Heart Health Archive

Research we're watching

About four in 1,000 adults in this country are born with a genetic condition marked by abnormally high cholesterol levels, known as familial hypercholesterolemia (FH). Their "bad" LDL cholesterol can be two to three times as high as the common target LDL value of 100 milligrams per deciliter (mg/dL) or lower for healthy people. But only about half of people with FH are getting proper treatment for the disease, according to a report in the May 22 issue of Circulation.

For the study, researchers analyzed health surveys done between 1999 and 2014 with nearly 42,500 adults in the United States. Although more than 80% of people with FH or severely high cholesterol were aware of their condition, only half were taking cholesterol-lowering statins. And among those who were, only one-third were taking optimal doses of the drugs.

Research we're watching

Staying physically fit helps lower your risk of heart disease — even if the condition runs in your family, a new study finds.

Researchers relied on data from nearly half a million middle-aged and older adults in the United Kingdom. Over the six-year study, people with high levels of grip strength, self-reported physical activity, and cardiorespiratory fitness (as measured by a stationary bike test) were less likely than others to have a heart attack or stroke. That was true even among people with high genetic risk, based on whether they carried certain gene variants that have been linked to heart disease.

Heart tests help show artery blockage and assess the risk of heart attack

If you are at high risk for heart disease or have a symptom such as shortness of breath or discomfort in your chest, your doctor may order certain heart tests. But there's more to testing than simply finding out if you have heart disease. Your doctor may also want to determine whether the fatty plaques inside your blood vessels pose a high, medium, or low risk for a heart attack. The answer will help determine whether you need treatment, and if so, which type of treatment will be best.

No single test is better than another, and no test is appropriate for everyone. "The best test for an individual is the one that provides the information needed to guide management," says Dr. Ron Blankstein, a cardiovascular imaging specialist at Harvard-affiliated Brigham and Women's Hospital.

Machine learning may improve the way doctors detect heart disease.

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Imagine a world in which a photo of your eye — taken with your smartphone — could determine your risk of a heart attack, and your smartwatch could estimate your odds of experiencing a stroke. Sounds pretty futuristic, right?

In fact, preliminary studies showing the feasibility of both approaches have already been published. They're just two examples of the new wave of technology-based innovations (see "Transformative technologies") that are beginning to change health care as we know it.

Ask the doctor

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Q. I understand there's a genetic test that can tell you how well you might respond to antiplatelet drugs. Do you recommend this test?

A. The short answer is no, not yet. For now, I think it is best to wait for the results from studies looking at personalized antiplatelet therapy. Also known as tailored medical therapy, personalized therapy refers to treatments that are based on your own information, including genetics. But first, I will address two other relevant questions: (1) what is antiplatelet therapy, and (2) who needs it?

Leg veins that bulge just beneath the skin's surface are linked to a higher risk of deep-vein thrombosis.

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Varicose veins are gnarled, bluish veins near the surface of the skin, usually on the legs and feet. Most people think of them as mainly a cosmetic problem, although varicose veins can cause a range of unpleasant symptoms, from a heavy, achy feeling in the legs to burning, throbbing, or itching sensations. Now, new research suggests that people with varicose veins may also have a higher risk of developing a clot in the deeper veins of the legs, known as deep-vein thrombosis or DVT.

"It's a good reminder for people with varicose veins to talk to their health care provider about their overall risk for vascular disease," says Dr. Gregory Piazza, assistant professor of medicine at Harvard Medical School. Most people with varicose veins won't experience a DVT. But it's still important to know the warning signs of this potentially dangerous condition (see "What is deep-vein thrombosis?") and to address any factors that might add to your risk, such as smoking, high blood pressure, and elevated cholesterol, he says.

For people at high risk, PCSK9 inhibitors may prevent heart attacks and save lives. But gaining access to these pricey drugs remains a challenge.

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Three years ago, the FDA approved two drugs that lower harmful LDL cholesterol values dramatically — by more than 50%. The drugs, alirocumab (Praluent) and evolocumab (Repatha), belong to a new category of medications known as PCSK9 inhibitors. Both are given by a self-administered injection once or twice a month.

They're intended for people whose cholesterol levels remain stubbornly high, despite making lifestyle changes (such as diet and exercise) and taking the maximum dose of a high-potency statin and other cholesterol-lowering drugs. In the past two years, results from two large studies found that both PCSK9 inhibitors lowered the risk of serious heart-related events such as heart attack and stroke by 15%.

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Avocados are one of the few fruits (yes, technically they're a fruit, not a veggie) that contain healthy unsaturated fats. These fats help lower undesirable LDL cholesterol when eaten in place of saturated fat.

The popular Haas avocado, which has dark-green, nubby skin, grows year-round in California. A larger variety with smoother, bright-green skin grows in Florida. Marketed as SlimCado, it contains about half the fat and a third fewer calories than Haas avocados.