By Caleb Hellerman
CNN Medical Senior Producer

Last week I traveled with Dr. Sanjay Gupta to Levittown, Pennsylvania, to meet Chris Brooks, a recent college grad who survived an unexplained cardiac arrest that stopped his heart for more than 15 minutes. That he survived – and without brain damage – is pretty incredible, and probably a tribute to the CPR performed by his father and the fact that he was cooled by emergency physicians at the local hospital, and at the University of Pennsylvania, where he was transferred afterwards.

What caught my attention the other day came when we asked Brooks whether doctors had figured out what caused the cardiac arrest in the first place. It’s a life-or-death question; Brooks now has a defibrillator implanted in his chest, and in the past six months it’s been triggered to shock him twice. In other words, his heart is stopping for no obvious reason.

But he hasn’t gone for a battery of tests that might provide an answer. The reason: no health insurance. He was covered by a family policy at the time of his cardiac arrest, but no more. “What we’re dealing now is insurance,” Brooks told us. “I’m 22 years old and not in college any more, so I don’t have insurance. I can’t see [my cardiologist] now. I want to, I guess, but I can’t.” His doctors are looking for a way to make it work, but in the best-case scenario it’s delaying those tests by two to three months - a reminder that even serious illness can slip through the cracks of the current health care system.

Health care bills moving through Congress might make life easier for Brooks; they would let people under 26 still be covered on their parents’ insurance. But the bills would also place a new burden on those 26 or older, by requiring them to purchase insurance or pay a penalty. Critics say people should be free to take the risk of going insurance-free, if they like – or if they can’t afford it.

Are you under 30 without health insurance? Do you have children in that boat? What would you do if there were a serious health crisis?

Programming note: See Chris Brooks’ story as part of Dr. Sanjay Gupta’s special, “Cheating Death,” October 17, 8 p.m.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

Asked by Sharon, Mays Landing, New Jersey

“My husband’s doctor told him to take an aspirin a day. Should I be taking one too?”

Answer:

Thanks for the question Sharon. Aspirin is a medication we often get questions about, probably because an estimated one-third of Americans take it every day. The popular pain reliever is easily accessible, inexpensive, and available at your local pharmacy. It is commonly used to treat arthritis, headaches and fever among other minor pains. But what is often confusing is whether taking it every day can help prevent ailments– a heart attack or stroke.

Most daily users were most likely prescribed aspirin to lower their risk of cardiovascular disease. But it is important to note that not all people will benefit from this treatment, and in some cases, it can be dangerous.

The U.S. Preventive Services Task Force is a group of independent health experts who review effectiveness and offer usage guidelines for medical treatments and drugs. Last month, the USPSTF updated its 2002 recommendations of who could benefit from a daily aspirin regime.

Men aged 45 to 79, and women aged 55 to 79 who are at high risk of heart attack may benefit from a daily aspirin as a prevention tool. The USPSTF concluded that aspirin is most effective in this group of men to prevent heart attack and for women to prevent stroke.

Being overweight, having high blood pressure, high cholesterol, and smoking cigarettes are all factors that put you at high risk for heart attack. The group added that even if you fit this age and risk factor category, aspirin is not recommended if you have a history of gastrointestinal bleeding.

Women under the age of 55, or men under the age of 45 who have never had a stroke or heart attack should not take daily dose of aspirin as a preventive measure. Additionally, USPSTF did not find a clear benefit or risk of a daily aspirin in adults over the age of 80.

Aspirin works by suppressing your body’s natural production of substances and blood cells that can cause swelling, pain and blood clots. It’s a type of drug known as salicylate. It is critical to discuss the risks with your doctor before beginning an aspirin regime. It can be dangerous for people with a history of ulcers and GI bleeds among others ailments. It can also interfere with certain prescription and over-the-counter drugs, so disclose to your doctor what meds you take.

The FDA warns that women who are pregnant or breastfeeding should not take aspirin (unless specifically prescribed by a doctor). Up to 8 percent of each aspirin dose can be transferred to the baby and may cause birth defects or complications with pregnancy.

So Sharon – you can see there is no clear answer to your question because many variables come into play. You and your husband can be the same age but have different health histories and risk factors that would impact the effectiveness of a daily dose of aspirin. Talk to your doctor, who can determine the potential risk vs. benefit specific to your health history.

