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Cardiac cure-alls: Sorting fact from fiction

» Should I be taking an aspirin a day?

» Will niacin supplements help control my cholesterol?

» What are the facts on fish oil?

» What’s the fuss over vitamin E?

Behind the headlines

How can you sort reliable medical news from nonsense? Here are a few tips:

  • Look for the source of the information. It’s more credible if it comes from a well-known medical institution or was originally published in a respected medical journal.
  • Do some number crunching. Phrases like “a 50 percent increase” may sound impressive, but what are the real numbers? For example, 50 percent of 10 does not amount to much.
  • Weigh the results. It usually takes many studies to confirm a theory. Remember that before the results of a single study move you to make a drastic lifestyle change.

If medical news raises more questions than answers, talk to your doctor. The American Heart Association is also glad to answer questions about heart-health headlines. You can reach them at 1-800-AHA-USA1.

Cardiovascular disease. Controversy. Confusion. They may as well be synonyms when it comes to interpreting reports that promise to keep heart disease away—or at least fix it fast. What’s the truth about aspirin therapy, fish oil, niacin and other widely publicized cardiac cure-alls? Keep reading to find out.

Should I be taking an aspirin a day?

If you have coronary artery disease or have had a heart attack, an ischemic stroke or bypass surgery, the answer may be yes. That’s because by inhibiting the activity of platelets (one of the clot-forming components of blood), aspirin may help prevent further attacks. And taken in the first hours of a heart attack, aspirin may well be lifesaving.

Daily aspirin can also help prevent first heart attacks in people at high risk. Women ages 65 and older should consider aspirin therapy even if they have no other cardiovascular risk factors.

On the other hand, aspirin’s anticlotting effect may make a daily dose dangerous for people who have had a hemorrhagic stroke or who are already taking anticoagulant medication. Aspirin therapy may also be unsuitable for those with stomach ulcers, uncontrolled high blood pressure, liver or kidney disease or any other condition that may increase the risk of internal bleeding.

By the way, don’t take a daily dose of aspirin as a preventive measure without talking to your doctor first.

Will niacin supplements help control my cholesterol?

Niacin, a B vitamin, has been touted as an easily available remedy for high cholesterol. Trouble is, to achieve the desired effects—lower levels of LDL (“bad”) cholesterol and higher levels of HDL (“good”) cholesterol—you’d have to take more than 1,000 milligrams a day. Not only is that way over the government’s RDA, but it can also cause side effects ranging from nausea and wartlike spots to liver damage and elevated blood-sugar levels.

The bottom line: It’s not safe to swallow niacin supplements by the handful. While niacin remains a treatment option for high cholesterol, experts agree that it’s best taken under a doctor’s supervision.

What are the facts on fish oil?

If you want to keep your heart healthy, eating fish rather than taking fish-oil capsules is the best bet for most people. While omega-3 fatty acids (found in certain cold-water fish and available in capsule form) can help lower blood triglyceride levels and decrease the growth of plaque in your arteries, they have little effect on cholesterol levels. What’s more, to see an improvement in triglycerides you have to take megadoses of fish oil—an expensive and risky proposition: Fish-oil capsules are high in calories, and many contain large amounts of vitamin A, which can lead to a dangerous buildup of the vitamin in the body. The blood-thinning effect can also be harmful for people taking anticoagulants. Eating fish at least twice a week, on the other hand, is an American Heart Association (AHA)-approved way to lower your fat intake and control cholesterol. In fact, in a 30-year study of nearly 2,000 middle-aged men, those who ate an ounce of fish a day were more than 40 percent less likely to have a heart attack than men who ate no fish.

If you already have coronary artery disease or need to lower your triglyceride level, high doses of omega-3’s from fish-oil capsules might be right for you, but only under your doctor’s supervision.

What’s the fuss over vitamin E?

To hear past reports tell it, vitamin E can delay the onset of Alzheimer’s disease, boost the immune system and protect against cancer. It’s long been rumored to confer heart-health benefits as well. Animal studies suggest that by slowing oxidation—the changes that occur when cells are exposed to oxygen—vitamin E makes it harder for fat cells to enter the bloodstream. That, in turn, helps slow the development of atherosclerosis. Two human studies bolster the case for E, linking it to a 40 percent reduction in heart disease. Now for the downside: You couldn’t possibly eat enough vitamin E-rich foods to get the quantity used in the studies (at least 400 IU a day). Of course, you could get the vitamin in supplement form—however, be warned that doses above 1,000 IU a day have been linked to bleeding disorders, stroke and liver problems. For those reasons, the AHA does not recommend the use of vitamin E supplements to prevent cardiovascular disease.

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