For Your Heart, Watch the Summertime Heat

When summer arrives, you may wonder how to stay cool as temperatures rise. Dehydration, heat exhaustion, and heatstroke can be a concern for people with heart trouble?especially heart failure. That?s because your heart may have difficulty pumping blood to your skin, where heat is released. Your medication may make it harder to sweat, too. Sweating also helps you cool off.

Seek out the cool

The best way to cool off is to get to an air-conditioned environment. If your home is not air-conditioned, head to the mall, library, or movie theater.

Try these tips, too:

• Plan activities for early morning or late evening.

• Shower, bathe, or sponge yourself off with cool water.

• Wear loose, lightweight, light-colored clothes.

Stay hydrated

If you?ve been sweating, your body probably needs more fluid. Experts usually suggest drinking electrolyte drinks or freezer pops in warm weather. But some people with heart problems need to limit their fluid intake. So be sure to check with your health care provider about whether it is safe for you to drink more fluids when it's hot out.

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Heart Failure: After Hospitalization

Being in the hospital for heart failure can be a difficult and frightening experience. Once you?re back at home, you may worry about your health. Here?s how you can stay healthy and prevent the problems that lead to a stay in the hospital.

Eat healthy foods

You?ll need to consume less salt and sodium. Try to eat fewer fast foods and packaged foods, such as canned soups, frozen meals ("TV dinners")?and snack foods, which are high in sodium. Anything brined, such as pickles or olives, should be avoided. Canned vegetables are often high in sodium, even if they don't taste salty. Frozen vegetables are generally preferable, so long as no salt was added. It goes without saying that you should not add salt to your food, and a good general rule is that if a condiment, such as soy sauce, tastes salty, it probably contains too much sodium and should be avoided. Avoid foods high in saturated fat. Read food labels to see how much sodium is in the product. Ask your health care provider whether it?s safe for you to drink alcohol.

Manage medications

Be sure that you know what each of your medications is for, when to take it and how much to take. Find out whether you should continue taking all the medications you were taking before you were admitted to the hospital. If a medication type or dose has changed, taking previously prescribed medications may cause problems. It?s a good idea for a family member to know this information, too. A timer that rings or vibrates or a divided pillbox can help you remember to take your medications. Bring a current list of all your medications, including doses and when you take them, to each doctor's appointment. If you do not have a list, bring all your pill bottles. Also let your health care provider know what over-the-counter and herbal medications (if any) and what dietary supplements you are taking.

Weigh yourself

One of the best ways to tell if your treatment is working involves your bathroom scale. Sudden weight gain is a sign that your heart is having trouble. A change in medication may be all that?s needed to get you back on track. Weigh yourself every day, or as often as your provider tells you to. Call your provider if you gain more than two pounds in a day, five pounds in a week or another amount that your provider has asked you to report.

Check blood pressure

By checking your blood pressure at home, you can catch problems early. Your provider or pharmacist can help you choose a home monitor and show you how to use it. Ask your provider what your blood pressure numbers should be and when to call him or her if your numbers are high.

Balance activity and rest

Make time in your day for naps and putting your feet up. You may need to start small with exercise, such as walking to the mailbox and back. Work with your provider to make a plan for safe exercise.

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A Little Chocolate May Do the Heart Good

TUESDAY, March 30 (HealthDay News) -- For those who believe in the Easter bunny (or at least in what he is believed to bring), good news awaits.

Just one small square of chocolate a day might help lower your blood pressure and reduce your risk for heart disease.

After analyzing the diet and health habits of 19,357 people, aged 35 to 65, for at least 10 years, German researchers found that those who ate the most chocolate (an average of 7.5 grams, or 0.3 ounces, a day) had lower blood pressure and were 39 percent less likely to have a heart attack than those who ate the least amount of chocolate (an average of 1.7 grams, or 0.06 ounces, a day).

"To put that in terms of absolute risk, if people in the group eating the least amount of chocolate [of whom 219 per 10,000 had a heart attack or stroke] increased their chocolate intake by 6 grams [0.2 ounces] a day, 85 fewer heart attacks and strokes per 10,000 people could be expected to occur over a period of about 10 years," study leader Dr. Brian Buijsse, a nutritional epidemiologist at the German Institute of Human Nutrition, said in a news release from the European Heart Journal, which published the findings online Tuesday.

"If the 39 percent lower risk is generalized to the general population, the number of avoidable heart attacks and strokes could be higher because the absolute risk in the general population is higher," he said.

Six grams of chocolate is equivalent to about one small square of a 100 gram (3.5 ounce) bar, the researchers said.

But Buijsse cautioned that eating chocolate shouldn't increase a person's overall intake of calories or reduce the consumption of healthy foods.

"Small amounts of chocolate may help to prevent heart disease, but only if it replaces other energy-dense foods, such as snacks, in order to keep body weight stable," he said.

More information

The American Heart Association has more about preventing heart disease, heart attack and stroke.

SOURCE: European Heart Journal, news release, March 30, 2010

A Little Chocolate May Do the Heart Good

TUESDAY, March 30 (HealthDay News) -- For those who believe in the Easter bunny (or at least in what he is believed to bring), good news awaits.

Just one small square of chocolate a day might help lower your blood pressure and reduce your risk for heart disease.

After analyzing the diet and health habits of 19,357 people, aged 35 to 65, for at least 10 years, German researchers found that those who ate the most chocolate (an average of 7.5 grams, or 0.3 ounces, a day) had lower blood pressure and were 39 percent less likely to have a heart attack than those who ate the least amount of chocolate (an average of 1.7 grams, or 0.06 ounces, a day).

