An inside look at aortic stenosis

Aortic stenosis occurs when the heart’s aortic valve becomes stiff and calcified, narrowing its opening so blood cannot flow normally. This can cause symptoms such as shortness of breath, fatigue, lightheadedness, fainting, and chest tightness. Neither lifestyle nor medications can slow or reverse aortic stenosis. People born with a bicuspid aortic valve are at high risk, but most people with aortic stenosis have a normal appearing valve. The only treatment is to replace the damaged valve using open heart surgery or a less invasive, nonsurgical approach called transcatheter aortic valve implantation.

Content restricted. Requires subscription

Dietary salt and blood pressure: A complex connection

About a third of healthy people—and about 60% of people with high blood pressure—are salt sensitive, meaning they have an exaggerated response to dietary sodium. But an estimated one in 10 people may have inverse salt sensitivity: their blood pressure goes up when they eat less salt. Understanding the genetic basis of these differences may one day improve the treatment of blood pressure.

Content restricted. Requires subscription

Gene therapy for cardiovascular disease

Clinical trials are under way using gene therapy to treat inherited cardiovascular conditions, including familial hypercholesterolemia (one form of abnormally high cholesterol), hypertrophic cardiomyopathy (a type of heart muscle disease), and transthyretin amyloid cardiomyopathy (a form of heart failure resulting from amyloid deposits). But challenges remain in developing and delivering these therapies.

Content restricted. Requires subscription

Does a coronary stent make sense for stable angina?

Tiny mesh tubes called stents, used to prop open heart arteries, can relieve stable angina (chest pain with exertion or emotional stress) in many people with coronary artery disease. But this treatment—which carries a risk of complications and a high cost—should be reserved only for people who don’t get relief from drug therapy. Stents do not prevent future heart attacks or improve survival compared with drug therapy. Angina usually results from arteries that are more than 70% blocked, but most heart attacks occur in arteries that are narrowed by only about 40% or less but harbor plaque that ruptures without warning. The resulting blood clot blocks blood flow, triggering a heart attack.

Content restricted. Requires subscription

A new tool to predict heart disease risk

The PREVENT equation is a new online calculator to predict a person’s odds of developing heart disease. Compared to previous calculators, the updated tool considers broader measures of health (including biomarkers for kidney and metabolic health) and a longer age span (starting at 30 instead of 40 years of age). The goal is to encourage earlier, more targeted strategies to help people avoid cardiovascular problems.

Content restricted. Requires subscription