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Understanding COPD from a cardiovascular perspective

Published

Some of the causes and symptoms of this common lung disease overlap with those of heart disease.


Even though chronic obstructive pulmonary disease (COPD) is one of the nation's leading causes of death, many people don't know much about it. What's more, they may mistakenly attribute COPD symptoms — such as trouble breathing, fatigue, and chest tightness during physical activity — to either heart disease or aging.

But recognizing this common condition is important, because treatment and lifestyle changes can help quite a bit, says Dr. Marilyn Moy, a pulmonologist at the VA Boston Healthcare System and associate professor of medicine at Harvard Medical School. "There is far more awareness about heart disease than COPD, so when people have breathing-related symptoms, they often assume it's their heart," she says. Because the breathing challenges caused by COPD appear gradually, people may overlook them or simply adjust their activities to them. People may notice they can't walk as far as they used to, or do other things they enjoy, such as playing with their grandchildren or gardening, Dr. Moy says.

Avoiding atherosclerosis: The killer you can't see

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Be proactive to ward off clogged arteries that can lead to heart attack, stroke, and even death.


 Image: © CreVis2/Getty Images

Most people don't spend a lot of time thinking about atherosclerosis. After all, you can't see any buildup of waxy plaque that may exist in your arteries, and the disease doesn't make itself known until it's advanced. "It can progress for decades before you have symptoms like chest discomfort or shortness of breath," explains Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital.

Yet atherosclerosis quietly and invisibly puts many millions of people at risk for heart attack, stroke, leg amputation, disability, and even death.

Updated exercise guidelines showcase the benefits to your heart and beyond

Published

Every little bit of activity counts — and the first steps toward fitness have the most impact.


 Image source: hhs.gov

Without question, being physically active is the best thing you can do for your heart health. Here's the good news: according to new federal exercise guidelines, even just a few minutes of moving can count toward the recommended aerobic exercise goal of 150 minutes of moderate-intensity activity per week.

"Studies show that the total amount of energy expended is what's important for health, not whether it comes in short or long bouts," says Dr. I-Min Lee, a professor of medicine at Harvard Medical School who studies the role of physical activity in disease prevention. "This certainly is an encouraging message for people who are inactive," she adds, noting that the previous guidelines recommended exercising in sessions lasting at least 10 minutes.

In case my father needs a transfusion, should I donate blood?

Published

Ask the doctor


 Image: © Cylonphoto/Getty Images

Q. My father is having open-heart surgery because of blocked arteries, and I'm concerned that he might need a blood transfusion. I have the same blood type as he does, so should I donate blood in case he needs it?

A. Transfusions related to cardiovascular surgery are far less common today than in the past. One reason is the routine use of a "cell saver." This device suctions, washes, and filters lost blood and returns it to the person during surgery. Still, there is a reasonable chance your father might need a blood transfusion during or after his surgery. Many people undergoing open-heart surgery end up needing a transfusion, though rates do vary widely depending on the length and complexity of the surgery, as well as by surgical center.

A more personalized approach to treating high cholesterol

Published

New guidelines refine the recommendations for treating the leading causes of death and disability.


 Image: © Bill Oxford/Getty Images

Cholesterol, the waxy, fatlike substance that contributes to heart attacks and strokes, is among the best-known contributors to cardiovascular disease — and with good reason. For decades, doctors have recommended blood cholesterol testing, often during annual checkups. Nearly one in three American adults has high levels of LDL, the most harmful type of cholesterol. Expert advice on managing this common problem now takes a more personalized approach, according to updated guidelines released by the American College of Cardiology and American Heart Association last November.

"The new guidelines really codify and support what many preventive cardiologists already do," says Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women's Hospital. They tailor treatment based not just on LDL values but also a person's overall risk, he explains.

Prescription-strength omega-3 fatty acids to prevent heart disease?

Published

A drug made from a highly purified fat from fish reduced cardiovascular events in people with heart disease or diabetes.


 Image: © ksbank/Getty Images

Some people at high risk for a heart attack or stroke now have a new option to help them dodge those dangerous events: a prescription drug that contains large doses of EPA, an omega-3 fatty acid found in fish oil.

In a recent study, the drug, icosapent ethyl (Vascepa), led to dramatic drops in heart attacks, strokes, and deaths from cardiovascular disease in people with high triglycerides (see "What is the REDUCE-IT trial?"). Triglycerides, a type of fat in the blood, have been getting more attention of late for their role in heart disease.

Lead and heart disease: An underappreciated link?

Published

This toxic metal can boost blood pressure and may raise the risk of cardiovascular disease.


 Image: © ogiana/Getty Images

Lead is widespread in our environment, and even low blood levels of this toxic metal may raise the risk of heart disease, a growing body of evidence suggests.

Last year, a study in Lancet Public Health found a link between lead exposure and a higher risk of death from cardiovascular disease. The data came from a nationally representative sample of more than 14,000 people in the United States who were adults in the late 1980s. The association persisted after researchers controlled for many confounding factors and was evident even among people with blood lead levels of less than 5 micrograms per deciliter (mcg/dL). Until 2013, only levels higher than 10 mcg/dL were considered worrisome, and mainly for children.

Legume of the month: Black beans

Published


 Image: © cheche22/Getty Images

Black beans are a staple in many Central and South American countries. In Guatemala, they may be stuffed in a thick corn tortilla (pupusa), while Costa Ricans enjoy a dish of refried black beans, rice, and onions called gallo pinto. The Brazilian national dish, fejoiada (pronounced "feyj wah dah"), also features black beans, and while it traditionally includes sausage and other meat, you can find recipes for vegetarian versions online.

Black beans are also popular in the United States, thanks in part to the proliferation of fast-casual Mexican restaurants that feature black beans as a side dish or tucked into burritos, tacos, and other specialties.

Does blood pressure rise because of age — or something else?

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Research we're watching


 Image: © AndreyPopov/Getty Images

Among people in the United States and other westernized countries, blood pressure readings tend to rise with age. But a new study suggests that's not true for the Yanomami, a tribe of hunter-gatherer-gardeners living in a remote Venezuelan rain forest.

Researchers measured blood pressure in 72 Yanomami people and 83 people from a nearby tribe, the Yekwana. The people ranged in age from 1 to 60 years old. The Yekwana have been slightly "westernized," thanks to missionaries and an airstrip that allows for occasional deliveries of processed food and salt.

Healthy habits help people sidestep clogged leg arteries

Published

Research we're watching

The buildup of fatty plaque in arteries outside of the heart, especially in the legs, is known as peripheral artery disease (PAD). A new study finds that middle-aged adults with optimal scores on a metric of cardiovascular health called "Life's Simple 7" are much less likely than people with less favorable scores to develop PAD.

Developed by the American Heart Association, the Simple 7 score takes into account cholesterol, blood pressure, blood sugar, physical activity, diet, smoking status, and body mass index. For the study, published in the November 2018 American Journal of Epidemiology, researchers followed 12,865 people with an average age of 54 over a median of about 24 years. People with optimal scores or average scores had, respectively, a 91% and 64% lower risk of PAD compared with people whose scores suggested poor health. The findings are similar to or even stronger than previous studies focusing on the predictive power of Life's Simple 7 for heart disease or stroke risk, according to the authors.

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