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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.

While fertility preservation treatments like egg freezing and IVF are significant investments of time and resources, there are many ways to lower or manage the costs of treatment. As you prepare for the financial aspects of treatment, be sure to explore all of your options for financial assistance and savings, including patient assistance programs from fertility medication manufacturers.

A Guide to Ferring Pharmaceuticals’ Fertility Medication Savings Programs

If Alto is your fertility pharmacy, your fertility medication protocol may include medications manufactured by Ferring Pharmaceuticals, which has several financial assistance programs that offset the cost of fertility medications. Here’s more on eligibility for these programs and how to apply.

The OneHeart program provides a $200 rebate for out-of-pocket costs for select Ferring fertility medications. Eligibility is for those with no insurance coverage or commercial health insurance plans. In addition, you must have started your ovarian stimulation cycle between June 1, 2020 and June 30, 2022, with all medications purchased by June 30, 2022.

Learn more about program terms and conditions and the application process.

The HeartFelt program helps individuals whose cycles were canceled due to COVID-19 or a natural disaster resume fertility treatment. It offers medication replacement for up to 15 vials of Menopur® and up to five syringes of Fyremadel™ (ganirelix acetate) depending on the amount of medication used in the canceled cycle. Eligibility is for those with no insurance coverage or commercial insurance coverage.

To learn more about program terms and conditions and the application process, download the HeartFelt brochure on Ferring’s patient resources page.

The HeartTomorrow program provides Menopur® at $68 per vial for those undergoing an elective egg freezing cycle. To be eligible, you must be paying cash for your fertility medications and purchase a minimum of 20 vials in your first fill.

The Heart for Heroes program provides IVF medications at no cost to eligible military veterans who have experienced infertility due to a service-related injury or who do not have insurance coverage for fertility medications. To learn more about terms and conditions and the application process, call 1-800-515-3784.

The HeartBeat program provides select fertility medications at no cost for cancer patients. To be eligible, you must be a female U.S. citizen or permanent resident with a cancer diagnosis who has not received chemotherapy within the previous six months. To learn more about terms and conditions and the application process, call 1-888-347-3415. (Residents of Arkansas, Massachusetts, or New Jersey can call 1-877-252-0553.)

If your fertility medications are manufactured by EMD Serono, read our previous post for an overview of EMD Serono’s patient assistance programs. You can also read our previous posts on managing the costs of fertility treatment to learn about additional financial resources, including Alto’s financial support for fertility medications:

Managing the Costs of Fertility Treatment

A Financial Planning Guide for Egg Freezing

We’re here for you during fertility treatment

At Alto, we understand that fertility treatment is a physical, emotional, and financial investment, and we offer support with all aspects of your fertility journey.

We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. In addition to automatically applying any coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We’re here to help with the rest of the process, too, with free same-day delivery of your medications, temperature controlled packaging, and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

To get a price quote specific to your fertility medication protocol, complete our online form.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

While it can be overwhelming to receive a diagnosis of type 2 diabetes, following your doctor’s treatment plan can help you manage the condition and live a healthy and active life. In some cases, lifestyle changes alone can help you keep your blood sugar levels in a healthy range. For other individuals, insulin, oral medication, or a combination of both may also be necessary. Here’s what to know about metformin, one of the most common oral medications used to treat type 2 diabetes.

What to Know About Metformin

Metformin belongs to a class of medications called biguanides, which regulate your blood sugar levels by reducing how much glucose is produced during digestion. Currently, metformin is the only biguanide approved for diabetes treatment in the U.S.

Metformin is taken one to three times a day depending on your dosage and the form of metformin your doctor has prescribed. It is available in the following formulations and strengths:

Immediate-release tablet: 500mg, 850mg, 1000mg 

Extended-release tablet: 500mg, 750mg, 1000mg

Unlike individuals with type 1 diabetes, who are unable to produce any insulin at all and take insulin every day, individuals with type 2 diabetes typically can produce some insulin but experience problems with insulin production. They may not produce enough insulin, or cells in their body may have become resistant to insulin. Metformin does not change the amount of insulin you produce, but it does help counter insulin resistance. If your type 2 diabetes has progressed to a later stage, you may need insulin therapy to manage your blood sugar levels. Metformin is often used alongside insulin therapy at this stage to help the body use insulin more efficiently.

