Dr. Claudia Hochberg, an interventional cardiologist at Boston Medical Center, will be here at noon today to answer your questions on coronary stents. You can leave questions in the comments field in advance, or check back at 11:45 a.m., when the chat interface (below) will be open for questions. We'll actually begin our chat at noon on the dot.
Adults with high levels of artery-clogging "bad" cholesterol decreased by a third between 1999 and 2006, new research finds.
At the same time, though, researchers found that many adults still have very high cholesterol levels and are not being treated for them. This, despite the widespread use of drugs known as statins, which lower bad cholesterol levels.
While the use of such medications increased from 8 percent to 13.4 percent over the study period, screening rates remained unchanged at less than 70 percent, the researchers write in the article published in today's Journal of the American Medical Association,
Researchers from the CDC studied 7,044 men and women 20 years and older and examined their levels of "bad" cholesterol, or LDL.
Overall, the prevalence of people with bad cholesterol decreased from 31.5 percent in 1999 to 21 percent in 2006. But about two-thirds of people in the highest risk categories -- susceptible to heart attack and other problems -- were not on medication, the authors found.
Why are so many people at risk not getting treated?
An accompanying editorial suggests that screening guidelines are too confusing and need to be simplified. Doctors evaluate patients with a fixed threshold of LDL levels. As a result, doctors sometimes miss people with high risk factors for developing heart disease even if their LDL levels aren't high enough to meet the threshold. In another editorial, other experts suggest factoring age into the equation -- offering generic statins (cheaper than the name brands and therefore more accessible) to all adults above a particular age.
Baltimore Sun photo
Continue reading "Levels of "bad" cholesterol on the decline" »
Smoking bans--love them or hate them--appear to reduce the risk of heart attack and heart disease of nonsmokers, a major government report concludes.
It's a finding that many researchers had expected. As smoking bans proliferate around the globe, health officials' major argument for implementing them is to prevent illness in non-smokers.
The report, from the Institute of Medicine, part of the National Academies of Sciences, is based on a major review of numerous studies on smoking and long-term cardiovascular problems.
Eleven key studies of smoking bans in the US, Italy, Canada Scotland showed repeatedly a reduction of heart attack rates in places after bans had been instituted. It was hard to say precisely how much the risk decreased, since the studies varied in their methods. But the range was between 6 percent and 47 percent decrease in the incidence of heart attack in places with smoke-free policies.
The bottom line, according to the report: smoking bans work.
Continue reading "Study: smoking bans cut heart attack risk" »
Congratulations to Alan C. Reese. His question has been chosen by a panel of distinguished judges (OK, Kelly and me) to be answered as part of Picture of Health's inaugural "Ask the Expert" feature. And as the first, he wins our special prize, a one-year membership at Brick Bodies. (Cue the confetti).
Dr. Richard A. Desi, a gastroenterologist at the Institute for Digestive Health and Liver Disease at Baltimore's Mercy Medical Center is our expert today. 
Q: How do you distinguish between heartburn and a heart attack?
A: "That's actually not a very easy question," says Dr. Desi. "It's a difficult question for patients and for doctors."
One key, he said, is to look for what are considered the classic symptoms of each. With heartburn, burning sensations are likely to radiate from the center of the stomach and into the chest. Typically those symptoms will improve when you take an antacid and worsen when you lie down. It can be set off by a meal.
With a heart attack, the common sensation is left-sided chest pain, radiating down the left arm with numbness or tingling. It can be accompanied by shortness of breath and can be set off by physical exertion.
But sometimes, Desi says, the typical symptoms don't appear and sometimes, they will overlap, making it hard to know the difference. His advice: If you've never had the pain before, have it checked out by a doctor. "It's probably something that you shouldn't be gambling with," he says, considering that heart disease is the No. 1 killer in the United States.
He says some people are sent to his office from the emergency room, where they raced after thinking they were having a heart attack only to be told it was acid reflux instead. "It's better to err on the side of being a little bit embarrassed," he says.
To read more, try this explanation from the Mayo Clinic.
Photo of Dr. Desi/Mercy Medical Center
Two new studies by Harvard researchers affirm what doctors have been trying to drill into us for years: adopt a healthy lifestyle and you'll keep your heart healthy.
Sure, to all you diet and fitness buffs out there, this may not be earth shattering news. Still, the studies, which appear in this week's Journal of the American Medical Association drive home the link between behavior and health.
In the first paper, researchers used the Nurses Health Study -- a long-running research project -- to examine the connection between lifestyle and the risk of developing high blood pressure in some 84,000 women between 1991 and 2005. They measured how well the nurses followed advice on six lifestyle factors such as exercising for 30 minutes a day, having a body mass index of less than 25 and even drinking moderate alcohol. Women who followed all six, had about an 80 percent lower risk of developing high blood pressure than those who did not.
Kelly Brewington came to the health beat a year ago after covering everything from education and government to race and immigration in her 11 years as a reporter. Since then, she has tackled stories on autism, heart failure and acupuncture used to treat drug addiction. She’s been fascinated by medicine since childhood, when her doctor dad and nurse mom gave her Gray’s Anatomy coloring book to play with. She also blames her early exposure to the field of medicine for her hypochondria. 
