Peripheral artery disease (PAD) is a common circulatory problem that occurs when there is a narrowing or blockage in the arteries that supply blood to the limbs, most commonly the legs. It is estimated that around 8 million people in the United States have PAD, and the prevalence of the disease increases with age. PAD is a significant risk factor for cardiovascular disease (CVD) and is associated with an increased risk of heart attack, stroke, and other cardiovascular events, such as limb ischemia leading to amputation. In this article, we will discuss how PAD increases the risk of CVD and the underlying mechanisms that link the two conditions.


The Link between PAD and CVD


PAD is a manifestation of atherosclerosis, a condition in which plaque accumulates within the walls of arteries, causing them to become stiff and narrow. Atherosclerosis is a systemic disease that can affect any artery in the body, including those that supply blood to the heart and brain. When plaque accumulates in the coronary arteries that supply blood to the heart, it can cause coronary artery disease (CAD), which is the leading cause of death worldwide. Similarly, when plaque accumulates in the carotid arteries that supply blood to the brain, it can cause carotid artery disease, which is a major risk factor for stroke.


PAD and CVD share many common risk factors, such as age, smoking, high blood pressure, diabetes, and high cholesterol. The accumulation of plaque in the arteries is a complex process that involves inflammation, oxidative stress, and immune dysfunction, which are also involved in the development of CVD. However, the mechanisms by which PAD increases the risk of CVD are not entirely clear and are likely to be multifactorial.


One possible mechanism is that PAD can lead to reduced blood flow to the heart and brain, which can cause ischemia and hypoxia. Ischemia refers to a lack of blood supply, while hypoxia refers to a lack of oxygen supply. These conditions can lead to the development of atherosclerosis, which further narrows the arteries and exacerbates the ischemia and hypoxia. In the heart, this can lead to angina pectoris (chest pain) or myocardial infarction (heart attack). In the brain, this can lead to transient ischemic attack (TIA) or stroke.


Another possible mechanism is that PAD can cause endothelial dysfunction, which is a condition in which the cells that line the arteries (endothelial cells) do not function properly. Endothelial dysfunction is a hallmark of atherosclerosis and is characterized by reduced production of nitric oxide, which is a vasodilator that helps to regulate blood flow and prevent platelet aggregation. When endothelial cells are dysfunctional, they produce less nitric oxide, which can lead to vasoconstriction, platelet aggregation, and thrombosis. These processes can contribute to the development of CVD by causing coronary artery spasm, thrombosis, or plaque rupture.


In addition to these mechanisms, PAD and CVD may also share common genetic factors. Recent genome-wide association studies have identified several genetic loci that are associated with both PAD and CVD, indicating that there may be shared pathways involved in the pathogenesis of the two conditions. However, more research is needed to understand the genetic basis of PAD and CVD and their interactions with environmental factors.


Prevention and Treatment


Given the strong link between PAD and CVD, it is important to prevent and treat PAD as early as possible. Lifestyle modifications, such as smoking cessation, regular exercise, and a healthy diet, can help to reduce the risk of both PAD and CVD. In addition to prevention, there are treatments once the diagnosis of PAD has been established. The common treatments include medications such as statins, antiplatelet and anticoagulation agents, and blood pressure-lowering drugs can help to reduce the risk of cardiovascular events in patients with PAD. For severe atherosclerotic disease with major symptomatic blockages or occlusions, PAD, CAD and CVD are treated with both minimally invasive catheter techniques and surgical procedures.


Has your doctor advised you to include omega-3-rich food in your diet to reduce the risk of developing heart disease?


One person dies every 34 sec from cardiovascular disease in the USA with heart disease. The situation is getting grimmer every day, and doctors and researchers are working hand-in-hand to reduce the number of people developing heart ailments.


Several pieces of research have shown that including Omega-rich food in the diet can reduce the risk of developing heart disease.
Let us understand how omega-3 fatty acids reduce the risk of developing a heart attack.


Does supplementation with marine-derived omega-3 fatty acids reduce the risk of a heart attack?


The American Heart Association advocates that Americans eat fish at least twice a week to lower their risk of coronary heart disease (CHD). A diet high in marine-derived omega-3 fatty acids like Mussel oil, which includes eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), from fish and seafood sources lowers rates of inflammation and heart disease risk.


Observational studies show that men with CHD who had a previous heart attack significantly reduced their risk of a subsequent heart attack if they consumed more omega-3 fatty acids in their diet. A different trial of men with angina reported increased associations of CHD-related deaths when consuming more omega-3 fatty acids.


Aung et al. (year) published an article investigating if supplementation with marine-derived omega-3 fatty acids has any associations with reductions in fatal or non-fatal coronary heart disease in people at high risk of cardiovascular disease in the Journal of American Medical Association Cardiology. The study included a meta-analysis of 10 randomized control trials comparing people in the treatment group versus the placebo group for at least one year in populations with previous CHD, a stroke, or a high risk of developing cardiovascular disease.


