Heart Health

Should I get a c-reactive protein test to check for heart disease?

DEAR DOCTOR K: Both my parents had heart disease, so I'm worried I might get it. A friend said I should get a CRP test, but my doctor hasn't ordered one. Should I ask him about the test?

DEAR READER: The answer is controversial. For full transparency, I should say that this test was developed and studied by a colleague of mine at Harvard Medical School, and revenue from the test comes to my colleague and to the hospital where I practice.

What is interval training?

DEAR DOCTOR K: What is interval training? What are the benefits of exercising this way?

DEAR READER: Interval training simply means alternating between short bursts of intense exercise and brief periods of rest (or a less-intense activity). The payoff is improved cardiovascular fitness with shorter workouts. Aerobic activities such as walking, biking, running and swimming make the heart and lungs work harder, which increases cardiovascular endurance.

Can exercise cause sudden cardiac arrest?

DEAR DOCTOR K: My wife saw something on the news about a man who died of sudden cardiac arrest while jogging. Now she doesn't want me to exercise. I'd really love to get my running shoes back on. What can I tell her to ease her worries?

DEAR READER: I read your letter as I was cooling off after exercising. So your question is timely. Your wife's concerns are understandable, but probably misguided. I spoke to my colleague Dr. Aaron L. Baggish, the associate director of the Cardiovascular Performance Program at Harvard-affiliated Massachusetts General Hospital. He confirmed what I thought I knew.

What are triglycerides?

DEAR DOCTOR K: My recent cholesterol blood test came back pretty good, but my doctor said he was worried about my high triglyceride levels. What are triglycerides? Should I be worried, and what can I do about this?

DEAR READER: When doctors perform cholesterol blood tests, they actually test for LDL ("bad") cholesterol, HDL ("good") cholesterol, total cholesterol (a combination of good and bad cholesterol), as well as triglycerides --another type of fat. Levels of triglycerides that truly are high increase your risk for pancreatitis, an inflammation of the pancreas, as well as heart disease and stroke.

Do I really need to take warfarin after getting a stent?

DEAR DOCTOR K: I recently had a stent placed and am now taking warfarin. I hear this medicine causes bleeding. Is it really necessary for me to take it?

DEAR READER: Warfarin is an anticoagulant, or blood thinner. It decreases your blood's ability to clot. There are times when we need our blood to form clots. If we cut our skin and it starts bleeding, or if an ulcer in our stomach starts bleeding, we need the bleeding to stop. When the blood forms clots, bleeding stops. On the other hand, some conditions tend to increase the tendency of the blood to clot.

What is a leaky mitral valve?

DEAR DOCTOR K: My doctor says I have a leaky mitral valve. What does this mean? And does it need to be treated if it's not causing symptoms?

DEAR READER: The four valves of your heart work like one-way swinging doors: They open and close in a perfectly timed sequence to keep blood flowing through your heart in the right direction. Your heart is a pump with four chambers. Oxygen-poor blood enters one chamber.

Do the microbes that live on our bodies cause heart disease and autism?

DEAR DOCTOR K: You recently wrote that the microbes that live on and within us might be a cause of disease. A friend told me she heard they might cause heart disease and autism. Is there any truth to that?

DEAR READER: For a long time we've known that defects in how our genes are built, and defects in whether our genes are appropriately turned on, powerfully influence whether we develop diseases. However, our human genes may not be the only genes that affect our health. Trillions of germs live on and within us, all of our lives. They live on our skin, in our mouth, in our gut and elsewhere. And they have genes, too. We call their genes, collectively, our "microbiome." Indeed, our microbiome contains about 400 times more genes than we have human genes.

Should I take a low-dose aspirin if heart disease runs in my family?

DEAR DOCTOR K: Heart disease runs in my family, and my doctor thinks I should take low-dose aspirin even though I don't have heart disease now. What do you think?

DEAR READER: Your question seems simple enough, and I wish I had a simple answer. The problem is that aspirin, like virtually all medical treatments, has benefits and risks, and they are different for one person than for another. The main risk of aspirin is bleeding. For some people, the decision to take aspirin is easy.

Heart disease runs in the family, how do I talk to my kids about what this means for them?

DEAR DOCTOR K: I had a heart attack in my 50s, and so did my dad. Heart disease obviously runs in the family. How do I talk to my kids about what this means for them?

DEAR READER: As a parent, you already know that taking care of your children is just as (if not more) important as taking care of yourself. If you have a family history of heart disease, that means teaching your children what they can and should do to prevent heart disease.

Should I eat fish, or take fish oil supplements to prevent heart disease?

DEAR DOCTOR K: Heart disease runs in my family. Should I eat fish, or take fish oil supplements?

DEAR READER: Eating fish regularly reduces a person's risk of sudden death from heart disease. It's also brain-healthy. For that reason, I and most doctors recommend a regular diet of fish for people who have heart disease. And also for people like you where heart disease runs in the family. Fish oils are rich in omega-3 fatty acids, a kind of "healthy fat."