Heart Health

One of every two North American adults has high blood pressure, and only 40 percent of those taking medications have their hypertension well-controlled (Int...

Checking your own blood pressure several times a day may offer better blood pressure control than just taking occasional blood pressure measurements in a doctor's office.

Most heart attacks are caused by clots, and aspirin helps to prevent clots, but taking aspirin to prevent clots may cause bleeding so it is not for everyone. • In 1988, a study reported an impressive 44 percent reduction in heart attacks in North American male physicians, aged 40-84, who took aspirin. As a result, by 2017, many people took aspirin with the belief that they were helping to prevent heart attacks.

Virtually all doctors agree that exercise helps to keep you healthy and to prolong your life. People who exercise into later life live longer than non-exercisers and are at reduced risk for high blood pressure, heart attacks, premature death, diabetes, strokes and even some cancers (Circulation, July 25, 2022;146(7):523–534). Endurance bicycle racers who participated in the Tour de France from 1947 to 2012 have lived an average of five years longer than their countrymen. People who exercise regularly are far less likely to develop irregular heartbeats called atrial fibrillation.

Two recent breakthrough studies on controlling blood pressure found that frequent blood pressure variation between one doctor's appointment and the next is a major risk factor for heart attacks; and, in people with high blood pressure, reducing salt intake can lower their average blood pressure in as little as one week.

A study of 937 patients suggests that all cancer patients should follow heart-attack preventing lifestyle changes including a heart-healthy diet such as the Mediterranean, MIND or DASH diets (Presented at the American Heart Association Congress meeting in Philadelphia, November 2023). The study found that having a history of cancer increases heart attack risk and that having heart-attack risk factors is associated with increased cancer risk.

Having blood triglyceride levels above 150 mg/dL (1.7 mmol/L) puts you at increased risk for a heart attack, stroke, or heart valve disease, even if your blood cholesterol levels are normal (Eur Heart J, Dec 2021;42(47):4791-4806). About 10 percent of North Americans suffer from high triglyceride levels. High triglycerides are often found in people who are diabetic, obese or alcoholic.

A study from the UK examined the links between having a big belly, amount of physical activity and risk for a heart attack. The study followed 70,830 people, average age 61, for 6.8 years and in that time, 2795 suffered heart attacks. Among those people in the study group who had large bellies, those who jogged regularly for about 30 to 35 minutes per week had their heart attack rate reduced to the same level as people who did not have a big belly.

At the American Heart Association Scientific Sessions (November 13, 2023), researchers presented the results of the 11,255 patient ESPRIT trial of patients who also had diabetes and/or a past history of a stroke. When they were treated very aggressively for three years to drop their high systolic blood pressures below 120 mm Hg (compared to the old standard of 140 mm Hg), they had a 12 percent lower incidence of heart attacks and a 39 percent lower incidence of deaths from heart attacks.

A new study found that reducing daily sodium (salt) intake by one teaspoon per day significantly lowered systolic blood pressure in as little as a week. The study participants were 213 adults, ages 50-75, who had• normal blood pressure, or high blood pressure and were taking medication for high blood pressure, or high blood pressure and were not taking medication for high blood pressure.

It is overwhelmingly established that exercise helps to prevent heart attacks, but a recent study showed that very vigorous exercise may be associated with increased plaque size. For more than six years, researchers followed 289 men, ages 50 -60, who exercised for an average 41 MET hours per week.

In Europe, fish oil pills must now list that atrial fibrillation is a common side effect, according to the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency. Fish oil pills are also called omega-3 supplements and they may be recommended to treat high blood triglyceride levels if lifestyle changes fail to lower triglycerides to normal

More than 40 percent of North American adults are seriously overweight, which puts them at high risk for heart attacks, diabetes, certain cancers and premature death. Researchers at Boston University have explained how being obese is a major cause of heart attacks and death from heart attacks by preventing the bad LDL cholesterol from performing its beneficial functions such as helping to form cell membranes

It is established that having a high bad LDL cholesterol increases your chances of suffering a heart attack and that reducing high levels of LDL helps to prevent heart attacks. Statins are the most used drugs to treat high cholesterol, but about 75 percent of people suffer muscle pains and other side effects when they take statins.

Thirty percent of North Americans over the age of 85 suffer from dementia. A recent study shows that people whose blood cholesterol levels varied the most over a 12 year period had a 19 percent increased risk for Alzheimer's dementia compared to those with little or no variability, and people who had high variations in their triglyceride levels had a 23 percent increased risk for Alzheimer's disease.

A recent review of seven studies covering more than 19,000 adults found that taking one alcoholic drink a day for more than four years is associated with a rise in blood pressure, even if a person previously had normal blood pressure. None of the people in the study had previously been diagnosed with high blood pressure, heart disease, diabetes, liver disease, alcoholism or binge drinking.

