Heart Health Archive

Research we're watching

If you have coronary artery disease, you may be at higher risk for cognitive problems, according to a study published in the June issue of the Journal of the American College of Cardiology. People with coronary artery disease have blockages in the arteries that lead to the heart. When blood flow to the heart is slowed or blocked, the result can be a heart attack or the chest pain known as angina.

Study authors looked to see whether this condition had any effect on thinking skills. They selected people with no history of heart disease and followed them for 12 years, administering three cognitive tests throughout the course of the study. Ultimately, 5.6% of people in the study experienced a heart attack or angina. Researchers found that these people were not more likely to have experienced cognitive decline before their heart episode or immediately after, but were at much higher risk for cognitive decline in the years that followed. It's not clear why this occurred, but the study authors say that doctors should be aware of this risk and should monitor people with coronary artery disease carefully.

It's your doctor's call, but it's good to understand, and to weigh, your options.

Your heart doesn't just pump blood—it needs blood to survive. So, when blocked coronary arteries threaten the heart's blood supply, something must be done.

Ask the doctor

Q. My cardiologist mentioned that he was going to do a "bubble study" during my echocardiogram. What is that?

A. During an echocardiogram, a technician uses a probe that emits high-frequency sound waves (ultrasound) that "echo" off the structures of your heart. The waves, which are translated into video images visible on a monitor, can reveal in-formation about your heart's structure and function. A bubble study gives added information, as it can identify potential blood flow issues inside your heart.

Plenty of people avoid red meat or eat only small amounts of it. But relying on white meat for protein may not be such a good nutrition choice either. According to the results of a small study, those who ate red meat and white meat had similarly higher cholesterol levels.

There are several things you can do to prevent or minimize the aches and pains that might accompany statin use.

If you're not taking a statin now, you may well be soon. These medications are commonly prescribed to lower "bad" LDL cholesterol and have been shown to reduce the risk of heart attack, stroke, and death. They are routinely recommended for people who have cardiovascular disease and for many people ages 40 to 75 who don't have cardiovascular disease but have at least one risk factor (high blood pressure, high cholesterol, diabetes, or smoking) and a 7.5% or greater risk of a stroke or heart attack in the next decade. Moreover, recent research indicates that they may benefit high risk individuals over age 75 as well.

Muscle pain and other statin side effects

Taking a statin may give you some assurance that you're doing all you can to avoid heart attack and stroke, but you may also experience side effects. Reported side effects include an increased chance of developing diabetes — which is largely restricted to people who are already at risk for diabetes, and who can be monitored with glucose or hemoglobin A1c tests. Statin use has also been associated with difficulties with memory and reasoning, although there is no clear evidence that the drugs were responsible. In very rare cases, statins may cause liver problems or a potentially life-threatening breakdown in muscle cells.

Research we're watching

Got a high cholesterol reading? You may have a higher risk for a dangerous eye condition called glaucoma, according to a recent study published online May 2 by JAMA Ophthalmology. The condition, characterized by pressure in the eye that can damage the optic nerve, can lead to vision loss.

The study looked at 866 cases of primary open-angle glaucoma, the most common type of glaucoma, among more than 136,000 study participants who were followed for 15 or more years. Participants provided researchers with updates on statin use and cholesterol levels every other year throughout the study period. After analyzing the information, study authors found that for every 20-point increase in total cholesterol there was a 7% increase in glaucoma risk. But the use of cholesterol-lowering statin drugs seemed to reduce risk. People who used statins for five years or longer had a 21% lower risk of developing glaucoma.

News briefs

Vitamins and supplements won't help stave off dementia, but a healthy lifestyle might, suggest new guidelines released May 19, 2019, by the World Health Organization (WHO). The WHO warns that the number of new dementia cases around the world — currently 10 million per year — is set to triple by 2050. While there's no cure for any kind of dementia (such as Alzheimer's disease and vascular dementia), the WHO says it may be possible to delay the onset of the disease or slow its progression. The key: managing modifiable risks, such as chronic disease and unhealthy habits. The guidelines recommend that you keep your weight, cholesterol, blood pressure, and blood sugar under control; get lots of exercise; and eat a Mediterranean-style diet (which emphasizes olive oil, fruits, vegetables, nuts, and fish; minimizes red meats and processed meats; and includes a moderate amount of cheese and wine). The WHO also advises that you don't smoke and you avoid harmful use of alcohol (no more than one drink per day for women, no more than two drinks for men). But don't count on supplements to help you stave off dementia. The WHO says there's no evidence that vitamin B, vitamin E, multivitamins, or fish oil supplements help reduce the risk for dementia. The agency recommends against using supplements as a means to ward off cognitive decline.

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In the journals

Another way to lower LDL (bad) cholesterol levels? Eat more soy protein, suggests a study published online April 22, 2019, by The Journal of Nutrition.

Researchers examined 43 trials to evaluate the effect soy had on LDL levels. (High LDL levels can lead to a buildup of cholesterol in arteries and increase a person's risk of cardiovascular disease.)

Eating too much salt usually boosts blood pressure, but not in everyone. Understanding the genetic basis of these differences may improve treatment of high blood pressure.

Do you know someone who eats lots of salty food — pizza, pickles, pretzels, and the like — but has naturally low blood pressure? That person may be salt-resistant, which means his or her blood pressure doesn't rise very much in response to a diet high in salt (sodium chloride). In contrast, other people are salt-sensitive, which means their blood pressure rises by 5 points or more if they switch from a low-sodium to a high-sodium diet.

Unfortunately, there isn't an easy test to determine who is salt-sensitive, says endocrinologist Dr. Gordon Williams, professor of medicine at Harvard Medical School. "Still, we know that Americans eat far more salt than they actually need, so it makes sense to advise everyone cut back on salt," he says.

Apps that pair with devices that record data may help your doctor fine-tune your treatment.

Health-related smartphone apps are a dime a dozen, but some are more sophisticated than others. Of special interest for people with heart disease are apps that pair with devices that measure your blood pressure, your heart's electrical activity, or your weight. Data from these apps may help doctors make faster and better informed treatment decisions for their patients, says Dr. Eric Isselbacher, who heads the Healthcare Transformation Lab at Harvard-affiliated Massachusetts -General Hospital.

App acceptability

Contrary to popular belief, the 65-plus crowd is comfortable using apps, says Dr. Isselbacher, who co-authored a recent study looking at the willingness of heart patients to use apps and related technologies. Compared with millennials, older people have been slower to adopt and adjust to smartphone apps. But now that they're using them for ride-hailing services and the like, they recognize that apps are actually pretty simple to use.