Heart Health Archive

Q. You've emphasized that people generally eat too much sodium and not enough potassium. Could I solve both problems at once by replacing my regular table salt with a substitute containing potassium?

A. Many Americans do eat too much sodium and not enough potassium. Your condiment approach to the sodium/potassium balancing act might help, but most people's excessive sodium intake comes largely from processed and packaged foods. So a far better strategy would be to replace salt-saturated prepared foods with fresh fruits and vegetables, almost all of which are high in potassium and low in sodium, and which offer other health benefits as well.

Q. I come from a long line of family members with heart disease. Right now, my HDL is 62 mg/dL [milligrams per deciliter], and my LDL is 115 mg/dL. My doctor isn't worried about my LDL, but shouldn't I shoot for an LDL level under 100 mg/dL?

A. First, your HDL is terrific, and is probably the envy of many of your friends (if you sit around comparing lipid profiles). Based on these numbers, you don't have a high-risk lipid profile. Assuming that you don't currently have a personal history suggestive of coronary artery disease — like having angina (chest pain with exercise or stress) or having had a heart attack — an LDL-lowering medication such as a statin is not something I'd suggest if you were my patient. I don't think the potential for side effects and the cost of the medication are worth whatever small gain you might achieve from driving your LDL lower.

Q. My wife's medication to treat atrial fibrillation recently was changed from warfarin to a new drug called Pradaxa. They say that the new medicine does not require regular INR tests and is just as effective. Is that so?

A. Yes, it is so. Before I explain why, let me provide a little background.

Evidence suggests that depression is a treatable risk factor for heart disease and stroke.

Harvard Women's Health Watch readers probably know that the leading cause of death in women is cardiovascular disease (CVD) — that is, heart disease and stroke. Nearly 43 million women in the United States have some form of CVD, and every year, nearly 422,000 die of it — that's more than succumb annually to all forms of cancer combined. Heart disease and stroke are also major causes of life-altering disabilities.

The FDA has approved a nonsurgical alternative to open-heart surgery for replacing a failing aortic valve. For now, though, it is only available for people who can’t, or shouldn’t, have open-heart surgery.

Most Americans fall back from daylight savings 2011 during the wee hours of Sunday morning, November 6. Although the time change can be discombobulating, our hearts like it better than springing ahead. One study showed fewer heart attacks on the Monday after the end of daylight savings time in the fall; the opposite happens in the spring. Getting, or losing, that extra hour of sleep may explain the differences. Ways to ease into the time change include going to bed and waking up at the same time as usual, and getting some sunlight on Sunday as soon as you get out of bed.

A new study involving 1.2 million children and young adults provided reassuring evidence that the drugs used to treat ADHD do not increase the risk of death from heart disease. Researchers analyzed medical records from a nationwide private insurance plan along with health plans based in Tennessee, California, and Washington State. They compared children taking stimulant drugs (like Ritalin and Adderall) that are commonly used to treat ADHD to children not taking these drugs. Cardiac problems were no more common among children using a stimulant as among those not taking one.

The focus is on foods, not on food components like fat and fiber.

Scientific research often advances our understanding of health and disease. Sometimes, though, it leads to dead ends. The latter is what happened to several decades of nutrition research that focused on individual nutrients like cholesterol, saturated fat, fiber, and antioxidants. Although that work shed ample light on how nutrition affects health and disease, it unintentionally complicated and often confused the concept of healthy eating.

If you need to lower your cholesterol and want to try changing your diet first, your best bets are a Mediterranean-type diet or the so-called portfolio diet. In a head-to-head trial, a standard low-fat diet had little effect on cholesterol.

Mediterranean-type diets

There’s no such thing as "the" Mediterranean diet. You may already be following one and not know it (see “Mediterranean quiz”). Here are the general characteristics: