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The latest recommendations focus on newer medications, lifestyle changes, and procedures.

If you have heart disease, following a healthy diet and getting regular exercise should be a top priority. Both habits can help you reach and stay at a healthy weight and lower your blood pressure and cholesterol level. Chances are you'll also need to take medications to further improve those common heart-related risk factors. But if you also have diabetes, you may need even more aggressive treatment, according to new advice from the American Heart Association.

The recommendations, published May 12, 2020, in the journal Circulation, detail the latest evidence about treatments for people with both heart disease and diabetes. Diabetes, which affects about one in 10 adults, doubles the odds of having a heart attack or stroke (see "Why is diabetes hard on your heart?").

Cardiac CT angiography is gaining ground as a fast, effective way to diagnose coronary artery disease.

If you experience a short-lived squeezing sensation or discomfort in your chest when you exercise or feel stressed, one possible cause is inadequate blood flow to the heart. Known as stable angina, this condition suggests you have heart disease and may be at risk for a heart attack.

Doctors can use a number of different tests to diagnose (or rule out) inadequate blood flow to the heart muscle. The first step is frequently a type of stress test, which checks the heart's electrical activity, muscle function, or blood flow patterns while the heart is under stress from exercise or medication. Stress tests can identify areas of reduced blood flow, which suggest a narrowing in the artery that supplies that part of the heart.

You may be familiar with the claims featured on packages of old-fashioned oatmeal, which note that "As part of a heart-healthy diet, the soluble fiber in oatmeal can help reduce cholesterol." Guess what? Back in 2008, the FDA also approved the equivalent health claim for barley products.

In fact, barley contains about three times as much fiber per serving as oats. Barley is particularly rich in a type of soluble fiber known as beta glucan, which is recognized for its cholesterol-lowering abilities. Barley is also a good or excellent source of several vitamins and minerals.

Many lifestyle factors can influence the development of atrial fibrillation, and doctors now better understand the importance of these factors in treating afib. Those who are at risk of developing afib can take action to improve their health, and in some cases they may be able to reduce their symptoms.

Some common painkillers may boost the odds of a heart problem. Use them wisely to lessen your risk.

In 2004, the drug maker Merck pulled rofecoxib (Vioxx) off the market, following revelations that the popular prescription painkiller increased the risk of heart attacks and strokes. That action triggered a closer look at drugs in the same class, known as nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs, which are widely used to ease pain, quell inflammation, and cool fevers, include over-the-counter drugs such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) and the prescription drug celecoxib (Celebrex).

A few supplements show limited, possible benefits for people with heart disease. But some popular ones don't—and others may be dangerous.

Watch for the warning signs of depression, which is often missed in people with heart disease.

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All people have days when they feel sad, gloomy, or down in the dumps. But if those feelings last for weeks and you gradually stop feeling hopeful or happy about anything in your life, you may have depression. Like heart disease, depression is common, so it's not unusual to have both conditions together. In fact, depression is about twice as likely to occur in people with heart disease compared with the general population. And people with depression face a heightened risk of heart disease.

"It's really important for people to be aware of this link and to get treatment for depression, because it can be very debilitating," says Dr. Christopher Celano, a psychiatrist at the Cardiac Psychiatry Research Program at Harvard-affiliated Massachusetts General Hospital.

How maintaining a healthy weight and other lifestyle habits can help prevent this common heart rhythm disorder.

During a bout of atrial fibrillation, your heart may beat so rapidly, it may feel as though it's going to explode out of your chest. Commonly known as afib, this heart rhythm problem can leave you breathless and lightheaded—or cause no symptoms at all. About 9% of people ages 65 and older have afib, which raises the risk of stroke and other heart-related problems. But there are ways to lower your odds of developing afib—or to reduce its impact if you already have the condition.

Lessen your load

By far, the most important step you can take is to attain and stay at a healthy weight. "We have good evidence from multiple studies showing that people who are overweight have a higher risk of afib than people who are at a healthy weight," says Harvard professor of medicine Dr. Christine Albert, former director of the Center for Arrhythmia Prevention at Brigham and Women's Hospital. And the more you weigh, the higher your risk: people who are overweight have a 20% to 25% higher risk, whereas those who are obese (a body mass index, or BMI, of 30 or higher) have a 60% higher risk.

A high pain tolerance may account for some "silent" heart attacks. But failing to recognize atypical symptoms is a more likely explanation.

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Nearly half of people who have a heart attack don't realize it at the time. These so-called silent heart attacks are only diagnosed after the event, when a recording of the heart's electrical activity (an electrocardiogram, or ECG) or another test reveals evidence of damage to the heart.

What's behind this surprising phenomenon? One explanation may be a higher-than-average tolerance for pain, as a recent study suggests (see "Does a high pain tolerance mask heart attack symptoms?"). Other people mistake their symptoms as indigestion or muscle pain. Still others may feel pain, but in parts of their upper body other than the center of the chest.