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Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory condition that obstructs the airflow from the lungs. Here’s what you need to know about keeping your lungs healthy to avoid or manage COPD. 

Understanding Chronic Obstructive Pulmonary Disease (COPD)

The delicate, branching structures of the lungs bear a striking resemblance to trees. The air you breathe travels down your windpipe, or trachea, and enters the lungs through two large tubes known as bronchi. Just like the roots and limbs of a tree, these tubes divide again and again into smaller bronchioles before finally ending in clusters of tiny air sacs called alveoli—what you might consider the leaves. 

Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory condition that obstructs the airflow from the lungs and makes it difficult to breathe. Although it's the third leading cause of death in the U.S., the good news is that it can be prevented and treated to slow the progression and maintain quality of life. Here’s what you need to know about keeping your lungs healthy to avoid or manage COPD. 

COPD refers to a group of progressive lung diseases, meaning the condition becomes worse over time. The most common are emphysema and chronic bronchitis, and many people with COPD have both of these conditions. 

Emphysema destroys the fragile air sacs in the lungs, which impairs the airflow. The air carrying carbon dioxide out of the body cannot be adequately expelled and some remains trapped in the lungs. Fresh, oxygen-rich air is then blocked from entering the lungs, causing gradually worsening shortness of breath, even while at rest.

According to the Mayo Clinic, most people with emphysema also have bronchitis, which causes inflammation and narrowing of the bronchial tubes. With bronchitis, mucus builds up in the lungs, spurring a persistent cough. 

The CDC reports that sixteen million Americans have trouble breathing due to COPD. However, they estimate that the actual number includes millions more who have not yet been diagnosed. 

In the vast majority of people with COPD, lung damage is caused by cigarette smoking. According to the COPD Foundation, about 90% of people with COPD are current or former smokers. However, damage can also be caused by long-term exposure to irritating gases or particulate matter, including air pollution and workplace exposure to dust, smoke, or fumes. 

An estimated five percent of people with COPD have a deficiency in a protein known as alpha-1-antitrypsin, which causes the lungs to deteriorate and can also affect the liver. People with severe asthma can also progress into COPD. 

The most telling—and distressing—symptom of COPD is difficulty breathing. According to the Mayo Clinic, another major symptom is a constant cough that produces a lot of mucus. Additional symptoms may include chest tightness, wheezing, frequent respiratory infections, and fatigue. Severe COPD can cause swelling in the ankles, legs, and feet and weight loss. 

As a progressive disease, symptoms often begin mildly and may be confused for the common cold. But rather than clearing up after a week or two, the coughing and shortness of breath will continue to worsen over time and make daily activities more difficult. 

Unfortunately, by the time COPD symptoms appear, there may already be significant lung damage. Symptoms will continue to escalate, particularly if smoking or exposure to lung irritants continues. With proper intervention and treatment, however, most people with COPD can slow the disease’s progression and maintain their quality of life. 

People with COPD often experience flare-ups known as exacerbations. During these episodes, symptoms become much more severe for several days or weeks and may require treatment with antibiotics, oral corticosteroids, and even hospitalization. 

Respiratory infections or inflammation triggers—such as air pollution, secondhand smoke, dusts, fumes, or other toxic substances—are common causes of exacerbations. Anyone who experiences a marked increase in coughing, difficulty breathing, or mucus in the lungs should seek immediate medical attention. 

The best way to prevent COPD is to never smoke or stop smoking now. Quitting isn’t easy for most people, so it’s a good idea to enlist your healthcare provider’s support.  They may recommend nicotine replacement products or medications that can help. 

The CDC offers a variety of resources that can help you quit smoking, including a free text message program (text QUIT to 47848) and their quitSTART app, which is available for both Android and iOS. The Mayo Clinic outlines ten tips to help you resist the urge to smoke that you may find helpful as you get started. 

