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Cardio Metabolic Health Congress – Official Blog

Simple & Preventive Changes to Combat CVD

Cardiovascular disease has the highest mortality rate in the United States, and billions of dollars are given to pharmaceutical industries each year in order to combat and reduce risks.

Yet recent research on cardiovascular risk factors offers renewed hope and optimism regarding heart disease, demonstrating a number of simple life changes to implement in order to prevent the onset of cardiovascular disease. Changing behavior can significantly lower risks, even for those genetically predisposed to heart disease—though it has long been thought that these factors were outside one’s control.

Data gathered from four large prospective cohort studies, all of which tracked thousands of people for years, analyzed and assessed the relationships between various risk factors and heart disease. Researchers examined the ways in which lifestyle factors were associated with outcomes, including not smoking cigarettes, not being obese, engaging in weekly physical activity, and following a healthy diet. The final criterion was based upon recommendations including eating more fruits, nuts, vegetables, whole grains, and not eating sugar-sweetened beverages, processed foods, etc.

The cumulative lifestyle factors were all associated with a significantly decreased risk of coronary events, and those who followed all of them had a favorable lifestyle. The reduction in heart attacks, bypass procedures, and deaths from cardiovascular causes was 45%: a 47% reduction even among those with genetic risks.

These numbers are substantial; the risk of a coronary event in a decade was halved. The data demonstrated that lifestyle changes were as powerful, if not more powerful, than many drugs and pharmaceuticals that are recommended. While there were caveats, including the sample size and population’s race and ethnicity, the lessons imparted must encourage us to understand and internalize that genetics do not necessarily determine overall health.

Changes in lifestyle can ultimately overcome many of the hurdles and challenges posed by DNA and genetics. These alternations will also reduce risks of other diseases like cancer, and a healthier lifestyle can have enormous implications for many more people across the globe.

Interested in learning about the latest updates in hypertension, heart failure, diabetes, lifestyle management, and cardiovascular health? Attend CMHC West, and listen to the nation’s top experts in cardiometabolic health while networking with hundreds of other healthcare professionals and practitioners. 

Cardiovascular Morbidity and Mortality in Pregnancy

More than one fifth of all pregnancy-associated deaths during a 10-year period in Illinois were the result of cardiovascular causes, and the mortality rate resulting from cardiac causes rose with maternal age, new data study show.

Further, of the cardiac-associated deaths, 28.1% of them were potentially preventable, Joan Briller, MD, from the Division of Cardiology, Department of Medicine, and the Center for Research on Women and Gender at the University of Illinois at Chicago, and colleagues report in an article published online April 4 in Obstetrics & Gynecology.

Recent research has shown that the maternal mortality rate in the United States has risen substantially in recent years, with one study of national trends reported by Medscape Medical News indicating a relative increase of more than 25% between 2000 and 2014.

Because cardiovascular disease is recognized as a leading contributor to US maternal mortality, Dr Briller and colleagues sought to identify the most common etiologies of maternal cardiac death in Illinois and to assess their potential preventability.

The investigators reviewed data on pregnancy-associated cardiovascular deaths in the state from 2002 to 2011. Data were collected by a network of regional perinatal centers and recorded in the Illinois Department of Public Health maternal mortality review database. Illinois requires the reporting and review of all deaths to women within a year of pregnancy.

During the period of study, there were 636 deaths in women who were pregnant or within 1 year of pregnancy, reflecting an overall death rate of 37.1 per 100,000 live births. Of the deaths, 140 (22.0%) were cardiac-related, predominantly (97.1%) resulting from acquired heart disease. The most common etiology was cardiomyopathy (27.9%), followed by stroke (22.9%), hypertension-related death (12.9%), arrhythmias (10.7%), and coronary artery disease (9.3%). Of the 39 women who died of cardiomyopathy, 30.8% (n = 12) developed the condition during the peripartum period.

Of the cardiovascular deaths, those attributed to cardiomyopathy “were significantly more likely to be considered directly related to pregnancy (P<.01) than other cardiac etiologies,” the authors write, and women with cardiomyopathy “were more likely to be younger than women who died of other cardiovascular causes,” they observe. The cardiomyopathy mortality rate in women younger than 20 years was nearly three times that of women aged 20 to 29 years (rate ratio [RR], 3.38; 95% confidence interval [CI], 1.38 – 8.27).

