Heart Health Archive

For these popular pills, the evidence has been mixed. Here's advice about getting the recommended amounts of both nutrients.

In the body, calcium and vitamin D work together to build and maintain healthy bones. Many adults (especially women) take these two nutrients in supplement form, hoping to stave off osteoporosis, the bone-weakening disease that leaves older people prone to fractures. But how do these supplements affect cardiovascular health?

The answer is a bit complicated. Here are the key points, with additional context and advice below:

Even short stints of structured exercise may improve your heart health — and it's never too late to start.

Are you one of those people whose typical day includes doing chores around the house and yard, running errands, and caring for a spouse, grandkids, or pets? Having a busy, active life is one reason people think they don't need to set aside time devoted solely to exercise, says Gisele Bousquet, program director at Harvard-affiliated Brigham and Women's Cardiac Rehabilitation Program in Foxborough, Mass.

"People say, I'm very active, I'm always on the go," she says. Being physically active is good, she tells them. But doing regular moderate exercise — ideally for at least 30 minutes most days of the week — can lower your blood pressure and many other risk factors linked to heart disease. Even if you've never done formal exercise, starting in the second half of life can still make a difference (see "Exercise: Even starting after 60 can help").

Taking these medications at bedtime rather than in the morning may make them more effective.

Many people take their medications as part of their morning ritual, along with a cup of coffee and the daily newspaper. But for blood pressure drugs, evening may be a better option. Last year, a large study found that taking blood pressure drugs before bed may lower the risk of serious heart-related complications more than taking the drugs in the morning (see "Benefits of bedtime blood pressure dosing").

The concept of chronotherapy, or adjusting medication dosing to a specific time of day, isn't new. There's not a great deal of evidence to support the practice with cardiovascular drugs, but it makes sense, says Dr. Naomi Fisher, director of the Hypertension Specialty Clinic at Harvard-affiliated Brigham and Women's Hospital.

Ask the doctor

Q. I have noticed my legs are getting more swollen lately. Is this anything to worry about? My mother also had this problem and was diagnosed with heart failure.

A. Leg swelling is very common, especially as people get older. Heart failure, which means the heart can't function well enough to meet the body's needs, is certainly on the list of serious causes. However, people usually experience other symptoms such as shortness of breath and fatigue by the time the heart failure becomes serious enough to cause leg swelling.

Lowering LDL cholesterol has been shown to lower risk of cardiovascular disease. Recent studies have suggested that more aggressive goals for LDL levels in people who already have CVD can decrease risk even further.

A recent study confirms that people born with congenital heart disease have a significantly greater risk of being diagnosed with an autism spectrum disorder. The research highlights the need for autism screening in children with CHD as early as possible.

Eating more unprocessed, plant-based foods is one of the best ways you can protect your heart.

What do you usually eat for breakfast? How about for lunch and dinner? These questions are standard fare during a consultation with Dr. Ron Blankstein, a preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital. The answers help him tailor the dietary advice he gives, which can have a profound effect on the future health of his patients' hearts.

"Most people really aren't aware of the importance of a healthy diet, or they're confused about what they should be eating," says Dr. Blankstein. About five years ago, he revamped his own diet to follow what the current evidence suggests is the best way to avoid heart disease: a whole-food, plant-based style of eating. "I find that when I tell my patients I follow this diet myself, they're far more likely to buy into it," he says. (For an idea of what he typically eats, see "A day of plant-based meals.")

Several new technologies and medications that may benefit the heart are moving into cardiology care.

As regular readers of the Heart Letter know, our features tend to focus on lifestyle advice and currently available therapies for heart disease. As the new decade begins, we're also looking to the future. Editor in Chief Dr. Deepak L. Bhatt selected five promising new developments in cardiovascular research that you may be hearing more about in the coming years.

1. Digital stethoscopes

First developed more than 200 years ago, the instrument doctors use to listen to the heart and lungs has undergone some high-tech improvements in recent years. The latest digital stethoscopes feature specialized microphones and sensors that filter, buffer, and amplify sounds from the heart. The sounds are then converted to a digital signal and sent wirelessly to a smartphone, where the patterns can be visualized and further analyzed. Some models are so sensitive they can detect turbulent blood flow in the arteries of the heart, possibly enabling doctors to detect coronary artery disease. Studies assessing that potential use are currently under way.