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Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart.

What to Know About Heart Failure

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart. While heart failure is a progressive condition with the potential for serious health complications, it can be managed through lifestyle changes and medication. Read on to learn about heart failure symptoms, causes, and treatment options.

In all cases of heart failure, the heart cannot deliver enough blood and oxygen to the rest of your body. Sometimes this is because weakened heart muscle leaves the heart’s main pumping chambers — the ventricles — unable to carry out their pumping function. This type of heart failure is called heart failure with reduced left ventricular function (HF-rEF). In other cases, the ventricles are too stiff to fill with enough blood between beats. This type of heart failure is called heart failure with preserved left ventricular function (HF-pEF).

Ejection fraction (EF) is an important measurement of heart function for those who have heart failure with reduced left ventricular function. Expressed as a percentage, EF measures the amount of blood pumped from the left ventricle when it contracts. An EF of 55 to 70% is considered a healthy range.

Since heart failure is a progressive condition, your EF gives your doctor insight into any changes in your heart function. An echocardiogram is the most common way to measure your EF, but a magnetic resonance imaging (MRI) scan or nuclear stress test may also be used.

Despite the importance of EF, it is not the sole determinant of heart function. Those who have heart failure with preserved left ventricular function may have a normal EF. These cases of heart failure are often caused by high blood pressure, which gradually thickens the ventricles. Stiff ventricles cannot relax enough to fill to their full capacity, which is why they do not pump out enough blood.

Heart failure can affect many other organs, including the lungs, liver, and kidneys. The potential for additional health complications increases as heart disease progresses, which is why it’s important to stay proactive about your health and follow your doctor’s recommendations for treatment.

Heart failure primarily occurs as the result of other health conditions that weaken or stiffen the heart. Coronary artery disease, the most common type of heart disease, is the leading cause of heart failure. The condition gradually narrows and thickens the arteries that supply your heart with blood and oxygen. Severe blockages in the arteries can prevent the heart from pumping enough blood, leading to the development of heart failure.

High blood pressure is another common cause of heart failure, particularly cases of heart failure with preserved left ventricular function (HF-pEF). If you have high blood pressure, your heart has to work harder to deliver blood to the rest of your body. Over time, this can make your left ventricle too stiff to properly pump out blood.

Both type 1 and type 2 diabetes are linked to heart failure, as high blood sugar can affect your blood vessels and cardiac nerves. Heart failure may also be caused by a variety of heart health conditions including cardiomyopathy, congenital heart disease, heart valve disease, and arrhythmias.

Lifestyle factors such as smoking, eating a high-cholesterol or high-sodium diet, heavy alcohol consumption, and a lack of physical activity may increase your risk for heart failure, especially if you have one of the conditions above.

These are some of the most common symptoms of heart failure:

Shortness of breath when exercising or lying down

Fatigue and a feeling of weakness in your legs

Swelling in your ankles, legs, and abdomen

A persistent dry, hacking cough or wheezing

There is a spectrum of severity of heart failure cases, and treatment varies by individual depending upon symptoms and heart function, as well as the underlying cause. If you have early-stage heart failure, your doctor may recommend lifestyle changes and prescribe medications that can alleviate symptoms and prevent the condition from progressing.

The following medication classes, many of which lower blood pressure, are commonly used to treat early stages of heart failure.

Angiotensin converting enzyme (ACE) inhibitors

Often used to treat high blood pressure, ACE inhibitors block production of a hormone that causes blood vessels to narrow, helping constricted blood vessels expand so that more blood can flow through.

Like ACE inhibitors, ARBs protect blood vessels from a hormone that causes them to narrow, lowering blood pressure.

Another medication class commonly used in the treatment of high blood pressure, beta blockers cause the heart to beat more slowly, which lowers your blood pressure and opens up your veins and arteries.

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart can beat with less force. This opens up narrowed blood vessels and lowers blood pressure.

If you have atrial fibrillation — an irregular heart rate condition — or another heart health condition, your treatment plan for heart failure may include anticoagulants, medications that reduce the blood’s ability to form new clots and prevent existing clots from growing.

Cholesterol-lowering medications such as statins may be used to treat those who have early-stage heart failure and high cholesterol.

Many people with heart disease retain fluid. Diuretics, also referred to as water pills, can help eliminate excess water and sodium, which reduces the heart’s workload.

Small lifestyle changes are an important part of managing mild to moderate cases of heart failure. They can help alleviate symptoms and slow the progression of the condition. Here are some of the lifestyle changes your doctor may recommend.

Avoiding or limiting your caffeine intake

Anyone can benefit from these lifestyle changes, even those who do not have heart failure. Heart-healthy living is a lifelong practice, and the best way to prevent health issues like heart failure in the future is to prioritize your heart health today.

Some individuals with more advanced heart failure may need a procedure such as coronary bypass surgery or an angioplasty, both of which target a blocked coronary artery. Pacemakers may also be used to help control the rhythm of their heart, often in tandem with a bypass surgery and medications. 

Protect your heart with support from Alto

At Alto, we make it as simple as possible to manage your risk for heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Overall heart health involves all the components of this complex network. Coronary artery disease — the most common type of heart disease — affects your blood vessels and the flow of blood to your heart. It typically develops over the course of many years, and many of the key risk factors can be managed. Here’s what to know about preventing and treating this type of heart disease.

Coronary Artery Disease, Explained

Your heart is at work every minute of the day, pumping blood to deliver oxygen to vital organs. Each part of the heart plays a role in this important task, along with the rest of your cardiovascular system, including your arteries and blood vessels.

