DEAR MAYO CLINIC: One of the biggest things I have missed since my office went remote is going on walks with my coworkers throughout the day. With so many added responsibilities at work, I can hardly find time to leave my desk. How is all this sitting affecting me? How can I find a balance?

ANSWER: We understand the reality is that people have less and less time to exercise. While exercising before or after work is extremely important, it is just as important to stay active throughout the day. You may be surprised to hear that sitting for eight or more hours a day is comparable to smoking a pack of cigarettes a day in terms of heart risk. Sitting for too long throughout the day is one of the major risk factors for heart disease, cancer and many medical conditions. The solution? An active office can empower you to break out of a sedentary lifestyle. 

An active workstation is essentially a desk where you are not sitting. This can mean a standing desk or one where you move around, such as biking, walking or using a step machine. An active workstation has many benefits. The main benefit is that it allows the user to be productive while burning calories at the same time. Walking pads or treadmills allow you to walk at a slow speed and answer emails, work on a project or participate in a video conference call.

An active workstation does not mean that you need to be moving all the time. And you don't have to be active for too long to reap the benefits of activity. It has been shown that even when you are standing, you are more likely to be spontaneously mobile than when you are sitting. This is important to keep in mind. Overall, sitting for less than three or four hours throughout the day is a good goal for those who are able.

Another concept that is gaining popularity is the idea of "snack" activities. A "snack" is doing something for two or three minutes after sitting for an hour. This helps you break the sedentary status of your body by taking the stairs for a few flights, doing some pushups or something meaningful in terms of activity for just a few minutes, and then coming back and continuing your work. These little episodes of activity reset your metabolic clock. Activity snacks can cause significant biological changes in your cells, metabolism and cholesterol. You may notice your mind feeling sharper for the next half hour. 

While "activity snacking" is an affordable way to implement movement into your daily routine, you don't need a lot of money or a big investment to switch up your office furniture. There are some adapters out there that you put on top of your desk to raise or lower your monitor or laptop computer, allowing you to stand. Some people get creative and use a stack of books or other existing items. The bottom line is that everyone should feel motivated to redesign their home offices in order to be active longer throughout the day. This leaves us with less room for excuses. And, if you have days where you’re stuck going into the office, you still have options. Consider taking the stairs instead of the elevator. — Francisco Lopez-Jimenez, M.D., Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

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Phoenix — Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack. One of those people is country rap music artist Colt Ford.

"I couldn't have been anymore on death's door. I died twice that day," recalls Colt, describing the massive heart attack that nearly claimed his life following a concert performance last year. "When one of the top heart doctors in the world looks at you and goes, 'You're 1% of 1%,' it can't get more dire than that."

The 55-year-old musician was performing a sold-out show with his band in Gilbert, Arizona, last April. After what Colt describes as "one of the band's best shows ever," he walked backstage, and moments later, he was found slumped over in a chair due to a massive heart attack. Colt says he was feeling great during the concert. "When I played the show that night, I could do anything," he recalls. Emergency crews quickly responded to the scene and rushed Colt to the hospital. "I woke up eight days later, and I couldn't pick up a cup with ice in it and feed it to myself," he says.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Kwan Lee, M.B., B.Ch., M.D., interventional cardiologist at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or a silent myocardial infarction.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Eight months after suffering his heart attack, tests show Colt is healing well and on the road to recovery. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. While his strength improves, Colt admits the health scare has left him with anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that, and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Colt is back to writing his signature blend of music that combines country, rap and hip-hop. The Georgia-born singer just released a new song and is about embark on a new tour. He's hoping his music and his story will serve as inspiration for others. "Be happy that you're here and you're alive and you get a chance," Colt says. "I get a second chance, and I want to do something positive with it. I hope I can make a difference in somebody else's life."

You can watch more about Colt's story here.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network to learn more.

Media contact:

• Marty Velasco Hames, Mayo Clinic Communications, newsbureau@mayo.edu

Media kit including interviews, video and photos available for download here.

