Heart Advisor

Ask The Doctors: May 2013

By our most recent guidelines for the evaluation and treatment of hypertension, your blood pressure barely makes it into the “prehypertensive” range, defined by a systolic blood pressure (SBP) between 120 and 139. As you suggested, the diastolic blood pressure (DBP)

Know the Latest in Stroke Prevention and Treatment

Clogged coronary arteries can not only raise your risk of heart attack, but also put you in danger of a stroke. A recent study, in fact, published in the American Heart Association journal Stroke, found that blockages in the heart’s arteries can raise the odds of you having a stroke even if you’re otherwise considered at low risk for the cerebrovascular event. The study, which involved more than 4,000 patients who had no previous history of strokes or heart attacks, found that those with coronary artery calcium (CAC) density levels of more than 400 were three times more likely to have a stroke than those with levels under 399.

Risk Factor Control Needs More Attention in Diabetes Patients

Living with diabetes means being especially mindful, not just of your blood glucose levels, but of your blood pressure and cholesterol, too. And while research suggests that patients are doing a better job in those areas, it appears that fewer than one in five individuals with diabetes are actually reaching all three targets. In a study published in the Feb. 15 issue of Diabetes Care, researchers found that blood glucose control was being achieved by more than 52 percent of patients with diabetes between 2007 and 2010, up from just 44 percent in 1999 to 2002.

Gastric Bypass May Help Put Type 2 Diabetes Into Remission

Headlines were made last year when results of a Cleveland Clinic study of bariatric surgery showed that the procedure could actually reverse the course of type 2 diabetes in moderately obese individuals. Now, further analysis of the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial results find that the surgery provides durable blood glucose control for at least two years compared to intensive medication therapy in these patients. “We can put diabetes into remission, and if this is only for a few years, it will delay the development of complications, says lead author and Cleveland Clinic diabetes specialist Sangeeta R. Kashyap, MD.

Benefits of Quitting Smoking Greater than Risks of Weight Gain

If you’ve ever tried to stop smoking, you know that weight gain can often be an unwanted result. But if you’re worried about how those extra pounds will impact your heart health, a recent Swiss study suggests you’re still much better off stubbing out those cigarettes. The research, published in the Journal of the American Medical Association, found that middle-aged and older adults who stop smoking were about half as likely as smokers of the same sex and age to have a subsequent cardiovascular event, even though they tended to gain weight.

Darbepoetin Alfa Not Advised for Anemic Heart Failure Patients

A drug that commonly prescribed to treat anemia in heart failure patients may not improve the patients’ health or reduce the risk of death from heart failure, according to a study presented at the American College of Cardiology’s annual meeting in March. The study, conducted by researchers at the University of Gothenburg, Sweden, Cleveland Clinic and many other centers, found that patients who took the drug darbepoetin alfa experienced similar clinical outcomes as those who took a placebo. The study involved more than 2,000 anemic heart failure patients in 33 countries.

Mediterranean Diet Tops Low‑Fat Eating Plan for Heart Health

You’ve no doubt heard plenty of about the Mediterranean-style eating plan and its heart-healthy benefits. But a new study further confirms that for patients at high risk of heart disease, a Mediterranean diet, supplemented with virgin olive oil and/or mixed nuts, may cut the risk of developing heart disease by as much as 30 percent compared to a reduced-fat diet. The study was presented at the International Congress on Vegetarian Nutrition conference in California earlier this year.

Heart Beat: May 2013

Older Patients With Implantable Cardiac devices may like the convenience of remote monitoring of the wireless devices by their physicians, but a new study found that most patients prefer to have in-person consultations with their doctors. The study, published in the journal Telemedicine and e-Health, reported that 53 percent of patients with pacemakers, defibrillators and other implanted, wireless devices that regulate or measure heart rhythm said they would rather have in-office follow-ups with their doctors. Only 27 percent expressed a preference for the remote monitoring. Interestingly, the majority of device patients in the study said it was “easy” or even “very easy” to use the wireless technology.

Subcutaneous ICD May Be a Better Option for Some Heart Rhythm Patients

Most implantable cardiac defibrillators (ICDs) work by using thin, insulated wires that are fed into the heart through veins and administer a shock to the heart when it the devices detect a life-threatening arrhythmia. But a new type of ICD requires a less invasive procedure to implant it, and can shock the heart back into a healthy rhythm without having a lead actually enter the heart.