Like any organ in your body, your heart needs oxygen to function. Coronary arteries are the blood vessels that supply your heart with oxygen-rich blood. Coronary artery disease occurs when these blood vessels are hardened or blocked, affecting the flow of blood to the heart itself.

This condition is often caused by atherosclerosis — the accumulation of substances like cholesterol and blood-clotting material in your arteries. (These substances are collectively referred to as plaque). A variety of factors can increase your risk for atherosclerosis — and therefore your risk for heart disease — including high LDL cholesterol, high blood pressure, diabetes, obesity, physical inactivity, and smoking. Additional key risk factors for heart disease include age and family history. 

There are several known symptoms of coronary artery disease, including chest pain or tightness (also called angina) and shortness of breath. Depending on where your blood vessels have narrowed, you may also experience pain, numbness, or weakness in your arms or legs. Women are more likely than men to experience additional symptoms such as nausea, back and jaw pain, and shortness of breath without accompanying chest pain.

Symptoms of coronary artery disease present differently from one person to another. It is best to discuss your risk of heart disease with your doctor if you have concerns rather than waiting for symptoms to appear. It’s especially important to be proactive if you have a family history of heart disease.

In the long term, coronary artery disease can increase your risk for other heart health issues, including heart attack and heart failure, which occurs when your heart cannot pump all of the blood that your body needs. These serious health risks are preventable — by identifying coronary artery disease at an early stage and following the treatment plan your doctor recommends, you can manage the condition and lower your risk for related complications.

Too often, people learn that they have coronary artery disease only after experiencing a more serious complication like a heart attack, stroke, or heart failure. Consulting with your doctor about your risk for heart disease and staying up to date with blood pressure, cholesterol, and blood glucose screenings is key to detecting heart health problems early on. Here are some of the numbers your doctor will track to identify your risk for heart disease, along with your individual and family health history.

The National Institutes of Health defines normal blood pressure for most adults as below 120 mm Hg systolic and 80 mm Hg diastolic. (Systolic pressure, the first number in your blood pressure reading, is typically the reading that’s most important when monitoring blood pressure.) If your blood pressure falls in this range, typical screening frequency is at least once per year. If your blood pressure is in a higher range, ask your doctor about recommended screening frequency.

Your cholesterol levels can also help your healthcare provider identify your risk for heart health issues. If your total cholesterol is under 200 mg/dL, you can have your cholesterol checked every 4-6 years. If you are at higher risk for heart disease and stroke, consult your doctor about recommended screening frequency.

In the long term, high blood sugar can damage your blood vessels, and diabetes is a risk factor for coronary artery disease. It’s important to monitor your blood glucose levels as part of your broader heart disease prevention efforts, especially once you enter your 50s and 60s. Your doctor can advise you on recommended screening frequency.

Remember that it’s never too early or too late to prioritize heart-healthy living. Read our previous blog, ‘How to Prevent Heart Disease at Any Age’ to learn about important heart disease prevention actions for your age group.

If you have coronary artery disease, your doctor may recommend lifestyle changes and/or medications to manage your heart disease risk factors. Quitting smoking, planning a heart-healthy diet, and exercising more frequently are often a first step in managing coronary artery disease.

The specific medications used to treat coronary artery disease vary by individual. Your doctor may prescribe one or more of the following types of medications depending on your health history:

Cholesterol-lowering medications like statins, fibrates, and niacin

Blood pressure medications like beta blockers, calcium channel blockers, and ACE inhibitors

Anticoagulants and antiplatelets to reduce your risk of blood clots

Heart-healthy living is a lifelong practice, and heart disease prevention or treatment is an ongoing commitment to your health. At Alto, we make it as simple as possible to manage your risk for heart health issues like coronary artery disease and stay on top of cholesterol-lowering or blood pressure management medications. 

We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Prioritizing your heart health becomes even more important during the holiday season. The good news? A little self-care goes a long way, and even small actions can have a big impact on your physical and mental well-being. Here are simple ways to keep your heart healthy this holiday season

How to Keep Your Heart Healthy During the Holidays

Prioritizing your heart health becomes even more important during the holiday season. Not only is it more difficult to maintain your typical exercise routine and healthy habits amid the shopping, traveling, and hosting, but the seasonal stress can also put more strain on your heart. The good news? A little self-care goes a long way, and even small actions can have a big impact on your physical and mental well-being. Here are simple ways to keep your heart healthy this holiday season.

Stress can increase your risk of heart disease both directly and indirectly. It increases inflammation, which is linked to high blood pressure, and can also lead to sleep deprivation or disruption, another risk factor for heart disease.

As you plan for heart-healthy holidays, identify potential sources of stress in advance and look for opportunities to limit it. Some degree of holiday stress is bound to occur, but try to avoid overextending yourself by setting priorities and limiting how much you take on.

Throughout the season, watch for the emotional, physical, and behavioral symptoms of stress. Each individual experiences stress differently, but common signs include headaches, chronic pain, decreased energy, changes in appetite, digestive issues, and depression.

If you find yourself feeling overwhelmed, seek out positive outlets for stress relief, like mindfulness, meditation, and exercise. Simply pausing to take a breath on a busy day can help counteract the physical effects of stress: in signaling the brain to calm, deep breathing can lower your heart rate and blood pressure.

In addition, here are some apps that can help you proactively manage stress and anxiety this holiday season:

Insight Timer, which offers a variety of free guided meditations

What’s Up?, which uses a cognitive behavioral therapy (CBT) approach to managing stress and negative thoughts

It may seem difficult to maintain a heart-healthy diet during the holidays: sodium — which can lead to high blood pressure — and trans fats — which increase your blood levels of “bad cholesterol” — are found in many popular seasonal dishes.

