Cholesterol Archive

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Fight chronic inflammation and cholesterol to protect your heart

It takes a one-two punch to lower these risks for heart disease, heart attack, and stroke.

High cholesterol has long been known as a bad actor in heart health. Too much LDL (bad) cholesterol in your blood can lead to fatty deposits in your arteries and the formation of artery-narrowing plaque (atherosclerosis), heart attacks, and strokes.

But LDL doesn't act alone. Chronic inflammation — a persistent activation of the immune system — also fuels heart attack and stroke risks. That means you must address both high LDL levels and chronic inflammation to protect your health.

Go big green

Studies show that people who regularly adhere to the Mediterranean diet lower their risk of cardiovascular disease, many types of cancer, and cognitive decline with age. But it’s possible that this healthy diet can be made even healthier. New research suggests that making the diet "greener" by boosting amounts of dark green vegetables, green tea, and plant proteins high in the micronutrients known as polyphenols offers even greater benefits.

Why nuts may be good for your heart

Research we're watching

Eating nuts even just a couple of times a week is linked to a lower risk of dying from heart disease, a new study suggests.

The study included 39,000 women who filled out dietary questionnaires at the start of the study and again about 10 years later. During the follow-up, which lasted an average of 19 years, nearly 1,000 of the women died of cardiovascular disease.

Conquer your fear of dietary fat

For decades, high intake of fat was thought to cause weight gain, heart disease, and maybe even cancer. The solution? Go low-fat, which often meant consuming more carbs and more sugar. But nutritionists now suggest people actually need adequate amounts of "good" unsaturated fat, and less "bad" saturated fat, for optimal health. Following popular heart-healthy diets, like the Mediterranean and MIND diets, and making simple dietary changes can help people get adequate amounts of good fats.

Having one chronic condition can boost the risk for others

Many chronic conditions seem to be related. Examples include obesity, high blood pressure, type 2 diabetes, high cholesterol, and heart disease; hearing loss and dementia; obstructive sleep apnea and high blood pressure; various autoimmune diseases; and obesity and joint problems. People with chronic conditions should ask their doctors about the risk for associated diseases.In some cases, they should have certain health screenings to check for them. In other cases, additional screening isn't automatic.

"Green" Mediterranean diet: Better than the original?

Research we're watching

Widely considered the healthiest diet for your heart, the Mediterranean diet is rich in plant-based foods and features only small amounts of meat and dairy products. But a variation that includes more green plant foods may be even better for you, a small study suggests.

The study included 294 sedentary, moderately obese people whom researchers randomly divided into three groups. Each received different dietary advice: a standard healthy diet, a low-calorie Mediterranean diet, or a "green" Mediterranean diet. Both Mediterranean diet groups included about a quarter-cup of walnuts daily, and poultry and fish replaced beef and lamb.

Fears about statin side effects: Often unfounded?

A novel study suggests that the "nocebo effect" could be why some people believe they cannot tolerate statins.

Are you hesitant to fill your statin prescription because you're worried the drug will cause muscle aches and other side effects? Although you're far from alone (see "A royal pain?"), the reality is that all drugs have side effects, and statins aren't worse than other drugs. And fears about statin side effects may be depriving people of a potentially lifesaving medication.

The nocebo effect — the flip side of the well-known placebo effect — occurs when people experience negative effects from a drug, placebo, or other treatment based on an expectation of harm. Because of the widespread belief that statins cause muscle aches, statins have been suspected of triggering a strong nocebo effect. A recent study confirmed this observation (see "A study to assess statin side effects").

Treating heart attacks: Changes from Eisenhower’s era to the present day

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."

Can you supercharge the Mediterranean diet?

News briefs

A Mediterranean-style diet is rich in vegetables, legumes, fruits, whole grains, nuts, seeds, poultry, fish, and olive oil, and it's associated with lower risks for heart disease and diabetes. And a "greener" version of the eating style might be even more effective, according to a small, randomized study published online Nov. 23, 2020, by the journal Heart. Researchers — some from Harvard — recruited about 300 sedentary, middle-aged people (mostly men) with high cholesterol or abdominal obesity and divided them into three groups. One received guidance for exercise and a healthy diet; another received exercise guidance and was assigned to eat a calorie-restricted Mediterranean diet; and one group received exercise guidance and was assigned to eat a "greener" calorie-restricted Mediterranean diet with less animal-based and more plant-based proteins (including walnuts and a type of duckweed — an aquatic plant), plus lots of green tea. After six months, people on the "green" diet had lost more weight and inches around their middles, and had bigger drops in cholesterol, than people in the other two groups. "Green" dieters also had steeper declines in insulin resistance, inflammation markers, and diastolic blood pressure (the lower number in the measurement), compared with the other two groups.

Image: © Lilechka75/Getty Images

Statin side effect could be due to the "nocebo" effect

In the journals

People who are worried about statins because of possible side effects may experience what's called the "nocebo effect" when they try taking the drugs. This is the opposite of the placebo effect; with the nocebo effect, people who have negative expectations about medicine or a treatment experience harmful symptoms they otherwise wouldn't have.

Researchers recruited 60 people, average age 66, who had previously stopped statins after two weeks because of side effects. For one month each, they took 20 milligrams of atorvastatin (Lipitor), a placebo, or no pill. They then continued this monthly rotation for a year without knowing which pill was which.

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