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Fight chronic inflammation and cholesterol to protect your heart

Updated May 1, 2021

It takes a one-two punch to lower these risks for heart disease, heart attack, and stroke.

High cholesterol has long been known as a bad actor in heart health. Too much LDL (bad) cholesterol in your blood can lead to fatty deposits in your arteries and the formation of artery-narrowing plaque (atherosclerosis), heart attacks, and strokes.

But LDL doesn't act alone. Chronic inflammation — a persistent activation of the immune system — also fuels heart attack and stroke risks. That means you must address both high LDL levels and chronic inflammation to protect your health.

Conquer your fear of dietary fat

Updated April 1, 2021

Here's why you need more fat (the right kind) in your diet — not less.

For decades, the message was loud and clear: high intake of fat causes weight gain, heart disease, and maybe even cancer. The solution? Go low-fat. Unfortunately, that often meant consuming more carbs and more sugar.

Today, that advice is considered misguided. Nutritionists now suggest people actually need adequate amounts of fat for optimal health — but only the right kind.

How much will fried foods harm your heart?

Updated April 1, 2021

News briefs

Fried foods carry heart risks in part because they spur inflammation. But how many servings of crispy French fries does it take to raise your risk for cardiovascular disease? Not many, suggests a large analysis published online Jan. 18, 2021, by the journal Heart. Scientists pooled the findings of 17 studies on fried foods and problems like heart attacks, clogged coronary arteries, heart failure, and stroke. The studies included more than half a million people. Researchers also looked at the data from another six studies assessing the association of eating fried food and dying prematurely. Those studies involved more than 750,000 people. People who ate the most fried foods each week were 28% more likely to have heart problems, compared with people who ate the least. Each additional 114-gram (4-ounce) serving of fried foods per week bumped up overall risk by 3%. But the analysis failed to show that people who ate lots of fried foods were more likely to die prematurely. Besides provoking inflammation, fried foods are often also high in sodium as well as harmful saturated fats. If you choose to indulge in them, do it sparingly. And avoid foods fried in animal fats; instead, choose foods fried in vegetable oils.

Image: © Amarita/Getty Images

When it comes to activity, the more the better

Updated April 1, 2021

In the journals

Regular exercise is good medicine, but more may be better, suggests a study published online Jan. 12, 2021, by PLOS Medicine. Scientists asked more than 90,000 people without heart disease to wear a fitness tracker for a week to measure the duration and intensity of their physical activity. Five years later, they found that the most active people were less likely to have had a heart attack or stroke or be diagnosed with heart disease.

That's no surprise, but the researchers also discovered that risk continued to shrink as weekly minutes of activity and intensity rose. People who exercised the most and at the highest intensity had the best odds of maintaining good cardiovascular health. Guidelines recommend people get 150 to 300 minutes of moderate-intensity exercise per week, but these findings suggest that trying to do a little extra — whether in time, intensity, or both — offers more reward.

Which blood pressure number matters most?

Updated April 1, 2021

Ask the doctor

Q. My doctor told me I should get a home monitor to keep tabs on my blood pressure. Which number is most important in the reading, the top or the bottom one?

A. This question comes up often, perhaps because doctors and patients alike tend to pay more attention to the top (first) number, known as systolic pressure. It reflects the amount of pressure inside the arteries as the heart contracts. The bottom (second) number, diastolic pressure, is always lower since it reflects the pressure inside the arteries during the resting phase between heartbeats.

Arm yourself to get better blood pressure readings

Updated April 1, 2021

In the journals

Blood pressure readings are usually done on only one arm, but a new analysis makes the case for checking both arms, as the difference between them may suggest an elevated risk for heart disease. The findings were published in the February 2021 issue of Hypertension.

Researchers examined 24 studies that measured blood pressure in both arms in 53,827 adults without high blood pressure. They found that a difference of more than five points between the left and right arm systolic readings (the top number) was linked with a 9% higher risk for a first-time heart attack or stroke and a 6% increase in cardiovascular death within 10 years. The greater the difference between the two readings, the higher the risk.

Dangers of heavy drinking if you have atrial fibrillation

Updated March 1, 2021

Research we're watching

People with atrial fibrillation (afib) who consume more than 14 alcoholic beverages a week may face a higher risk of stroke and other blood clot-related problems, according to a new study.

The study included 9,411 people with afib, who were divided into four groups based on how much they typically drank per week: abstainers or rare drinkers (less than one), light drinkers (less than seven), moderate (seven to 14), and heavy (14 or more). Researchers then tracked the participants for a median follow-up period of 17.4 months, noting the incidence of strokes, transient ischemic attacks (ministrokes), blood clots in a limb or organ (embolisms), or hospitalization for management of either atrial fibrillation or heart failure.

Understanding "blood thinners"

Updated March 1, 2021

These drugs actually help stop dangerous blood clots from forming. Here's when you may need them.

Nearly everyone has heard of "blood thinners." Maybe you or someone you know takes one. But these drugs don't "thin" blood at all.

"They are actually anti-clotting drugs," says Dr. Gregory Piazza, a cardiologist with Harvard-affiliated Brigham and Women's Hospital. "They prevent potentially dangerous blood clots from developing in people at high risk, like those who have atrial fibrillation or a stent in a blood vessel, or who are immobile after surgery."

A little-known factor that boosts heart attack risk

Updated March 1, 2021

About one in five people has high levels of lipoprotein(a), a fatty particle linked to premature heart disease.

Most people probably haven't heard of lipoprotein(a), although that's not surprising. Cardiologists have known for years that having high levels of these fatty particles circulating in the bloodstream poses a risk to the cardiovascular system. But there wasn't much they could offer in terms of therapy, so widespread testing for lipoprotein(a) — also known as Lp(a) — didn't make sense.

Recent progress means the landscape may soon be shifting. Earlier research showed that injectable cholesterol-lowering drugs known as PCSK9 inhibitors, such as evolocumab (Repatha) or alirocumab (Praluent), may lower Lp(a) by up to 25%. Until last year, however, it wasn't clear whether that reduction actually helped people with high Lp(a).

Migraine: A connection to cardiovascular disease?

Updated February 1, 2021

Some people who get these intense, throbbing headaches may face a heightened risk of stroke and heart attack.

About one in six adults in the United States reports having migraines, but these debilitating headaches are three times more prevalent in women. During a migraine attack, people often feel nauseated and are sensitive to light and sound. And up to a third of migraineurs experience odd visual or physical sensations known as an aura (see "What is a migraine aura?").

Usually, the aura occurs soon before the headache, although some people experience just the aura without a headache. Both versions are known as migraine with aura or classic migraine. And both have long been linked to an increased risk of cardiovascular disease, especially stroke. But migraine sufferers should interpret this risk in context, says Dr. Christopher Anderson, chief of stroke and cerebrovascular diseases at Harvard-affiliated Brigham and Women's Hospital.

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