Heart Health Archive

People with atrial fibrillation are at higher risk of having a stroke because they are more susceptible to the blood clots that cause stroke. When the atria (the top two chambers of the heart) fibrillate (beat chaotically), blood collects in the heart, giving clots a chance to form. One of those clots can travel to the head, get stuck in a blood vessel there, and cause a stroke by depriving a part of the brain of the oxygen and nutrients it needs; some of the cells of the brain die, possibly taking with them the ability to move, speak, feel, think, or even recognize people.

Warfarin prevents blood clots by making the platelets in the blood less sticky. It's a good, time-tested drug. But warfarin is tricky to use. Some experience bleeding problems like nosebleeds. Yet if you take back the dose too far to avoid bleeding, you're back to where you started: running the risk that a blood clot may form and cause a stroke.

Iodized salt provides only a small fraction of daily iodine intake.

The surplus of sodium in the American diet contributes to a host of cardiovascular problems, from high blood pressure and stroke to heart attack, heart failure, and more. Cutting back on salt is generally good for the heart and arteries. But could this strategy have the unintended consequence of making some Americans deficient in iodine?

Reduce salt — get your iodine elsewhere

Markel H. "When it rains it pours": endemic goiter, iodized salt, and David Murray Cowie, MD. American Journal of Public Health 1987; 77:219-29.

Dasgupta PK, Liu Y, Dyke JV. Iodine nutrition: iodine content of iodized salt in the United States. Environmental Science and Technology 2008; 42:1315-23.

Statins and lower cholesterol …

According to the National Center for Health Statistics (NCHS), the percentage of Americans ages 45 and older taking a statin drug jumped from 2% in 1988–94 to 25% in 2005–08. There are roughly 117 million Americans over age 45, so that means there are almost 29 million statin users, or the equivalent of the entire populations of Florida and Georgia combined. Here is a graph from the NCHS that shows the increase:

The fact that one in every four Americans older than the mid-40s is taking a statin is really kind of stunning (presuming, of course, that there hasn't been a big fall-off since 2005–08).

The aorta is the largest artery in the body; it's also the strongest. But size and strength are not enough to protect this crucial blood vessel; in fact, the aorta is one of the body's most vulnerable arteries.

Although many things can go wrong with the aorta, the most common is an aneurysm; it's an unfamiliar term, but it's a well-chosen name based on the ancient Greek word that means "to widen."

If you are having a stroke, a stroke center may be the place to go.

When talking about stroke, doctors often say that "time is brain." The faster you get medical help, the greater the chances of surviving and recovering from a stroke. A movement to establish special stroke centers across the country is ushering in a seemingly contradictory phrase: the old real estate adage "location, location, location." The rise of stroke centers means that emergency medical crews could bypass a nearby hospital and take a few extra minutes to reach a more distant one.

Understand the risks and limitations before embarking on this last-ditch option.

An operation that changes how the stomach and intestines digest food has been hailed as a potential lifesaver for people who are severely overweight. It can dramatically improve blood sugar, lower blood pressure and cholesterol, lessen sleep apnea (a dangerous pattern of breath holding during sleep), and improve heart function. But these benefits, which accrue only with a lifelong commitment to healthy eating and exercise, must be balanced against possible risks.

Apple, pear — it doesn't matter which of these fruits your body shape resembles. Extra body fat, whether you carry it around your midsection (apple shape) or your thighs (pear shape), is bad for your heart and health. So say researchers who reviewed the health records of more than 220,000 men and women taking part in 58 long-term studies (The Lancet, published online March 10, 2011).

The findings are the latest salvo in a spirited debate about the best way to gauge the health effects of overweight and obesity. The three most common measures are as follows:

If you need to fix a bunch of unhealthy trends — high blood pressure, high blood sugar, high triglycerides, low HDL, and excess belly fat — following a Mediterranean-type diet could be a single solution to them all. Greek and Italian researchers combined the results of 50 studies that included more than half a million men and women. Adopting and sticking with a Mediterranean-type diet improved each of those measures (Journal of the American College of Cardiology, March 15, 2011).

Note that we say "Mediterranean-type diet." That's because the 50 studies didn't look at a single, rigid diet, but rather an eating pattern that shares these general characteristics: It's low in saturated fat and high in fiber. Fruits, vegetables, grains, beans, nuts, and seeds are eaten daily and make up the lion's share of food items. Fat, much of it from olive oil, may account for up to 40% of daily calories. Small portions of cheese or yogurt are usually eaten each day, along with a serving of fish, poultry, or eggs. Red meat makes an appearance now and then. Small amounts of red wine are typically taken with meals.

Hypertension on the rise. One-quarter to one-third of U.S. adults — between 60 million and 70 million Americans — have high blood pressure (also known as hypertension). Less than half of them manage to keep their blood pressure under control with diet, exercise, medication, stress reduction, and other strategies (Centers for Disease Control and Prevention and the federal Medical Expenditure Panel Survey).

Exercise and HDL. Physical activity boosts protective HDL more in some people than others. Why? Research suggests that exercise affects the function of several genes that influence HDL (Circulation: Cardiovascular Genetics, February 2011). Variants of these genes from person to person could explain why some people have larger increases in HDL in response to exercise than others.