I was diagnosed with coronary artery disease about a year ago and have since had one stent put in. I take my medications and try to live a healthy lifestyle with regular exercise and a good diet, but I frequently find myself worrying about my heart and my life expectancy. Any advice?
Its been well-established that end-stage renal disease (ESRD) raises the risk of atrial fibrillation (AFib)-chronic kidney disease (CKD) and AFib share risk factors and underlying mechanisms, suggesting that the two conditions have a close relationship. "Studies have shown that kidney dysfunction increases the risk of new-onset AFib, and that Afib increases the risk of developing CKD," says Curtis Rimmerman, MD, the Gus P. Karos Chair of Clinical Cardiovascular Medicine at Cleveland Clinic.
Consistently high blood pressure (hypertension) damages the arteries in the heart and kidneys, increasing the risk of heart attack and kidney failure. The same process also damages the small arteries in the brain, which may cause dementia. In a recent study of 1,424 women, MRI scans revealed significantly more white matter lesions in the brains of women with high blood pressure (BP)-indicating areas of damage-than in those with normal blood pressure.
Because patients with chronic kidney disease (CKD) have a high risk of complications after invasive surgeries, there has often been reluctance by some physicians to perform operations, such as those used to clear blockages in blood vessels, that could lower the risk of stroke. But a recent study, published in the January issue of the Journal of the American Society of Nephrology, found that CKD patients undergoing carotid endarterectomy greatly reduced their risk of stroke. Endarterectomy is generally recommended for symptomatic high-grade (70 to 99 percent) stenosis of the internal carotid artery. In the re-analysis of data from the North American Symptomatic Carotid Endarterectomy Trial (NASCET), researchers included patients with symptomatic stenosis and either stage 3 CKD or preserved kidney function.
Family get-togethers, parties and many hours indoors enjoying a warm kitchen are all part of the holiday season. But this time of year can often be a time of overeating and excessive alcohol consumption-both of which not only can pack on the pounds, but pose real risks for heart patients. Cleveland Clinic cardiologist and Heart Advisor physician-editor Leslie Cho, MD, reminds heart patients and those with risk factors to be mindful of their choices, especially during the holidays.
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.
Many heart failure patients retain excess water that can pool in their lungs, making it hard to breathe despite the best drugs available today. This is the congestion in "congestive heart failure." Fluid-reducing diuretics are the primary treatment for congestion. But diuretics prevent the kidneys from retaining salt, and indirectly eliminate their ability to retain water, so the drugs often do an imperfect job. When this happens, powerful intravenous diuretics are needed. But the kidneys cant tolerate a lot of diuretics, and kidney function worsens.
A new wave of medications is helping those with diabetes better manage their disease by mimicking enzymes and hormones in the body that help control glucose and insulin levels. "In recent years, insulin has been perfected," says Cleveland Clinic dietitian Andrea Dunn. "Now the big focus is on developing other drugs to help manage some of the other issues [such as insulin resistance and reducing unwanted glucose production by the liver]."
To guard your heart from one of its most significant threats as you age, watch your back. Specifically, keep watch over your kidneys, the two bean-shaped organs in your lower back that provide vital housekeeping services to your heart and the rest of your body.
How to guard your bloods essential waste-filtration system.
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