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These drugs help prevent potentially life-threatening events. Make sure you're taking them correctly.

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Recently, a Heart Letter subscriber emailed us this query: "Does taking your blood pressure medication at night protect the heart more than if you take it in the morning? If so, why?"

Maybe you've wondered the same thing, or have other questions about the drugs you take to prevent or treat heart disease. In addition to blood pressure pills, these include drugs to lower cholesterol and to prevent blood clots.

Two recent drugs have opened new treatment opportunities for this common eye disease.

Glaucoma is a leading cause of blindness in people over age 60, and it's estimated that the number of new cases will more than double over the next few decades. "There is no cure for glaucoma once it appears, so treating it at its earliest stages can help save your vision," says Dr. David Sol谩-Del Valle, an ophthalmologist with Harvard-affiliated Massachusetts Eye and Ear.

Once diagnosed, glaucoma is treated with eye drops to reduce pressure inside the eye by lowering the amount of fluid or improving fluid drainage. They can keep glaucoma from getting worse and hopefully avoid the need for surgery to correct this drainage problem.

In the journals

Anticholinergic medications used to treat bladder conditions, Parkinson's disease, and depression are associated with an increased risk of dementia, according to a large study published online April 25, 2018, by The BMJ. Anticholinergic drugs help to contract and relax muscles. They work by blocking acetylcholine, a substance that also transmits messages in the nervous system. In the study, researchers compared the medical records of 40,770 people older than 65 who were diagnosed with dementia and 283,933 seniors without.

They found that people diagnosed with dementia were up to 30% more likely to have been prescribed anticholinergic medications for Parkinson's, bladder problems, or depression. Frequently prescribed anticholinergic drugs include procyclidine (Kemadrin) for Parkinson's; tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions like overactive bladder or incontinence; and amitriptyline, dosulepin, and paroxetine for depression. However, there was no association between dementia and anticholinergic drugs used to treat other common conditions like hay fever, travel sickness, and stomach cramps.

Understanding superbugs can help you avoid them.

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It used to be that if you got an infection, you could pop an antibiotic pill and rest assured that it could help you fend off your bacterial attacker. But those old tried-and-true pills may not be as effective as they once were, thanks to a rising number of new types of bacteria often referred to as superbugs.

"'Superbug' is essentially a slang term developed by the press that refers to highly antibiotic-resistant bacteria that can cause human infections," says Dr. David Hooper, an infectious disease specialist and professor of medicine at Harvard Medical School.

Constipation from pain medication 鈥� such as opioids 鈥� is a common problem

Prescription opioids provide pain relief, but constipation from pain medication is an all too common side effect.

As we age, pain and pain control become an important issue. Many of the conditions that cause pain disproportionately affect people starting at about age 65. In some surveys, half of respondents ages 60 and older have said that they suffer from chronic pain. About 70% of cancer deaths occur in people ages 65 and older, so cancer pain is frequently the older person's problem.

Constipation from pain medication 鈥� such as opioids 鈥� is a common problem

Prescription opioids provide pain relief, but constipation from pain medication is an all too common side effect.

As we age, pain and pain control become an important issue. Many of the conditions that cause pain disproportionately affect people starting at about age 65. In some surveys, half of respondents ages 60 and older have said that they suffer from chronic pain. About 70% of cancer deaths occur in people ages 65 and older, so cancer pain is frequently the older person's problem.

Sharing readings from a home monitor with your physician may help you reach your blood pressure goal more quickly.

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For treating certain health problems, finding the best drug or combination of drugs at the correct dose often requires some trial and error. High blood pressure is a good example. Because this common problem raises heart attack and stroke risk, the sooner you can get your blood pressure down to a healthy range (130/80 millimeters of mercury [mm Hg] or lower), the better. New research suggests that people could speed things up a bit by taking a more active role in the process (see "Tracking your blood pressure at home: Does it help?").

"The study showed that a period of home blood pressure monitoring 鈥� one week per month 鈥� was sufficient to guide people to better blood pressure control," says Dr. Paul Conlin, professor of medicine at Harvard Medical School and chief, Medical Service, at the VA Boston Healthcare System.

Advancing age may warrant changes to preventive therapies for heart disease. But one size does not fit all.

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Currently, the average life expectancy in the United States is about 79 years. But among people who survive to age 80 and beyond, health status can vary quite a bit. Some stay hale and hearty for years, while others gradually become weak and frail.

These differences are one reason there aren't any set guidelines for preventing heart disease in octogenarians. But there's a larger underlying issue 鈥� one that also explains why heart attack risk calculators (such as www.health.harvard.edu/heartrisk) don't allow you to enter an age above 79.

This heart rhythm disorder is linked to thinking and memory problems. But anti-clotting drugs may lower the risk.

Bouts of atrial fibrillation, or afib 鈥� a rapid, chaotic heartbeat 鈥� make some people feel lightheaded and dizzy, while others don't notice any symptoms. But the most serious threat of this condition is the higher risk of stroke among people with afib compared with those without the disorder (see "Blood clot dangers, large and small"). Now, there's a growing recognition that people with afib also face an increased risk of thinking and memory problems 鈥� even if they do not experience a stroke.

Known as cognitive impairment, these problems include trouble remembering, learning new things, concentrating, or making routine decisions. The presumed underlying cause? Tiny blood clots that cause "silent" (that is, unrecognized) strokes and gradually injure parts of the brain involved with cognition.

Research we're watching

About four in 1,000 adults in this country are born with a genetic condition marked by abnormally high cholesterol levels, known as familial hypercholesterolemia (FH). Their "bad" LDL cholesterol can be two to three times as high as the common target LDL value of 100 milligrams per deciliter (mg/dL) or lower for healthy people. But only about half of people with FH are getting proper treatment for the disease, according to a report in the May 22 issue of Circulation.

For the study, researchers analyzed health surveys done between 1999 and 2014 with nearly 42,500 adults in the United States. Although more than 80% of people with FH or severely high cholesterol were aware of their condition, only half were taking cholesterol-lowering statins. And among those who were, only one-third were taking optimal doses of the drugs.