One thing I know for sure is if you're concerned about your risk of heart disease, eating a balanced diet and 45 minutes of moderate cardiovascular exercise a day is one of the best “medicines.”

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Bill, Dawsonville, Georgia

“I am a pretty healthy 50-year-old guy, but I notice a lot of my friends and colleagues in the same age group are starting to get heart disease and prostate cancer. What is your advice for men wanting to stay a step ahead of potential health concerns?”

Answer:

Thanks for the question. I’m happy to hear you’re interested in health prevention during the prime years of your life. You might be surprised to know that many men don’t get regular health check-ups. It’s interesting when you think about it: Many men tend to focus on their outer appearance around age 50 - get new clothes, new haircut maybe. But when it comes to regular health screenings, they often skip them! The problem is, age 50 is when potential health issues develop.

All men (and women) should be getting annual physicals and screenings for cancer and heart disease. Heart disease is the No. 1 killer for men in the United States and it is often preventable. Keeping your weight down and your vital signs at a healthy level are two of the easiest things a person can do to reduce their risk. In addition to annual check-ups with your general physician, get your eyes examined at least once every two years.

If you’re like me, you might have trouble remembering when your last appointment was. But no excuses! One easy solution is to schedule your annual check-up for the week of your birthday. You’ll likely never forget.

One last piece of advice, don’t let fitness be the first thing to fall off your schedule. It always seems to, especially when life gets busy. But exercise is truly the single best thing a person can do for a long health life. It is not only good for your heart, your brain, and your body weight but also relieves stress. Some studies even show that people who work out are overall happier than those who don’t.

Bottom line: Investing time in your health now, will pay off years down the road. Best of luck, Bill!

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

There were headlines this morning about CT scans for your heart.  An article in the Journal of the American Medical Association reports that the 64-slice cardiac computed tomography (CT) angiography (CCTA) of the heart has an average of 600 times the radiation of a single chest X-ray – that was the takeaway message. Pretty scary to read that, no doubt. In full disclosure, I had one of these scans as part of a story I did a few years back and it was interesting to see 3-D pictures of my heart. Take a look.

Still, I wanted to put a couple of things in context. It’s true that if you have had a single one of these scans, you are probably not going to get cancer as a result, which seems to be the biggest concern. But, if you are being asked to get multiple scans, it’s worth asking your doctor if they are really necessary and to balance the risks. Furthermore, because these scans have been more routinely used only since 2004, the data are pretty minimal on whether they have much effect on your outcome from heart disease.

I think there is a larger issue here. What is the right screening for you and should the costs be through the roof? A CT like this one is often not covered by insurance and the cost is between $800 and $1,200 dollars. Well, according to the U.S. Preventive Services Task Force, which studies this sort of thing based on cost and effectiveness, getting a simple cholesterol check around age 35 is a good idea and approximately every five years after that, depending on what the tests show. Also, a baseline EKG (electrocardiogram –to look at the electrical conduction of your heart) around age 40 can be helpful. To be sure, they recommend a more advanced test if you have heart disease or are having symptoms, such as chest pain.

Now, despite all these screening tests, if you are pretty healthy, ironically, the advice will most likely be the same. Eat right, including less fat in your diet. Don’t smoke and try to get exercise. Yes, even will all these fancy tests, the basics still apply.

So, how good are you at getting your recommended screening tests and would you pay the extra money for a CT scan to get more information?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Kate, Cherry Hill, New Jersey

"My 10-year-old is overweight and our doctor suggested he start taking statins. Is he too young to begin this type of medication? Is it even safe?"

Answer:

Strange as it sounds, in rare cases prescribing statins to kids as young as 8-years-old is recommended by the American Academy of Pediatrics.

But certainly, not every child who is overweight needs such treatment.

The academy recommends that doctors use the following criteria when prescribing statins to kids: a child’s LDL level above 160 plus two risk factors, such as being overweight and high blood pressure. Or a child with no risk factors but an LDL level above 190.

Although controversial to some, many experts agree that these cholesterol-lowering drugs are safe, and the benefits outweigh any potential side effects.

