Heart Health Archive

Discovered more than 150 years ago, this drug comes in a variety of formulations. Does one make sense for you?

If your heart's arteries are choked with cholesterol-filled plaque, a sudden increase in the heart's demand for oxygen-rich blood from physical exertion or emotional stress can trigger the chest pain known as angina. But a tiny tablet of nitroglycerin often relieves the pain within minutes.

Nitroglycerin is underused

Nitroglycerin and related drugs, known as nitrates, widen the arteries that nourish the heart and reduce the heart's workload. Under-the-tongue (sublingual) nitro- glycerin tablets are perhaps the best-known version of this common medication. But nitrates come in a variety of different formulations (see "Nitrates for angina: Many choices").

Plant chemicals known as flavonoids may explain why tea drinkers seem less likely to have cardiovascular disease.

Black or green, hot or iced, tea is gaining in popularity. Many cities and shopping malls feature specialty tea shops, and bottled teas vie for space on store shelves. The tea market continues to grow year after year.

Ask the doctor

Q. Should I take aspirin if I think I'm having a heart attack, and what kind of aspirin should I take?

A. First, what symptoms indicate you might be having a heart attack? The main symptom is a squeezing, tight sensation in the middle of the chest that can travel up into the jaw and shoulders, and even down the left arm. Along with the pain you may begin to sweat and to feel weak, like you might pass out, and be short of breath. While other conditions besides a heart at-tack can cause similar symptoms, you need to take such symptoms very seriously. First, call 911.

Ask the doctor

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Q. My recent cholesterol test result included "non-HDL cholesterol." What is the significance of this number?

A. Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. When you get your blood drawn for a cholesterol test (also known as a lipid profile or lipid panel), the report usually includes four numbers: low-density lipoprotein (LDL) cholesterol; high-density lipoprotein (HDL) cholesterol; triglycerides; and total cholesterol.

This screening test is simple and painless, but it isn't appropriate for most people.

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For years, for-profit companies have mailed offers for health screening tests to homes across the United States. For about $150, you can undergo a series of ultrasound scans, which the companies claim can uncover potentially dangerous cardiovascular conditions. One scan looks at your carotid arteries, which run up either side of your neck.

Just like arteries in the heart and elsewhere in the body, the carotid arteries can become clogged with fatty deposits. Narrowing of a carotid artery (also called carotid artery stenosis) can increase the risk of stroke — the narrower the artery, the higher the risk.

Ask the doctor

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Q. A friend of mine shared a Facebook post about how to survive a heart attack when you're alone. It says that you should cough very forcefully every few seconds until help arrives. Can that actually help?

A. This "advice" has been circulating around the Internet for nearly 20 years. I was reluctant to even address this question out of concern for perpetuating the idea of "cough CPR" or causing undue worry. However, I think it's important to clear up the confusion around this topic.

Ask the doctor

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Q. I recently got a coronary artery calcium scan and the results showed that I have quite a bit of calcium in my heart arteries (my score was 900). Should I have an angiogram to confirm the results? I don't have any heart-related symptoms, but I'm worried about having a heart attack.

A. That is a very high coronary artery calcium score. But the short answer to your question is no. The main reason to have an angiogram is to locate a narrowed heart artery that is causing chest pain or other symptoms. For the test, a cardiologist injects a dye that is visible on x-rays into the blood vessels of your heart, then takes a series of x-ray images. This is done in preparation for angioplasty, in which a narrowed artery is opened, or as a prelude to referral for coronary artery bypass surgery.

A stent can save your life during a heart attack, but can it help prevent one?

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An estimated two million people get coronary artery stents every year, and if you have coronary artery disease, there is a good chance your doctor will suggest you get one.

But do you really need it? In 2013, the American Medical Association issued a report that said stents were one of the most highly overused medical interventions.

Research we're watching

Doing easy leg stretches may improve blood flow throughout the body by making the arteries more flexible and able to dilate, according to a small study in the July 1, 2020, Journal of Physiology.

The study included 39 young adults, 27 of whom did passive leg stretches five times a week for 12 weeks, while the other 12 did no stretching. (Passive stretching involves holding a stretch for a set period of time aided by an outside force, such as one's body weight or gravity). Volunteers held the thigh and calf stretches for 45 seconds, followed a 15-second rest. They repeated each set a total of five times.

Research we're watching

A team of scientists have created a tiny heart muscle "pump" using human cells and a three-dimensional bioprinter. The model heart — which was sized to fit inside a mouse's abdominal cavity — may one day prove useful for studying new heart medications and other therapies, they say.

The researchers first tried using heart muscle cells (cardiomyocytes) in the 3D printer, but the cells didn't grow to a sufficient size and volume. So they instead used so-called pluripotent stem cells, which have the ability to transform into different cell types. After printing a chambered structure, they were able to program the stem cells to become cardiomyocytes, which then began to organize and work together. Within about a month, the cells began beating together, similar to a human heart. The research is detailed in a study published July 3, 2020, in the journal Circulation Research.