More than half of the cardiovascular deaths in this patient population occurred during the first 6 weeks postpartum compared with deaths from noncardiac causes (56.7% vs 49.2%; P < .01). This suggests that women with hypertension, preeclampsia, or other cardiac risk factors or symptoms should receive more extensive postpartum care, the authors write.

“[T]he preponderance of cardiovascular deaths in the older population is especially striking given that only 40.1% of births occurred in women older than age 30 years of age,” the authors write. “Increasing cardiovascular death as women aged is partly explained by the rising prevalence of cardiovascular disease in the older population,” they explain.

Of the cardiac deaths, 28.1% were determined to be potentially preventable and point to aspects of care that are “amenable to change such as monitoring patients at risk for several weeks postpartum,” the authors write.

The Illinois findings “add to our understanding of cardiovascular disease as a leading contributor to maternal mortality by addressing risk factors to be assessed and that a large proportion of maternal mortality is potentially preventable by addressing issues such as the importance of monitoring patients at risk for several weeks postpartum while hemodynamic changes are still in flux,” the authors conclude. “Our data support the need for more investigations into cardiovascular maternal mortality, organized communication between obstetricians and cardiologists, and the need for systems designed to better educate and communicate cardiovascular risk factors and warning signs to pregnant women and medical care providers.”

Higher Risk Factors for Women

Fewer women who suffer a heart attack each year in the UK would die if they were simply given the same treatments as men, according to new research.

Scientists at the University of Leeds and the Karolinska Institute in Sweden used data from Sweden’s extensive online cardiac registry, SWEDEHEART, to analyze the outcomes of 180,368 patients who suffered a heart attack over a 10 year period to December 2013.

After accounting for the expected number of deaths seen in the average population, the researchers found that women had an excess mortality up to three times higher than men’s in the year after having a heart attack.

While the analysis uses Swedish data, the researchers believe that the situation for women in the UK is likely to be worse than in Sweden, which has one of the lowest mortality rates from heart attacks anywhere in the world. The study, published yesterday in the Journal of the American Heart Association, was co-funded by the British Heart Foundation.

Professor Chris Gale, Professor of Cardiovascular Medicine at the University of Leeds, who co-authored the study, said: “We need to work harder to shift the perception that heart attacks only affect a certain type of person. Typically, when we think of a heart attack patient, we see a middle-aged man who is overweight, has diabetes and smokes. This is not always the case: heart attacks affect the wider spectrum of the population, including women. Sweden is a leader in healthcare, with one of the lowest mortality rates from heart attacks, yet we still see this disparity in treatment and outcomes between men and women. In all likelihood, the situation for women in the UK may be worse.”

Analysis of the Swedish data found that women who had a heart attack resulting from a blockage in the coronary artery were 34 per cent less likely than men to receive procedures which clear blocked arteries and restore blood flow to the heart, including bypass surgery and stents.

The paper reported that women were also 24 per cent less likely to be prescribed statins, which help to prevent a second heart attack, and 16 per cent less likely to be given aspirin, which helps to prevent blood clots. Critically, when women received all of the treatments recommended for patients who have suffered a heart attack, the gap in excess mortality between the sexes decreased dramatically.

Professor Gale, from the Leeds Institute of Cardiovascular and Metabolic Medicine, added: “The findings from this study suggest that there are clear and simple ways to improve the outcomes for women who have a heart attack – we must ensure equal provision of evidence-based treatments for women.”

Previous British Heart Foundation research has shown that women are 50 percent more likely than men to receive the wrong initial diagnosis and are less likely to get a pre-hospital Electrocardiogram (ECG) which is essential for swift diagnosis and treatment.

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: “Heart attacks are often seen as a male health issue, but more women die from coronary heart disease than breast cancer in the UK. The findings from this research are concerning – women are dying because they are not receiving proven treatments to save lives after a heart attack.”

This year, attend our 13th Annual CMHC conference, taking place from October 24-27 in the heart of downtown Boston. We are hosting our first pre-conference Women’s Health Summit on October 24th: highlighting the latest research unique to women’s healthcare. Expand your therapeutic options to enhance and optimize your female patients’ health, while learning tangible solutions to complex medical problems. This day is designed for you to become well-versed in integrative practices and protocols, and understand the unique challenges faced by women.