It’s also important to avoid secondhand smoke exposure and occupational exposure to chemical fumes and dust. If you work with any type of lung irritant, the Mayo Clinic advises talking with your supervisor about the best ways to protect yourself, like using respiratory protective equipment. 

Staying active will not only improve your overall health; it will also strengthen your lungs. The American Lung Association recommends getting thirty minutes of moderate physical activity five days a week. Both aerobic and muscle-strengthening exercises will benefit your lungs, so you can include anything from brisk walking to weight lifting to vigorous household cleaning. 

Lastly, make sure to get your annual flu vaccine each fall, as well as a pneumococcal vaccine, to prevent infections that can weaken your lungs. 

While there is no cure for COPD, treatment can ease symptoms and lower the risk of complications like heart disease, lung cancer, respiratory infections, pulmonary hypertension, and depression. 

COPD can be treated with medications, supplemental oxygen therapy, and surgery. However, many people with mild forms of the disease may only need to quit smoking and avoid other inflammation triggers. 

The most common medications used to treat COPD include: 

Bronchodilators, which usually come in inhalers and relax the muscles around the airways to make breathing easier. 

Inhaled corticosteroids, which help to reduce airway inflammation and prevent exacerbations. 

Oral steroids are sometimes used in short courses during periods of exacerbation to prevent further worsening of symptoms.

Phosphodiesterase-4 inhibitors are used for severe COPD. These medications decrease airway inflammation and relax the airways.

Theophylline may be used when other treatments are ineffective or if cost is a factor. It may help improve breathing and prevent exacerbations but can cause side effects like nausea, headache, rapid heartbeat, and tremors.

Antibiotics may also be used to treat respiratory infections but are generally not recommended for prevention. 

Often, a combination of these medications is used to treat COPD. Inhaled medications are taken using a device called an inhaler, which allows the medication to be absorbed straight into your lungs. If you’re prescribed a new inhaler, one of Alto’s pharmacists can walk you through how to use it.  Not all inhalers work the same way, so learning the proper technique is crucial for ensuring adequate therapy.

People with COPD are also generally prescribed a pulmonary rehabilitation program. These individually tailored programs combine exercise, nutrition advice, and counseling to prevent exacerbations, slow the progression of symptoms, and improve quality of life.

Those with insufficient oxygen reaching their blood may benefit from supplemental oxygen therapy. It involves using a lightweight, portable device to deliver oxygen directly to your lungs as needed.

Surgery may be an option for those with severe COPD, particularly severe emphysema. It’s usually reserved for when other types of treatment have failed. 

Because breathing is so elementary, it’s easy to take it for granted. But so many of the activities we enjoy—and life itself—depend on the healthy function of our lungs. 

When breathing becomes difficult, life can change drastically, so it’s important to find support. That may mean sharing your feelings with a close friend or family member, joining a support group for people with COPD, or enlisting the help of a mental health professional. 

Above all, it’s critical to follow your treatment to avoid worsening symptoms. At Alto, we want to make getting the COPD medications you need as easy as possible, so we offer free hand-delivery, automatic savings investigations, and user-friendly medication management through our website and app. We always have a team of pharmacists on-call to answer your questions by phone, text, or chat, and we’ll even remind you when your inhaler or other medications are due for a refill, then schedule a time to drop them off. 

If you’re interested in learning more about how Alto can support your COPD treatment plan, our team is available from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. Download the mobile app for secure messaging or call 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 other qualified health provider with any questions you may have regarding a medical condition.

Heart disease is the leading cause of death for women in the United States. Here’s what our pharmacists think every woman should know about protecting and supporting their hearts. 

What Every Woman Should Know About Heart Health

We’re used to seeing dramatic Hollywood depictions of heart attacks in men. But heart disease is the leading cause of death for women in the United States. The American Heart Association reports that one woman dies of heart disease every minute in America. 

Harvard Health reports that this “heart attack gender gap” can have serious consequences for women. With less awareness of crucial heart-health risk factors and warning signs, many women lack effective prevention strategies or delay life-saving care. 