Prioritizing your heart health during the holidays doesn’t mean avoiding your favorite foods altogether, but rather trying to strike a balance. If you’re preparing food for holiday celebrations, look for small ingredient swaps that can transform a dish into a heart-healthy recipe. The American Heart Association has a list of holiday recipe hacks like swapping Greek yogurt for sour cream and applesauce for butter, and cooking with low-sodium or frozen vegetables.

The importance of moderation also applies to drinking, as increased alcohol consumption over the holidays can also impact your heart health. In the long term, heavy alcohol use — defined by the CDC as 8 or more drinks per week for a woman and 15 drinks or more for a man — may increase your risk for high blood pressure, heart failure, and stroke. In the shorter term, experiencing an increased heart rate as the result of drinking heavily during holiday celebrations is sometimes referred to as “holiday heart syndrome.”

Get creative with making time for exercise

It’s great to set New Year’s fitness goals, but that doesn’t mean November and December are a time to step back from your exercise routine. Regular physical activity lowers your risk for heart disease, and it’s especially important to stay active during the holidays in light of the added stress and opportunities to overindulge.

If you’re struggling to carve out time for exercise amid the hectic holiday season, get creative with how you fit exercise into your day. While it’s generally good to aim for about 30 minutes of exercise per day, your heart will benefit from even a quick 15 or 20-minute workout. Look for opportunities to fit in quick bursts of physical activity. Doing an extra lap at the mall while holiday shopping or taking the stairs instead of the escalator counts! Other daily activities that will get your heart pumping? Gardening or shoveling snow, depending on where you live, or going for more frequent walks with family.

And if you’re looking for easy ways to get in exercise during your holiday travels, browse free online workouts or try travel-friendly exercises like push-ups, planks, walking lunges, or jumping jacks.

It’s also important to continue to follow the treatment plan your doctor recommends even when celebrating or traveling. Most medications used to treat high cholesterol or blood pressure, or other conditions related to your heart health, need to be taken as prescribed every day in order to be effective. Not only that, but skipping the medication or stopping use of it abruptly may put you at risk for serious heart health issues.

During the holidays, it isn’t uncommon to accidentally leave your medication at home while traveling, or to run out of refills on a holiday. Take stock of your prescriptions well in advance of the holidays and make sure you have what you need to manage your health, especially if traveling. (We designed our app to help you stay on track with your medication, with reminders and auto refills.)

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications this holiday season. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly

Here are seven unconventional ways to support your heart that have sparked the interest of leading health experts. 

7 Unusual Heart Health Risk Factors

What Science is Revealing About Heart Health

Researchers are working hard to curb the impact of heart disease, which is currently the leading cause of death in the United States. These efforts to develop new prevention strategies have led them to some surprising heart health hypotheses. You probably know that you should eat well and stay active, but these lesser-known risk factors may not be on your radar. Here are seven unconventional ways to support your heart that have sparked the interest of leading health experts. 

It turns out, brushing your teeth may have more benefits than just sparkly whites and fresh breath. Numerous studies have documented a link between poor dental health and heart disease. The verdict is still out as to why, but the prevailing theories point to inflammation. It could be that the bacteria which infect gums enter the bloodstream and cause blood vessel inflammation or that the body’s immune response is to blame. While more research is needed, it’s one more reason to brush your teeth for the recommended two minutes twice a day and get regular dental checkups. 

There have been some interesting studies exploring the connection between workplace stress and heart health. A decade-long study in Sweden found that having a bad boss increases your risk of a heart attack. Additional research has suggested that working long hours may increase your risk of cardiovascular disease and stroke. 

A key takeaway here is that stress, in general, isn’t great for your overall health. Stress causes your cortisol levels to spike, which can lead to high blood pressure, weight gain, sleep disruption, and reduced energy over time. Not to mention, your diet, exercise routine, and other healthy habits often suffer when you’re stressed out. Make sure to find ways to unwind at the end of your workday, whether that means listening to a relaxing soundtrack on your drive home or a brief meditation before you make dinner. Sometimes you can’t avoid challenging coworkers or chaotic days, but you can put strategies in place to help you feel calmer and more resilient. 

Not that you needed another reason to love your pets, but several studies have shown that pet ownership, especially having a dog, can improve heart health. According to Harvard Health, researchers have found that dog owners have lower blood pressure and cholesterol than non-owners, probably because dogs require daily walks and tend to have a calming effect on their humans. 

If you’re not a dog owner, we don’t advise adding pets to your life purely as a health strategy. Instead, you might consider stopping to meet some of your four-legged neighbors. A few studies have found that just petting a dog can lower your blood pressure. 

Sleep is the unsung hero of the health world. It allows your whole body to rest and replenish. Although your heart never stops beating, it does slow down and recover during sleep. According to John Hopkins Medicine, by depriving your heart of this crucial recovery time, lack of sleep increases your risk of heart attack and heart disease.

If you have trouble sleeping, creating a nightly ritual can help. Try to wind down at the same time every evening and create a calm, dark, and quiet environment in your bedroom. You should turn off your electronic devices at least thirty minutes before bedtime to help your body prepare for restful sleep. 

If you find yourself tossing and turning on the regular, it’s best to talk with your doctor. Various underlying and unsuspecting conditions could be causing your lack of sleep and there are many different therapies that can help.  

For more sleep-enhancing tips, read, “Too Stressed to Sleep? These Strategies Can Help.”