Middle-Aged? Reverse Heart Risk with Exercise

For those who fear it may be too late in life to improve their fitness and wellness, a recent study published in the journal Circulation has found that people into late middle age can reverse or reduce the risk of heart failure caused by decades of sedentary living by exercising.

There, is, however, a catch: research indicates that it takes two years of aerobic exercise, four to five days a week, to mitigate the risk of heart failure. Research has shown that sedentary behaviors – such as sitting or reclining for long periods of time – increase the risk of heart disease.

The study’s participants, all of whom did not exercise regularly, were divided into two groups, with one following an aerobic exercise routine that progressed in intensity over the two years and another doing yoga, balance training and weight training three times a week, also for two years.

The aerobic exercise group showed an 18% improvement in their maximum oxygen intake during exercise and a more than 25% improvement in “plasticity” in the left ventricular muscle of the heart – both markers of a healthier heart. However, the benefits were not seen in the second group.

Dr Benjamin Levine, lead author of the study and the founder and director of the Institute for Exercise and Environmental Medicine, a joint program between Texas Health Resources and UT Southwestern Medical Center Dallas, Texas, states: “The key to a healthier heart in middle age is the right dose of exercise, at the right time in life. We found what we believe to be the optimal dose of the right kind of exercise, which is four to five times a week, and the ‘sweet spot’ in time, when the heart risk from a lifetime of sedentary behavior can be improved – which is late-middle age. The result was a reversal of decades of a sedentary lifestyle on the heart for most of the study participants.”

Dr Richard Siow, vice-dean for the faculty of life sciences and medicine at King’s College London and director of aging research at King’s, told the BBC the study was valuable in that shows we can delay cardiovascular aging. Dr. Siow said that it provided further evidence that “we can, in a way, rejuvenate or make the cells in the heart, and also in the blood vessels for that matter, resemble younger cells through an exercise program”.

“I think that’s a very important take-home message for those of us who may have a doom and gloom view there’s nothing we can do about it. Yes there is, we can start by getting off the couch to have a more active lifestyle.”

Physical Activity to Combat Cardio Risk

A study of close to 500,000 people without cardiovascular disease at baseline showed that total physical activity related to work, recreation, or utilitarian needs such as walking to do errands was associated with a lower short-term risk of developing CVD. The researchers found that there is a “clearly positive . . . dose-response relationship between levels of total activity and risks of major CVD,” senior author Dr Zhengming Chen (University of Oxford, UK) told theheart.org | Medscape Cardiology.

Lead author Dr Derrick A Bennet (Oxford University) and colleagues analyzed data from adults who participated in the China Kadoorie Biobank study, and their findings were published November 8, 2017 in JAMA Cardiology.
Compared with people in high-income countries, these participants in middle-income China had a much higher average level of physical activity: 21.5 metabolic equivalents of task (MET) hours/day, which equals 5 hours of cycling or brisk walking a day.

With each added 4 MET hours/day of physical activity—roughly equal to 1 extra hour of brisk walking per day—people had a 5% to 12% lower risk of developing different types of CVD during a 7.5-year follow-up. The association was similar in men and women, and young and old, Chen noted. However, among patients with hypertension, the benefits of physical activity in lowering risk of CVD—especially stroke—were weaker, although fewer than 10% of these patients had properly controlled hypertension.

Dr Scott A Lear (Simon Fraser University, Vancouver, BC) told theheart.org | Medscape Cardiology that this “huge study in the largest population in the world” showed that “being physically active is associated with a substantial reduction in risk for major CVD events,” which “is as good as or better than some of the most effective CVD pharmaceuticals we have.” Added to other evidence, it emphasizes that “more attention needs to be paid to prescribing physical activity as an effective and low-cost intervention with few side effects,” he said. “Public-health policy and other administrative units need to be involved (since it is rare that healthy people see a clinician) to ensure being physically active is the easy choice.”

The study also supports World Health Organization (WHO) recommendations of 20 or 30 minutes of moderate intensity exercise on most days, which would reduce the risk of premature death by 20% compared with people who do not meet this target.

“Our study is the first really large study in low- and middle-income countries of the effects of physical activity on CVD risks, and the study findings support current WHO guidelines that promote any type of activity to reduce the risk of major chronic disease,” said Chen. The challenge, say Lear and Yusuf, is for low- and middle-income countries to find ways to mitigate the decrease in occupational physical activity that follows economic prosperity and for high-income countries to find ways to increase fitness levels when most people have sedentary jobs.