Though heart disease is deadly, it is also largely preventable. Making heart health part of the conversation for women has the power to save lives. Here’s what our pharmacists think every woman should know about protecting and supporting their hearts. 

The first step in building a heart-health strategy is understanding your individual risk for heart disease. Make sure to undergo any necessary screenings, and discuss risk factors like high blood pressure, high cholesterol, smoking, and age with your doctor at your annual checkup. You’ll want to go over your lifestyle and family history and identify your key health numbers, such as blood pressure, cholesterol, and blood sugar levels. 

According to the American Heart Association, research has uncovered a link between heart disease and pregnancy-related complications. Talk with your doctor if you were diagnosed with diabetes or hypertension during pregnancy or if you had an early delivery. These factors may increase your risk of cardiovascular disease in the future, so it’s essential to be aware and take steps to mitigate that risk. 

All women must understand the signs of a heart attack and the importance of seeking immediate medical attention. Research suggests that women tend to downplay symptoms and delay treatment—a life-threatening issue during a heart attack when every minute counts. 

According to the CDC, the most common signs of a heart attack for both men and women are chest pain or pressure; sharp pain in the jaw, neck, or back; and shortness of breath. However, only about 60% of women experience chest pain or discomfort during a heart attack. Studies suggest that women are more likely to experience less recognizable symptoms like nausea, dizziness, cold sweats, and unexplained fatigue. 

If you experience any discomfort in your chest or upper body or simply feel that something isn’t right, it’s crucial to seek emergency medical attention. Treatment is most effective if given within one hour of the onset of symptoms, so take these symptoms seriously and do not delay care. 

The CDC reports that approximately 200,000 preventable deaths occur each year in the United States due to heart disease and stroke. That’s why it’s so important to put heart-health strategies into place early. Try to augment your diet with plenty of vegetables, fruits, healthy fats, and fiber-rich whole grains while limiting sodium, saturated fats, alcohol, and sugar. Aim for balanced nutrition that you can maintain over time; a little dietary leeway is your best bet for success in the long term. 

Numerous studies have connected poor sleep to heart disease. Not only does a lack of sleep put stress on the body, but it also makes you less likely to exercise and make other healthy choices. If you constantly find yourself cutting back on sleep to tend to your to-do list, it’s time to prioritize rest. 

The American Heart Association recommends getting seven to nine hours of sleep every night to help your body function at its best. Smartphones and other screens are known to disrupt sleep if used at bedtime, so try to power down as early as you can. You might also try using a blue-light blocking filter on your devices at night. Apple devices have a built-in blue-blocking function called “Night Shift,” or you can try out popular apps like Twilight or f.lux. 

It’s also vital that women find ways to manage stress in their daily lives. According to the Mayo Clinic, women's hearts are impacted by stress and depression more than men’s. Stress causes inflammation in the body, which has been linked to heart-health risk factors like high blood pressure and lower “good” HDL cholesterol. It also negatively impacts sleep and may make you less likely to exercise and eat well. 

A comprehensive report on “Stress in America” by the American Psychological Association found that exercise and listening to music were the most popular stress reducers for both men and women. However, women are more likely to find social and sedentary activities relaxing, such as spending time with friends or reading. While daily physical activity is a crucial heart-health strategy, it’s also essential for women to reach out to their social networks and find time to relax and unwind. 

Last year, Harvard Health reported on a recent study, which suggested that women are less likely to be prescribed aspirin, statins, and certain blood pressure medications than men. Experts attribute this discrepancy, in part, to the general lack of awareness about heart disease in women, which can cause both healthcare providers and patients to miss critical warning signs. 

All men and women, regardless of age, should routinely visit their doctor for the necessary heart-health screenings. During these visits, ask your doctor about your individual risk for heart disease, and discuss the risks and benefits of taking cardiovascular medications, if necessary. It’s also crucial to listen to your body and not minimize or explain away any early warning signs of heart trouble. Take any symptoms seriously and seek immediate help. 

