It’s easy to think of heart disease and stroke as an almost inevitable part of aging in a developed country like the United States. After all, they are our leading causes of death and disability. But the truth is that these are largely preventable conditions. New estimates from the Centers for Disease Control and Prevention (CDC) indicate that one-quarter of all deaths from heart disease and stroke are preventable. And that is almost certainly an underestimate. According to the report, published in Morbidity and Mortality Weekly Report, among American adults under age 75, approximately 200,000 of deaths caused each year by heart disease, stroke, and high blood pressure (hypertension) are preventable. Surprisingly, more than half of those preventable deaths occurred among individuals under age 65. The good news is that the rate of preventable death declined 29% from 2001 to 2010, the last year for which there are complete statistics.
A heart attack can be a frightening wake-up call with long-lasting aftereffects. It’s no surprise that women often tread gently after having a heart attack—and many don’t tread back into the bedroom for sex. Up to 60% of women are less sexually active after a heart attack, often due to worries that sex could trigger a repeat heart attack. A new study suggests that although women believe sex is important for resuming a sense of normalcy and intimacy with their partners, many are fearful that it would be too much for their hearts to take. Reassurance from a doctor is sometimes all that’s needed to ease those fears. How does a woman know if she’s physically ready for sex after a heart attack? It’s safe to have sex if you can work up a light sweat without triggering symptoms like chest pain or shortness of breath.
Summer’s heat is as predictable as winter’s chill. Heat-related illnesses—and even deaths—are also predictable. But they aren’t inevitable. In fact, most are preventable. Most healthy people tolerate the heat without missing a beat. It’s not so easy for people with damaged or weakened hearts, or for older people whose bodies don’t respond as readily to stress as they once did. There are three different levels of heart-related illness: heat cramps, heat exhaustion, and heat stroke. Some simple choices can help you weather the weather. Drinking water and other hydrating fluids is essential. Putting off exercise or other physical activity until things cool down also helps. Chilled air is the best way to beat the heat. Sticking with smaller meals that don’t overload the stomach can also help.
Do-it-yourselfers, take heart. Here’s something else to do at home that can have a substantial benefit on your health: measure your blood pressure. It’s easy, inexpensive, and helps control blood pressure better than visits to the doctor. The latest evidence for the benefits of home blood pressure monitoring comes from researchers in Minnesota. In a 12-month clinical trial, 72% of those doing home monitoring had their blood pressure under control compared to 57% who received usual care. The benefits persisted six months after the program had ended. Anyone can monitor blood pressure at home. You can buy a good home blood pressure monitor at a pharmacy or online merchant for anywhere from $50 to $100. Some insurance companies cover the cost.
There’s something gratifying about volunteering. Whenever I work a charity event—which I try to do with some regularity—I often get more out of it than I give. A new study suggests that volunteering has positive implications that go beyond mental health, and may include better physical health. They study, from Carnegie Mellon University, found that adults over age 50 who volunteered on a regular basis were less likely to develop high blood pressure than non-volunteers. High blood pressure is an important indicator of health because it contributes to heart disease, stroke, and premature death. It’s impossible for this study to prove that volunteering was directly responsible for the lower blood pressure readings, but the results are in line with other findings on the topic. Aristotle once surmised that the essence of life is “To serve others and do good.” If this line of research is any indication, serving others might also be the essence of good health.
Long-awaited results from a nearly 10-year trial exploring the effect of changes in diet and exercise among people with diabetes weren’t what most people expected. The Look AHEAD trial found that intensive efforts to lose weight by eating less and exercising more didn’t provide any more protection against heart disease—a common co-traveler with diabetes—than standard diabetes support and education. The spin from some media reports is that weight loss doesn’t reduce heart disease risk among people with type 2 diabetes, but I think that’s the wrong interpretation. The results of the Look AHEAD trial don’t contradict the value of lifestyle changes. People in the intensive change group improved their blood sugar with fewer drugs, saving an estimated $600 per year, they were also less likely to have developed chronic kidney disease and less self-reported vision problems. The Look AHEAD results reinforce for me that diabetes care needs to be tailored to the individual.
The Mediterranean diet has been getting a lot of press as being the very best for health. But there’s another diet that appears to be equally good: a vegetarian diet. A study published in JAMA Internal Medicine found that people who ate a vegetarian diet were 12% less likely to have died over the course of the five-year study than nonvegetarians. The benefits were especially good for men, who had a significant reduction in heart disease. This study underscores the idea that meat consumption influences long-term health, and not in a good way. Should you consider ditching the Mediterranean diet and becoming a vegetarian instead? Either one is healthier than the typical American diet, so it’s really a matter of personal choice.
My twice-daily walks with my border collie, Clair DeNoon, are the highlights of my day. A new report from the American Heart Association will put an extra spring in my steps on these walks. A panel of experts from the American Heart Association has weighed all the available evidence on pet ownership and cardiovascular disease. The verdict: Having a pet—a dog in particular—likely lowers the risk of heart disease. Some of the connection can be attributed to the extra walks dog owners take. Companionship also contributes. If dog ownership is heart healthy, should everyone who cares about heart health have a dog? No. According to the heart association panel, “the primary purpose of adopting, rescuing, or purchasing a pet should not be to achieve a reduction in cardiovascular risk.”
• Fast-food restaurants deliver filling, inexpensive meals and snacks. But there’s usually a hidden added cost: a wallop of salt (sodium) that isn’t good for cardiovascular health. Even with the current clamor for reducing sodium in the American diet, and industry promising to do just that, the amount of sodium in prepared foods hasn’t changed much since 2005, according to a report published in the latest issue of JAMA Internal Medicine. The average sodium in chain restaurant items increased 2.6% between 2005 and 2011. In packaged foods, it fell on average 3.5%. While some are calling for tighter government regulation on the sodium content in processed and restaurant foods, you can take action now.
In the past decade, a remarkable series of experiments from laboratories all over the world has begun to show what causes aging—and how to slow it. In the latest example of such aging research, two of my Harvard Medical School colleagues, cardiologist Richard T. Lee (co-editor in chief of the Harvard Heart Letter) and stem cell biologist Amy Wagers and their teams have found a substance that rejuvenates aging hearts in mice. The researchers joined the circulation of an old mouse with a thick, stiffened heart to that of a young mouse. After four weeks, the heart muscle of the old mouse became dramatically thinner and more flexible. The team then identified a substance called growth differentiation factor 11 (GDF11) as the probable “anti-aging” substance. It’s too soon to tell if this discovery will ever help humans with heart failure. But it reveals that there are substances naturally present in all living things that cause aging and that retard it. By understanding them, we may someday be able to slow aging.