Heart Health

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.

To find out if they could predict how long an older person will continue to live, Duke University researchers used 1507 blood samples and lifestyle data from participants in the D-EPESE study that was conducted in New Haven, CT, in 1992. Participants were at least 71 years old when the study started, and the Duke researchers counted their years to death over the following 27 years

A respected group of researchers found that after a patient had a heart attack, taking one pill containing three heart drugs was more effective than taking similar prescribed drugs in separate pills during three years of follow-up (New Engl J of Med, August 26, 2022). The combined pill was more effective in preventing death from heart disease, another heart attack, strokes, or urgent surgery to replace heart blood vessels.

A study of 14,392 individuals with high blood pressure, followed for 5-10 years, found that those who adopted a healthful lifestyle along with taking medication had a much lower risk for suffering heart attacks and lived significantly longer than those who treated their high blood pressure just with drugs.

The US Preventive Services Task Force (USPSTF) has advised against people aged 60 and older taking aspirin for primary heart attack prevention because of their increased risk for bleeding into the brain or gastrointestinal tract.

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.

You can’t depend completely on blood pressure measurements done only in a doctor’s office because being active, having “white coat syndrome,” (feeling nervous or stressed), or an improper hurried measurement can raise blood pressure considerably. In one study, systolic blood pressure was 7.3 mm Hg higher in a doctor’s office than when measured more precisely in a research setting.

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.

A very important new study of 27,599 adults, average age 47-50, showed that almost 15 percent of North American adults and almost 19 percent of those with high blood pressure take medications that can raise blood pressure. The blood-pressure-raising medicines taken most frequently were antidepressants, NSAIDs, steroids, and estrogens.

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.

Daily aspirin can help to prevent heart attacks, but the United States Preventive Services Task Force now recommends that: adults 60 years and older should not take aspirin to help prevent a first heart attack, and those 40-59 years old who are at high risk for heart disease should take aspirin only on their doctor’s recommendation

Heart attacks are not caused by plaques making arteries too narrow. They are caused by plaques suddenly breaking off from the inner lining of a heart artery, followed by bleeding, and then a clot forms that completely blocks all blood flow to a part of the heart muscle.

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.

High blood pressure affects 108 million adults, increasing risk for heart attacks, the leading cause of death in the United States. A Harvard study of 412 adults found that a low-salt version of the DASH diet dramatically lowered both high blood pressure and markers of heart muscle damage in just four weeks

More than one hundred million North Americans have taken statin drugs that help to save lives by lowering cholesterol and preventing heart attacks. Ten to 20 percent of people who take statins have been reported to have suffered muscle pain, but a recent study from the UK claims to show that statins are no more likely than a placebo to cause muscle pain.