How to talk with your kids when heart disease runs in the family

Heart disease, stroke, and the conditions that trigger them often run in families. Family history is not necessarily family future—if family members get an early start on a heart-healthy lifestyle and regular medical care. Some children may need to be tested for conditions affecting the heart, such as hereditary high cholesterol. For most, though, it’s more important that they become aware of their family history at an early age and adopt healthy habits. Young adults and adults with family histories of heart disease should not only maintain a healthy lifestyle, but also should have a relationship with a primary care physician to monitor their heart status. More »

Ask the doctor: Beta blockers and alcohol

Alcohol can affect blood levels of beta blockers. If you drink alcohol in the evening and need a beta blocker, it's a good idea to take a once-daily beta blocker in the morning to avoid this effect. (Locked) More »

Ask the doctor: Warfarin interactions

A long list of drugs and substances affect warfarin's blood-thinning effect. They may make the warfarin more or less effective. Or they may affect blood clotting in different ways that increase the risk of bleeding. (Locked) More »

Angioplasty and stenting safe in smaller hospitals

In the early days of cardiac catheterization, it was necessary to have a heart surgeon standing by in case something went wrong. But such problems have become extremely rare. Now emergency percutaneous coronary intervention (PCI) is often performed at hospitals without on-site cardiac surgery. Even when it’s not an emergency, a recent Harvard study confirms that outcomes are the same after diagnostic cardiac catheterization regardless of whether a hospital is staffed and equipped for heart surgery—as long as the hospital and the interventional cardiologist regularly perform these procedures and meet certain quality standards. (Locked) More »

New alternatives to warfarin

Warfarin (Coumadin, generic) has been the mainstay for preventing blood clots caused by atrial fibrillation since the 1950s. Today, new prescriptions for novel anticoagulants approved in 2010 and 2012—dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis)—now outnumber those for warfarin. The new drugs are safer than warfarin and carry only half the risk of dangerous bleeding within the skull. Harvard experts say the new drugs may be the best initial anticoagulant therapy for atrial fibrillation. However, there is no compelling reason for people doing well on warfarin to switch to one of the newer agents, which are 30 times more expensive than the older drug. (Locked) More »

First rule of dementia prevention: Take care of your heart

There’s a growing awareness among cardiologists and neurologists that a combination of atherosclerosis (buildup of plaque in the arteries) and arteriosclerosis (stiffening of the arteries with age) is a major cause of mental decline. The term vascular cognitive impairment describes the entire disease process, from the first signs of impaired mental function to full-blown vascular dementia. Many if not all of the risk factors for heart disease and stroke are also risk factors for vascular dementia; high blood pressure, high LDL cholesterol, and high blood sugar appear especially relevant. There’s no treatment for vascular dementia, but controlling heart disease risk factors and remaining physically active may prevent it. (Locked) More »

7 simple changes lower stroke risk

The American Heart Association has developed the “Life’s Simple 7” tool as an easy way for people to understand and track their risk of having a stroke or heart disease. The tool tracks seven things a person can improve: blood sugar, cholesterol level, blood pressure, weight relative to height (body mass index or BMI), physical activity, diet, and cigarette smoking. Studies have found that lower scores on the Life’s Simple 7 tool reflect lower real-world risk of serious heart disease. A new study now links better Life’s Simple 7 scores to lower stroke risk. (Locked) More »

Blood pressure high? Control LDL

High blood pressure (hypertension) affects 1 in 3 Americans, and doubles their risk of heart disease. More than 75% of people with hypertension also have high "bad" LDL cholesterol. (Locked) More »

Emergency Rx for major TIA

A minor stroke or serious transient ischemic attack (TIA) is often followed by a second, devastating stroke. Combination treatment with aspirin and clopidogrel (Plavix) given within 24 hours cuts stroke risk by one-third. (Locked) More »