Harvard Heart Letter: April 2008

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.

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?

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?

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?

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.

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.

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.

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.

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.

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.

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.