Heart Health

I’ve been eating more salmon for its omega-3 fats. Does it matter if the salmon is farmed or wild-caught?

DEAR DOCTOR K: You've written that fatty fish like salmon are a good source of omega-3 fats. Does it matter whether the salmon is farmed or wild?

DEAR READER: Salmon and other fatty fish certainly are an excellent dietary source of omega-3 fatty acids, which lower the risk of heart disease. Many supermarkets offer both farmed and wild-caught salmon. The two types have noticeably different tastes and textures. Wild-caught also tends to be more expensive.

Is red wine good for heart health?

DEAR DOCTOR K: I've heard that drinking red wine, or any alcoholic beverage, in moderation is "heart-healthy." Is it true, and is red wine any healthier than other alcoholic beverages?

DEAR READER: There are many studies of the two questions you ask. As for the first question, most studies have found that moderate drinkers are less likely to develop Type 2 diabetes and heart disease. That's when moderate drinkers are compared either to non-drinkers or to heavy drinkers.

I have a heart condition. What do I need to know before I get pregnant?

DEAR DOCTOR K: I have a heart condition. What do I need to know before I get pregnant?

DEAR READER: When a woman is pregnant, her heart is working for two. Blood passes through her placenta to her baby. This places additional demands on her body's circulatory system, particularly the heart. Among other changes, her heart pumps a much higher volume of blood each minute. As a woman with a heart condition, it's particularly important for you to understand what this added workload might mean to your health, and to your baby's.

Has the SPRINT trial led to a change in blood pressure goals?

DEAR DOCTOR K: A few months ago, I read that results from a big trial were going to change blood pressure treatment goals. Where do things stand now?

DEAR READER: I'll bet you're referring to SPRINT. In September 2015, the National Institutes of Health (which funded the study) reported that the study had been stopped earlier than planned because its results were clear. Recently, the complete report of the study (called SPRINT) and its results was published in The New England Journal of Medicine.

Is it safe to take ibuprofen after an angioplasty?

DEAR DOCTOR K: I had angioplasty with a stent recently. I need to take aspirin and Plavix every day. I used to take ibuprofen for pain, but a neighbor said I shouldn't take it if I'm on aspirin and Plavix. Is that right?

DEAR READER: Taking aspirin and Plavix after angioplasty and stent placement is standard care. Both aspirin and clopidogrel (Plavix) attach to blood cells called platelets to make them less sticky. You need these drugs to prevent the formation of a blood clot inside the stent. If a clot forms in the stent, it can suddenly cut off the blood supply and cause a major heart attack.

Do drugs that raise good cholesterol reduce the risk of heart disease?

DEAR DOCTOR K: I have high levels of HDL cholesterol -- the "good" cholesterol. I was happy about that, but now I hear that medicines raising your HDL levels don't seem to help. Should I be disappointed?

DEAR READER: The HDL cholesterol story is complicated. It has been solidly established that people who have high levels of LDL (bad) cholesterol have a higher risk of developing heart disease. Moreover, it has been solidly established that treatments that lower LDL cholesterol reduce the risk of developing heart disease.

Does radiation therapy for cancer increase heart disease risk?

DEAR DOCTOR K: I had radiation therapy for breast cancer a few years ago. Now I'm reading that radiation therapy might increase my risk for heart disease. Is this true? Can I do anything to decrease my risk?

DEAR READER: Radiation therapy uses high-energy rays to damage or destroy cancer cells. It harms cancer cells primarily by damaging their genes. But the radiation can also damage the genes of healthy non-cancerous cells.

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.