Bring on the oatmeal and scrambled eggs! When a panel of experts from the American Heart Association reviewed studies on eating habits and heart health, they formed an intriguing conclusion: breakfast-eaters tended to have lower instances of heart disease and were less likely to have high cholesterol and high blood pressure.

If you struggle to make time to eat in the morning, the American Heart Association suggests these breakfast hacks for some quick and easy meal ideas. Harvard Health recommends including whole grains in your morning meal to further reduce your risk for heart attack, stroke, and heart failure. They offer this menu of options full of whole grains, protein, and fruit. 

We all love a good movie marathon, but regularly sitting for hours at a stretch could be putting your heart at risk. And yes, that includes long workdays at the computer. 

The American Heart Association and the American College of Cardiology have both warned that regularly sitting for long periods is a significant contributor to heart disease. It’s not an issue of laziness—in a world full of deskjobs, car trips, and the all-important need to unwind, many of us struggle to find time to get the consistent movement our bodies need.

If you’re stuck sitting for long periods, the American Heart Association suggests finding ways to sneak movement into your day. You might try setting a timer and taking a five-minute stretch break every hour or using your lunch break to go for a walk. Every extra minute on your feet will help you get to the recommended 150 minutes of activity per week. Exercise also helps you reduce stress and sleep better, making it a true heart-health allstar. 

Several studies suggest an association between optimism and a lower risk of cardiovascular disease. A 2015 study found that those with a more positive outlook were more likely to make healthy lifestyle changes after a heart attack. And a researcher at the University of California, San Diego, found that patients with a greater sense of gratitude had lower levels of inflammation and better heart health overall.

Robert A. Emmons, Ph.D., a professor of psychology at the University of California, Davis, told the American Heart Association, “Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life. It can lower blood pressure and improve immune function...grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol and have higher rates of medication adherence.”

If optimism doesn’t always come easy to you, you’re not alone. Psychologists believe we have a natural tendency to fixate on negative information as a way to avoid it in the future. It’s a phenomenon known as “negativity bias.” Practicing gratitude is a powerful way to counteract this inclination. Best of all, it’s easy to get started. Your new habit can be as simple as writing down what you’re grateful for every day. 

When you look closely, these unconventional risk factors aren’t really that surprising. They each relate to foundational heart-healthy lifestyle choices such as managing stress, eating healthy foods, and staying active. This advice aligns with the CDC’s guidance, which outlines six essential strategies for living a heart-healthy lifestyle. 

If you’re concerned about your heart, the CDC recommends learning about your family’s health history and talking to your healthcare provider about your risk. Together you can create an action plan that’s best for you. If your doctor prescribes medication to treat high cholesterol, high blood pressure, or diabetes, the CDC stresses the importance of taking it as directed. 

Alto’s expert pharmacists will always be available via in-app message or phone to answer questions about dosage instructions or side effects, and we’d be happy to bring your medications to your doorstep for free. Your heart-healthy lifestyle does not have to include standing in line at the pharmacy or worrying about refills. We’ll take care of the details so you can focus on cooking a healthy breakfast or walking your dog. 

Blood pressure is one critical way the heart maintains its happy, healthy medium. In this article we'll explore how to manage high blood pressure and what you can do to maintain healthy blood pressure.

The Lowdown on Healthy Blood Pressure

Blood is constantly flowing through every part of your body, propelled by the beating of your heart. Though this hardworking muscle is only about the size of your fist, it contracts sixty to eighty times per minute, sending oxygen-rich blood to the farthest reaches of your body and back. 

Like any finely-tuned machine, the heart requires balance to remain in optimal condition. If it doesn’t pump hard enough, its vital job doesn’t get done. But if it starts working too hard, it runs the risk of tiring and eventually giving out. Blood pressure is one critical way the heart maintains its happy, healthy medium.

Blood pressure is the force of the blood as it moves through the body. It’s important because we need blood to deliver the oxygen and nutrients that nourish our tissues along with antibodies and white blood cells for immunity. Blood pressure also helps us remove the waste products of our metabolism, like carbon dioxide and toxins from the liver and kidneys. 

The heart creates blood pressure with every contraction, but there are other forces at work as well. Blood keeps moving through the network of blood vessels in our bodies because of differences in pressure in our continuously narrowing arteries, veins, and capillaries. It’s similar to what occurs with multi-function showerheads. The amount of water flowing through your pipes remains the same, but a more narrow flow exerts more pressure while a widened spray feels more gentle.  

The initial, most substantial pressure comes from the heart, and the arteries’ structure helps maintain it as the blood continues to flow. 

A blood pressure reading measures two forces. Systolic pressure is the force that occurs as blood flows out of the heart and into the arteries. Diastolic pressure is the force created when the heart fills with blood as it rests between beats. 

These forces are measured using a sphygmomanometer, or what many of us know as the inflatable arm cuff that healthcare providers use during checkups. 

The cuff is inflated enough to stop the pulse, and a reading is taken. When the pulse returns, the cuff is allowed to deflate slowly, and another reading is taken. The numbers are expressed in terms of the pressure it takes to move mercury around a tube against gravity, a unit called millimeters of mercury (mm Hg). Your healthcare provider will give your reading as two figures—systolic pressure first and the diastolic pressure second—such as “140 over 80 mm Hg.” 

The National Institutes of Health advises that normal blood pressure for most adults is below 120 mm Hg systolic and 80 mm Hg diastolic. While both readings provide important information, “high blood pressure” typically refers to systolic pressure, the first number in your blood pressure reading. 

