Heart Disease Archive

A calcium score is a good indicator of how much plaque is inside the heart's arteries. Treatments can replace cholesterol in plaque with scar tissue, which contains calcium and produces a higher calcium score, but this stabilized plaque lowers heart attack risk.

Treatments for angina include medications to lower LDL cholesterol to very low levels to help reduce artery-narrowing plaque. Drugs that slow the heart rate and widen arteries can improve symptoms.

Clinical trials are under way using gene therapy to treat inherited cardiovascular conditions, including familial hypercholesterolemia (one form of abnormally high cholesterol), hypertrophic cardiomyopathy (a type of heart muscle disease), and transthyretin amyloid cardiomyopathy (a form of heart failure resulting from amyloid deposits). But challenges remain in developing and delivering these therapies.

Tiny mesh tubes called stents, used to prop open heart arteries, can relieve stable angina (chest pain with exertion or emotional stress) in many people with coronary artery disease. But this treatment—which carries a risk of complications and a high cost—should be reserved only for people who don't get relief from drug therapy. Stents do not prevent future heart attacks or improve survival compared with drug therapy. Angina usually results from arteries that are more than 70% blocked, but most heart attacks occur in arteries that are narrowed by only about 40% or less but harbor plaque that ruptures without warning. The resulting blood clot blocks blood flow, triggering a heart attack.

The weight-loss drug semaglutide is the first obesity treatment shown to help people live longer and have fewer cardiovascular problems. Developed as a drug for type 2 diabetes, semaglutide was first marketed as Ozempic; a higher-dose version for weight loss is called Wegovy. But because the drug is so popular, it can be hard to find, and it might not be covered by insurance.

Indirect evidence suggests that for people with atrial fibrillation who always take apixaban (Eliquis) every 12 hours as prescribed, it may be slightly better than once daily rivaroxaban (Xarelto).

The portfolio diet, which emphasizes foods rich in fiber and healthy fats, helps lower LDL cholesterol. A 2023 study suggests that the more closely people follow the diet, the lower their risk of cardiovascular disease. The diet discourages foods from animal sources and features foods from five main categories, including (1) plant protein such as legumes; (2) nuts and seeds; (3) foods rich in viscous fibers such as oatmeal, eggplant, and berries; (4) plant sterols such as phytosterol-enriched margarine; and (5) monounsaturated fats such as olive and canola oils.

When people with atrial fibrillation sleep poorly, they may be more likely to have an episode of atrial fibrillation the next day, according to a 2023 study.

Harvard Medical School professor Dr. Eugene Braunwald, known as "the father of modern cardiology," identified five promising future trends in cardiology. They include (1) using polygenic risk scores in newborns for early prevention of heart disease; (2) the emergence of a battery of drugs to treat inflammation; (3) improvements in cardiac cell therapy for repairing damaged hearts; (4) the development of smaller, more powerful, and less expensive left ventricular assist devices; and (5) transplanting genetically modified pig hearts into humans.

A nonsurgical approach for replacing a damaged aortic valve, known as transcatheter aortic valve replacement (TAVR), has become very popular in recent years. But it may not make sense for people in their 60s, who are likely to need a second valve replacement later in life. The valves used in TAVR only last about 10 years, on average. In addition, diagnosing and treating coronary artery disease may be more challenging in people who've had TAVR. Also, the surgery to replace a failed TAVR valve is more complicated than regular valve replacement surgery. So people who are likely to need least one traditional valve surgery are better off having the surgery in their 60s rather than in their 70s. A TAVR can be done the second time around.