The previous trials reported conflicting results without being able to substantiate support for or against omega-3 consumption. For example, the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione trial involved 11,323 recent survivors of a heart attack. Patients who took omega-3 fatty acids experienced a 10% reduction in major cardiovascular events compared to the placebo group. The Japan EPA Lipid Intervention Study (JELIS) trial involved 18, 645 participants with a total cholesterol of 243.24 mg/dL or higher. Almost 20% had a prior CHD in those who took omega-3 fatty acids, and 19% reported a reduction in CHD events. However, none of the placebo-controlled trials reported any significant decrease in CHD or mortality. Therefore, it is difficult to conclude whether omega-3 fatty acids make a substantial difference in reducing cardiovascular events compared to taking a statin.


In summary, the current meta-analysis involved 77,917 individuals who took marine-derived omega-3 fatty acids for an average of 4.4 years. These individuals showed no significant reductions in fatal or non-fatal CHD or any major vascular events (stroke, heart attack, and peripheral arterial disease). The researchers concluded that consumption of omega-3 fatty acids did not cause lower mortality or cancer. Since this was a meta-analysis, a significant amount of data was gathered together instead of individual analysis. Thus, researchers concluded that the AHA recommendation to take Omega-3 fatty acids to prevent coronary heart disease is unnecessary and shows no benefit for the consumer.



It is no secret that cardiovascular disease is both extremely common and serious. Chances are, you have been affected by cardiovascular disease in some way or another, whether it is personally or through a loved one. It should be unsurprising, then, to know that such conditions are researched tirelessly by experts in the medical field as they seek to understand, prevent, and treat these horrible diseases.


While progress has been made in the former two categories, the latter has seen tremendous strides in recent years thanks to the persistence and ingenuity of researchers. A perfect example of this creativity can be seen in a recent study that tested the effect of gout medication on the recovery of those who have suffered heart attacks.


Why did the researchers choose this particular drug and what were the results? Read on to find out!


The Study


Inflammation plays a significant role in cardiovascular diseases and events, prompting medical professionals to consider anti-inflammatory medication as a possible treatment for those who have recently experienced a heart attack. To test this theory, nearly 5,000 patients who had experienced a heart attack within 30 days were recruited.


Of these participants, approximately half were assigned to the control group that received placebo medication; the other half received colchicine, an anti-inflammatory gout medication. All participants were tracked for about two years before the data was examined and the results were compared.


The findings were as interesting as they were potentially groundbreaking. The risk of ischemic cardiovascular events in those who received the gout medication was significantly lower than those who received the placebo. This is, of course, exceptionally positive news for those who have suffered a heart attack.


It is important to note, however, that there were some negative side effects associated with the gout medication. Those included in the colchicine group experienced diarrhea at a higher rate than those in the placebo group. Worse, the colchicine group had an increased risk of pneumonia—a serious adverse event.


What it Means


Lower risk of ischemic cardiovascular events is a big deal and a huge step forward in the treatment of those who have recently experienced heart attacks. Not only are the results tangible in the immediate sense, but they also confirm a link between anti-inflammatory medication and reduced risk of cardiovascular events.


As such, this study sets the groundwork for future studies to build upon. A solid correlation has been proven, not researchers can move forward with even more treatment techniques. It may even lead to heart attack prevention methods!


While living with heart ailment can be distressing but if managed properly you can prevent serious complications. If you are looking for a cardiologist for treatment please contact Peak Heart which is one of the leading providers for heart and vascular services.


For years, doctors have encouraged aging Americans to take a daily low dose (typically 81 mg) of aspirin every day, to prevent thickening of the blood and reduce their risk of heart attacks and strokes. Low doses of aspirin are prescribed to knock out blood platelets and thin the blood, reducing the risk of forming blood clots, which can cause heart attacks, strokes, and other complications.


However, two leading cardiology groups – the American College of Cardiology (ACC) and the American Heart Association (AHA) – recently recanted that advice, saying that in most situations an aspirin a day is not necessary and may even do more harm than good.


Why the Change of Heart?


According to recent research, for low-risk adults who have no history of heart attack, stroke, or cardiac surgeries, taking a low-dose aspirin daily may cause bleeding, which is now considered a greater risk than benefit.


A 2010 St. George’s, University of London study of more than 100,000 people determined that an aspirin a day reduced heart risks by 10 percent, but that there was a 30 percent increase in life-threatening or debilitating internal bleeding. Also, they found that of those individuals who took a daily aspirin for around 6 years, 1 in 120 avoided a potential cardiovascular event, but 1 in 73 experienced potentially significant bleeding.


Even in low doses, aspirin can eat away the stomach lining, which causes bleeding and ulcers internally. Because low dose aspirin also slows down blood clotting, it also means more blood loss when external cuts and other injuries occur.


