Intensive lifestyle interventions may help people with heart disease lose weight, which improves factors that worsen heart disease. Trained experts teach participants behavior changes that foster healthy eating and exercise.
An valve can be replaced by a mechanical valve or one made from pig or cow tissue. Mechanical valves last longer but require the use of anti-clotting medicines.
Ask the doctor: When a stroke has no immediate symptoms
For about two hours after an angry outburst, a person has a slightly higher risk of having chest pain (angina), a heart attack, a stroke, or a risky heart rhythm.
Exercise stress tests help diagnose possible heart disease in people with symptoms of the disease.
Packable equipment (such as exercise bands and jump ropes), airport walking routes, and athletic shoe rentals available at some hotels are helpful options for maintaining a fitness program away from home.
Positive lifestyle choices help protect the heart and blood vessels from damage. These same steps may also work to quiet the genetic code that increases disease risk.
Most people with heart failure need to limit the amount of fluid they drink to eight cups a day. That includes foods that are liquid at room temperature.
Starting cardiac rehabilitation within 15 days of heart surgery, heart attack, or another cardiac event leads to greater improvements than starting rehab more than 30 days after the event.
The FDA approved a drug-coated balloon to open clogged leg arteries, providing a new option for treating peripheral artery disease or PAD.
A small percentage of people who take cholesterol-lowering statins complain of muscle pain.
4 myths about statins
Cholesterol-lowering statin drugs have been linked to various side effects. But some widely held beliefs about how the drugs affect your memory, muscles, and other habits aren't accurate.
Ask the doctor: Are vitamin D supplements a good idea?
Are vitamin D supplements a good idea?
Ask the doctor: Bleeding risks from low-dose aspirin
I had a heart attack several years ago and have been taking low-dose aspirin ever since to prevent a second one. But I keep hearing about the bleeding risks caused by aspirin. What should I be watching for?
Minerals to manage blood pressure
Cutting back on salt is the first commandment for controlling high blood pressure. But getting plenty of other important minerals such as potassium, calcium, and magnesium is also critical.
Imaging stress tests: A clearer view of your heart's health
Stress tests help show if your heart gets enough blood and oxygen when stressed.
Understanding the unsaturated fats
For decades, a key health message was "all fat is bad." Today we know that good fats are essential to good health. As research mounts, the recommendations can get confusing, but plant-based oils are still the best.
How to start exercising if you're out of shape
People who are out of shape often have a hard time getting the 2.5 hours of moderate exercise a week recommended by federal guidelines.
Salt substitutes: Another way to trim your sodium intake
Swapping regular salt for sodium-free or lower-sodium alternatives helps people scale back their sodium intake. One option is to use a potassium chloride salt, but many people prefer herb and spice blends.
Heart disease in retired football players
Among retired professional football players, linemen (who mainly tackle and guard other players) tend to be heavier, have bigger waists, and show more signs of hardening of the arteries compared with men who played other positions.
Fatty liver disease linked to clogged heart arteries
Nonalcoholic fatty liver disease (NAFLD), a condition marked by excess fat in the liver, is strongly linked to a higher risk of dangerous plaque in the coronary arteries.
Beware the danger of secondhand smoke
Secondhand smoke exposure raises a person's chance of developing heart disease up to 30%. But nonsmokers hospitalized for heart disease are rarely asked about this preventable risk.
A wake-up call on coffee
Coffee is a nearly calorie-free beverage brimming with antioxidants. It might ease artery-damaging inflammation and deliver substances that support heart health.
Ask the doctor: Calcium supplements: Not routinely recommended
Calcium is important for bone health, so doctors often recommend calcium supplements for people with osteoporosis.
Ask the doctor: Stroke danger from a hole in the heart?
I just discovered that I have a hole in my heart that my doctor called a patent foramen ovale, which was found during an ultrasound. What are the pros and cons of having it repaired?
The problem with plaque: Even lesser amounts are still risky
Areas of plaque in the coronary arteries that are too small to be detected on a stress test are known as non-obstructive coronary artery disease.
Having a big belly puts your heart in danger
Americans' bellies are getting bigger, a trend that's likely due to an increase in visceral fat, which surrounds the internal organs and raises the risk of heart disease.
Can memory woes foretell a stroke?
Well-educated people who report memory problems may face a higher risk of stroke.
Thyroid hormone: How it affects your heart
The thyroid gland releases hormones that affect the heart. Too little thyroid hormone slows the heart rate and may boost blood pressure and cholesterol levels, while too much can trigger abnormal heart rhythms and high blood pressure.
Can deep, slow breathing lower blood pressure?
Deep, slow breathing may dampen nerve activity that activates the "fight-or-flight" response, causing blood vessels to relax and widen. RESPeRATE, an FDA-approved device that slows a person's breathing, may help lower blood pressure.
A new way to "beet" high blood pressure?
Drinking a cup of beet juice daily may lower blood pressure. The ruby-red roots are rich in nitrates, which the body converts to nitric oxide-a compound that relaxes blood vessels and lowers blood pressure.
Doctors often mum about sex after a heart attack
Most doctors don't offer counseling about resuming sexual activity after a heart attack, especially to people who are older or female.
Chemical in food can liners may boost blood pressure
Consuming bisphenol A (BPA)-a chemical found in some plastic bottles, food containers, and can liners-may raise blood pressure.
Reaping gains from grains
Whole-grain foods offer nutritional benefits beyond just the fiber from the outer layer. The nutrients and compounds from all parts of the grain offer a wide range of cardiovascular benefits and have been linked to longer life.
Ask the doctor: What is pericarditis?
I had chest pains for a couple of days and thought I was having a heart attack. My doctor did an electrocardiogram and said I had pericarditis and that it was not serious. What exactly is pericarditis?
Ask the doctor: Dizziness from blood pressure medications?
I take several medicines to get my blood pressure under control, and they seem to do the job. However, I get dizzy at times. Is there anything I can do, other than stopping my medications?
Yoga's health advantages may extend to the heart
Yoga combines gentle physical movements, breathing, and meditation, all of which may lower heart disease risk. People who do yoga may reap benefits such as weight loss, lower harmful LDL cholesterol levels, and lower blood pressure.
The latest on cholesterol testing
Even though national guidelines on managing cholesterol have shifted away from targeting specific cholesterol levels, tests that measure fats (lipids) in the blood, known as a lipid profile or panel, are still widely used and important.
Smartphone apps for blood pressure: A clever choice?
Smartphone applications (apps) that track and create charts of blood pressure readings over time may help people to better control their condition. But apps that use the phone itself as a blood pressure-measuring device may not be accurate.
Blood sugar on the brain
Years of poorly controlled diabetes have a devastating effect on the cardiovascular system, kidneys, and brain. High blood sugar may also harm thinking and memory power even in people who do not have diabetes.
Heart attack risk rises after a bout of pneumonia
Older people hospitalized for pneumonia face four times their usual risk of a heart attack or stroke or dying of heart disease in the month following the illness. The elevated risk declines over time.
An avocado a day may keep cholesterol at bay
Eating a cholesterol-lowering diet that includes one avocado per day may lower levels of undesirable LDL cholesterol. The monounsaturated fats, as well as fiber and other compounds found in avocados, likely contribute to this beneficial effect.
Portable ultrasound reveals early signs of heart disease
A simple, inexpensive ultrasound of the arteries in the neck and upper leg may be a better way to screen people for possible cardiovascular disease than the current risk-based estimate used to guide treatment, though more research is needed.
Stressful job may raise stroke risk
Having a demanding job with little control may slightly increase the risk of a stroke. Job strain may activate factors that predispose a person to developing a blood clot, which can lead to a stroke.
A daily low-dose aspirin can help stave off heart attacks and certain clot-caused strokes. But fewer than half of the people who could benefit from this drug take it, while many others take it when they shouldn't.
Beta blockers can cause side effects such as trouble getting or keeping an erection. This side effect is less common with other classes of blood pressure medications, which may also offer better protection against stroke.
Narrowing of the carotid arteries can restrict blood flow to the brain and increase the risk of stroke. Treatments include surgery or stent placement, but this usually is done only if the artery is blocked by more than 70% or there are symptoms.
A flu shot may lower the risk of having a heart attack, a stroke, heart failure, or another major cardiac event-including death-by about a third over the following year. It's best to get the vaccine in the fall, but January isn't too late.
Quitting smoking is a huge step forward for improving health and extending life. To fully reap the benefits, it's important to take steps to remain smoke-free for years to come.
Chest pain from heart disease can mimic pain caused by heartburn or pericarditis. Likewise, peripheral artery disease may be mistaken for arthritis of the knees, hip, or back. Understanding the differences makes it easier to deal with pain.
The buildup of excess fluid in the body can be dangerous for your heart even before outward signs are apparent. Checking weight daily and taking action at the first signs of fluid retention can prevent life-threatening complications of heart failure.
Coconut oil is a popular item on grocery store shelves. Not so long ago, the same substance was demonized as a harmful saturated fat. Current research now shows that coconut oil is okay in small amounts, but is still not a substitute for healthy vegetable
For people with cardiovascular disease, exercise may boost survival just as much as taking medications.
Within two years of getting a stent, about one in five people needs noncardiac surgery. Only those who needed emergency surgery or who had advanced heart disease faced a higher risk of a major cardiac event during that surgery, according to a new study.
High cholesterol, high blood pressure, diabetes, and stiffening of the arteries are well-known contributors to cardiovascular disease.
The new strategy for statins: Should you be taking one?
New guidelines for prescribing the cholesterol-lowering drugs known as statins no longer focus on an individual's starting blood cholesterol value. Instead, the decision should focus on an individual's overall risk of heart disease.
Ask the doctor: Battling belly fat
There is no magical way to reduce belly fat. Cutting back on food intake, burning calories with regular aerobic activity, and doing core exercises to strengthen the back, sides, and abdomen will help.
Ask the doctor: CPR after bypass surgery or stenting
Doing cardiopulmonary resuscitation on someone who has had bypass surgery or angioplasty plus stent placement will not disrupt the surgery or damage the stent.
Double trouble: Coping with arthritis and heart disease together
For people with heart disease and arthritis, exercise can help ease both conditions. Medications commonly used for arthritis can interact with those used to treat heart disease.
Obesity as a cardiovascular disease: Time to take your BMI seriously
The recent designation of obesity as a disease by the American Medical Association and new guidelines on obesity treatment may change how the problem is discussed and treated.
5 things you need to do after a heart attack
After a heart attack, five pivotal steps can hasten recovery and help protect long-term heart health.
New options to reboot the heart
Tiny electronic devices called implantable cardioverter-defibrillators are used to detect and correct potentially deadly heart rhythms.
FDA deems trans fats unsafe
The FDA has proposed that trans fats should be taken off the list of additives "generally recognized as safe."
Research we're watching: Testosterone therapy linked to heart trouble
Testosterone therapy-which is widely marketed to boost energy and sexual function-may increase the risk of heart attack, stroke, and death in older men with low testosterone and other health problems.
Research we're watching: Weight loss eases atrial fibrillation
People with atrial fibrillation who are overweight or obese may be able to improve their symptoms by losing weight.
Research we're watching: MitraClip provides valve repair without surgery
The tiny MitraClip can be inserted into the heart via a catheter to secure a damaged mitral valve, thereby easing the problems associated with mitral valve regurgitation without the need for open-heart surgery.
Sizing up 'superfoods' for heart health
"Superfoods" are rich in soluble fiber, antioxidants, and omega-3 fatty acids that can help keep your arteries clear. They include oatmeal, oranges, beans, spinach, kale, salmon, extra-virgin olive oil, quinoa, avocados, nuts, berries, and dark chocolate.
Ask the doctor: Blood pressure drugs and potassium
People who take a potassium-sparing diuretic such as spironolactone (Aldactone, generic), should not use salt substitutes that contain potassium, and limit their intake of potassium-rich foods such as bananas, orange juice, and potatoes.
Ask the doctor: Exercise versus pharmacologic stress testing
A pharmacological stress test is a good alternative to a standard exercise stress test when a condition makes exercise difficult. Both can help detect heart problems, but the exercise test can also help a doctor determine a safe level of exercise.
5 Action Steps for Early Heart Failure
A variety of conditions can lead to heart failure. Regardless of what sets the process in motion, recognizing the problem early and taking appropriate action can help improve quality and length of life.
New techniques for treating atrial fibrillation
Atrial fibrillation is a fast irregular rhythm in the heart's upper chambers. It is a major risk factor for stroke. A host of new devices and technologies offer promise to people with atrial fibrillation who are not helped by medications.
Borderline hypertension: When do you need treatment?
Borderline high blood pressure still raises stroke and heart disease risk. Making diet and lifestyle changes proven to lower blood pressure can prevent or delay the need to take high blood pressure medicines in the future.
Understanding angioplasty: When you need it and when you may not
Angioplasty and stent placement, which widens a narrowed coronary artery, quickly restores blood flow during a heart attack or unstable angina.
Stroke and migraine: What's the link?
Individuals who have migraine with the visual disturbances known as aura are more likely to have strokes than those who have migraine without aura. These people should take steps to minimize other stroke risk factors.
Research we're watching: Vitamin supplements no help against heart disease
Multivitamin and mineral supplements do not reduce rates of heart disease, cancer, or death over all. The supplements also don't appear to lessen the risk of cardiovascular complications in heart attack survivors.
Research we're watching: Memory loss from statins unlikely
Statins, which are widely used to lower cholesterol and reduce heart attack risk, are unlikely to cause memory problems, despite an FDA warning to the contrary. But further research is needed in people who take high doses.
Research we're watching: Taking steps to avoid heart disease
Walking an extra 2,000 steps a day may lower the risk of heart attack, stroke, or dying of heart disease in people at high risk of diabetes and who also have (or are prone to) heart disease.
The best heart healthy workouts for your 60s 70s and 80s
Even after many years of not exercising, there are compelling reasons to get active. People who increase their activity in mid- to late life reap benefits in terms of longer life and lower heart disease risk.
Ask the doctor: Abdominal aortic aneurysm screening
Men ages 65 to 75 who have ever smoked should be tested for an abdominal aortic aneurysm. This potentially life-threatening condition is a ballooning in the wall of the aorta, the heart's largest artery, in the abdomen.
Ask the doctor: Calcium-channel blockers and cancer risk
Although a study found higher rates of breast cancer among women who took calcium-channel blockers for 10 or more years, this type of study doesn't prove these medications (which effectively treat blood pressure) caused the cancers.
Think FAST to recall the warning signs of a stroke
One in six people worldwide will have a stroke in his or her lifetime. Learn to recognize a "brain attack."
Take nitroglycerin to ease-and avoid-a common heart disease symptom
Nitroglycerin, which relieves the chest pain known as angina, can be taken as a short-acting tablet or spray, or longer-acting pill or skin patch. By reducing the heart's workload, nitroglycerin also helps ease symptoms of heart failure.
The diabetes-heart disease connection and what it means for you
High blood sugar and other diabetes-related problems harm the heart in several major ways. There are now many ways to better control diabetes and reduce heart risk.
PAD It is a pain in the leg
Calf or thigh pain while walking that goes away with rest is the hallmark of peripheral artery disease.
Back on your feet: Tips for recovering from cardiac surgery
Cardiac surgery takes a toll on the body. Following the discharge instructions and avoiding overexertion will help speed recovery and avoid setbacks.
Research we're watching: Many heart transplant recipients survive 20 years
More and more people who receive heart transplants can expect to live at least 20 years. Continuing improvements in immune-suppressing medications may help people who receive transplants live longer, healthier lives.
Research we are watching: Tend your garden and home .. and your heart?
Doing active projects around the home and garden may lower a person's risk of a heart attack or stroke by 27%.
Research we're watching: Obesity paradox? Just a myth
Being overweight or obese does not protect people with diabetes from heart disease or cancer
Heart attack and stroke: Men vs. women
Cardiovascular disease poses an equal threat to men and women, but the risks, symptoms, and outcomes for heart attack and stroke can differ along gender lines.
Ask the doctor: Erratic blood pressure readings
There can be many reasons for erratic blood pressure readings. Some people may also have higher readings in the doctor's office, called white-coat hypertension.
Ask the doctor: Concerns about low HDL
Several large clinical trials have failed to show a benefit from drug therapy to raise HDL cholesterol. Lifestyle change such as increasing aerobic activity, losing weight, and avoiding trans fats may be most effective.
Eat more fiber-rich foods to foster heart health
Many studies suggest that fiber-rich diets may help prevent heart disease. But most Americans eat only about 16 grams of fiber a day-far less than the recommended amounts.
When very high cholesterol runs in the family
Many heart attacks that occur at an early age result from an inherited condition that leads to very high cholesterol levels.
Another kind of heart rhythm problem
Sick sinus syndrome is a set of heartbeat irregularities that can cause fainting, weakness, palpitations, and shortness of breath. Once diagnosed, the problem is easily treated with an implanted pacemaker.
Common blood pressure drugs can trigger rare allergic reaction
People who take blood pressure drugs known as ACE inhibitors should be aware of a rare side effect that causes the lips, tongue, and face to swell.
Taking Lyme disease to heart
Lyme disease, an infection transmitted by the tiny deer tick, can cause systemwide problems, including a potentially life-threatening heart condition called AV block.
Vegetarian diet linked to lower blood pressure
Compared with meat eaters, people who followed a vegetarian diet had lower blood pressure.
Update: Quality of life after aortic valve replacement
Transcatheter aortic valve replacement offers a minimally invasive way to replace a stiff, failing aortic valve.
Gene therapy to regenerate heart muscle
Research using animal models shows that gene therapy may one day be used to stimulate damaged heart cells to regenerate after a heart attack.
Matters of the heart: Sex and cardiovascular disease
Sexual activity is a major quality-of-life issue for both men and women. Many of the symptoms of cardiovascular disease conspire to diminish sexual enjoyment.
Ask the doctor: Is it okay to eat leafy greens while taking warfarin?
Abundant in leafy greens and other vegetables, vitamin K interacts with warfarin, a commonly used blood thinner.
Ask the doctor: What is Prinzmetal's angina?
A coronary artery spasm is a tightening of the muscles within the arteries of the heart. These spasms, also called Prinzmetal's angina, briefly stop blood flow to the heart, triggering chest pain.
Should you seek advanced cholesterol testing?
Advanced lipoprotein testing, a more detailed version of a standard cholesterol test, measures the distribution, size, and number of different lipoproteins.
Heart failure caused by an infection
Unlike heart muscle weakness brought on by years of stress to the cardiovascular system, viral cardiomyopathy is a chance disease that develops from a routine viral illness.
When high blood pressure affects the arteries to the lungs
Pulmonary hypertension is characterized by shortness of breath, fatigue, and fluid buildup in the right side of the heart.
A sugary diet may spell trouble for your heart
A sugar-laden diet may raise the risk of heart disease, even in people who are not overweight.
Measure blood pressure in both arms
Measuring blood pressure in both arms may reveal important information about a person's cardiovascular risk.
Beware of possible risks from cold and flu remedies
Taking over-the-counter cold and flu remedies that contain phenylephrine plus acetaminophen may lead to high blood levels of phenylephrine.
Married women less likely to succumb to heart disease
Married women may be slightly less likely to die from heart disease than women who live alone.
A new warning sign for heart failure: "Bendopnea"
In people with heart failure, shortness of breath when bending over-dubbed "bendopnea"-may be a warning sign that the disease is more serious than presumed and requires additional treatment.
For a heart healthy diet, don't fixate on fat
Eating less fat has caused people to eat more processed foods, especially refined carbohydrates. People should to worry less about limiting saturated fat in their diets and focus more on eating a variety of whole or minimally processed foods.
Ask the doctor: Atrial fibrillation vs. atrial flutter
Atrial flutter and atrial fibrillation are heart-rhythm disorders that trigger palpitations and lightheadedness. While atrial flutter causes a rapid but regular heartbeat, atrial fibrillation is marked by a rapid but chaotic, unpredictable heartbeat.
Ask the doctor: Statins and the risk of diabetes
Statins may raise blood sugar levels in a small number of people, possibly triggering a diagnosis of diabetes. But the overall benefit of statins in treating heart disease outweighs any slight increase in the risk of diabetes.
Learning hands only CPR could help save a loved one's life
Cardiopulmonary resuscitation can double or triple a person's odds of surviving cardiac arrest. Doing CPR can keep blood circulating until emergency help arrives. The basic action is simple: push hard and fast in the center of the chest.
Pain relief that's safe for your heart
The popular painkillers known as NSAIDs include aspirin, ibuprofen, naproxen, and the prescription drug celecoxib. All except aspirin may slightly increase the risk of a heart attack, but naproxen appears to be the least risky.
Should you consider a coronary artery calcium scan?
A coronary artery calcium scan can reveal specks of calcium in the walls of the heart's arteries, an early sign of cardiovascular disease. For people with a modest risk of heart disease, the test may help with decisions about treatment.
New guidelines update treatment of atrial fibrillation
New guidelines for treating atrial fibrillation include a recommendation to consider newer oral anticoagulant drugs. Compared with warfarin, they are just as effective for preventing a stroke but are less likely to cause dangerous bleeds in the brain.
Easing depression and anxiety in people with heart disease
A phone-based counseling program to treat depression, anxiety, and panic disorder in people hospitalized for heart disease led to improvements in mental health and fewer, less severe symptoms of heart disease.
Statin users eating more calories and fat
People who take cholesterol-lowering statins appear to eat slightly more calories and fat than people who don't take statins.
Faster stroke treatment leads to better results
When a person having a stroke arrives at the hospital, the faster he or she is treated, the better.
Weight-loss surgery for uncontrolled diabetes
People with obesity and uncontrolled diabetes who underwent weight loss surgery lost much more weight, had better blood sugar control, and used fewer diabetes medications than people treated with medications alone.
Dietary supplements: Sorting out the science
About half of American adults take dietary supplements, including many who hope to prevent or treat heart disease.
Ask the doctor: Catheter ablation for afib
When medications can't ease the symptoms of atrial fibrillation, a procedure called catheter ablation may be an option.
Ask the doctor: Understanding aortic valve sclerosis
The aortic valve, which separates the left ventricle from the body's main artery (aorta), sometimes thickens in people over age 65.
The lesser-known fat in your blood
High triglycerides may be more important than low levels of "good" cholesterol when it comes to causing heart disease. Lifestyle changes such as weight loss, exercise, and smart food choices can lower high triglycerides.
Reaching the heart through an artery in the wrist
Artery-opening angioplasty done through the wrist has several advantages over the traditional approach done through the top of the thigh. Bleeding complications are less likely, recovery is shorter and easier, and costs are lower.
Heart failure with 'preserved ejection fraction': What does it mean?
Insights into the structural and biochemical abnormalities that contribute to poor heart muscle function lends new complexity to the diagnosis and treatment of heart failure when ejection fraction appears normal.
New guidelines for the prevention of recurrent stroke
The risk of a stroke in people who have had a previous stroke or TIA is high. Updated prevention guidelines aim to lower the chance of a future "brain attack."
E-cigs: A threat to the heart?
E-cigarettes have rapidly gained popularity as a low-risk alternative to tobacco. But many questions remain about their safety and utility as a smoking cessation aid.
Extra-virgin olive oil may lower afib risk
A Mediterranean diet rich in extra-virgin olive oil may lower the risk of the heart rhythm disorder known as atrial fibrillation.
Treating sleep apnea may decrease blood pressure
Continuous positive airway pressure, common treatment for obstructive sleep apnea, lowers blood pressure in people who have or are prone to heart disease.
Obesity raises heart disease risk despite healthy metabolic profile
Even in the absence of metabolic markers for cardiovascular risk, individuals with a BMI in the obese category had more signs of early atherosclerosis in their coronary arteries than non-obese people.
How to tame stubbornly high blood pressure
Nearly 10 percent of people with high blood pressure have resistant hypertension, meaning their blood pressure is still high despite taking at least three medications. Taking combination pills, exercising, and eating less sodium can help.
Ask the doctor: How to slow a racing heart
Coughing or gagging may help slow a very rapid heartbeat caused by supraventricular tachycardia. Known as vagal maneuvers, these techniques work by stimulating the vagus nerve, which runs from the brain to the abdomen.
Ask the doctor: Compression stockings for long-distance travel?
Compression stockings can help prevent the leg swelling and blood clot formation that can occur after long periods of sitting. Drinking water and moving the legs can also help.
Vena cava filters: Tiny cages that trap blood clots
For people who can't take blood thinners to prevent blood clots in the legs from traveling to the lungs, a tiny cage-like device called a vena cava filter placed within a major vein can trap migrating clots before they can travel to the lungs.
Digoxin: Old friend or old foe?
Digoxin is among the oldest cardiac drugs still in use, but its history has been marked by controversy. However, better knowledge of how the drug works has created a potential new role for digoxin in people with advanced heart failure.