The American Academy of Pediatrics looks at it as a preventive measure, hoping to avoid serious health problems later in life. The U.S. has a generation of children developing adult-like health conditions that will put them at high risk for blood clots and heart disease by their mid-30s if parents and doctors don’t monitor it.

That’s one reason, with an estimated one in three of our kids overweight, pediatricians are beginning to track weight and cholesterol levels starting at age 2.

But is medication the only answer? Absolutely not. Parents first need to exhaust all diet and exercise options. Take walks at night or race around the living room to burn extra calories each day. And lead by example. If you make healthy food choices, your kids will pick those habits as well. Small changes can save kids from years of potential health problems. For an overweight child, losing just 5 percent of their body weight can reduce cholesterol levels and prevent the need for medication.

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Collin, Oak Park, Illinois

"I'm in my 40s and was told I have cardiac calcification. I'm curious about treatments for it and read that chelation therapy might work. Does that work?"

Answer:

Thanks, Collin, for writing in. Cardiac calcification is fairly common sign of early artery disease. It shows up on X-rays or CT scans in people of all ages. If developed during middle-age years, family history probably plays a role. I get tested regularly for heart disease and calcium buildup because I, myself, have a family history of the disease. There are often no symptoms of distress or pain so its important to keep up with annual exams.

Let me back up and explain exactly what cardiac calcification is. During the beginning stages of artery disease, the lining of aortic wall becomes inflamed, then plaque starts to build up and over time, calcium deposits begin to form in the artery wall. Those deposits are the calcification.

It's not reversible, but you can control the inflammation and prevent the calcium from progressing by controlling your risk factors. I ran this question by the American Heart Association, which confirmed that if you don't smoke, keep your weight down and your blood pressure/cholesterol at a normal range, you can prevent future damage.

Sounds like a simple solution, right? Well thats because it is simple. Many people search the Web for a magic drug, or a quick fix treatment when the solution is often as easy as working out, eating healthily.

Consuming healthy food will keep your numbers at a healthy range and your weight down. Limit or avoid transfat and saturated fats found in fried foods, cookies, eggs, palm oil. Look for sources of good fats in fish, flaxseed and olive oil. They'll help lower cholesterol levels and reduce your overall risk of heart disease.

You mention chelation therapy as a treatment option. Chelation therapy is typically used for treating mercury poisoning. Some people report using it to treat heart disease but there is no evidence that it works. In fact, the American Heart Association and National Institutes of Health do not recommend chelation therapy for heart patients, noting lack of evidence and also unpleasant side effects. The side effects include vomiting, headache, inability to create new blood cells and even kidney damage. The best treatment option is monitoring your vitals signs.

Collin, it's a positive thing that you've discovered these calcifications at a young age. Now, be empowered to take the steps necessary to stop the progression of the disease and you'll go on to live a long, healthy life. Best of luck!

By Karen Denice
CNN Medical Senior Producer

As a medical producer I’ve become a bit of a de facto health adviser to my family. Usually it’s about knee pain or headaches, minor stuff. Unfortunately a few weeks ago it was major – my mother was feeling fatigued, coughing frequently and her heart ached. I was worried, but thought it might just be grief. Her brother had died suddenly just days before and anyone who has dealt with the death of a loved one knows it feels like your heart is physically breaking.

Marie Denice and Karen Denice

I’m lucky that my parents are great “empowered patients” and so now in their 70s they work hard to remain in good health. So after some prodding, my mom went to her doctor, who didn’t like the sound of things and sent her to a cardiologist. The cardiologist already had a baseline EKG for her, so when he did another he knew something was wrong. My mom called. “The doctor said I had a heart attack,” and she was going in the next day for an angiogram. Those words still shock me.

Luckily, rational thought returned, and I remembered a story we’d done a couple of years ago on a condition called "broken heart syndrome". It looks like a classic heart attack with an abnormal EKG, chest pain, fatigue etc., but doctors have discovered it is far less damaging to the heart. The New England Journal of Medicine published a study that found stress cardiomyopathy, or broken heart syndrome, can occur when someone, often older women, receive shocking news. The emotional impact of that news can set off a powerful chain reaction – adrenalin and other stress hormones surge – stunning the heart. While this syndrome is still a bit of a mystery, the good news is, doctors believe that, unlike a heart attack, there is usually no long-term impact on the heart.

