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Regular aerobic exercise such as walking and cycling may help people with resistant hypertension lower their blood pressure.

Pears are a good source of fiber and several beneficial plant compounds (phytochemicals), including catechins. Also found in apples and cocoa, catechins may help lower blood pressure, improve blood vessel health, and discourage blood clots.

Post-traumatic stress disorder (PTSD) can be triggered by many harrowing events, including serious car accidents, violent personal trauma, and military combat. Over a lifetime, about 8% of adults develop PTSD, which is linked to an increased risk of heart disease. Many factors closely linked to heart disease—such as smoking, high blood pressure, and diabetes—are also common in people with PTSD, so untangling the true nature of the association has proven challenging. But repeated, long-term stress can increase blood pressure, heart rate, and inflammation, all of which can encourage clogged heart arteries. Ongoing research looking at the genetics and epidemiology of PTSD, cardiovascular disease, and their shared, related risks is under way.

At least half of all artery-opening angioplasties done in the United States now begin at the wrist instead of the top of the thigh. The wrist (or transradial) approach is easier on patients, safer, and less expensive. After the procedure, people can sit up right away instead of lying flat for several hours, and they are much less likely to experience bleeding, including serious bleeding in the abdomen. The lower complication rates mean people can leave the hospital sooner, which translates to decreased costs.

So-called silent heart attacks (marked by unexplained weakness, fatigue, shortness of breath, or nausea) often go unrecognized. But they may be almost as concerning as regular heart attacks and have been linked to a higher risk of stroke. Some of this heightened stroke risk stems from shared risk factors, including high blood pressure, diabetes, and elevated cholesterol levels. But heart attacks can also damage the heart’s lower chambers. This may prevent the heart from contracting normally, which can lead to formation of a clot that then travels to the brain, causing a stroke.

Cycling outdoors may help people with diabetes (a strong predictor of heart disease) lower their odds of premature death. If inclement weather or traffic make outdoor cycling unsafe, using an indoor cycling machine can be a convenient way to stay fit. These machines are also ideal for people with physical limitations (such as mobility or balance issues) that make riding a traditional bike challenging. Different types that can accommodate people with varied fitness levels and physical abilities include under-desk cycles and recumbent or upright stationary bikes.

A rapid heartbeat may be due to supraventricular tachycardia or ventricular tachycardia. The former is usually harmless, while the latter is more serious and more likely to occur in older people with heart disease.

To help prevent high LDL cholesterol, experts recommend limiting saturated fat to 7% of total daily calories. Changes such as avoiding red and processed meats, cheese, and other full-fat dairy products can help. People can look up the saturated fat content of foods with free apps such as Lose It! or MyFitnessPal. To replace lost calories, the best choices are unsaturated fats such as liquid vegetable oils from vegetables, nuts, and seeds, as well as avocados, nuts, and nut butters.

An international study published online June 1, 2021, by JAMA Network Open found that middle-aged and older adults had an increased risk of being obese or having a big belly if they went to sleep late, compared with a bedtime between 8 p.m. and 10 p.m.

A study published online Aug. 16, 2021, by JAMA Network Open suggests that older adults with good listeners in their lives have better thinking skills—despite decreases in brain volume—compared with people who don’t have good listeners in their lives.