However, both the AHA and ACC continued to emphasize that a daily aspirin is important for high risk individuals – particularly those with a medical history of stroke, heart attack, or other cardiac procedures like stents or open-heart surgery. For these high-risk individuals, an aspirin a day may save their lives.


For low-to-average risk individuals, however, maintaining a healthy lifestyle is a much smarter way to protect their heart taking a low-dose aspirin. A heart-healthy lifestyle includes the following smart behaviors:


  • Not smoking or vaping and avoiding secondhand smoke.
  • Eating heart-healthy diets that include plenty of fruits and vegetables, whole grains, nuts, and lean meats and fish.
  • Limiting salt, fried foods, processed foods, sugar, and saturated fats.
  • Getting at least 150 minutes of moderate exercise per week.
  • Maintaining a healthy weight.


High Cholesterol and Diabetes


Another reason for the reduced need for daily aspirin is that overall, doctors are doing a better job at treating risk factors such as high cholesterol and diabetes.


Keeping arteries clear by controlling cholesterol is an important step to prevent heart disease. While the above healthy behaviors can often help with high cholesterol, sometimes statins – a type of medication designed to reduce cholesterol – may need to be taken for people with low-density lipoprotein cholesterol levels of 190 mg/dl or higher. Individuals with Type 2 Diabetes or who are considered to have high potential for a heart attack or stroke may also need to take statins.


In some situations, a low-dose aspirin a day may still be a good idea for people who struggle with controlling blood sugar or cholesterol. This really depends on whether or not their risk for bleeding outweighs the possible benefits of aspirin.



Have you recently been experiencing abnormal heart palpitations or chest pain? This could be an early sign of heart ailment.

Heart ailments often are accompanied by an impending fear of something fatal. Often people begin looking for a cardiologist after experiencing initial symptoms of heart ailments like chest discomfort, and palpitation. But the first question that comes to their mind is how to choose the best cardiovascular specialist to manage their heart ailments.

Since the heart is a vital organ, you must ensure that you get treated by the best cardiovascular specialists. However, choosing the best doctor for managing heart ailments sometimes becomes difficult.

While selecting the right cardiologist for you or your loved one is your decision here, are a few tips that can help to ease the selection process:

Consider the experience of the Cardiovascular specialist:


When it comes to your heart, you must make an informed decision, and choosing a doctor is one of the crucial decisions you make. While selecting a cardiovascular specialist, do consider their experience.

However, while considering the experience, you must ascertain the experience in successfully managing heart ailments.

Prefer a doctor with whom you feel comfortable to talk:

While choosing a heart specialist, you must ascertain that you are comfortable talking to the doctor about your condition. Sometimes due to gender or age, a few people hesitate to discuss their symptoms with their doctor.

The inability to discuss symptoms can sometimes cause complications. Therefore, you must choose a doctor with whom you can freely discuss your symptoms.

Ascertain the qualification of the doctor:

Before selecting a heart specialist for treatment, you must check their qualification. You must always opt for a Board certified heart specialist. The Board certification ascertains the training, skills, and experience your doctor has in managing cardiology-related issues.

Also, ensure that your doctor does not have a history of malpractice claims or disciplinary actions.

Check the hospital the doctor is associated with:

Before choosing a doctor, you must also check for the hospital they are associated with. Heart ailments can sometimes call for an emergency. Sometimes the emergency can call for hospitalization.

To ensure that your or your loved one having heart ailment gets the best care, you must ensure that they are admitted to a hospital with advanced facilities.

Also, consider choosing a doctor to ensure it is associated with a hospital that is in your close vicinity.

Check what other patients have to say about the doctor:

Before selecting a doctor, you must also check the reviews that other people have shared.

These patient reviews can help you get an insight into their experience with scheduling appointments, office environment, wait time, and office friendliness.

Also, these reviews give you an idea of how much time the doctor spends. These reviews also give you an idea of how well the doctor answers your queries about their health.


Your heart health is vital, and choosing the right cardiovascular specialist is crucial. While choosing a doctor is a critical and equally important decision. We understand that selecting a doctor is not easy, however, by considering the above-given tips, the selection process of a doctor can be made easy.



    1. How do I choose a heart specialist in Arizona?

Choosing a heart specialist in Arizona is not difficult anymore. You can choose a doctor based on the tips we have discussed above. Apart from that, you must also ensure that the chosen heart specialist, from Arizona, participates in your insurance plans. By assuring this, you can avoid spending money from your pocket.

    1. Why choose a cardiovascular specialist for women?

Post-menopause women are more prone to develop heart-related ailments. [1] But sometimes, women do not feel comfortable talking about their symptoms with the doctor. The inhibition of women to share about their personal life can cause complications. To avoid these complications women must choose a cardiologist after being sure that they are comfortable with them.

    1. Why should I choose a doctor based on my comfort?

Choose a doctor with whom you are comfortable. If you are not comfortable talking with your doctor, you will not discuss your symptoms with them. This lack of communication between you and your doctor can sometimes cause fatal health outcomes.

