There's news that many people would like to hear. A small observational study of Greek patients presented at the annual meeting of the American College of Cardiology in March 2019 found that taking a daily nap can lower blood pressure.
"If you have side effects from your medications and would rather not take them, I can understand," says Dr. Mountis. "If you don't want to be evaluated for an advanced therapy like a mechanical heart pump or a heart transplant, I can respect that decision after we have discussed the pros and cons. Our conversation will then shift to what you can expect to happen from that point on."
Our biological clock (circadian system) governs many physiological processes, including blood pressure. Blood pressure normally dips at night. People who do not experience this temporary drop (called "non-dippers") are at increased risk for developing heart disease. Researchers discovered that one of four main genes comprising the circadian system act differently in men and women. They found that male mice missing this gene (PER1) become non-dippers and have a higher risk of heart and kidney disease. In contrast, female mice missing the PER1 gene continue to show normal dips in blood pressure at night (American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, January 2019 ahead of print). This phenomenon may explain in part why premenopausal women, who are less likely to be non-dippers than men of the same age, have a lower risk of heart disease. After menopause, their risk climbs due to other factors and quickly erases this biological benefit.
The midsole is the part of a shoe sandwiched between the outsole, which touches the ground, and the insole, which is located on the inside of the shoe underneath the liner. Oftentimes, the midsole of a walking shoe is thin and pliable and is made from ethyl vinyl acetate (EVA), which is light, compressible and pliable.
Cigarette smoking is a major risk factor for cardiovascular disease (CVD) and death from CVD. In fact, nearly one-third of U.S. deaths attributed to cigarette smoking are due to CVD. Although most smokers attempt to quit multiple times before they are able to call it quits, many do not stop smoking until they have developed smoking-related complications. Quitting smoking reduces subsequent CV events and mortality, regardless of duration or intensity of smoking, comorbidities or age. Patients benefit even when they quit smoking after they have developed CVD. This provides a strong rationale for quitting-if only the best way to accomplish this were known. Physicians have had little guidance to use in counseling patients on the most effective strategies to stop smoking. The American College of Cardiology addressed this need with an Expert Consensus Decision Pathway on TobaccoCessation Treatment (Journal of the American College of Cardiology, Dec. 25, 2018). It summarizes recommendations for a comprehensive approach to treating tobacco dependence with a chronic disease management strategy, monitoring tobacco use over time and making repeated efforts to encourage and assist smokers to quit using tobacco. The document gives physicians the information they need to answer smokers' questions about therapies for overcoming nicotine withdrawal, while bolstering self-control over smoking. It also discusses barriers to implementing and sustaining smoking cessation treatment that should be recognized and addressed to help smokers overcome their addiction to tobacco.
"It's good to know the symptoms of heart failure, because they can indicate that your heart is not functioning as well as it should. After you begin treatment, if your symptoms appear less often or become less severe, it tells us that your medications and lifestyle adjustments are working well to keep your heart performing to the best of its ability," says Cleveland Clinic heart failure specialist David Taylor, MD.
Some models are convertible, meaning they can be used by either the hands or feet. If balance is your main issue, pedaling with your feet while sitting in a chair may be easier than you think. In fact, you want to seek a gym with a recumbent cycle and try it out. It's basically a bicycle you ride while sitting in a chair with full back support.
The tricuspid valve initially received less attention because it fails less often, but also because treating the valve was a more daunting prospect. Patients with tricuspid disease often have mitral valve disease, as well as hypertension, atrial fibrillation and other problems. Although the valve can be repaired or replaced surgically, the operation carries a mortality rate as high as 35 percent and may not completely eliminate regurgitation.
According to the Centers for Disease Control and Prevention, more than 30.3 million people in the U.S. have diabetes. Another 84.1 million have pre-diabetes, a condition that can lead to type 2 diabetes within five years, if it's not treated. Diabetes is a major risk factor for early death from heart attack, stroke and many cancers. It also increases the risk of kidney disease, blindness and amputation. But these outcomes are not inevitable, if you learn about the disease and your role in managing it.
In the past, niacin, fenofibrates, bile acid sequestrants and fish oil were widely used to help normalize blood lipid levels. Most have fallen out of favor. But in November, physicians were wowed when a key study revealed that prescription-strength doses of eicosapentaenoic acid (EPA), a form of omega-3 fish oil, reduced the risk of cardiovascular death, heart attack, stroke, revascularization and unstable angina by 25 percent in patients with CAD or diabetes and high triglyceride levels.
It's very common for people to need multiple anti-hypertension medications to lower their blood pressure into an acceptable range. If you resent taking medications, try diet and exercise. Researchers studied 129 overweight adults with blood pressures between 130 and 160 millimeters of mercury (mmHg) systolic and 80 and 99 mmHg diastolic, but who were not taking anti-hypertension medication. The researchers randomized one-third to the DASH diet (an eating plan designed to lower blood pressure) plus supervised exercise three times a week and behavioral counseling for weight loss. One-third were randomized to the DASH diet only. The remainder made no changes to their diet or exercise habits. Over a 16-week period, those who participated in the diet, exercise and counseling group lost an average of 19 pounds and reduced their blood pressure by an average of 16/10 mmHg. The diet-only group lowered their blood pressure an average of 11/8 mmHg. Blood pressure in the group that made no changes dropped only 3/4 mmHg.
The study examined only outcomes up to five years after CABG. At this point, no difference was seen in survival rates with either the vein or artery graft. But other studies have confirmed that a second arterial graft significantly increases the likelihood the patient will be alive 10 years after CABG. Cleveland Clinic and other major heart centers follow Society of Thoracic Surgery guidelines and use an artery as a second conduit whenever possible.