Blood Pressure

Ask The Doctors: January 2010

I have type 2 diabetes and have been on aspirin therapy for several years. But my doctor told me recently that there is some question about whether the aspirin will help protect patients with diabetes. Should I keep taking aspirin (I have never had a heart attack, but I do take medications to manage my blood pressure and cholesterol)?
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Ask The Doctors: January 2010 Women’s Edition

I dont understand why cold weather is bad for the heart. I had a mild heart attack last year, but have lost 55 pounds and feel great! I did it mostly through exercise. Is there any reason I cant do outdoor sports in the winter?
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Get a Flu Shot and Closely Monitor Your Blood Pressure this Winter

If youre undecided about whether to get a flu shot this winter, consider the findings of a study reported in the October issue of the Lancet: Infectious Diseases. Researchers determined that a vaccination for influenza appears to offer protection against heart attacks in people with pre-existing cardiovascular disease (CVD). The findings were based on an analysis of 39 studies. And while there needs to be additional research to determine whether flu vaccines offer some protection to people without CVD, older adults are still advised to get their flu shots, because influenza can trigger an inflammatory response in the body that leads to myriad medical complications. "The evidence is fairly clear that infections with influenza, as well as other viruses and bacteria, can increase the risk of developing a heart attack," says Cleveland Clinic cardiologist Adam Grasso, MD, special consultant to Heart Advisor. "This is probably due to the inflammatory reaction in the body which occurs with the onset of these infections. Since atherosclerosis is in part an inflammatory disease, its likely that the systemwide inflammation during such infections can trigger rupture of cholesterol plaques in the coronary arteries, or in the cerebrovascular vessels, leading to heart attack or stroke. Getting flu vaccination, by helping prevent influenza, appears in some studies to reduce the likelihood of myocardial infarction (heart attack), as well as death from cardiovascular causes."
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Treat Sleep-Disordered Breathing to Protect Your Heart

In one of the strongest recent studies supporting the link between sleep-disordered breathing and an increased risk of death, the Sleep Heart Health Study found that people with severe sleep apnea had a 40 percent increased risk of death compared to those without the condition. The research, which included 6,440 men and women over the age of 40, studied from October 1995 to February 1998, was published in the Aug. 18 online edition of the Public Library of Science (PLoS) Medicine. An estimated nine percent of women and 24 percent of men in the general population have sleep-disordered breathing, which has been linked to coronary disease, hypertension, and stroke. Researchers suggest that despite the large numbers of people with sleep-disordered breathing, it remains significantly underdiagnosed.Obstructive sleep apnea (OSA)-a condition in which the soft tissues of the throat collapse during sleep, blocking the airway and causing loud snoring-can lead to cardiovascular problems including heart attack, heart failure, and stroke.
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Masked and White-Coat Hypertension Could Signal More Serious Complications

People with "masked" or "white-coat" hypertension arent safe simply because they dont experience the type of sustained high blood pressure that warrants a variety of daily medications and raises the risks of heart attack, stroke and other complications. According to recent research in Hypertension: Journal of the American Heart Association, both conditions significantly raise the risk of sustained hypertension. In white-coat hypertension, a patients blood pressure is only elevated in the doctors office, but not in everyday life. With masked hypertension, a patient may have normal blood pressure in a doctors office, but experience spikes at other times. "For people with either masked or white-coat hypertension, the true test is a 24-hour blood pressure monitor," says Cleveland Clinic cardiologist and hypertension expert Donald Vidt, MD. "And the awake, daytime blood pressure is probably the biggest key to cardiovascular risk."
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What You Need to Know About CCBs

Calcium channel blockers (CCBs) are used to treat heart disease, angina (chest pain), heart arrhythmias, and cardiomyopathy. They also may be used to treat high blood pressure in individuals with angina and/or a high risk of stroke, and alongside other drugs to treat resistant high blood pressure. CCBs increase the supply of blood and oxygen to the heart by relaxing blood vessels. They achieve this effect by attaching to the surface membrane of the muscles in the arteries, slowing the rate at which calcium passes into the heart muscle and into the blood vessel walls, which, in turn, decreases the contraction of both. The effect is to slow the rate at which the heart beats, reducing its workload and treating any arrhythmia, and also to increase the diameter of the arteries so that blood pressure falls-this also relieves pressure on the heart, by making it easier to pump blood.
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Uncover the Truth Behind 3 Common Myths of Heart Health

