Commonly asked questions about heart health and treating heart disease.

Q I'm taking a low-dose aspirin every day because I'm at risk for heart disease. Is "low-dose" enough to protect my heart?

A Low-dose aspirin therapy--taking 75 mg to 150 mg daily--to reduce your risk of heart disease, if you're at risk, has been shown to be as effective for lowering heart-disease risk, with lower incidence of gastro-intestinal bleeding, as aspirin therapy at doses over 150 mg. Because aspirin makes your blood less likely to clot, make sure you tell any health professional that you're taking it before undergoing any kind of surgical procedure, even a tooth extraction, to minimize the risk of excessive bleeding. Also be aware of stomach pain that may signal an ulcer or gastritis. Talk to your health care professional if you notice any unusual symptoms.

Q What kind of screening should I undergo to assess my risk of a heart attack or heart disease?

A First, speak with your health care professional about your personal or family risks for heart disease. Then, based on your medical history, your health care professional may order specific screening or diagnostic tests. For example, I suggest that all women age 35 and older have a cardiac stress test during their annual physical. This test, in which your heart function is evaluated while you ride a stationary bicycle or walk on a treadmill, can provide a good indication of your heart health. If it's normal, you don't need to have another for five years.

You should make a point to have your blood pressure and cholesterol levels checked at regular intervals. Your blood pressure is normally taken during regular physical exams, but you can also do it yourself at some local pharmacies. Cholesterol screenings should be done once every five years. Both screenings should be done more often if you develop risks or have heart disease.

Ask your health care professional about testing levels of C-reactive protein, a marker for inflammation that may be a warning sign of heart disease. However, in the Women's Ischemia Syndrome Evaluation (WISE) study, CRP didn't predict whether a woman had existing significant coronary disease. Instead, researchers identified another protein, called serum amyloid alpha (SAA), which showed a moderate association between high levels and heart disease in women.

--Jayne Middlebrooks, MD

Director of Cardiology, Health Screen America

Member, Association of Black Cardiologists

Atlanta, GA

Q I have diabetes and blockages in some of my small arteries. My doctor doesn't think I can undergo angioplasty and stenting because the vessels are so small. Are there other options available?

A People with diabetes sometimes have diffuse coronary disease, or plaques that run throughout the arteries, which make their arteries look "small" when they are really normal in size, just plugged more. Smaller stents are now available. Also, with the drug-eluting (medicated) stents the risk of restenosis (scar tissue reblocking the stent) is greatly reduced.

Bypass surgery may be a good option if multiple vessels are blocked, since studies suggest that diabetic patients live longer with bypass. New data is emerging that also suggests a benefit with drug-eluting stents for cardiac patients with diabetes.

Cindy L. Grines, MD

Director, Cardiac Catheterization Laboratory

William Beaumont Hospital 

Royal Oak, MI.