Heart Health Archive

Think of inflammation as the body's natural response to protect itself against harm. There are two types: acute and chronic. You're probably more familiar with the acute type, which occurs when you bang your knee or cut your finger. Your immune system dispatches an army of white blood cells to surround and protect the area, creating visible redness and swelling. The process works similarly if you have an infection like the flu or pneumonia. So in these settings, inflammation is essential—without it, injuries could fester and simple infections could be deadly.

Chronic inflammation

But chronic inflammation can also occur in response to other unwanted substances in the body, such as toxins from cigarette smoke or an excess of fat cells (especially fat in the belly area). Inside arteries, inflammation helps kick off atherosclerosis—the buildup of fatty, cholesterol-rich plaque. Your body perceives this plaque as abnormal and foreign, so it attempts to wall off the plaque from the flowing blood. But if that wall breaks down, the plaque may rupture. The contents then mingle with blood, forming a clot that blocks blood flow. These clots are responsible for the majority of heart attacks and most strokes.

Although no longer routine, this test is still a common, safe way to assess people with heart disease symptoms.

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That chest discomfort you felt during your evening walk disappeared once you got back home. But a week later, you're carrying a laundry basket upstairs and the pain returns, although only briefly. It's time to call your doctor to discuss these symptoms — and possibly undergo an evaluation for coronary disease.

One test you may need is an exercise stress test, also called a treadmill test. As recently as a decade or so ago, doctors ordered these tests as part of a routine check-up in middle-aged and older men, regardless of their symptoms. Today, they're done mainly in people with symptoms that suggest heart disease, says Dr. Hicham Skali, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. "In general, that means stable angina, which refers to chest pain that occurs in predictable patterns during exercise or other exertion," he says. Angina occurs when the heart muscle isn't getting enough blood, which is more likely during physical activity.

Research we're watching

Eating nuts even just a couple of times a week is linked to a lower risk of dying from heart disease, a new study suggests.

The study included 39,000 women who filled out dietary questionnaires at the start of the study and again about 10 years later. During the follow-up, which lasted an average of 19 years, nearly 1,000 of the women died of cardiovascular disease.

Research we're watching

A difference in the blood pressure readings from the left and right arms may herald a higher risk of heart disease, according to an analysis of 24 international studies.

The report, published in the February 2021 issue of Hypertension, included data from more than 57,000 adults in general health clinics who had their blood pressure measured in both arms. Researchers tracked the participants' cardiovascular health for more than a decade.

Research we're watching

Surveys show that about one in five Americans uses a smartphone app or tracker for monitoring exercise. Evidence for the benefits of these tools is mixed, but a new review suggests they may encourage people to move a bit more.

Researchers pooled findings from 28 studies involving a total of nearly 7,500 people who took part in studies using a smartphone app or activity tracker. They found that these tools have a small to moderate effect in boosting physical activity, motivating people to take an average of 1,850 additional steps per day.

Whether you've had a stent placed or may need one in the future, here's what you should know about these tiny devices

Close to a million heart stents to open blocked or narrowing arteries are implanted each year in the United States, and as you age, the odds rise that you'll end up on the list of recipients.

"Getting a stent can save your life during a heart attack, but what you do after the procedure can dictate your future heart health," says Dr. C. Michael Gibson, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center.

News briefs

Fried foods carry heart risks in part because they spur inflammation. But how many servings of crispy French fries does it take to raise your risk for cardiovascular disease? Not many, suggests a large analysis published online Jan. 18, 2021, by the journal Heart. Scientists pooled the findings of 17 studies on fried foods and problems like heart attacks, clogged coronary arteries, heart failure, and stroke. The studies included more than half a million people. Researchers also looked at the data from another six studies assessing the association of eating fried food and dying prematurely. Those studies involved more than 750,000 people. People who ate the most fried foods each week were 28% more likely to have heart problems, compared with people who ate the least. Each additional 114-gram (4-ounce) serving of fried foods per week bumped up overall risk by 3%. But the analysis failed to show that people who ate lots of fried foods were more likely to die prematurely. Besides provoking inflammation, fried foods are often also high in sodium as well as harmful saturated fats. If you choose to indulge in them, do it sparingly. And avoid foods fried in animal fats; instead, choose foods fried in vegetable oils.

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With expanded options for replacing stiff or leaky heart valves, more people can avoid surgery.

The heart's four valves open and shut in a carefully timed sequence to move blood through and out of the heart to the body. But as people age, these one-way valves may narrow and stiffen — a problem known as stenosis — which partially limits blood flow. Heart valves can also leak, allowing blood to flow backward; that's called regurgitation.

About one in 10 adults ages 65 and older has moderate to severe heart valve disease. Without timely diagnosis and treatment (see "Monitoring heart valve disease"), valve problems can worsen, causing serious and sometimes fatal consequences. The good news: More people who need a new heart valve can get one without major surgery.

Ask the doctor

Q. My doctor told me I should get a home monitor to keep tabs on my blood pressure. Which number is most important in the reading, the top or the bottom one?

A. This question comes up often, perhaps because doctors and patients alike tend to pay more attention to the top (first) number, known as systolic pressure. It reflects the amount of pressure inside the arteries as the heart contracts. The bottom (second) number, diastolic pressure, is always lower since it reflects the pressure inside the arteries during the resting phase between heartbeats.

If you need inspiration, here are some heart-friendly suggestions from Harvard cardiologists.

Even if you enjoy cooking, chances are you find yourself wondering what to make for dinner once in a while — especially if you're trying to eat more healthfully. And maybe you or someone in your household avoids all animal products or follows a low-carb eating style. Perhaps you need an easy meal for a quick weeknight supper or something a little fancier for a special occasion.

No matter what your family's preferences, there's a wealth of options when it comes to following a diet that promotes cardiovascular health. The two main guidelines: include plenty of plant-based foods (especially fruits and vegetables), and choose mostly unprocessed or minimally processed foods. Below, five cardiologists who treat patients at Harvard-affiliated hospitals share their favorite meals, along with some of the inspiration for their choices.