Heart Health Archive

Ask the doctor

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Q. My recent cholesterol test result included "non-HDL cholesterol." What is the significance of this number?

A. Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. When you get your blood drawn for a cholesterol test (also known as a lipid profile or lipid panel), the report usually includes four numbers: low-density lipoprotein (LDL) cholesterol; high-density lipoprotein (HDL) cholesterol; triglycerides; and total cholesterol.

This screening test is simple and painless, but it isn't appropriate for most people.

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For years, for-profit companies have mailed offers for health screening tests to homes across the United States. For about $150, you can undergo a series of ultrasound scans, which the companies claim can uncover potentially dangerous cardiovascular conditions. One scan looks at your carotid arteries, which run up either side of your neck.

Just like arteries in the heart and elsewhere in the body, the carotid arteries can become clogged with fatty deposits. Narrowing of a carotid artery (also called carotid artery stenosis) can increase the risk of stroke — the narrower the artery, the higher the risk.

Ask the doctor

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Q. A friend of mine shared a Facebook post about how to survive a heart attack when you're alone. It says that you should cough very forcefully every few seconds until help arrives. Can that actually help?

A. This "advice" has been circulating around the Internet for nearly 20 years. I was reluctant to even address this question out of concern for perpetuating the idea of "cough CPR" or causing undue worry. However, I think it's important to clear up the confusion around this topic.

Ask the doctor

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Q. I recently got a coronary artery calcium scan and the results showed that I have quite a bit of calcium in my heart arteries (my score was 900). Should I have an angiogram to confirm the results? I don't have any heart-related symptoms, but I'm worried about having a heart attack.

A. That is a very high coronary artery calcium score. But the short answer to your question is no. The main reason to have an angiogram is to locate a narrowed heart artery that is causing chest pain or other symptoms. For the test, a cardiologist injects a dye that is visible on x-rays into the blood vessels of your heart, then takes a series of x-ray images. This is done in preparation for angioplasty, in which a narrowed artery is opened, or as a prelude to referral for coronary artery bypass surgery.

A stent can save your life during a heart attack, but can it help prevent one?

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An estimated two million people get coronary artery stents every year, and if you have coronary artery disease, there is a good chance your doctor will suggest you get one.

But do you really need it? In 2013, the American Medical Association issued a report that said stents were one of the most highly overused medical interventions.

Research we're watching

Doing easy leg stretches may improve blood flow throughout the body by making the arteries more flexible and able to dilate, according to a small study in the July 1, 2020, Journal of Physiology.

The study included 39 young adults, 27 of whom did passive leg stretches five times a week for 12 weeks, while the other 12 did no stretching. (Passive stretching involves holding a stretch for a set period of time aided by an outside force, such as one's body weight or gravity). Volunteers held the thigh and calf stretches for 45 seconds, followed a 15-second rest. They repeated each set a total of five times.

Research we're watching

A team of scientists have created a tiny heart muscle "pump" using human cells and a three-dimensional bioprinter. The model heart — which was sized to fit inside a mouse's abdominal cavity — may one day prove useful for studying new heart medications and other therapies, they say.

The researchers first tried using heart muscle cells (cardiomyocytes) in the 3D printer, but the cells didn't grow to a sufficient size and volume. So they instead used so-called pluripotent stem cells, which have the ability to transform into different cell types. After printing a chambered structure, they were able to program the stem cells to become cardiomyocytes, which then began to organize and work together. Within about a month, the cells began beating together, similar to a human heart. The research is detailed in a study published July 3, 2020, in the journal Circulation Research.

Research we're watching

A recent study found that nearly one in 10 people who received opioid pain relievers following heart surgery continued to take them for three to six months — a time point when no one should still be experiencing pain from the operation.

The study included nearly 36,000 people with private health insurance who had a coronary artery bypass graft (known as CABG or bypass surgery) or a heart valve replacement between 2003 and 2016. People who were prescribed more than 40 5-mg tablets of oxycodone (Oxycontin, Roxicodone, others) or an equivalent amount of a similar drug were at a much higher risk of prolonged opioid use than people who were prescribed lower doses. Other factors that increased a person's odds of taking opioids long-term included having CABG, being female, or having a history of chronic pain or alcoholism.

Heart attack symptoms can differ between men and women, but not as much as you might think.

Thanks to national campaigns to boost awareness, more people now recognize that heart disease is the leading cause of death in women as well as in men. For both sexes, cardiovascular disease is to blame for one of every three deaths in the United States.

Throughout the country, someone has a heart attack — the most common manifestation of this prevalent disease — about every 40 seconds, on average. Maybe you've heard that women are more likely to have "atypical" heart attack symptoms than men. But what does that really mean? A review article in the May 2020 Journal of the American Heart Association offers some perspective.

In the journals

Age may not be a factor when it comes to who can benefit from statins. A study published online July 7, 2020, by JAMA found that people who started taking the cholesterol-lowering medication in their mid-70s or later had fewer heart-related problems and lived longer than non-users.

Researchers looked at 326,981 mostly male veterans, ages 75 and older, who were free of cardiovascular disease and did not take statins. Over the next 10 years, more than 57,000 began statin therapy.