I e-mailed my mother the study and other articles, hoping this is what she had, hoping there was no damage to her heart. But her angiogram would tell the tale – showing any blockages or damage. Thank goodness, she came out with a clean bill of health and the doctor diagnosed stress cardiomyopathy. Phew!

Days later she went back to her primary care physician to tell him the good news and brought the research I’d sent her. The doctor had never heard of broken heart syndrome. This is an important point for everyone who comes to CNNhealth and is a health consumer. In this state of health care, primary doctors often don’t have time to read all the medical journals and research out there. So, empower yourself and if you suspect your symptoms are something other than what they say – speak up and talk it over with your doctor.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Caitlin Hagan
CNN Medical Associate Producer

Everyone is afraid of something. Some people are scared of heights. Some people hate small spaces. Some people can't stand snakes. Me? I'm afraid of having my blood drawn. Luckily (or unluckily depending on your perspective), I was able to dodge it for years. But that all changed at my annual physical last January. At the time my only concern was the needle going into my arm but days later when the doctor called with my results, I learned I had a much bigger problem: high cholesterol. Despite being a healthy non-smoking 24-year-old, my cholesterol levels were much too high. I had to lower my numbers or I faced a lifetime of medicine.

For a few months I made an effort to reduce my saturated fat intake. Most mornings I took a quick walk around my neighborhood for 30 minutes. I thought high cholesterol was an easy problem to solve if I just stopped eating cheese and exercised more. But another blood test four months later proved me wrong; not only had my numbers not changed at all, but my doctor wanted to write a prescription immediately. I needed to make some drastic changes but I had no idea where to start.

My parents don’t have high cholesterol and I was at a loss to understand how I did. What foods did I need to avoid? What foods did I need to start eating? What lifestyle changes did I need to make? What, exactly, is cholesterol anyway? Armed with all these questions I started researching and what I learned was pretty sobering. Research has shown that people with high cholesterol in their 20s and 30s are more likely to suffer from heart disease later in life. Women especially need to beware because heart disease kills more women annually than any other affliction. My goal became very clear: Get my heart in shape now and save myself from possible trauma later.

Fixing my cholesterol meant making some major lifestyle changes. I joined a gym and with my new membership came a new mentality. To keep perspective, I remind myself that I'm working out to elevate my heart rate, not to drop ten pounds. I love the instant gratification of leaving an hourlong cardio class knowing that I might not have lost any weight but I literally worked my heart out. On off days I walk a two mile loop around my neighborhood to soak up some sunshine while I exercise. My goal is to move my body and elevate my heart rate once every day, either through a cardio class, a weightlifting class, a yoga class, or hiking or walking outside.

Of course, you cannot keep your cholesterol levels in check without healthy eating. Over the last several months I have restricted my diet to portions of fruits and vegetables, lean meats, whole grains, and omegas 3s. I rarely drink soda or eat fried food (although I randomly indulge in French fries; I can't help it!) and I have learned to cook healthy meals at home. I am not a vegetarian but I have reduced the amount of meat I eat, especially processed deli meats. So far my efforts have made a difference; I dropped my cholesterol level 11 points over the past five months. There is still room for improvement but for now I am confident in the life changes I've made.

Do you know your cholesterol levels? What have you done to lower your cholesterol score?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Val Willingham
CNN Medical Producer

l love my iPod. From Etta James to Roy Rogers, my playlist is pretty diverse. Each song is part of who I am. And I guess I have a lot of parts, because I've loaded over 4,000 songs into that tiny device. I take it with me everywhere. On the train, in my car, on trips, I even have a port in different rooms of my home. There's just something about music that makes me feel good. Even on a very bad day, my tunes can calm my inner "savage breast."

