Heart Health Archive

The old adage that you can't change your genes may be true, but research suggests that lifestyle choices can modify some of the influence your genes have on your health. Case in point is one study that determined that a "prudent" diet — especially one replete with raw vegetables and fruits — can noticeably reduce the elevated risk of heart disease that comes with a specific genetic variation.

Analysis of DNA information made available since the mid-1990s has helped researchers identify variations in small snippets of DNA that increase a person's risk for heart problems. Because genes come in pairs (alleles), a person with potentially harmful variations in both alleles is presumably at even greater risk than someone with a single variation.

Wire-mesh stents were invented to prop open heart arteries that balloon angioplasty had just cleared of cholesterol-laden plaque. Coating them with drugs helped fix an early problem: cells from the artery wall surrounding the stent sometimes grew over and around the stent and clogged the space through which blood flows.

But without a protective coating of artery-wall cells, a stent is an attractive surface for blood-clot formation. If such a clot is large enough, it can trigger a heart attack. This is called stent thrombosis.

On the surface, the vexing skin disease known as psoriasis (sore-EYE-uh-sis) seems to have nothing in common with heart disease. Yet research from around the globe suggests the two conditions are somehow linked.

Two reports strengthen the connections between psoriasis and heart disease. In a study of almost 18,000 Britons, major cardiac events (namely heart attack, stroke, and death from cardiovascular disease) were more common among those with psoriasis, occurring in 16.4 per 1,000 people per year, than among those without this skin condition, who had 11.6 events per 1,000 people per year (American Journal of Medicine, August 2011). In a huge study that included the entire population of Denmark from 1997 to 2006, atrial fibrillation, a heart-rhythm problem, and ischemic stroke, which is often caused by atrial fibrillation, were significantly more likely to occur in people with psoriasis (European Heart Journal, published online, Aug. 12, 2011).

Erection problems (known as erectile dysfunction, or ED) and cardiovascular disease often occur together. Clogging of arteries by cholesterol-laden plaque and damage to the inner lining of blood vessels from high blood pressure contribute to both conditions.

It would make sense, then, that treating heart disease risk factors with cholesterol-lowering statins and lifestyle changes — such as exercise, smoking cessation, and weight control — might help men with their erections.

Q. My systolic blood pressure is high in the morning (about 165), but in the evening it drops to below 100. I am taking two blood pressure medications daily and still experiencing seriously low blood pressure at night. What would you suggest?

A. Everyone's blood pressure changes throughout the day, and it's often highest in the morning and lowest at night. You seem worried about the low pressure at night, but that would concern me only if it's accompanied by symptoms such as dizziness or fainting. A systolic (top number) pressure below the normal of 120 is usually not worrisome. In fact, studies show that low blood pressure while you are sleeping predicts low cardiovascular risk.

Q. I am 76 years old and still get hot flashes. Is it true that women who have hot flashes many years after menopause are more likely to experience heart problems than those whose symptoms end early in menopause?

A. If there is a relationship between hot flashes and the risk of heart disease, it is not very strong, and you shouldn't worry about it.

If you want to have a healthy heart in your senior years, take care of it while you’re young. In a large study, researchers from Northwestern University found that a 45-year-old man who had normal blood pressure and cholesterol levels, who didn’t smoke, and who didn’t have diabetes had just a 1.4% chance of having a heart attack or stroke during the rest of his life. Having one major risk factor boosted the risk 20-fold. The results were similar for men and women, blacks and whites. Lead researcher Donald Lloyd-Jones said that making it to middle age with no heart disease risk factors is like “the fountain of youth for your heart.”

A bold initiative called Million Hearts aims to prevent one million heart attacks and strokes from happening over the next five years. As explained in the Harvard Heart Letter, the initiative is spearheaded by the federal Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services. Its main focus is to encourage more widespread and appropriate use of simple, effective, and inexpensive heart-protecting actions, dubbed the ABCS. These include taking daily low-dose Aspirin, if prescribed; managing Blood pressure and Cholesterol levels; quitting Smoking. The Harvard Heart Letter adds D for Diet and E for Exercise.

Are you doing everything possible to prevent a heart attack or stroke?

Dear Reader,

Information about health is often accompanied by numbers — how many people have this disease, what's the risk of developing that condition. Then there are more personal numbers, such as your targets for blood pressure and cholesterol. Understanding all those numbers can be confusing, and much of what the Harvard Heart Letter does is help you make sense of them.

The Centers for Disease Control and Prevention (CDC), in partnership with the Centers for Medicare and Medicaid Services, is spearheading the Million Hearts initiative. We spoke with the CDC's director, Dr. Thomas R. Frieden, about how the initiative will improve the care of people with heart disease and those unknowingly headed toward it.

Do you think people realize just how much their health is affected by high blood pressure, smoking, lack of exercise, and other conditions or choices?