On an individual level, people with sedentary jobs “can do simple things,” they advise, such as getting up every 20 to 30 minutes for a 2-minute walk, taking the stairs instead of an elevator, and parking further from their destination. However, individual changes only go so far, they note, and for substantial increases in physical activity to be achieved “national and community-level programs are needed.” Having safer neighborhoods where people can access parks and bicycle paths can help, and in China, building bike lanes would not only increase activity, but reduce traffic and air pollution, they point out.

“If the entire population met the WHO [physical activity] guidelines, whether through recreational, occupational, household, or other obligatory activities, this would prevent around one in 12 (or approximately 3.0 million) premature deaths in adults worldwide,” they conclude.

Cardiovascular Mortality Rates Vary by Geography

It’s a testament to modern medicine that death rates from heart disease around the nation have been cut in half, yet new research sheds light on the wide disparities in cardiovascular death rates depending on geography. Using death certificate data, a research group led by University of Washington Medical Center cardiologist Dr. Gregory Roth conducted the most comprehensive analysis of deaths due to cardiovascular diseases in history.

Their findings indicated that cardiovascular death rates have been cut in half since 1980, though cardiovascular disease still represents the cause of death in the United States. In 2014, for instance, cardiovascular diseases accounted for more than 846,000 deaths, according to the research, which was published in the Journal of the American Medical Association.

But death rates can vary widely: for example, cardiovascular death rates are twice as high in Richmond, Martin and Columbus counties as they are in Chatham County. “This kind of variation occurs on a really small geographic level. So even from one county to the next we see these huge gaps in health related to heart disease,” said Roth. “We clear see higher rates of cardiovascular deaths in places that are poor, and we know that health care quality is worse in locations with lower incomes and lower levels of education.”

Moreover, there are early warning signs. Across the state and nation, cardiovascular death rates have begun to creep up again. “Cardiovascular disease is down on average in the United States, but the rate that it’s been going down has really flattened and in the last year or two we’ve seen very little decline at all. And in some states and counties we are actually seeing it go up again for the first time in 50 years,” said Roth.

Mental Stress: The Enemy for Women’s Hearts

New research published in Arteriosclerosis, Thrombosis and Vascular Biology Indicates that mental stress has a greater effect on peripheral vessels in women than in men. The additional constriction of blood vessels seen in women may increase their risk of heart-related events and death.

Stress is a normal part of life and our body has a range of responses designed to help us react accordingly. These include physical, mental and emotional adjustments intended to be a positive reaction to keep us alert and ready to avoid danger. However, with the ever-increasing challenges of life today, some people experience a continuous stress response that can have negative consequences.

One of the common physiological responses to mental stress is constriction of peripheral blood vessels to free up more blood to support increased activity in the brain. In healthy people, this increases alertness and concentration. However, if a person has heart disease the constriction of peripheral blood vessels can also result in less blood reaching the heart, which can cause cardiac ischaemia. Previous research reported that stress-induced reduction in cardiac blood supply was more common in women aged <50 years compared with men and older women.

The Mental Stress Ischemia Mechanisms Prognosis study was designed to evaluate the extent of the effects of stress-induced vasoconstriction.

Dr Viola Vaccarino, professor of epidemiology and medicine at Emory University’s Rollins School of Public Health in Atlanta explained “This research is important because previous studies have shown that a reduction in blood supply to the heart (ischaemia) during mental stress doubles the risk of heart attack or death from heart disease. This increased risk of adverse cardiovascular events is about the same level as that seen in people who develop reduced blood flow in the heart muscle during a conventional test, such as a treadmill stress test.”

During the study of 678 patients with coronary artery disease, the constriction of tiny arteries supplying blood to the fingers was measured using myocardial perfusion imaging and heart rate and blood pressure recorded before and during a public speaking stressor.

The results showed that in women the reduced blood supply to the heart observed during mental stress was a consequence of constriction of peripheral blood vessels. In contrast, in men it was an elevation in blood pressure and heart rate during mental stress that led to a reduction in blood supply to the heart.