Metformin is also sometimes used off-label to treat polycystic ovary syndrome (PCOS), as insulin resistance may be a symptom of the condition.

Some people experience gastrointestinal issues like nausea and diarrhea as a result of taking metformin, most often when they first begin taking the medication. Taking metformin with meals often helps prevent these side effects. Your doctor may also have you start on a lower dosage of metformin and gradually work up to a larger dosage as an additional precaution against side effects.

There are fewer gastrointestinal side effects associated with the extended-release formulation of metformin. This formulation releases the medication slowly, maintaining a consistent level of the medication in your bloodstream over a longer period of time. If you have concerns about potential side effects of metformin, you may want to ask your doctor if an extended-release formulation of metformin is a good fit for your needs.

Metformin can decrease your levels of vitamin B12, which can lead to anemia — a condition defined by low levels of red blood cells — in rare cases. Your risk for anemia is greater if your diet is low in vitamin B12 and calcium. If you experience symptoms of anemia such as fatigue, dizziness, or lightheadedness, reach out to your doctor for an evaluation of your red blood cell levels.

In rare cases, metformin may lead to lactic acidosis, an uncommon but serious condition in which an accumulation of lactic acid in the body leads to an imbalanced pH level. The chance of this side effect occurring is low, and individuals with impaired kidney function or heart failure are most at risk. To determine if metformin is a good fit for your treatment needs, your doctor will consider your overall health history and possibly order an estimated glomerular filtration rate (eGFR) test, which is a blood test that assesses your kidney function.

Hypoglycemia occurs when your blood glucose levels drop below a healthy range, most often after taking insulin. It is typically caused by not eating enough or exercising too much, and the timing of your insulin doses may also be a factor. These are some common signs of hypoglycemia to watch for:

Coordination problems, clumsiness, and confusion

When taken on its own, metformin typically does not cause hypoglycemia. However, if you take metformin with other diabetes medications including insulin, it’s important to more carefully monitor your blood sugar and be mindful of how your diet, exercise, and alcohol intake can interact with metformin.

To prevent hypoglycemia when taking metformin, be sure to take all of your diabetes medications as prescribed and on schedule, follow your doctor’s recommendations for exercise, and eat a balanced diet. In addition, make sure your doctor has a complete picture of your health history and is aware of all the medications you take.

When your diabetes treatment plan includes multiple medications, staying on top of your prescriptions can be easier said than done. The Alto app can help you manage all of your diabetes needs in one place, and our dedicated diabetes support team is here to offer guidance and make sure you have everything you need for your treatment.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can be a partner in your diabetes care.

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.

When inflammation persists, it no longer serves a helpful purpose. This type of inflammation, also referred to as chronic inflammation, occurs when your body consistently acts like it’s under attack, releasing white blood cells indefinitely. In the long term, an elevated white blood cell count can affect other organs such as your heart, lungs, and kidneys. Research has also found a connection between chronic inflammation and other chronic diseases including heart disease, diabetes, cancer, Alzheimer’s disease and Crohn’s disease.

Inflammation, Explained

Acute inflammation is the body’s natural way of fighting infections and injuries as part of the healing process. When you have an injury, blood flow increases as your body instinctively releases white blood cells, proteins, and other inflammatory chemicals to protect the wounded area. This leads to redness, swelling, and pain at the site of injury. The body reacts similarly when you have a virus or cold, but in these instances, the blood cells and inflammatory chemicals are released throughout the whole body rather than to one spot. This type of inflammation is good for you, as it allows your body to heal.

But when inflammation persists, it no longer serves a helpful purpose. This type of inflammation, also referred to as chronic inflammation, occurs when your body consistently acts like it’s under attack, releasing white blood cells indefinitely. In the long term, an elevated white blood cell count can affect other organs such as your heart, lungs, and kidneys. Research has also found a connection between chronic inflammation and other chronic diseases including heart disease, diabetes, cancer, Alzheimer’s disease and Crohn’s disease.

Read on for more information about the causes and symptoms of chronic inflammation and how to prevent or treat it.

