Not much has changed in treating high blood pressure, high cholesterol and diabetes, but there is growing recognition that medications are more effective when combined with lifestyle changes. For heart attack and heart failure patients, there are better stents, pacemakers and defibrillators – and a more aggressive approach to using drugs to lower LDL cholesterol to less than 70 mg/dL, says Dr. Robert O. Bonow, chief of cardiology at Northwestern Memorial Hospital in Chicago. Cardiologists also are changing their views on two key issues:

1. Hormone therapy: In recent years, hormone therapy (HT) had fallen out of favor because research found that it didn’t protect against heart disease and may increase the risk of stroke. But new evidence suggests that timing may be everything. “If HT is started 10 to 15 years after menopause, it may accelerate heart attacks,” Bonow says. “But if women take it around the time of menopause, it may help prevent clogged arteries.” Case in point: A study from Harvard Medical School found that women between 50 and 59 who took estrogen therapy were less likely to have plaque in the arteries that lead to the heart.

2. Cardiac rehab: Cardiologists are increasingly advising heart attack survivors to participate in one of these programs, which offer diet and stress-reduction counseling, exercise programs, physical rehabilitation, depression screening and social support. “If you have a heart attack or heart disease, you have a 20 to 30 percent lower risk of dying from it if you go to a cardiac rehabilitation program,” Hayes says. Additionally, a recent study at New York Hospital Queens found that depressed heart disease patients who entered a cardiac rehab program felt significantly better without using antidepressants.

In the news

YOGA AS MEDICINE: Practicing yoga regularly can reduce systolic and diastolic blood pressure by an average of 19 mm Hg and 13 mm Hg, respectively, shows a recent review of 12 randomized trials. This is comparable to what happens when you take medication. In another study, people with chronic heart failure who did yoga for eight weeks reported that they could exercise for longer and had an overall improved quality of life.

POWER DRINKS SPIKE MORE THAN YOUR ENERGY: Having two energy drinks daily can increase blood pressure and heart rate levels. While this probably isn’t dangerous in healthy adults, it could be risky for people who have heart disease or high blood pressure.

GET OFF TO A HEALTHY HEART START: Eating whole-grain cereals at least seven times a week is associated with a 28 percent lower risk of heart failure, says a recent report from the Physicians’ Health Study. Can’t do it every day? No worries. Even those who ate whole-grain cereal two to six times a week had a 22 percent lower risk of heart failure.

BLACK WOMEN AND LATINAS: TAKE CARE OF YOUR HEART! Although statistics show that black women and Latinas have a very high risk of developing heart disease – Latinas have a 30 percent chance of having heart disease and stroke, and black women have a nearly 40 percent chance – they’re less likely to be aware of their risk factors, including high blood pressure, obesity, diabetes and inactivity. “These are the forgotten women,” says Dr. Jennifer Mieres, co-author of the new book “Heart Smart for Black Women and Latinas.” She hopes that it will promote heart disease awareness in these communities and make healthy changes seem more doable. “We’re trying to translate knowledge into action.”