So it was no surprise when I read, that researchers from the University of Maryland Medical Center had found that listening to your favorite music may be good for your cardiovascular system. That's right: Beyonce, Kenny Chesney and Joshua Bell could be good for your heart! Now before you replace your statins with an MP3 player and Yo Yo Ma, listen up. The study was tiny - only 10 people, but this is the same group of doctors that conducted the "laughter is good for your heart" study a few years ago. "We had previously demonstrated that positive emotions, such as laughter, were good for vascular health. So, a logical question was whether other emotions, such as those evoked by music, have a similar effect," says principal investigator Michael Miller, M.D., director of preventive cardiology at the UMM. "We knew that individual people would react differently to different types of music, so in this study, we enabled participants to select music based upon their likes and dislikes."

In the music study, participants listened to pieces they enjoyed and picked themselves. In another phase they tuned into music that made them anxious and in a further setting, they listed to music designed to relax them. After each session, a number of their larger blood vessels were scanned and measured through a special ultrasound device. Researchers were looking at the endothelium, or the lining of the blood vessels, and its response to the musical stimuli. By looking at these images doctors found that when participants listened to music they really enjoyed, the average blood vessel diameter increased by 26 percent compared to not listening to music at all. That's even better than relaxing music, which opened the vessels by 11 percent. And while listening to music that caused listeners anxiety, like heavy metal or rap, the blood vessels narrowed by 6 percent compared with music such as country, gospel, pop and rock and roll.

Could other types of music produce similar positive effects on blood vessels? It's possible, Miller said. "The answer, in my opinion, is how an individual is 'wired.' We're all wired differently, we all react differently. I enjoy country music, so I could appreciate why country music could cause that joyful response." Miller believes the physiological impact may also affect the activity of brain chemicals called endorphins. "The emotional component may be an endorphin-mediated effect," says Miller. "The active listening to music evokes such raw positive emotions likely in part due to the release of endorphins, part of that mind-heart connection that we yearn to learn so much more about.
“Needless to say, these results were music to my ears because they signal another preventive strategy that we may incorporate in our daily lives to promote heart health."

This morning the traffic was brutal and the train was packed. I forgot my briefcase and my computer was giving me problems. But it didn't matter. Because I just pushed the “PLAY” button and let Ella sing my cares away.

Do you believe music is good for your health? Tell us about it.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

by Miriam Falco
Managing Editor CNN Medical

A new study presented at a major heart conference over the weekend suggests that many of us who have good cholesterol numbers could help prevent heart disease by taking cholesterol-lowering drugs. Currently these drugs, known as statins, are prescribed only for people with existing heart problems and/or high bad cholesterol.

Could I be one of those candidates? Maybe I am, I don’t know. My cholesterol level is well below 200, which is what folks should aim for. But It’s been a couple of years since I last had my cholesterol checked, and I’m not sure how good my LDL, or “bad” cholesterol level is.

More important, people who participated in this study may have had optimal ‘bad” cholesterol levels, but they had high levels of “high-sensitivity C-reactive protein” or hsCRP, an indicator of inflammation in the body, which can contribute to the clogging of arteries. You may have had heard about CRP, but I for one have never had it tested.

Now, after folks read about this new research, they may be asking their doctors if they should get the test.

The men who particpated in this trial were 50 and older; the women were over age 60.

But as Dr. Elizabeth Nabel, director of the National Heart, Lung, Blood Institute, points out, adults at any age who are at "intermediate risk" for heart disease probably will want to talk to their doctor about having a 'high-sensitivity C-reactive protein or 'hsCRP" test.

How do you know if you are at intermediate risk?  Nabel suggests one way to determine your risk for heart disease is by checking the so-called "Framingham score," which estimates the risk of developing coronary heart disease within 10 years based on risk factors including age, gender, cholesterol levels, blood pressure and if you smoke.

By using a simple risk calculator, which can be found here, anyone can calculate his or her risk for heart attack and coronary death.

If your score suggests you have a 10-20 percent risk of having a heart attack within the next 10 years, you are at “intermediate” risk.

Dr. Paul Ridker, from Brigham and Women's Hospital in Boston, Massachusetts who is the lead researcher of this big study says there are two types of CRP tests – but only one tests for the high-sensitivity C-reactive protein. So patients who want to know if they should be taking statins even though they have good cholesterol levels, need to ask for an “hsCRP” blood test. The regular CRP test isn't sensitive enough to detect the risky inflammation in people with normal to good cholesterol levels.

Do you think you might get your hsCRP tested?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.