Causes and symptoms of chronic inflammation

Several known factors can trigger chronic inflammation:

Lifestyle factors including obesity, diet, smoking, alcohol use, stress, and sleep disorders

Autoimmune diseases like type 1 diabetes or lupus, in which the body mistakenly attacks itself

Long-term exposure to pollution, industrial chemicals, or other toxins

Some individuals with this type of inflammation experience fatigue, fever, and joint and muscle pain. However, while there are clear physical signs of acute inflammation, chronic inflammation does not always have visible symptoms.

Your doctor can help determine if you have chronic inflammation. They will likely ask about your symptoms and perform a physical exam as a first step. They may then order additional tests to detect inflammation. These tests look for various indications of inflammation in your body, but they cannot formally diagnose inflammation or any other health condition. Rather, they provide a more comprehensive picture of your health so that your doctor can recommend the best next steps.

Potential tests your doctor may recommend during this process include a C-reactive protein (CRP) test and/or an erythrocyte sedimentation rate (ESR) test. A CRP test identifies your blood levels of CRP, a protein produced in your liver. Chronic and acute inflammation have both been linked to high levels of CRP.

An ESR test examines how quickly your red blood cells sink to the bottom of a test tube, with higher rates of settlement pointing toward more inflammation. Doctors often recommend this test when there is a possibility of high inflammation.

Sometimes these tests may help your doctor diagnose an inflammation-linked condition, such as rheumatoid arthritis or type 2 diabetes.

Chronic inflammation and other health conditions

There is a connection between chronic inflammation and many other health conditions. Inflammation can occur directly as the result of rheumatoid arthritis, which is both an autoimmune condition and an inflammatory disease. If you have rheumatoid arthritis, your immune system attacks your joints — often in your hands, writs, and knees — which leads to inflammation. There is also a direct link between inflammation and other inflammatory diseases, like ulcerative colitis and Crohn’s disease.

Inflammation has also been linked to heart disease and diabetes, but research into this connection is ongoing. While inflammation is more common in individuals with these health conditions, there is not yet definitive evidence that inflammation by itself directly increases your risk for these conditions.

Inflammation in the walls of your blood vessels has been linked to atherosclerosis, the accumulation of fats, cholesterol, and other substances in your arteries. In the long term, atherosclerosis increases your risk for a heart attack or stroke.

Since obesity, smoking, and physical activity are all risk factors for inflammation, heart disease, and diabetes, the overlap of these risk factors likely plays a role in the connection between the conditions. The good news is that a single healthy choice can lower your risk for all three diseases at once.

Your healthcare provider will recommend treatment based on the type of inflammation you have, however not all cases of chronic inflammation require medication.

Two types of medications are commonly used to lower both acute and chronic inflammation: nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®) and oral steroids including prednisone (Deltasone®, Prednicot®), methylprednisolone (Medrol®), and dexamethasone (Decadron®, Dexasone®). Steroid injections can reduce inflammation in a specific joint or muscle and are often used to treat rheumatoid arthritis.

If you have an inflammatory disease, your doctor may recommend medications specifically used to treat that disease. Medication classes commonly used to treat inflammatory diseases include:

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®). These medications can slow the progression of rheumatoid arthritis.

Statins, a type of medication commonly used to treat high cholesterol. They have anti-inflammatory effects and can lower CRP levels.

You can also fight inflammation simply by what you eat. An anti-inflammatory diet includes antioxidant-rich foods like the following: 

Cherries, blueberries, oranges, and other fruits

There are also some foods that have been linked to higher levels of inflammation. If you have chronic inflammation, your doctor may suggest limiting your intake of the foods below as part of your treatment plan:

White bread, pasta, pastries, and other refined carbohydrates

Soda, fruit juices with added sugar, energy drinks, and other beverages high in sugar

Red meat and processed meat like hot dogs and sausage

At Alto, we’re committed to making it as simple as possible to prioritize your health and well-being and stay on top of your 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.

Emphysema — which falls under the umbrella of chronic obstructive pulmonary disease (COPD), along with chronic bronchitis — is a lung disease that most often develops as the result of many years of heavy smoking. It affects more than 3 million people in the United States.