A study of 59,124 patients in 223 medical care centers had one group of patients check their blood pressures several times throughout the day and night, while the other group had blood pressure checked in their doctors' offices only. After 10 years, 12.1 percent of patients died, including 4.0 percent from heart disease. The study found that having patients check their blood pressure several times during the day and night, and following those results, was six times more effective in predicting death overall and death from heart attacks than just taking patients' blood pressure in the doctor's office.

There are many ways to measure risk factors for having a heart attack, but since the 1950s the criteria used most by doctors to predict your likelihood to suffer a heart attack has been that HDL ("Healthy") cholesterol predicts protection, and the LDL ("Lousy") cholesterol predicts increased risk for heart attacks. An extensive review of the world’s literature demonstrates that this is not always true.

A review of 30 clinical trials published between 1982 and 2022, covering about 2,400 participants in many different countries, found that vegetarian and vegan diets reduced blood levels of total cholesterol levels by seven percent, the harmful LDL cholesterol by 10 percent, and apolipoprotein B by 14 percent. These blood factors are strong predictors of likelihood to suffer a heart attack or stroke, and reducing these three factors has been consistently shown to reduce risk for heart attacks in normal-weight and obese patients.

Most people with high blood pressure are not able to achieve normal blood pressure with daily doses of a single medication. In one study, more than 45 percent of people with high blood pressure did not take their medication regularly, and 84 percent of those with persistent high blood pressure did not take their mediation regularly.

Exercise has been shown to help prevent heart attacks, and a new study suggests that you can gain protection with as little as 150 minutes of moderate exercise per week, or 75 minutes per week of more vigorous activity. Pushing yourself to exercise at high intensity for many long hours did not appear to provide additional protection from heart attacks. The Master@Heart study found that middle-aged competitive endurance athletes had more plaques in their heart arteries than similarly fit and healthy exercisers with a healthy lifestyle who did not compete.

Doctors try to predict and prevent heart attacks by measuring blood levels of LDL cholesterol and treating you if they are too high. Statins and PSK9 inhibitors are among the most effective drugs used to lower high LDL cholesterol. Almost half of all North American adults will suffer heart and blood vessel disease , and statins can help to save your life by lowering LDL cholesterol and reducing inflammation.

An analysis of three large studies of people taking statins found that a blood test for inflammation levels was better than tests of cholesterol levels for predicting future heart attacks). More than 30,000 participants were given CRP (c-reactive protein test that measures inflammation) and cholesterol tests, and the researchers found that CRP was a stronger predictor for risk of future cardiovascular events and deaths than the cholesterol assessment (LDL).

Researchers followed more than 110,000 people for nine years and found that the more free sugar a person takes in, the greater the risk for heart disease. Each five percent increase in free sugar intake in a participant's daily diet resulted in a six percent higher risk of heart disease and a 10 percent higher risk of stroke. Furthermore, a higher fiber intake and replacing refined grain starch and free sugars with whole grains and non-free sugars appeared to help protect against heart attacks.

The American Academy of Family Physicians (AAFP) recommends that you get your blood pressure below 140/90 mm Hg. Taking medication to reduce blood pressure below that did not further reduce your chances of dying overall or from heart disease, even though it did lead to a 16 percent reduction in heart attacks. It also did not reduce the incidence of strokes, and it increased risk for multiple side effects from medications.

The MARC-2 study followed 291 older men for 6.3 years with a test called Coronary Artery Calcification (CAC), and found that the amount of calcium in the arteries leading to the heart increased most in men who exercised at the highest intensity, even more than those who exercised the most. The authors said this showed that intense exercise increases the amount of plaques in arteries, which may be true. However, they would then have to explain why intense exercisers are far less likely to suffer heart attacks than non-exercisers

Researchers analyzed data from 3865 adults and found that more than 50 percent said that they did not know that alcohol increases cancer risk. The people who incorrectly thought that alcohol doesn’t cause cancer were the ones most likely also to think incorrectly that alcohol can help to prevent heart attacks.

Two blood tests that are done during routine physical exams can be used to predict whether you are at increased risk for diabetes and heart attacks. It’s called the triglyceride/HDL ratio, calculated by dividing your triglycerides number by your HDL number.

If you have high blood pressure in the winter, you are at increased risk for a heart attack, even if your blood pressure is normal in the summertime. Blood pressure is often higher in winter and lower in summer, and heart attacks are significantly more common in the winter than in the summer.

A study of supplements that claim to lower cholesterol followed 199 patients at the Cleveland Clinic for 28 days. Participants were given either a supplement (fish oil pills, red yeast rice, cinnamon, garlic, turmeric or plant sterols), a statin drug (rosuvastatin, brand name Crestor, 5 mg/day) or a placebo.