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Heart Health Archive
Articles
Blockages in tiny heart arteries a big problem for women
About 10% of women who have heart attacks seem to have clear, unblocked arteries. They don’t, really. Instead, they have a problem inside tiny arteries supplying the heart muscle, called microvessels. Traditional diagnostic tests can’t “see” into microvessels. In larger coronary arteries, the buildup of cholesterol-filled plaque creates distinct bulges that narrow the vessel at a particular spot, reducing blood flow. In microvessels, plaque uniformly coats the inner layer. This reduces the space for blood flow and makes the arteries stiff and less able to expand in response to exercise or other stress. Researchers are still trying to determine the best ways to diagnose and treat microvessel disease. Talking to cardiologists at Harvard-affiliated Brigham and Women’s Hospital, Dr. C. Noel Bairey Merz said that the erectile dysfunction drug Viagra (sildenafil), which was originally developed to improve blood flow to the heart, is being tested as one possible therapy.
Cancer can be tough on the heart in more ways than one
The death of Kara Kennedy, the only daughter of the late Senator Edward M. Kennedy, at age 51 from an apparent heart attack while exercising offers a reminder of the possible long-term effects of cancer and its treatment. In 2002, Kennedy was diagnosed with lung cancer. After having part of her lung removed, she underwent chemotherapy and radiation therapy. She lived for another nine years, in apparently good health. One of the hazards of some cancer survivors face is that the treatments used to fight cancer—drugs, radiation, and hormones—sometimes damage the heart and arteries.
Doctors can confuse heartburn and heart disease, even in themselves
Many people have trouble telling whether they are having heartburn or a heart attack. “Many people” includes doctors. A personal story from a Harvard physician describes how he treated himself with strong acid-suppressing pills until a near heart attack made him realize he had heart disease. His story appears in an updated Special Health Report from Harvard Medical School called “Heart Disease: A guide to preventing and treating coronary artery disease.”
Change: One man’s steady struggle to become healthier
It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories often sugar-coat changes like these, making them seem easier than they really are. In a moving essay in the American Journal of Health Promotion, Michael P. O’Donnell (the journal’s editor) describes his dad’s efforts to become healthier for his sake and the sake of his family. There was no monumental struggle, no epiphany—just a regular guy doing his best each day to become healthier for his sake and for his family. It’s a truly inspiring story.
Abundance of fructose not good for the liver, heart
Another reason to avoid foods made with a lot of sugar.
The human body handles glucose and fructose — the most abundant sugars in our diet — in different ways. Virtually every cell in the body can break down glucose for energy. About the only ones that can handle fructose are liver cells. What the liver does with fructose, especially when there is too much in the diet, has potentially dangerous consequences for the liver, the arteries, and the heart.
Sodium, potassium together influence heart health
When it comes to salt and food, the sodium in table salt gets most of the attention for its role in boosting blood pressure and contributing to cardiovascular disease. Potassium should get equal billing for its role in keeping blood pressure in check. Before processed foods became widely available, humans consumed much more potassium than sodium. Today, we get almost twice as much sodium as potassium. A new report from the National Health and Nutrition Examination Survey suggests that this imbalance — more sodium than potassium — contributes to heart disease and premature death. Here are some foods rich in potassium and low in sodium. Note the huge differences between unprocessed foods and the processed or salted foods marked in italics. (A more extensive list of potassium in foods, ranked high potassium content to low, is available from the US Department of Agriculture.)