Should an abnormal electrocardiogram be a cause for worry?
Left and right bundle branch blocks are abnormalities of the heart's electrical conduction system that show up on an electrocardiogram. They rarely cause symptoms and don't need special treatment in most cases.
Blood transfusions for heart surgery: Less necessary than in the past
Blood transfusions for heart surgery are less common than in the past, in part due to a better understanding of the risks and benefits of transfusions. People slated for open-heart surgery should ask about how to avoid a transfusion.
Can calming your mind help your heart?
Meditation involves quiet, focused attention on breathing, an object, or a word or phase known as a mantra. It can modestly lower blood pressure and may offer other cardiovascular benefits, some of which may work by dampening the body's stress response.
From hot dogs to heart failure
Men who eat processed red meats such as sausages and cold cuts may raise their risk of heart failure. These foods may be especially detrimental because of their high levels of sodium, nitrates, and other additives.
Long-term exposure to traffic fumes may damage blood vessels
Researchers measured the vascular health of over 5,000 people who lived near major roadways to assess the effects of long-term proximity to car fumes.
Cardiac rehab after a heart attack
Cardiac rehabilitation-a customized exercise and lifestyle education program that helps people recover after a heart attack-may lower your odds of needing a long-term hospital stay and might also extend your life.
Uncovering a hidden cause of stroke
Unrecognized atrial fibrillation may be to blame for up to 40% of unexplained strokes. Monitoring stroke survivors for irregular heartbeat beyond the standard 24-hour period after a stroke can potentially prevent some repeat strokes.
Ask the doctor: Understanding conflicting test results
A noninvasive stress test can err in either a false negative or false positive direction. Further appropriate invasive testing can often sort out what is really going on.
Ask the doctor: Heart risks of breast cancer treatment
Radiation and chemotherapy can damage heart structures and lead to heart attacks or other cardiac problems later on. Baseline imaging tests before treatment starts may help doctors monitor heart changes.
Rethinking alcohol use and heart disease
Light to moderate drinking has long been heralded as heart-healthy, but evidence for this link is weak. New research on how genes affect alcohol use and heart disease has added to the understanding of this issue.
What's new with the LVAD?
A left ventricular assist device (LVAD) is a battery-driven pump implanted in the chest to support the pumping action of the heart's ventricles. The rapidly evolving device has become a valuable asset in treating people severely ill with heart failure.
Blood pressure drugs with bonus benefits
Two classes of drugs, ACE inhibitors and angiotensin-receptor blockers (ARBs), are the first-line choices for lowering blood pressure in people with diabetes. They also lower heart failure risk and slow the progression of kidney disease.
Halt heart disease with a plant-based, oil-free diet
A low-fat vegan diet appears to halt or reverse heart disease. But this strict diet may be tough to follow. A more lenient eating pattern, such as the Mediterranean diet, appears to be very beneficial and easier to follow.
Testosterone therapy may not be as safe as once thought
Some men use testosterone products to offset the decline in muscle strength and stamina that occurs with age. Recent reports of blood clots in men using the drug are leading doctors to re-examine its safety.
What happens when heart drug refills look different?
Heart attack survivors who are prescribed generic medications are more likely to stop taking them if their refill pills are a different shape or color.
FDA approves another device to replace aortic valve without surgery
The FDA has approved another device, the CoreValve system, to replace a diseased aortic valve without the need for open-heart surgery.
High blood pressure in midlife linked to brain decline
People who had high blood pressure in middle age showed greater declines in memory and thinking skills over a 20-year period compared with people who maintained normal blood pressure.
Exercise is still the best medicine
Better medicines and safer procedures have contributed to the increase in longevity, but exercise may be the key ingredient in the mixture that allows some people to not only survive but also thrive in later life.
Ask the doctor: Different ways to do echocardiograms
Echocardiograms create still and moving images of your heart. The probe is typically used on the outside of the chest, but sometimes the probe is put on a flexible tube passed down the esophagus to get a clearer picture of the heart's valves.
Ask the doctor: Tracking down the possible causes of fainting
Heart problems that can cause people to faint include an abnormally fast or irregular heartbeat (arrhythmia) or a heart valve problem.
Treating gum disease: Save your smile, help your heart?
Gum disease, which happens when sticky, bacteria-laden film builds up and hardens around the teeth, has been linked to cardiovascular disease.
Treating narrowed arteries in the neck
The buildup of plaque deposits in the carotid arteries of the neck can block blood flow to the brain and cause a stroke. The arteries can be unclogged either with carotid endarterectomy surgery or placement of a stent.
For heart health, less salt makes the most sense
A high-sodium diet can boost blood pressure, which may raise the risk of heart attack and stroke. Experts recommend that people limit their daily sodium intake to 1,500 milligrams.
Beyond statins: Assessing the alternatives
For people who experience side effects from statins or need additional medications to achieve healthy cholesterol levels, non-statin drugs may be an option.
Pregnancy complications may herald heart disease after menopause
A miscarriage, stillbirth, or problems during pregnancy like high blood pressure or diabetes may signal hidden cardiovascular vulnerabilities later in life.
Probiotics may lower blood pressure
Probiotics are the live bacteria that can be found in yogurt, fermented foods, milk and soy products, and dietary supplements.
Chiropractic neck adjustments linked to stroke
Quick, thrusting movements done to ease neck pain-known as cervical manipulative therapy-have been linked to tears in the arteries of the neck.
Long-detection interval for ICDs helps avoid harmful shocks
Electronic devices called implantable cardioverter-defibrillators (ICDs) detect and terminate irregular beats in the heart's lower chambers.
Top 10 cardiovascular advances of 2014
In 2014, the top 10 advances to treat and prevent heart disease and stroke include novel drugs and procedures, as well as improvements in and newfound benefits from existing treatments to address cardiovascular problems and related risks.
Ask the doctor: When your heart "skips" a beat
Premature ventricular contractions happen when one of the heart's lower chambers (ventricles) contracts early. This common, usually harmless condition is often described as feeling as though the heart has skipped a beat.
Ask the doctor: Understanding the different types of aneurysms
An aortic aneurysm is a weakened area in the aorta, the vessel that travels from the heart through the torso. Most aortic aneurysms occur in the abdominal area, but about 25% occur in the chest and are called thoracic aortic aneurysms.
Improving heart health is also good for your brain
Everything that is unhealthy for your blood vessels and heart has also been linked to memory and thinking problems. Your brain will appreciate the heart-healthy steps you take to better your diet, exercise more, and reduce stress.
Eating fish linked to fewer heart attacks
Salmon, tuna, and other fatty fish contain omega-3 fatty acids, which may help prevent blood clots, stabilize dangerous heart rhythms, and lower blood pressure.
How to choose and use a heart rate monitor
Heart rate monitors help people exercise at the right intensity, allowing them to safely reach their fitness goals.
Adjusting your blood pressure medicines at home
Many people with diabetes can successfully tailor drug dosages according to daily measurements. A similar strategy for self-regulating high blood pressure drugs may produce good results for some people.
The evolution of artery-opening stents
The tiny wire-mesh tubes called stents that prop open arteries cleared during an angioplasty have improved a great deal in the past 30 years.
Better outcomes with generic statins
People prescribed a generic statin may be more likely to take their pills and have better outcomes than people prescribed a brand-name statin.
Clogged arteries in the legs? It may run in the family
People with a parent or sibling with peripheral artery disease are nearly twice as likely to develop the painful leg condition as people with no family history of the disease.
Potassium-rich foods linked to lower stroke risk
Eating a potassium-rich diet may decrease the risk of having an ischemic stroke, which is caused by a blood clot blocking an artery in the brain.
Resolution: Eat your way to a healthy heart
A heart-healthy diet is low in salt and saturated fats and high in soluble fiber and nutrients. Making heart-healthy changes to your diet is easy if you make one change a month.
Ask the doctor: Sleep apnea and heart risk?
Sleep apnea may cause or aggravate heart disease by creating surges of adrenaline, which likely contribute to high blood pressure and strain the cardiovascular system.
Ask the doctor: Should I try one of the new blood thinners?
Although new blood thinners such as dabigatran (Pradaxa) and rivaroxaban (Xarelto) do not require regular monitoring, people who manage well on warfarin may want to stay on warfarin until additional information on these new drugs becomes available.
Chest pain could be aortic valve disease
People with aortic stenosis eventually need to have the aortic valve replaced. Whether it is done before or after symptoms appear depends on whether the goal is to prevent sudden death (a common consequence of aortic stenosis) or preserve quality of life.
New wireless defibrillator approved
The new wireless implantable cardioverter-defibrillator will likely be useful for people at risk for a life-threatening arrhythmia who do not need the device to pace a slow or fast heart rhythm.
Is angioplasty right for you?
Although nearly 80% of people who undergo angioplasty and stenting discuss the procedure with their doctor, less than 20% are told about possible drawbacks, and only 10% are told about other options.
ACE inhibitors after bypass surgery
Angiotensin-converting enzyme (ACE) inhibitors are important to the length and quality of life in people with heart disease or hypertension. Doctors do not agree on the value of these drugs in people undergoing bypass surgery.
Heart Advances from Harvard: Overall health may determine survival after cardiac arrest
The health of a person with a sudden cardiac arrest who is admitted to a hospital through the emergency department may be as important to the outcome as the quality of care the person receives.
Heart Advances from Harvard: Blood type associated with risk
Type O blood is associated with the lowest risk of coronary artery disease. People with type A, B, and AB have risks 5%, 10%, and 23% higher than those with type O, respectively.
Heart Advances from Harvard: Restless legs syndrome and coronary artery disease risk
Restless legs syndrome lasting more than three years appears to increase the risk of developing coronary artery disease in women.
Our concept of heart attack is changing
Diagnosing a heart attack requires a blood test for troponin, plus symptoms or evidence of heart attack on an ECG or imaging test. There are six different types of heart attack, each of which may be treated differently.
Ask the doctor: What does my doctor mean by "clearance for surgery"?
Cataract surgery puts very little strain on the heart. In the absence of symptoms of heart disease, the cardiovascular risks of cataract surgery are low.
Ask the doctors: Can I stop taking antiplatelet drugs to have my hip replaced?
For people with stents who need elective surgery, it's safest to take antiplatelet therapy for six to 12 months before stopping it in order to have an operation.
New approach to fighting heart disease
When lowering traditional risk factors fails to prevent a heart attack or stroke, targeting inflammation may help. Two clinical trials are beginning to test whether anti-inflammatory drugs can provide additional protection.
Aortic aneurysm: a potential killer
Fatty deposits in the aorta can cause this blood vessel to bulge outward, causing an abdominal aortic aneurysm, which can weaken and burst, usually without warning.
How sleep apnea affects the heart
In the sleep disorder called sleep apnea, sleep is interrupted many times a night. Sleep apnea appears to increase the risk of developing or dying from heart disease. Several treatments are available to halt sleep apnea and restore better sleep.
Can you die of a broken heart?
In people at risk for heart disease, the stress of losing a loved one greatly increases the risk of suffering a fatal or nonfatal heart attack. In healthy people, the stress can cause a serious but reversible condition that imitates a heart attack.
Some heart attacks go unrecognized
More than one-third of heart attacks produce no symptoms, yet these so-called silent heart attacks are as dangerous as heart attacks that do cause symptoms.
Heart Advances from Harvard: Risk factors for peripheral artery disease pinpointed
Type 2 diabetes, high blood pressure, past or current smoking, and high cholesterol are the four factors most closely associated with the development of peripheral artery disease-blockages in the arteries of the legs or arms.
Heart Beat: Aspirin may prevent blood clots in the legs from recurring
Blood clots in the legs are treated with several months of warfarin (Coumadin). After this period, low-dose aspirin may be a reasonable alternative to long-term use of warfarin for preventing another blood clot.
Should bypass surgery be done off-pump?
Anyone at risk for complications from the heart-lung machine during open-heart surgery should have the procedure performed without it, or "off-pump." For everyone else, whether or not to use the pump should be left up to the surgeon.
Ask the doctors: Why do I need to take blood thinners after a valve replacement?
After receiving a bioprosthetic heart valve, using warfarin for three to six months can lower the risk of a blood clot without increasing the risk of unwanted bleeding.
Ask the doctors: Is interval training safe for someone with heart disease?
High-intensity interval training offers an excellent cardiovascular workout. Anyone with heart disease who has not been very active and wants to try this approach should have a stress test first.
What we need: geriatric cardiology
Cardiologists lack evidence on how to treat older people with heart disease, who often take many medications and have other medical problems. This creates uncertainty about the risks versus the benefits of conventional treatments.
New thinking about stable heart disease
People with stable heart disease are at low risk for heart attack and may not need invasive treatment until significant chest pain is no longer relieved by medication.
Coming soon: many drugs in one pill
A pill that contains several different heart medications is being investigated as a way to help people take the medicines they need.
Don't ignore "mild" strokes
Strokes that produce only mild symptoms still damage brain cells. The accumulated damage from several mild strokes may be harmful and irreversible. Anyone who experiences the symptoms of stroke, no matter how mild, should call 911.
Generics as safe as brand-name drugs
Problems in manufacturing occasionally occur with both generic and brand-name drugs. FDA protocols enable problems to be caught quickly and remedied immediately.
Smoking interferes with bypasses
Smoking adversely affects the quality of leg veins used to bypass blockages in the heart's arteries, increasing the risk of graft failure.
Heart Advances from Harvard: Daily multivitamins do not prevent heart disease
Taking a daily multivitamin does not reduce the rate of heart attack, stroke, heart failure, revascularization, or death. It may lower the risk of cancer by 8%.
Heart Beat: ECG? There's an app for that!
People with heart disease will soon be able to transmit information about their heart rhythm to their doctor's office using an iPhone app.
Heart Beat: Diet matters after a heart attack
Eating a heart-healthy diet after a heart attack or stroke can dramatically lower the risk of having a fatal or nonfatal second heart attack or stroke, or developing heart failure.
Heart Beat: Smoking raises the risk of sudden death in women
Light-to-moderate smoking doubles the risk of sudden death in women. In women with heart disease, quitting smoking lowers the risk to that of nonsmokers in 15 to 20 years.
Bypass best for people with diabetes
People with diabetes often need a procedure to improve blood flow and avoid a heart attack. Those who undergo bypass surgery tend to live longer and are less likely to have a heart attack than those who undergo angioplasty.
Ask the doctors: Can a low magnesium level cause an arrhythmia?
Low magnesium levels can trigger the development of abnormal heart rhythms such as atrial fibrillation. Proper magnesium levels can be restored by taking magnesium supplements or eliminating a cause such as excessive alcohol use.
Ask the doctors: What can I do about varicose veins?
Varicose veins are not dangerous, but can cause legs to ache. Treatment options include compression stockings, lifestyle changes, surgical removal of the veins, and sealing them off from the circulation.
Building a better stent
Researchers continue to try new ways to prevent stents from clogging with cells from the artery wall or from attracting blood clots. Their goal is to develop a stent that can be used in any person to prevent a heart attack.
Advice on using painkillers safely
To minimize the risk of heart attack, people with heart disease who need a nonsteroidal anti-inflammatory drug (NSAID) for pain relief should start with the lowest dose of the least risky NSAID (naproxen) for the shortest period of time possible.
Many treatment choices for leg pain
Fatty blockages in the leg arteries can cause pain in the thigh or calf muscle that occurs when walking and disappears with rest.
How thyroid hormone affects the heart
Too little thyroid hormone can interfere with the heart's pumping strength and raise cholesterol and blood pressure. Too much thyroid hormone can cause the heart to race and raises the risk of developing heart failure.
Digoxin useful … with restrictions
Although digoxin is commonly used in atrial fibrillation, it can increase the risk of death and should be used only in very low doses and as a second rate-control drug when a safer drug is not adequate.
Promising news about heart failure
Serelaxin, a new drug derived from hormones that cause muscle relaxation, appears to reduce the symptoms of heart failure, organ damage from poor blood flow, and heart failure deaths.
Tests to evaluate risk of heart attack
Diabetes increases the risk of developing heart disease. Among people with diabetes, a variety of imaging tests can be used to estimate the risk of having a heart attack or stroke.
Heart beat: An egg a day may be A-okay
In people without diabetes, an egg a day does not increase the risk of heart attack or stroke. In all people, eating eggs lowers the risk of hemorrhagic stroke.
Heart beat: Overeating? Blame fructose
Fructose may not signal the brain to stop eating when the stomach is full, which could make it easier to overeat. Since sugar is half fructose, this offers another reason to cut back consumption of sugar-sweetened beverages and other sugary foods.
Heart beat: Aspirin after heart attack or stroke
Aspirin reduces the risk of a second heart attack or stroke by 20%, yet doctors prescribe it for less than half the people who might benefit from it.
Heart beat: It's never too late to quit smoking
Smoking takes about 10 years off a lifespan. Quitting smoking at any age can replace some of those years.
Tests your doctor may order to determine whether you have heart disease
Two types of tests are used to diagnose heart disease and risk of heart attack. The first determines if a blockage in the heart's arteries is affecting blood flow. If the answer is yes, a second type is done to pinpoint the location of the blockage.
Ask the doctors: Do I need valve surgery?
A leaky mitral valve causes the heart to pump twice as much causing it to enlarge and weaken. When the heart's pumping chamber starts to enlarge, it's time to repair or replace the valve.
Ask the doctors: Should I worry about prediabetes?
Type 2 diabetes damages blood vessels. People with "prediabetes" can lower the risk of progressing to diabetes by exercising 30 minutes a day, losing 5% of their weight, and changing the way they eat.
What it means when your doctor says…"You have atrial fibrillation"
Atrial fibrillation is an irregular heartbeat that may also be fast. Medications can be used to control the heart rate, regulate the rhythm, stop uncomfortable symptoms, and prevent a blood clot that may cause a stroke.
Watch your weight and your waist: Extra pounds may mean heart disease
At any age, extra weight, especially in the belly, increases the risk of developing diabetes, heart disease, stroke, and death. Losing weight is difficult, but there are many things you can do to drop pounds and keep them off.
Managing your blood thinners
Problems with warfarin (Coumadin) are often due to human error. Ask your doctor to verify the strength before calling in your prescription. Make sure the refill is the correct dose.
Heart Advances from Harvard: RX for heart failure: coffee
Drinking two cups of coffee a day may protect against heart failure, likely by lowering the risk of high blood pressure and diabetes.
Heart Advances from Harvard: Antidepressants and arrhythmias
Examination of 11 antidepressants found that three (citalopram, amitriptyline, and escitalopram) may increase the risk of a potentially dangerous heart rhythm disturbance. No one with a history of arrhythmias should take these medications.
Heart beat: Free app predicts risk of heart attack
A new app can be customized with personal data to show heart risk and what you can do about it.
Heart beat: How CPR has changed
It isn't necessary to provide mouth-to-mouth breathing when doing CPR for someone who suddenly collapses. Chest compression alone may be better.
10 myths about heart disease
Believing outdated ideas about heart disease and its risk factors can be dangerous. Myth busting can help you plan the best path to a healthy heart.
Ask the doctors: What could a sharp pain in the upper back mean?
A tear in the aorta produces a sudden, sharp, extraordinary pain with a ripping sensation between the shoulder blades and down the back or in the front of the chest.
Ask the doctors: What's the relationship between blood pressure and knee pain?
Blood pressure can rise when activity levels drop. If your blood pressure was controlled until your activity level changed, increasing your activity may prevent the need for additional medication.
Ways to reduce your dependence on blood pressure medications
Many heart medications interact with certain foods, beverages, vitamins, dietary supplements, over-the-counter drugs, and other prescription medications, causing the heart drug to be more powerful or less effective.
Avoid these with heart medications
Chest pain caused by a heart attack is often described as a squeezing type of pressure that emerges slowly, rather than a sharp, quick pain. A heart attack may cause shortness of breath, sweating, nausea, lightheadedness, or loss of consciousness.
When a drug you take comes under fire
When a medication receives negative press, asking whether the drug caused the side effect, how many people it affected, and whether the side effect was worse than the disease the drug treats can help you weigh the drug's benefits against its risks.
How to prepare for a safe vacation
Before going on vacation, people with heart disease should make sure it's safe to fly and pack pertinent medical information and more than enough medications. Buying air ambulance or repatriation insurance before leaving home may also be wise.
Harvard Heart Advances: Weight gain after quitting smoking does not increase heart risk
Gaining weight after quitting smoking does not negate the benefits of quitting. One study showed a 50% drop in risk of fatal or non-fatal heart attack and stroke six years after quitting, regardless of weight gain.
Harvard Heart Advances: For best results, take your medications as prescribed
Faithfully taking blood pressure, cholesterol, and other heart medications as prescribed can reduce the risk of developing heart disease or its consequences. Taking these medications sporadically can increase the risk of heart attack or death.
Heart beat: Mental decline from arrhythmia
Atrial fibrillation, a common heart -rhythm disorder, may increase the risk of memory loss, a decline in thinking skills, or dementia.
Balancing bleeding vs. stroke risk when you have atrial fibrillation
Taking two kinds of blood thinners-anticoagulant and antiplatelet drugs-increases your risk of dangerous bleeding. But for some people with atrial fibrillation, the stroke-prevention benefit of this double therapy far outweighs the risk.
Ask the doctors: Is one heart test enough?
More testing doesn't always mean better care. Special tests such as nuclear imaging or cardiac ultrasound may be a good idea for people with certain worrisome symptoms or conditions.
Ask the doctors: Can surgery cause a heart attack?
Operations, even those that don't directly concern the heart, put people with heart disease at risk of heart-related complications.
Eat blueberries and strawberries three times per week
Eat a half cup of blueberries or strawberries three times each week. It's nutritious-and it may very well lower your risk of heart attack, a study of young and middle-aged women suggests.
Bypass or angioplasty with stenting: How do you choose?
Bypass surgery is considered the best treatment when all three coronary arteries are blocked. It's usually the best choice when the most important of the three arteries is blocked.
Sleep problems may increase the risk of heart attack and stroke
Poor sleep is linked to poor heart health. That goes double for people with sleep apnea, who stop breathing many times during the night.
Best medicine: The science of exercise shows benefits beyond weight loss
Exercise isn't all about weight loss. Researchers studying the effects of exercise find that it affects the body down to the subcellular level.
More evidence red meat may be bad for your heart
Meat eaters should be careful about taking L-carnitine supplements, new research suggests.
Harvard Heart Advances: Old hearts made young by natural substance
Harvard researchers led by Harvard Heart Letter Co-editor in Chief Dr. Richard Lee have found a naturally occurring substance in the blood of young mice that rejuvenates the hearts of old mice.
Harvard Heart Advances: Had problems with statins? Try them again.
Statin drugs are very good at lowering cholesterol, but side effects such as muscle weakness or muscle pain can make the drugs hard to tolerate. Fortunately, there are several statin drugs on the market.
"Low salt" still the dietary rule
News reports that cutting back on salt (sodium) intake isn't helpful and may be harmful are misleading. They misinterpreted the results of an Institute of Medicine study.
Ask the doctor: Adding Plavix to Coumadin
Warfarin (Coumadin) belongs to the class of drugs called anticoagulants, which slow blood clotting. Clopidogrel (Plavix) belongs to another class of drugs called antiplatelet agents, which slow blood clotting in a different way.
Ask the doctor: The trouble with the body mass index
Body mass index (BMI) is easy to measure and is a good rough instrument for determining whether a person is overweight or obese. But it does not account for individual differences in body shape and muscularity.
Ask the doctor: Is warfarin plus aspirin safe?
People taking the anticoagulant drug warfarin (Coumadin) for atrial fibrillation may sometimes need to take a second type of anti-clotting drug-an antiplatelet drug such as aspirin. This dual therapy adds to bleeding risk, but lowers stroke risk.
How to lower your stroke risk
A few factors that boost the odds of having a stroke can't be changed, like age and family history. But there are a surprising number of things that can be done to prevent stroke.
Shortness of breath: A common reason for calling the doctor
Shortness of breath may signal a serious heart emergency. Know when it's time to call for help.
Too much sitting linked to heart attack and stroke-even if active
Sitting for long periods of time is bad for the heart, even among people who get recommended levels of daily physical activity.
What's more important than your life span? Your health span
Although a long life span is great goal, a long "health span" is even better.
Don't stop taking a medication if you experience an unpleasant reaction
If a medication causes troublesome side effects, it's important to talk with a health-care provider before stopping it.
Heart beat: Dietary vitamin E and heart failure
Men who consume the most vitamin E have an increased risk of heart failure, while those with the highest blood levels of vitamin C have a decreased heart-failure risk, an 11-year study of men age 60-79 finds
Heart beat: Thick air, thick arteries
People who live in parts of a city with high air pollution are at higher risk of stroke than residents of the same city living in less polluted areas.
Heart beat: Stroke: Every minute counts
When ischemic stroke strikes, time is of the essence. The sooner a person is treated with the clot-busting drug tPA, the sooner blood flow is restored to the brain and the better the odd of recovery.
How to talk with your kids when heart disease runs in the family
Family history of heart disease is one of the most powerful tools for guiding personal health decisions and motivating lifestyle change.
Ask the doctor: Beta blockers and alcohol
Alcohol can affect blood levels of beta blockers. If you drink alcohol in the evening and need a beta blocker, it's a good idea to take a once-daily beta blocker in the morning to avoid this effect.
Ask the doctor: Warfarin interactions
A long list of drugs and substances affect warfarin's blood-thinning effect. They may make the warfarin more or less effective. Or they may affect blood clotting in different ways that increase the risk of bleeding.
Angioplasty and stenting safe in smaller hospitals
Hospitals not equipped for heart surgery can perform diagnostic cardiac catheterization and balloon angioplasty as safely as hospitals that have heart surgeons standing by.
New alternatives to warfarin
New prescriptions for novel anticoagulants now outnumber new prescriptions for warfarin. The new drugs are safer and at least as effective. They may be the best initial therapy for atrial fibrillation, but those now doing well on warfarin need not switch.
First rule of dementia prevention: Take care of your heart
Many of the risk factors for heart disease are also risk factors for vascular cognitive impairment, which can lead to dementia. Controlling these risk factors can delay or prevent this kind of mental decline.
7 simple changes lower stroke risk
Real reductions in stroke risk are linked to improvements on the American Heart Association's "Life's Simple 7" health tool.
Research we're watching: Blood pressure high? Control LDL
High blood pressure (hypertension) affects 1 in 3 Americans, and doubles their risk of heart disease. More than 75% of people with hypertension also have high "bad" LDL cholesterol.
Research we're watching: Vitamin D, heart disease and race
Low vitamin D has been linked to heart disease. A new study suggests this may apply to whites but not blacks.
Research we're watching: Emergency Rx for major TIA
A minor stroke or serious transient ischemic attack (TIA) is often followed by a second, devastating stroke. Combination treatment with aspirin and clopidogrel (Plavix) given within 24 hours cuts stroke risk by one-third.
Make these better food choices for better heart health
When a family member develops a type of heart disease with a known genetic cause, all close family members should consider genetic testing.
Ask the doctor: Poor circulation in the legs
Leg pain with walking can indicate peripheral artery disease. A walking regimen and medication are usually the first steps in treating the condition.
Ask the doctor: High blood pressure in the doctor's office, but not at home
When blood pressure is normal measured at home but high when taken at the doctor's office, that indicates "white-coat hypertension." Undergoing 24-hour blood pressure monitoring may help make a correct diagnosis.
Prevent kidney disease to prevent heart disease
Adopting a heart-healthy diet doesn't necessarily mean drastic lifestyle change. Small dietary tweaks may suffice. Pick tasty substitutes for saturated fat, trans fat, sugar, sodium, and calories while increasing fiber and nutrient intake.
When to seek genetic testing for heart disease
Thickening of the heart-hypertrophic cardiomyopathy-is a genetic disease. People with a first-degree relative who has the disease have a 50-50 chance of having it, too. Family genetic testing is indicated, as early detection can prevent sudden death.
Tell your dentist about your heart problems
Although dental disease and heart disease share many of the same risk factors, the American Heart Association says there's no convincing evidence that dental disease causes heart disease. People with valve disorders need special dental care.
Research we're watching: Eat breakfast to lower heart risk
Regularly eating breakfast is associated with a 27% lower risk of heart attack or death from heart disease than skipping the first meal of the day.
Research we're watching: Belly fat linked to heart disease and cancer
Belly fat-fat accumulation around the internal organs, including the heart and arteries-increases risk of heart disease and cancer. Evidence suggests that this kind of fat emits disease-promoting chemical messengers.
Research we're watching: Protecting heart cells after heart attack
Blocking a molecule that inhibits an important heart gene helps prevent heart cells from dying after a heart attack.
Make peace with your prescriptions
Only 20% of people take their medications as prescribed. Cost and access are big parts of the problem, but people who understand their disease risks and make peace with their need for medication are more likely to take them as prescribed.
Ask the doctor: Vitamin E for the heart
Vitamin E was once recommended by doctors to prevent heart attacks, but the studies supporting that advice are contradicted by newer and better research. Vitamin E supplements are no longer recommended for prevention of either heart disease or cancer.
Ask the doctor: Smoking: cut back or cut it out?
It's important to quit smoking. It's not clear whether there's a benefit to merely cutting back on the number of cigarettes smoked. Smoking-cessation methods are most effective in the context of a comprehensive cessation program.
Don't skip cardiac rehab after a heart event
A cardiac rehabilitation center is a lot more than a gym. After a major heart event-or even before one happens-cardiac rehab is proven to decrease cardiac risk factors. Get it if your doctor advises it; ask about it if your doctor doesn't.
For a healthy brain, treat high blood pressure
Studies suggest that blood pressure-lowering drugs may do more than treat hypertension-they may also delay or prevent dementia. This isn't yet proven, but maintaining a healthy blood pressure and reducing other heart risks likely lowers dementia risk.
Aortic valve disease: Surgical or transcatheter replacement?
A stiff, poorly working aortic valve is a life-threatening condition. Open-heart surgery to replace the aortic valve is the gold standard. For some individuals less invasive transcatheter aortic valve replacement is an appropriate option.
8-step plan for heart-healthy holiday dinners
A heart-healthy plan for holiday meals includes snacking before the meal to reduce hunger, limiting appetizers, savoring each bite, and staying active.
Pacemaker safe after age 90
Pacemaker implantation does carry higher risks of complications and death for people over age 90 compared with those in their 70s-but the benefits may be well worth the risks.
Research we're watching: Fruit fights aortic aneurysms
People who eat more than two servings of fruit each day have a 25% lower risk of an abdominal aortic aneurysm (AAA) and a 43% lower risk of having a ruptured AAA than people who eat the least fruit, a Swedish study suggests.
Research we're watching: Obese teens' hearts in trouble
Using a newly developed cardiac MRI technique, Harvard researchers found that obese teens' hearts already are undergoing changes that if left untreated will lead to irreversible heart damage and ultimate heart failure.
Research we're watching: From the cutting edge: Patch heals heart
A bioengineered collagen patch allows the heart to do something it can't do by itself: regenerate heart muscle killed by a heart attack. It works in mouse studies, and may in the future be used to deliver stem cells or medicines directly to the heart.
Treat depression, help the heart
Depression is common in people with heart disease. It puts them at higher risk of death-yet it's often unrecognized. People with heart disease, and their families, should be aware of depression warning signs and seek medical evaluation if they appear.
Ask the doctor: Yearly stress test
Stress tests used to be part of routine check-ups for middle-aged and older people. But practice has changed.
Ask the doctor: Borderline high blood pressure
People with mild high blood pressure may be able to avoid taking medication by making lifestyle changes such as cutting back on salt, losing 5 to 10 pounds, and drinking less alcohol. If medication is needed, these changes add to its benefit.
Living with AFib
People with atrial fibrillation are at high risk of stroke and may need a blood thinner to prevent clots. Treatment may also include medications or procedures such as pulmonary vein ablation or left atrial appendage closure.
Exercise: 15 minutes a day ups lifespan by 3 years
Just 15 minutes of physical activity a day can increase your life span by as much as three years. The benefits increase with each added minute of activity.
Get Started: Medication management for CAD
Learning about heart medicines and remembering to take them on schedule can be daunting. Get support from a doctor's office, pharmacy, family, and friends. It may help to use new tools such as smartphone apps and smart pillboxes.
Get a heart monitor
People with heart disease who are otherwise fit may want to maximize the benefit they get from exercise. The best way to do this is to use a heart monitor to ensure workouts in the optimal heart rate zone.
Emotional stress induced ischemia
Mental or emotional stress can cause inadequate blood flow to the heart that may increase heart attack risk. Learning to cope with stress is the best first option; some people may benefit from antidepressants or other drugs.
Research we're watching: No heart risk-or benefit-from diabetes drug Onglyza
In the largest and most comprehensive study of the heart effects of a diabetes drug, the blood sugar-lowering drug saxagliptin (Onglyza) showed no benefit in protecting against heart disease or stroke. Importantly, the drug also did not increase cardiovas
Research we're watching: Longer life after heart attack
Adopting a healthy diet improves survival after a heart attack. A Harvard study found that the one-fifth of heart attack survivors whose diets most improved had a 24% lower chance of all-cause death and a 26% lower chance of heart-related death.
Research we're watching: Arsenic and heart disease
A 20-year study of Native Americans suggests that low-to-moderate consumption of inorganic arsenic is a risk factor for cardiovascular disease.
You could be one in a million
Dr. Thomas Lee, the editor in chief of the Harvard Heart Letter, introduces an issue focused on the Million Hearts initiative, which aims to reduce heart disease.
CDC director explains simple steps to saving lives
The director of the Centers for Disease Control and Prevention discusses the goals of the Million Hearts initiative.
Daily aspirin prevents dangerous clots
For people who have had a heart attack or are at risk of having one, a daily aspirin can be an effective prevention measure.
Why blood pressure matters so much
Blood pressure gets so much attention because uncontrolled hypertension is a significant risk factor for heart attacks and strokes.
Keys to managing your cholesterol
Managing cholesterol involves more than just changing eating habits.
Zero exposure is the only safe bet with smoking
Smoking just a few cigarettes a day carries as much heart disease risk as smoking a pack a day, and secondhand smoke exposes nonsmokers to risk as well.
Developing healthful eating habits is not so hard
Fruits and vegetables provide a foundation for healthy eating.
Increasing activity can be a walk in the park
Adding regular physical activity to your daily routine is easier than you might think.
What are your barriers to exercise?
Million Hearts' national initiatives help you help yourself
Changes in health care laws and policies are aimed at helping people make choices that can improve their health.
Weight loss: Fewer calories in, more calories out
The key components of weight loss are taking in fewer calories and, through physical activity, burning more calories than consumed.
Weight loss turns back the clock on heart disease
A reduction in body mass index could offset age-related increase in heart disease risk.
On the horizon: An ultrasound device barely bigger than a smartphone
A pocket-sized ultrasound device could give doctors more flexibility in monitoring patient progress.
On the horizon: Signaling the brain to lower blood pressure
A pacemaker-like device may provide help to people who are unable to control their blood pressure through standard treatments.
Ask the doctor: Which type of replacement valve should I get?
I am 77 years old, and my doctor recommended surgery to replace my aortic valve. He said my choice is between a mechanical valve and a pig valve. Which is the preferred option?
Ask the doctor: Should I switch to generic Lipitor?
After a heart attack six years ago, I went on Lipitor because my doctor said it was proven to reduce the risk of a second heart attack. Three years ago, I switched to a generic to save money. Now that Lipitor is going generic, should I switch back?
Medications help the heart - if you take them
Strategies for getting the most from medications include ensuring they are obtained at the lowest possible cost, and working with a doctor or pharmacist to minimize side effects.
Another warfarin alternative for stroke prevention in people with a-fib
Newly available medications offer alternatives to warfarin that are easier for some people to take.
No-surgery aortic valve replacement okay for some, not all
A less invasive procedure for replacing the aortic valve means a shorter hospital stay and recovery, but for now its availability is limited to those who are unable to undergo open-heart surgery.
Living with an implantable cardioverter-defibrillator
Understanding the function of an implanted cardioverter-defibrillator device, and its impact on the recipient's life, will better prepare potential recipients to live with one.
Heart Beat: Smart at Heart bridges the emotional and physical shores of heart health
A book by a Massachusetts General Hospital cardiologist presents a view of heart health that aims to merge its physical and emotional components.
Heart Beat: Fruit and veggie diet may offset genetic risk for heart disease
Certain genetic variations increase a person risk of heart disease, but eating a diet rich in vegetables and fruits can counter this risk.
Heart Beat: Clots can form in stents years after placement
Clots can form in stents years after placement.
Heart Beat: Psoriasis again linked to heart disease
Research suggests that people with psoriasis are more likely to experience some form of cardiovascular disease.
Follow-up: Treating cardiovascular risk factors also aids ED
Analysis of clinical trials supports the belief that men with ED who treat their cardiovascular risk factors will also experience improved erectile function.
Ask the doctor: Should I worry about low nighttime blood pressure?
My systolic blood pressure is high in the morning (about 165), but in the evening it drops to below 100. I am taking two blood pressure medications daily and still experiencing seriously low blood pressure at night. What would you suggest?
Ask the doctor: Are hot flashes linked to heart disease?
I am 76 years old and still get hot flashes. Is it true that women who have hot flashes many years after menopause are more likely to experience heart problems than those whose symptoms end early in menopause?
Three (more) cheers for statins
A study boosts support for the ability of statins to help clear arteries of plaque, while two others reaffirm the drugs' safety.
Teamwork in angioplasty-bypass decisions
Updated guidelines for using bypass surgery or angioplasty to treat blocked cardiac arteries emphasize collaboration between these treatment groups.
Fun and exergames: Not just for kids anymore
Video games that involve physical activity can be beneficial for people of all age groups and abilities.
HDL cholesterol: Is higher really better?
A cholesterol study found that lowering LDL with a statin was more beneficial than attempting to boost HDL with niacin.
Small step forward for stem cells, giant leaps remain
In a very small study, stem cells from heart tissue helped boost pumping power in the hearts of heart attack survivors.
Heart Beat: Fixing faulty heart rhythms may help kidneys filter better
Treating atrial fibrillation with ablation may improve kidney function as well.
Heart Beat: A direct drug hit with alteplase busts up leg clots
Blood thinners keep clots at bay, but a different medication delivered by catheter directly to the site of a leg vein clot could eradicate it altogether.
Heart Beat: New from Medicare: Free counseling for heart disease and obesity
Medicare recipients are eligible for counseling programs designed to help people prevent heart disease or deal with obesity.
Heart Beat: Which drugs work best for resistant high blood pressure?
Many people with resistant hypertension are not receiving the most effective combination of medications for the condition.
If heart attack victims have to wait to be transferred to another hospital for emergency angioplasty, the delay is life threatening.
Ask the doctor: Is an egg a day okay?
Can eggs be part of a balanced, heart-healthy diet?
Ask the doctor: Will exercising less vigorously fix my heart rhythm problem?
I'm a fit 61-year-old who had bypass surgery 15 years ago. Recently, I've been having rapid heartbeats (what my doctor calls supraventricular tachycardia) during or just after vigorous exercise. Should I tone down my exercise?
Overuse, underuse, and valuable use
Most doctors do not misuse the resources available to them, but the potential for overuse exists. Informed patients should be aware of this and be prepared to question the necessity of tests or treatments.
What's at the heart of fainting?
Most fainting is not connected to cardiovascular issues, but anyone who experiences a fainting episode should be examined by a doctor.
Tales of two heart failures
Incidence of heart failure is split about evenly between two types, in which the heart's muscle has either weakened or stiffened.
Blood clots: The good, the bad, and the deadly
Blood clots inside the body can be dangerous, especially if a clot blocks an artery, or forms in one location and then is carried through the bloodstream to a lung or the brain.
Gut microbes may affect heart disease risk
Researchers are exploring a possible link between microbes that live in the digestive system and the development of atherosclerotic plaque.
Heart Beat: No beef with beef if it's lean
Red meat can be an acceptable part of a healthy diet, as long as it is very lean and is eaten in small amounts along with fruits, vegetables, and whole grains.
Heart Beat: Stroke risk rises in people who are depressed
Researchers found that people with a history of depression were more likely to suffer a stroke compared to people who were not depressed.
Heart Beat: Radiation for breast cancer linked to narrowed heart arteries
Radiation therapy for breast cancer can lead to narrowed coronary arteries, particularly for women with left-sided breast cancer.
Ask the doctor: In search of the wholly healthy muffin
I see in-store promotions for low-fat muffins almost everywhere. Is there such a thing as a heart-healthy muffin?
Ask the doctor: Are testosterone and cholesterol levels related?
I am 70 years old, and since I started taking testosterone to boost below-normal levels of that hormone, my LDL and HDL levels have dropped. What's the cholesterol-testosterone connection?
Take the hassle out of taking warfarin
Frequent testing or home monitoring may be options to take the hassle out of taking warfarin.
Arm-to-arm variations in blood pressure may warrant attention
Arm-to-arm blood pressure variations may warrant attention.
Exercise protects the heart when diabetes threatens
Excercise protects the heart when diabetes threatens.
Angina in the intestines mirrors what happens in the heart
Angina in the intestines mirrors what happens in the heart.
The wake-up-call heart attack
The wake-up-call heart attack
Heart Beat: Heart attack risk soars soon after losing a loved one
Grief raises heart attack risk.
Heart Beat: Satisfaction with job, family, sex life, and self may help the heart
Satisfaction with life keeps heart healthy.
Heart Beat: No more routine liver tests for statin users
Routine liver tests for statin users nixed.
Heart Beat: Everyday foods are top sources of sodium
Everyday foods are top sodium sources; more.
Heart Beat: Hidden atrial fibrillation is a possible culprit in mystery strokes
Hidden atrial fibrillation is a possible culprit in mystery strokes.
Ask the doctor: Should I worry about my homocysteine level?
Should I worry about my homocysteine level?
Ask the doctor: Is diet soda good or bad?
Is diet soda good or bad?
MRI and pacemakers: A risky mix
Unless you have an MRI-friendly pacemaker, a CT scan may be safer.
Ask the doctors: Can radiation damage the lungs?
Can radiation damage the lungs?
Ask the doctors: Fainting while doing chin-ups?
Fainting while doing chin-ups?
Ask the doctors: High BP and diabetes?
High BP and diabetes?
Warfarin users, beware of antibiotics
Warfarin may interact to increase your risk of internal bleeding.
Losing weight may require trial and error
No weight-loss method works for every heart patient.
Omega-3 may not protect the heart
Expert adivce in favor of omega-3 supplementation is mixed.
Blood pressure drugs compared
ACE inhibitors beat ARBs hands-down for survival benefit.
Robotics help stroke survivors walk again
Sophisticated devices enhance traditional rehabilitation techniques.
Soft drinks found to increase stroke risk
Study implicates both diet and sugar-sweetened sodas.
Heart beat: Harvard researchers identify genetic cause for a form of cardiomyopathy
Researchers identify genetic cause for one form of cardiomyopathy.
Heart beat: Atherosclerosis growth process explained
Atherosclerosis growth process explained.
Heart treatment designed just for you
Biomarkers help individualize care for heart attack and heart failure.
Ask the doctors: How can I prevent another clot?
How can I prevent a blood clot?
Ask the doctors: Is it okay to discontinue warfarin?
Is it safe to stop warfarin?
Caution: Watch your radiation exposure
Radiation can add up overtime to an uhealthy amount from heart tests.
Breakthrough in aortic valve treatment
A nonsurgical in aortic valve treatment gains favor.
Avoid another hospital stay
Two simple factors can keep you out of the hospital or put you back in.
Yes to heartburn meds plus clopidogrel
Evidence that PPIs interfere with blood thinning is weak.
The art of refining heart risk prediction
When it comes to refining heart risk prediction, one model comes out the winner.
Pollution may shorten lifespan
Pollution may shorten your life after a heart attack.
Heart beat: Stop-smoking drug may be safe
Stop-smoking drug may be safe after all.
Heart beat: FDA approves third weight-loss drug
FDA approves another weight loss drug.
Heart beat: One reason for diabetes identified
One cause for diabetes found.
Cancer treatments may harm the heart
Radiation therapy and chemotherapy are increasing the number of people who survive cancer. But they also cause cardiovascular disease in some of the people who get these therapies.
Ask the doctors: Should I replace my ICD?
Elderly people with an implantable cardioverter-defibrillator that has never "fired" can consider having the device turned off.
Ask the doctors: Do I really need a statin?
I'm a little overweight, but my cholesterol numbers aren't bad. Do I really need the statin my doctor wants me to take?
When an implantable defibrillator fails
Implantable cardioverter-defibrillators can stop a potentially deadly heart rhythm and restore a healthy one. Repeated bending and flexing can cause their leads to fail. Replacement or removal is an option.
Resuming sex after a heart attack
New evidence-based recommendations from the American Heart Association answers questions about resuming sexual activity after a heart attack that many people (and their doctors) are too embarrassed to bring up.
Dual antiplatelet therapy after stenting
After angioplasty and stent placement, it may not be necessary to take aspirin plus Plavix-what's called dual antiplatelet therapy-for more than a year.
Women are at higher risk for stroke than men.
Women with heart disease or atrial fibrillation are more likely than men to have a stroke.
Measure blood pressure in both arms
It's a good idea to have your blood pressure measured in both arms every so often. A difference between the two readings of more than 10 points may indicate increased cardiovascular risk.
Heart beat: Bleeding risk with aspirin must be balanced against benefit
An aspirin a day has been shown to lower the risk of a first heart attack in men and a first stroke in women, but it also increases the risk of major bleeding in the digestive tract or brain.
Heart beat: Heart problems from Z-Pak
The antibiotic azithromycin sometimes can trigger abnormal heart rhythms. Though uncommon, it is more likely to happen to people with heart failure, diabetes, or a previous heart attack.
Heart beat: An Aingeal to watch over you
For people in the hospital, a miniature sensor attached to the torso can transmit vital information about the heart and breathing to doctors and nurses in the hospital.
Update on genetic testing for heart disease
Genetic testing is useful for determining if someone has inherited a condition caused by a problem with a single gene, like hypertrophic cardiomyopathy. But it can't yet add much to predicting who will have a heart attack.
Ask the doctors: Is a high potassium level bad?
Kidney disease and some medications, like ACE inhibitors and NSAIDs such as ibuprofen, can cause potassium levels to be high. It is almost impossible to achieve high potassium levels simply by eating foods rich in potassium.
Ask the doctors: Why did my heart rate slow down?
The combination of a beta blocker and digoxin to treat atrial fibrillation can cause the heart rate to slow too much. Most people need a resting heart rate in the 60s to 80s to feel well.
The dangers of pulmonary hypertension
Pulmonary arterial hypertension occurs when arteries that supply the lungs become stiff and thick. New treatments are extending life for people with this chronic condition.
When a clot interferes with blood flow
Blood clots that form in the legs (deep-vein thrombosis) or lungs (pulmonary embolism) can be painful, and even deadly. Prompt treatment and good follow-up can minimize the danger.
Viagra and Cialis for heart failure?
Drugs used to treat erectile dysfunction (Cialis, Levitra, and Viagra) may also help ease heart failure. These drugs cause arteries to relax, which could help a failing heart pump more effectively.
A pacemaker to prevent fainting
For people who faint because their heart rates suddenly plummet (a condition called cardioinhibitory syncope), a dual-chamber pacemaker has been shown to reduce fainting episodes by 57%.
Use food to hold off vascular damage
Antioxidants from food-not from pills-can protect arteries and other tissues from damage caused by highly reactive compounds created when oxygen combines with other molecules. Colorful fruits and vegetables are great sources of antioxidants.
High HDL may not protect the heart
People with naturally high levels of protective HDL cholesterol have lower rates of cardiovascular disease. New studies suggest that boosting low HDL with medication may not pay off as much as lowering harmful LDL cholesterol.
The promise of a total artificial heart
A growing number of people with failing hearts are being given total artificial hearts as they wait for donor hearts to become available.
Heartbeat: New cholesterol drug is promising
Adding an investigational new drug called AMD 145 to a statin dramatically lowers levels of harmful LDL cholesterol.
Heartbeat: Heart attack accelerates plaque
A heart attack or stroke triggers an immune response that boosts inflammation and speeds the development of atherosclerosis in artery walls. This may explain why heart attack or stroke victims are at risk for repeat events.
Heartbeat: Drug-eluting stents being misused
Many people who don't need a drug-eluting stent during angioplasty get one anyway. More appropriate use would save $200 million a year in the cost of the stents plus the medications that must be taken afterwards.
Treatments for heart failure
Medications and devices can help many people with heart failure with low ventricular ejection fraction live longer with a better quality of life. But not all therapies are right for everyone, and treatment must be individualized.
Ask the doctors: Do I have heart disease?
Developing chest pain while taking an exercise stress test is worrisome.
Ask the doctors: Could I have serious kidney damage?
An increasing creatinine level could indicate problems controlling diabetes and blood pressure. Measuring the kidneys' glomerular filtration rate offers helpful information.
When should we treat blood pressure?
In addition to blood pressure, doctors are now considering all factors that increase an individual's cardiovascular risk as a guide to whether to begin antihypertension medications.
Carotid stenosis treatments compared
The surgical procedures known as endarterectomy and noninvasive stenting are equally safe and effective treatments for preventing stroke in people with blocked or narrowed carotid arteries.
Women: Cardiac rehab key to recovery
Women are less likely than men to take advantage of cardiac rehabilitation after a heart attack, bypass surgery, or angioplasty even though women benefit more from it.
