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This new test won’t replace your typical screening for LDL cholesterol, as NPR’s Allison Aubrey reports. But testing the blood for a protein called lipoprotein(a) "can give a more complete picture of someone's cardiovascular risk and help inform decisions about whether lipid-lowering therapy is needed sooner rather than later,” wrote Dr. Roger Blumenthal, a cardiologist who contributed to the American Heart Association’s updated guidelines.
Lipoprotein(a) is a genetic marker with levels that remain fairly stable over a person’s life – so you only need to be tested for it once. High levels mean higher inherited risk for heart attacks and other cardiovascular conditions. The test is highly available, and your primary care provider might even already be ordering it as part of standard care.
There are other changes to the new guidelines too. They call for wider use of a scan that measures plaque in the arteries, called coronary calcium scoring. And they encourage providers to use an assessment tool to help calculate a patient’s heart disease risk over the course of decades. The new guidelines are all about assessing lifetime risk, says Dr. Steven Nissen, a cardiologist at Cleveland Clinic. This “will result in more people being treated earlier,” Nissen says. He expects this new more proactive approach to cholesterol will affect millions of people, and lead to a significant reduction in heart disease.
Learn more about the new guidelines for managing cholesterol.
Plus: Got muscle pain from statins? A cholesterol-lowering alternative might be for you |
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What does it mean to be an American? There’s no single answer. At NPR, we think of American identity as a story, one that’s constantly being rewritten by the people who live it.
The American Storytelling collection brings together stories from local stations across the NPR Network, from small-town struggles to natural wonders to the layered histories that shape our nation. These are some of our biggest little-known shows, all in one place.
Explore the American Storytelling channel on Apple Podcasts or find it in the NPR App. |
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Sunnu Rebecca Choi for NPR |
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If you've never worried about your blood pressure, having a blood pressure reading can feel like just a routine step at the beginning of a regular check up. But if you do have concerns, it can actually be a little tricky to know if you’re heading in the right direction.
A reader wrote in to our Real Talk with A Doc column this month to ask family physician Dr. Mara Gordon about monitoring their blood pressure at home. The reader said they were concerned because they had a high blood pressure reading at their annual physical, but their doctor didn’t prescribe medication. Should they be doing something to stay on top of their blood pressure in between appointments?
Dr. Gordon says that while a once yearly blood pressure reading is generally recommended for adults, your provider can’t actually diagnose high blood pressure based on one elevated reading. Normal blood pressure fluctuates throughout the day, and it requires repeated high blood pressure ratings to reach a hypertension diagnosis.
To make matters worse, your blood pressure might be unusually high when you’re at the doctor’s office, especially if you tend to get stressed out in a medical setting. That phenomenon is called “white coat hypertension.”
So yes, Gordon writes, taking your blood pressure at home can provide valuable information for you and your doctor. And guidelines from the American College of Cardiology back her up on that. If you have a high or borderline reading in a medical setting, it could be worth buying yourself a blood pressure cuff.
Proper technique is key to getting accurate readings, says Gordon. First of all, make sure you have a cuff that’s the right size for your arm. People with bigger arms may need cone-shaped cuffs rather than the typical burrito shape.
The idea is to get your “resting,” blood pressure, so it’s important to take the reading when your body is in a rested state, according to the American Heart Association. That means chilling quietly in a seated position for five minutes before you test. Also: Avoid caffeine, exercise or smoking 30 minutes before your test, and empty your bladder.
The cuff should be placed on bare skin on your upper arm, and your arm should be supported at the level of your heart.
Gordon typically diagnoses hypertension and recommends a medication if a patient has had multiple blood pressure readings of 130/80 or above over the course of a month or longer.
Read the full column for more details, and advice on what to do if you do get a high blood pressure diagnosis. (Hint: You don’t need to cut all the salt from your cooking🧂).
Also: A misplaced arm position can skew blood pressure readings |
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In South Carolina, measles shows how far apart neighbors can be on vaccines
Listen: Where does depression come from?
Researchers find sparse evidence for cannabis to treat mental health conditions
Vaccinating bats could be good for people. But how do you vaccinate a bat? |
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We hope you enjoyed these stories. Find more of NPR's health journalism online.
All our best,
Andrea Muraskin and your NPR Health editors |
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Listen to your local NPR station. |
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