Food | Amount | Potassium (mg) | Sodium (mg) | Potassium to sodium ratio |
Banana, raw | 1 medium | 422 | 1 | 422:1 |
Black beans, cooked without salt | 1/2 cup | 305 | 1 | 305:1 |
Orange | 1 medium | 232 | 1 | 232:1 |
Orange juice | 3/4 cup | 357 | 2 | 178:1 |
Grapefruit juice | 3/4 cup | 252 | 2 | 126:1 |
Peanuts, dry roasted, no salt | 1 1/2 ounces | 280 | 3 | 93:1 |
Peanuts, dry roasted, with salt | 1 1/2 ounces | 280 | 346 | 0.8:1 |
Avocado | 1/2 medium | 487 | 7 | 69:1 |
Raisins | 1/2 cup | 543 | 8 | 68:1 |
Prune juice | 3/4 cup | 530 | 8 | 66:1 |
Baked potato, plain, with skin | 1 medium | 926 | 17 | 54:1 |
Fast-food French fries | 1 medium order | 655 | 266 | 2.5:1 |
Peanut butter, without salt | 2 tablespoons | 208 | 5 | 42:1 |
Peanut butter, with salt | 2 tablespoons | 208 | 147 | 1.4:1 |
Brussels sprouts, steamed | 1/2 cup | 248 | 7 | 35:1 |
Applesauce (jar), no salt | 1/2 cup | 92 | 3 | 31:1 |
Applesauce (jar), with salt | 1/2 cup | 78 | 36 | 2.2:1 |
Oatmeal, regular | 1 cup | 164 | 9 | 18:1 |
Quaker’s Instant Oatmeal | 1 packet | 116 | 249 | 0.5:1 |
Cantaloupe | 1/4 medium | 368 | 22 | 17:1 |
Halibut, baked | 3 ounces | 490 | 59 | 8:1 |
Spinach, boiled | 1/2 cup | 420 | 63 | 7:1 |
Salmon, baked | 3 ounces | 244 | 39 | 6:1 |
Salmon, canned | 3 ounces/em> | 311 | 399 | 0.8:1 |
V8, low-sodium | 1 cup | 820 | 140 | 6:1 |
V8, regular | 1 cup | 470 | 480 | 1:1 |
Carrots, raw | 1/2 cup | 205 | 44 | 5:1 |
Beet greens | 1/2 cup | 655 | 173 | 4:1 |
Milk, 1% | 1 cup | 366 | 107 | 3:1 |
Cheerios | 1 cup | 171 | 186 | 0.9:1 |
Marinara sauce, prepared | 1/2 cup | 406 | 527 | 0.8:1 |
Pork and beans, canned | 1 cup | 726 | 1075 | 0.7:1 |
Fast-food cheeseburger | 1 regular | 444 | 1176 | 0.4:1 |
French bread | 1 medium slice | 82 | 416 | 0.2:1 |
Cornflakes | 1 cup | 33 | 266 | 0.1:1 |
Source: USDA National Nutrient Database |
September 2011 references and further reading
COURAGE not followed by action
Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB, Weintraub WS. Optimal medical therapy with or without PCI for stable coronary disease. New England Journal of Medicine 2007; 356:1503-16.
Borden WB, Redberg RF, Mushlin AI, Dai D, Kaltenbach LA, Spertus JA. Patterns and intensity of medical therapy in patients undergoing percutaneous coronary intervention. JAMA 2011; 305:1882-9.
Ask the doctor: Have I given up steak for nothing?
Q. I read that Harvard researchers found no association between eating red meat and developing heart disease and diabetes. Have I been depriving myself of steak for more than 20 years for no good reason?
A. In 2011 some of my colleagues at the Harvard School of Public Health reported findings from a meta-analysis that summarized the results of 20 studies. You're right: they didn't find an association between consumption of unprocessed red meat and heart disease and diabetes. On the other hand, one serving per day of processed meat was associated with a higher risk of developing those diseases. In this and other studies, red meat is defined as beef (including hamburger), lamb, pork, and game, and processed meat as any meat preserved by smoking, curing, salting, or chemicals, which would include bacon, hot dogs, sausage, and cold cuts. The processed meat was primarily processed red meat, but in some of the studies in the meta-analysis, poultry cold cuts were also included in the processed meat category.
COURAGE not followed by action
Results of landmark trial have little effect on use of angioplasty.
The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial should have been a game changer for people with stable angina (chest pain from cholesterol-clogged coronary arteries) or a severe narrowing in one or more coronary arteries. In such individuals, COURAGE showed that artery-widening angioplasty plus stent implantation was no better than optimal medical therapy at preventing heart attacks or improving survival. In other words, it made sense to first try medical therapy — that is, drug treatment and lifestyle changes — and turn to angioplasty if it didn't work.
What to do when blood pressure resists control
Taming resistant hypertension requires extra attention from you and your doctor.
Among the 60 million Americans who know they have high blood pressure (also known as hypertension), fewer than half have it under control. Some of them haven't made the necessary lifestyle choices or aren't taking medicines to lower their blood pressure. Some of their doctors aren't prescribing the right medicines at the right doses. But some people with hypertension (about one in eight) are doing all the right things yet still can't manage to control their blood pressure. They have what's known as resistant hypertension — blood pressure that lingers above a preset target despite the use of three medications, or control achieved only with the use of four or more medications.
Recent Blog Articles
Tick season is expanding: Protect yourself against Lyme disease
What? Another medical form to fill out?
How do trees and green spaces enhance our health?
A muscle-building obsession in boys: What to know and do
Harvard Health Ad Watch: New drug, old song, clever tagline
Concussion in children: What to know and do
What color is your tongue? What's healthy, what's not?
Your amazing parathyroid glands
When — and how — should you be screened for colon cancer?
Co-regulation: Helping children and teens navigate big emotions
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