Vaccarino commented “Our findings in the peripheral circulation also could reflect what occurs in the arteries in the heart. Instead of dilating and increasing blood flow to the heart during stress, in women the tiny blood vessels are constricted, leading to areas of reduced blood flow. Constriction of peripheral vessels can also induce ischemia in the heart indirectly, because the heart has to pump against increased resistance.”

This research highlights the importance of finding effective means of combating mental stress, such as relaxation techniques and physical exercise, especially among people with heart disease. Furthermore, the observed gender differences suggest that health professionals need to pay particular attention to the burden of mental stress among their female patients with heart disease.

Future research will examine whether these cardiovascular responses to mental stress are reflected in an increased incidence of heart attacks or other indicators of worsening heart disease.

Live Longer By Saying “I Do”

In a new study published last week in the Journal of the American Heart Association, researchers at Emory University in Atlanta found that people with cardiovascular disease who were not married –- including those who were divorced, separated, widowed or never married –- had 24 percent higher rates of death from any cause during the study period, compared to those who were married. 

Specifically, not being married was associated with a higher risk of death from cardiovascular causes, like heart attacks and strokes, for the more than 6,000 Emory Healthcare patients in this study. Divorced and separated people had a 41 percent increased risk of death; widowed people had nearly double that risk.

“I was somewhat surprised at the impact,” Dr. Arshed Quyyumi, the study’s lead researcher and co-director of Emory Clinical Cardiovascular Research Institute, told ABC News. “But we suspected there might be something, since there have been studies that signal that marital status affects how well people do.”

This was a large study conducted between 2003 and 2015 that included 50 to 70 year old participants, from diverse racial groups, who had cardiovascular disease — including coronary artery disease, heart failure and previous heart attacks. Each participant was followed for an average of 3.7 years.

Even after accounting for known cardiac risk factors — such as diabetes and smoking, different types of heart disease, socioeconomic background, age, sex and appropriate treatment –- being unmarried still showed higher risk of death for these patients.
One expert not involved with the research agreed that the findings offer additional clues to the importance of relationships when it comes to health.

“This study adds to this line of research,” Dr. Matthew Dupre, an associate professor at Duke University who has done extensive research on social factors and heart outcomes, told ABC News. “There is now a growing body of work showing how our social relationships, particularly the disruption of these relationships through divorce or widowhood, can get under our skin and have immediate and lasting consequences for our cardiovascular health.”

For this study, the researchers did not specifically look for why these differences exist. But the research team, as well as Dupre, note that previous research suggests less social support, stress from divorce or a spouse passing and less motivation to have a healthy lifestyle, or to stick to medical treatment, may play a role.

“All these things can be put under the basket of social support,” study author Quyyumi said. “Cardiovascular disease, even though we consider diabetes and high cholesterol to be high risk factors, it is sizably impacted by psychosocial status –- how stressed you are, how depressed you are. Being alone, lonely, etc. may well do the same.”

For people who are widowed or getting divorced, there may be other stressors that can lead to worse heart health. “After the depression and grieving, be alerted to the fact that your life is altered and don’t fall into high risk behaviors. Perhaps, create a social network,” Quyyumi said. “All those things become important.”

The researchers did not account for people who changed their marriage status during the study, but Quyyumi explained that would not likely affect the results because only a small amount of people in their sixties change marital status over the course of two to seven years. The study also did not specifically account for people who have partners, but are not married.

“I wouldn’t say that if you have heart disease, you have to get married. I’m not sure anyone has prescribed getting married to prevent getting sicker,” Quyyumi said. “But I think doctors and even family and friends can pay more attention when life events occur –- perhaps these people need extra care and attention to compensate for things they are now missing.”

Stroke & Dementia Risk Grows with Intake of Artificial Sweeteners

Diet sodas are gaining negative attention yet again, and for good reason. A recent study found that consuming a daily can of sugar-free soda is associated with higher risks of suffering a stroke or developing dementia. Heavily sugared drinks already had a bad rap for causing a myriad of health issues such as weight gain, liver damage, kidney stones, diabetes, and heart disease. This study has refreshed the concern for disease risk in those that believe diet soda is a suitable replacement.