    1. When should I see a cardiologist?

You should visit a cardiovascular specialist if you’re experiencing:

      • An abnormal feeling that your heart is beating very fast (heart palpitations)
      • Dizziness.
      • Shortness of breath especially, while climbing stairs or uphill
      • Constant chest discomfort.
      • Unexplained swelling in the legs


    1. What are the early signs of heart ailments?

The early signs of heart ailments include:

    • Pain and discomfort in the chest
    • Sudden pain in the left side of the arm and neck. The pain
    • sometimes extends to the jaws and teeth.
    • Dizziness
    • Fatigue
    • Excessive sweating
    • Swelling in the legs
    • Consistent cough
    • Abnormal heartbeat

The Number One Cause of Death


Cardiovascular disease is the number one leading cause of deaths in the world. According to American Heart Association, 17.3 million people die due to heart disease. This figure is expected to be more than 23.6 million by the year 2030. We will examine the causes, diagnosis, and treatment of heart attacks and discuss how diet and fitness can be utilized to prevent future attacks.


What is the Difference Between a Heart Attack and Cardiac Arrest?


Often, people confuse a heart attack with cardiac arrest. Although related, the two are different conditions. A heart attack occurs after the coronary artery is blocked and prevents necessary blood and oxygen from reaching parts of the heart. These parts begin to die as a result. Cardiac arrest occurs suddenly and usually without any warning. It is the product of an electrical malfunction which makes the heart stop beating unexpectedly. A heart attack increases the risk of having a cardiac arrest.

HealthSoul - Learn The Warning Signs Of Heart Attack - Post| HealthSoul

Causes of Heart Attack


Coronary Heart Disease


Coronary Heart Disease is the most common cause of heart attacks. CHD occurs when the coronary arteries that are responsible for bringing oxygenated blood to the heart are blocked or clogged. Blocking takes place when cholesterol deposits, also referred to as plaques, build up inside the arteries. The process usually takes place over a couple of years. The plaque eventually ruptures leading to a blood clot which, if it becomes large enough, blocks blood from flowing to the heart. If not treated promptly, portions of the heart begin to die, and scar tissue replaces healthy heart tissue.


Coronary Artery Spasm


Coronary artery spasms are less common causes of heart attacks. A spasm is a severe tightening of the coronary artery. The tightening interrupts blood flow to the heart. It is not yet clear what causes these spasms, but it could be related to substance abuse, emotional stress or exposure to extreme cold.




Hypoxia is lack of enough oxygen in the blood. It is a less common cause of heart attacks, too. Levels of oxygen in the blood may decrease due to carbon monoxide poisoning or malfunctioning in the lungs. If the heart doesn’t receive enough oxygenated blood, its muscles may get damaged thus triggering a heart attack.

HealthSoul - Learn The Warning Signs Of Heart Attack - Post 2| HealthSoul

What are the Symptoms of Heart Attack?


Identifying early signs of an impending heart attack is crucial for prompt treatment. Heart attacks usually start slowly, and their symptoms will vary from one individual to another. They may include;


  1. Chest Pain – Most heart attack patients experience discomfort in their chest which manifests as pressure, fullness, squeezing or pain. The pain usually lasts a couple of minutes and may disappear and come back. It may spread to the neck, back, shoulders or head and is one of the most common symptoms of heart attack in both genders.
  2. Shortness of Breath – You may experience difficulty in breathing, which is a medical condition referred to as dyspnea. It may occur with chest pain or without chest pain.
  3. Nausea – a less common symptom of heart attacks. Sometimes it is accompanied by burping or belching. Severe nausea may lead to vomiting. This symptom is more common in women than men.
  4. Feeling tired for no reason
  5. Lightheadedness or dizziness
  6. Sweating
  7. Heartburn and indigestion
  8. Upper body discomfort


How Are Heart Attacks Diagnosed?


A doctor will inquire about your medical history and that of your family before carrying out any tests. They may also do a physical exam and a host of other tests and procedures which may include:


  1. Electrocardiogram (ECG) – The procedure records the heart’s electrical signals. It monitors its rate and rhythm and assists the doctor in detecting any irregularities in the rhythm and structure. ECG is performed when you’re exercising or during rest.
  2. Blood Tests – The doctor may use blood tests to measure the extent of the heart damage. When the cells of the heart are injured, they release cardiac enzymes into the bloodstream. Measuring the level of these enzymes will help determine the extent of the damage.
  3. Chest x-ray – To take a look at the inner structure of the heart, blood vessels and lungs, a chest x-ray is beneficial. This imaging reveals any anomalies and disorders that could be CHD related.
  4. Echocardiography – Defined as the use of sound waves and echo to create images of the heart, Echocardiography reveals details about the shape and size of the heart. Echo can detect heart muscle injury, poor blood flow and unusual contractions.
  5. Stress Test – Stress testing uses rigorous exercises or medication to raise your heart rate. The doctor then performs tests to check how your heart is responding to the demand for more blood and oxygen.


