Heart Health Archive

There is good evidence that the more you drink, the more likely you are to develop atrial fibrillation. A study found that people with afib who were willing to abstain from alcohol were less likely to have a recurrence.

Timing may improve potency and help you cope with side effects.

We all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks, and to check that medications won't interfere with each other.

And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.

Ask the doctor

Q. I've taken blood pressure medicines every morning for many years, and they keep my pressure under control. Recently, my doctor recommended taking them at bedtime, instead. Does that make sense?

A. It actually does make sense — based on recent research. For many years, there have been at least three theoretical reasons for taking blood pressure medicines before bedtime. First, a body system that strongly affects blood pressure, called the renin-angiotensin system, has its peak activity during sleep. Second, circadian rhythms cause differences in the body chemistry at night compared with daytime. Third, most heart attacks occur in the morning, before medicines taken in the morning have a chance to "kick in."

People monitor their cholesterol levels, but they should also watch their triglycerides.

Most people have heard of the two main kinds of cholesterol: the "good" HDL and the "bad" LDL. Doctors focus on controlling LDL, as high levels can lead to a buildup of fatty deposits in the arteries and block blood flow, which can trigger a heart attack or stroke.

A blood test called a lipid profile measures your HDL, LDL, and total cholesterol levels. But within that test is another number you should not ignore: your triglyceride levels.

In the journals

High levels of low-density lipoprotein (LDL), or "bad" cholesterol, have long been associated with a greater risk of heart disease. Yet, research has shown that about 75% of heart attack sufferers do not have dangerously high LDL levels.

A study published Nov. 18, 2019, in the International Journal of Nanomedicine looked closer at this issue. Researchers found that high amounts of a subclass of LDL may be a stronger predictor of potential heart problems than overall LDL levels.

Research we're watching

If you drink alcohol to excess, you may be doing damage to heart tissue, even if you don't have symptoms, according to a study published in the Dec. 18, 2019, Journal of the American Heart Association.

Researchers analyzed blood samples from more than 2,500 adults ages 35 to 69 who had participated in a heart study. Most of the samples studied came from the general population in northwest Russia; these were compared with nearly 300 people being treated for alcohol-use disorder at a Russian hospital. Study authors categorized the general population group as harmful drinkers, hazardous drinkers, non-problem drinkers, and nondrinkers, based on their self-reported drinking habits. Investigators then examined the blood samples for specific biomarkers that can indicate three specific heart problems: a heart injury, stretching of the cardiac wall, and increased inflammation.

Research we're watching

A long work week may raise your blood pressure, according to a study published online Dec. 19, 2019, by Hypertension. Researchers found that among more than 3,500 Canadian workers, those who worked 49 hours a week or more were more likely to have high blood pressure than workers who were on the job fewer than 35 hours a week. Blood pressure was measured at the start and end of the five-year study as well as once midway through. Readings were taken by both a trained technician and a wearable monitoring device. Even after adjusting for other factors, the 49-hour-plus workers were 70% more likely to have a type of high blood pressure called masked hypertension (normal blood pressure readings at doctor visits but high outside of that setting) and 66% more likely to have sustained hypertension (defined as consistently high blood pressure readings both in and outside of the doctor's office). People who worked 41 to 48 hours a week also had higher blood pressure than those who worked fewer than 35 hours a week.

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Your salt shaker usually isn't the worst culprit. Instead, check your condiments, sauces, and spice blends, many of which are high in sodium.

For decades, health experts — especially cardiologists — have been telling people to eat less sodium, one of the main components of salt. Most Americans still consume far too much of this mineral, which raises blood pressure and the risk of heart disease.

Despite these warnings, the average sodium intake in this country is around 3,200 milligrams (mg) per day. That's about 30% more than is recommended by the federal dietary guidelines, which advise people to limit their daily sodium to 2,300 mg. And it's more than twice the target suggested by the American Heart Association of 1,500 mg per day.

Primary care providers can help people manage their blood pressure and cholesterol. But those with additional risks for heart disease should consider consulting a cardiologist.

Seeing a cardiologist is standard practice after you've experienced a heart attack or other serious heart problem. But in certain situations, you may want to consult a physician who specializes in managing heart disease even if you haven't had a heart-related scare.

"We encourage people with a family history of premature heart disease or who have many risk factors for heart disease to consider an evaluation by a cardiologist," explains cardiologist Dr. Michelle O'Donoghue, associate professor of medicine at Harvard Medical School. A premature heart attack is one that occurs before age 55 in a man or before age 65 in a woman. If you have a parent or sibling who falls into that category, make sure your primary care provider knows, as your odds of heart disease are higher than average.

Genetic advances are improving the recognition and treatment of hypertrophic cardiomyopathy.

The term "heart disease" often refers to plaque-filled heart arteries that can lead to a heart attack. More accurately described as coronary artery disease, it's by far the most common and best known type of heart disease. Most people are far less familiar with the most common inherited form of heart disease, hypertrophic cardiomyopathy (HCM), which affects the heart muscle rather than its arteries.

HCM is thought to affect one in 500 people. It's far more common than better known diseases such as multiple sclerosis and cystic fibrosis. But HCM can be tricky to diagnose. "In the clinic, we suspect hypertrophic cardiomyopathy in people who have unexplained thickening of the heart muscle seen on an echocardiogram," says Harvard Medical School professor Dr. Christine Seidman. Other conditions, such as longstanding high blood pressure, can also cause the heart to enlarge. Because high blood pressure is so common, it's sometimes mistakenly blamed for the signs of HCM in older people, she says. In younger people, HCM is sometimes misdiagnosed as exercise-induced asthma or anxiety.