How to Help Your Heart

We'd all like to hear that our risk is zero, but you are not going to get that kind of reassurance from any honest physician or risk-prediction tool. Given your family history, you should do your best to get your blood pressure and cholesterol to optimal levels, even if your current levels are normal. That means using diet and exercise to get your blood pressure under 120/80 and your LDL cholesterol under 100.

Albuquerque, N.M.: My 18-year-old son's blood pressure has been running 140/90. He is thin, walks a lot and doesn't smoke. Since childhood he has taken daily decongestants (Rynatan or Sudafed) for allergies. Could that be the cause? If he stops the Sudafed, how long will it take for his blood pressure to come down?
That is high blood pressure for a teenager, and the decongestants you describe could indeed be the problem. They include a medication called pseudoephedrine, which helps runny noses by causing blood vessels to clamp down and allow less fluid to leak into the lining of nose, throat and sinuses.

The problem with pseudoephedrine is that this constricting of blood vessels can also cause blood pressure to rise. He should stop those medications, and use just antihistamines (like over-the-counter Loratadine) to control his allergy symptoms.

If his blood pressure is still high after a few days, then his doctor should examine him to look for other causes of high blood pressure, such as kidney disease, narrowing of the aorta or arteries supplying the kidneys, or hyperthyroidism.

Oakville, Canada: Does extra-virgin coconut oil increase the risk of heart disease?
It's a mixed story at best. Coconut oil is a saturated fat, like the kind of fat found in milk, butter and red meat. This kind of fat raises LDL cholesterol, which increases your risk for heart disease. Saturated fats also raise the "good" cholesterol, HDL, but the consensus is that saturated fats cannot be considered a heart-healthy food.

Why, then, are their ads in magazines and on the Internet claiming that extra-virgin coconut oil might reduce one's risk for heart disease? The fatty acids that are the main components of coconut oil are shorter than those found in saturated fats in animal products, so they might not have the same adverse effects as, say, a cheeseburger. Still, no one has proved that this type of saturated fat is good for your heart. If anything, we think it's "guilty until proved innocent."