Heart Health Archive

Treadmills and related fitness equipment can make aerobic workouts more convenient. Which type is best for you?

Even if you enjoy exercising outdoors, there are times when it's too cold, too hot, or otherwise uncomfortable or impractical to walk, jog, or cycle outside. And like many people, perhaps you've let your gym membership lapse. So how do you make sure you're getting an aerobic, heart-protecting workout most days of the week?

Maybe it's time to invest in a home exercise machine, such as a treadmill or elliptical machine. Not only can you exercise in the privacy of your home, you can also easily break up your workout into 10- to 15-minute stints throughout the day, whenever it's convenient for you. Current guidelines recommend getting at least 2.5 hours of heart rate–elevating (aerobic) exercise each week.

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).

Studies have consistently shown that lowering LDL cholesterol reduces the risk of cardiovascular events and death. But do older adults — even those with existing cardiovascular disease — get the same benefits from lowering cholesterol, and do they face any additional risks from taking cholesterol-lowering medication? An analysis of data from previous studies reached some favorable conclusions.

A single exercise session may provide immediate and long-lasting protection.

Why is exercise so good for your health? Let us count the ways. One obvious answer is that exercise burns calories, which can help you maintain or reach a healthy weight. Regular exercise also improves factors linked to cardiovascular health, resulting in lower blood pressure, healthier cholesterol levels, and better blood sugar regulation.

And that's not all: Exercise also promotes positive physiological changes, such as encouraging the heart's arteries to dilate more readily. It also helps your sympathetic nervous system (which controls your heart rate and blood pressure) to be less reactive. But these changes may take weeks, months, or even years to reach their full effect.

How plaque on your teeth may be connected to plaque in your arteries.

 Image: © Thomas_EyeDesign/Getty Images

For decades, researchers have probed the link between gum disease and cardiovascular health. Gum disease begins when the sticky, bacteria-laden film dentists refer to as plaque builds up around teeth. A completely different type of plaque — made of fat, cholesterol, calcium, and other substances found in blood — can build up inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.

People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. But there may not be a direct connection. Many people with heart disease have healthy gums, and not everyone with gum disease develops heart problems. Shared risk factors, such as smoking or an unhealthy diet, may explain the association. Still there's a growing suspicion that gum disease may be an independent risk factor for heart disease.

Some simple steps can help minimize or avoid muscle problems from Crestor and other cholesterol-lowering drugs.

All drugs have side effects. The trick is to weigh the potential for serious side effects against the gain you can get from the medication. The balance sheet for Crestor and other statins looks like this: These drugs cut the risk of heart attack, angina (chest pain), stroke, and death from cardiovascular disease by 30%. They cause muscle pain in under 5% of the people who take them, and these pains often stop by themselves even with continued statin use. The chance of rhabdomyolysis, a potentially deadly breakdown of muscle tissue, is less than one per million statin prescriptions.

Ask the doctor

Q. I'm 66 and will be having my aortic valve replaced soon. My surgeon suggested a tissue valve, but he also mentioned that I could get a mechanical valve instead. What are the key differences between these two choices?

Ask the doctor

 Image: © LordHenriVoton/Getty Images

Q. I have high blood pressure and have been checking my blood pressure more often since my doctor added another drug. But lately, my readings have been all over the place. For example, one morning it was 127/70, but then it was 170/100 in the late afternoon. What's going on?

A. You may have a condition known as labile hypertension, which refers to blood pressure that fluctuates far more than usual. Everyone's blood pressure rises and falls many times during the course of a single day, sometimes even within minutes. Many factors contribute to these changes, including physical activity, emotion, body position, diet (especially salt and alcohol intake), and sleep deprivation. However, there is no clear definition or standard criteria to distinguish between normal and abnormal fluctuations.

Q. When doctors interpret a blood pressure reading, should they also consider the heart rate? I am a 78-year-old man and have had high blood pressure (under control) for more than 40 years. I frequently monitor my blood pressure at home, resting for five minutes before I take the reading. My blood pressure is often higher when my heart rate is close to its usual resting rate (about 50 beats per minute) and lower when my heart is beating faster than that. Can the body's demands that cause higher blood pressure be partially satisfied by a faster heart rate?

A. First, let me congratulate you on monitoring your blood pressure at home. This is a great way for you to take control of your high blood pressure, and a good step toward preventing a stroke. Knowing that your blood pressure at home is under consistent control is more important than getting isolated readings at the doctor's office. You are also resting before taking the reading, and this is important to avoid spuriously high readings that happen when someone rushes around, and then sits down quickly to take a blood pressure reading. (Readers interested in monitoring their blood pressure at home can watch a video of how this is done at www.health.harvard.edu/128.)