Muscle aches and pains from statin use
People who take statins without experiencing muscle pain or discomfort do not need regular blood tests to check for muscle damage. Anyone who takes a statin and experiences severe muscle pain and weakness, however, should seek medical help immediately.
New devices compensate for foot drop
When stroke causes a person to have trouble lifting or moving a foot (foot drop), two new devices can help. Both stimulate the peroneal nerve so the weak foot lifts, rather than drags.
Aspirin not effective in some people
When people who take aspirin suffer a heart attack or stroke, they are said to be aspirin-resistant. But this condition is rare, and most cases can be attributed to failure to take aspirin as prescribed.
Heart-healthy menu choices now clear
The American Heart Association's "Heart-Check" menu symbol ensures that an entree or meal meets specific requirements for calories, cholesterol, saturated fat, trans fats, and sodium.
Heart advances from Harvard: Fat that's bad for the heart, brain
Women who eat a diet high in saturated fat are more likely to develop memory loss and thinking problems than those who eat more monounsaturated and polyunsaturated fats.
Heart advances from Harvard: ER evaluation methods compared
Contrast-enhanced computed coronary tomographic angiography (CCTA), a noninvasive technology, accurately diagnosed or ruled out heart attack much faster than standard evaluation methods.
Heart advances from Harvard: Impact of inactivity assessed
Physical inactivity is responsible for 6% of coronary artery disease, 7% of diabetes, 10% of breast and colon cancers, and 9% of premature deaths worldwide. Increasing activity by 10% to 25% could prevent up to 1.3 million deaths per year.
Heart Beat: "Smart pill" won't let you forget to take your medications
About 50% of Americans don't take their medications properly. A new "smart" pill that reveals whether a medication has been taken as prescribed could improve medication taking.
Should you have stenting or bypass surgery?
Angioplasty and bypass surgery can both restore blood flow to the heart. Which one is better depends on factors like the location and severity of the blockages, symptoms, and heart function.
Ask the doctors: Should I get an LVAD?
A left ventricular assist device (LVAD) can greatly improve quality of life for people with heart failure who are too old for a heart transplant.
Ask the doctors: Do I have diabetes?
A high blood glucose level may signal increased risk of diabetes, but in the absence of common symptoms of diabetes, a hemoglobin A1c test may provide a more accurate diagnosis.
Vitamin D: Cardiac benefits uncertain
Low vitamin D levels have been linked to increased risk of cardiovascular events or death, but there's no evidence that taking vitamin D supplements offers protection. Vitamin D consumption should be limited to 600-800 international units a day.
Choosing a heart surgeon
Information on heart surgeons is widely available on the Internet. But a Harvard study shows that most consumers often do not correctly interpret the data the way they are presented.
Protect your heart with a flu shot
The influenza vaccine dramatically reduces the number of heart attacks and cardiovascular deaths. Anyone with heart disease should get a flu shot (not the nasal drops) every year.
Beware of "holiday heart syndrome"
Overdrinking, particularly binge drinking, can trigger the fast, erratic heart rhythm known as atrial fibrillation. Because this tends to occur during holiday celebrations, the condition is known as "holiday heart syndrome."
Unexplained shortness of breath
For unexplained shortness of breath, cardiopulmonary exercise testing may solve the mystery. Shortness of breath can often be eliminated or reduced with medical or surgical treatment, or cardiac or pulmonary rehabilitation.
Medications Management: Generic heart medications
Generic heart medications are equivalent to their brand-name versions and are safe for people with heart disease to use.
Heart Advances from Harvard: HDL and heart attack
High LDL cholesterol levels are known to increase the risk of heart attack, and lowering LDL levels has been proven to help protect against heart attack.
Heart Beat: Childhood abuse raises heart risk
Childhood abuse is bad enough on its own, and now it appears it may also increase the risk of developing cardiovascular disease earlier than usual.
Breakthrough in mitral valve treatment
New devices are enabling doctors to repair loose mitral valves without the need for open-heart surgery. Several devices are in development, and one of them, MitraClip, is now being tested in clinical trials in the United States.
Ask the doctors: Do I really need a statin?
The risk of heart complications in people with kidney disease may be reduced as much as 20% by lowering cholesterol with medications.
Ask the doctors: Can I have heart surgery while taking pain medication?
Addiction to pain medication makes it hard to monitor and manage pain after heart surgery.
Ask the doctors: Is it safe to stop taking my antiplatelet therapy?
In people who received a cardiac stent more than a year earlier, it is safe to stop clopidogrel use before elective surgery, and possibly permanently.
Stem cell therapy for heart disease
Researchers are aiming to find a way to repair damaged hearts with stem cells. Many uses for stem cell therapy are being pursued, but its future likely lies in the prevention and treatment of heart failure.
Treating resistant hypertension
When blood pressure remains high despite the use of three antihypertensive medications, additional medications need to be added until blood pressure responds. Restricting salt and increasing exercise may help.
Recovering from coronary bypass surgery
Five strategies can pave the way to a smooth recovery after bypass surgery: staying as active as possible before surgery, quitting smoking, eating a healthy diet full of protein, staying positive, and taking your heart medicines as prescribed.
Choosing options for life-sustaining care
For individuals with a serious disease like heart failure, making decisions in advance about life-sustaining measures and medical decision-making can help ensure their wishes are followed.
Green tea may lower heart disease risk
Green tea can significantly lower LDL cholesterol and triglycerides, and this may explain why green tea drinkers have a lower risk of coronary artery disease and death from heart disease and stroke.
Heart Advances from Harvard: Radial artery grafts prove durable
In coronary artery bypass grafting (CABG), the internal mammary (or thoracic) artery is the graft of choice for bypassing blockages in the main coronary artery, because it tends to remain open and functioning well for many years.
Heart Advances from Harvard: Potential cure for type 1 diabetes
A study conducted at Massachusetts General Hospital has confirmed that a vaccine designed to raise levels of tumor necrosis factor (TNF) temporarily restores insulin secretion in people with type 1 diabetes.
Heart Advances from Harvard: CABG vs angioplasty in kidney disease
Older people with chronic kidney disease often develop heart disease, since atherosclerosis can affect the arteries of both organs.
Top five habits that harm the heart
Five poor heart habits are responsible for the majority of heart disease, but their opposite, healthy behaviors can help protect the heart and improve overall health.
Conversation with an expert: Plavix: What you need to know
Dr. Patrick O'Gara, a member of the Health Letter's editorial board, talks about safety issues regarding the use of Plavix after angioplasty.
Tiny pumps can help when heart failure advances
A ventricular assist device helps boost the heart's pumping capacity in people with advanced heart failure, allowing them to resume some normal mobility and activities.
On the horizon: Squeezing the arm to protect the heart
Preconditioning the heart by using a blood pressure cuff to halt and release blood flow could protect heart muscle during surgery or a heart attack.
On the horizon: Exercise at rest - no longer an oxymoron?
A bedlike device that shakes the body head-to-toe stimulates blood vessels and improves blood flow, which may benefit people with heart failure who have difficulty exercising.
On the horizon: Nanoburrs seek, heal injury in artery
Microscopic particles that contain medication could one day be used to repair damaged arteries.
On the horizon: A pacemaker to lower blood pressure
People who are unable to control their high blood pressure through diet, exercise, and medication may benefit from a pacemaker-like device that stimulates the body's sensors for regulating blood pressure.
On the horizon: An ICD that works without wires
A new type of implantable cardioverter-defibrillator that works without wires may be an option for younger people living with heart rhythm problems.
On the horizon: Removing fat makes HDL ("good cholesterol") even better
A process called delipidation, in which cholesterol and fats are removed from HDL particles that are then returned to a person's bloodstream, stimulates the HDL to attack cholesterol in blood vessels more effectively.
Ask the doctor: Do I really need surgery to fix my aortic valve?
I have had a leaking aortic valve for many years. I get an echocardiogram every six months. After the latest one, my doctor told me that my heart was enlarging. He wants me to have surgery to replace the valve. Should I do this at age 68?
Ask the doctor: Racing heart and pneumonia
When someone has pneumonia, is it common for the heart rate to fluctuate wildly?
Ask the doctor: Is 10,000 steps a day a good target for an older person?
My daughter gave me a pedometer and told me to walk 10,000 steps a day. When I wore it for a while, I realized I was taking only about 3,000 steps a day. Is 10,000 a realistic number for someone my age (70 years)?
Acetaminophen may boost blood pressure
A small Swiss study found that daily use of acetaminophen can cause an increase in blood pressure, which is of concern to people with cardiovascular disease.
Magnesium helps the heart keep its mettle
Magnesium is essential to the body's proper functioning, but most people don't get enough of it. A healthy diet and a vitamin-mineral supplement should provide the necessary amount.
Protect your heart during dental work
In the past, people taking an antiplatelet medication were usually told to stop taking it temporarily before dental surgery, but doing so may increase the risk of a heart attack or stroke in the weeks following the procedure.
Coping with shortness of breath
Chronic shortness of breath is a common adjunct to heart disease. Researchers have formulated new guidelines to identify and treat this condition in those who suffer from it.
New drug offers warfarin alternative for atrial fibrillation
People who take the blood thinner warfarin have a new option, Pradaxa, which is not affected by diet and does not require its dosage to be fine-tuned.
Heart Beat: Taking the myth (and, alas, some of the romance) out of chocolate and the heart
Everyone wants to believe that eating chocolate will offer some protection to the heart and arteries, but so far the mdeical evidence to support this idea isn't there.
Brief updates on coughing as a side effect of a type of blood pressure medication, waist circumference as an indicator of longevity, and a possible correlation between multiple miscarriages and increased risk of heart attack.
Ask the doctor: Could a sudden gain in weight be caused by hot weather?
At 80 I am in relatively good health. During a period of extreme heat this summer, my ankles were more swollen than usual, and my weight jumped three pounds in just two days. Was that because of the heat, or did salt have something to do with it?
Ask the doctor: How much psyllium is needed to lower cholesterol?
What amount of psyllium should I take each day to lower cholesterol?
Ask the doctor: Could getting a pacemaker have damaged my vagus nerve?
I recently had a pacemaker implanted. While the process was going on, I felt a pulsation. I still feel it months later. My primary care doctor thinks that my vagus nerve could have been damaged when the pacemaker was implanted. Is that possible?
Ask the doctor: Is it okay to have an MRI after getting a stent?
I needed angioplasty in 2007 and had a stent implanted during the procedure. Due to another health problem, my doctor now wants me to have an MRI. Could this cause any problem with the stent?
11 ways to prevent stroke
Some risk factors for stroke, such as family history and ethnicity, cannot be changed, but attention to factors like weight, blood pressure, cholesterol, and physical activity can significantly reduce stroke risk.
Fish oil questioned as treatment for heart disease
Results of several studies suggest that taking fish oil does not benefit people who already have some form of heart disease, but eating fish is still likely to offer health benefits to most people.
Hybrid heart surgery expands options
People who need more than one type of heart procedure may be able to have them done in a hybrid operating suite, reducing risk and some recovery times.
Transfusion and heart surgery: Only when needed
The practice of routinely giving blood transfusions to patients during and after heart surgery is being challenged by research findings.
Heart Beat: When stocks crash, heart attacks go up
Researchers correlated the stock market's woes in 2008 and 2009 with an increase in heart attacks.
Heart Beat: Eyelids as windows into the heart
Small, yellow skin lesions that develop on the eyelids may be an indicator of heart disease.
Heart Beat: Dual-chamber pacemaker helps heart failure
Combining a biventricular pacemaker and an implantable cardioverter-defibrillator may help prevent death from cardiac arrest better than the ICD alone.
Heart Beat: Stay lean, live longer
Despite studies that suggested those who gain weight with age might live longer, having a body mass index in the normal range still correlates with a lower death rate.
Heart Beat: Rheumatoid arthritis should heighten heart awareness
People with rheumatoid arthritis may be more likely to develop heart problems.
Ask the doctor: Why does my blood pressure rise in the afternoon?
I am a 50-year-old woman with newly diagnosed high blood pressure. My pressure seems to be normal in the morning, averaging 121/74, but in the afternoon the upper number is often in the 140s to 150s. Is this normal, especially while on a medication?
Ask the doctor: Is high potassium a problem?
You have written about low potassium in the blood and ways to improve it, but I never read about too much potassium in the blood. Can you tell me why it happens and what is done about it?
Same-day angioplasty feasible, safe
People who undergo an angioplasty typically stay in the hospital overnight, but at some hospitals patients who meet strict criteria are now being allowed to go home the same day.
Long-term look at aneurysm repair
A study comparing the two methods of repairing an abdominal aortic aneurysm found differences in survival rates after the first month, but after several years survival rates for both groups were approximately the same.
Study suggests caution on statins after a bleeding stroke
People who take a statin after a hemorrhagic stroke may be at a slightly higher risk of having another stroke, but this potential risk may be outweighed by the protection against heart attack provided by a statin.
Hypertrophic cardiomyopathy: Optimism tinged with caution
Hypertrophic cardiomyopathy is a thickening of the heart's inner dividing wall that can weaken the heart's ability to pump blood effectively. Though its effects vary considerably, many people are able to live normally with the condition.
Heart Beat: Family matters: Your parents' heart health affects yours
Research suggests that a family history of heart attack is another factor that should be considered in estimating a person's own heart attack risk.
Brief reports on temporary heart damage caused by running marathons, the effect of kidney disease on the necessary dose of warfarin, and a possible increased risk of heart trouble for women taking a breast cancer drug.
Ask the doctor: Are my blood pressure and heart rate changing normally during exercise?
Sometimes I walk while wearing my blood pressure cuff. At first my systolic blood pressure rises while my heart rate hardly changes. But when I start walking faster, my pressure stays steady while my heart rate increases to 110. Is this a normal pattern?
Ask the doctor: Does smoked fish contain omega-3 fats?
I like smoked salmon and kippered herring, and thought that eating them was good for me. But I read in another health newsletter that the smoking process destroys all the heart-healthy omega-3 fats. Is that true?
Ask the doctor: What is venous insufficiency?
I have been diagnosed with venous insufficiency. What does that mean?
Gloomy forecast on heart disease
The American Heart Association is predicting significant increases in heart disease among baby boomers, along with associated health care costs. Following better health habits can help prevent heart disease.
Let's put the "public" in public defibrillation
Many people are reluctant to use an emergency defibrillator to attempt to revive a person in cardiac arrest, but the instructions are clear and simple, and taking action could save a person's life.
Two-way street between erection problems and heart disease
Heart disease and erectile dysfunction are often related conditions. Instance of either should prompt a conversation with your doctor about the other, as well as lifestyle choices that can improve sexual function and cardiovascular health.
Hysterectomy linked to increase in heart disease
Women who have a hysterectomy, especially those under 50 who also have their ovaries removed, seem to be at increased risk of heart disease.
Pre-sports check-up can prevent sudden death among athletes
Young people who want to take part in athletic activities should have a pre-sports checkup to identify an potential conditions or irregularities that could lead to a sudden cardiac event.
Heart Beat: HDL function, not just amount, could affect artery health
Research suggests that some HDL cholesterol is stronger, enabling it to pull more cholesterol out of white blood cells.
Heart Beat: Recycling effort keeps hearts ticking
A program is collecting and donating medical goods, including pacemakers and other implanted devices, to people in less-developed countries who would not be able to afford them.
Heart Beat: Exercise to strengthen heart and muscles best for diabetes
Combining aerobic exercise and strength training is better for people with diabetes than either form of exercise alone.
Ask the doctor: Is it okay to drink alcohol if I have an implanted defibrillator?
You have said that alcohol can cause heart rhythm problems. I have an implanted defibrillator. Is it okay for me to drink alcohol?
Ask the doctor: Headache and stroke
I have heard that one symptom of a stroke is "the worst headache you can imagine." I recently had a migraine that was so much more painful than previous ones that I worried it was a stroke. Is there any way to tell a migraine from a "stroke headache"?
Cut salt - it won't affect your iodine intake
Concern about sodium intake has raised the question of whether cutting back on salt could put people in danger of not getting enough iodine, but this should not be a cause for concern.
Specialized care improves stroke survival
Care at a specialized center may provide a better chance of surviving a stroke, even if it requires extra travel time to reach.
Weight-loss surgery can help - and harm - the heart
Although weight-loss surgery benefits the body with improvements in blood pressure, blood sugar, and cholesterol levels, the procedure stresses the heart significantly, so this risk must be weighed if considering the surgery.
Who needs an implantable cardioverter-defibrillator?
Thousands of people receive implantable cardioverter-defibrillators each year, but not everyone who receives the device really needs it, and some people would be better off pursuing other treatment avenues.
Heart Beat: The shape of cardiovascular risk
Excess body fat, regardless of whether it is carried on the midsection or thighs, is bad for the heart and for overall health.
Heart Beat: Mediterranean-type diet can fix multiple problems
Eating a Mediterranean-style diet can help with a number of health issues.
Brief reports on hypertension statistics, a theory about why some people show more of an HDL cholesterol benefit from exercise than others, and more about the connection between depression and heart disease.
Ask the doctor: My defibrillator has never "fired." Should I keep it or have it taken out?
My doctors recommended I get a defibrillator as "insurance," but I have had it for eight years and it has never gone off. My doctor wants to put in a new battery. At age 86 I'd rather not. Could I just leave the device in place or have it taken out?
Ask the doctor: Is hip replacement surgery dangerous for my heart?
I am a 72-year-old with diabetes, and I need to have a hip replaced. Does my diabetes make this surgery too dangerous for my heart?
Ask the doctor: What is pericardial effusion?
My doctor told me I have pericardial effusion. I know it has something to do with fluid in the heart. Can you tell me more?
Ask the doctor: Why does my heart sometimes feel like it stops, then starts up again with a jerk?
I am 92 and have atrial fibrillation and high blood pressure, both controlled by medication. Every so often when I am relaxing after dinner, my heart feels like it stops and then starts up again with a jerk. Is this something I should worry about?
Surviving a heart attack: A success story
Heart attack survival rates are much higher than they were a few decades ago, thanks to greater awareness, new clot-busting drugs, and expanded access to specialized cardiac treatment centers.
Measuring blood pressure: Let a machine do it
Participants in a research trial who had their blood pressure taken by a machine had lower readings than those who had their pressure taken by a doctor.
New dietary guidelines offer sketch for healthy eating
The latest edition of the government's Dietary Guidelines for Americans tries to nudge people toward healthier eating habits and patterns.
Heart Beat: Another yellow light for calcium supplements
The debate over calcium supplements continues, with a new analysis suggesting that people who take them may have an increased risk of heart attack or stroke.
Heart Beat: Unexpected benefit for digoxin?
Researchers found that digoxin, a drug used to treat heart problems, may also be effective at preventing the growth of prostate cancer cells.
Heart Beat: Emotional control and the heart
A positive emotional outlook may lead to a lower risk of heart disease.
Heart Beat: Trends in high cholesterol and statin use
The effectiveness of statin drugs is contributing to a reduction in the number of Americans with high cholesterol.
Heart Beat: Heart-health questions stump many
A poll by the American Heart Association found that many people do not know some basic facts about heart health.
Further information about cardiac rehabilitation programs for people with heart disease and yoga as a way to reduce episodes of atrial fibrillation.
Ask the doctor: Would moving to a lower altitude help my heart rate?
I have bradycardia. I live at 5,765 feet - would moving to a lower altitude help my heart rate? Recent cardiac tests were normal. My cardiologist said I don't need a pacemaker, and to keep on doing what I've been doing. At age 85 I walk three miles a day.
Ask the doctor: Are advanced blood tests needed for coronary artery narrowing?
I had a stent put in at age 59. Thanks to diet, exercise, and medications, my cholesterol numbers are excellent. Recent tests showed ischemia and new blockages requiring two additional stents. Why do my arteries keep getting clogged despite my efforts?
Aiming for ideal improves heart health
The American Heart Association hopes that its definition of ideal cardiovascular health will encourage people to strive to be healthier.
Trial clouds use of niacin with a statin
A clinical trial of niacin in combination with a statin to lower cholesterol was stopped early because of safety concerns.
Update on aspirin
For people who have not had a heart attack, the question of whether or not to take a daily aspirin is a matter of weighing potential benefits against potential harm.
What's the best target for blood pressure when it is high?
Lowering blood pressure is a primary goal for those with hypertension, but if blood pressure goes too low in someone with high blood pressure, it can cause the heart to get overworked.
Sliding scale for LDL: How low should you go?
Research has lowered the target for the level of "bad" LDL cholesterol, but an individual's cardiovascular risk should factor into determining the appropriate target.
Heart Beat: Research continues to serve up heart perks for coffee drinkers
Evidence of coffee's cardiovascular benefits continues to accrue.
Heart Beat: "Just in case" artery scans offer little or no payoff, possible harm
Carotid ultrasound tests are not necessary or helpful for people who are in good health and not experiencing any warning signs of stroke risk.
Heart Beat: No connection between ARBs and cancer
The Food and Drug Administration has concluded that angiotensin-receptor blocker medications used to treat high blood pressure do not increase the risk of developing lung cancer.
Ask the doctor: Is swimming in cold water okay for my heart?
I love to swim in the ocean for 20 or 30 minutes. The water is cold (55? F) but I don't mind. I'm almost 80. I had my mitral valve repaired five years ago, and my heart rate is sometimes irregular. Are my cold-water swims okay for my heart?
Ask the doctor: Should I be taking a statin?
I had a heart attack three years ago at age 78. My doctor started me on lisinopril, carvedilol, and aspirin. My total cholesterol is 190, and my LDL is 128. Should I be taking a statin?
Ask the doctor: What should I do about high triglycerides?
On my last blood test, my triglycerides were 280. Should I be worried about that? My doctor wants me to start taking something called Lopid. Is there another solution?
COURAGE not followed by action
The results of the COURAGE trial were expected to change the attitude of doctors regarding angioplasty procedures, but it seems that this shift has not happened.
What to do when blood pressure resists control
Resistant hypertension can be brought down to a safer level, but it requires extra effort and careful attention.
Peripheral artery disease often goes untreated
Peripheral artery disease often goes untreated until it is too late, and research suggests that millions of people with peripheral artery disease are not taking the appropriate medications to control it.
Abundance of fructose not good for the liver, heart
A high intake of fructose, in foods like soda, pastries, and breakfast cereals, can lead to a buildup of fat in the liver, as well as an increase in bad cholesterol, blood pressure, and other factors that are bad for the heart.
Heart Beat: "Polypill" test raises questions
Researchers are still exploring the concept of a pill that combines aspirin, a statin, and two or more blood pressure medications.
Heart Beat: Caution advised on Chantix use
The FDA is warning people with heart disease that using Chantix to try to quit smoking increases their risk for cardiovascular problems.
Heart Beat: Another day in the sun for olive oil?
Another study promotes the heart-healthy virtues of olive oil, but it's also important to be mindful of the broader impact of diet on cardiovascular health.
Heart Beat: Failing hearts linked to broken bones
Researchers believe there may be a connection between heart failure and an increased incidence of broken bones.
Heart Beat: Pause in CPR before shock reduces survival
When pausing CPR before administering a shock from a defibrillator, the shortest possible pause will help increase the cardiac arrest victim's chances of survival.
Follow-up: Sodium/potassium ratio important for health
Most people now consume more sodium than potassium, but it should be the other way around. The ratio is important to heart health.
Ask the doctor: Do I need to take warfarin for occasional lone atrial fibrillation?
I'm 64 and have had lone atrial fibrillation for about a decade. My doctor wants me to take a blood thinner, but I'd rather not do this. Should I follow her recommendation? Also, is it possible that endurance-type exercise led to my atrial fibrillation?
Ask the doctor: How do I check my heart rate?
My doctor told me to check my heart rate when I feel certain symptoms, but I don't know how to do it? Can you explain?
Blood vessel disease linked to dementia
Blood vessel problems can have a significant effect on the health of the brain, including contributing to the development of dementia.
Angioplasty via wrist artery safe, effective
A trial found that using the wrist as a point of entry for angioplasty procedures is as safe and as effective as using the femoral artery.
The smartphone will see you now
Smarthpone apps assist in keeping track of personal health data, provide general information, offer emergency assistance, and more.
More to the story than alcohol = heart protection
Alcohol's benefits to cardiovascular health are well known, but even moderate consumption comes with an increased risk for a stroke.
Heart Beat: Nature trumps nurture for heart disease
According to a Swedish study, the influence of genes on the development of heart disease is stronger than environment.
Heart Beat: Water exercise safe for troubled hearts
Water exercise is beneficial and safe for those with heart disease.
Heart Beat: Repeat "zaps" often needed to stop atrial fibrillation
People with atrial fibrillation who undergo an ablation procedure may need two or more of the procedures to ease the arrhythmia.
