Heart Health Archive

I’m a big fan of diet soda. I like the taste, and I love that it doesn’t have any calories. I can drink two or three diet sodas a day and not worry about gaining weight. But a new study has me wondering if enjoying the sweetness of soda without the sugar and calories is such a good thing after all. University of Miami and Columbia University researchers found that daily diet soda drinkers were more likely to have had a stroke or heart attack over the course of a 10-year study, or to have died from vascular disease, as folks who didn’t imbibe diet soda. My husband gently (but persistently) tells me there is nothing good about drinking diet soda, not even the taste I claim to enjoy so much. The evidence seems to be backing him up.

Media reports describing “broken heart syndrome” often lump together two completely different conditions. One is stress cardiomyopathy, sometimes known as takotsubo cardiomyopathy. The other is myocardial infarction, better known as a heart attack. A huge sudden stress—like news that a loved one has died, experiencing an earthquake, or learning that your accountant has stolen all of your retirement savings—unleashes a torrent of stress hormones that can trigger one of those conditions. Stress cardiomyopathy is a weakening of the left ventricle, the heart’s main pumping chamber. Over the course of a week or longer, the left ventricle tends to recover its pumping power. Heart attacks occur when something—usually a blood clot—blocks blood flow to part of the heart muscle.

A new report from the Centers for Disease Control and Prevention (CDC) shows that just 10 types of deliver almost half of the average American’s daily sodium. Topping the list are breads and rolls, cold cuts, pizza, poultry, and soups. Almost two-thirds of our daily sodium comes from food bought in stores, and one-quarter comes from food bought in restaurants (which includes fast-food shops and pizza places).The report also showed that Americans take in an average of 3,266 milligrams of sodium a day (about 1½ teaspoons of salt), well above the healthy target of 2,300 milligrams a day. As a nation, cutting back on salt by an average of 400 milligrams a day could prevent 28,000 deaths a year and save $7 billion in health care costs.

The physical act of taking most medications is simple: pop a pill in your mouth, and gulp it down with water. But people often don't take their medications when and how they should. Cost is one barrier, of course. So are complicated dosing regimens, side effects, and medication pick-up hassles.

Not taking medications as prescribed — what doctors call nonadherence — has profound personal, public health, and economic consequences (see "Striking statistics"). You and your doctor play important roles in remedying the problem.

Dr. Lynne Warner Stevenson is a Harvard Medical School professor and director of the heart failure program within the Advanced Heart Disease Section at Brigham and Women's Hospital in Boston.

Heart failure — that's such a scary term.

Heart failure, unfortunately, creates this vision in people's minds of the heart just stopping. A better term might be a handicapped heart, which either doesn't pump very well or doesn't receive blood well.

In 2011, federal health officials ended an important government-funded clinical trial designed to test whether taking niacin in addition to a cholesterol-lowering statin might do more to lower heart attack and stroke risk than just taking a statin alone. Interim data indicated that the niacin had no benefit and may have been associated with a small, unexplained increase in stroke risk.

Full results of the AIM-HIGH trial, as it was called, were published several months later in The New England Journal of Medicine. Experts continue to fight over the AIM-HIGH results in that ferocious way that experts often do. Some say the results are strong evidence for not adding niacin to statin therapy. Others are adamant that AIM-HIGH missed the mark because of the way it was designed and that it will take the results of a different trial, dubbed THRIVE, to determine if niacin-statin combinations have cardiovascular benefits.

To switch or not is a decision for you and your doctor to make.

Warfarin's long reign as the drug for preventing stroke in people with atrial fibrillation is being challenged by the second new blood thinner to come on the market within the span of less than a year.

Seek help from a heart team when considering your options.

Age and unhealthy habits can harm the aortic valve, a three-flapped structure that ensures the one-way flow of blood from the heart's main pumping chamber to the rest of the body. In some people, the aortic valve becomes encrusted with calcium deposits that stiffen and narrow it, restricting blood flow. When people with this condition (called aortic stenosis) start feeling symptoms — such as dizziness, breathlessness, fatigue, and loss of appetite — quality of life goes inexorably downhill unless the valve is replaced.

These high-tech devices can save — and change — a person's life.

Implantable cardioverter-defibrillators (ICDs) save many lives. They monitor the heart's rhythm and rate, emitting a low-energy electrical correction when they detect a minor heart rate abnormality. They can also deliver a more significant jolt, likened to a swift kick in the chest, to halt potentially life-threatening rhythm disruptions.

In the Harvard Heart Letter, we usually break down matters of the heart into parts. Talking about the arteries supplying the heart, the electrical signals that make it pump, or specific therapies that correct problems helps turn complex processes into manageable bites. We also focus on a healthy lifestyle as the key to preventing and treating heart disease.

But it's difficult to tie all this together in an eight-page newsletter. A book from Harvard Health Publications, called Smart at Heart, admirably advocates for a truly holistic approach to heart health. Written by Dr. Malissa J. Wood, a cardiologist at Harvard-affiliated Massachusetts General Hospital, the book offers readers practical steps to bridge the gaps between their physical and emotional hearts. Dr. Wood is also principal investigator of the ongoing HAPPY Heart trial, which is looking at the effectiveness of holistic interventions to reduce cardiovascular risk among low-income women. The book's subtitle — "a holistic 10-step approach to preventing and healing heart disease for women" — identifies the primary audience, but there's much in this book for men, too.