High blood pressure, also known as hypertension, is a condition that occurs when the force of the blood flowing through a person’s arteries is consistently above 130 over 80. The added pressure forces the heart to work harder and can stretch or injure the blood vessels. It also speeds the build-up of harmful plaque that can block blood flow, increasing blood pressure even further.

Over time, high blood pressure can lead to life-threatening issues like heart disease, heart attack, and stroke. It can also damage major organs such as your heart, brain, kidneys, and eyes. According to the CDC, high blood pressure usually has no early warning signs or symptoms. Getting your blood pressure checked regularly by your healthcare provider is the only way to determine whether your blood pressure is too high. 

It’s critical to detect high blood pressure early because it can be treated, usually through heart-healthy lifestyle changes with or without prescription blood pressure medications. Your healthcare provider can determine the right treatment plan for you. 

The American Heart Association encourages everyone to know their blood pressure numbers and adopt a more heart-healthy lifestyle. Impactful changes include eating a well-balanced diet that limits salt, staying physically active, taking steps to manage stress, reducing alcohol, and eliminating smoking. 

Even if you don’t have high blood pressure, eating less salt is one of the best choices you can make for your heart. Though sodium is essential for life, consuming too much salt pulls water into the bloodstream, increasing the volume of your blood. More blood flowing through your blood vessels exerts greater pressure on your heart. 	

The American Heart Association recommends that everyone limit their sodium intake to 1,500 mg/day. The biggest sodium culprits in the average American diet often don’t emerge from the salt shaker on the table. Processed or prepackaged foods like soups, cold cuts, bread, and frozen meals are major sources of excess salt because they often contain sodium-based preservatives and additives to enrich their flavor. It’s not always easy to determine by looking at their labels, however, there are several sodium-containing compounds to watch out for in the ingredient list, such as sodium benzoate, sodium tripolyphosphate, and monosodium glutamate (MSG). 

Start to make a habit of looking at labels while you grocery shop and choosing low-sodium options when possible. The American Heart Association created this sodium fact sheet to help you make heart-healthy choices. 

If your doctor determines that your blood pressure is too high, you’re certainly not alone. According to the CDC, nearly half of American adults have hypertension. If blood pressure medications become part of your treatment plan, we’d be happy to connect you with one of our pharmacists, who are specialists in heart medications. Plus, our free hand-delivery means you’ll never have to plan an extra trip to the pharmacy. With a few healthy lifestyle changes and the support of your doctor and pharmacy, your life doesn’t have to miss a beat. 

Managing your health during the pandemic is a long game. Here are five important heart health strategies to put into play during the COVID-19 pandemic.

Your Heart Health Playbook During COVID-19

What We Know about Heart Health and COVID-19

We mostly hear about how COVID-19 affects the lungs. But any serious viral infection can put stress on the heart by forcing it to work faster and harder as the body mobilizes to defend itself. Even more troubling, COVID-19 infection can cause blood clots in the heart’s arteries or attack and weaken the heart muscle itself. 

Anyone who is already managing high blood pressure or heart disease should take the potential for damage to their cardiovascular system seriously. Just don’t let vigilance and caution spiral into fear. While the gravity of the link between COVID-19 and cardiovascular health should not be understated, there are proactive ways you can support your heart and protect yourself from infection. 

Remember—managing your health during the pandemic is a long game. It’s crucial that you continue to take your medications as prescribed and receive necessary medical care. With this in mind, here are five important heart health strategies to put into play during the COVID-19 pandemic.

Five Heart Health Strategies During COVID-19

For months now you’ve been wearing a mask, social distancing, and avoiding crowded areas whenever possible. We know it hasn’t been easy, but keep it up. According to Penn Medicine cardiologist Helene Glassberg, MD, “The number one thing is to continue what you're doing, which is staying at home when possible, practicing safe distancing, and seeking medical attention if you're having problems.” Dr. Glassberg also recommends exercising caution as states experiment with loosening restrictions, advising, “Stay the course for as long as you can to stay well.”

There have been conflicting news reports involving some blood pressure medications and COVID-19. Despite what you might have read, don’t stop taking your medications without consulting your doctor. Not only is that never a good idea, but several recent studies indicate that there is no cause for concern when it comes to these medications. 

The confusion stemmed from the fact that two common classes of blood pressure drugs, known as angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), affect the same pathways in the body that the coronavirus takes to reach the lungs and the heart. Multiple types of both medications are available—commonly prescribed ACE inhibitors include lisinopril, captopril, and benazepril, while common ARBs include losartan, valsartan, and azilsartan. 

For a while, experts were unsure if these shared pathways meant that these medications might either help or harm people with the virus. According to Harvard Health, three different studies have found no evidence of harm for people infected with COVID-19 who continue to take ACE inhibitors and ARBs. While there is still research to be done, experts recommend that people already taking these medications should continue to do so. 

The same advice goes for any medications or lifestyle interventions that your doctor has prescribed. If anything, it is more important than ever to remain diligent with your cardiac care plan and stay in communication with your doctor. 

The prospect of sitting in the waiting room at the doctor’s office can be anxiety-provoking right now. While avoiding the doctor might feel like a safe choice in the short-term, skipping your appointments or ignoring symptoms could mean putting yourself at risk of serious health issues like heart attack and stroke, and increasing the danger of complications should you be exposed to COVID-19. 

Talk with your doctor about what safety measures have been put in place to protect you from COVID-19 exposure during your visits. Together you can assess the risks and create a plan to continue monitoring your blood pressure and heart health. Telehealth, which allows you to meet with your doctor via phone or video, may be an option and is often covered by insurance. 