You read up on heart health, listen to your doctor and try to follow all that good advice. But somehow, ideas about how you should manage your health can get a little skewed. Cleveland Clinic cardiologist Curtis Rimmerman, MD, author of Heart Attack, A Cleveland Clinic Guide, says many well-meaning patients sometimes need reminders about the basics of a healthy lifestyle. Here are three common myths or misunderstandings and some advice from Dr. Rimmerman to set things straight.
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Ask The Doctors: May 2009

Implantable cardioverter defibrillators (ICDs) can indeed save and extend lives, but they are not for everyone. There are two main groups of individuals who should have an ICD placed. The first are those with a history of heart attack, and a left ventricular ejection fraction of less than or equal to 35 percent. In this group, the risk of a dangerous cardiac arrhythmia such as ventricular tachycardia (VT) or ventricular fibrillation (VF) is high enough to warrant placement of such a device. Some studies have suggested that patients with a low ejection fraction, but without a history of heart attack, can also benefit from an ICD. The other group are people who have previously experienced VT or VF. Such individuals are much more likely to have another possibly lethal arrhythmia, and would qualify for an ICD. Some important reasons why a person who otherwise needed an ICD might not get one would be frequent bloodborne infections. ICDs can become infected, and their removal is an involved procedure, which is quite risky.
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Controlling Hypertension Is Crucial for Heart Patients

The relationship between hypertension and other conditions known as "cardiovascular comorbidities" (CVCs)-conditions that affect the heart and/or blood vessels, such as coronary artery disease, heart failure, stroke, chronic kidney disease, peripheral arterial disease, and diabetes-is raising red flags in the medical community. According to a study in the Dec. 10/24, 2007 issue of Archives of Internal Medicine, nearly 75 percent of 1,671 study participants with one or more CVCs also had hypertension, and less than half achieved their blood pressure goals. "Its well established that high blood pressure is strongly associated with stroke, cardiovascular disease, and chronic renal disease, as well as a reduced overall survival rate," says Richard Krasuski, MD, a cardiologist at Cleveland Clinic.
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Low Blood Pressure Vital at Any Age

Preliminary results from the Hypertension in the Very Elderly Trial (HYVET) suggest that trial participants, who were in their 80s, had a lower risk of dying when they were treated with antihypertensive medications. "High blood pressure medication has been known to reduce the rate of stroke, but the HYVET study suggests that both incidence of stroke and survival rate were improved. These data, although not yet published, confirm our belief that high blood pressure should be treated regardless of age," says Gary Francis, MD, head of the Section of Clinical Cardiology at Cleveland Clinic and editor-in-chief of Heart Advisor.
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Control Hypertension to Prevent Cardiovascular Complications

Controlling high blood pressure is crucial to prevent cardiac events, including stroke and heart attack. Fortunately, an array of proven hypertension medications is available to reduce blood pressure. However, the mechanics of how these classes of medications work varies, so it is important to know which drugs work best for each individual, given the patient-specific complications that can occur. The type of antihypertensive medication used may have a direct impact on the reduction in stroke risk, according to an article in the August 6 issue of The American Journal of Cardiology. "In general, any reduction in blood pressure, even if small, is likely to reduce the risk of stroke. However, some antihypertensive medications are particularly effective in this regard," says Gary Francis, MD, head of the Section of Clinical Cardiology at Cleveland Clinic and editor-in-chief of Heart Advisor.
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Small Dietary Changes Yield Big Blood Pressure Benefits

We all know that you can lower your cholesterol by avoiding foods that are high in saturated fats and trans fats. But did you know that eating certain foods can lower your blood pressure? High blood pressure, or hypertension, makes your heart work harder, which can lead to heart failure. High blood pressure is also a serious risk factor for stroke, heart attack, and kidney failure.
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