Harvard Heart Letter: December 2008

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.

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.

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.

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.

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.

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.

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.

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.

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?

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?

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?