While it’s essential to be your own advocate when it comes to your health, we’re here to support you with exceptional pharmacy care every step of the way. If you are prescribed medications for your heart, our pharmacists would be happy to walk you through dosage instructions and answer your questions. We’ll look for any available savings so you can be sure you’re getting the lowest price, and we’ll deliver your medications to your home for free. Simply tell your doctor to send your new prescription to Alto or contact our care team, and we’ll transfer your existing prescriptions for you. 

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.

The beginning of a new year is a perfect opportunity to refresh your routine and set health and wellness goals, but it can be difficult to follow through on these intentions in the long term: studies show that 80% of New Year’s resolutions fail by mid-February. If you entered January with big intentions only to find your new habits slipping, there’s no time like the present to recommit to your physical and mental well-being. Here are a few potential areas to focus on as you hit reset.

A Guide to Year-Round Wellness

Exercising more frequently is one of the most common New Year’s resolutions every year, and for good reason: regular physical activity can lower your risk for many chronic health conditions and improve your mood and sleep, among other benefits.

To make lasting, meaningful changes, set achievable goals. Many Americans exercise less during fall and winter in comparison to warmer months. If you don’t currently have a regular routine, aiming to work out for an hour each day may not be a practical starting point. Behavioral scientist Susan Weinschenk Ph.D., outlines three critical steps for building new habits that stick: start with a small and specific action, tie it to an existing habit, and make it easy to accomplish during the first week. 

Rather than trying to become a hardcore workout enthusiast overnight, resolve to enjoy your morning coffee while walking, then increase your daily walk by ten minutes the next week. When you anchor your intention to an existing action, you give your brain a natural cue to put it into practice. And since the key to solidifying your new habit is repetition, starting with an easy action will create self-trust and allow you to expand on your goal over time.

Mental health is an important aspect of your overall health, as mental health disorders such as depression can increase your risk for numerous physical conditions, from diabetes to heart disease. For many, this is a particularly challenging time from the standpoint of mental health. Approximately 5% of U.S. adults experience seasonal affective disorder (SAD), a type of depression triggered by changes in the weather and reduced exposure to sunlight, while 10-20% of Americans experience a milder form of the winter blues.

To combat the effects of winter depression, try to keep your home as bright as possible by keeping curtains and blinds open and sitting closer to well-lit windows when you can. Be sure to spend some time outside every day, even if the weather is cold or the sky is gray. The morning is an especially impactful time to get outside and walk around.

For many Americans, mental health challenges persist year round. Burnout, a form of chronic stress often linked to workplace demands, has grown increasingly common throughout the course of the Covid-19 pandemic. Of the 1,500 U.S. workers who participated in a 2021 survey about burnout, over half reported experiencing burnout related to their job responsibilities. The effects of burnout go beyond missed deadlines and a lack of motivation — chronic stress influences many aspects of your physical health, from your risk for heart disease to the brain-gut connection.

To maintain emotional balance, start by learning the signs of burnout. Look out for insomnia, exhaustion, changes in your appetite, headaches, and stomachaches. Opt for healthy stress management strategies, like meditation and exercise. In addition, try to stick to your usual sleep schedule. 

If you find that symptoms of burnout or other mental health disorders are interfering with your relationships or daily responsibilities, reach out to your doctor or a mental health professional. You may also benefit from free mental health apps like What’s Up?, which helps you manage stress and negative thoughts through a therapy approach called cognitive behavioral therapy (CBT), and Insight Timer, which has a diverse library of free guided meditations.

As you prioritize your overall mental health, focus on deepening social connections or creating new ones. Social isolation and loneliness have been growing issues in the U.S. even before the Covid-19 pandemic — a 2018 study from the Kaiser Family Foundation and the Economist found that one in five Americans often or always feel isolated — and the pandemic-related rise of remote work has only solidified the trend. In a recent public opinion poll from the American Psychiatric Association (APA), nearly two-thirds of the participants said that they felt isolated or lonely at least sometimes as a result of working from home.