If you pair virtual doctor visits with free hand-delivery of your prescription medications through Alto, you can avoid both the waiting room and long lines at the pharmacy. Transferring your prescriptions to Alto is easy and free—we’ll take care of the work for you. We’ll ask you to choose a convenient delivery window, and one of our couriers will bring your medications straight to your door at no additional cost. We can even provide completely contactless delivery if you prefer. 

Don’t Drop the Ball on Your Healthy Habits

Even though we’ve been at it for months, staying motivated to keep up healthy habits from home can still be a struggle. The stress and anxiety so many of us are feeling right now may affect our energy levels or cause us to lose interest in our usual activities. When facing distressing news reports or personal hardship, it’s tempting to self-soothe in various unhealthy ways. It’s okay to indulge sometimes, but try not to slide too far into less healthy coping mechanisms for the sake of your heart and your emotional well-being.

Cooking heart-healthy meals at home can boost your overall wellness and serve as a creative outlet. The American Heart Association created this resource for making smart shopping choices on a budget and offers a library of recipes to suit any skill level or craving. Staying active is equally important. If you find it difficult to work out from home, try thinking outside the box of what you’d normally consider fitness. For example, giving your kitchen a good scrub will get your heart rate up, and seeing your countertops sparkle will most likely relieve some stress. If you prefer to keep it simple, a brisk walk around your neighborhood is an effective choice that can help you feel connected to your community from a safe distance. 

Unfortunately, heart attacks and strokes don’t take a break when a global pandemic strikes. Do not delay getting emergency medical care because you fear going to the emergency room due to COVID-19. Heart disease is the number one cause of death in the United States, even now, and the hospital is the safest place you can be if you think you are experiencing a heart attack or stroke. Call 911 immediately at the first sign of trouble—the American Heart Association offers this resource for identifying a heart attack or stroke. We also recommend reading our article, “Heart Health Warning Signs to Watch Out For.” 

We are fully prepared to deliver your heart medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are stocked, our couriers are standing by, and our pharmacists are on-call to answer questions and assist with coordinating refills or requesting longer fills. We offer free, contactless delivery with every single prescription so you can rest easy at home knowing that everything you need is on its way. 

It’s important to be vigilant for symptoms of cardiovascular disease. But if your heart was on the decline would you know the warning signs? From the subtle to the serious, let’s take a look at some of the ways your body could be sounding the heart health alarm.

Heart Health Warning Signs to Watch Out For

Unfortunately, not everybody has a tell-tale heart. Sometimes, when trouble is brewing within your chest, the signs can be surprisingly subtle. The heart might send an SOS with barely a whisper or offer clues that it’s pumping less effectively in areas of the body where you don’t expect them. 

Chest pain is a classic sign of heart trouble. If the pain comes on suddenly, especially if it’s accompanied by dizziness, sweating, nausea, or shortness of breath, it’s time to call 911. You could be having a heart attack and you don’t want to hesitate.

While this sensation may be felt as a sharp or stabbing pain, it can also present as a tightness or pressure. Many people have described the feeling of a heavy weight on their chest. However it presents, any sudden and overwhelming feeling in your chest is cause for alarm. Be sure to seek medical attention right away.

It’s important to note that chest pain doesn’t always center on the heart. It’s common for pain to radiate to the jaw and neck or even into your back or arms. While pain in the center of the chest is the most common sign of heart trouble for both men and women, women are more likely to experience radiating pain signals than men (although men experience them too). 

Before a full-blown heart attack occurs, the heart might send warning signs in the form of more subtle pain for months or even years. If you have pain in your upper body that comes on with exertion and subsides with rest, it could be an indication there’s an issue with your heart. On the other hand, some heart attacks happen without any of these warnings, so don’t assume your pain is innocuous just because it’s happening for the first time. 

Your heart is a pump. When it isn’t functioning properly, less blood reaches your lungs and muscles, causing you to become tired and out of breath more easily. We all get breathless after a set of jump squats or a sprint, but if you find that your threshold is noticeably diminished—for example, becoming very tired or out of breath after walking up a flight of stairs or carrying groceries—it’s time to talk to your doctor. Additionally, if you experience breathlessness while lying down or otherwise at rest, it’s definitely a sign to get checked out.

Strange Sensations or Swelling in Your Limbs

If your blood vessels have become narrowed due to a buildup of fatty deposits, it can reduce the circulation of blood to your arms and legs. When this happens, you might experience pain, numbness, weakness, or coldness in your limbs. Much like chest pain, if the sensation worsens with exertion and subsides upon rest, it may be of particular concern. But tell your doctor about your symptoms no matter what.

On the flip side, when blood flow slows down, the blood returning to the heart can get backed up, causing a build-up of fluid in the tissues. If you have unexplained swelling in your feet, ankles, or legs it could be a warning sign of heart failure, so let your doctor know. 

If your heartbeat feels irregular or rapid, it’s not necessarily a reason to be concerned. That fluttery feeling could be caused by anxiety, dehydration, or even too much caffeine. However, it could also be a sign that your heart is attempting to play “catch up” after falling behind. Take note of what else is going on when you feel this sensation. If your heartbeat suddenly becomes rapid while you’re at rest or has frequent bouts at an oddly irregular pace, it could indicate that your heart is struggling. Tell your doctor about your symptoms. 

We all sweat, but usually we can attribute it to the blazing sun or a tough workout. Sweating is a normal, healthy function that helps the body cool itself down. However, if you break out into a cold sweat for no apparent reason, it could be a sign of a heart attack, especially if it is accompanied by any of the other symptoms mentioned here. If unexplained sweating starts suddenly and you don’t feel right, call 911 right away.