Emphysema: Causes, Symptoms and Treatments

As a progressive lung disease, symptoms of emphysema become more pronounced over time. While there is no cure, emphysema is both manageable and preventable. You can slow the progression of the disease by following the treatment plan your doctor recommends and maintaining a healthy lifestyle.

Read on to learn more about the causes and symptoms of emphysema and common treatment options.

Emphysema involves slow and gradual damage to the tiny air sacs in your lungs (alveoli). As these air sacs weaken over time, the surface area of the lungs is reduced, limiting how much oxygen can travel to your bloodstream.

Since emphysema progresses gradually, signs and symptoms may not appear until the lung tissue has already been significantly weakened. For many people, the first noticeable symptoms include shortness of breath and more frequent coughing, especially during physical activities. Other symptoms of emphysema include wheezing, exhaustion, and chest tightness, and producing greater amounts of mucus.

In some cases, the lack of oxygen can cause blue or gray lips or fingernails. If you experience this symptom, seek immediate medical attention.

The majority of emphysema cases occur as the result of cigarette smoking, with heavier smoking linked to a higher risk of developing emphysema. Additional risk factors for emphysema include the following:

Age — in many cases of smoking-related emphysema, symptoms first become noticeable between the ages of 40 and 60

Exposure to high pollution chemical fumes or lung irritants

Having a history of childhood respiratory infections

To determine if you have emphysema, your doctor will ask about your health history and the potential symptoms of emphysema that you are experiencing. They may ask you questions about your smoking history, your exposure to secondhand smoke or chemical fumes, and if you have a family history of lung health issues.

After taking your health history, they may order one or more of the following tests to confirm a diagnosis of emphysema:

Imaging tests, including chest X-rays and computerized tomography (CT) scans, which combines X-ray images taken from different angles.

An arterial blood gas test, which measures how well your lungs transfer oxygen to your bloodstream and remove carbon dioxide.

An electrocardiogram (ECG) to check your heart’s function and rule out a diagnosis of heart disease.

A pulse oximetry, which measures the oxygen level of your blood. This can show how well oxygen travels to the parts of your body furthest from your heart.

Lung function tests, which measure how much air your lungs can hold, how easy it is for them to empty air, and how well they deliver oxygen into your bloodstream.

Quitting smoking is the most important thing you can do to slow the progression of emphysema. If you are having trouble quitting, ask your doctor for smoking cessation resources like nicotine replacement therapy to help manage withdrawal symptoms and cravings. In addition, the treatment options below can slow the progression of emphysema and help you live an active lifestyle.

Several types of medications are used to manage and treat emphysema.

Bronchodilators like albuterol (Ventolin®, Proventil®, AccuNeb®), albuterol sulfate (ProAir® HFA®, ProAir RespiClick), and levalbuterol (Xopenex®) help relax your airway muscles and open your lungs to reduce discomfort. Although not common, potential side effects of bronchodilators include nervousness or shakiness, headache, throat or nasal irritation, and muscle aches. Your doctor can explain more about the risks and benefits of using a bronchodilator when building your treatment plan.

Inhaled corticosteroids reduce swelling in your lungs and open your airways so that more air can move in and out of your lungs. They may be taken via inhaler or nebulizer. Corticosteroids commonly prescribed to treat emphysema include beclomethasone dipropionate (branded options include Qvar Redihaler®), budesonide (Pulmicort®), ciclesonide (Alvesco®), flunisolide (Aerospan®), fluticasone propionate (Flovent®), and mometasone (Asmanex Twisthaler®). 

Inhaled corticosteroids typically do not cause long-term side effects, but mouth and throat irritation and oral yeast infections may occur. As a precaution, rinse your mouth with water after each dose to prevent infections.

Antibiotics may also be used to fight infections that can lead to emphysema-related complications like acute bronchitis or pneumonia.

Pulmonary rehabilitation is an outpatient educational program that provides the skills and knowledge needed to manage your emphysema and increase your level of physical strength and fitness. The classes are led by a team of healthcare professionals, physical therapists, and dietitians and taught in a group setting, giving you the opportunity to connect with other individuals living with emphysema and other lung diseases. Pulmonary rehabilitation is often a good fit for individuals who frequently experience shortness of breath when performing daily activities despite taking medication as prescribed.