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It was the evening of April 4, 2024 on a concert stage in Gilbert, Arizona.

Colt Ford and his band were performing their signature blend of country, rap and hip-hop music. It was a sold-out crowd. Colt was feeling at the top of his game, and the concert was shaping up to be one of the band's best shows ever.

No one expected how this night would end.

Watch Colt Ford's story of survival

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"Like it was really clicking. We had just made some changes in the set and it was feeling really good. The vibe was good, it all felt good," remembers Colt. "My stage manager said 'That's the best show we've done this year, man, you killed it,' It was incredible."

At the end of the show Colt thanked fans, turned and exited the stage.

No one expected what happened minutes later

"I woke up seven or eight days later, whatever, and I woke up in the hospital and was like 'What's going on?' I had no concept of anything," says Colt. "When I played the show that night I could do anything but when I woke up in the hospital I couldn't pick up a cup with ice in it and feed it to myself."

Minutes after exiting the stage, Colt suffered a massive heart attack. He was found slumped over in a chair backstage by one of his fellow band members. Emergency crews responded immediately and Colt was rushed to the hospital.

"When one of the top heart doctors in the world looks at you and goes 'You're 1% of 1%,' it can't get anymore dire than that," says Colt about his odds of surviving his heart attack.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Dr. Kwan Lee, interventional cardiologist at Mayo Clinic. Lee is part of the multidisciplinary team overseeing Colt's care at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

A silent killer

Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or silent myocardial infarction.

Colt says he had recently undergone a regular check-up at a different medical center and got a clean bill of health.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Nearly nine months after his heart attack, test results at Mayo Clinic indicate Colt is making excellent progress. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. "I'm about back to being in my college shape," says Colt, who played on the golf team for the University of Georgia before his singing career took off.

While his physical health improves, Colt admits the health scare has left him battling anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Dr. Lee says it is not uncommon for patients to experience anxiety, panic attacks and even depression following a heart attack. He recommends patients maintain an open dialogue with their health care team and discuss any issues that arise.

"I'm back, baby!"

Colt has been open about sharing his experience with his nearly three million followers on social media. "I'm back, baby!" Colt shared recently on Instagram. "It's been quite a journey but you guys have inspired me, you kept loving me, kept praying for me, kept sending me messages and I'm working hard to get better."

Just a year shy of his heart attack, Colt has released a new song and is embarking on a new tour. He is hoping his music and story will serve as inspiration for others.

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No matter if you need five hours of sleep or eight, the key is getting good, refreshing rest. According to Dr. Virend Somers, a cardiologist who specializes in sleep disorders, how much sleep a person needs varies from person to person. However, there are some simple tips that everyone can use to get better sleep.

Watch: The Mayo Clinic Minute

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Different people need different amounts of sleep, and, on average, we can say most people need seven to eight hours," explains Dr. Somers.

He says to consider the quality of sleep, not the quantity. He offers these ideas to help you have good sleep hygiene.

Tips for better sleep

"In the bedroom, you want absolute darkness," says Dr. Somers.

And that means no screens, no TV, no laptops, no phones, and no ticking clocks or LED displays.

"Avoid bright lights, avoid looking at your phones because light from there can affect your melatonin," Dr. Somers says. That's the hormone that regulates sleep.

He says when it comes to quality sleep, less stimulation is best.

"Minimize alcohol, minimize exercise, minimize lights, minimize external inputs before about two hours or so before bedtime. The bedroom is for sex and sleep. It's not for spreadsheets," says Dr. Somers.

Exercise can help improve sleep, but working out near bedtime can raise arousal levels, making it harder to sleep. And consider a sleep schedule. Going to bed and getting up at the same time each day reinforces your body's sleep-wake cycle.

Related posts:

• Mayo Clinic Minute: What happens to your body when you have obstructive sleep apnea?
• Mayo Clinic Minute: How excessive daytime sleepiness can affect heart health

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One of the reasons for the disparity is the high hypertension rates in the Black community. Hypertension, also known as high blood pressure, can increase your risk of developing heart disease.