A little snoring here and there is totally normal. However, if you’re regularly waking up your whole household or making choking or gasping noises in your sleep, it could be a sign of sleep apnea—a condition where you stop breathing for brief moments throughout the night. According to John Hopkins Medicine, sleep apnea is associated with high blood pressure and an increased risk of heart attack. If you frequently wake up short of breath or your loved ones have resorted to sleeping with pillows over their heads, it’s a good idea to schedule a checkup. 

Most of the time, trouble achieving or maintaining an erection is a problem with circulation or blood pressure. According to the Mayo Clinic, erectile dysfunction could be an early warning sign of heart disease. While there may be other factors at play, your doctor should investigate the possibility of heart issues before recommending treatment. 

Your heart sometimes has a roundabout way of speaking up, so it’s important to know what you’re listening for. The earlier you detect the warning signs of heart disease, the easier it will be to treat. If any symptom or sensation is causing you concern, talk to your doctor, especially if you have a family history of heart disease, smoke, or have other underlying risk factors such as high cholesterol, high blood pressure, or diabetes. Heart disease is the number one cause of death in the United States year after year, but experts believe it is about 80% preventable. There are lifestyle changes, treatments, and medications that can help. 

If you and your doctor decide to explore treatment options for heart disease, know that our team will be standing by. Our pharmacies are stocked with the full assortment of heart health medications your doctor might prescribe and our cardiology specialists are available to answer your questions with a simple call or in-app message. We offer same-day delivery on all your medications so you don’t have to miss a beat while you ensure that your heart stays steady and strong. 

Our hearts work so hard for us. Is there a way we can return that effort and hopefully keep them beating for a long time to come? We answer this question and more as we explore your top heart health FAQs.

Your Top 5 Questions About Heart Health, Answered!

The human heart is astonishingly tireless. Over an average lifetime, it will beat 2.5 billion times and pump out millions of gallons of blood. With such an impressive output, it’s amazing it doesn’t malfunction more often. However, as exceptionally reliable as our hearts may be, they’re still susceptible to wear and tear. Heart disease is the leading cause of death in the United States, although the CDC estimates that it’s 80% preventable. 

What is the link between cholesterol and heart health?

Cholesterol gets a bad rep, but it isn’t inherently bad. Our bodies need it to build cells. We produce enough cholesterol on our own, but we also take it in when we eat animal products like meat and dairy. Additionally, foods that are high in saturated and trans fats can stimulate our bodies to make more cholesterol than we need. 

When there’s too much cholesterol in our blood it can build up in our artery walls, limiting or even blocking the flow of oxygen-rich blood to the heart. Even worse, if a chunk breaks off and blocks an artery that leads to the heart or brain, a heart attack or stroke may occur. 

The American Heart Association recommends having your cholesterol levels tested every 4 to 6 years unless your doctor determines that you should check more frequently. High cholesterol can be addressed through diet and lifestyle changes or your doctor may prescribe a cholesterol-lowering drug, such as a statin. 

We need the sodium in salt to live. But, as is often the case, we can have too much of a good thing. Excess sodium causes the body to hold on to more fluid. More water in the bloodstream increases the volume of blood, which in turn increases blood pressure. High blood pressure can put a strain on our heart and is a major risk factor of heart disease, so make sure your doctor checks yours regularly.

Most Americans consume far more sodium than they need. The American Heart Association recommends no more than 2,300 mg of sodium per day, which is equivalent to one teaspoon of salt. Some of the biggest hidden-sodium culprits are processed meats, canned foods, frozen dinners, and prepared sauces and condiments. If you’re seeking convenience, look for an option that’s labeled “low sodium.” 

How do I make heart-healthy food choices?

Beyond reducing sodium, The American Heart Association recommends including plenty of vegetables, fruits, and whole grains at every meal. A high-fiber diet has been shown to reduce the risk of heart disease.

Limiting saturated and trans fats will have the biggest impact on lowering your cholesterol. Try to choose skinless poultry, fish, and legumes over red meat and stick to low-fat dairy when you can. You’ll also want to favor nontropical vegetable oils like olive, corn, or canola over saturated oils like coconut or palm and avoid hydrogenated margarine and shortening. There are plenty of ways to substitute ingredients in your favorite meals to make them better for your heart.

Finally, while there are many vitamins and supplements out there claiming to promote heart health, studies on some, such as calcium and vitamin E, have been conflicting. After completing a review of the relevant research, a team of researchers at Johns Hopkins cautioned against relying on supplements. Physician Edgar R. Miller III, M.D., Ph.D., summed up their findings by saying, “The bottom line is, we don’t recommend supplements to treat or to prevent cardiovascular disease.” One possible exception is omega-3 fatty acids, however Miller recommends dietary sources such as fish or walnuts. 

What lifestyle choices will help keep my heart healthy?

We’ve already discussed the importance of monitoring your blood pressure and cholesterol levels as well as reducing sodium intake and choosing heart-healthy foods. Here are three more ways to give your heart a boost. 

Quit smoking: According to the CDC, smoking is a major cause of heart disease, accounting for about a quarter of all related deaths in the United States. It’s not easy, but you can give up cigarettes for good—the American Heart Association provides some helpful tips. 

Don’t forget your cardio: Activities like walking, running, swimming, and biking will help to condition your heart and lungs. Try to get your heart rate up by exercising at a moderate intensity for at least 2-3 hours per week. How do you know if you’ve hit the sweet spot in terms of intensity? Well, the CDC explains that the “talk test” can help. You’ll know you’ve reached moderate intensity if you can comfortably talk but not sing. 

