Heart Health

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).

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.

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.

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.

Many people who take statin drugs complain of muscle pain and muscle damage. A new study associates this statin-induced muscle pain with low blood...

At last we have a reasonable explanation why statins can cause some people to suffer skeletal muscle pain and damage, but do not cause heart muscle damage.

Aspirin has been shown to help prevent a second heart attack in people who have already had a heart attack. However, aspirin also causes bleeding that can kill a person, so researchers wanted to find out if the heart-attack-preventing effects of aspirin would be offset by the complications of bleeding that aspirin can cause.

Up to 75 percent of people who are prescribed statins stop taking them within two years, and 65 percent of those patients reported that they stopped because of side effects, primarily muscle pain.

Very aggressive control of high blood pressure helps to prevent heart attacks, strokes and premature death far more effectively than less stringent control. You cannot cure high blood pressure with drugs, you can only control it as long as you continue to take the drugs. Most of the time, your blood pressure cannot be controlled with just one drug and most people end up with three or more drugs to treat their high blood pressure.

If you have pain in your chest, jaw, arm, or neck when you exercise, you could have angina, which is pain caused by reduced blood flow through narrowed arteries leading to your heart. You should check with a doctor as soon as possible. Symptoms of angina can also include feeling lightheaded, over-tired, short of breath or nauseated

You are at high risk for a premature death if you can pinch more than three inches in your belly. Even people who are not overweight are at high risk for a heart attack and diabetes if they store most of their fat in the belly instead of in the buttocks, hips and thighs.

More than 40 percent of people who have had heart attacks are diabetic and these patients are the ones who are most likely to die from their heart attacks (Lancet, 2002; 359: 2140-44). Three tests are commonly used to diagnose diabetes: fasting blood sugar, blood sugar level two hours after eating, and HbA1c, a measurement of how much sugar is attached to cells.

Before you jump on the bandwagon of avoiding gluten, consider its benefits as well as potential problems. People who are gluten-intolerant should avoid wheat, barley, rye and probably oats (because of potential cross-contamination). Your doctor can do tests to see whether you are one of the small minority who need to avoid gluten. Otherwise, consider a study from the University of Toronto which showed that a high-gluten diet helps to lower oxidized LDL cholesterol, triglycerides and uric acid.

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.

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

Having high blood levels of cholesterol increaes your chances of getting a heart attack, but your blood cholesterol level is influenced far more by how many calories you eat than by how much cholesterol is in the food you eat.

The evidence is overwhelming that statin drugs do help to lower cholesterol and to reduce risk for heart attacks. However, a new study confirms that statins interfere with the ability to exercise and to compete in sports, even in patients who report no symptoms.

An analysis of 7,743 people suffering from osteoarthritis found that those who took NSAIDs (non-steroidal anti inflammatory drugs) were at 41 percent increased risk for suffering heart attacks, heart failure and strokes, compared to arthritis patients who did not take NSAIDs.

You have two blood pressures: the systolic that measures blood pressure when your heart contracts, and the much lower diastolic reading that measures the pressure when your heart relaxes. When your heart contracts, it pushes a huge amount of blood forward to your arteries. Your arteries are supposed to act like balloons and expand to accept the blood and prevent your blood pressure from rising too high.

High blood pressure (greater than 130/90 before you go to bed at night) markedly increases risk for heart attacks, strokes, heart failure, and premature death. Almost 50 percent of North American adults have high blood pressure, and it causes more than 80,000 U.S. deaths each year. A plant-based diet can help to prevent and treat high blood pressure because it contains lots of soluble fiber.

Extensive recent research shows that high blood pressure is associated with having specific harmful bacteria in your colon, and that reducing harmful colon bacteria and increasing healthful ones can help to control high blood pressure. You can do this primarily by eating an anti-inflammatory diet, as well as by exercising regularly, losing excess weight, and avoiding smoke and alcohol.

A review of six major studies that measured salt intake by the amount of salt in the urine found that a high salt intake is associated with significantly increased risk for suffering heart attacks and strokes. This review is extremely dependable because it measured salt intake directly by how much salt and potassium was secreted in a person’s urine each day, and did not depend on a patient's memory.

Virtually all doctors agree that stents can save lives if used within three hours of the start of a heart attack. However, there is no good evidence that stents prevent heart attacks in people who have chest pain during exercise. The ORBITA study showed that in patients with medically-treated heart pain and severe heart artery blockage, stents did not increase exercise time more than a placebo procedure.

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.

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.

The majority of heart attacks are caused by unhealthful lifestyles, not by genetic defects. Statins remain the major choice of preventative drug, but everyone should realize that many studies show that lifestyle changes are probably more effective than statins in preventing heart attacks.

Almost everyone agrees that having total blood cholesterol levels above 250 is likely to shorten your life and markedly increases your chances of suffering a heart attack, unless you have a very high HDL (which is good). Other studies also show that people with very low cholesterol are at increased risk for cancer of the stomach, esophagus, liver and colon, but it looks like the incubating cancers cause the low cholesterol, rather than a low cholesterol causing the cancers.

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 resting heart rate greater than 80 beats per minute is a strong predictor for future heart attacks, diabetes and even cancer. From 1974 to 2002, 53,322 healthy people were followed at the Cooper Clinic in Dallas, Texas. Those with a resting heart rate lower than 60 beats per minute were far less likely to suffer heart attacks or to die than those with a resting heart rate greater than 80 beats per minute

For many years HDL cholesterol has been called "good" because it carries plaque-forming particles from your arteries and bloodstream back to your liver where they can be removed from your body. An exciting new study shows that regular HDL cholesterol may not be very effective in doing this, but another form called Nascent HDL carries these protein-fats much more quickly to your liver to be removed from your circulation.