Blood Pressure Archive

In many cases, another physician's perspective about a proposed heart procedure can be helpful.

You've just found out that several of your heart's arteries are almost completely blocked. Your doctor believes bypass surgery is the best treatment option for you, but you wonder if a less invasive procedure might be possible. Or perhaps you have a heart valve that isn't working well — should you have it repaired, or fully replaced?

These scenarios are two heart-related examples that often prompt people to seek a second opinion. "But any time a physician suggests a surgery or procedure, consulting another doctor often makes sense, especially if you have questions that aren't being explained in a way that makes sense to you," says cardiologist Dr. Dale Adler, professor of medicine at Harvard Medical School.

Bulky recorders with lots of wires are being replaced by small patches and implanted devices.

An abnormal heart rhythm — when your heartbeat is too fast, too slow, or irregular — can be tricky to detect and diagnose. These electrical misfires are often short-lived and sporadic, so they're rarely seen on a routine electrocardiogram (ECG), a 10-second recording of the heart's electrical activity.

Many heart rhythm changes are harmless, but some cause fainting or other worrisome problems — including stroke. That's why doctors often rely on portable ECG devices that record your heart rhythm for several days — or even up to a month. But they're a bit of a nuisance because of the many wires, and you must remove and replace the electrodes when you shower or bathe.

A little bit of worry and stress is normal — even beneficial. But chronic anxiety may raise your risk for heart problems.

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If you feel anxious now and then, that's perfectly normal. In fact, worrying can spur you to take positive action that may benefit your health, such as getting screening tests or doing regular exercise. But excessive worrying can have the opposite effect.

"Small amounts of anxiety and stress can push people to be more productive. The problem happens when anxiety becomes so overwhelming that you're unable to function normally," says Dr. Christopher Celano, a psychiatrist at the Cardiac Psychiatry Research Program at Harvard-affiliated Massachusetts General Hospital. That level of worry and stress may represent an anxiety disorder, a group of conditions that affect some 40 million adults in this country.

Research we're watching

People with cardiovascular disease who exercise regularly, don't smoke, and manage other risk factors spend far less money on medications than people who don't take such steps, a new study finds.

The study included 4,248 people ages 40 and older with clogged arteries (atherosclerosis), the most common form of cardiovascular disease. Researchers also relied on the Medical Expenditure Panel Survey, a national snapshot of health care expenses based on a survey of nearly 76,000 Americans.

Research we're watching

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Want to help improve your cholesterol profile? Swap your midmorning muffin for a handful of almonds, suggests a study in the Aug. 1, 2017, Journal of Nutrition.

Nutritionists have long known that eating almonds and other nuts tends to lower harmful LDL cholesterol and raise desirable HDL cholesterol. But recent evidence suggests that the heart-protecting effects of HDL depend on a person's particular complement of the various forms of HDL, some of which are more beneficial than others.

Irregular or insufficient sleep increases your risk of cardiovascular disease.

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If you're one of the many people who toss and turn nightly, you already know that a bout of sleeplessness can hamper your productivity and sap your quality of life. But the ramifications of poor sleep extend far beyond a cranky mood. Research shows that an on-going sleep deficit can ultimately endanger your heart health.

Hazards of poor sleep

Tens of millions of Americans experience a chronic lack of sleep. While some people shortcut the customary eight hours of snooze time in favor of work or social pursuits, many others suffer from insomnia or another disorder that curtails a healthy slumber.

Ask the doctor

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Q. My doctor prescribed Lovaza to help lower my high triglyceride level, which is 530 milligrams per deciliter (mg/dL). But I'm a vegetarian and don't want to take a drug made from fish oil. Are there other options?

A. You're not alone: several of my vegetarian patients also have asked me this question. But let's begin with some background. Triglycerides — which are the main form of fat found in our bodies — are part of a standard lipid panel blood test. Values higher than 150 mg/dL are associated with a higher risk of heart disease.

The type and amount of fat, carbohydrate, sugar, and salt in our food supply has changed over the years — for better and for worse.

Remember when packaged foods emblazoned with the words "fat free" seemed to be everywhere? Then came labels boasting "zero grams of trans fat." "Sugar free" and "low sodium" claims soon joined the chorus. These days, gluten-free foods are all the rage.

For the most part, these food industry trends echoed the nutritional mantras of the time and were designed to improve our health — especially cardiovascular health. Not only is heart disease the nation's leading killer, there's overwhelming evidence that better dietary choices could prevent many heart attacks and strokes. But just how successful have these efforts been?

Recent discoveries hold the promise of better detection and treatment of coronary artery disease.

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Coronary artery disease — the buildup of cholesterol-laden plaque in the heart's arteries — is by far the most prevalent life-threatening heart condition. Despite many important discoveries, the genetic influence on this complex condition remains far from clear. But research continues to provide clues that may soon improve both the prediction and the treatment of this common disease beyond current testing of risk factors.

Inherited heart disease: Rare vs. common

Many different types of heart disease can be passed down through families. Some are caused by just one or a few genetic changes that have a very strong effect in causing disease. Known as monogenic conditions, they include uncommon disorders that mostly affect the heart's muscle (such as hypertrophic cardiomyopathy) or electrical system (such as long QT syndrome). Another example is familial hypercholesterolemia, which causes very high cholesterol levels and may lead to premature coronary artery disease (occurring before age 50).