Heart Health

The heart beats about 2.5 billion times over the average lifetime, pushing millions of gallons of blood to every part of the body. This steady flow carries with it oxygen, fuel, hormones, other compounds, and a host of essential cells. It also whisks away the waste products of metabolism. When the heart stops, essential functions fail, some almost instantly.

Given the heart's never-ending workload, it's a wonder it performs so well, for so long, for so many people. But it can also fail, brought down by a poor diet and lack of exercise, smoking, infection, unlucky genes, and more.

A key problem is atherosclerosis. This is the accumulation of pockets of cholesterol-rich gunk inside the arteries. These pockets, called plaque, can limit blood flow through arteries that nourish the heart — the coronary arteries — and other arteries throughout the body. When a plaque breaks apart, it can cause a heart attack or stroke.

Although many people develop some form of cardiovascular disease (a catch-all term for all of the diseases affecting the heart and blood vessels) as they get older, it isn't inevitable. A healthy lifestyle, especially when started at a young age, goes a long way to preventing cardiovascular disease. Lifestyle changes and medications can nip heart-harming trends, like high blood pressure or high cholesterol, in the bud before they cause damage. And a variety of medications, operations, and devices can help support the heart if damage occurs.

Heart Health Articles

Cholesterol testing at home: It may be faster, but is it better?

If you don't mind pricking a finger, you can check your cholesterol without sitting around in a doctor's waiting room or laboratory. Devices available in pharmacies or through the Internet make this easy to do at home. But is it worth doing? The makers of home cholesterol tests rightly tout their products as faster than visiting a doctor. You prick your finger, gently squeeze a few drops of blood onto a test strip or into a small "well," and you get the results in a few minutes, instead of waiting a few days. But faster isn't necessarily better. The results won't give you the information you need to figure out your risk of having a heart attack or other cardiovascular problem. Nor will they help you check whether a diet and exercise program is working. More »

Resistant hypertension needs special attention

At least half of the 80 million Americans with high blood pressure don't have it under control. Sometimes poor control stems from lack of trying. A growing number of people, though, have what's called resistant hypertension — blood pressure that stays stubbornly above the target (see "Blood pressure goals") in spite of lifestyle changes and medications. Persistently high blood pressure is a problem. It is a key contributor to stroke, heart failure, and other cardiovascular conditions. Strictly speaking, you have resistant hypertension if your blood pressure is still high even though you are taking three or more pressure-lowering medications, or if you need to take four or more medications to reach your blood pressure target. More »

“Mini-strokes” have major risks

What's the difference between a stroke and a transient ischemic attack (TIA)? At first, not much. They look the same, feel the same, and stem from the same thing — blocked blood flow to the brain. But a stroke lasts for hours, maybe longer, while a TIA fades away after a few minutes. Don't be fooled by the disappearance of symptoms. Even after they are gone, danger still lurks in the form of other TIAs, stroke, and even death. A study published in the April 2005 Stroke looked at all the people who had a TIA in the Cincinnati area during a single year. In the three months following the mini-stroke, 1 in 7 people (14.6%) had a full stroke, and 1 in 4 (25.2%) had either died or suffered a stroke or another TIA. More »

Aspirin for heart attack: Chew or swallow?

You've always been healthy, but you seemed to run out of steam at your wife's 60th birthday dinner last week. And now your chest feels heavy, as if you're in a vise. You take some antacids, even though it's 7:00 a.m. and you haven't even had breakfast. But you get no relief, and the pain is spreading to your jaw and shoulder. You call your wife, who takes one look at you and rushes to the phone. After calling 911, she brings you an aspirin and some water. Your wife got it right: You may be having a heart attack, and you need to get to the hospital fast. You also need to get some aspirin into your system quickly — but should you chew the tablet or swallow it? More »

Making sense of cholesterol tests

Time to get your cholesterol checked. Okay, but which test should you get? It's not so simple anymore. Here is a rundown of some of the choices and their pros and cons: Total cholesterol. This is the simplest and least expensive test, and fasting isn't necessary. The test doesn't require any sophisticated lab work, either. The simple, do-it-yourself home cholesterol tests measure total cholesterol. If you otherwise have a low heart risk, a reading of 200 or below puts you in the desirable category; 200–239 is borderline high; and 240 or more is high. But total cholesterol includes both "good" high-density lipoprotein (HDL) cholesterol, and the "bad" varieties, chiefly low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL). So if your total cholesterol is in the desirable category, it's possible that you may have unhealthy levels of HDL (too low) and LDL and VLDL (too high). Think of total cholesterol as a first glimpse, a peek. Doctors are not supposed to make any treatment decisions based on this number alone. More »

