Heart Health Archive

Don't let misconceptions about these medications prevent you from taking them. 

Q. I've heard that low vitamin D levels have been linked to heart disease, so I'm wondering if I should
be taking a vitamin D supplement, just in case. What's your advice? 

A. I suggest that you make sure you're getting the Recommended Dietary Allowance for vitamin D, which is 600 international units (IU) for adults up to age 70 and 800 IU for those older than 70. It's true that low vitamin D levels have been linked to heart disease in some studies. However, low vitamin D might just be a consequence of a poor diet and lack of exercise, which can contribute to obesity, heart disease, and a host of other health problems. And to date, there is no evidence that taking additional vitamin D helps prevent or treat any of those conditions, though large studies are ongoing and should provide a definitive answer in the next few years.

Q. I had a heart attack several years ago and have been taking low-dose aspirin ever since to prevent a second one. But I keep hearing about the bleeding risks caused by aspirin. What should I be watching for? 

A. Aspirin prevents tiny cell fragments in the blood called platelets from clumping together and forming clots. But it also increases the risk of minor bleeding. You may notice that cuts bleed a little longer than usual. Bruises, which happen when blood leaks out of small vessels (capillaries) after an injury, may also be more noticeable.

Are you getting enough calcium, potassium, and magnesium to keep your blood pressure in a healthy range?

Cutting back on salt is the first commandment in controlling high blood pressure, or hypertension. But managing your intake of other dietary minerals also appears to be key. "We're moving beyond just looking at sodium," says Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital. Research from the landmark DASH (Dietary Approaches to Stop Hypertension) trial and more recently the OmniHeart study has shed light on the synergy of different foods and the role of minerals such as potassium, calcium, and magnesium in controlling blood pressure.

Exercise tests may include special scans that evaluate blood flow to your heart.

If you have chest discomfort, shortness of breath, or other symptoms that suggest heart disease, your doctor may recommend a stress test. Plaque buildup in your arteries may be limiting blood flow to your heart, which is more evident when the heart is stressed. In many cases, exercise provides the "stress"—you walk or run on a treadmill or pedal a stationary bike. If you're unable to exercise, a pharmacologic stress test (see box) is a good alternative.

Confused about fats? Learn the latest on which fats offer the best health benefits.

There used to be one simple rule—all fat is bad. More recently, we've been told that fat is absolutely essential to our health, especially polyunsaturated fats in plant-derived oils. But, as research piles up, the picture of fats and health has sometimes become blurred.

Try some low-impact activities to ease into an exercise routine.

You know that regular exercise is good for your heart. But only about half of American adults manage the 2.5 hours per week of moderate exercise (such as brisk walking) recommended by the federal physical activity guidelines. Being too busy is a common excuse, but there are bona fide reasons for not exercising. If you're recovering from a heart attack, are overweight, or are simply out of shape, 30 minutes of exercise a day may feel out of reach.

Potassium chloride salts are one option, but many people prefer herb and spice blends.

If you have high blood pressure, scaling back the sodium in your diet is a smart move. Excess sodium (a main component of salt) makes the body hold on to extra water, which can elevate blood pressure. And most of us consume more than double the limit of 1,500 milligrams per day of sodium recommended by the American Heart Association.

Because professional athletes exercise for a living, you might assume that they have healthier hearts than the rest of us. But that's not necessarily the case, at least among retired National Football League linemen. Those former players—who played tackle, guard, center, or defensive end positions—have a higher risk of dying of cardiovascular disease compared with the general population, according to a study in the November American Journal of Cardiology.

Linemen are also more likely to have calcifications in their arteries (an early warning of future heart disease) than non-linemen, the study showed. Non-linemen included all other positions, such as running backs, wide receivers, tight ends, and others.

As many as one in four adults has nonalcoholic fatty liver disease (NAFLD), a condition marked by excess fat in the liver. Although often symptomless, it can eventually damage the liver, leading to fatigue, weakness, abdominal pain, and other symptoms. NAFLD tends to occur in people who are overweight or obese, or who have diabetes—problems that are also common in people with heart disease. Now, new research finds a strong link between NAFLD and dangerous plaque inside in the heart's arteries.

The study, in the Nov. 4, 2014, issue of Radiology, included 445 people who were admitted to emergency rooms with suspected heart attacks. Researchers used computed tomography (CT) scans, a type of enhanced x-ray imaging, to assess the participants' livers and coronary arteries. People with NAFLD were six times as likely to have high-risk plaque—the type most likely to cause a heart attack—than those without the liver condition. There are no treatments for NAFLD, but eating a healthy diet, exercising regularly, and losing weight if needed may help prevent or even reverse possible liver damage from the condition.