Manage stress: Research suggests that high levels of cortisol from long-term stress can increase cholesterol, blood sugar, and blood pressure—all common risk factors for heart disease. Plus, some of the unhealthy ways we deal with stress, like smoking and comfort foods, are contributors as well. For a more positive outlet, The American Heart Association suggests these stress-busting activities. 

What are the warning signs of a heart attack?

Though we’re used to seeing dramatic depictions in the movies, not all heart attacks occur with sudden intensity. Many come on gradually with only mild discomfort, but that doesn’t make them any less dangerous. 

According to the American Heart Association, chest discomfort—whether tightness, pressure, squeezing, or pain—is a major symptom to watch out for. The sensation may even radiate across your arm, back, neck, or jaw. Another major warning sign is shortness of breath, which can occur with or without chest discomfort. Additional symptoms of a heart attack include sweating, nausea, vomiting, or lightheadedness. 

If you experience these symptoms or any unusual sensations in your chest, call 911 right away. Getting immediate medical care could save your life. Every minute matters, so even if you’re not sure, don’t hesitate to get help. 

Staying curious about the many facets of heart health could help you live a longer, healthier life. Your heart needs your help maintaining its steady, life-giving pulse. Ask your doctor how you can reduce your risk of heart disease and make sure to get your blood pressure and cholesterol levels checked regularly. At Alto, we’re specialists in cardiac medications, so if you need a prescription to take care of your heart, we’ll be here to take care of you. 

Switch to Alto and you’ll always have a team of experts on your side. Our team is available to answer your questions from 6 am - 9 pm PT Monday - Friday, and 7 am - 6 pm PT on weekends; reach out by phone or in-app secure messaging.

Empowering Patients By Accelerating Healthcare Innovation

Mattieu Gamache-Asselin, CEO & Co-founder

Editor's Note: This post was updated on November 8, 2021, to reflect the rebrand of AltoMD to Alto Connect.

Today, I’m proud to announce Alto’s Series C round of $50 million. Over the past three years, we’ve proven that Alto’s model works for doctors and patients alike, reducing administration time for physicians and improving drug adherence rates for patients. This new funding will enable us to expand, reaching even more patients, and to further develop our full-stack platform, driving better health outcomes at a lower cost.

Alto removes the complexity from prescriptions to improve patients’ quality of life. Every prescription requires coordination among doctors, insurance companies, pharmaceutical companies, and of course the patient. Traditional brick-and-mortar pharmacies depend on fax, phone and paper, which causes delays, errors in fulfillment, poor adherence rates, and 20 hours of administrative work a week per physician.

We’ve reimagined and completely rebuilt the pharmacy infrastructure to eradicate these problems. Through our provider platform (Alto Connect) and pharmacy management software, doctors and insurers spend less time on administration and more time on patient care. For patients, we offer free same-day prescription delivery, but more importantly, cost transparency, personalized in-app and phone support, and faster coordination with doctors and insurance companies to get patients the care they need. Learn more about our app.

The typical Silicon Valley playbook is to enter many new markets rapidly, throw money at problems, and figure things out on the fly. That’s never been Alto’s approach. Because we’re working with critical, life-saving medications, messing up is not an option. We’ve diligently, methodically built robust systems to make certain we leave no patient behind, and we’ll keep that mentality as we expand. Now that we’ve built our critical foundations — the platforms and clinical expertise — it’s time to scale.

Geographic expansion
We want to make sure all of America can benefit from the Alto experience. Last month, we opened our HQ2 in Denver, where we’ve already hired 60 employees across patient care, pharmacy and clinical operations, as a stepping stone to nationwide expansion.

Therapeutic area expansion
So far, we’ve focused on deeply understanding and serving the retail, dermatology, fertility, biologics, and HIV markets. We’re now bringing the same empathy and customized service to autoimmune, endocrinology, and cardiology — areas where patients are frequently overwhelmed with logistics, paperwork and side effects, and where Alto could offer deep value as a trusted partner.

Pharmacy represents 10% of healthcare spending, a $3.3 trillion market. Most pharmacies focus on just capturing as much of that 10% as possible. A select few are working to eliminate the ineffective portions of pharmacy spending. But even they look at the pharmacy spending in isolation.

The truth is, pharmacy shouldn’t be viewed as a disjoint piece. At Alto, we believe better pharmacy will make all of healthcare more effective and reduce healthcare spending overall. We’ve already seen progress — for instance, Alto’s primary adherence rate is 40% higher than the industry average.

From patients, we’ve heard, “Being able to speak to an Alto pharmacist directly allowed me to figure out how my drugs were interacting and causing painful side effects.” Some patients are cost-sensitive and consider skipping the medications that manage their chronic conditions and prevent hospitalizations. We’ve helped by delivering $11 million in medication savings to our patients so far.

From doctors, a common refrain is: “This is the first time my patients have talked to me positively about a pharmacy, and it’s the first time I can actually see what happens to a prescription after I write it.” This experience is why doctors have been the primary fuel of Alto’s growth. UCSF, One Medical, Stanford, and over 10,000 other providers recommend Alto as their preferred pharmacy.

This early progress is energizing, and only possible because of the dedication of Alto’s hardworking team, investors, and partners. Thank you all! The feedback I’m getting from the health ecosystem is even more inspiring — that our potential is nothing short of transformative for our patients and healthcare as a whole. As far as we’ve come, we’re only just getting started.

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