Researchers found that drinking one diet soda a day is associated with a 2.96 times more likely chance of suffering an ischaemic stroke and a 2.89 times higher chance of developing Alzheimer’s. While it would be irresponsible to imply that artificial sweeteners actually cause stroke or dementia (proving causation is very difficult in health studies) it is important to acknowledge the study’s warning. There is a correlation between artificial sweeteners and the increased risk of dementia and stroke that’s very concerning. It’s certainly an added consideration that keeps me far away from diet sodas.

Artificial sweeteners have also been associated with health concerns besides stroke and dementia. A 2009 study found that people who consumed diet drinks daily had a 67 percent higher risk for type 2 diabetes and a 36 percent higher risk of metabolic syndrome.

It has been found that artificial sweeteners can dangerously impact your gut microbiome. One study suggests that artificial sweeteners favor bacteria that pull energy from food and convert it into fat. Meaning, If you are consuming zero calorie sweeteners specifically to cut down on weight gain, you aren’t doing yourself any favors. Additionally, studies suggest that fake sugar can induce glucose intolerance, which can be a precursor of increased risk for liver and heart disease.

It has also been shown that artificial sweeteners can have a more potent taste and flood your sugar receptors. Meaning if you are regularly using artificial sweeteners you may find naturally sweet foods less appealing making it more difficult to satisfy your sweet craving. It can also contribute to making bitter foods such as vegetables taste downright disgusting. This can contribute to a vicious cycle of increased sugar intake, which can cause a cascading effect on your overall health.

Cheese: A Heart Healthy Snack?

Cheese is typically considered more of an indulgence than a health food, but a new review of research suggests that it may not be as bad for you as once thought. In fact, people in the analysis who ate a little bit of cheese every day were less likely to develop heart disease or have a stroke, compared to those who rarely or never ate cheese.

Cheese, like other dairy products, contains high levels of saturated fat—which has been linked to high cholesterol, atherosclerosis and an increased risk of heart disease. (Recently, however, some nutrition experts believe that saturated fat is more benign.) But cheese also contains potentially beneficial ingredients like calcium, protein and probiotics, wrote the authors of the new paper, published in the European Journal of Nutrition.

To learn more about how long-term cheese consumption affects a person’s risk for cardiovascular disease, researchers from China and the Netherlands combined and analyzed data from 15 observational studies including more than 200,000 people. All but one of the studies excluded people with existing heart disease, and all but two tracked people for 10 years or more.

The researchers’ findings were “certainly different from what people might expect,” says Dr. Allan Stewart, director of aortic surgery at Ichan School of Medicine at Mount Sinai Medical Center, who was not involved in the new analysis. Overall, people who consumed high levels of cheese had a 14% lower risk of developing coronary heart disease and were 10% less likely to have a stroke than those who rarely or never ate cheese.

The relationship, however, was U-shaped rather than linear—meaning that higher quantities of cheese were not necessarily better. The people who had the lowest risks for heart disease and stroke were those who consumed, on average, about 40 grams a day—about the size of a matchbook. (According to the review, the average American eats about 42.5 grams a day.)

“This is not the same as eating a big slice of cheesy pizza every day,” says Stewart. He also cautions against reading too much into data that’s self-reported—as much of the data was—because people tend to over- or under-estimate their consumption of specific foods.

Stewart points out that the study was only able to find an association between cheese consumption and decreased risk of heart disease, rather than a cause-and-effect relationship. It could be that people who eat cheese on a daily basis are healthier overall, or have more disposable income and higher socioeconomic statuses.

But it’s also possible that cheese has beneficial qualities that offset the negative impact of its high saturated fat content, says Stewart. “Cheese can be high in probiotics, which tend to put you in less of an inflammatory state,” he says. Cheese also contains conjugated linoleic acid (CLA), an unsaturated fatty acid that may increase the amount of of HDL “good” cholesterol and decrease “bad” LDL levels.

“There is some evidence that cheese—as a substitute for milk, for example—may actually have a protective effect on the heart,” says Stewart. “No one’s saying you should definitely go out and eat 40 grams of cheese a day. But on the upside, a bit of cheese on a cracker doesn’t sound unreasonable.”

The study did not look at different types of cheeses, and Stewart says more research is needed to know whether certain varieties hold more health benefits (or risks) than others. Overall, though, the news is good for cheese lovers.

“We’re always are searching for ways to minimize heart disease and reduce atherosclerosis,” he says. “It’s promising to find that something that actually tastes good—and pairs well with a nice glass of red wine—may offer some protection, as well.”