How Can You Prevent Future Heart Attacks?


A healthy lifestyle means a healthy life. Living a healthy lifestyle will not only help in preventing a heart attack but also accelerate the recovery process. Studies have revealed that eating healthy foods and exercising lowers the risk of getting a heart attack significantly. Eating anti-inflammatory foods and healthy fats reduces inflammation thus decreasing the risk of CHD. Such foods include:

  1. Fruits
  2. Vegetables
  3. Legumes and beans
  4. Herbs and spices like raw garlic and turmeric
  5. Red wine
  6. Green tea or white tea

Regular exercises also help prevent heart attacks by improving blood flow, providing cells with more oxygen, controlling blood sugar levels and managing hormones. Other home remedies may include stress reduction, quitting smoking, drinking in moderation and maintaining a healthy weight.


What is the Treatment for Heart Attack?


Treatment for a heart attack should commence as soon as possible. How quick the response is could mean life or death. That’s the reason why treatment should begin even before getting to the hospital. The most important thing is to restore the flow of blood, and it can be done using aspirin, Nitroglycerin and oxygen therapy. After the diagnosis is confirmed, the doctor may commence the following treatments:

  1. Medication – this may include pain relievers, thrombolytics, antiplatelet agents, beta-blockers, and ACE inhibitors.
  2. Coronary angioplasty and stenting – a long tube is inserted into the artery to unblock and restore blood flow.
  3. Coronary artery bypass surgery – it involves creating a new route for the blood by sewing vessels to bypass the blocked section.


Final Thoughts


You don’t have to wait for a heart attack to react. You can take preventive measures by eating healthy and exercising regularly. If you detect the symptoms outlined above or you suspect that you are going through a heart attack, you should seek medical treatment almost immediately. Every minute counts. The longer you wait, the greater the extent of the damage.

You can learn how heart attack in women is different in our blog.




  • American Heart Association

Aortic valve replacement(AVR) is the standard treatment for patients with severe symptomatic Aortic Stenosis (AS). This procedure can be carried out surgically through open-heart surgery or through a minimally invasive approach. Both procedures have their own specific indications along with risks and benefits.


Indications for Aortic valve replacement (AVR)

The identification of candidates is based on symptoms and echocardiogram findings. The American Heart Association and the American College of Cardiology have released guidelines for AVR in 2014.


Valve replacement is highly beneficial and is strongly recommended

  • Individuals who are symptomatic with severe AS with high-pressure gradient across the valve.
  • Asymptomatic individuals with severe AS and a reduction in the left ventricle ejection fraction (LVEF) to <50%. The LVEF is a measure of the function of the heart and reduction is a marker for disease progression with poor prognosis.
  • Individuals with severe AS who are planned to undergo some other cardiac surgery.


Valve replacement is beneficial and may be recommended

  • Individuals who are asymptomatic with severe AS who are at low risk from surgery.
  • Individuals with severe asymptomatic AS who experience a reduction in exercise tolerance


Choice of Valve Surgery

After the decision is made to replace the aortic valve, there are two procedures to consider

  • Surgical Aortic Valve Replacement (SAVR)
  • Transcatheter Aortic Valve Replacement (TAVR)

The patient undergoes evaluation by a multidisciplinary heart valve team which includes a cardiologist and a cardiothoracic surgeon.


Surgical Aortic Valve Replacement

This procedure involves open-heart surgery and is the treatment of choice provided the individual has a high mortality benefit and is not at increased risk of complications from surgery. This is preferred when the patient is to undergo cardiac surgery for another condition.


The procedure of Surgical Aortic valve replacement

The patient is taken to the operating room and is placed under general anesthesia. An incision is made into the chest to access the heart. The heart is stopped and the patient is placed on a heart-lung machine. The abnormal valve is removed and is replaced with a new valve. Once the procedure is complete, the patient is taken off the heart-lung machine. The skin is closed and he or she is revived from anaesthesia.


The new heart valve may be made from any of the following

  • Animal heart valves from pigs or horses
  • Metallic prosthesis
  • Valves from human cadavers


Complications of  Surgical Aortic valve replacement

  • Complications related to anaesthesia
  • Infection
  • Heart attack
  • Abnormal heart rhythms
  • Blood clot formation
  • Stroke



After the surgery, the patient is placed for a specified duration on blood thinners to prevent clot formation on the new valve and also receives antibiotics to prevent infective endocarditis, an infection of the heart valves.


Transcatheter aortic valve replacement

This is a newer procedure that is minimally invasive. This procedure carries fewer risks and is the treatment of choice in patients who have contraindications to surgery. The benefits of TAVR are faster recovery and fewer days spent in the hospital as compared to SAVR. The long-term effects of TAVR appear to be favorable, however further studies and trials are required to recommend TAVR as first-line therapy.