Ask the doctor: Can exercise damage my pacemaker's wires?
I had a pacemaker implanted a few months ago. I am planning to join a gym, but I am afraid of damaging the wires with some of the presses and pull-down movements I would have to do to work out. Are there any exercises or movements I should avoid?
Ask the doctor: Compression stockings for a long-distance flight?
My 61-year-old mother plans to take a long plane trip. Her legs usually become swollen when she flies a long distance. Should she wear elastic stockings or take any other precautions so she doesn't develop a blood clot in her legs?
Ask the doctor: What accounts for wide swings in blood pressure?
My blood pressure has wide swings each day. It can go as high as 210/110, then fall to 100/50, tiring me. My doctor says I'm just a "reactive person." My diet is excellent, and I try to keep active. Could my adrenal glands have anything to do with this?
Ask the doctor: What is a good plan for serious heart failure?
My 69-year-old husband has had cardiomyopathy and diabetes for years. Lately his ankles are always swollen. At his last doctor visit, his cardiologist said his heart has leaky valves and his ejection fraction is 10%. What would be the best plan for him?
The hidden burden of high blood pressure
In addition to necessary changes in diet, activity, and the need to take medication, hypertension also takes a toll on life expectancy.
Can a hospital stay make you anemic?
Receiving hospital treatment for a heart attack may lead to anemia, due to the amount of blood taken for testing.
Don't delay if heart failure symptoms worsen
Paying attention to changes in your body can help prevent a recurrence of heart failure.
Latest thinking on a "cardioprotective" diet
Structuring a diet around types of foods rather than specific nutrients to eat or avoid is an easier way to practice healthy eating.
Heart Beat: Low-fat diets place third of three in cholesterol-lowering power
Low-fat diets are not as effective at lowering cholesterol compared to Mediterranean and portfolio diets.
Heart Beat: No need to stop aspirin, Plavix before tooth removal
Thanks to a change in dental procedure, people who take aspirin and Plavix to prevent clotting do not have to stop taking the drugs before oral surgery.
Heart Beat: Two-drug combo a good start for high BP
People who take a combination of two blood-pressure medications are more likely to get their pressure under control than those who take just one medication.
Heart Beat: Heart attack treatment happening faster
Hospitals have shortened the interval from when a person having a heart attack arrives to when angioplasty begins.
Heart Beat: Cholesterol level in middle age predicts length and quality of life
A decades-long study found that people who had a lower cholesterol reading at midlife lived an average of five years longer than their high-cholesterol counterparts.
Heart Beat: The race to high blood pressure
African-Americans with prehypertension are more likely to progress to full-fledged high blood pressure, and to do so sooner, than whites.
Further information about a breast cancer drug that may weaken the left ventricle.
Ask the doctor: Can stopping aspirin cause heart problems?
I've read that if you take aspirin every day, stopping it temporarily increases your chance of having a heart attack more than if you had never taken aspirin. Is that true? If I need to stop taking aspirin for some reason, is there a safer way to do it?
Ask the doctor: Can medications make the heart stronger, like exercise does?
When a friend of mine had a stress test, his doctor gave him a medication to make his heart work harder, instead of having him run on a treadmill. Does that mean medications could replace exercise to strengthen the heart?
Angioplasty a day after a heart attack not worth it
People who wait more than 24 hours after a heart attack to get an angioplasty do not benefit from it.
Preventing pacemaker, ICD infections now a priority
An increase in the number of infections in people receiving implanted heart devices means caregivers need to make prevention of infection their priority.
Putting heart attack, stroke triggers in perspective
Certain activities and situations can trigger heart attacks in those at risk, but researchers are showing how these risks need to be placed in the proper context.
Beta blockers: Cardiac jacks of all trades
Beta blockers are useful in treating a variety of cardiovascular conditions including angina, heart failure, and hypertension.
Healthy Eating Plate dishes out sound diet advice
The Harvard School of Public Health and Harvard Health Publications have worked together to offer a more detailed alternative to the government's MyPlate dietary recommendations.
Heart Beat: Leg workouts improve exercise capacity in people with heart failure
A specifically tailored exercise program may help people with heart failure regain strength without overworking the heart.
Heart Beat: Just-in-case electrocardiograms not recommended
An expert advisory panel reiterated its belief that healthy people who have not been diagnosed with heart disease do not need to get an electrocardiogram test.
Heart Beat: Any exercise better than none to thwart peripheral artery disease
For people with peripheral artery disease, any sort of physical activity is better than not doing anything.
Ask the doctor: Should I get more potassium from a salt substitute?
You've emphasized that people generally eat too much sodium and not enough potassium. Could I solve both problems at once by replacing my regular table salt with a substitute containing potassium?
Ask the doctor: How low should my LDL go?
I come from a long line of family members with heart disease. Right now, my HDL is 62 mg/dL [milligrams per deciliter], and my LDL is 115 mg/dL. My doctor isn't worried about my LDL, but shouldn't I shoot for an LDL level under 100 mg/dL?
Small change adds up
Trying to make major lifestyle changes to improve health is difficult. These ten small changes are easier to implement and can help you take better care of your heart.
How good is your hospital?
Organizations that track and compile data on the quality of hospitals can help prospective patients make better decisions about their care.
Bringing hospital care home
A movement called Hospital at Home seeks to provide professional-caliber meeical care at home to people who need care but do not need to be hospitalized.
Spotlight on cardiovascular drugs: Statins on the front line against heart disease
Statins are widely prescribed cardiovascular medications that lower LDL cholesterol and help fight inflammation. But they can cause side effects, so it is important to discuss their benefits and risks with a doctor.
How old are your arteries?
Two tests can be used to evaluate the health of a person's arteries, but there is also a free tool that estimates risk using answers to a few health questions.
On the horizon: Targeting nerves to heal the heart
The body's nerve system regulates heart rate and blood pressure, so researchers are looking at ways to use nerve stimulation to treat cardiovascular conditions.
On the horizon: DNA 'caps' offer target for heart drugs
Tiny parts of chromosomes called telomeres appear to have a relationship to the development of heart disease, opening a new avenue of research.
A study is planning to test the effectiveness of continuing to take post-stent medication past the recommended 12 months.
Ask the doctor: Is it safe to take ginkgo with warfarin?
I have been taking ginkgo pills for my memory for several years. I was just diagnosed with atrial fibrillation, and my doctor put me on Coumadin. Is it okay to keep taking ginkgo?
Ask the doctor: Is it okay to drink wine if you have a slow heart rate?
If you have a slow heart rate (bradycardia), is it safe to drink wine? If so, how much per day? Does alcohol affect the heart rate?
Do healthy people need an aspirin a day?
Healthy people who do not have existing cardiovascular disease are unlikely to benefit from a daily aspirin.
Slow adoption of helpful heart failure drug
Studies have shown that people with heart failure can benefit from the drug spironolactone, but concerns about possible side effects may have made some doctors reluctant to prescribe it.
Raynaud's: The big chill for fingers and toes
Raynaud's phenomenon is a sudden spasm of the blood vessels in the hands that blocks blood flow to the skin, causing pain.
Off-pump bypass surgery: Promise unfulfilled
Off-pump bypass surgery was touted as a better alternative to the traditional method, but findings show the two types yield similar results.
Heart Beat: Don't give frozen produce the cold shoulder
Eating frozen fruits and vegetables is a good way to boost the nutritional value of your diet when fresh local produce is not available.
Heart Beat: Controversial warning on Plavix and stomach-protecting medications
The FDA has warned doctors that certain stomach-protecting medications may interfere with the clot-blocking drug Plavix.
Heart Beat: A vanishing breed
Researchers claim that only 8% of Americans are healthy enough to remain free of cardiovascular disease without the assistance of a medication.
Ask the doctor: What is diastolic dysfunction?
My last echocardiogram showed mild diastolic dysfunction. What does that mean?
Ask the doctor: Should I have an angiogram to confirm a worrisome calcium score?
CT scans show my arteries are in the 89th percentile for calcium scores. My stress tests and echocardiograms are normal, so are my blood pressure and cholesterol, and I feel fine. Should I have an angiogram to confirm the calcification?
Ask the doctor: Can getting too excited while watching sports be harmful to my heart?
I like sports, and now that I am in my 60s and have had some trouble with my heart, I mainly enjoy them on television. My family sees how excited I sometimes get watching a game and they worry that it is bad for my heart. Can you tell them to relax?
Ask the doctor: Can a blocked artery cause jaw pain?
Lately when I climb the stairs or get really stressed, my jaw starts hurting. Is that just an oddity or something I should worry about?
HDL: The good, but complex, cholesterol
HDL cholesterol can be boosted by taking niacin or a fibrate, but there are possible side effects to these medications. Lifestyle changes like exercising, losing weight, and paying attention to diet should help boost HDL.
Bringing clarity to CRP testing
The hsCRP test measures the blood level of C-reactive protein, an indicator of inflammation. Whether or not the test is worthwhile depends on a person's level of cardiovascular risk and whether there is a family history of heart disease.
Protecting the heart from cancer therapy
Treatment for cancer may have unwanted effects on the heart. Depending on the type of cancer and the type of treatment, these can include irregular heart rhythm, inflammation, atherosclerosis, or an increased risk of blood clots.
Heart Beat: New prescription for some leftover drugs
The Food and Drug Administration offers guidelines on how to properly dispose of leftover medications.
Heart Beat: Cut salt for resistant hypertension
People with hypertension who are unsuccessful at controlling it with medications may benefit from a low-salt diet.
Heart Beat: It's never too late to quit smoking
Quitting smoking, even after a heart attack, will likely increase a person's longevity, and even cutting back on cigarettes is beneficial.
Heart Beat: No sailing away from heart disease
Cardiologists offer advice to people with cardiovascular conditions who are traveling on cruise ships.
Heart Beat: Lack of sex affects the heart
A lack of interest in sexual activity may be connected to cardiovascular issues.
Brief reports on a link between heart transplants and higher risk of skin cancer, the possibility that drinking coffee or tea may slightly lower the risk of diabetes, and atherosclerosis in mummies.
Ask the doctor: Is no-flush niacin as effective as other kinds of niacin?
I tried taking niacin to increase my HDL but didn't like the flushing it caused. A friend told me about no-flush niacin, which works like a charm. Why not tell your readers about it?
Ask the doctor: Does joint replacement surgery cause heart rhythm problems?
Six months after having my knee replaced, I developed an arrhythmia. I know of this happening to others, including a friend who developed an arrhythmia after having his hip replaced. Does joint replacement surgery often cause heart rhythm problems?
The American Heart Association is promoting a series of healthy lifestyle habits known as "The Simple 7" in an effort to improve the health of Americans and reduce deaths from cardiovascular disease.
Exercise stress test
The exercise stress test is used to identify potential problems with heart rate, rhythm, or blood pressure. It is used when there is cause to suspect a person has heart disease, but it does not make sense for healthy people to have the test.
A personal approach to heart failure
A self-care plan can help keep people with heart failure healthy and active. This advice will also be helpful to the people caring for those with heart failure.
Taming a killer
Heart attacks are much less deadly than they used to be, primarily due to advances in knowledge and understanding of the underlying cause of heart attacks, and to the prevalence of specialized coronary care units.
Heart Beat: Dual protection
The steps that should be taken to prevent dementia are also likely to help protect the heart and the rest of the body.
The VITAL study hopes to determine whether taking vitamin D and omega-3 fats have an effect on rates of cardiovascular disease, cancer, and other illnesses, and whether high dosages of these supplements are safe.
Brief reports on the potential risks of a certain diet drug, cutting salt intake, the effect of bronchitis and emphysema on the heart, and fish oil and longevity.
Ask the doctor: Can I take PreserVision for my eyes even though I take warfarin?
I recently began treatment for macular degeneration in one eye. My retinologist said that PreserVision might protect the other eye. But she cautioned that it contains vitamin E, which could cause a bleeding problem with Coumadin. What would you suggest?
Ask the doctor: Can allergies cause high blood pressure?
I have allergies. Could they be the reason I have high blood pressure?
Ask the doctor: Is it okay to travel to a high altitude with high blood pressure?
Some friends invited me to accompany them to Rocky Mountain National Park. I would love to go, but I have high blood pressure and worry that high altitudes are dangerous for people with this condition. Is that the case?
Chest pain: A heart attack or something else?
Chest pain is an indicator of a possible heart attack, but it may also be a symptom of another condition or problem. The type and location of the pain can help doctors determine what is causing it.
Banishing secondhand smoke
Secondhand smoke is a serious public health problem, and is almost as harmful for nonsmokers as smoking is for smokers.
A no-surgery fix for atrial fibrillation?
Catheter ablation has emerged as a potential treatment for atrial fibrillation, but about half of those who have the procedure need a follow-up, it is not known if the treatment is permanent, and there can be serious side effects.
Heart Beat: Blood clot prevention lacking in hospitals
The lack of mobility that often accompanies a hospital stay can cause a blood clot to form in a vein. Blood-thinning medication can prevent clots from forming.
Heart Beat: Walnuts and arteries
People who ate walnuts daily as an addition to their regular diets had more flexible arteries at the end of the trial period.
Heart Beat: Women and heart disease
Statistics from an American Heart Association survey reveal what women do and do not know about heart disease.
Heart Beat: Diabetes drug interferes with vitamin B12
About one third of those who take the diabetes drug metformin develop a vitamin B12 deficiency.
Heart Beat: Motorized scooters
In a study, people who used a motorized scooter to enhance their mobility experienced an increase in their levels of blood sugar.
Brief reports on a connection between shingles and stroke, the heart-protective properties of oats, and a warning about combining two HIV drugs in people with a heart rhythm problem.
The FDA has approved a heart replacement valve that is implanted via a catheter. Men with heart disease who receive androgen-deprivation therapy for prostate cancer should have their heart health monitored carefully.
Ask the doctor: What can I do to stop smoking if the "standard" treatments don't work for me?
I recently had stents placed in two coronary arteries. The doctors, of course, told me to quit smoking. I have tried to quit but just can't. Hearing over and over that I need to quit leaves me feeling depressed. Is there news that might give me some hope?
Persistence pays off in cardiac rehabilitation
The key to a successful cardiac rehabilitation program is sticking with it. Those who complete a program have increased longevity and less chance of having a heart attack or stroke.
Better ways to get your produce
For better, fresher produce this summer, consider buying your produce from a local farmers' market or planting a garden and growing your own.
Coronary artery vasospasm
Vasospasm is a sudden narrowing of an artery, caused by a chemical imbalance, that can feel like a heart attack. It can disrupt the heart's rhythm or trigger a heart attack in a person with clogged arteries or a weak heart.
Clearing clogged arteries in the neck
A blockage in one of the carotid arteries can be cleared either by endarterectomy or carotid angioplasty. The latter is less invasive, but some research is showing that this method may have a higher risk of complications.
Heart Beat: Your choice for dieting
Researchers comparing diets found that the type of diet a person follows (low-fat, low-carb, etc.) is not so important, as long as it provides the necessary nutrition and matches a person's metabolism.
Heart Beat: Going steady
Wide-ranging daily blood pressure readings could be an indicator of increased risk of a heart attack or stroke.
Heart Beat: Some leniency on heart rate control in atrial fibrillation
Controlling heart rate is one strategy for managing atrial fibrillation. Keeping the heart rate below a more lenient number of beats per minute may be just as effective as aiming for a lower number.
Heart Beat: Get help with a huge medical bill
People who believe they have been overcharged for medical care or services can enlist a company to examine their bills.
Ask the doctor: Do I really need carotid artery surgery?
I am 86 years old and have high blood pressure and diabetes. My doctor ordered tests to check my carotid arteries. They showed that one was nearly 70% blocked. My doctor said I had to have surgery right away or I would have a stroke. Is she right?
Ask the doctor: Can I fly again after having a DVT?
Last year I had a deep-vein thrombosis with a small pulmonary embolism, apparently precipitated by flying across the country without getting up and walking around. Is it safe for me to fly again? If so, what precautions would you recommend?
Ask the doctor: Is earwax connected to heart disease?
I heard somewhere that the type of earwax you have is linked to your risk of heart disease. Can that be true?
Ask the doctor: Is CholestOff safe to take for someone who has had breast cancer?
I have been taking CholestOff for a few years to lower my cholesterol. Does CholestOff have any long-term side effects that might be a problem for breast cancer survivors like me?
Ask the doctor: Is my LDL too low?
I am a 59-year-old man. The results of my latest blood test showed that my LDL cholesterol was 67, which was flagged as low. (I do not take any cholesterol-lowering drugs.) Should I be worried, or do anything to raise my LDL?
Heat can beat the heart
Hot, humid weather can overwork the heart, which can pose risks for people with certain conditions, or those who take beta blockers or diuretics.
Eating can cause low blood pressure
Postprandial hypotension, low blood pressure that occurs after eating, can cause dizziness, chest pain, nausea, or other issues, particularly in the elderly.
Potential salt assault
The average person consumes more salt each day than the body requires, most of it from "hidden" salt in prepared and packaged foods. The FDA may ask food companies to voluntarily reduce the salt content of their products over the coming decade.
When and how to treat a leaky mitral valve
If the mitral valve in the heart becomes damaged it can leak, causing blood to flow backward and overwork the heart. A leaky valve can be surgically replaced, but in some situations repairing the valve is more effective than surgery.
Heart Beat: Tape of meeting eases jitters before bypass
Researchers found that when people having conversations with their doctors about impending bypass surgery were given a recording of the consultation, they had a better understanding of the procedure.
Heart Beat: Generic ARBs are coming
The FDA has approved the sale of a generic version of the angiotensin-receptor blocker medication losartan, and generic versions of two other ARBs may soon follow.
Brief reports on heart failure and avoiding rehospitalization, the dangerous combination of prehypertension and prediabetes, and a warning about eating Dead Sea salt.
Ask the doctor: Are there noninvasive alternatives to a nuclear stress test?
My doctor wants me to have a nuclear stress test to check my arteries for any blockages. What noninvasive test would give as much information as a nuclear stress test? I have had many scans, so I would like to limit my exposure to radiation if possible.
Ask the doctor: Does prednisone increase blood pressure?
I have rheumatoid arthritis, and my doctor wants me to take prednisone for it. Will this drug be bad for my blood pressure, which is already high?
Ask the doctor: What can I do to protect my heart if my body no longer makes testosterone?
I had an orchiectomy for prostate cancer. Not long afterward, I had two cardiac stents implanted. I still have some angina and shortness of breath. I started Ranexa, which helps my angina. Do you have any suggestions for protecting my heart?
Shining a light on thoracic aortic disease
A thoracic aortic aneurysm can be small and stable, or it can tear or rupture. People with certain genetic conditions, and those who have a relative who has had this condition, are at higher risk and should be tested.
Red meat: Avoid the processed stuff
Eating red meat regularly may not be as bad for us as was once believed, but frequent consumption of processed meats like hot dogs, cold cuts, and bacon is still unhealthy.
Diastolic heart failure
In diastolic heart failure, the left ventricle becomes thick and stiff. The symptoms are the same as those for systolic heart failure, but researchers are still searching for the best treatment strategies.
Heart Beat: Stents make later surgery riskier than usual
Getting a stent implanted within six weeks before having another, noncardiac surgery carries a much higher risk of having a heart attack or dying.
Heart Beat: Converting blood sugar to HbA1c
People with diabetes who take blood sugar readings at home now have a way to convert that information into a hemoglobin A1c value, which indicates a person's average daily blood sugar.
Heart Beat: Steroids and the heart
Among the side effects of steroid use, one serious consequence is a weakening of the heart's left ventricle.
Heart Beat: A sweet, nutty plan for better cholesterol, blood pressure
Eating moderate amounts of nuts and chocolate may being heart-protective benefits in the form of lower LDL cholesterol and lower blood pressure, respectively.
Heart Beat: Exercise no trigger for defibrillator shocks
Having a defibrillator implanted does not preclude exercising.
Brief reports on an interaction between warfarin and a particular antibiotic prescribed for urinary tract infections, and outdoor exercise as a mood booster.
Ask the doctor: How could I have a heart attack after a normal exercise test?
I had a nuclear exercise test last fall, and it was perfectly normal. Imagine my surprise this spring when I developed burning chest pain that turned out to be a heart attack on the bottom part of my heart. Did the doctors mess up the reading of my test?
Ask the doctor: What are the alternatives to a statin for lowering cholesterol?
I have tried all of the statin drugs to lower my cholesterol, but each one has caused severe muscle pain. Are there any non-statin medications I could try using to lower my cholesterol?
Heart attacks come in all kinds, sizes
The term "heart attack" encompasses a number of conditions that vary in severity and treatment approach.
Diagnosing sleep apnea at home
Diagnosing sleep apnea typically requires an overnight stay in a hospital or sleep lab, but portable monitoring equipment may make diagnosis easier for some people.
Stand up for your heart
Research examining the dangers of inactivity suggests that those who are not currently physically active are likely to benefit from even a small amount of activity or exercise.
New thinking on saturated fat
The evolving understanding of the different types of fats in foods has changed the perception of saturated fat. Eaten in moderation, it is a useful part of the diet and is unlikely to affect cardiovascular health.
Heart Beat: Aspirin and diabetes
Guidelines for whether or not people with diabetes should take a daily aspirin to prevent heart attacks have been revised based on risk.
Heart Beat: Faith in medications fades
The challenges of maintaining a medication regimen for a long period of time are compounded by diminishing belief in their effectiveness
Brief reports on migraines and stroke risk, HDL's potential role in lowering cancer risk, unhealthy food ads on TV, and the benefits of defibrillators in public places.
Reader to Reader
Readers offer suggestions and strategies for quitting smoking.
Readers' stories of how they quit smoking
Ask the doctor: How often does a leaky mitral valve need to be checked?
Your article on mitral valve surgery didn't mention how often someone like me - with mild regurgitation from a leaky mitral valve but no symptoms - should have his or her valve checked. Are there any standards for this?
Ask the doctor: My heart is better - should I stop taking amiodarone?
After a heart attack my doctor put me on amiodarone. Three years ago, I started cutting back on it because of side effects. My latest electrocardiogram showed no signs of tachycardia, and my doctor wants me to stop taking amiodarone. What should I do?
Beating high blood pressure with food
A healthy diet that includes poultry, fish, whole grains, vegetables and fruits, nuts, legumes, low-fat dairy products, and unsaturated fats can help control high blood pressure.
Standing guard over blood vessel health
The layer of endothelial cells that lines blood vessels helps protect them and keep them functioning properly, but smoking, poor diet, and other risk factors can damage the endothelium, opening the door to heart disease.
Choosing the right replacement heart valve
If replacing a heart valve becomes necessary, the decision is mainly a choice between a mechanical valve, which requires the recipient to take warfarin to prevent clotting, or a tissue valve, which will not last as long as a mechanical one.
New heart rate estimate for women
A revised formula for calculating peak heart rate in women can help those who may want to determine a target heart rate as a guideline for exercise.
Heart Beat: Geography influences treatment of clogged carotid arteries
Researchers found that the rates of artery-clearing procedures varied significantly among different regions in the United States.
Heart Beat: Treat yourself to better blood pressure
Daily self-monitoring of blood pressure readings can help keep pressure from drifting upward.
Brief reports on anxiety disorders and increased risk of heart disease, the decline in trans fat use in fast food, and the health benefits of bicycling.
Ask the doctor: Am I exercising too much?
I am 80 years old. 40 years ago I had a heart attack. I stopped smoking but remained very active. My blood pressure, with the help of medications, is around 125/70. My physician thinks I am pushing too hard and has urged me to take it easier. Is he right?
Ask the doctor: Are raw oats better than cooked oats?
My family has squabbled about oats for some time. Some members say that to get the biggest health benefit from oats you need to eat them raw, moistened with water. Others say they should be cooked. Does cooking take something beneficial out of oats?
Calcium supplements and heart attack
As we age, bones lose calcium and arteries accumulate calcium, which causes them to stiffen. But it's still important to get enough calcium, which works with vitamin D in the body to keep bones strong.
Light and social smoking carry cardiovascular risks
Almost 25% of smokers smoke only a few cigarettes per day, or smoke only once in a while, but they are still exposing themselves to the same health risks as heavier smokers.
Resveratrol for a longer life - if you're a yeast
Many claims have been made about the ability of resveratrol to prevent heart disease and other illnesses, but the little research in humans has not tested for long-term health, and there are many unanswered questions about side effects.
Yoga could be good for heart disease
Yoga's combination of gentle exercise, stretching, focus on deep breathing, and the resulting greater mindfulness may be of particular benefit to people living with cardiovascular disease.
Heart Beat: Bad reaction to a medication? Let your voice be heard
The Food and Drug Administration has established a toll-free number that consumers can use to report adverse side effects from medications (both prescription and over-the-counter) and medical devices.
