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Calhoun DA, Jones D, Textor S, et al. Resistant hypertension:
Diagnosis, evaluation, and treatment: A scientific statement from
the American Heart Association Professional Education Committee
of the Council for High Blood Pressure Research. Hypertension
AJ, Fretz EB, Warburton WP, et al. Association of the arterial
access site at angioplasty with transfusion and mortality: The
M.O.R.T.A.L study (mortality benefit of reduced transfusion after
percutaneous coronary intervention via the arm or leg).
Heart 2008; 94:1019-25.
Rao SV, Ou F-S, Wang TY, et al. Trends in the prevalence and
outcomes of radial and femoral approaches to percutaneous
coronary intervention: A report from the national cardiovascular
Journal of the American College of Cardiology Interventions
Our bodies need a steady supply of what used to be known as
vitamin B9. It comes in several forms. In food, it's called
folate. A synthetic form, folic acid, is added to some foods and
used as an ingredient in vitamin supplements. The body absorbs
folic acid faster than it absorbs folate. But folic acid must
then be converted into folate before it can get to work.
When referring to the amounts of these in food, the USDA relies
on what it calls dietary folate equivalents (DFE). The DFE of a
food equals the amount contributed by folate naturally in the
food plus 1.7 times the times the amount of added folic acid. In
list of folate in foods, it uses the DFE to rank foods,
putting breakfast cereals and other fortified foods near the top.
Here's a list of foods naturally rich in folate.
Naturally occurring folate in food
Resistant hypertension is the term for blood pressure that stays
stubbornly above the target your doctor has set (see Blood
pressure goals, below) in spite of lifestyle changes and
medications. The American
Heart Association has published a state-of-the-art paper that
covers the diagnosis, evaluation, and treatment of resistant
Blood pressure goals
Under 120/80: the ideal
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?