Heart Health Archive

High blood pressure can damage the brain in several ways. Treating this common problem can protect your mind as well as your heart.

High blood pressure seldom causes any symptoms. But over time, the excessive force and friction of blood pushing against the inner walls of the arteries can damage blood vessels throughout the body. And while the biggest threat may be to your heart, your brain can also suffer.

Even slightly elevated blood pressure in middle age has been linked to a 30% higher risk of dementia two decades later. But taking blood pressure drugs may help people avoid that risk, according to a study in the May 19, 2020, issue of JAMA.

Researchers are beginning to better understand if, when, and how to address this condition, which is linked to a newly recognized type of stroke.

In the womb, all fetuses have a foramen ovale (Latin for "oval hole") between the heart's right and left upper chambers (atria). This opening allows blood to take a shortcut within the heart rather than following a longer path through the lungs, which cannot work until they are exposed to air. After birth, when a newborn baby takes his or her first breath, the foramen ovale begins to close. Most of the time, it seals completely within a few months.

But in about a quarter of people, that doesn't happen. This anatomical variation is called a patent foramen ovale (patent means open) or PFO. Most people never know they have it, because a PFO doesn't cause any signs or symptoms. For the most part, the condition is harmless.

Studies of drugs, diets, and devices all come with their own unique set of challenges.

The best way to know if a new medical treatment truly works is with a randomized controlled trial — the "gold standard" of research studies, also known simply as a clinical trial. Volunteers are randomly assigned to receive either the new treatment or the comparison, which may be a placebo (an inactive therapy) or a treatment that's already available.

As the nation's top cause of death, cardiovascular disease has been at the leading edge of evidence generation, says Dr. Robert Yeh, director of the Smith Center for Outcomes Research in Cardiology at Harvard-affiliated Beth Israel Deaconess Medical Center. "We probably have more evidence for cardiovascular treatments than for any other field of medicine," he says. Among the studies with the greatest impact were the clinical trials that heralded new therapies to treat heart attacks. These include clot-dissolving drugs in the 1980s, followed in the 1990s by artery-opening angioplasty procedures, which remain the standard of care today. Stents, the tiny mesh tubes used in these procedures, have also been extensively studied in clinical trials (see "Testing devices: Different dilemmas").

Ask the doctors

Q. I read that taking a hot bath might have cardiovascular benefits. Is this true?

A. It's possible. Past research has found that your body experiences some of the same changes during a warm bath as it does during exercise, including better blood flow, a higher heart rate, and stronger heart contractions. And now, a study published online March 24, 2020, by the journal Heart has shown that middle-aged people in Japan who took a daily bath in either warm or hot water had a 28% lower risk of heart and blood vessel disease than people who didn't bathe in the tub more than twice a week. The daily bathers also had a 26% lower risk of stroke than those who tub bathed less frequently. The study authors analyzed questionnaires filled out by some 30,000 people and then followed them for 20 years. However, note that this study was observational and relied on people to report their bathing activity accurately. It also isn't clear if bathing was the only factor associated with the reduction in cardiovascular problems.

Sesame seeds may be most familiar as a topping on bagels, burger buns, and breadsticks. The tiny, tear-shaped seeds have a nutty, slightly sweet flavor that's enhanced when they're baked or lightly toasted in a skillet. Most are off-white or tan, but you can also find black varieties, which are popular in Asian cuisine.

Sesame seeds contain lignans and phytosterols, plant compounds that may have cholesterol-lowering effects. They're also a decent source of calcium and magnesium, two minerals linked to better blood pressure control.

Research we're watching

Most of the evidence supporting olive oil as a heart-healthy fat comes from people living in Mediterranean countries, where olives are abundant. On average, Americans don't consume much olive oil. But those who swap in even a little olive oil to replace less healthful fats appear to lower their risk of heart disease, a new study finds.

Researchers relied on health and diet data from nearly 93,000 adults in two studies beginning in 1990. Over the next 24 years, there were nearly 10,000 cases of heart disease in the group. After adjusting for other dietary habits, age, and other heart-related risks, the researchers found that people who consumed at least a half-tablespoon of olive oil a day had a 14% lower risk for heart disease compared with people who used no olive oil.

Research we're watching

Healthy lifestyle changes may lower blood levels of a marker linked to heart disease risk, a new study finds. The substance, C-reactive protein (CRP), is a byproduct of inflammation, an immune-related response involved in the formation of artery-clogging plaque. CRP levels of 3 milligrams per liter (mg/L) and higher are associated with an elevated risk of heart disease.

The study involved people at risk for heart disease who were part of an ongoing study in the Netherlands. Researchers looked at 1,794 people with known heart disease who had CRP levels between 0.8 and 3.1 mg/L at their first visit. At the second visit, after a median follow-up period of nearly 10 years, the participants' CRP levels had dipped only slightly on average. However, CRP levels fell more substantially among people who quit smoking, lost weight, or increased their physical activity levels. The results suggest that healthy lifestyle changes help to lower inflammation, which in turn may lower cardiovascular risk, according to the authors. Their study appeared in the May 2020 issue of the journal Atherosclerosis.

Research we're watching

Regular, moderate-to-vigorous exercise may help prevent atrial fibrillation (afib), according to a study in the May 2020 issue of The American Journal of Cardiology.

Previous studies looking at the connection between afib (which causes a rapid, irregular heart rate) and exercise have produced conflicting results. But those studies relied on participants to self-report their exercise habits. For the new study, the 5,147 participants wore devices that measured their activity levels for four to seven consecutive days.