Dr. LaPrincess Brewer, a Mayo Clinic cardiologist, discusses cardiovascular disease and reversing the disturbing trend.

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The statistics are startling. One person dies every 33 seconds from cardiovascular disease in the U.S. High cholesterol, obesity, diabetes and hypertension can cause heart problems.

"African Americans, unfortunately, have the highest rates of uncontrolled hypertension in the world, which dramatically increases their risk for developing heart disease," says Dr. Brewer.

Black Americans are disproportionately impacted by cardiovascular disease

She says elevated hypertension rates in the Black community can be attributed to various factors, including chronic stress, systemic racism and socioeconomic issues.

"That includes food insecurity, housing insecurity, redlining, which really limits certain individuals from receiving opportunities and resources to better their health," explains Dr. Brewer.

Dr. Brewer says simple lifestyle changes can reduce high blood pressure and heart disease, like eating healthier, getting regular physical activity and adequate sleep to reduce stress.

Related posts:

• What is heart disease?
• Success in reducing heart disease deaths, except for young women

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A new solution is transforming cardiac care by leveraging the power of artificial intelligence (AI) in point-of-care ultrasound. This innovation enables a wider range of medical professionals to capture high-quality cardiac images with confidence, ultimately enhancing diagnostic accuracy and improving clinical outcomes. Check out the latest episode of Tomorrow's Cure to learn more.

The podcast episode features Dr. Paul Friedman, cardiologist and chair of Cardiovascular Medicine at Mayo Clinic in Rochester, Minnesota, and Davidi Vortman, CEO of UltraSight. Together, Mayo Clinic and UltraSight are at the forefront of developing algorithms to analyze and interpret cardiac ultrasound images. The collaboration seeks to create a comprehensive solution to support diagnostic and treatment decisions using point-of-care ultrasound devices.

This AI-driven technology is designed to overcome existing barriers and expand access to high-quality cardiac imaging and diagnostics. UltraSight's innovation simplifies cardiac sonography by providing real-time guidance on maneuvering the ultrasound probe to capture high-quality images. Now, with the added power of AI, healthcare professionals can analyze those images more effectively.

"Historically, ultrasound has been somewhat difficult for an average person to get," says Dr. Friedman. "So, in many places around the world, if a physician orders an ultrasound of the heart, an echocardiogram, it may take several months to be scheduled."

"It hasn't been used for first-line screening because of those barriers. This is where some of the visionary work of a portable device that uses AI can turn that upside," he adds.

This innovative technology isn't about replacing experts, notes Vortman. "We're not replacing the experts, we are giving them more data from more patients, faster than ever before. So AI is an accelerator for access that gives much better data at the right time," he says.

"It doesn't replace human interpretation and action, but it can provide a common groundwork for consistency," Dr. Friedman adds.

Looking ahead, Vortman envisions a future where diagnostic tools are more accessible and affordable. "This is the future. Diagnostic tools like ultrasound that are low-cost and can be used by a wider variety of healthcare team members are going to be future of healthcare and disease detection," he says.

The collaborative effort between Mayo Clinic and UltraSight holds the potential to democratize cardiac care, offering hope faster and more efficiently. Tune in to the latest episode of Tomorrow's Cure to learn more about this solution.  

Mayo Clinic has a financial interest in the technology referenced in this podcast. Mayo Clinic will use any revenue it receives to support its not-for-profit mission in patient care, education and research.

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Dr. Juan Cardenas Rosales, an internal medicine physician at Mayo Clinic, stresses that adequate sleep is crucial for your overall well-being, including your heart health.

Watch: The Mayo Clinic Minute

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Getting a good night's sleep can give you the energy to jump-start your day and your health. 

"Sleeping is very important to try to prevent other chronic conditions in the future, such as diabetes, heart attacks and strokes," says Dr. Cardenas Rosales.

When it comes to how many hours a night adults should sleep, keep the number 7 in mind.

"It's usually recommended for you to sleep at least seven hours per night in order to allow your body to recover to be ready for the following day," he says.

