Heart Health Archive

Research we're watching

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New research suggests that eating plenty of nitrate-rich vegetables — such as lettuce, spinach, and beets — may lower your risk of dying of a stroke or heart attack.

During digestion, your body converts nitrates into nitric oxide. This compound relaxes and widens blood vessels, which helps lower blood pressure. But does that translate to a longer life? To find out, researchers studied the diets of 1,226 older women who had no signs of fatty plaque in their arteries (atherosclerosis) and tracked them for 15 years.

Research we're watching

Roughly half of Americans ages 75 or older take a daily, low-dose aspirin to prevent a heart attack or stroke. New research suggests these people might benefit from taking a stomach-protecting drug to prevent a higher-than-expected risk of gastro­intestinal (GI) bleeding.

The study, published online June 13, 2017, by The Lancet, involved nearly 3,200 people who were prescribed aspirin because of a previous heart attack or stroke. Researchers followed them for up to 10 years to see how many were hospitalized for bleeding — a well-known side effect of aspirin use. Upper GI bleeding usually results from a stomach ulcer, which can cause anemia, heartburn, and abdominal pain.

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For years, doctors prescribed cholesterol-lowing statins based largely on cholesterol test results. The goal was to lower total cholesterol to under 200 mg/dL, and LDL (bad) cholesterol to under 100 mg/dL. But in late 2013, new guidelines on statin use issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) proposed a major change to that strategy.

These guidelines shifted from a numbers-based approach to a risk-driven approach. Instead of aiming for a specific cholesterol value, doctors were urged to look at a person's entire cardiovascular risk profile when considering treatment. This is a reasonable approach that can help better define when to initiate drug therapy.

Ask the doctor

Q. I keep hearing that chocolate is good for heart health. Is it too good to be true?

A. It is not too good to be true — but it also is complicated. We have previously discussed studies indicating that foods derived from the cocoa bean — in particular, dark chocolate, which has a higher cocoa content than milk chocolate — are heart-healthy. Specifically, people who eat more chocolate have lower rates of heart attacks, heart failure, and even death from heart disease.

Research we're watching

To provide more information on the value of statins for older people, which is still a matter of debate, researchers analyzed data on people over 65 who were enrolled in ALLHAT-LLT, a large study conducted between 1994 and 2002.

All participants (average age 71) had high cholesterol and high blood pressure but not heart disease. They were randomly assigned to two groups. One group, of 704 women and 763 men, took pravastatin (Pravachol). The other group, of 711 women and 689 men, didn't take a statin. The analysis indicated that during the five-year study period, there was no significant difference between the groups in the frequency of heart attacks, deaths from heart disease, or deaths from any cause, either among participants ages 65 to 74 or among those 75 or older. The results were published online May 22, 2017, by JAMA Internal Medicine.

Some studies suggest a possible link. But don't switch to regular sugary sodas — try infused water instead.

For diet soda fans, recent news reports linking these popular drinks to a higher risk of stroke may have been alarming. A closer look at the study behind the headlines suggests there's no need to panic. But beverages naturally low in calories are probably a healthier option than artificially sweetened drinks.

For starters, observational studies like this one (see "Diet soda and the brain: The latest findings") cannot prove cause and effect. Also, only 97 people had strokes during the 10-year follow-up, which means only two or three of those strokes could possibly be attributed to drinking diet soda, says Dr. Kathryn Rexrode, an associate professor of medicine at Harvard-affiliated Brigham and Women's Hospital who co-authored an earlier, larger study looking at soda consumption and stroke risk.

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 Illustration by Scott Leighton

Q. I was recently admitted to the hospital with heart failure and received a heart ultrasound. The test report stated that my heart's pumping ability is normal. I don't understand. Was my diagnosis wrong, or is the test wrong?

A. If you were diagnosed with heart failure in the hospital, I'm presuming that you were admitted with symptoms such as shortness of breath, fatigue, and difficulty doing everyday activities. Other common symptoms include swelling in your legs and feet and trouble breathing at night.

After calling 911, do you know what to do if a person is unresponsive and not breathing?

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Each year, an estimated 600,000 Americans suffer a cardiac arrest, during which the heart suddenly and unexpectedly stops beating. If someone nearby immediately begins cardiopulmonary resuscitation (CPR), the chest compressions can keep blood flowing to the person's brain and other vital organs — and more than double the odds of survival.

"About 70% of cardiac arrests happen at home. If this happened to your spouse or loved one, wouldn't it be awful if you didn't know what to do?" says Dr. Charles Pozner, associate professor of emergency medicine at Harvard-affiliated Brigham and Women's Hospital. But only 18% of adults in the United States have been trained in CPR within the past two years, according to a recent nationwide survey of 9,022 people, published in the May 24, 2017, Journal of the American Heart Association.

Are you exercising enough to prevent heart disease?

It can help you lose weight; decrease your blood pressure, cholesterol, and blood sugar; and reduce your stress. But wait, there's more: it also lowers your odds of a heart attack or other cardiovascular event and may even extend your life.

This wonder drug isn't a drug at all, of course — it's exercise. Yet only about half of all American adults do enough physical activity to benefit their health. And exercise is especially vital for people who are at risk for heart disease or already have it.

Research we're watching

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Heart attack risk may rise within a week of taking daily high doses of certain over-the-counter pain relievers, according to a new study.

Previous research has linked the use of pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) to a heightened risk of heart attack. The new report, published in the May 9, 2017, issue of The BMJ, analyzed data from nearly half a million people, of whom about 61,000 had heart attacks.