There are 3 approaches to access the heart to perform this procedure

  • Transfemoral: the catheter is inserted through a puncture in the femoral artery located in the groin.
  • Transapical: A small cut is made between the ribs on the left side of the chest overlying the apex of the heart.
  • Transaortic: A small cut is made in the upper part of the chest at the level of the aorta.

The patient is usually sedated through the procedure and is given a local anesthetic to numb the pain from the cut. Heparin, a blood thinner is injected to prevent clot formation. A dye is inserted via the catheter and repeated images are taken to visualize the location of the tip. At the correct level, the catheter releases the new valve which expands and fits into position. The catheter is withdrawn.


Complications of TAVR

  • Bleeding
  • Incorrect positioning of the valve
  • Blood clots
  • Stroke
  • Heart attack
  • Abnormal heart rhythm



Following the procedure, the individual is placed on medicines to prevent blood clots and to prevent infection of the new valve. To prevent clots, generally, two drugs, one of which is aspirin, is given for 3 to 6 months followed by lifelong aspirin.


Cardiovascular disease (CVD) is the primary cause of a higher death rate across the world. In the U.S., CVD accounts for approximately 600,000 deaths every year. Although there was a constant decline over the last five decades, its frequency is rising again.

Among multiple risk factors, low physical activity is considered the major contributor to poor cardiovascular health. Hence, the American Heart Association recommends a range of 75-150 minutes/week of vigorous physical activity or 150-300 minutes/week of moderate physical activity, or a combination of both. However, it was unclear whether performing a higher level of moderate and vigorous exercise could reduce mortality risks.


The Study

A team of researchers performed a research analysis study involving more than 100,000 adults over a 30-year follow-up period (1988-2018), which was published in the journal Circulation in 2022.

The average age of the participants was 66 years where more than 96% were white adults and 63% were females. These participants were asked to complete a validated questionnaire study every two years where they reported their health information, family medical histories, personal habits, and frequency of physical activities including the average time spent per week.

Moderate physical activities include walking, weightlifting, lower-intensity exercise, and calisthenics while vigorous physical activities include running, jogging, bicycling, and swimming.


The Findings

Duration of exercise (min/wk)

Reduction in mortality risk (%)


CVD mortality

Non-CVD mortality

Overall mortality

150-300 (Moderate)




75-150 (Vigorous)




300-600 (Moderate)




150-300 (Vigorous)





What It Means

People who performed 2-4 times the weekly recommended moderate or vigorous physical activity had a significant reduction in CVD-related mortality rate.

Although this study supports national physical activity guidelines, it further recommends performing medium to a high level of either moderate or vigorous physical activity or a combination of both every week to achieve maximum overall health benefits. The bottom line is to set realistic goals and start doing physical activity consistently by selecting the right amount and intensity.

For more guidance on physical activity, you can consult with one of our experienced cardiologists through a virtual visit or in person at one of our clinic locations. To schedule an appointment, call Peak Heart & Vascular in Surprise, Avondale, Flagstaff, or Phoenix, Arizona, or connect online to submit an appointment request for an in-office or virtual visit.




Fewer than 1 out of 14 American adults have optimal heart and metabolic health according to the recent July 2022 study published in the Journal of the American College of Cardiology. The research evaluated heart health trends and disparities compared to 20 years ago.

Researchers from the Friedman School of Nutrition Science and Policy at Tufts University assessed more than 55,000 adults aged 20 and older from the past 10 cycles of the National Health and Nutrition Examination Survey (NHANES). The duration considered for this study was from 1999-2000 to 2017-2018. Along with the heart disease diagnosis, this research study assessed four more indicators such as blood sugar level, body fat level, blood cholesterol, and blood pressure level. It was shocking to know that only 6.8 percent of them had excellent levels of above five indicators with significant differences across sex, age groups, race/ethnicity, and education levels.

Among these components, blood glucose and adiposity worsened significantly between 1999 and 2018. When 1 in 3 adults had optimal adiposity levels in the year 1999, this number got reduced to 1 in 4 by 2018. Similarly, 3 out of 5 had neither diabetes nor prediabetes in the year 1999. By 2018, less than 4 out of 10 were free from diabetes and prediabetes.

Between the years 1999 and 2018, cardiometabolic health declined among all groups, especially Hispanic and Black Americans. Among non-Hispanic White Americans, the rate of proper heart health improved slightly although it remained low.

Optimal Cardiometabolic Health Was Poorest Among:


  • Men compared to women
  • People aged 65+ compared to those between 20 to 34 years of age
  • Mexican Americans compared to non-Hispanic White Americans
  • Adults with lower educational attainment than higher educational attainment

While evaluating the indicators, the greatest decline was observed in glucose and adiposity levels.

