July Newsletter
July, 2022
Welcome to the July newsletter. This newsletter aims to provide information and analysis of timely topics from recent articles published in the medical literature. I hope you find this information useful and helpful in your health journey. If you have comments or questions, please let us know!
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Heart disease is the top health problem. In previous newsletters, we have discussed methods of detection. This month We will look at ways to prevent the progression of heart disease. The first study examined the most important factor in the progression of coronary artery plaque. It will not be what you think it is, but this factor increased risk 4X if it was higher than it should be. Since we all will develop heart disease if we live long enough, this article is of interest to everyone.

After the first article, we will know what we need to control to reduce our risk of heart disease progression. The second article shows us something we can do to improve our risk without medication.

Finally, we will look at a more vigorous option which is great for maintaining body weight (very important) and also getting a great low-impact workout that can be intense enough for any athlete.

I hope you enjoy these articles!
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Keep It Down
Coronary atherosclerosis is a build up of plaque in the arteries supplying the heart. People can have coronary events even when considered low risk and subclinical atherosclerosis is responsible for most of these events. This is why we screen lipid levels and I often recommend heart scans to get an idea of potential risk in people who don’t have any cardiac symptoms. Waiting until people have symptoms is too late. What are the most important things to monitor when we are worried about plaque development and progression? Is it just cholesterol levels? How about blood glucose levels? Does BMI/body weight matter? There is one risk factor that stood out in this study. Controlling this risk factor likely trumps everything else in people with no cardiac symptoms.  

How To Do It
Can walking lower blood pressure? We learned in the last article that lower blood pressure is very important for the prevention of coronary artery plaque progression. Most of us don’t want to take more medications, so how can we lower our blood pressure naturally? Is walking the answer? 
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Better Way To Do It?
We know that physical activity is important for our healthy lifestyle. As we age some of us may be looking for low-impact activities that provide a good workout. This study compared 12-week training programs of high-intensity interval training (HIIT), moderate-to-vigorous intensity continuous training (MICT), and Nordic walking (NW) and their effects on functional capacity, quality of life, and depression symptoms. Is one exercise type better than the others? If so, which one is the best for overall health? 
To Your Health...
Thank you for taking the time to read through this newsletter. We hope you have found this information useful. Feel free to pass this on to anyone you think would benefit from this newsletter.

Mark Niedfeldt, M.D.


Old-fashioned medicine with 21st Century convenience and technology