minute, more than 100,000 times each day. The conventional role of a cardiologist is that of a technical specialist who can, with a wide range of technologic equipment and professional acumen, diagnose and treat the physical issues of the heart.

　　As Mimi Guarneri, MD, FACC,[1] notes in her book The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing:

　　No one spoke of the other layers of the heart that didn't appear on a stress test or electrocardiogram: the mental heart, affected by hostility, stress, and depression, the emotional heart that could be crushed by loss, the intelligent heart that has a nervous system of its own and communicates with the brain and other parts of the body. No one lectured about the spiritual heart that yearns for higher purpose, the universal heart that communicates with others, or the original heart that beats in the unborn fetus before the brain is formed.
Dr. Guarneri, Founder and Medical Director of Scripps Center for Integrative Medicine in La Jolla, California, and attending physician in cardiovascular disease at Scripps Clinic since 1995, provided an informative and inspiring keynote address.[2] Her presentation addressed foundational information about heart health, guidelines for maintaining a healthy heart, and an exploration of the deeper messages of the heart.

　　Foundational Information on Heart Health
Dr. Guarneri provided foundational information about heart health and cardiac disease to lay the groundwork for her presentation.

　　Risk factors for cardiac disease include:

　　Family history of heart disease;

　　
Smoking;

　　
Diet;

　　
Cholesterol levels over 200 mg/dL;

　　
Inflammatory processes;

　　
Depression;

　　
Stress;

　　
Anxiety; and

　　
Social isolation.
Statistics that opened her eyes to a deeper meaning of cardiac disease include:

　　80% of people with a heart attack will have the same cholesterol level as those who do not have a heart attack;

　　
300,000 Americans die each year of poor diet, inactivity, and stress-related illnesses;

　　
American children spend an average of 6 hours/day watching television or sitting at the computer; and

　　
The rate of diabetes has increased multifold in Americans: 1958 (less than 2 million), 2000 (15 million), and 2025 (projected 23 million).
Dr. Guarneri, in reflecting on thefactors influencing cardiovascular health, recognized that the heart is complex, and treating the heart required more than the insertion of stents and the use of statin drug therapy. She began to see that "behind every heart there is a story," and listening intently to her patient's words could provide deeper insight into their heart health. She recognized that "how we live our lives and, more importantly, whom we live our lives with" are critical factors that must be considered when looking at the big picture of a person's heart health. "Western medicine excels at crisis and acute care, and cardiologists are taught to treat only a piece of the person. They deliver therapies that would not get to the underlying factors of heart disease by treating only the symptoms."

　　Guidelines for Maintaining a Healthy Heart
Dr. Guarneri noted that heart disease was related to an inflammatory reaction that increased the potential for plaque formation and the capacity for the plaque to adhere to the walls of the arteries. She indicated a direct relationship between proper nutrition and heart health, noting that when patients ate within the following guidelines, there was a 70% reduction in cardiac disease:

　　Following an Indo-Mediterranean diet: high in fruits, beans, vegetables, whole grains, nuts, soy, and fish;

　　
Using inflammation-reducing herbs: turmeric, ginger, and rosemary;

　　
Drinking green tea;

　　
Avoiding trans fats, partially hydrogena

　　
ted oils, simple sugars, meat, and saturated fats;

　　
Avoiding supersizing: being aware of the quantity of food ingested; and

　　
Reducing intake of alcohol.
In addition to dietary recommendations, Dr. Guarneri recommends exercising 6 days/week and indicates that with this regimen, there may be a 50% reduction in heart disease, a reduction in blood pressure, an increase in high-density lipoproteins (HDLs), an overall improvement in the lipid profile, and a decrease in stress.

　　Deeper Messages of the Heart
When in medical school, Dr. Guarneri recalls learning not to "open Pandora's box" by asking patients leading questions, but she quickly added that "it is not until you ask the questions that you can really help someone." She said it was from her patients that she learned "much more than the physical aspects of the heart" and learned to listen for the deeper messages.

　　"Thought can become biology" grew to have meaning for her when she recognized that 75% to 90% of all patient visits to medical practitioners were related to stress-related disorders. She noted that these "disorders" included anger, anxiety, hostility, and depression, noting that anger is the most toxic emotion for the heart (increasing the rate of a heart attack 230%), and anxiety yields a 5% increase in sudden death. In her professional opinion, depression yields the worst cardiac outcomes.

　　Simple, nonpharmacologic interventions to

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