Heart Beat: Antidepressant little help in heart failure
A trial of the antidepressant sertraline in people living with heart failure did not ease their depression.
Heart Beat: Atrial fibrillation? Don't blame caffeine
Researchers have concluded that caffeine does not affect the development of atrial fibrillation.
Ask the doctor: Does pomelo juice affect drugs the same way grapefruit juice does?
I avoid grapefruit juice because my doctor says it affects how my body handles the Lipitor I take for my cholesterol. Should I also stay away from pomelo?
Ask the doctor: Do I need an MRI scan of my heart?
I am an 84-year-old man with atrial fibrillation, mild heart failure, and high blood pressure. My doctor had me wear a Holter monitor and get a SPECT scan. Now he wants me to have a cardiac MRI. What info would this test give that he doesn't already have?
Ask the doctor: Is there a safe way to stop taking warfarin before surgery?
I'm a 79-year-old man with atrial fibrillation on Pacerone. I also take warfarin and aspirin. I plan to have a tooth pulled next month and wonder if it is safe to go off the blood thinners. How are these medications handled when serious surgery is needed?
Ask the doctor: Is wood smoke a problem for my heart?
Many people in my neighborhood heat their homes with wood stoves. The smoke really bothers me. Does what's coming out of their chimneys affect my heart?
What can angioplasty do for you?
If you are having a heart attack, angioplasty will open a blocked artery and hopefully limit muscle damage, but the procedure does nothing to stop the spread of atherosclerosis or reduce the risk of a future heart attack.
Protein "package" matters in a low-carb diet
Evidence from ongoing health studies suggests that the source of protein in a low-carb diet influences the risk of heart disease, and that getting more protein from plant sources is better.
Refining the rules for abdominal aneurysm testing
A scoring system may help identify people who should be screened for an abdominal aortic aneurysm.
Coping with what you can't change
A number of risk factors for heart disease cannot be changed or controlled. Awareness of these factors can act as encouragement to pay attention to what can be controlled, such as diet and exercise.
Heart Beat: Alcohol: Moderation matters, especially with high blood pressure
Binge drinkers are more likely to have heart ailments, which may be of particular concern for those who also have high blood pressure.
Heart Beat: Snow and stents a chilly mix
Snow shoveling is a known trigger for heart attacks, and people with stents are at additional risk.
Heart Beat: Ornish, Pritikin get Medicare okay for cardiac rehab
The Pritikin and Ornish diets are now included in Medicare coverage for intensive cardiac rehabilitation, though only in certain locations.
Heart Beat: Heart, arteries thrive with more potassium
Boosting daily potassium intake by eating more fruits, vegetables, and low-fat dairy foods is likely to reduce the risk of a heart attack or stroke.
Further information from studies on an aortic valve repair procedure, the benefits of eating whole-grain foods, the heart risks of testosterone therapy, and underactive thyroid.
Ask the doctor: Do I need to get a flu vaccination this year?
Now that the fuss over H1N1 swine flu has died down, do I need to get vaccinated this year?
Ask the doctor: Do angiotensin-receptor blockers cause cancer?
I read that angiotensin-receptor blockers cause cancer. I take one (Diovan) for my blood pressure. Should I stop?
The editors of the Harvard Heart Letter introducean issue focused on acquiring new knowledge in order to improve your health.
Nine tips for a healthier 2009
Start the year with these tips for heart care and healthier living. Suggestions include learning CPR, reducing stress, establishing an advance care directive and choosing a health care proxy.
The results of a large trial suggest that people with LDL cholesterol in the normal range but with a high C-reactive protein level may benefit from taking a statin. This may lead to increased use of the CRP to test for heart disease.
Make your health information personal
Gathering all your health records and vital information in one place can streamline your care and help doctors in the event of an emergency. Several web sites now offer ways to simplify the online storage of health information.
Changing picture of atherosclerosis
The medical view of atherosclerosis is changing from the traditional one of arteries blocked by plaque to a more encompassing one, with inflammation as the main cause and an emphasis on stopping it before it even starts.
Navigating the ocean of health information
There is plenty of information available online to help you learn about cardiovascular health, but not all of it is unbiased or accurate.
Ask the doctor: Is it possible to reverse coronary artery disease?
I have coronary artery disease. Is this something I can have cured or get rid of, or is keeping it from getting worse the best I can do?
Ask the doctor: Are big surges in blood pressure dangerous?
When I am under great stress, my blood pressure sometimes shoots up to 200/120 but then quickly goes down to 120/80 or lower and stays there. One doctor told me that spikes like these are normal. Another told me this isn't healthy. Who is right?
Ask the doctor: Is bundle branch block serious?
I had an electrocardiogram in preparation for minor surgery. My doctor told me it showed that I have right bundle branch block. Neither he nor my cardiologist are worried about it, but I am. Is this serious?
Bypass results vary by hospital
Researchers examining deaths during or soon after bypass surgery found that the surgeons and hospitals that did the most surgeries had the lowest death rates.
Spotlight on heart tests: C-reactive protein testing comes of age
A high-sensitivity version of the C-reactive protein test can help detect inflammation caused by atherosclerosis in people at moderate risk of heart disease.
Generic heart drugs as good as brand names
Analysis of clinical trials showed that generic versions of cardiovascular medications are as effective as their name-brand counterparts.
Two-way street between depression and heart disease
Heart disease and depression are often closely linked. Depressed people are more likely to develop heart disease, and those living with heart disease are more likely to become depressed. The main avenues of treatment are medication, therapy, and exercise.
Heart beat: Preeclampsia poses later heart risk
Women who experience preeclampsia during a pregnancy may be at higher risk of a heart attack, stroke, or other heart disease later in life.
Heart beat: Statins, aspirin affect prostate cancer test
Two studies found that use of a statin or daily low-dose aspirin may artificially lower the reading of a prostate-specific antigen (PSA) test.
Heart beat: Trial gives nod to home warfarin monitoring
Home monitoring devices for use by people taking warfarin compared favorably to regular blood tests done at a medical facility.
Heart beat: When success leads to failure
More people are surviving heart attacks and receiving better care afterward, which has led to an increase in the number of people living with heart failure.
Heart beat: C+E get an F for heart protection
Another large study adds to the evidence that taking vitamin C and vitamin E to protect against heart disease is not effective.
Heart beat: Beware cardiac arrest after heart attack
In the first month after surviving a heart attack, people are four times more likely to have a cardiac arrest than in the following months.
Using a special garment to squeeze the legs in time with the heart can ease chest pain. The inflammation that causes rheumatoid arthritis affects the heart as well as the joints.
Ask the doctor: What does an enlarged heart signify?
My doctor told me I have an enlarged heart. What is this? What causes it and what does it mean for my health?
Ask the doctor: Could my statin or exercise be affecting my kidneys?
Can muscle damage from a statin, or from strenuous exercise, elevate creatinine even after I stopped taking the statin and exercising but continue to take Zetia and Diovan HCT?
The flap over mitral valve prolapse
Mitral valve prolapse is a bulging of the valve between the left atrium and left ventricle. Most people with the condition need no treatment and can expect to have a normal life span, though in certain cases the valve can start to leak.
Snapshot of the American diet: Foods out of balance
Americans eat too much fat and refined sugar, and not enough vegetables, fruits, whole grains, and fish. Making some conscious substitutions and food choices can promote heart health.
Creating order from chaos: Taming atrial fibrillation
Atrial fibrillation occurs when the heart receives an overload of signals telling it to beat, causing an irregular rhythm. It can be caused by a number of conditions including high blood pressure, heart failure, a viral infection, or stress.
Heart Beat: Exercise benefits clogged leg arteries
People with peripheral artery disease will most likely benefit from an exercise regimen, regardless of whether or not they are experiencing the leg pain that frequently accompanies the condition.
Heart Beat: Gasping shouldn't delay CPR
If a person who is having a heart attack is not breathing but occasionally gasps for air, CPR should still be administered. In the first few minutes after an attack, it is more important to focus on chest compressions.
Brief updates on a possible link between too little sleep and heart disease, higher blood pressure in winter, and the danger of fat around the heart.
Ask the doctor: Can I have a catheter procedure to stop atrial fibrillation?
My doctor told me I should think about having a procedure something like angioplasty to stop my atrial fibrillation. Can you tell me more?
Ask the doctor: Can I exercise even though my valves are leaking a little bit?
I am 78 years old. An echocardiogram showed a leak in my mitral valve. A follow-up test showed some leakage in my tricuspid valve. I like to exercise, but don't want to make these problems worse. Is it okay for me to walk on a treadmill or lift weights?
Ask the doctor: Do statins affect blood pressure?
I have been arguing with a friend about whether the statin drugs lower blood pressure. Do they, or don't they?
Radiation in medicine: A double-edged sword
Tests such as CT scans have become crucial tools in the diagnosis and treatment of many diseases and conditions, but the radiation exposure from these tests may lead to an increased risk of developing cancer.
Women's hearts need extra attention
Heart disease, once thought to be a man's disease, is now understood to affect women and men equally, but there are still disparities in the diagnosis and treatment of heart disease in women.
Potassium and sodium out of balance
The body needs the combination of potassium and sodium to produce energy and regulate kidney function, but most people get far too much sodium and not enough potassium.
Heart Beat: Binge drinking and stroke
A study from Finland shows an association between binge drinking and an increased risk of having a stroke.
Heart Beat: Osteoporosis drugs not linked to atrial fibrillation
An FDA review of trials involving bisphosphonate drugs used to treat osteoporosis found no link between their use and any increased risk of atrial fibrillation.
Brief updates on the benefit of the Maze procedure, St. John's wort's interference with statins, the safety of angioplasty performed through the radial artery, and the cardiac risks of newer antipsychotic drugs.
Ask the doctor: Will taking arginine and citrulline protect my arteries?
My husband is taking arginine and citrulline supplements because he read that they will protect his heart and arteries. Should I try these supplements, too, or is this a waste of money?
Ask the doctor: Does the length of the ST segment on an electrocardiogram matter?
I have an electrocardiogram as part of my yearly checkup. After the last one, my doctor mentioned that my ST segment was longer this year than it was last year. He recommended that I have a stress test to check this out. I passed with flying colors. When I asked the cardiologist who did the stress test about the ST segment, he said the length isn?t really important, that the height and shape are what matter. Can you explain?
Ask the doctor: Does narrowing of the aortic valve get better on its own?
Does mild aortic stenosis (causing a mild heart murmur) ever correct itself without medication or surgery?
Trial renews surgery vs. stent debate
People with artery disease may have a choice between bypass surgery and angioplasty, depending on the circumstances of one's condition and other factors such as whether or not a person can take the medication clopidogrel.
Take the plunge for your heart
Swimming is exercise that benefits the heart, lungs, and blood vessels, without the joint stress and potential pain caused by running.
On the alert for deep-vein blood clots
Deep-vein thrombosis is a clot that forms in a leg or arm vein. Sometimes a piece of the clot can break away and travel through the bloodstream. If the clot lodges in a lung, it can be fatal.
No need to avoid healthy omega-6 fats
Omega-6 fats were once criticized as unhealthy, but researchers for the American Heart Association have concluded that they are in fact beneficial to the heart.
Heart Beat: Mindfulness helps ease heart failure
Mindfulness is a form of meditation that encourages greater awareness of one's surroundings and experiences. Volunteers with heart failure who participated in a mindfulness study reported lower levels of anxiety and feelings of better overall health.
Heart Beat: Say "nuts" to chips
Nuts are considered a healthy food when eaten in moderate amounts, but chewing them thoroughly seems to release more of the nut's nutritional value.
Heart Beat: A weight loss "secret": Calories matter
A comparison of several different diet strategies found that the choice of diet is less important than cutting daily calorie intake and exercising enough to burn extra calories.
Ask the doctor: How is atrial flutter different from atrial fibrillation?
What are the differences between atrial flutter and atrial fibrillation?
Ask the doctor: Is donating blood good for the heart?
Are there any cardiovascular benefits to donating blood? Is it like getting an oil change for your car, with the donation getting rid of old blood cells and the body making new ones?
Defining a moderate-intensity workout
A researcher has determined that the recommended "moderate intensity" exercise level can be accomplished by walking at least 100 steps per minute. An inexpensive pedometer can help you determine your walking speed.
Exercise equals angioplasty for leg pain
Angioplasty can be used as a treatment for intermittent claudication in leg veins. While the results are quicker, equivalent benefits can be achieved with an exercise program combined with medication, without the risk and recovery period of surgery.
Treat "mini-strokes" as an emergency, not a gentle warning
A transient ischemic attack is similar to a stroke. While it may be over quickly, it must be treated as a serious medical condition. Prompt attention and treatment may prevent the subsequent occurrence of a full-fledged stroke.
New guidelines refine aspirin prescription
Taking a daily aspirin can help prevent heart attacks in men and strokes in women, but not everyone who takes aspirin should do so, because aspirin may increase the risk of stomach bleeding.
Heart Beat: Atrial fibrillation and blood pressure
People with atrial fibrillation benefit from aggressive blood pressure control, resulting in fewer deaths from stroke and other cardiovascular causes.
Heart Beat: Billions for heart care
In 2006 Americans spent more than $190 billion on heart-related health care issues, nearly one-fifth of total health care costs that year.
Brief reports on giving proper attention to high triglycerides, undermining cardiovascular drug therapy with unhealthy lifestyle choices, and an apparent bonus from taking a statin: reduced risk of blood clots.
Ask the doctor: How did my blood pressure suddenly become normal?
I was taking diltiazem and Atacand, which gave me an average blood pressure of 110/65. Recently while in the hospital, my blood pressure got so low I was told to stop taking these medications. My blood pressure has remained at 105/65. How can this be?
Ask the doctor: Why aren't prevention efforts stopping an increase in heart disease?
Why is heart disease still on the rise despite the incredible increase in the number of people taking cholesterol-lowering drugs and the more than 30 years of "low-fat" propaganda?
Ask the doctor: Do I need to take precautions if I stop taking warfarin before a colonoscopy?
I am due to have a colonoscopy. My cardiologist told me that I will need to stop taking Coumadin, which I take for atrial fibrillation, a few days before the procedure and get some injections. Is that really necessary?
Ask the doctor: Will a memory-boosting supplement interfere with my heart medications?
Since having a heart attack, I have been taking lisinopril, Zocor, Plavix, aspirin, fish oil, calcium, and a number of other vitamins and supplements. I am thinking of taking a brain booster called Procera AVH. Will it interfere with my heart medications?
Regenerating the heart
Researchers from Sweden have demonstrated that the heart is capable of growing new muscle cells, though this process occurs very slowly.
Redefining myocardial infarction
The definition of a myocardial infarction has been revised to reflect the significance of a protein called troponin, which is released into the bloodstream when heart muscle damaged.
Advanced pacemaker gets the heart in sync
One-third of people with heart failure have ventricles that beat out of sync. A biventricular pacemaker sends electrical signals to the ventricles to keep them working together, making everyday activities easier.
Heart infection can pose a medical mystery
Myocarditis is an inflammation of the middle layer of the heart. It may be caused by a virus, allergic reaction, or exposure to a toxin. Diagnosis is difficult because symptoms are not specific and may suggest other causes.
Heart Beat: A single pill for prevention?
A "polypill" containing multiple blood pressure medications, a statin, and aspirin may be a simple, workable approach to help prevent heart disease.
Heart Beat: Aspirin gets a backup against atrial fibrillation
Aspirin plus warfarin is an effective defense against stroke-causing blood clots, but many people cannot take warfarin. A study found that aspirin plus clopidogrel (Plavix) was also effective.
Heart Beat: Summer: A good season for cholesterol
Levels of LDL cholesterol drop a few points in summer, while HDL rises slightly.
Heart Beat: Black tea and blood pressure
Black tea may lower blood pressure slightly, but the effect is small.
Heart Beat: The biggest loser
Results of a trial showed that exercise and weight loss combined with the DASH diet for blood pressure control achieved a greater reduction in systolic blood pressure than the diet alone.
Heart Beat: Traffic, anger strain the heart
A study of German heart attack survivors found a slight correlation between being stuck in traffic and risk of a heart attack.
On the horizon
A brief summary of research with potential future applications: closing off the left atrial appendage to prevent clots, stimulating the brains of stroke victims with laser beams, and a new type of stent that dissolves over time.
Ask the doctor: Why is peanut butter "healthy" if it has saturated fat?
I keep reading that peanut butter is a healthy food. But it contains saturated fat and has more sodium than potassium. That doesn't sound healthy to me.
Ask the doctor: Is the term "coronary heart disease" redundant?
I always thought that coronary and heart meant pretty much the same thing. If that's so, isn't "coronary heart disease" redundant?
Stomach-protecting drug could block Plavix
Many people who take aspirin and clopidogrel (Plavix) to prevent blood clots also take a proton-pump inhibitor (PPI) to ease the gastrointestinal bleeding the other medications can cause. But a study found that PPIs can limit the effectiveness of Plavix.
Hole in the heart opens questions
Stroke victims are more likely to have a patent foramen ovale, a hole between the heart's left and right atria, but closing the hole may not prevent the occurrence of another stroke.
13 ways to add fruits and vegetables to your diet
Adding fruits and vegetables to your diet is a simple way to eat more healthfully. Here are some suggestions to make healthy eating more fun and interesting.
When the lights suddenly go out
Fainting occurs when blood flow to the brain is blocked or interrupted. An incident of fainting should be reported to a doctor, because if it was caused by a problem in the heart, it may lead to more serious problems.
Heart Beat: New name for TIA?
Readers suggest alternative terms for a transient ischemic attack.
Heart Beat: Preventable threats to survival
Everyone wants to live longer, and there are many preventable causes of death that can be avoided with proper health habits.
Heart Beat: Extending the time for stroke treatment
When someone has a stroke, immediate treatment is essential. The American Stroke Association says a clot-destroying drug called tPA may work for up to four and a half hours after the onset of a stroke, but should be given within an hour if possible.
Brief reports on CPR and an improved cardiac arrest survival rate, chewable aspirin as a rapid heart attack aid, and the effect of lack of sleep on blood pressure.
Ask the doctor: Are isometric exercises safe for the heart?
Long ago I was told that isometric exercises, like weight lifting, shouldn't be done by anyone with a heart condition. Is that still the prevailing wisdom?
Ask the doctor: What are silent heart attacks?
What are silent heart attacks? How are they different from regular ones? If they are silent, how does anyone know about them?
Ask the doctor: Why do I get chest pain when I don't warm up before exercising?
I work out regularly, but suffer from exercise-induced angina. If I start exercising without warming up, my chest starts to feel "tight" quickly. If I warm up properly, I can walk for several miles at a pretty fast pace without any pain. Can you explain?
Ask the doctor: How can you tell when a leaky mitral valve needs to be fixed?
I am an 82-year-old man with borderline leakage in my mitral valve. What symptoms or tests would help me and others recognize when it is time to consider having the valve fixed?
Pain relief balancing act
Frequent use of pain relievers can irritate the stomach, digestive tract, or possibly the heart and blood vessels. For people with heart disease, a study suggests that regular use of naproxen will not harm the heart.
Walk often, walk far
A cardiac rehabilitation program can help people with heart disease regain strength and stamina. An exercise program that emphasizes frequent walking over a more intense workout can result in greater loss of weight and body fat.
Heart Beat: Treating sleep apnea may pay off for the heart
Sleep apnea can damage the heart or cause rhythm problems. Treating the apnea may stop or reverse this damage.
Heart Beat: Double treatment for heart attack
People who receive a clot-destroying drug after a heart attack may also benefit from a subsequent angioplasty.
Heart Beat: Anxious about angina
Anxiety and depression greatly increase the probability of developing angina.
Brief reports on the use of compression stockings by stroke survivors, and the benefit of adding a second blood pressure medication.
Special section: Cardiovascular connections: Two-way street between heart and health
This special section highlights the relationships between the heart and many other parts of the body.
Special section: Cardiovascular connections: Body fat: The good, the bad, the...
Abdominal fat cells are responsible for many cardiovascular problems.
Special section: Cardiovascular connections: Two-way street between head, heart
Stress, anxiety, and negative emotions can bring on or worsen heart disease, and cardiovascular problems can contribute to dementia.
Special section: Cardiovascular connections: Psoriasis is more than skin deep
Psoriasis, which is not a skin disease but an immune disorder, may be linked to heart disease, possibly through inflammation.
Special section: Cardiovascular connections: Testosterone, sex, and the heart
Low levels of testosterone have been linked to many health problems in men.
Special section: Cardiovascular connections: The ovarian connection
Hormones produced by the ovaries are beneficial, but taking a hormone medication increases certain health risks.
Special section: Cardiovascular connections: Skeleton key
Taking measures to protect the heart, such as exercising and eating a healthy diet, can also help prevent osteoporosis.
Special section: Cardiovascular connections: Odd associations
A number of odd connections exist between body parts and the cardiovascular system.
Ask the doctor: Does exercise help damaged heart muscle?
After my heart attack, my doctor told me that damaged heart muscle cannot be replaced. If this is true, why am I walking on a treadmill five days a week? Is this helping repair the damage or strengthen what's left?
Ask the doctor: Are there radiation-free tests for checking my arteries?
Are there any noninvasive, radiation-free tests that can give the same information about possible blockages in my coronary arteries as a nuclear stress test? I've had so many CT scans for other conditions that I'd prefer to go non-nuclear for a while.
11 foods that lower cholesterol
Certain foods, such as beans, oats and whole grains, fatty fish, and fruits and vegetables that are high in fiber, can lower "bad" LDL cholesterol.
After a heart attack
Carefully following the discharge instructions after a heart attack, including participating in a cardiac rehabilitation program, provides a much better chance of a full recovery and preventing another attack.
Atrial fibrillation, angioplasty drugs approved
Two new medications have been approved by the Food and Drug Administration, one for people with atrial fibrillation and one that works to fight the formation of clots.
Cautious confirmation for easier aneurysm repair
An abdominal aortic aneurysm can be dangerous if it grows beyond a certain size. A newer, less invasive procedure can correct the problem with less risk than open surgery.
Heart Beat: Big chill for cardiac arrest
Rapid cooling of cardiac arrest victims increases their chances of eventual survival by reducing the extent of damage caused by lack of oxygen to the brain when the heart stops.
Heart Beat: Trial Watch
A new study is comparing methods of treating leg pain caused by peripheral artery disease.
Ask the doctor: Does heart rate affect blood pressure?
When doctors interpret a blood pressure reading, should they also consider the heart rate? My pressure is often higher when my heart rate is close to its usual resting rate and lower when my heart is beating faster than that.
Ask the doctor: Should I wait to have my aortic valve replaced?
I'm an 85-year-old man with aortic valve stenosis, coronary artery disease, and atrial fibrillation. My doctor said I should wait until I experience signs of heart failure before having my aortic valve replaced. Shouldn't I get it done sooner?
Ask the doctor: Are some blood vessels more prone to blockages than others?
Are the coronary arteries more prone to developing blockages than arteries elsewhere in the body? When arteries from other parts of the body are used in bypass surgery, does their tendency to become blocked change?
Ask the doctor: Is vinegar good for the arteries?
I've heard that apple cider vinegar can clean out the arteries. Is there any truth to that?
Sporadic high blood pressure deserves attention
Monitoring your blood pressure by taking daily readings at home over a period of time can provide a more accurate sense of your true pressure than a reading in the doctor's office, which may be artificially high or low.
Exercise prescription for diabetes
The American Heart Association recommends that people with type 2 diabetes should undertake an exercise program combining aerobic exercise with strength training. This strategy is best for protecting the heart and improving muscles' response to insulin.
6 steps to safer use of triple therapy
People taking the "triple therapy" combination of aspirin, Plavix, and warfarin are at increased risk of bleeding. A panel of experts has recommended a set of guidelines intended to make taking this drug combination safe and effective.
Using music to tune the heart
Researchers are exploring how the use of music therapy may aid in the treatment and recovery of cardiovascular patients.
Heart Beat: Setting standards for pacemaker and ICD lead extraction
The Heart Rhythm Society has published guidelines for the procedure to remove broken, damaged, or worn out pacemaker or ICD leads.
Heart Beat: Heart failure tough on B vitamins
People with heart failure are more likely to have a B vitamin deficiency, possibly due to decreased appetite, faster metabolism, and medications that may remove certain nutrients from the body.
Heart Beat: Statins before vascular surgery
A Dutch study that recommends starting to take a statin medication prior to having vascular surgery supports existing advice from the American Heart Association.
Heart Beat: Go Mediterranean for the brain and heart
A pair of studies adds to the evidence that a Mediterranean-style diet not only benefits the heart, but can also help counter age-related decline in brain function.
Heart Beat: Blood pressure reading affected by eating
Eating before having a blood pressure test can artificially lower the reading by a few points.
Brief reports on a potential alternative to warfarin, the added harm of cholesterol in fried foods, reducing stroke risk, and comparing higher doses of a statin with a combination drug.