Having a strong social network and regularly connecting with others can improve many areas of your health, including your cardiovascular and cognitive health. Whether volunteering, exploring new hobbies, or catching up with friends or family virtually or in person, small acts of connection go far.

It’s challenging to keep up with health goals if you’re sidelined by the cold, flu, or other illnesses. Fortunately, there are simple steps you can take to give your immunity a boost, even beyond getting your annual flu shot and staying current with vaccines. 

Experts at the Cleveland Clinic recommend incorporating immune-boosting foods into your winter menu to help your body dispatch any seasonal invaders. Fill your grocery cart with a wide range of colorful fruits and vegetables to ensure you consume a full arsenal of antioxidants. Be sure to stock up on raw garlic, which contains antiviral compounds, along with vitamin-C-rich foods like citrus fruits, peppers, broccoli, and kiwis.

According to the Mayo Clinic, people who don’t get enough sleep are more likely to succumb to sickness after being exposed to a virus. Aim for seven to eight hours of sleep per night to support healthy infection-fighting antibodies and cells. We’ve compiled these tips for getting the nightly rest you need when sleep is elusive.

At Alto, we believe that staying on top of your health should be as simple as possible, and we’re here to support you with exceptional pharmacy care all year long. We offer free, same-day delivery and medication management tools like reminders and auto refills in our mobile app.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Editor’s Note: This post was originally published in January 2021 and has been updated for accuracy and completeness.

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

What to Look for in a Prenatal Vitamin

Whether you have recently found out that you are pregnant or are just starting to consider the possibility, prenatal self-care can feel a lot more complicated. Everything you do now has implications for two (or more!). 

The good news? A simple prenatal vitamin can help put your mind at ease. It’s one of the easiest and most effective ways to ensure you get the key vitamins and minerals needed to nourish your baby through a healthy pregnancy. 

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. By beginning early, you’ll help seed your body with the nutrients it needs for the earliest stages of fetal development. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

With a wide range of over-the-counter prenatal supplements to choose from, we recommend consulting with your healthcare provider about the ideal choice for you. In some cases, your doctor might even prescribe a prenatal vitamin based on your unique nutritional needs. If you’re starting to do your research, here are the key nutrients your doctor will likely recommend supplementing. 

As you tour the ingredient label on any prenatal supplement, folic acid should be your first stop. This B vitamin helps the body make new cells and prevents congenital disabilities that affect a baby’s brain and spinal cord. 

Folic acid’s role in fetal development is crucial, so the CDC recommends all women of reproductive age take at least 400 micrograms per day. Birth defects of the brain and spine, known as neural tube defects, usually occur during the earliest weeks of pregnancy, often before many women know that they are pregnant.  

You will find that most over-the-counter prenatal supplements contain between 400 and 800 micrograms of folic acid. Sometimes, your provider may want you to take a little more, however any product with 1,000 micrograms of folic acid or more requires a prescription. 

You may also see this vitamin listed as “folate,” a general term for vitamin B9. Folic acid is a synthetic version of folate that is more stable when exposed to heat and easily absorbed by the body. 

Iron is a mineral that helps your body make blood cells that supply oxygen to your growing baby. It also helps prevent anemia, which occurs when your blood has too few healthy red blood cells. Your body needs more iron than usual during pregnancy because your total blood volume increases. The Mayo Clinic recommends supplementing with 27 milligrams of iron a day. 

Developing babies need calcium for bone growth. If you’re not getting enough, your own bone density could suffer. The general guideline is to take 1,000 milligrams per day while pregnant or nursing, which is the equivalent of three to four servings of dairy. Calcium can also be found in greens like spinach and broccoli. If you’re concerned that you’re not getting enough calcium in your diet, be sure to look for this mineral in your prenatal supplement. 