Outcomes of Cardiometabolic Health Indicators:

A separate June 2022 study, using the American Heart Association’s new Life Essential 8 metrics, reported that only 1 in 5 U.S. individuals have ideal heart health. In this study, physical activity, diet intake, sleep duration, nicotine exposure, blood glucose, blood pressure, blood lipids, and body mass index were considered to assess the overall cardiovascular health. While assessing the heart health of more than 23,400 people in the U.S. during the 2013-2018 U.S. National Health and Nutrition Examination Survey, 80 percent were found with a poor or moderate heart health condition.

Reasons for Worsening Cardiometabolic Health:

The trend of worsening cardiometabolic health should not be a shocking surprise since the following factors seem to be the usual lifestyle for many people in the U.S.

  • Unhealthy diet patterns include foods and beverages rich in salt, sugar, calories, and saturated fat
  • Alcohol intake
  • Little or no physical activity
  • More hours of screen time
  • Little or too much sleep


Final Thoughts

As these cardiovascular health outcomes prove to be a crisis for everyone, the urgent need of the hour is to improve cardiometabolic health. Although it’s impossible to regain cardiometabolic health overnight, cardiology specialists will have to treat the problem at the personal, clinical, as well as community level.

Contact Us

Searching for cardiology specialists near you? Visit Peak Heart & Vascular to make sure your cardiovascular health is in ideal condition. You can either call Peak Heart & Vascular at 602-698-PEAK or submit an online request form. Consult our experienced cardiology specialists through a virtual visit or in-person at one of our 10 clinic locations conveniently located across Arizona.


Study Shows that Poor Sleep Leads to Plaque Buildup and Poor Cardiovascular Health

It makes sense, doesn’t it? A good night’s sleep is good for you-you to feel better, more rested. But now, a study is showing that a good night’s sleep means more for your health than you might have ever imagined.

According to a study from the Journal of the American College of Cardiology, it’s thought that lower sleeping times – and fragmented sleep times, for that matter – are independently associated with an increased risk of subclinical multi-territory atherosclerotic plaque in the carotid.

In laymen’s terms, this means that poor, interrupted, and low-quality sleep has been linked to plaque buildup in the heart, negatively affecting a person’s cardiovascular health.



In this study, seven-day sleep recordings were performed on almost 4,000 patients. These patients were divided into separate groups, each characterized by sleep durations and fragmentations; very short durations (less than six hours), short sleep durations (six-seven hours), reference sleep durations (seven-eight hours), and long sleep duration (over eight hours).

What did this study deduce? 


In short, very short sleep duration was independently associated with a higher atherosclerotic burden. In other words, a link to plaque buildup in arteries was linked back to those who had the shortest sleep durations, supporting the theory that shorter, interrupted, lower-quality sleep durations tend to result in poorer cardiovascular health. We already know the relationship between sleep apnea and heart health, this study establishes the strong link between lack of sleep and heart health.

What Does this Mean for Your Health? 


As we stated above, irregular sleep, poor sleep, or infrequent sleep can lead to the increase in the development of plaque in your arteries in your heart, but more than that, this can lead to an increase in damaging plaque increases throughout your entire body.

The issue with an increase in plaque throughout your body (especially in your heart)? It dramatically reduces your health and puts you at extreme risk for dangerous, damaging health conditions and issues. For example, a buildup of plaque in your body can lead to issues with digestion, circulation problems, extremity pain, and even put you at increased risk for strokes and heart diseases. Further, lack of sleep can lead to issues like depression or anxiety, as well as play a huge role in diseases like dementia and Alzheimer’s.

How You Can Sleep Better


The easiest fix here? Sleeping for longer, more uninterrupted periods of time. Note that there are far more factors that affect your heart health than just your sleep schedule, but it certainly can help better your overall health to promote better productive sleep.

Are you looking for ways to ensure you’ll sleep better? Try setting an alarm to remind yourself of when you should be getting to bed (and try to stick to it!). It helps to establish a set, bedtime routine to get your body regimented and prepared for a regulated sleep schedule. Still struggling to get better sleep? Try to implement healthy tricks like walking, biking, or aerobic exercise to improve the quality of your sleep, too!


High cholesterol effects 38% of American adults and proves to be a key trigger for the onset of cardiovascular disease such as coronary heart disease, stroke, and peripheral vascular disease. High cholesterol also increases the risk of diabetes and high blood pressure. The underlying cause is that high cholesterol leads to plaque buildup inside your blood vessels limiting blood flow.

A proper nutritious diet and regular exercise can help in managing cholesterol. However, your physician might also prescribe medication to reduce your cholesterol level. Among cholesterol-lowering medications, physicians often opt for statins.

As stated by the Centers for Disease Control and Prevention (CDC), statins can effectively reduce LDL cholesterol (bad cholesterol) by slowing down cholesterol production from the liver. Furthermore, they can improve the ability of the liver to eliminate LDL cholesterol from the blood.