Practical steps to help you get better sleep

"Try to sleep at the same time. Try to get a schedule in which you're going to sleep at the same time and you're waking up also at the same time, that's very important," Dr. Cardenas Rosales says.

Create good sleep habits

• Keep the time you go to bed and the time you wake up the same every day, including weekends.
• Stay active. Regular activity can lead to a good night's sleep.
• Limit naps or do not nap at all.
• Limit or do not use caffeine, alcohol and nicotine.
• Do not eat large meals or drink a lot of fluids before bed.
• Make your bedroom comfortable.
• Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music.

"You want to set up the environment to make it easier for your body to fall asleep," he says.

Related posts:

• Little by little: Small changes can lead to heart health, Mayo Clinic expert says
• Treating sleep apnea made easier: Upper airway stimulation therapy
• Mayo Clinic Minute: What are the stages of sleep?

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ROCHESTER, Minn. — Aortic valve stenosis (AVS) is a significant health concern affecting over 1.5 million Americans and millions more globally. Researchers at Mayo Clinic are exploring the use of a new drug called ataciguat to manage AVS. Results from preclinical and clinical studies, published in Circulation, show that ataciguat has the potential to significantly slow disease progression. The final step to establish the drug's long-term effectiveness and safety is a phase 3 trial, and efforts to launch that pivotal trial are soon to be underway with an industry partner.

In AVS, calcium deposits build up and narrow the aortic valve, forcing the heart to work harder to move blood. The condition typically progresses over time, with symptoms like chest pain, shortness of breath and fatigue affecting people over age 65. The current standard of care — watchful waiting — often leads to reduced quality of life before the condition is severe enough for the patient to have a surgical or interventional valve replacement.

"This research represents a significant advancement in the treatment of aortic valve stenosis," says Jordan Miller, Ph.D., director of the Cardiovascular Disease and Aging Laboratory at Mayo Clinic.  "Ataciguat has the potential to substantially delay or even prevent the need for valve replacement surgery, significantly improving the lives of millions."

Dr. Miller notes that the impact extends beyond simply delaying surgery. Younger patients with aggressive disease or congenital valve defects may develop symptoms in midlife. If a patient requires valve replacement before the age of 55, there is a more than 50% likelihood they will require multiple valve replacement surgeries over their lifetime due to recalcification of the implanted valve. Ataciguat, which slowed progression of native aortic valve calcification in the clinical trial, offers the potential for a once-in-a-lifetime procedure if they can reach the age of 65. The older a patient is, the less likely the implanted valve is to calcify.

Over the past decade, Mayo Clinic's research revealed that ataciguat reactivates a pathway crucial in preventing valvular calcification and stenosis. Preclinical studies in mice showed that this drug substantially slowed disease progression even when treatment began after the disease was established.  

Clinical trials in patients with moderate AVS demonstrated that once-daily ataciguat dosing was well tolerated, with minimal side effects compared to placebo. This latest phase 2 trial in 23 patients showed a 69.8% reduction in aortic valve calcification progression at six months compared to placebo, and patients receiving ataciguat tended to maintain better heart muscle function. Crucially, the research team confirmed that — despite its profound effect on slowing valve calcification — ataciguat did not negatively impact bone formation.

This important finding is the result of a collaborative effort between Mayo Clinic, the National Institutes of Health, the University of Minnesota, and Sanofi Pharmaceuticals. The research was conducted under an innovative academic-industry partnership grant administered by the National Center for Accelerating Translational Sciences and a Minnesota Biotechnology and Genomics Partnership grant.

Mayo Clinic and Dr. Miller have a financial interest in the intellectual property referenced in this news release. Mayo Clinic will use any revenue it receives to support its not-for-profit mission in patient care, education and research.  

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

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Dr. Said Alsidawi, a Mayo Clinic cardiologist, says the problem is that many people don't even know they have it because they have no symptoms. And in many cases, the first presentation is sudden cardiac death. 