Vitamin D helps with calcium absorption and bone growth. The Mayo Clinic recommends that you get 600IUs of Vitamin D per day. 

Omega-3 fatty acids include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These essential fats support heart and neurological health. DHA, in particular, is known to support fetal brain development. 

While dietary sources like fatty fish are the best source of omega-3’s, this can present an issue if you want to limit fish consumption while pregnant. Some fish contain high levels of mercury, which can impair brain development in babies. For that reason, researchers at the Women's and Children's Health Research Institute advise that you take the recommended 200 milligrams of DHA a day in supplement form. 

The Mayo Clinic also suggests looking for a prenatal vitamin that includes vitamins C, A, and E; B vitamins; zinc; and iodine. Penn Medicine created this helpful chart to find the recommended daily allowance while you’re pregnant or lactating, but it’s important to consult with your doctor about your needs. 

The Mayo Clinic cautions against taking extra doses of your prenatal vitamin or doubling up on multivitamins as this could be harmful to your baby. You should always take your prenatal vitamins as directed by your doctor. If you forget to take a dose, don't worry, there is no need to double up. Just take your next dose at your regularly scheduled time.

A quality prenatal vitamin combined with a healthy, balanced diet is the best way to ensure your body and growing baby get all the nutrients they need. Talk with your healthcare provider to develop a plan to eat well and supplement your nutrition before and during pregnancy. 

Prenatal vitamins pack a powerful punch, which can make them tough to stomach for some people. The iron in prenatal vitamins can cause constipation, so it helps to drink plenty of fluids, get physical activity daily (if your healthcare provider gives you the okay), and eat more fiber. If constipation becomes a problem, talk with your doctor. Trying another form of iron or a stool softener can help with constipation. 

Some people become nauseous when taking vitamins. If you’re already feeling queasy during your pregnancy, this can present a significant hurdle. Try taking your prenatal vitamin with a meal and experiment with different times of the day. Some people cut their pill in half and take one piece in the morning and the other at night. You might also consider trying a different vitamin brand as each will vary in size, shape, and smell. A gummy, chewable, or liquid option might provide a more palatable option as well. 

If you just can’t seem to stomach your daily pill, don’t give up on your prenatal completely. Your healthcare provider can help you find a solution that won’t sacrifice your nutritional needs. 

The Mayo Clinic recommends that you do not use additional nutritional or herbal supplements during pregnancy. The FDA does not review dietary supplements for safety and effectiveness, and some ingredients could be harmful during pregnancy. 

The Mayo Clinic notes that one possible exception is ginger, which has been shown to help with nausea and is safe for pregnancy. 

If you are considering taking any supplements, always talk with your healthcare provider first. And remember that supplementation—your prenatal vitamin included—should not replace a well-balanced diet full of healthy vegetables and fruits. 

Think of your prenatal vitamin like any medication—more isn’t necessarily better. Stick with the recommended daily dose unless your doctor advises a more significant boost or suggests additional supplements. 

If your doctor recommends a prescription prenatal, you can have the prescription sent straight to Alto, and we’ll hand-deliver it to your home for free. Plus, our pharmacists will only be a phone call or in-app message away if questions come up. You’ve likely got plenty on your mind right now, so allow us to handle all the details of your medication needs. 

Here are seven unconventional ways to support your heart that have sparked the interest of leading health experts. 

7 Unusual Heart Health Risk Factors

What Science is Revealing About Heart Health

Researchers are working hard to curb the impact of heart disease, which is currently the leading cause of death in the United States. These efforts to develop new prevention strategies have led them to some surprising heart health hypotheses. You probably know that you should eat well and stay active, but these lesser-known risk factors may not be on your radar. Here are seven unconventional ways to support your heart that have sparked the interest of leading health experts. 

It turns out, brushing your teeth may have more benefits than just sparkly whites and fresh breath. Numerous studies have documented a link between poor dental health and heart disease. The verdict is still out as to why, but the prevailing theories point to inflammation. It could be that the bacteria which infect gums enter the bloodstream and cause blood vessel inflammation or that the body’s immune response is to blame. While more research is needed, it’s one more reason to brush your teeth for the recommended two minutes twice a day and get regular dental checkups. 