Ask the doctor: Is it worrisome to hear a pulse in my ear?
One morning last week I woke up hearing my heartbeat in my left ear. I hear it most clearly when I am in bed or sitting quietly. My health is good, and I was told after a recent cardiac workup that my heart was "perfect." Should I be worried?
Another reason to get a flu shot: your heart
Any infection, including the flu, can stress the heart and lead to higher blood pressure, breathing problems, increased heart rate, or inflammation. Getting a flu shot can help protect the heart.
Vitamin D: a bright spot in nutrition research
Many older people do not get enough vitamin D, which may contribute to coronary artery disease and high blood pressure. Exposure to sunlight is not a reliable source of vitamin D during the winter months, so taking a supplement is recommended.
Blood pressure: How low should you go?
Keeping blood pressure low is important to overall health, but for people with coronary artery disease, lowering diastolic blood pressure too much could increase the risk of a heart attack.
Heart Beat: Peripheral artery disease and stroke
People who have had a transient ischemic attack or a stroke should consider getting an ankle-brachial index test to check for peripheral artery disease.
Heart Beat: Shellfish for the heart?
Shellfish may not offer the same protection against heart disease as finned fish, but it is still a healthier alternative to red meat.
Brief reports on the beneficial effect of weight loss on the heart, eating a Mediterranean-style diet to control blood sugar, and an attempt to compare angioplasty and exercise as treatments for angina.
Ask the doctor: Should I double up on aspirin if I think I am having a heart attack?
I've heard you should take an aspirin if you think you are having a heart attack. I already take aspirin (325 mg) every day. Should I still take an aspirin if I feel a heart attack coming on?
Ask the doctor: How can I keep my coronary arteries from going into painful spasms?
What can be done for endothelial dysfunction that causes coronary artery spasms and requires nitroglycerin at least four times a day?
Ask the doctor: Can I take red yeast rice instead of a statin to lower my cholesterol?
What is the story on using red yeast rice to lower cholesterol? You have warned readers against using it in the past, but I heard about a new study that shows it works. Are you ready to admit you are wrong on this one?
Gene tests for some, not all
Certain inherited genetic conditions increase the risk of cardiovascular disease, so having a genetic test may show whether a person is at risk for heart disease, especially if a family member has one of the conditions.
When an artery becomes narrowed by plaque, the body responds by growing and strengthening nearby blood vessels to move blood around the narrowing, possibly preventing heart disease. Vigorous exercise can stimulate this blood vessel growth.
Mechanical assist for heart failure
For people with severe heart failure, a pumping device called a left ventricular assist may prolong life for those who are not healthy enough for transplant surgery, or who face a lenghty wait on the transplant list.
Repairing the heart one cell at a time
Researchers are hoping to one day be able to use stem cells to repair heart muscle damaged by a heart attack, but so far the tests have not succeeded.
Heart Beat: Look alive - it's Monday!
A public service campaign aims to encourage people to make healthier lifestyle choices by thinking about them each week on Monday.
Heart Beat: New vitamin helps lower cholesterol
A new multivitamin includes phytosterols, which help the body block the absorption of cholesterol. Phytosterols occur naturally in plants, but in small quantities, making it difficult to eat enough from foods to obtain their benefits.
Heart Beat: Chilling out
In an emergency cardiac arrest situation, rapid cooling of the body can improve a person's chance of survival and limit the possibility of brain damage.
Bystanders using defibrillators on cardiac arrest victims double their chances of survival. A new type of defibrillator provides audio guidance to help bystanders use the device properly.
Ask the doctor: Can I take a diuretic?
I had to take hydrochlorothiazide and Lasix together. After an electrolyte imbalance, my doctors told me never to take these medications again. I recently had my aortic valve replaced, and am retaining water. Are there any diuretics I can safely take?
Ask the doctor: Can a massage cause a stroke?
I have a deep muscle massage every month or so. After my sister had a stroke, I started worrying that my massages could loosen any plaque in my carotid arteries, which could make me have a stroke. Could this happen?
Mini strokes are a maxi problem
Transient ischemic attacks (TIAs), while seemingly insignificant, often lead to strokes within a short time span. If you experience a TIA or have symptoms that suggest one, take it seriously and seek treatment right away.
Angiotensin inhibitor or blocker?
For people who need medication to lower blood pressure, there are two types of drugs available. ACE inhibitors have been available longer than ARBs. They are comparably effective, though several ACE inhibitors are available in generic form.
Surgery or angioplasty for opening a clogged neck artery?
Those with a narrowed carotid artery have a choice between two procedures to clear the blockage: endarterectomy or angioplasty. Although it is less invasive, the risk of stroke is higher following angioplasty, making it the riskier choice for most people.
Triglycerides: A big fat problem
Triglycerides contribute to atherosclerosis, usually (but not always) in combination with other factors. Triglycerides can be lowered by making lifestyle and diet changes, though some people also need a medication.
Heart Beat: Sexy supplements can be bad for the heart
Several supplements marketed to men claiming to enhance sexual function were found to contain substances similar to erectile dysfunction drugs, which can be dangerous for men who take certain medications for heart disease.
Heart Beat: Pedometer-powered walking
A pedometer is an inexpensive tool that can help promote fitness by measuring a person's steps. Being aware of how much one is walking acts as a motivator to walk more.
Heart Beat: New blood sugar measure
The American Diabetes Association has set a standard for measuring blood sugar that expresses the information in two different forms, corresponding to the way the reading is given in medical tests and also in home testting.
Brief updates on tingling stents, Alzheimer's disease and blood pressure, exercise as medicine, and vascular disease in women.
Ask the doctor: Is this pain from my heart?
Every now and then I get a sudden, sharp pain on the left side of my chest, like a knife. I get a little dizzy, and then it disappears as quickly as it came on. Even though the test results were fine, it still scares me. Should I be concerned about this?
Ask the doctor: Could heart surgery have affected my lung?
Almost three years ago I had triple bypass surgery and mitral valve replacement. I did so having only one lung. It feels like the operation somehow harmed my lung, making it harder to breathe. Can heart surgery do this?
Ask the doctor: Is my blood pressure normal?
I'm a 75-year-old woman. The top number of my blood pressure is between 135 and 140, the bottom number around 75. My doctor says this is fine. Should I believe him?
Ask the doctor: Are all dark chocolates good for the heart?
Dark chocolate is supposed to be good for the heart. But how do I know which chocolate is "dark"? Some labels list percent dark chocolate, others percent cocoa solids. Can you help me pick the best one?
Several medications commonly prescribed to heart patients can cause adverse reactions, even when taken as directed. Therefore caution should be used and any unusual symptoms or side effects should be reported to a doctor right away.
Electrocardiogram: Visualizing the heart's electrical signature
An electrocardiogram test is an important tool in diagnosing heart disease. Doctors can analyze the information to evaluate a patient's condition and identify problems.
Focus on hormones: Estrogen therapy - benefits in the timing?
Estrogen is beneficial for controlling symptoms of menopause, but its benefits for younger women seem to become risks for older women, so it should not be taken to prevent heart disease.
Focus on hormones: Testosterone therapy's benefits, risks need crystallizing
Lower levels of testosterone may correlate with a higher risk of heart disease, but taking a testosterone supplement may also increase the risk of prostate cancer and reduce beneficial HDL cholesterol.
Heart Beat: It's never too late for healthy eating and exercise
Changing one's dietary and exercise habits is beneficial to overall health, regardless of age.
Heart Beat: Lopsided decline in heart disease deaths
Death rates from heart disease had been declining since the 1960s, but recently they have leveled off in men and increased very slightly in women, probably due to increases in obesity and diabetes.
Heart Beat: Hole in the heart
A patent foramen ovale is a small hole in the heart which usually closes soon after birth, but if it does not, it may be a cause of stroke later in life.
Heart Beat: It was only a matter of time: Plant sterols in chips
Plant sterols have been shown to reduce cholesterol, so a company is manufacturing tortilla chips with sterols added.
Heart Beat: Good news keeps brewing on coffee and heart disease
According to an Italian study, heart attack survivors can safely drink a cup or two of coffee a day without increased risk for additional heart disease.
Heart Beat: A Chia Pet for diabetes?
A seed related to those used in Chia Pets is a good source of fiber, protein, and antioxidants, but the same benefits can be obtained from eating whole-grain food products.
Heart Beat: Red light, green light on medications
Certain medications used to treat anemia may increase the risk of heart attack, while the FDA concluded that the heartburn drugs Prilosec and Nexium are not harmful to the heart.
Heart Beat: Checking blood pressure at home
People with high blood pressure who regularly monitor their blood pressure at home seem more likely to lower their pressure over time than those who only have it checked at a doctor's office.
Ask the doctor: Is it okay to take aspirin, Plavix, and warfarin?
I am 85. I had an angioplasty with a stent and I'm on aspirin and Plavix. Now I have atrial fibrillation, and my doctor wants me to take Coumadin. Is this dangerous? Should I stop taking aspirin and Plavix? Or could I just take them without the Coumadin?
Ask the doctor: Can a pacemaker cause dizzy spells?
My father recently had a pacemaker installed. Now, almost every time he stands up or gets out of bed, he feels dizzy. Is this a common side effect of getting a pacemaker, something he needs to get used to? Is there anything he can do about it?
Angioplasty or bypass surgery?
Blocked arteries can be resolved by either angioplasty or bypass surgery. Angioplasty is a much easier procedure, but frequently needs to be repeated later. For some, medication, exercise, and changes to diet are more effective than either procedure.
Trial fails to enhance cholesterol drug's reputation
Research found that the cholesterol drug Vytorin, which combines Zetia with the statin Zocor, is no more effective than a statin alone at preventing plaque from growing in arteries.
Big trouble from small arteries
Coronary microvascular disease, which affects the smallest arteries in the heart, is difficult to detect because of the small size of the vessels, but tests are improving, and awareness of the condition among doctors is growing.
State-of-the-heart therapy for prostate cancer
Aggressive prostate cancer can be treated by using hormone therapy to lower testosterone, but it can result in higher cholesterol, high blood pressure, stiffening arteries, and other heart-unhealthy conditions.
Heart Beat: Golden opportunity to fight heart disease
Research has found a potential connection between low levels of vitamin D and increased risk of heart attack, stroke, heart failure, and other cardiovascular conditions.
Heart Beat: Small price to pay for an extra 14 years
People who exercised, ate a diet rich in fruits and vegetables, drank alcohol in moderation, and did not smoke lived an average of 14 years longer than others who did not do any of these things.
Heart Beat: Dual duty for WelChol
The FDA has approved WelChol, a medication that helps to lower both LDL cholesterol and blood sugar, which may be beneficial to some diabetics, though they would still have to take insulin along with WelChol.
An excess of aldosterone, a hormone produced by the adrenal glands, can increase the risk of heart disease. The problem can be treated with medication, but sometimes it is necessary to remove the glands.
An article on very high triglycerides in the February 2008 issue neglected to mention that cutting back on processed carbohydrates and replacing them with whole, minimally processed foods can substantially lower triglycerides.
Ask the doctor: Do people on warfarin need to avoid vitamin supplements that contain vitamin K?
You mentioned Centrum Cardio, a new multivitamin supplement that supposedly lowers cholesterol. Taking two tablets a day would deliver 25 micrograms of vitamin K. Is it wise to recommend this product for someone taking warfarin or other anticoagulants?
Ask the doctor: Is a nuclear imaging stress test the same thing as an exercise stress test or exercise echocardiogram?
I had some chest pain on vacation. The doctor told me to have a nuclear imaging stress test when I got home. My physician sent me for a treadmill test. But the cardiologist had me do an exercise echocardiagram on a bicycle. Are these tests the same?
Ask the doctor: Are medications for ADHD safe for the heart?
I am a fairly healthy 52-year-old man. For many years I have felt like I have ADHD. A recent work-up confirmed my suspicion. My doctor suggested I take Ritalin. Is that okay for the heart?
Know the warning signs
Many people do not know or recognize the warning signs of a heart attack, stroke, or cardiac arrest. Because the brain may be deprived of oxygen during such an event, quick action could save someone's life.
ACCORD's discord on blood sugar control
A clinical trial measuring the effectiveness of maintaining tight control of blood sugar in diabetics was ended early due to a higher than expected number of deaths, but keeping blood sugar below a certain level is still important for those with diabetes.
It's time to accentuate the positive
A study found that people who maintained a positive approach to life in their thoughts and feelings, referred to as high emotional vitality, had a lower risk of heart disease.
Get a hearty start on the day
Eating a healthy breakfast has always been a smart nutritional choice. A breakfast containing whole grains and fruits may lead to reduced risk of heart attack, stroke, diabetes, or other cardiovascular ills.
A new crystal ball
Researchers with the Framingham Heart Study have developed a new tool to assess overall risk of cardiovascular disease by assigning points to various risk factors, then aligning total points with levels of risk.
Heart Beat: Heparin: a risky bridge over troubled waters?
People who take warfarin to prevent blood clots who need to undergo a surgical procedure generally need to stop taking the drug a few days beforehand, but for those who are at high risk of a clot, taking heparin instead for a few days may be necessary.
Heart Beat: Bypass surgery no barrier to sexual satisfaction
A survey of patients both before and several years after bypass surgery found that men were more satisfied with their sex lives than before surgery, but women were less satisfied than before.
Heart Beat: Dangers of skipping medications after a heart attack
After a heart attack, getting prescriptions filled and taking the medications consistently is crucial. Those who do not do so are at a much higher risk of dying within the year following an attack.
Heart Beat: Kudos on cholesterol?
The average American's cholesterol level has dropped for the first time, but this is due more to the prevalence of statin drugs than to improvement in people's dietary habits.
Heart Beat: New guidelines for bleeding disorder
The National Heart, Lung, and Blood Institute has released guidelines to assist physicians in identifying patients with von Willebrand disease, a blood disorder that prevents clotting.
Heart Beat: Panic attacks linked to heart disease
According to a study, women who suffered from panic attacks were more likely to have a heart attack or stroke than those who did not.
Brief updates on a possible connection between age-related macular degeneration and heart disease, the effectiveness of diuretics to treat metabolic syndrome, and an alternate way to test for claudication.
Ask the doctor: Are heart drugs causing my nighttime leg cramps?
Many nights I wake up once, twice, or several times with leg cramps. The only medications I take are a statin, niacin, Plavix, and baby aspirin. Are any of them causing these aggravating cramps?
Slow rehabilitation of drug-coated stents
Drug-coated stents were thought to cause a higher occurrence of thrombosis (clots) compared to bare-metal stents, but further research has shown the incidence to be about the same. Many people with a blocked artery could benefit from a drug-coated stent.
Don't delay when heart failure threatens
People living with heart failure need to pay attention to warning signs, such as shortness of breath, or swelling of the ankles or feet, that may indicate a worsening of their condition.
A second look at beta blockers and blood pressure
Beta blockers have helped millions of people lower their blood pressure, but for people with hypertension who do not have other cardiovascular issues or symptoms, a beta blocker might not be the most effective medication.
Seeing the heart with sound
An echocardiogram creates images of the heart using sound waves. It can reveal a great deal of information useful to doctors in treating heart patients.
Heart Beat: Warfarin home monitoring program expanded
People who take the medication warfarin need to test their blood regularly to monitor its clotting time. A Medicare program is providing the equipment and means to do this testing at home.
Heart Beat: Chrome dome doesn't mean sicker ticker
Researchers found no substantive links between baldness and the risk of a heart attack, or between baldness and the buildup of plaque in carotid arteries.
Having a home defibrillator was found to be no more useful at saving the life of someone in cardiac arrest than having family members trained in CPR.
Ask the doctor: Can I keep myself from fainting when I have blood drawn?
I want to donate blood, but I faint or come close to it nearly every time I have blood drawn at the doctor's office. Can I do anything to keep myself from fainting?
Ask the doctor: Is high blood pressure in the morning a problem?
My blood pressure is high when I first get up in the morning, but always drops back to normal by 9 a.m. and stays that way throughout the day. I take Avapro. My doctor says I shouldn't worry about the temporary high morning pressure. What do you think?
Age no barrier to blood pressure control
Doctors used to worry that the potential harm of blood pressure medication outweighed any benefit to elderly patients, but a study found that the medication did reduce the incidence of heart disease, stroke, and premature death in older patients.
Going after angiotensin
An angiotensin-receptor blocker controls blood pressure as well as an ACE inhibitor, but taken together they are more likely to cause unwanted side effects. ACE inhibitors are also available in generic form, which costs much less.
Fish and fish oil: Good for most folks, but not all
Fish oil contains beneficial omega-3 fats, but people with heart failure, angina, or an implanted cardioverter-defibrillator (ICD) should minimize their consumption of fish, and should not take fish oil capsules.
Does fitness offset fatness?
A person can be overweight and still be fit and healthy, but it is still better for the body to lose weight if possible, and even better to lose weight and get regular exercise.
Taking heart disease to new heights
Travel to high-altitude locations is risky for people with heart disease, but knowing the limitations of the condition and taking proper precautions can make the trip possible for some.
Heart beat: Air pollution fails the heart, vitamins may help
Air pollution is harmful to the heart, but a diet with adequate amounts of B vitamins and methionine, an amino acid, may counteract the health problems caused by pollution.
Heart beat: Heart-stopping thrills
Roller coasters and other high-velocity amusement park rides can cause spikes in heart rate and blood pressure that may be dangerous for riders with heart problems.
Heart beat: Hands-only CPR
The American Heart Association has revised its guidelines for administering CPR to a victim of cardiac arrest, and now recommends using only firm, quick chest compressions.
Heart beat: Sweeter note sounded for iPod users
An earlier advisory to keep an iPod away from the heart of a pacemaker wearer may not be necessary, but caution is still advised.
Heart beat: Calcium scan benefit still uncertain
A CT scan for calcium buildup in arteries near the heart can help predict the likelihood of an attack, but its cost outweighs its usefulness in people with low risk of heart disease.
Brief updates on why diabetics should limit their consumption of eggs, attempting to patch a hole in the hearts of some migraine sufferers, and a possible connection between clogged vein grafts and depression.
Ask the doctor: Should I worry about my low diastolic pressure?
I am a 70-year-old woman with type 2 diabetes. I take Glucophage, Glucotrol, and a statin. My diastolic pressure used to be between 70 and 80, but now it's down into the 50s and 40s. This seems low to me. Could this indicate a problem?
Ask the doctor: Does Tricor cause gallstones?
I started taking Tricor because I have low HDL and high triglycerides. Someone I know at work developed gallstones after being on Tricor for a while. Is this a common side effect? If so, is there another medication I can take?
Hypertension and diabetes - double trouble
People with hypertension should be tested for diabetes. Treating both conditions with lifestyle changes (exercise, weight loss, quitting smoking) can substantially reduce the risk of a heart attack or stroke.
Balancing hope and reality in heart failure
A hopeful outlook can help heart failure sufferers live with the condition, but hope must be tempered by reality in order to achieve a clear understanding of the limits of treatment.
Joint inflammation may point the finger at heart disease
Inflammation from rheumatoid arthritis, lupus, or gout has been linked to an increased risk of heart disease. Drugs are being tested, but the current advice is to exercise, eat a healthy diet, and control weight, blood pressure, and cholesterol.
When quitters are winners
Many people do not realize that smoking is as bad for cardiovascular health as it is for the lungs. Quitting has some almost-immediate benefits, and after 20 years quitters have the same risk of death as nonsmokers.
Heart beat: Trial questions beta blockers for all before noncardiac surgery
The recommendation to take beta blockers before noncardiac surgery is now tempered by the information that the drug should be started a few days prior to surgery.
Heart beat: DASH diet ignored
While the DASH diet helps people lower their blood pressure and reduce the risk of heart disease, fewer people are following it.
Brief updates on a warfarin information booklet, a possible link between loop diuretics and bone loss, and a drug for peripheral artery disease that may also help prevent strokes.
Ask the doctor: How long do I need to keep taking Plavix?
I need to catheterize myself. I had stents put in my heart and started taking Plavix. I sometimes see a tinge of blood in the catheter bag, though lately the blood flow has been more substantial. I am 88 years old. How long will I need to take Plavix?
Ask the doctor: Can I have my hernia fixed while taking Plavix?
I had stents placed. My doctor told me to take Plavix and aspirin indefinitely. Now I need a hernia repair. My surgeon said to stop taking the drugs before the operation. My cardiologist says that would increase my chance of a clot in one of the stents.
Ask the doctor: Are community heart check-ups worth doing?
I often get mail from companies like Life Line Screening about having tests to look for "hidden" heart risks. The events are usually held at a local church and cost about $130. Are these tests valid? Are they worth the money?
Ask the doctor: Is sotalol making me tired and heavier?
My doctor put me on a calcium-channel blocker, but after I had angioplasty and got a stent, my doctor switched me to sotalol. Now I feel tired all the time and have gained weight, even though I feel like I'm eating less. Can this be from the sotalol?
Checking blood pressure: Do try this at home
Regular home blood pressure monitoring, for people with hypertension or those who are at risk for it, is a recommended health practice that can help keep blood pressure under control.
Aches and pains - is your statin to blame?
About ten percent of people who start taking a statin experence muscle pain. Usually this will go away on its own, or by adjusting the dosage of the medication or switching to a different one.
Get the lead out
The leads of implanted cardiac devices can break or become infected over time. If this happens, the leads must be replaced. A defective lead can be left in the heart, but it is considered safer to have it removed.
Mediterranean diet sails well in the USA
Long-term research finds that following a Mediterranean diet, which emphasizes vegetables, fruits, whole grains, and fish, can reduce the risk of heart disease, benefit heart attack survivors, and help with weight loss.
Heart beat: Post-heart attack angina common, and commonly untreated
A study found that a year after a heart attack, about 20% of people were still suffering from angina. A program of cardiac rehabilitation can strengthen the heart and help eliminate angina's pain.
Heart beat: Heart disease a major killer among people with HIV/AIDS
People living with HIV are more susceptible to heart disease, so it is important for them to stay healthy and fit, in order to ward off risk factors like high triglycerides, low HDL cholesterol, and hypertension.
Brief updates on controlling heart rate with medication, quality of heart attack care at night and on weekends, and vitamin D's importance to the heart and arteries.
Ask the doctor: What's the difference between blood sugar and hemoglobin A1c?
In your article on blood sugar control, you kept talking about hemoglobin A1c. I measure my blood sugar all the time, but my meter doesn't have a setting for a percentage reading. Is there a simple connection between blood sugar and hemoglobin A1c?
Ask the doctor: What's the connection between statins and coenzyme Q10?
Why don't you ever tell your readers that everyone who takes a statin to lower cholesterol should be taking coenzyme Q10, too?
Dial 911 when a heart attack has your number
Starting treatment quickly provides the best chance of surviving a heart attack. If you think you are having a heart attack, you should call 911 rather than have someone take you to the hospital, because paramedics can start treatment on the way there.
Alcohol's cardiac effects differ by sex
Women who drink too much alcohol risk cardiovascular problems and an increased chance of breast cancer, but in moderation (no more than one drink per day) alcohol is associated with a lower risk of heart disease and stroke.
The ankle-brachial index is a comparative blood pressure test, taken at the arms and ankles, that is done to check for the presence of peripheral artery disease.
Smaller surgery speeds recovery from valve fix
A minimally invasive version of heart surgery to replace or repair a mitral or aortic valve has shown excellent results and has a shorter recovery time on average, making it an option that older people should consider.
Heart beat: Coffee: A connection to good health?
Coffee lovers should be reassured by a study showing that death rates among coffee drinkers were no higher than for people who did not drink coffee.
Heart beat: CT scans may interfere with pacemakers, other devices
People with a pacemaker or ICD know they need to avoid MRIs. The FDA says that the CT scans may also interfere with these devices, but that they can be safely shut off for the duration of the scan.
Heart beat: Tapping the power of potassium
Potassium helps fight high blood pressure, but most Americans do not get enough potassium from their diet. Eating more fruits, vegetables, beans, and certain other foods boosts potassium levels.
Brief updates on the heart benefits of obesity surgery, a heart medication's effect on bone health, and taking statins prior to heart surgery.
Ask the doctor: Is my blood pressure medicine changing my ability to taste?
My sense of taste isn't as good as it was a few months ago. I started taking Capoten on top of the diuretic I have been taking for some time to control my blood pressure. Could the new drug be affecting my sense of taste? If it is, what can I do about it?
Ask the doctor: How is a blocked stent fixed?
What happens when a stent gets clogged up? Someone told me that a new one gets put over the plugged-up one, but that doesn't sound right.
Ask the doctor: How do I know if my new valve isn't working correctly?
I had a mechanical valve put in to replace a stiff aortic valve. But it hasn't made a big difference in how I feel. I still get short of breath when I try to walk fast. Could it be the wrong size, or not working properly?