"To put that in terms of absolute risk, if people in the group eating the least amount of chocolate [of whom 219 per 10,000 had a heart attack or stroke] increased their chocolate intake by 6 grams [0.2 ounces] a day, 85 fewer heart attacks and strokes per 10,000 people could be expected to occur over a period of about 10 years," study leader Dr. Brian Buijsse, a nutritional epidemiologist at the German Institute of Human Nutrition, said in a news release from the European Heart Journal, which published the findings online Tuesday.

"If the 39 percent lower risk is generalized to the general population, the number of avoidable heart attacks and strokes could be higher because the absolute risk in the general population is higher," he said.

Six grams of chocolate is equivalent to about one small square of a 100 gram (3.5 ounce) bar, the researchers said.

But Buijsse cautioned that eating chocolate shouldn't increase a person's overall intake of calories or reduce the consumption of healthy foods.

"Small amounts of chocolate may help to prevent heart disease, but only if it replaces other energy-dense foods, such as snacks, in order to keep body weight stable," he said.

More information

The American Heart Association has more about preventing heart disease, heart attack and stroke.

SOURCE: European Heart Journal, news release, March 30, 2010

Stents May Be Effective Weapon Against Stroke

FRIDAY, Feb. 26 (HealthDay News) -- Both stents and conventional surgery appear to be equally effective in preventing strokes in people whose carotid arteries are blocked, according to research presented Friday at the American Stroke Association's annual meeting in San Antonio.

However, a second stents-versus-surgery trial, published Thursday in The Lancet, seemed to give surgery better marks, so the jury may still be out on which approach is better in shielding patients from stroke.

"I think both procedures are excellent and I'm happy to say we have two good options to treat patients," said Dr. Wayne M. Clark, professor of neurology and director of the Oregon Stroke Center, Oregon Health Sciences University in Portland, and a co-author of the stroke association study.

"I think the [ASA] trial is really a positive for both stenting and surgery," said Dr. Craig Narins, associate professor of medicine at the University of Rochester Medical Center in New York, who was not involved with the study. "I think this is going to change the way that physicians look at carotid artery disease."

That study, the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), was funded by the U.S. National Institute of Neurological Disorders and Stroke and Abbott, which makes the carotid stents.

"There has been a lot of skepticism about the ability of stenting to equal surgery and this trial pretty nicely shows that it does equal it overall," Narins added.

But the findings from CREST need to be squared with the second trial, the International Carotid Stenting Study (ICSS). That European trial found that surgery remained superior to stenting in the short-term, and stenting did not appear to be as safe as surgery.

"They're very similar studies, although the European [ICSS] study didn't use embolic protection devices which are the standard of care in the U.S. That could have skewed the results," Narins said. Embolic protection devices are tiny parachute-like devices placed downstream from a stent to safely catch dislodged materials.

Nevertheless, he added, "nothing is going to change overnight. It's a sea change because surgery has been the standard of care for so long. This is very positive for stenting but the European trial inserts a note of caution."

In carotid endarterectomy (CEA) surgery, doctors scrape away the built-up plaque that is causing a narrowing of the artery supplying blood to the brain.

In contrast, the stenting procedure involves inserting a wire mesh device to prop the artery open.

Carotid artery disease is one of the leading causes of stroke and occurs when the arteries leading to the brain become blocked.

The CREST study is the largest clinical trial comparing these two approaches. In all, 2,502 patients were randomly picked to receive either CEA surgery or carotid artery stenting.

The researchers did use embolic protection devices for the stenting procedure, Clark said.

Overall, there was no difference between the two procedures, Clark said, with a 7.2 percent risk of stroke, heart attack and death in the stenting arm of the trial, versus 6.8 percent for surgery. The mean follow-up was 2.5 years.

In the first 30 days after the procedures, there also was little difference in heart attack, stroke or death risk between the two procedures overall: 5.2 percent with stenting and 4.5 percent with surgery.

Death rates were low in both groups, although the rate of all strokes (small, medium, large) was higher in the stented group, 4.1 percent versus 2.3 percent. The rate of large strokes was the same.

Heart attack rates were higher in the surgery group compared with the stenting group (2.3 percent versus 1.1 percent), which, said Clark, was "highly significant."

The overall findings applied to both patients with symptoms and those without symptoms and to men and women, said study lead author Dr. Thomas Brott, professor and director of neurology at the Mayo Clinic in Jacksonville, Fla.

Surprisingly, "there was a slight advantage to surgery for those over 70 which became greater for those as they got older," Brock added. "There was an advantage for those under the age of 70 which got greater as one was younger from that particular point."

In the ICSS trial, which involved over 1,700 patients followed for four months, risks for stroke, heart attack or death were higher in the stented group (8.5 percent) versus those who got the artery-scraping surgery (5.2 percent).

Based on those findings, researchers led by Martin Brown, of The National Hospital for Neurology and Neurosurgery, London, concluded that "completion of long-term follow-up is needed to establish the efficacy of treatment with a carotid artery stent compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for symptomatic patients suitable for surgery."

In the end, approaches to clearing clogged carotid arteries may be decided on a case-by-case basis, Narins said.

"I think patient preference will play a big role but older patients may do better with surgery and younger patients may prefer the less invasive option," he said.

More information

There's more on carotid artery disease at the American Heart Association.

SOURCES: Craig Narins, M.D., associate professor, medicine, University of Rochester Medical Center, Rochester, N.Y.; Feb. 25, 2010, news conference with Wayne M. Clark, M.D., professor of neurology and director, Oregon Stroke Center, Oregon Health Sciences University, Portland, and Thomas G. Brott, M.D., professor and director of neurology, Mayo Clinic, Jacksonville, Fla.; Feb. 25, 2010, news release, The Lancet