Heart Health Archive

Overuse, underuse, and valuable use

Qaseem A, Alguire P, Dallas P, Feinberg LE, Fitzgerald FT, Horwitch C, Humphrey L, LeBlond R, Moyer D, Wiese JG, Weinberger S. Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care. Annals of Internal Medicine 2012; 156:147-49.

What’s at the heart of fainting?

Cooper PN, Westby M, Pitcher DW, Bullock I. Synopsis of the National Institute for Health and Clinical Excellence Guideline for management of transient loss of consciousness. Annals of Internal Medicine 2011; 155:543-49.

For more information about peripheral artery disease:

American Heart Association

HeartHealthWomen.org

National Heart Lung and Blood Institute

Peripheral Arterial Disease Coalition

Peripheral Artery Disease Program, Massachusetts General Hospital, Boston

Society for Vascular Surgery

Vascular Disease Foundation

To find a vascular specialist:

Society for Vascular Medicine

Society for Interventional Radiology

Society for Vascular Surgery

Women with severe obstructive sleep apnea may be at increased risk of dying from a cardiovascular event such as a stroke or heart attack, and treatment with a therapy called continuous positive airway pressure, or CPAP, may reduce that risk. These are the findings of the first study to examine the relationship between obstructive sleep apnea and cardiovascular death exclusively in women. Obstructive sleep apnea causes pauses in breathing during sleep, with symptoms that include snoring and daytime sleepiness. Studies have shown that severe apnea raises the risk of fatal cardiovascular events in men, and that CPAP is protective, but until now, data on women have been lacking. Results were published in the Jan. 17, 2012, issue of Annals of Internal Medicine.

The study. The participants were 1,116 women (average age 57) referred to sleep clinics at two hospitals in Spain between 1998 and 2007. All of the women underwent sleep studies to determine whether they had obstructive sleep apnea. If they did, and if it was sufficiently severe (scoring 30 or higher on a measure called the apnea-hypopnea index, or AHI) or was moderate but accompanied by daytime sleepiness, the women were offered CPAP treatment. CPAP use was tracked by reading a time counter on the device. On the basis of the sleep study and CPAP recommendations, participants were divided into five groups: those without sleep apnea, those with mild to moderate sleep apnea treated with CPAP, those with severe sleep apnea treated with CPAP, those with mild to moderate sleep apnea not treated with CPAP, and those with severe sleep apnea not treated with CPAP. The women were monitored for six years.

Most fainting is not related to abnormal heart rhythms.

Fainting, the temporary loss of consciousness that doctors call syncope (SINK-uh-pee), can be embarrassing, scary, and dangerous. It's also quite common — an estimated one in three people faints at least once in their lifetime.

Both "stiff" and "weak" types demand attention, but stiff hearts are trickier to treat.

The term "heart failure" is ambiguous. It doesn't refer to a heart that has come to a screeching halt — that's sudden cardiac arrest.

Those arising from atherosclerosis and atrial fibrillation can be very dangerous.

When you poke yourself on a thorn while gardening or get a paper cut at the office, your body marshals the forces needed to stop the flow of blood and repair the damage. If it weren't for the blood's ability to clot (form a thrombus, in medicalese), even these minor scrapes of daily living could cause us to bleed uncontrollably. These healing clots also form inside the body at sites of blood vessel injuries. Normally, when the clot's job is done, it dissolves away.

But studies in rodents suggesting a link may not play out in people.

You never eat alone. Instead, you share every meal or snack with an entire community — trillions of bacteria, fungi, and other microbes that live in your digestive system. A provocative study suggests that these microorganisms may affect the development of artery-clogging atherosclerosis.

What should you eat if you don't like poultry, fish, or beans — the often-cited heart-healthy sources of protein? One study showed that a diet including daily portions of lean beef can lower LDL cholesterol — as long as the rest of the menu includes fruits, vegetables, and whole grains.

Researchers gave 36 healthy men and women with elevated LDL cholesterol levels four different diets for five weeks each. All meals and snacks were prepared by the researchers and consumed either at the study center or at home.

People who are depressed are more likely to develop heart disease than those who aren't. It works the other way, too — people who have heart disease are more likely to lapse into depression than their disease-free counterparts.

The same association appears to exist between depression and stroke. This isn't a huge surprise, considering that the conditions that cause heart disease — like clogged arteries and inflammation — also contribute to strokes. Still, researchers can only speculate on how depression contributes to these dangerous cardiovascular events or the biological disorders leading up to them.

Radiation to treat breast cancer increases the risk of developing narrowed coronary arteries in areas that receive the most radiation, according to a study. Because most of the heart is located in the left side of the chest, the greatest concern is for women who receive radiation to the left breast. Prior studies linked radiation for breast cancer to an increased risk of developing heart disease later.

Swedish researchers evaluated the angiograms of 123 Swedish women who underwent radiation therapy for breast cancer between 1970 and 2003. Those with left-sided breast cancer were about four times more likely than those with right-sided breast cancer to have moderately narrowed coronary arteries, and seven times more likely to have severe narrowing (Journal of Clinical Oncology, published online Dec. 27, 2011).