Nutrition & Exercise

The Evolution of a Heart Attack

Immediate testing is done to determine whether or not a heart attack has occurred. These include an electrocardiogram (ECG) and a blood test for troponin, a protein that spills into the blood when heart muscle dies. If the troponin test is negative, a heart attack has likely not yet occurred. These patients are given several types of medication to prevent their condition from deteriorating.

Heart Beat: October 2018

Depression after a heart attack can have serious, even deadly, consequences. However, the effect of antidepressants on outcomes has been unknown. A 300-patient study published in the July 24/31 issue of JAMA suggests that treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro) significantly reduced the risk of a major cardiac event. Patients who had recently suffered a major or minor heart attack were randomized to the antidepressant or placebo for 24 weeks and then followed for a median of eight years. All-cause death, deaths from heart disease, heart attacks and revascularizations with angioplasty and stenting were tracked. At the end of the study, 40.9 percent of the patients on escitalopram had met one of these outcomes, compared with 53.6 percent of those who had received the placebo. When individual outcomes were examined, the SSRI beat placebo in all measures. However, only reduction in heart attack (8.7 percent vs 15.2 percent) was statistically significant.

Fainting May Indicate an Underlying Heart Problem

Sixty percent of people in the world have fainted at least once in their life. In most cases, the underlying reason is a benign condition called vasovagal syncope (the medical word for fainting). It occurs when blood pressure suddenly plummets, causing a drop in blood flow to the brain.

Keys to a Longer Life Revealed

The average life expectancy in the United States is estimated to be 79 for a woman and 75.5 for a man-lower than that of other developed nations. A prosperous life with too much food and too little exercise is to blame. Experts say the rapid rise in obesity and decline in physical activity are mainly responsible for high levels of cardiovascular disease in this country and many cancers. They say three-fourths of premature deaths from cardiovascular disease and half of premature deaths from cancer can be attributed to lack of a low-risk lifestyle.

New Approaches to Losing Weight and Gaining Blood Sugar Control

Fasting: Intermittent fasting has been shown to be effective for both weight loss and diabetes resolution. With this approach, you eat a very low-calorie diet (500 calories if youre a woman, 600 if youre a man, split between two meals) two days a week, but not on successive days. Just make sure you talk with your physician first to ensure fasting will not interact with your medications, she advises.

Ask The Doctors: October 2018

In clinical trials, certain newer diabetes medications have been shown to reduce CVD events in addition to lowering blood sugar in diabetics at high risk for CVD. The GLP-1 receptor agonists liraglutide (Victoza, Saxenda) and semaglutide (Ozempic), and the SGLT2 inhibitors empagliflozin (Jardiance) and canagliflozin (Invokana) have been shown to be superior to placebo at preventing CVD death, heart attack, stroke and heart failure in patients with known CVD. Both drug classes are associated with lower risk of symptomatic low blood sugar levels (hypoglycemia) and weight loss.

How to Stay Out of the Hospital

Cleveland Clinic offers heart-failure education classes designed to teach patients and their families what they need to know about the condition, its progression, its impact on day-to-day life and its medications. Ask your cardiologist if theres a similar program in your area. If not, ask for information in writing.

Download The Full September 2018 Issue PDF

If you have risk factors for cardiovascular disease, or have been diagnosed with heart or vascular disease, what are you doing to lessen the likelihood you will suffer a heart attack or stroke? Are you eating a heart-healthy diet and exercising? Keeping your blood pressure, blood sugar and cholesterol levels under control? Have you tossed your cigarettes to the curb.

What Vitamins Should You Take to Improve Your Heart Health?

A Chinese study (included in the JACC paper) found that folic acid supplements reduced the risk of stroke 22 percent overall and 73 percent in participants who took folic acid in addition to their blood pressure medication. But those findings might be different if a similar study were conducted in the U.S., where cereals, breads, pasta and rice are fortified with folic acid. The Chinese diet is lower in folate than our diet. It is unclear whether additional dietary folate would be beneficial here, says Dr. Hazen.

Hidden Sources of Salt May Be Raising Your Blood Pressure

Its no surprise that bacon, sausage and lunchmeats are sky-high in sodium. But many top offenders dont taste salty. These include ketchup, bread, processed cheese, breakfast cereals, bottled salad dressings, canned soups and nearly any frozen, boxed food. That means you have to make an extra effort to read labels in order to understand the sodium content of what you areeating.

Your Heart Is Your Responsibility

If you have risk factors for cardiovascular disease, or have been diagnosed with heart or vascular disease, what are you doing to lessen the likelihood you will suffer a heart attack or stroke? Are you eating a heart-healthy diet and exercising? Keeping your blood pressure, blood sugar and cholesterol levels under control? Have you tossed your cigarettes to thecurb?

Dont Let a Stress Test Stress You Out

This is a special type of stress test ordered to evaluate heart failure or a potential heart transplant recipient, or to determine whether shortness of breath is caused by heart or lung disease. It is performed on a treadmill or cycle with EKG, but a breathing apparatus is used to measure oxygen use and carbon dioxide production.