As some of you may know, a new definition of hypertension (high blood pressure) was recently proposed by the American Heart Association, the American College of Cardiology, and 9 other sponsoring organizations.

According to the new definition, if one’s resting blood pressure (measured properly) is more than 120/80, it should be considered “elevated.”  And if one’s BP is more than 130/80, then the person with that blood pressure should receive a diagnosis of hypertension.

Needless to say, the proposed definition has generated a lot of controversy.  If all doctors adopted the new definition, that would create millions of new patients overnight, and a third of American adults would be considered to have a chronic disease!

What’s more, anyone with a blood pressure over 120/80 would be advised to have close medical follow-ups: repeat visits every 3-6 months, according to the new guidelines.Read more

Case report (part 1 – diagnosis)

A 57-tear-old man made an appointment for an Athletic Heart SF screening.  He was feeling well.  His exercise routine included lifting weights, but also doing some light treadmill activity at the gym several times a week.

He played competitive football and basketball in high school, and played various other sports throughout his life.  He played full court basketball until 4 years ago but had to stop due to mild knee arthritis.  He had been coaching sports for many years.  For the last 1-2 years, he had noted some mild shortness of breath walking uphill.

He had no prior history of heart disease.  He was advised by his primary care physician to take blood pressure and cholesterol-lowering medications, but he declined.  He had no other chronic illnesses except for mild knee arthritis and occasional tension headaches.  He considered himself in good overall health.

During the Athletic Heart SF screening, we confirmed that his blood pressure was elevated.  We also discovered a significant aneurysm of the ascending aorta.  Left undetected and unattended, this aneurysm could rupture and lead to very serious complications: stroke, heart attack, paralysis, kidney failure, or death.Read more

Image attribution: www.volganet.ru CC.BY.SA.3.0

The adverse effect of lack of exercise on the blood pressure is well known.  A sedentary life frequently leads to chronic hypertension, and in turn, high blood pressure can lead to heart, brain, and kidney damage.

We will address the topic of chronic hypertension in a separate article.  Today, we will discuss a phenomenon called “hypertensive response to exercise” which can occur in seemingly healthy subjects who have no history of hypertension but whose blood pressure during exercise seems to increase “too much.”Read more

Image attribution: Iconshock CC BY-SA 3.0

Is your job putting you at risk of a heart attack?

As you can imagine, this question has preoccupied epidemiologists and public health specialists for decades.  But despite years of research, straightforward or clear answers are not always available for specific job descriptions.  The medical literature is usually guarded in its assessment of occupational factors leading to heart disease.

Also, if a certain job is linked to an increased risk of heart disease, the job itself may not be the cause of the problem.  For example, risk factors for heart disease (such as smoking) may be more common in certain occupations than in others, making it seem like the job itself imparts the risk.

With this in mind, below are 8 findings that have emerged from years of research:

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Image attribution: Julian Mason/Flickr.

Professional athletic trainer and sports journalist Ian MacMahan asked us that question as part of an article he published in The Atlantic Monthly magazine.

McMahan reported on recent research that raises concerns about ultra-endurance sports carried to an extreme level for many years.  Such an exercise regimen increases one’s chance of having arrhythmia, such as atrial fibrillation, and may also cause scarring in the ventricle of the heart.

Some cardiologists have sounded alarm bells, comparing such exercise regimens to a “toxin.”  In my opinion, it is not yet clear if long-term, high-intensity exercise alone is the cause of the problem, or if those affected have other factors that come into play.  Nevertheless, the research should not be dismissed.   Here are some highlights:Read more

Cardiomyopathies are very common causes of exercise-related cardiac arrest in youth and young adults, but can occur to anyone at any age.  An unfortunate example is the case of a 45-year-old seasoned runner who collapsed during a marathon last November in Tennessee.  The autopsy revealed an unsuspected cardiomyopathy.Read more

What are the coronary arteries?

The coronary arteries are the blood vessels that run on the surface of the heart, bringing blood, oxygen, and nutrients to the heart muscle.  As you can see on the image below, each coronary artery has a name that corresponds to its location on the surface of the heart.Read more