Hence, statins are recommended as the first-line drugs to prevent the onset of heart attack or stroke. The CDC statistics reported that nearly 93% of adults using cholesterol-lowering medications used a statin. However, not everyone is the right candidate for statin therapy.

Side effects such as liver problems or muscle pain can cause difficulty to take statins. Fortunately, there are other medications to reduce bad cholesterol and increase good cholesterol (HDL cholesterol) that your physician may prescribe.

Injectable Alternative to Statins

PCSK9 inhibitor, a new class of injectable drugs, is an antibody that targets PCSK9 protein and inhibits its ability to work. They can significantly improve the liver’s ability to eliminate stubborn LDL cholesterol from the blood by reducing overall LDL cholesterol levels. Thus, these cholesterol-lowering injectable drugs can reduce the risk of stroke or heart attack.

As published in the Physicians’ Academy for Cardiovascular Education news, PCSK9 inhibitors could help reduce LDL cholesterol by as much as 75 percent when used in combination with statins.

Who are the best candidates for PCSK9 inhibitors treatment?

  • Patients who have the most difficult-to-treat LDL cholesterol levels who are at high risk for cardiovascular disease.
  • Patients with familial hypercholesterolemia(a genetic disorder that increases the level of cholesterol at an early age).
  • Patients with atherosclerosis (an arterial disease caused by the fatty deposit on the inner walls).
  • Patients who are intolerant to statins.

Newest Inhibitor Treatments

Recently, the US Food and Drug Administration (FDA) approved Repatha (evolocumab)‎ and Praluent (alirocumab)‎ injections under PCSK9 inhibitors. They can be used alone or in conjunction with lifestyle changes and other cholesterol-lowering medications.

Both Praluent and Repatha are given as subcutaneous injections (delivered just under the skin). However, Praluent and Repatha come in different strengths and formulations. In addition, Praluent is not FDA approved for use in patients under 18 years old. Repatha, however, is FDA approved to treat children aged 10 years and older.

Both treatments are effective medications to help lower LDL cholesterol and decrease the risk of heart attack, stroke, or chest pain. They are similarly effective when used in combination with statin medications or other cholesterol-lowering drugs. One drug may be preferred over the other depending on different factors, such as price, potential side effects, and allergies.

The most common minor side effects of these treatments include:

  • Back or muscle pain
  • Cold or flu-like symptoms
  • Pain at the injection spot
  • Redness, swelling or bruising

PCSK9 inhibitors are a safe and effective adjunct to lifestyle changes and statin treatment in patients who are in need of a drastic reduction in LDL-C levels.

Contact Us

You can consult with one of our experienced cardiologists through a virtual visit or in person at one of our 10 clinic locations conveniently located throughout the valley and Northern Arizona. To schedule an appointment, call Peak Heart & Vascular at 602-698-PEAK or submit an online request form.


The vaccine developed to treat COVID-19 has been a topic of hot debate since its inception. With questions swirling regarding the speed at which it was developed, its long-term efficacy, potential side effects that may not yet have come to light, and mandates instituted by businesses and governments across the globe, everyone is craving one thing—actual data to dispel or legitimize concern.

One cause for concern has come from the emergence of an unforeseen side effect. Myocarditis, inflammation of the heart muscle, has been linked to the COVID-19 vaccine, adding fuel to the fire of debate. Without long-term research, however, the commonality and severity of this side effect remain unknown.

Different Types of COVID-19 Vaccines



The Data

A recent study  shed light on this topic by evaluating exactly those issues. How common is myocarditis in COVID-19 vaccine recipients, and how severe are the cases that do occur?

Included in the data set used for this study were patients who had received a minimum of one dose of the Pfizer-BioNTech mRNA vaccine. At the time of this research, this included 2.5 million vaccinated individuals aged 16 or older.

Anyone who fit this demographic and developed myocarditis up to 42 after their first dose was counted as being affected by this side effect. At the time, this was found to be 2.13 people per 100,000. However, this incidence rate varied based on a number of factors. For example, males aged 16 to 29 years old experienced the highest rate of myocarditis, with 10.69 cases per 100,000 vaccinated persons.

The majority of cases (98%) of myocarditis were overwhelmingly mild. 76% of cases fell into this classification, while 22% were considered intermediate.

What it Means

This study is a start, but it is too soon to determine how the data will change as time progresses. Because the research only included patients up to 42 days removed from their first dose of vaccine, it is possible that myocarditis developed in more patients after the 42-day window closed. The research performed does provide actual numbers to inform the concerns regarding vaccination and myocarditis. Majority of the myocarditis cases were mild and no risk of death.

According to CDC, most individuals can safely receive the vaccine and enjoy the benefits of protection and peace of mind.

You can consult with one of our experienced cardiologists through a virtual visit or in person at one of our clinic locations. To schedule an appointment, call Peak Heart & Vascular in Surprise, Avondale, Flagstaff, or Phoenix, Arizona, or connect online to submit an appointment request for an in-office or virtual visit.