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High Calcium Artery Score Doesn’t Always Mean High Risk for a Heart Attack

Since heart attacks are usually caused by plaques breaking off from the inner linings of arteries leading to the heart, doctors use a test called Coronary Artery Calcium Score (CAC) to predict which people have the largest plaques and therefore are at high risk for suffering heart attacks that cause one out of four deaths in North America.

Stents and Bypass Surgery Not More Effective than Lifestyle Changes and Medication for Stable Heart Disease

The $100 million ISCHEMIA Trial showed that after four years, surgical treatments (stents or coronary artery bypass surgery) were not more effective than lifestyle changes and medication in preventing heart attacks deaths in patients with stable heart disease.

Statins and Alternatives to Lower Cholesterol

Having high cholesterol increases risk for a heart attack, but a review of 49 studies showed that the reduced risk for suffering a heart attack is the same for statins as it is for dietary changes.

NSAIDs and Heart Attack Risk

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.

Statin Drugs and Muscle Pain

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.

Reduce Inflammation and Clotting to Prevent Heart Attacks

Heart attacks and strokes cause 50 percent of the deaths in North America today, yet many people are not adopting the lifestyle changes needed to prevent the factors that cause them: inflammation and clotting. A new study from the University of Michigan shows how important inflammation is as a cause of heart attacks and strokes.

High Blood Pressure and Colon Bacteria

The recently published CARDIA Study shows that having certain types of bacteria in your colon is associated with having high blood pressure, and that you can lower blood pressure by improving the proportion of healthful to unhealthful bacteria in your colon. Lifestyle changes may be more important than drugs in treating high blood pressure.

Bad Colon Bacteria May Cause Heart Attacks

A strong new study shows that with aging, there is an increase in the types of harmful colon bacteria that produce amines, specifically TMAO (trimethylamine oxide), that damage arteries to increase risk for heart attacks, strokes and cell damage throughout your body.

Exercisers Have Fewer Heart Attacks

A study of 21,758 men, average age 51.7 years, followed for an average 10.4 years, showed that men who exercised the most have more plaques in their arteries, but do not suffer more heart attacks or deaths than those with less heart artery calcification.

Daily Aspirin May Not Save Lives

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.

Vigorous Exercise Won’t Hurt a Healthy Heart

Some recent research articles seem to warn people not to exercise too long or too hard, but the overwhelming scientific and epidemiological evidence is that vigorous exercise strengthens a healthy heart and helps to prevent heart disease. Elite endurance athletes who exercise long hours each day outlive their less-active peers, as do Tour de France cyclists. However, three studies raise the possibility that extreme exercise such as running a marathon could possibly increase risk for heart problems, particularly in people who are not adequately trained for their events.

How Soluble Fiber Lowers High Blood Pressure

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.

Excess Weight Linked to Larger Plaques

Being overweight is associated with having larger plaques in the arteries leading to the heart and a marked increase and progression of these arterial plaques that cause heart attacks, even if a person does not have the risk factors that predict increased risk for diabetes and heart attacks.

Heart Attack Prevention Guidelines

On November 10, 2018, heart specialists presented the latest recommendations for preventing heart attacks from the American College of Cardiology and the American Heart Association: Treat all of their patients with recommendations for heart-attack-preventing lifestyle changes, and Treat all patients with significant heart attack risk factors with medications that lower blood levels of the bad LDL cholesterol.

Stents and Bypass Surgery

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.

High HDL Cholesterol May Not Protect You from a Heart Attack

Several recent studies show that high levels of HDL cholesterol are not always associated with preventing heart attacks. Today, doctors depend far more on the results of your LDL cholesterol test and how much plaque you have in your arteries.

Exercise and Plaques

Paul D. Thompson, M.D., an accomplished competitive international marathon runner as well as a respected cardiologist, has written an editorial on two studies that show how important regular vigorous exercise is to prolong lives and prevent heart attacks and strokes. The results of these studies should stimulate every able-bodied person to try to exercise for at least 30 minutes every day for as long as they can.

What Do High Triglycerides Mean?

If your routine blood tests show that you have high triglycerides (greater than 150 mg/dl), this usually means that you are at high risk for diabetes and all of its side effects, including heart attacks. Your doctor measures blood levels of the bad LDL cholesterol to predict your susceptibility to suffering a heart attack, but triglycerides are just as important in predicting your risk for a heart attack, diabetes and premature death.

Statin Drugs and Exercise

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.

Fish Oil Pills Have Not Been Shown to Prevent Heart Attacks

Studies this month show that neither taking omega-3 polyunsaturated fatty acids (PUFAs) in fish oil pills nor eating fish reduce the risk for heart attacks, September 16, 2016). A review of studies in the world's scientific literature agrees that taking fish oil pills does not prevent heart attacks.

What Do Blood Cholesterol Levels Mean?

Having a high (>100 mg/dL) bad LDL cholesterol or a low (<40) good HDL cholesterol has long been associated with increased risk for heart attacks. However, new studies show that you can form plaques and be at risk for a heart attack even if your bad LDL cholesterol is as low as 50.

Insulin Resistance Predicts Heart Attacks and Diabetes

An article written by two highly-respected physicians and an investigative reporter concludes that, "Emerging evidence shows that insulin resistance is the most important predictor of cardiovascular disease and type 2 diabetes" .

Both Low and High HDL Can Predict Harm

Having high blood levels of the bad LDL cholesterol predicts increased risk for heart attacks, but contrary to what we thought in the past, having high levels of "good" HDL cholesterol does not necessarily predict protection from heart disease. A recent report from the Copenhagen General Population Study shows that having either low or high levels of HDL cholesterol also predicts increased risk for infections such as gastroenteritis and bacterial pneumonia.

Blood Pressure Guidelines

The American Heart Association, the American College of Cardiology and nine other heart health groups now agree that you have high blood pressure if your blood pressure is above 130/80, not 140/90 as the previous guidelines recommended.

HDL Cholesterol: a New Understanding

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.

Questions About Stents

A recent study suggests that stents placed in arteries leading to the heart have not been shown to cure chest pain (Lancet, Nov 2, 2017). Placing stents in people who have heart pain from narrowed arteries and giving them medication is not more effective in relieving pain than just giving them medication and no stents. Stents do help to prevent the heart muscle from dying when put in place within the first few hours after the start of a heart attack.

Exercise Helps People with Heart Disease

A recent study shows that stable angina patients who exercise are less likely to die from heart attacks. Stable angina means that you may or may not have chest discomfort or pain at rest, but pain occurs or worsens when you exert yourself.

Deceptive Headlines about Exercise and Heart Attacks

"You Can Exercise Yourself to Death, Says New Study" was the headline in The New York Post on October 17, 2017. Headlines like that are likely to discourage people from exercising and thus to shorten their lives.

Breakfast Skippers Have More Plaques

A new study surveyed more than 4,000 adults ages 40 to 54 about their breakfast habits and then checked them for heart attack risk factors. The researchers found that people who eat a large percentage of their total daily calories for breakfast have the fewest heart attack risk factors, while those who skip breakfast are more likely to have plaques in their arteries and other heart attack risk factors.

Plaques are Reversible

Most heart attacks are caused by lifestyle factors, not by genes, and the prevention of heart attacks depends far more on what you do now than what you did earlier in your life. It is an incredible tragedy that many physicians prescribe statin drugs to prevent heart attacks without also explaining the importance of lifestyle changes.