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Harvard Heart Letter: September 2011

Articles in this issue:

COURAGE not followed by action

Results of landmark trial have little effect on use of angioplasty.

The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial should have been a game changer for people with stable angina (chest pain from cholesterol-clogged coronary arteries) or a severe narrowing in one or more coronary arteries. In such individuals, COURAGE showed that artery-widening angioplasty plus stent implantation was no better than optimal medical therapy at preventing heart attacks or improving survival. In other words, it made sense to first try medical therapy — that is, drug treatment and lifestyle changes — and turn to angioplasty if it ...

What to do when blood pressure resists control

Taming resistant hypertension requires extra attention from you and your doctor.

Among the 60 million Americans who know they have high blood pressure (also known as hypertension), fewer than half have it under control. Some of them haven't made the necessary lifestyle choices or aren't taking medicines to lower their blood pressure. Some of their doctors aren't prescribing the right medicines at the right doses. But some people with hypertension (about one in eight) are doing all the right things yet still can't manage to control their blood pressure. They have what's known as resistant hypertension — blood pressure that ...

Peripheral artery disease often goes untreated

Problems in arteries supplying the legs, kidneys, and elsewhere pose problems for the heart, too.

The arteries that supply the heart (coronary arteries) and the brain (carotid arteries) get far more attention than the vast network of arteries below the heart. These so-called peripheral arteries are often overlooked — and a study suggests that problems in these blood vessels are often undertreated — even though they cause as much mayhem as problems in the coronaries and carotids.

"Peripheral arteries" is an unfortunate catchall term that undervalues these vital sections of the circulatory system. They include the lower part of the ...

Abundance of fructose not good for the liver, heart

 

Another reason to avoid foods made with a lot of sugar.

The human body handles glucose and fructose — the most abundant sugars in our diet — in different ways. Virtually every cell in the body can break down glucose for energy. About the only ones that can handle fructose are liver cells. What the liver does with fructose, especially when there is too much in the diet, has potentially dangerous consequences for the liver, the arteries, and the heart.

Fructose, also called fruit sugar, was once a minor part of our diet. In the early 1900s, the average ...

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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?

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