Doctors have long assumed that saturated fat and cholesterol in red meat are what raise the risk of heart disease. But a study in the journal Nature Medicine fingers another culprit: carnitine, a compound abundant in red meat that also is sold as a dietary supplement and found in some energy drinks.
Carnitine typically helps the body transport fatty acids into cells to be used as energy. But researchers at the Cleveland Clinic found that in both humans and mice, certain bacteria in the digestive tract convert carnitine to another metabolite, called TMAO, that promotes atherosclerosis, or a thickening of the arteries.
The researchers, led by Stanley Hazen, chief of cellular and molecular medicine at the Cleveland Clinic’s Lerner Research Institute, tested the carnitine and TMAO levels of omnivores, vegans and vegetarians, and examined records of 2,595 patients undergoing cardiac evaluations. In patients with high TMAO levels, the more carnitine in their blood, the more likely they were to develop cardiovascular disease, heart attacks, stroke and death.
Many studies have linked consumption of red and processed meat to cardiovascular disease and some cancers. The Harvard School of Public Health reported last year that among 83,000 nurses and 37,000 male health professionals followed since the 1980s, those who consumed the highest levels of red meat had the highest risk of death during the study, and that one additional serving a day of red meat raised the risk of death by 13 percent.
The new findings don’t mean that red meat is more hazardous than previously thought. But they may help explain the underlying risk of eating red meat, which some researchers have long thought was higher than the saturated fat and cholesterol content alone could explain.


A silent heart attack is a heart attack that has few, if any, symptoms. You may have never had any symptoms to warn you that you’ve developed a heart problem, such as chest pain or shortness of breath. Some people later recall their silent heart attack was mistaken for indigestion, nausea, muscle pain, or a bad case of the flu.
The risk factors for having a silent heart attack are the same as having a heart attack with symptoms. The risk factors include:
-Smoking or chewing tobacco
-Family history of heart disease
-High cholesterol
-Lack of exercise
-Being overweight

Having a silent heart attack puts you at a greater risk of having another heart attack, which could be fatal. Having another heart attack also increases your risk of complications, such as heart failure.
If you wonder if you’ve had a silent heart attack, talk to your doctor. A review of your symptoms, health history and a physical exam can help your doctor decide if more tests are necessary. The only way to tell if you’ve had a silent heart attack is to have additional tests, such as an electrocardiogram, echo-cardiogram or other imaging tests. These tests can reveal changes that signal you’ve had a heart attack.

When do you need to wear a Holter Monitor?

If you have signs or symptoms of a heart problem, such as an irregular heartbeat (arrhythmia), your doctor may order a test called an electrocardiogram. An electrocardiogram is a brief, noninvasive test that uses electrodes taped to your chest to check your heart’s rhythm.
However, sometimes an electrocardiogram doesn’t detect any irregularities in your heart rhythm. If your signs and symptoms suggest that an occasionally irregular heart rhythm may be causing your condition, your doctor may recommend that you wear a Holter monitor for a day or so.
The Holter monitor may be able to detect irregularities in your heart rhythm that an electrocardiogram couldn’t
, since an electrocardiogram usually takes only a few minutes.
Your doctor may also order a Holter monitor if you have a heart condition that increases your risk of an abnormal heart rhythm, such as hypertrophic cardiomyopathy. Your doctor may suggest you wear a Holter monitor for a day or two, even if you haven’t had any symptoms of an abnormal heartbeat.

What Does Stress Testing Show?

Stress testing shows how your heart works during physical stress (exercise) and how healthy your heart is.
A standard exercise stress test uses an EKG (electrocardiogram) to monitor changes in your heart’s electrical activity. Imaging stress tests take pictures of blood flow throughout your heart. They also show your heart valves and the movement of your heart muscle.
Doctors use both types of stress tests to look for signs that your heart isn’t getting enough blood flow during exercise. Abnormal test results may be due to coronary heart disease (CHD) or other factors, such as poor physical fitness.
If you have a standard exercise stress test and the results are normal, you may not need further testing or treatment. But if your test results are abnormal, or if you’re physically unable to exercise, your doctor may want you to have an imaging stress test or other tests.
Even if your standard exercise stress test results are normal, your doctor may want you to have an imaging stress test if you continue having symptoms (such as shortness of breath or chest pain).
Imaging stress tests are more accurate than standard exercise stress tests, but they’re much more expensive.
Imaging stress tests show how well blood is flowing in the heart muscle and reveal parts of the heart that aren’t contracting strongly. They also can show the parts of the heart that aren’t getting enough blood, as well as dead tissue in the heart, where no blood flows. (A heart attack can cause heart tissue to die.)
If your imaging stress test suggests significant CHD, your doctor may want you to have more testing and treatment.

Is Drinking in Moderation Good for your Health?

Moderate alcohol use may be of most benefit only if you’re an older adult or if you have existing risk factors for heart disease, such as high cholesterol.
Women who have two or more drinks a day and men who have three or more may run into detrimental effects ranging from weight gain to relationship problems. But in smaller quantities, alcohol can actually be good for you.
A 2010 study in the Journal of the American College of Cardiology linked light drinking (defined as one drink a day for women and two for men) to significant heart benefits.
Guidelines for moderate alcohol use:
If you choose to drink alcohol you do so only in moderation — up to one drink a day for women or two drinks a day for men.
Examples of one drink include:
Beer: 12 fluid ounces (355 milliliters)
Wine: 5 fluid ounces (148 milliliters)
Distilled spirits (80 proof): 1.5 fluid ounces (44 milliliters)
Keep in mind that moderate use of alcohol doesn’t mean that using alcohol is risk-free.

