Heart Health Archive

News briefs

People with coronary artery disease or strong risk factors for developing it are often treated with statin drugs. Statins were developed to treat high levels of LDL (bad) cholesterol, because such high levels increase the risk of coronary artery disease. Studies convincingly showed that statins do indeed reduce both cholesterol and the risk of coronary artery disease, as expected. However, a large Harvard study published in 2008 found that statins also lowered the risk even in people with normal LDL levels. Why? Many doctors speculated that the reason might be that statins also reduce inflammation, another contributor to heart attacks and stroke. A new Harvard study, published online August 27, 2017, by The New England Journal of Medicine used a novel medication called canakinumab, which attacks inflammation but does not lower LDL cholesterol. The study involved over 10,000 people who had suffered a heart attack and whose blood showed a modest level of inflammation. The inflammation-fighting medicine lowered the rates of heart attacks, strokes, and death from heart disease. This study supports the theory that the beneficial effects of statins may result from their ability to both lower cholesterol and tamp down inflammation. It also will lead to further study of this new drug as well as other treatments for inflammation.

In the journals

A study published in the September 2017 issue of JAMA Internal Medicine found that doctors may prescribe an electrocardiogram (ECG) as part of an annual health examination even for people at low risk for heart disease. The study looked at about 3.6 million people with no history of heart problems, like heart attack, high blood pressure, or diabetes, who had at least one routine exam over a five-year period. Of these people, 21.5% had an ECG within 30 days after their exam.

The researchers found that those who got the ECG were five times more likely to get further cardiology testing that not only increased out-of-pocket costs, but also raised their risks of radiation exposure and complications from additional procedures. The addition of an ECG did not appear to offer additional benefits, as the rates of death, heart-related hospitalizations, and bypass surgery were equally low in both the ECG and non-ECG groups at the one-year follow-up.

These devices help you keep tabs on a key indicator of your cardiovascular health.

Of all the things you measure to assess your health, blood pressure certainly ranks among the most important. High blood pressure not only puts you at risk for a heart attack or a stroke, but also can damage your brain, eyes, and kidneys.

For some people with this common condition, checking blood pressure intermittently at the doctor's office may not be enough. Investing in a simple, inexpensive home blood pressure monitor often makes sense. It's especially helpful when you're starting a new medication or are taking several different ones and still working to reach your blood pressure goal.

Ask the doctor

Q. I recently started taking low-dose aspirin, per my doctor's advice. But I heard that for some people, aspirin doesn't help prevent heart attacks. Is this true, and is there any way to find out if I'm one of those people?

A. The phenomenon you're referring to is sometimes called aspirin resistance. However, true aspirin resistance is very uncommon. There are tests for the problem, but I don't recommend them.

The net benefit of these popular supplements is very limited.

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Millions of Americans swallow an amber-colored capsule of fish oil each day, lured by its alleged health benefits. In the supplement aisle of most pharmacies, supermarkets, and big-box stores, the shelves are crowded with different brands of fish oil supplements (see "Fish oil: A brief history"). Many tout benefits for the heart. In fact, the label of one popular brand includes the phrase "May reduce coronary heart disease risk."

But those bold marketing claims haven't caught up with the latest science. Earlier this year, the American Heart Association (AHA) issued an updated advisory about fish oil supplements and their cardiovascular benefits. Their verdict: Fish oil supplements may slightly lower the risk of dying of heart failure or after a recent heart attack. But they do not prevent heart disease. (A separate AHA advisory about fish consumption is slated for release in 2018.)

Closing a gap inside the heart may help prevent a rare type of stroke from recurring.

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Most strokes occur when a clot blocks blood flow to part of the brain. Often, doctors can tell what caused the clot to form. But about a quarter of the time — especially in people younger than 60 — there is no obvious reason. These types of strokes are known as cryptogenic (meaning "of hidden origin").

One possible cause underlying a cryptogenic stroke is an opening in the wall that separates the heart's right and left upper chambers (atria). Known as a patent foramen ovale, or PFO, this flaplike opening is quite common. About one-quarter of all adults have a PFO (see "What is a patent foramen ovale?").

A novel anti-inflammatory drug may discourage repeat heart attacks.

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Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular disease. However, identifying a drug therapy that leverages this link has been more elusive. With the results of the recent Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), published in the Sept. 21, 2017, issue of The New England Journal of Medicine, it appears that the dots are finally beginning to connect.

"For the first time, we have an anti-inflammatory therapy that can reduce the chance that a person who has already had a heart attack will have a repeat occurrence," says Dr. Peter Libby, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. "This opens up a new field of treatment and offers hope to our patients." He is one of the co-authors of the study, which was led by his colleague and fellow Harvard Medical School professor Dr. Paul Ridker.

Screening for lung and breast cancer may reveal information about the health of your heart's arteries.

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Screening tests for two of the most common forms of cancer involve detailed x-ray images of the chest. Growing evidence suggests that these tests — chest computed tomography (CT) scans and mammograms — may also offer clues about a person's risk of heart disease.

"Both doctors and their patients should be aware that the low-dose CT scans used to find lung cancer can also detect plaque in the arteries of the heart," says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital. CT scans take a series of rapid-fire x-rays in seconds. Combined, the images allow doctors to "see" structures inside the body.

Research we're watching

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The ancient, mind-calming practice of meditation may have a role in reducing the risk of heart disease. So says a scientific statement from the American Heart Association in the Sept. 28, 2017, Journal of the American Heart Association.

Experts reviewed dozens of studies published over the past two decades. The results suggest that meditation may improve a host of factors linked to heart disease, including stress, anxiety, depression, poor sleep quality, and high blood pressure. It may also help people stop smoking. An added bonus: it's low-cost and poses no apparent risk.