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Hypertrophic cardiomyopathy is a genetic condition that causes the heart muscle to thicken, making it harder to pump blood and sometimes causing an irregular heart rhythm.

"So right now, what we think in the United States, we've only diagnosed 1/7 of the people who have hypertrophic cardiomyopathy. So we're trying to increase the awareness in the community about this disease," says Dr. Alsidawi.

He says patients are born with a genetic mutation. The disease can start at a young age or later in life — many times with no symptoms. 

"We know the patients that we lose to this condition, the majority of them are young, active and athletes. So high-level athletic exercise can put you at higher risk of sudden cardiac death," says Dr. Alsidawi.

He says it's important to seek medical attention if you have any symptoms, especially with exertion, "including shortness of breath, chest pain, lightheaded, dizzy or passing out."

If diagnosed, the good news is hypertrophic cardiomyopathy can be treated with medications, surgery, implanting a defibrillator that monitors the heart or, in severe cases, heart transplantation.  

Additional resources:

• Sex and race disparities found in management of patients with hypertrophic cardiomyopathy in the hospital
• Mayo researchers create, test AI to improve EKG testing for hypertrophic cardiomyopathy

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Proton beam therapy, traditionally used to treat cancer, is now bringing new hope to patients with life-threatening heart rhythm disorders. A clinical trial is harnessing this precise radiation treatment to target the specific area of the heart causing the irregular rhythm, providing a less invasive, potentially transformative solution. Tune in to the latest episode of Tomorrow's Cure to explore this innovative approach and its promise for revolutionizing heart rhythm treatment.

The podcast episode features Dr. Konstantinos Siontis, cardiac electrophysiologist and associate professor of medicine at Mayo Clinic in Rochester, Minnesota; Dr. Amanda Deisher, radiation oncology medical physicist, assistant professor of medical physics and researcher at Mayo Clinic's Comprehensive Cancer Center in Rochester; and Dr. William Stevenson, cardiac electrophysiologist, professor of medicine and director of the Cardiac Arrhythmia Clinical Research Program at Vanderbilt Heart and Vascular Institute. Together, they discuss a groundbreaking new approach to treating heart arrhythmias.

Proton beam therapy is a form of radiation treatment that uses a precise beam of protons to deliver targeted radiation. Now, a clinical trial is exploring the use of proton beam therapy to treat ventricular tachycardia (VT).

"Ventricular tachycardia is a type of fast heart rhythm that we see in people who have almost any type of heart disease. It can be an old heart attack, heart valve surgery or cardiomyopathy, which is a group of diseases that affect the heart muscle," says Dr. Stevenson. "What's common to many of these things is that they'll produce an area of scar in the heart. If you have an area of scar in your pumping chambers, it's almost like having a little electrical circuit in that scar. When the right thing comes along to trigger it off, it goes each time around the circuit as a heartbeat, and it can cause episodes of sudden rapid heart action, which are ventricular tachycardia."

Treatment of VT aims at restoring normal heart rhythm and can include medication, use of a defibrillator and catheter ablation. Unlike catheter ablation, proton beam therapy is completely noninvasive and can be delivered directly to the target in the heart.

"The idea of targeting any-size lesion in the middle of the patient without having to put the patient under anesthesia or any sort of access to veins or chest cavity, sounds like it's right up our alley," says Dr. Deisher.

The clinical trial using proton beam therapy to treat VT offers promise for patients who continue to battle the condition despite previous treatments.

Dr. Siontis discusses the results of the study thus far, "I certainly think that there were some patients who benefited from radiation with protons when everything else that we did for them, including multiple catheter ablation procedures and medications, had failed. I think adding noninvasive options generates a broad spectrum of options for patients who have the most difficult arrhythmias." To learn more about this innovative work, explore the new episode of Tomorrow's Cure. The podcast is available on all audio platforms, including Apple Podcasts, Spotify and Amazon Music. Episodes also feature a video component, which can be viewed on Mayo Clinic's YouTube channel.

Related Article:

• (VIDEO) Using proton beam therapy on the heart

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