Alternatives to Vioxx if Heart Disease Present — TheFamily HealthGuide

Although the sudden decision to withdraw Vioxx came as a surprise, it wasn't entirely unexpected. Concerns about the cardiovascular safety of this medication were raised soon after it was approved for sale in the United States . As of this early October 2004 article, hard and fast guidelines for replacing Vioxx haven't yet been published. What many doctors are telling their patients with heart disease is to first try one of the older, more established anti-inflammatory drugs. Many people turned to the new drugs, called COX-2 inhibitors, because they thought they were superior for relieving pain or easing inflammation. In reality, Vioxx, Celebrex, or Bextra aren't any better at this than older and much less expensive nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, others), and naproxen (Aleve, Naprosyn, others). Like the older drugs, the COX-2 inhibitors can also irritate the stomach. Their main advantage is that they aren't as likely to cause bleeding ulcers. Keep in mind, though, that this "advantage" is small and far from complete - about 1%-2% of people who use an older NSAID develop serious stomach bleeding, compared to 0.5%-1% of those using a COX-2 inhibitor. More »

Artery opening trumps clot busting

As late as a decade after Neil Armstrong walked on the moon, doctors could do little to stop a heart attack. They could offer support, something for pain, and drugs to ease the heart's workload and keep blood from clotting readily. They could also halt the rhythm problems that sometimes surfaced. But they didn't have any tools to get rid of an artery-blocking clot and restore blood flow to oxygen-starved heart muscle. The advent of clot-busters such as tPA and streptokinase changed that. Instead of letting nature take its course, doctors could break the logjam and get blood flowing again. This saved lives and helped preserve heart function. Now there's an equally sweeping change afoot. An artery-opening procedure, balloon angioplasty (usually with the placement of a metal-cage stent), saves even more lives than clot-dissolving drugs. It's also better at preventing repeat heart attacks and doesn't cause bleeding in the brain, a possible side effect of drug therapy. More »

Low potassium levels from diuretics

Thiazide diuretics like hydrochlorothiazide (Esidrix, HydroDIURIL, other brands) continue to be a very effective way to lower blood pressure for people with hypertension. They're inexpensive, and results from large studies have shown them to be at least as effective as other types of blood pressure drugs for most patients. But if you're taking a diuretic, your potassium levels need to be watched. These drugs direct the kidneys to pump water and sodium into the urine. Unfortunately, potassium also slips through the open floodgates. A low potassium level can cause muscle weakness, cramping, or an abnormal heartbeat, which is especially dangerous for people with heart problems. Potassium pills are one solution, but some tend to taste bad, so people may neglect to take them. Eating foods rich in potassium, like bananas, may help, but often that's not enough. Spironolactone (Aldactone) and triamterene (Dyrenium) are diuretics that "spare" potassium, leaving levels high, but they're pretty weak as diuretics. Dyazide (available as a generic) is an attempt to strike a balance: It's part thiazide, part potassium-sparing diuretic. More »

Public Defibrillators

If you suffer from cardiac arrest, help is only a 911 call away. Paramedics can use defibrillators to shock your heart back to a normal rhythm. But unfortunately, every minute you spend waiting for their arrival reduces your chance of survival by 10%. Help may soon be closer than your local paramedic and it may come from an unlikely source — someone without medical expertise. Until recently, witnesses to someone having a cardiac arrest were limited in the help they could provide — calling 911 and performing CPR (cardiopulmonary resuscitation). Now, portable automated defibrillators about the size of a laptop computer are available. These devices not only deliver a shock to restore a regular heartbeat, they also determine whether a shock is really needed, making it possible and safe for people without medical training to use. A recent study placed the automated defibrillators in roughly 1,000 public locations in 24 cities, including shopping centers, sports facilities, office buildings, community centers, factories, entertainment venues, apartment buildings, and schools. Volunteers who worked in these locations were trained to perform CPR or trained to perform CPR and use the automated defibrillator. After two years and 292 resuscitation attempts, the overall survival rate for the study was still very low, 15%, but the use of automated defibrillators saved almost twice as many lives as CPR alone. This shows automated defibrillators can save lives when used by common people trained to operate the equipment. More »

Stress tests for the heart: What happens after exercise just as importantas what happens during—The FamilyHealth Guide

An exercise stress test measures how the heart responds to and copes with increasing amounts of activity. It can warn of impending heart trouble or monitor the aftermath of a heart attack. Research suggests that checking not only how the heart does during exercise, but also how the heart recovers from it adds an extra dimension to the test. During a cool-down period, the heart should slow toward its normal rate with a steady pattern of regular, healthy electrical activity. But sometimes the heart may take too long to slow down or may beat irregularly — signs of possible trouble ahead. An exercise stress test gauges how exercise affects blood pressure, the heart rate, and its electrical activity. More »