MONDAY, Jan. 12 (HealthDay News) -- Too much sodium and too little potassium in one's diet may increase one's risk of cardiovascular disease, a new study suggests.

The findings, based on a long-term analysis by the U.S. National Heart, Lung, and Blood Institute of almost 3,000 people with pre-hypertension, also suggests that increasing potassium consumption along with the common wisdom of lowering one's salt intake may reverse the risk.

Researchers found that for people with high normal blood pressure levels (120 to 139/80 to 89 mmHg), every unit increase in the person's sodium-to-potassium ratio raised his or her chance of cardiovascular disease by 24 percent.

The findings were published in the Jan. 12 issue of the Archives of Internal Medicine.

A third of American adults have high blood pressure, defined as 140/90 mmHg or higher, while another 37 percent have pre-hypertension.

More information

The American Heart Association has more about factors affecting the risk of cardiovascular disease  .

THURSDAY, Jan. 8 (HealthDay News) -- Treating patients with symptoms of clogged arteries could become more effective now that leading U.S. cardiology groups have published guidelines for deciding how best to proceed.

"Appropriate Use Criteria for Coronary Revascularization," which has been published online and in several leading heart journals, is said to be the first set of guidelines focused on treatment rather than diagnostic testing. The guidelines clarify under what conditions people with chest pain should be treated with just medication and therapy -- or with that combination plus revascularization.

Revascularization is the medical procedure in which proper blood flow to the heart is restored through bypass surgery or use of a balloon-tipped catheter that breaks up plaque in the arteries.

The guidelines categorize people by four main criteria: severity and type of symptoms; plaque levels in the arteries; amount of ischemia (how badly the heart muscle is starved for blood and oxygen, based on stress testing); and whether they already use heart medication.

"One of the strengths of this document is that it provides a framework for thinking about clinical scenarios and having a discussion about coronary revascularization," Dr. Manesh R. Patel, chairman of the appropriate use criteria writing group and an assistant professor of medicine at Duke University and the Duke Clinical Research Institute, said in a news release issued by the American College of Cardiology. "These recommendations describe when coronary revascularization would be expected to improve a patient's health status."

The guidelines were developed by a 17-member panel of experts from the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, the Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the American Heart Association and the American Society of Nuclear Cardiology. The panel examined 180 clinical scenarios to determine when revascularization or other measures were appropriate.

The guidelines call for revascularization only if the potential for health and quality-of-life improvements outweigh the possible risks. People with plaque buildup in less than three arteries and little heart muscle at risk, who experience symptoms only during strenuous exercise and are not on medication are not considered candidates for revascularization. The exception would be people already on the best available heart medication to combat severe symptoms, according to the guidelines.

In addition to helping medical professionals, the guidelines could also aid health insurers by providing proper criteria so they can develop uniform policies about payment and preauthorization and perform quality reviews of medical care, according to the news release.

More information

The U.S. National Heart, Lung and Blood Institute has more about coronary revascularization procedures.

FRIDAY, Nov. 21 (HealthDay News) -- It's one of medicine's mantras: If you have high blood pressure, taking steps to lower it will have a dramatic impact on your risk of stroke, heart disease and more.

But 70 percent of people with high blood pressure still aren't doing a good enough job controlling it, according to a U.S. Centers for Disease Control and Prevention study.

"High blood pressure is clearly associated with stroke, and it's a very preventable and treatable condition, but a lot of people still aren't doing what they should," said Dr. Keith Siller, medical director of the Comprehensive Stroke Care Center at New York University Langone Medical Center in New York City.

Almost one in three American adults has high blood pressure, which is also known as hypertension. Blood pressure is a measurement of the force exerted when the heart is beating (systolic pressure) or when the heart is at rest (diastolic pressure). Systolic is the top number and diastolic is the bottom number on a blood pressure reading.

A reading above 140/90 mmHg is considered high blood pressure, and anything between 120/80 mmHg and 139/89 mmHg is considered prehypertension, according to the U.S. National Heart, Lung, and Blood Institute. A reading below 120/80 mmHg is considered normal.

Diet, exercise, and blood-pressure lowering medications are all mainstays of blood pressure management. Many people have to take a combination of medications to properly control their blood pressure.

To assess what measures those who've been diagnosed with hypertension are taking to control their high blood pressure, government researchers interviewed almost 25,000 Americans with high blood pressure. Almost all -- 98 percent -- said they were doing at least one thing to try to lower their blood pressure.

Most also said they were taking some or all of the commonly recommended measures to control blood pressure. For example:

• 71 percent said they had changed their eating habits.
• 80 percent were limiting or eliminating the use of salt.
• 80 percent said they'd reduced alcohol consumption or abstained from drinking alcohol.
• 69 percent said they exercised.
• 73 percent were taking high blood pressure medications.