Supplemental oxygen, or oxygen therapy, can relieve shortness of breath and increase your tolerance for physical activities. There are several devices used in oxygen therapy. Your doctor can guide you in choosing the right oxygen delivery system based on your health needs, lifestyle, and insurance benefits. You may be prescribed one oxygen device to use at home and one to use when you are on the go.

Be sure to follow all of your doctor’s instructions when using your oxygen device, including the flow rate setting (how much oxygen you’ll need per minute). In addition, you may find it helpful to explore the American Lung Association's resources on oxygen therapy.

We’re here to support your emphysema treatment

Sticking to the treatment your doctor has recommended is critical to managing emphysema. At Alto, we make that as easy as possible by offering free hand-delivery, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions by phone or through the Alto app. 

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can support your emphysema treatment plan.

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

A consistent lack of sleep can also affect your physical and mental health in the long term. Here's what you can do to improve your sleep hygiene.

How Sleep Affects Heart Health | Alto Pharmacy

If you’ve ever slept less than the CDC-recommended minimum of seven hours per night, you may have experienced short-term effects of sleep deprivation like forgetfulness, irritability, and an inability to focus. A consistent lack of sleep can also affect your physical and mental health in the long term. And just like diet choices and frequency of physical activity, your sleep habits are linked to your risk for heart disease.

Below, we explain more about how sleep affects heart health and what you can do to improve your sleep hygiene.

Sleep allows your body to recharge. As you enter a state of deep sleep, your heart rate slows down and your blood pressure drops. These physical changes give your heart a chance to recover from how hard it works when you’re awake.

When you don’t spend enough time in uninterrupted deep sleep, your heart doesn’t get the opportunity to rest. Research has found that chronic sleep deprivation and sleep disorders can contribute to numerous cardiovascular health issues including high blood pressure, high cholesterol, and a greater risk for a heart attack or stroke.

Cardiovascular health issues related to sleep

Over time, many sleepless nights can lead to higher baseline blood pressure levels during the day. High blood pressure, or hypertension, is among the leading risk factors for heart disease and stroke. If you experience consistent stress or if you have other risk factors for high blood pressure, you may be more likely to develop high blood pressure as a result of sleep deprivation.

Poor sleep may also contribute to these cardiovascular health issues:

Coronary artery disease occurs when cholesterol and other fatty material (collectively referred to as plaque) builds up in your arteries, making it harder for your heart to pump blood to the rest of your body. This accumulation of plaque is also called atherosclerosis.

Some research has found that a lack of sleep may contribute to atherosclerosis. This is partially due to the connection between sleep deprivation and hypertension, as high blood pressure strains your arteries. In addition, poor sleep can trigger chronic inflammation over time, which also contributes to the accumulation of plaque and the hardening of your arteries.

Chronic sleep deprivation may also increase your risk for a heart attack. One research study found that people who slept less than six hours per night had a 20% higher risk of a heart attack in comparison to those who got more sleep.

While your heart slows down when you are in a state of deep sleep, your heart rate and blood pressure can increase if you wake up suddenly. Over time, consistent sleep disruptions can put greater stress on your heart and contribute to your overall heart attack risk.

A stroke is a cardiac event in which blood flow to your brain is interrupted, causing brain cells to die. Because sleep deprivation can drive high blood pressure and plaque accumulation in your arteries — two leading risk factors for strokes — there is also a correlation between a lack of sleep and your risk of having a stroke.

Type 2 diabetes is a condition in which your body’s cells become resistant to insulin, and your pancreas cannot produce enough insulin to regulate levels of blood glucose. It develops gradually due to a mix of genetic, lifestyle, and environmental factors.

Research has linked poor sleep to prediabetes, a health condition defined primarily by blood sugar levels that are higher than normal but below the official range for a type 2 diabetes diagnosis. If left untreated, prediabetes can progress into type 2 diabetes and lead to health complications in the long term, including cardiovascular issues.

If you already have diabetes, a lack of sleep or frequently interrupted sleep may also impact blood sugar management.

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