February 2012
Ask The Doctors: February 2012
A document known as the JNC-7 is our main set of guidelines for blood pressure therapy. It defines normal blood pressure as a systolic blood pressure (SBP) 140 mm Hg or the DBP is >90 mm Hg. In between the normal and hypertensive ranges, when the SBP is 120-139 mm Hg or the DBP is 80-85 mm Hg, is referred to as pre-hypertension. Generally, pre-hypertension is only treated with lifestyle modifications, including pursuance of a low-sodium diet, weight loss, exercise, moderate alcohol consumption, and smoking cessation.
Ambulatory Blood Pressure May Best Predict Health Events
High blood pressure is the most important risk factor for stroke because a weakened blood vessel can break and bleed in the brain. By monitoring your blood pressure for 24 hours you and your doctor can see when your blood pressure rises, and then design a medication regimen to treat you.
There are several factors that can affect your blood pressure reading. Rushing to get to an appointment on time or “white coat syndrome” (a spike in blood pressure, probably caused by anxiety, that some patients experience when they are in a doctor’s office) can all provide doctors with false readings. In an effort to combat this, ambulatory blood pressure monitoring (ABPM), which involves wearing a blood pressure monitor for several hours, can help give your doctor a more accurate reading.
Research Raises Questions About Vitamin D’s Heart Benefits
When the skin is exposed to UVB radiation from the sun, an inactive form of vitamin D3 is formed and transported to the liver and converted into 25-hydroxy vitamin D3. From there, it travels to the kidneys, where the active form of vitamin D—1, 25 dihydroxy vitamin D3—is produced. Vitamin D from foods and supplements also are processed through the liver and kidneys.
Vitamin D’s importance to bone and muscle health is indisputable, though it’s less clear how that key nutrient affects heart health. Several studies in recent years have suggested that vitamin D plays a key role in keeping your blood vessels healthy and your heart muscle strong. The consensus is that individuals with low vitamin D levels tend to be at higher risk of cardiovascular events such as heart attack. But not all research supports the idea that vitamin D supplementation is the answer to lowering your risks.
How Much will Niacin Help if LDL Levels are Already Low?
Adding niacin to your cholesterol-control regimen may not further reduce your risk of cardiovascular events, including stroke and heart attack. A study in the Nov. 15 issue of the New England Journal of Medicine found that even though niacin can have a positive impact on HDL (“good”) cholesterol levels and triglycerides, patients who took niacin and who already had an LDL (“bad”) cholesterol level of 70 or lower did not see a significant reduction in major events.
Surgical Ablation May Treat AFib Better than Catheter Approach
In a comparison between surgical ablation and radiofrequency catheter ablation to treat atrial fibrillation (AFib), researchers found that the surgical approach is superior in preventing arrhythmias for at least one year. The study, published online Nov. 14, 2011 in Circulation, included patients who were resistant to antiarrhythmic drugs. However, about two thirds of the participants had been treated unsuccessfully with a catheter ablation, suggesting that many patients may simply have a predisposition to catheter-ablation failure.
Calorie Restriction Boosts Heart Function in Diabetes Patients
Weight loss has long been the recommendation for many patients with type 2 diabetes. That’s because chemicals in fat diminish your body’s ability to use its own insulin. When the pancreas tries to make more insulin to compensate, the insulin-producing part of the pancreas can essentially wear out over time. But researchers now have evidence that eating a low-calorie diet may not only help eliminate insulin dependence, but it may help improve heart function in obese patients with type 2 diabetes.
Heart Beat: February 2012
If you can improve your physical fitness levels, even if you don’t lose weight, you can lower your death risk. A study published in the Dec. 5, 2011 issue of Circulation found that over time, improvements in fitness correlated to lower risks of heart disease-related and stroke-related causes of death, as well as all causes of death. The lower risks held true whether the individual maintained the same weight or even gained some weight. Researchers say the study illustrates the risks of inactivity and should help reassure individuals who are active, but have trouble losing weight, that their dedication to exercise is helping protect against cardiovascular complications.
Learn the Truth Behind Seven Heart-Health Myths
What you think you know about cardiovascular disease may not always be true, and sometimes that misinformation could put you at risk. To help explain the truth behind some common heart myths, Cleveland Clinic cardiac surgeon Marc Gillinov, MD, shares some insight. Dr. Gillinov and Steven Nissen, MD, head of Cardiovascular Medicine at Cleveland Clinic, also teamed up recently to write a book that addresses myriad issues surrounding heart health called Heart 411.