Despite these measures, just 30 percent of Americans with high blood pressure have it under control, according to the study, which was published in a recent issue of the CDC's journal, Morbidity and Mortality Weekly Report.

"The single most important thing people can do to prevent stroke is to manage their modifiable risk factors," said Dr. Bruce Silverman, a neurologist at Providence Hospital and Medical Centers in Southfield, Mich. "That means controlling blood pressure, quitting smoking, controlling blood sugar if you're diabetic, managing stress, exercising regularly, and watching your diet."

"There are so many risk factors you can't do anything about, like age or gender, but you can do something about your blood pressure, weight and stress levels, and it will significantly impact your risk of stroke," he added.

Both experts said that home monitoring of your blood pressure can help, and if your readings are consistently high, you should let your doctor know.

"People get frustrated when they're taking a medication as they should, and they still have a high blood pressure reading," Siller said. "But, sometimes it's not enough medication, or you may need more than one medication to really get your blood pressure under control."

Silverman also pointed out that "it's not about taking the medicine and hoping it goes away. Lifestyle and behavioral changes are still important. And, if you can control your weight, quit smoking, and exercise, you can make a big dent in high blood pressure on your own."

More information

To learn more about preventing stroke, visit the U.S. National Institute of Neurological Disorders and Stroke.

WEDNESDAY, Oct. 29 (HealthDay News) -- High blood levels of C-reactive protein do not increase the risk of heart disease and stroke, a new study suggests.

The inflammation-linked molecule has gained prominence in recent years as a possible marker of heart disease. But the question remained -- does the protein only reflect cardiovascular woes, or does it help cause them?

The new study, based on detailed genetics, suggests that C-reactive protein (CRP) does not help spur heart disease.

"The most likely explanation is that atherosclerosis that is not clinically manifested leads to increased CRP levels," said study author Dr. Borge G. Nordestgaard, a professor of genetic epidemiology at the University of Copenhagen. Atherosclerosis involves a thickening of arteries that can result in a blockage of blood vessels that can cause heart attacks and strokes.

Nordestgaard and his team published its findings in the Oct. 30 issue of the New England Journal of Medicine.

A number of studies have found an association between high blood levels of CRP and increased risk of heart disease and stroke -- the same sort of association that led to suspicions that high blood levels of LDL cholesterol might help cause those problems.

Years ago, the cholesterol theory was proved by controlled trials that showed that lowering cholesterol levels by dietary changes or drug treatment decreased the risk of heart disease and stroke. However, such studies are not possible with CRP because there are no drugs that affect blood levels of the protein.

So, Nordestgaard and his colleagues turned to the ultimate source for the variety between individuals' blood levels of CRP -- genetics. Some people are genetically programmed to have high levels of CRP, while others have genes giving them low levels of the protein.

The Danish researchers performed genetic studies on more than 10,000 people, looking at four variant forms of the CRP genes.

In theory, people whose genetic profile gave them high levels of CRP should have an increased incidence of ischemic diseases such as heart attack and stroke -- if the causal theory was true.

But no such relationship was found, Nordestgaard said.

"So, we cannot say that high CRP levels per se lead to ischemic vascular disease," he said.

By contrast, a study of the genes for apolipoprotein E -- a protein that governs blood levels of cholesterol -- did find such an association for people in the study. People genetically destined to have high levels of cholesterol did have a higher risk of heart disease and stroke, the study found.

But one expert said the findings should be treated with caution. Dr. Peter W. F. Wilson is a professor of medicine at Emory University and a researcher on the role of CRP as a risk factor.

The Copenhagen effort is "a definitive genetic study," Wilson said, but he added that genetics still has a limited role in assessing a person's overall risk.

"Whether you can truly say how important a genetic marker is in middle-aged adults in the modern era, when you have many other factors to consider, is not certain," he said. "My guess is that a lot of these people were being treated with statins, and that might have something to do with the results."

Statins -- drugs such as Lipitor, Pravachol or Zocor -- are taken to reduce cholesterol, but they also might affect CRP levels, Wilson noted. And there are "a fair number of lifestyle and metabolic things that increase CRP -- obesity, being female, smoking, inflammatory conditions such as arthritis," he said. "On the other side, there are medications that can lower CRP levels."

CRP does have a role as a risk factor, Wilson believes. "The question is, how broad is its effect and how should clinicians and researchers use CRP information?" he said. The results of several soon-to-be-released studies, including one that he has done, will help answer the question, Wilson said.

More information

The conventional wisdom on the role of CRP in heart disease and stroke is described by the American Heart Association  .