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Labels on the bottles promise better health, but these supplements may wind up hurting you.

Keeping your heart healthy requires a combination of strategies, such as eating a healthy diet, exercising regularly, and managing stress. Adding a dietary supplement may seem like another means of protection.

But be careful. Unlike prescription medications, supplements are often sold without evidence that they work or they're safe. There's no way to know what's really inside pills or potions, since the FDA doesn't evaluate whether the manufacture of supplements is high quality, such as whether the pills are free from impurities. The following supplements may pose heart risks.

Research we're watching

People with low HDL (good) cholesterol and high triglycerides may be more likely to be hospitalized for pneumonia, according to a study in the Aug. 15, 2020, American Journal of Medicine.

The study included more than 13,000 people who were part of a long-term study designed to look at lipids and other factors linked to heart disease. Using hospital discharge records, researchers found that nearly 15% of the participants had been hospitalized with pneumonia during the follow-up, which lasted a median of 21 years.

In the journals

Scientists continue to explore the right balance of carbohydrates and fat in people's diets. But for overweight or obese older adults, a recent study found that a low-carbohydrate, high-fat diet might offer special health benefits. The results were published online Aug. 12, 2020, by Nutrition and Metabolism.

Researchers asked 40 obese adults, ages 60 to 75, to follow an eight-week diet in which 10% of calories came from carbs, 25% from protein, and 65% from fat. Carb sources included leafy greens, non-starchy vegetables, some fruit, and high-fiber grains. Protein intake consisted of eggs, fish, pork, and poultry. Fat-containing foods included olive oil, coconut oil, nut oils, nut butter, cheese, coconut milk, and avocados.

Ask the doctor

Q. My doctor says I'm at risk for a heart attack because a test shows inflammation. I know about high cholesterol and blood pressure, but how does inflammation increase the risk for heart attacks?

A. I can understand why you're puzzled. In medical school I learned that there is a simple road to a heart attack. First, cholesterol starts building up in the wall of a coronary artery carrying blood to the heart muscle. Over many years, the plaque of cholesterol slowly grows bigger. When it grows large enough that the heart can't get the blood it needs to work hard, the heart cries out in pain � chest pain, a condition called angina. Finally, when the plaque grows large enough, it blocks the flow of blood completely, causing a heart attack. It was a beautifully simple explanation.

Ask the doctor

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Q. My recent cholesterol test result included "non-HDL cholesterol." What is the significance of this number?

A. Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. When you get your blood drawn for a cholesterol test (also known as a lipid profile or lipid panel), the report usually includes four numbers: low-density lipoprotein (LDL) cholesterol; high-density lipoprotein (HDL) cholesterol; triglycerides; and total cholesterol.

In the journals

Age may not be a factor when it comes to who can benefit from statins. A study published online July 7, 2020, by JAMA found that people who started taking the cholesterol-lowering medication in their mid-70s or later had fewer heart-related problems and lived longer than non-users.

Researchers looked at 326,981 mostly male veterans, ages 75 and older, who were free of cardiovascular disease and did not take statins. Over the next 10 years, more than 57,000 began statin therapy.

People who take frequent saunas or hot baths may lower their risk of heart problems. But be cautious if you have low blood pressure.

Soaking in a bathtub or basking in a sauna can be a pleasant way to relax. Done on a regular basis, both habits may also help prevent heart attacks and strokes, according to several studies.

"The high temperatures in a warm tub or sauna cause your blood vessels to dilate, which lowers blood pressure," says Dr. Adolph Hutter, professor of medicine at Harvard Medical School. The volume of blood your heart pumps will also rise, especially in a hot tub. That's a result of the pressure of the water on the body, which increases the heart's workload, he explains.

Many provide links to published research about these heart -protecting drugs. Others mention personal beliefs about statins, some of which are inaccurate.

Statins are among the most frequently prescribed medications in the United States. These cholesterol-lowering drugs help reduce the risk of heart attacks and strokes, especially for people who've already had one of those life-threatening events. But many people stop taking their statins or don't take them as prescribed, a phenomenon doctors refer to as nonadherence.

Hoping to gain some insight into this trend, researchers analyzed 11,852 posts that mentioned statins on Twitter over a five-year period. About a quarter of Americans use Twitter, which is one of the most popular social media platforms. Although many of the tweets featured ads or financial market information, nearly half were related to health issues associated with statins. Of these, more than a third provided resource information, such as a link to a published study. About 20% included personal beliefs or attitudes about statins, which proved to be quite polarized. Some people described statins as lifesaving, while others referred to them as poisonous or deadly, according to the researchers, whose study was published June 25, 2020, in JAMA Network Open.

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Ask the doctor

Q. My husband is reluctant to get tested for sleep apnea. But I'm pretty sure that he has it, and I'm concerned because I've heard that it can contribute to heart disease. How are these two conditions connected?

A. As you likely know already, people with sleep apnea may snore loudly and may also periodically gasp for breath throughout the night. These explosive snorts often wake up bed partners or roommates � although not necessarily the person with apnea.

Sesame seeds may be most familiar as a topping on bagels, burger buns, and breadsticks. The tiny, tear-shaped seeds have a nutty, slightly sweet flavor that's enhanced when they're baked or lightly toasted in a skillet. Most are off-white or tan, but you can also find black varieties, which are popular in Asian cuisine.

Sesame seeds contain lignans and phytosterols, plant compounds that may have cholesterol-lowering effects. They're also a decent source of calcium and magnesium, two minerals linked to better blood pressure control.