Heart Health Archive

Coronary artery disease (CAD) is very rare in males too young to drive, but it begins to creep up after men are old enough to vote. In the U.S., the average age for a first heart attack in men is 65. That's why coronary artery disease is labeled a disease of senior citizens. But as many as 4% to 10% of all heart attacks occur before age 45, and most of these strike men. It's a reminder that men should not ignore warning symptoms just because they are "too young" to have heart disease. And since atherosclerosis can — and does — start in youth, it's a reminder that prevention should start early in life before problems develop.

What causes heart disease in young adults?

In older men, nearly all heart attacks are caused by atherosclerotic blockages in coronary arteries. Conventional coronary artery disease also predominates in young adults, accounting for about 80% of heart attacks. About 60% of these young patients have disease of just one coronary artery, while older patients are more likely to have disease in two or three arteries.

A higher-than-normal blood sugar level puts you at risk for developing diabetes and heart disease.

If you're hoping to avoid heart disease, you probably pay close attention to your blood cholesterol levels. But you also should keep an eye on your blood sugar, because an elevated blood sugar level is an early warning sign of diabetes, one of the main risk factors for cardiovascular disease.

A fasting blood sugar level of 100 to 125 milligrams per deciliter (mg/dL) means you may have a common precursor to diabetes, called prediabetes. (Normal blood sugar values range from 70 to 99 mg/dL.) An estimated one in three American adults has prediabetes, although most of them don't know it.

A sleep shortfall can be hard on your heart. Make sure you're getting enough quality snooze time.

Maybe you stay up past midnight watching TV or checking your smartphone while lounging in bed. Or perhaps you snuggle under the covers and close your eyes at a decent hour, but then toss and turn, unable to fall asleep. Whatever the reason, the results are familiar to many people — feeling unrefreshed and maybe even a bit cranky when you wake up the next morning. According to the CDC, about one in three adults doesn't get enough sleep.

"Some people have trouble falling asleep. But others choose to stay awake and end up chronically sleep deprived," says Dr. Sogol Javaheri, a sleep specialist at Harvard-affiliated Brigham and Women's Hospital. When you don't sleep enough, feeling tired and bleary-eyed is only part of the problem. People who consistently get less than six hours of sleep nightly face a higher risk of heart disease as well as other, often co-occurring conditions such as diabetes and obesity. The exact mechanisms aren't fully understood, but disruptions in blood pressure and blood sugar regulation likely play a role. Insufficient sleep also appears to raise stress hormone levels and inflammation, which also strain the heart.

Here's a host of ideas that support healthy eating and exercise habits.

This holiday season, how about giving the gift of good health? From kitchen tools to a session with a personal trainer, there are many thoughtful presents that can have a lasting impact on a person's cardiovascular health. Here are suggestions from several Harvard experts.

Kitchen tools and gadgets

"Many of my patients want to eat healthier, and one good strategy is to prepare more meals at home. Because this takes time, kitchen tools and gadgets really can be helpful," says registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital. One great time-saving tool is an Instant Pot, which works as a pressure cooker, slow cooker, yogurt maker, rice cooker, and steamer, she says.

These drugs are mainstays for preventing heart disease. Are they safe and effective in older people?

Low-dose aspirin and statins are both common, inexpensive drugs that help prevent the two root causes of most heart attacks — blood clots and cholesterol-laden plaque clogging the arteries of the heart. In recent years, a number of studies have helped experts refine their advice as to who should or should not take these medications.

However, evidence-based advice for people in their mid-70s and beyond is a bit harder to come by. Historically, most drug trials have included only a small proportion of people 75 and older, in part because there are fewer people in that age demographic. Also, older people tend to have other chronic health conditions. As such, they may be more prone to drug side effects, making doctors reluctant to enroll them in clinical trials.

Preparing for future medical decisions — for yourself or a loved one — can help make the experience less scary.

Have you ever sat down with a relative or close friend to talk about what would happen if either of you became unable to make your own health care decisions? Most people haven't. Only about one in three Americans has any type of legal documentation (known as an advance directive) to cover such a situation.

Imagining possible scenarios, such as experiencing a stroke or having advanced heart failure, understandably makes people uncomfortable or scared. But avoiding the topic can leave people unprepared if their health — or the health of a parent, spouse, or friend — suddenly takes a turn for the worse.

In Southern states, people often eat black-eyed peas and collard greens on New Year's Day, a tradition believed to bring wealth and good fortune in the coming year. The classic recipe for this dish, called Hoppin' John, often includes some form of pork. But the Half-cup Habit website has a vegetarian version; see https://pulses.org/nap/recipe/hoppin-john.

It may be just luck, but black-eyed peas seem to be less likely than black beans or pinto beans to cause intestinal gas, according to a small study. All legumes contain fiber and substances known as oligosaccharides that can't be broken down by human digestive enzymes. But the billions of bacteria living in the gut can digest oligosaccharides, often creating gas in the process.

Research we're watching

Having a dog often means taking daily walks, a habit that helps stave off heart disease. But that might not be the only reason dog owners have healthier hearts, according to a new study.

The nearly 1,800 participants had no history of heart disease in 2013 when the study began. Researchers scored them based on the American Heart Association's "Life's Simple 7" factors: body mass index, diet, physical activity, smoking status, blood pressure, blood sugar, and total cholesterol. Then they compared the scores of people who owned any pet to those who did not own pets, as well as the scores of dog owners with owners of any pet or no pet.

Research we're watching

People with a positive outlook on life seem to be less likely to experience serious heart-related problems, according to a review published Sept. 27 by JAMA Network Open.

The study pooled findings from 15 studies involving a total of more than 220,000 people. After a follow-up period lasting an average of nearly 14 years, researchers found that optimism was associated with a 35% lower risk of angina, heart attack, stroke, or death from cardiovascular causes. That benefit held even when they considered studies that took into account depression, physical activity, and other possible confounding factors.

Research we're watching

Counting steps with a fitness tracker doesn't always inspire people to be more active. But a little friendly competition may help, a new study suggests.

The study, published online Sept. 9 by JAMA Internal Medicine, included about 600 overweight or obese adults, all of whom received wearable step trackers and set goals to increase their daily steps. Researchers randomly divided them into four groups. The control group had only their goals and the step trackers; the three other groups also had different elements of games (support, collaboration, or competition) tied to their goals, an approach known as "gamification."