Heart Diseases similar in women and men

An analysis of data from an international multicenter study of coronary computed tomography angiography (CCTA) reveals that men and women with mild coronary artery disease and similar cardiovascular risk profiles share similar prognoses. Results of the study were presented this month at the annual meeting of the Radiological Society of North America (RSNA).

“We conducted this study because we wanted to understand whether men and women with the same extent of coronary artery disease and similar risk profiles have similar or dissimilar prognoses,” said Jonathon Leipsic, M.D., FRCPC, director of medical imaging at St. Paul’s Hospital in Vancouver, British Columbia. “There is a tendency to think women’s heart disease is very different than men’s heart disease. Our data show that once plaque accumulates in the coronary arteries, the prognosis is very similar between men and women.”

Coronary artery disease occurs when the coronary arteries—the major blood vessels that supply the oxygen-rich blood to the heart muscle—begin to accumulate a buildup of fatty deposits called plaque. Over time, plaque may damage or narrow the arteries. CCTA is a noninvasive imaging test that uses computed tomography (CT) to image the amount of plaque present in the coronary arteries.

Heavy Drinking can lead to Heart Disease

Drinking more than the daily unit guidelines regularly and over a long period of time can increase your risk of developing heart disease. This is because, drinking at this level can:
-Increase the risk of high blood pressure. Drinking excessive amounts of alcohol causes raised blood pressure which is one of the most important risk factors for having a heart attack or a stroke. Alcohol is thought to do this through its effects on the kidneys and the blood vessels. Increases in your blood pressure can also be caused by weight gain from excessive drinking.
-Weaken the heart muscle. This means the heart can’t pump blood as efficiently. It’s known as cardiomyopathy and can cause premature death, usually through heart failure.
-Lead to an enlarged heart. This is a sign that the heart is unable to effectively pump blood around the body, and is known as heart failure.
Video: Coronary Artery Disease

Causes of Coronary Artery Disease

In CAD, narrowed coronary arteries limit the supply of blood to the heart muscle. If narrowing is not extensive, difficulties may occur only during physical exertion, when the narrowed arteries are unable to meet the increased oxygen requirements of the heart. However, as the disease worsens, the narrowed arteries may starve the heart muscle of oxygen during periods of normal activity, or even at rest.
-Smoking promotes the development of plaque in the arteries. Also, by increasing the amount of carbon monoxide in the bloodstream and decreasing the amount of oxygen available to the heart, smoking increases the likelihood of angina.
-High blood cholesterol levels lead to coronary artery disease.
-High blood pressure predisposes one to CAD.
-People with diabetes mellitus are at greater risk for atherosclerosis.
-Obesity may promote atherosclerosis.
-Lack of exercise (a sedentary lifestyle) may encourage atherosclerosis.
-Men are at greater risk than women for coronary artery disease, although the risk for postmenopausal women approaches that of men as estrogen production decreases with menopause.
-Women over age 35 who take oral contraceptives and smoke cigarettes have a higher risk of atherosclerosis.
-A family history of premature heart attacks is associated with greater CAD risk.
-A spasm of the muscular layer of the arterial walls may cause an artery to contract and produce angina. Spasms may be induced by smoking, extreme emotional stress or exposure to cold air.

New Chocolate that’s good for the Heart

A new chocolate that increases blood flow and reduces heart health risks could be on the shelves in months.
Tests have shown Acticoa, by Swiss company Barry Callebaut, increases the elasticity of blood vessels by one to two percent.
And with research showing that improving the elasticity of blood vessels by just one percent cuts the risk of cardiovascular disease by eight percent, this development could be good news for chocolate lovers.
Cocoa naturally contains flavanols, which are antioxidants that have been shown to benefit heart and brain health. The flavanols are usually removed during chocolate processing, but Acticoa uses a different production technique to keep them in.
This is not about artificially adding a nutrient — it is about preserving what is already present in cocoa,” spokesman Marijke De Brouwer said.
Studies also credit Acticoa chocolate with a host of other health benefits, from fighting wrinkles to sharpening the mind.


An exercise stress test may be appropriate for someone who is fit and in good general health. If you already run or walk or ride a bicycle, an exercise stress test may seem familiar to you.
How does it work?
Your heart is monitored while you walk or run on a treadmill or pedal a stationary exercise bike. Here’s what happens during the test:
Before you start the “stress” part of a stress test, a technician or nurse will put sticky patches called electrodes on the skin of your chest, arms, and legs.
-The electrodes are connected to an EKG (electrocardiogram) machine. This machine records your heart’s electrical activity.
-The technician or nurse will put a blood pressure cuff on your arm to check your blood pressure during the stress test, and you may be asked to breathe into a special tube so your breathing can be measured.
After these preparations, you’ll exercise on a treadmill or stationary bicycle. As you walk, run, or pedal, the test becomes gradually more difficult. You can stop whenever you feel the exercise is too much for you.
After the test, while you’re cooling down, the EKG continues to monitor your heart rate until it returns to normal. Generally, exercise test time is 15 minutes or less.