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HEART Insight:
doi: 10.1097/01.HEARTI.0000422827.21269.fc
Departments: Ask the Experts

Asked and Answered: A Panel of Leading Cardiologists Tackles Your Questions

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Send your questions via e-mail to: (please include “Ask The Expert” in the Subject Line) or write to HEART INSIGHT at: 333 Seventh Avenue, 19th Floor, New York, NY 10001.

This Information is Provided as an Educational Resource, and is not meant to substitute for medical consultation or care. all questions are subject to be edited for clarity. Neither the American Heart Association nor the publisher guarantees that every question will be published and answered.

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Drug Interactions

Q I've been told I can't eat green, leafy vegetables because I am on warfarin. Is that really true?

A Warfarin (brand name, Coumadin®) is a blood thinner that is used to treat blood clots in the veins or lungs and to prevent stroke in patients with artificial heart valves or heart rhythm problems, such as atrial fibrillation. Vitamin K, which is found in spinach, kale, collard and mustard greens, can counteract the effectiveness of warfarin. But these and other green, leafy vegetables are an important part of a healthy diet and should be eaten in moderate amounts. If you have stopped eating green, leafy vegetables and want to reintroduce them into your diet, your doctor can adjust the dose of warfarin so that it works the way it's supposed to.

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— CLYDE W. YANCY, M.D., F.A.C.C., F.A.H.A., F.A.C.P.

Medical Director, Baylor Heart & Vascular Institute

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Medical Devices

Q I have a pacemaker. Do I need to take any precautions when I go through airport security?

A If you have a pacemaker or an implantable cardioverter defibrillator (ICD), you should avoid the metal detectors at airport security checkpoints, as well as hand-held wands that may be used by screeners. The electromagnetic field generated by walk-through and hand-held metal detectors can adversely affect the functioning of these cardiac devices. It's best to tell security personnel that you have a pacemaker or ICD, and show them a note from your physician along with the government-issued ID that all passengers must show. You will then be taken aside and given a “pat-down” inspection.

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— N. A. Mark Estes, M.D., F.A.C.C.

Director, New England Cardiac Arrhythmia Center, Tufts-New England Medical Center

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High Blood Pressure

Q I have high blood pressure. Is it a good idea to monitor my blood pressure at home?

A In a word, yes! Your blood pressure can vary quite a bit over time, and checking it several times a week at home can determine whether it is being consistently and effectively controlled by the treatment regimen your doctor has prescribed. Uncontrolled blood pressure is a major contributor to heart attack, stroke and other cardiovascular problems. If you find that your blood pressure changes, keep a log so that you and your doctor can try to figure out when and why – and whether your medicine needs to be adjusted.

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For example, you may have “white coat hypertension,” meaning that your blood pressure is higher than usual when you're at the doctor's office. If the blood pressure measurements you take at home show that you are usually at the target level your doctor recommends, he or she will know that you are on the right medicines.

— Michael A. Bettman, M.D., F.A.H.A.

Vice Chair for Interventional Services, Wake Forest University Baptist Medical Center

© 2008 American Heart Association, Inc.