Sleep apnea wakes up heart disease
Sleep apnea causes increased production of stress hormones, faster heart rate, increased blood pressure, and inflammation. Research has found that people with the condition are more likely to die of cardiovascular disease.
Flap over tilapia sends the wrong message
Tilapia has been criticized because it is lower in omega-3 fats and higher in omega-6 fats than other kinds of fish, but it is still a good source of protein and has other nutritional value.
No-surgery valve repair puts excitement to the test
Progress is being made on developing less invasive surgeries to replace or repair heart valves, but more research is needed before they become a viable option for the average person.
Living with long QT syndrome
Long QT syndrome is a lengthening of part of the heart's normal rhythm that occurs when its muscle cells do not properly process certain substances. The resulting erratic heart rhythm can cause fainting, shortness of breath, and possibly death.
Slow down and savor the flavor
Eating meals more slowly allows the stomach time to signal the brain when it is getting full, which can result in lower overall food consumption. Drinking water with your meals can also help by making you feel fuller.
Heart Beat: Drugs, angioplasty nearly equal for angina relief
A clinical trial that compared angioplasty with aggressive drug therapy for treatment of angina found both treatments about equally effective.
Heart Beat: Uncertainty dogs Zetia and Vytorin
The cholesterol-lowering drug ezetimbe, sold as Zetia and in combination with the statin Zocor as Vytorin, has proved no better at reducing plaque than the statin alone, and may be linked to an increased risk of cancer.
Brief updates on a drug combination that may cause muscle damage, a blood test for rejection after a heart transplant, a possible link between retinopathy and heart disease, and running for heart health and longevity.
Ask the doctor: Is low blood pressure a problem?
You are always talking about high blood pressure. Mine is always on the low side, about 80/60. Is that a problem?
Ask the doctor: Are there different kinds of heart failure?
Several years ago, a friend in my sewing circle was diagnosed with congestive heart failure. My doctor just told me I have heart failure. Are these the same condition or different ones?
Resistant hypertension needs special attention
Blood pressure that stays high even when three or more medications are taken is called resistant hypertension. In such cases lifestyle changes are especially important, and there may be underlying causes such as sleep apnea.
Wrist artery a safe approach to the heart
Most angioplasty procedures are performed through the femoral artery in the groin, but the radial artery in the wrist is also a viable access point, and may be slightly safer for some patients.
Beats per minute a signal of heart health
A resting heart rate above 100 beats per minute may be an indicator of more serious conditions such as atherosclerosis. Making an effort to exercise and reduce stress can help slow the heart to a healthier rate.
Folic acid: Too much of a good thing?
Because some foods are now fortified with folic acid, people who take multivitamins may be getting too much of it. This can block the body's ability to process folate, the natural form of folic acid, which in turn may be linked to heart disease.
Pre-dental antibiotics for few, not many
In a reversal of its previous advice, the American College of Cardiology says that most people with heart disease do not need to take antibiotics before having dental work done, but people in certain categories still need the medication.
Heart Beat: New COPD medications seem okay for the heart
There is some concern that drugs used to keep airways open in people with COPD may increase the risk of heart disease, but the testing done so far suggests that the medications are safe.
Heart Beat: Green tea and statins
People who take a statin may want to watch their intake of green tea, as there is a possibility it may boost the blood concentration of the medication to pain-causing levels.
Heart Beat: Hot flashes and the heart
Postmenopausal women who continue to experience hot flashes may be at increased risk of having high blood pressure, high cholesterol, or clogged arteries.
Brief updates on niacin's beneficial effect on HDL, exercise's aid in preventing atrial fibrillation, and an FDA web site with information about guidelines for drug ads.
Ask the doctor: Is it dangerous to have calcium in the aorta?
A test showed that I have calcium in my aorta. My doctor said it isn't serious, and that, as a 79-year-old, I will have to "live with it." Can you tell me more about this condition?
Ask the doctor: Do calcium supplements counteract calcium-channel blockers?
My doctor started me on a calcium-channel blocker for high blood pressure. I also take a daily calcium supplement for my bones. Will that counteract the drug's effect?
Ask the doctor: Can you get a stent after bypass surgery and vice versa?
A friend told me that if you get a stent you can't have bypass surgery later on. Is that right? And what about the opposite - getting a stent after having bypass surgery?
Put some bite into heart disease prevention
Researchers are exploring how bacteria in the mouth might play a role in heart disease, though there is still no conclusive evidence that the two are linked.
Blood pressure drugs can boost blood sugar
Among the many types of blood pressure medications available, some have a tendency to increase blood sugar levels, but this does not necessarily lead to a higher risk of diabetes.
Fish: Friend or foe?
While toxins such as mercury and PCBs are present in seafood, the amounts are considered safe, and the health benefits of omega-3 fats are much more significant than any risk posed by the toxins.
No benefit for late angioplasty after a heart attack
Angioplasty to treat chest pain will be most efffective if the procedure is done within the first 12 hours after onset. If you have had symptoms for longer, drug treatment is likely to be as effective as angioplasty.
Heart Beat: Dancing away from heart failure
A study comparing different forms of exercise for people with moderate heart failure found that ballroom dancing was as effective as a traditional exercise regimen, and also improved patients' quality of life.
Heart Beat: Too soon to sell a gene test for warfarin?
Determining the correct dosage of warfarin for a heart patient can take several weeks. A company is selling a test that it claims will shorten the process, but there is no evidence yet to support the claim.
Heart Beat: Is there an afterlife for pacemakers and defibrillators?
Pacemakers and other implanted cardiac devices can be removed after a person's death and recycled for patients who cannot afford them. If you wish to do this, you should have a medical directive stating so.
Ask the doctor: What are the symptoms of, and tests for, an enlarged heart?
How would I know if I had an enlarged heart?
Ask the doctor: What's the skinny on fat-free half-and-half?
Is fat-free half-and-half good for you?
New drug fizzles at raising HDL
With the failure of torcetrapib, a drug that its maker hoped would raise HDL cholesterol, people seeking to lower their heart disease risk should rely on traditional strategies: exercise, diet, weight control.
Some blood pressure drugs act as a skeleton key
In addition to their known benefits as drugs that lower blood pressure, research suggests that thiazide diuretics, beta blockers, and ACE inhibitors may also help protect and strengthen bones.
Late blood clots tarnish drug-coated stents
After several years on the market, there is clear evidence that drug-coated stents pose a small but definite risk of causing blood clots. If you have chest pain, adopting a healthier lifestyle may be a safer alternative to having a stent implanted.
Heart Beat: Alcohol and high blood pressure
While people with high blood pressure are typically told to abstain from alcohol, a study suggests that moderate alcohol consumption may help prevent them from having a heart attack.
Heart Beat: Fatal attraction?
A new, stronger type of magnet used in some jewelry and clothing can interfere with the operation of a pacemaker or other implanted cardiac device if placed too close to it.
More Americans have their hypertension under control. Folic acid does not prevent heart attacks. Exercise after heart surgery is safe and beneficial. Program your cell phone with an emergency contact.
Ask the doctor: Do grapes and grape juice protect the heart like wine does?
For the health of my heart and arteries, how does regular consumption of red wine compare with grape juice or the equivalent in grapes?
Ask the doctor: Is it dangerous for me to go over my target heart rate?
My resting heart rate is on the high side, and it rises quickly when I exercise. I am afraid to go faster than 2 miles an hour on the treadmill, and I don't feel like I'm getting a real workout. Is it dangerous for me to go over my target heart rate?
Mixed marks for heart surgery report cards
A few states have begun to compile data on the success rates of cardiac surgeons, but the information may be outdated or otherwise inaccurate. One suggestion is to choose a doctor who regularly performs the surgery you need and has done it many times.
9 ways to protect your heart when diabetes threatens it
Most people with diabetes eventually develop some form of heart disease, but this is not inevitable. Focusing on improving health through diet, exercise, weight loss, and lowering blood pressure and cholesterol can help prevent heart disease.
Aldosteronism: Too much of a good thing
An excess of aldosterone, a hormone produced by the adrenal glands, causes hypertension in some people. Treatment depends on whether one gland or both is affected.
Statins for aortic valve narrowing?
Some research suggests that cholesterol-lowering statins may help prevent narrowing or hardening of the aortic valve, but there is not enough evidence to indicate you should start taking a statin if you are not taking one already.
Different shades of gray for post-heart attack depression
Depression can often develop as a result of a heart attack or cardiac surgery, and has more serious effects on heart health and overall health than depression that was present before a heart attack.
Heart Beat: Home defibrillator skills slip away
Research found that people who have a home defibrillator for use in case of a cardiac emergency tended to forget how to use the device over time. If you have such a device, it is vital to know how to use it and to maintain this knowledge.
Heart Beat: Parkinson's drugs linked to heart valve trouble
Two drugs used to treat Parkinson's disease have been found to cause heart valve leakage. If you take one of these medications, you should ask your doctor about switching to a safer one. If no other drug is effective, watch for signs of valve trouble.
Heart Beat: New Start! for exercise
The American Heart Association has launched a web site to help people track their eating habits and exercise, and offers tips and encouragement toward living a healthier life.
Heart Beat: Tea with a twist
If you drink tea, taking it with milk seems to negate any positive effect from the antioxidants it contains. However, there is still no definite evidence that tea can protect you from heart disease.
Ask the doctor: Is a lot of exercise bad for the heart?
I know that exercise is good for my heart, which is one reason why I took up long-distance running. But I have heard that marathon running damages the heart. Is that true?
Ask the doctor: Does it matter when I take a statin?
My doctor put me on a statin and told me to take it after dinner. I would rather take it with breakfast. Does it matter?
Heart scans hold intermediate promise
CT scans can detect calcium in arteries, but the presence of calcium does not automatically indicate the presence of heart disease. The test may still be of some benefit to those with an intermediate risk but without symptoms.
A new way to control blood pressure
The FDA has approved a new blood pressure drug that works by inhibiting hte production of renin, a substance made by the kidneys that is the first step in the body's system of regulating blood pressure.
New tool refines heart risk prediction
The Framingham heart disease risk-assessment tool has been refined and improved with the addition of several new risk factors that contribute to the overall score and make it a more accurate predictor of heart disease risk.
What the latest diet trial really means
The Atkins diet helped women lose weight more quickly compared to other diets, but long-term eating strategies that match food intake to calories burned are the most effective way to maintain a healthy weight.
Heart beat: As the hammock swings
A Greek study found that taking a nap may decrease the risk of heart disease, but the results may be due to other factors, such as a lower-stress lifestyle, so they cannot be interpreted as cause and effect.
Heart beat: States of the heart
A survey by the federal government provides data for a visual representation showing the incidence of heart disease in the United States.
Heart beat: Study suggests limiting use of aspirin plus warfarin
The combination of aspirin and warfarin is prescribed to prevent clotting, but it does not have this effect in all heart disease patients, and can sometimes cause stomach bleeding.
Ask the doctor: Is weight lifting safe if I have a stent?
I am 58 and have had several stents implanted. I used to lift weights, but stopped after getting the stents. My blood pressure is good, and I take medications. I want to resume lifting but worry that it could cause a heart attack. Is that possible?
Ask the doctor: Is my breathlessness a heart or lung problem?
I had a quadruple bypass seven years ago. A few months back I found myself taking frequent short breaths when I climbed the stairs. Once I stopped exerting myself, my breathing soon returned to normal. Is this due to a problem with my heart or lungs?
Ask the doctor: Does a low ejection fraction doom me to inactivity?
At age 64 I had a severe heart attack that left me with a 20% ejection fraction. A recent echocardiogram showed that my heart is getting larger. I have no shortness of breath or swelling, but wonder how long I have before symptoms of heart failure appear?
Ask the doctor: Can eye drops for glaucoma affect the heart?
I was recently diagnosed with glaucoma. My eye doctor prescribed eye drops to reduce the pressure inside my eyes. After a short time I had to stop using them because they made me dizzy and my heartbeat felt strange. What else can I do for my eyes?
Yellow light on pain relievers
While there is a risk of adverse effects from any pain reliever, most people can take them safely. Use common sense, and have your blood pressure checked regularly if you are in a higher risk group due to heart disease.
Reception still fuzzy for fast CT scans of the heart
A new type of CT scan produces a clearer image of the heart than current methods, and without the need for an invasive catheter. Though there are some drawbacks to its use, the test may be helpful in emergency settings, when a quick diagnosis is needed.
COURAGE to make choices
A long-term study of treatment for stable coronary artery disease found that angioplasty was no better than the combination of medication and lifestyle changes at preventing future heart disease or prolonging life.
Heart Beat: Big bend for blood pressure?
A study reports that if the vertebra that supports the skull is misaligned, careful manipulation of it may result in a significant drop in blood pressure.
Heart Beat: High pulse pressure poses risk for atrial fibrillation
Pulse pressure is the difference between the high and low blood pressure measurements. A high pulse pressue (larger than 40) may lead to the development of atrial fibrillation, an irregular heart rhythm.
Generic versions of the blood-pressure drug Norvasc will save consumers money. A high-fiber diet may lower C-reactive protein, which contributes to inflammation of arteries.
Heart Beat: A heartfelt legacy from long-lived parents
According to the long-term Framingham Heart Study, having parents who live to age 85 or beyond may offer a greater degree of protection from heart disease and stroke.
Heart Beat: More evidence against trans fats
Researchers measured the amount of trans fat in blood cells and found that those with higher levels in their blood had a higher risk of having a heart attack or dying of heart disease.
New guidelines for CPR say to do chest compressions only and skip mouth-to-mouth breaths. Scientists are still looking for ways to boost HDL cholesterol. Periodontal treatment may be beneficial to the heart and arteries.
Ask the doctor: Can I stop taking my blood pressure medicine?
After taking atenolol for years, my doctor suggested cutting the dose. Then my cardiologist suggested that I stop taking it altogether. On the first day I didn't take it I felt "buzzed." My pressure began to creep upward. Did I bail out too quickly?
Ask the doctor: Should I take nitroglycerin during exercise?
I have a prescription for nitroglycerin, but I rarely need it. Every once in a while on the treadmill, I feel my chest tighten up. I take a pill, then continue exercising. I read a column by a doctor who said this is "ludicrous." What do you think?
What triggers heart attacks?
People who are at risk for heart disease may be fine for some time, until a stressful event or situation acts as a trigger for a heart attack or stroke. Even in those with heart disease, some of these triggers can be minimized or avoided.
Guidelines offer women a change of heart
Women are at as much risk for heart disease as men are. The American Heart Association has compiled a list of guidelines that offer a number of ways women can reduce their risk.
A road map to life in the fat lane
The body's process of turning fat into artery-blocking plaque is described and illustrated.
Heart Beat: Drive-through angioplasty?
Several European studies have found that the majority of people who undergo nonemergency angioplasty do not have to remain in the hospital overnight, but further study is needed before this practice becomes common in the US.
Heart Beat: Applying cardiac advances saves lives
As the guidelines for treating heart disease are informed by evidence from medical studies, these treatments become more common and survival rates increase.
Heart Beat: Migraine, heart disease linked
A study found that men who suffered migraines were more likely to have heart disease, but there is no evidence that migraines cause heart trouble, and no evidence as to what the connection, if any, may be.
Ask the doctor: Is warfarin turning my toes purple?
I take warfarin. I have blood blisters on my arms and sporadically on my legs. Recently I developed purple toes on one foot. My cardiologist didn't seem concerned and wouldn't explain whether it was the warfarin. Can you shed some light on this?
Ask the doctor: What causes C-reactive protein levels to vary?
I had a high-sensitivity C-reactive protein test that was 38.6, which my doctor said was quite high. My cholesterol was fine. A heart scan and stress test were normal. When my doctor repeated the test, my hsCRP was 6.1. What can cause such variations?
Ask the doctor: Can you really prevent heart disease?
People know that they can "prevent" heart disease by not smoking, losing weight, exercising, watching cholesterol and blood pressure, and eating right, but they still get heart disease. Is it really possible to prevent heart disease, or just slow it down?
Ask the doctor: Why does my father feel wires poking him in the chest months after open-heart surgery?
My father had open-heart surgery 18 months ago. Fairly soon after the operation, he started having the feeling that wires are poking him in the chest. Is that possible? If so, is there a solution?
Outlook on diabetes drug less than rosy
The diabetes drug Avandia may increase the risk of heart attack in those taking it. Other medications are as effective at lowering blood sugar without Avandia's risks.
Aspirin: A user's guide to who needs it and how much to take
People at risk for heart attack or stroke will likely benefit from taking low-dose daily aspirin, but for some there are greater risks (such as ulcers or gastrointestinal bleeding) that outweigh aspirin's help.
Heart Beat: Longer workouts better for boosting good cholesterol
Exercise helps boost the body's production of HDL cholesterol, but the amount of the increase can vary. The longer the workout, the more the body's HDL cholesterol level is likely to be raised.
Heart Beat: Pacemakers, iPods out of sync
An iPod or other digital music player held too close to the chest of a person with a pacemaker can interfere with the heart device's function. Cell phones can also cause this interference.
Heart Beat: Talking it up: speech and atrial fibrillation
Cardiologists found a case where too much talking was a trigger for atrial fibrillation.
Eating soy nuts may lower blood pressure slightly. Allegedly natural male enhancement products were found to contain substances almost identical to ED medications, which could be dangerous to men taking a nitrate medication for chest pain.
Correction and Clarification
The medication Actiq was incorrectly identified in a previous article as a treatment for pain related to heart disease. As it is a narcotic, it should only be used in special cases.
Ask the doctor: Are Lipitor and Crestor equally good for me?
have been taking Crestor (10 mg) for several years. Now my insurance company tells me it is dropping Crestor from its preferred drug list and suggests I replace it with Lipitor. Will this be okay?
Ask the doctor: Do beta blockers and ACE inhibitors help or harm the heart?
Is my long-term use of beta blockers and ACE inhibitors setting me up for heart failure? I understand these drugs keep my heart rate low. If the heart is a muscle, and muscles are strengthened by exercise, won't slowing the heart weaken it?
Shake the salt habit for a longer life
Salt intake affects blood pressure, and can increase the risk of heart disease. Most of the salt people eat is added to foods during processing, so it is relatively easy to reduce salt consumption by choosing foods more carefully.
When high cholesterol is a family affair
A form of high cholesterol that is inherited, called familial hypercholesterolemia, can cause LDL levels of 200 or higher. Those who have it are at high risk for heart disease.
Skipping a beat - the surprise of palpitations
There are many possible causes of heart palpitations, including smoking, stress, and some medications. Though they are typically not serious or life-threatening, it can be difficult to determine the underlying cause.
Heart Beat: Paying attention to potassium in heart failure
Some medications taken by people with heart disease to counteract water buildup in the body can remove too much potassium from the body, while others can leave too much behind.
Heart Beat: A square of chocolate keeps the doctor away?
A German study suggests that, because of the antioxidants it contains, eating a small amount of dark chocolate daily may lower blood pressure by a few points.
Heart Beat: Diabetes poses danger for the heart, body
Many people with diabetes suffer from one of the numerous potential complications of the disease, but following a proper diet, getting exercise, and paying attention to risk factors can help prevent further problems.
Heart Beat: Waist watching
An increasing waistline in middle age could be an indicator of metabolic syndrome, which is a group of risk factors that often leads to heart disease or diabetes.
Heart Beat: Warfarin trumps aspirin for stroke prevention in elderly
Researchers found that the blood thinner warfarin is more effective than aspirin at preventing strokes and blood clots, allaying concerns that it was too powerful to be taken safely by older people.
Splitting statin pills saves money without risk to cholesterol control. Treating or preventing heart disease lowers the risk of memory loss. Tests of coenzyme Q10's effectiveness are inconclusive.
Ask the doctor: Is red yeast rice good for lowering cholesterol?
I saw a newspaper column that said red yeast rice is a safer, more effective way to treat high cholesterol than statin drugs. Is that true?
Ask the doctor: Why is my blood pressure higher in one arm than the other?
I was admitted to the hospital with chest pain. The doctors found my blood pressure was much lower in my right arm than in my left. They rushed me for a CT scan, looking for a "tear." Fortunately there wasn't one. What was it they were worried about?
Scaling back on antibiotics
Medical organizations have long recommended taking antibiotics before certain procedures that could cause bacteria to infect the heart, but new guidelines state that only people with certain heart conditions or diseases need take the drugs.
Driving under the influence of abnormal heart rhythms
The guidelines for how long to wait before driving after having an ICD implanted have been revised, to reflect the growing number of people who receive the device preventively.
Add intervals of intensity for a stronger heart
Exercise that includes interval training, where periods of slight or moderate exertion are alternated with short bursts of more intense exertion, can strengthen the heart and blood vessels.
Sticking it to blood pressure?
The belief that acupuncture can lower blood pressure has been tested by studies, but the conclusions regarding its effectiveness are divided.
Heart Beat: Nothing fancy
Death rates from coronary artery disease have been falling since the 1980s, due to emphasis on the need to combat the problem by adopting healthier habits.
Heart Beat: Beans, beans, the magical fruit
Besides the nutritional benefits, eating beans regularly can lower cholesterol and reduce the risk of a heart attack.
Heart Beat: The Mysterious Human Heart
A special program series on PBS will explore the workings of the human heart.
Ask the doctor: Does Fosamax cause atrial fibrillation?
I am 86 years old and have been taking Fosamax to strengthen my bones for nearly 10 years. A few months ago, I suddenly fainted and was later diagnosed with atrial fibrillation. Did that happen because I was taking Fosamax?
Ask the doctor: Is it safe to fly with heart failure?
I was just diagnosed with heart failure. My husband and I like to travel. Is it okay for people like me to fly?
Come back to the garden of eatin'
The foundation of good nutrition, eating the right foods in the right quantities, provides clear benefits for the heart, but exercise and weight control are just as important to good heart health as diet.
No denying the power of produce
The multiple nutrients that occur naturally in fruits and vegetables are beneficial to the heart and the rest of the body in numerous ways, and thus should be a part of everyone's diet.
In with the good, out with the bad
Our bodies need protein, carbohydrates, and fat, but some kinds are better for us than others. It's important to eat the right kinds and quantities of these components in order to receive the most benefit from them.
Translating good food into better diets
Several diets with roots in medical studies have the potential to provide some protection from heart disease and to lower cholesterol and blood pressure.
12 tips for holiday eating
These suggestions can help you negotiate the excesses of the holiday season, so you can enjoy yourself without overindulging.
Ask the doctor: Is canned fish good for the heart?
I know that eating fish is good for the heart. But fresh fish costs a lot and I can't get to the grocery store very often. Does eating canned fish help?
Ask the doctor: How many calories do I need?
How can I figure out how many calories I should take in every day?
Genetic help for a blood-thinner balancing act
The FDA is recommending a genetic test for people prescribed warfarin, to search for variants of certain genes that can affect the drug's effectiveness. But there is not enough evidence yet that the test makes using the drug safer.
Protecting the heart during noncardiac surgery
Guidelines from the American Heart Association and the American College of Cardiology offer advice on protecting the heart during noncardiac surgery.
A blood pressure problem that's isolated in name only
Isolated systolic hypertension, when the systolic blood pressure is above 140 while the diastolic pressure is below 90, is caused by stiffening of large arteries. Medication may be prescribed, but lifestyle changes will have more impact on overall health.
Heart Beat: Teachable moment
Research has established that heart disease tends to run in families, so if a family member has a heart attack or stroke, it should serve as a motivator for other family members to see their doctors.
Heart Beat: Steering clear of pacemaker infections
A small but growing number of people develop an infection after having a pacemaker or ICD implanted. Research has found that taking antibiotics before the procedure reduces the risk of infection.
Heart Beat: Newer bypass technique may be safer for women
A study found that women who had off-pump bypass surgery had much lower rates of heart attack, stroke, or death during the operation or shortly after, more so than for men.
Heart Beat: ACE, ARB duet questioned
ACE inhibitors and angiotensin-receptor blockers are both used to combat stress hormones, which can contribute to heart failure. Combining them brings additional risks that outweigh any possible benefits.
Heart Beat: Take a shot against heart disease
A study found that heart disease deaths peaked each year during flu season, because the flu can trigger a heart attack or stroke. Those with heart disease, and those at higher risk of getting it, should get a flu vaccine each year.
Heart Beat: Too few get the best therapy for an ailing heart
Cardiac rehabilitation programs have been shown to reduce deaths in the years following a heart attack or stent procedure, but not enough patients participate in the programs.
Ask the doctor: How do I handle conflicting advice about exercise?
Last year, I had an aortic dissection. My surgeon says not to do any cardio or resistance exercise and to keep my heart rate down. My cardiologist says I can do light cardio and resistance exercise but to watch my blood pressure. Whom should I believe?
Ask the doctor: Is yerba mate good for my heart?
Is it true that drinking yerba mate can lower blood pressure and cholesterol?