There have been some interesting studies exploring the connection between workplace stress and heart health. A decade-long study in Sweden found that having a bad boss increases your risk of a heart attack. Additional research has suggested that working long hours may increase your risk of cardiovascular disease and stroke. 

A key takeaway here is that stress, in general, isn’t great for your overall health. Stress causes your cortisol levels to spike, which can lead to high blood pressure, weight gain, sleep disruption, and reduced energy over time. Not to mention, your diet, exercise routine, and other healthy habits often suffer when you’re stressed out. Make sure to find ways to unwind at the end of your workday, whether that means listening to a relaxing soundtrack on your drive home or a brief meditation before you make dinner. Sometimes you can’t avoid challenging coworkers or chaotic days, but you can put strategies in place to help you feel calmer and more resilient. 

Not that you needed another reason to love your pets, but several studies have shown that pet ownership, especially having a dog, can improve heart health. According to Harvard Health, researchers have found that dog owners have lower blood pressure and cholesterol than non-owners, probably because dogs require daily walks and tend to have a calming effect on their humans. 

If you’re not a dog owner, we don’t advise adding pets to your life purely as a health strategy. Instead, you might consider stopping to meet some of your four-legged neighbors. A few studies have found that just petting a dog can lower your blood pressure. 

Sleep is the unsung hero of the health world. It allows your whole body to rest and replenish. Although your heart never stops beating, it does slow down and recover during sleep. According to John Hopkins Medicine, by depriving your heart of this crucial recovery time, lack of sleep increases your risk of heart attack and heart disease.

If you have trouble sleeping, creating a nightly ritual can help. Try to wind down at the same time every evening and create a calm, dark, and quiet environment in your bedroom. You should turn off your electronic devices at least thirty minutes before bedtime to help your body prepare for restful sleep. 

If you find yourself tossing and turning on the regular, it’s best to talk with your doctor. Various underlying and unsuspecting conditions could be causing your lack of sleep and there are many different therapies that can help.  

For more sleep-enhancing tips, read, “Too Stressed to Sleep? These Strategies Can Help.”

Bring on the oatmeal and scrambled eggs! When a panel of experts from the American Heart Association reviewed studies on eating habits and heart health, they formed an intriguing conclusion: breakfast-eaters tended to have lower instances of heart disease and were less likely to have high cholesterol and high blood pressure.

If you struggle to make time to eat in the morning, the American Heart Association suggests these breakfast hacks for some quick and easy meal ideas. Harvard Health recommends including whole grains in your morning meal to further reduce your risk for heart attack, stroke, and heart failure. They offer this menu of options full of whole grains, protein, and fruit. 

We all love a good movie marathon, but regularly sitting for hours at a stretch could be putting your heart at risk. And yes, that includes long workdays at the computer. 

The American Heart Association and the American College of Cardiology have both warned that regularly sitting for long periods is a significant contributor to heart disease. It’s not an issue of laziness—in a world full of deskjobs, car trips, and the all-important need to unwind, many of us struggle to find time to get the consistent movement our bodies need.

If you’re stuck sitting for long periods, the American Heart Association suggests finding ways to sneak movement into your day. You might try setting a timer and taking a five-minute stretch break every hour or using your lunch break to go for a walk. Every extra minute on your feet will help you get to the recommended 150 minutes of activity per week. Exercise also helps you reduce stress and sleep better, making it a true heart-health allstar. 

Several studies suggest an association between optimism and a lower risk of cardiovascular disease. A 2015 study found that those with a more positive outlook were more likely to make healthy lifestyle changes after a heart attack. And a researcher at the University of California, San Diego, found that patients with a greater sense of gratitude had lower levels of inflammation and better heart health overall.

Robert A. Emmons, Ph.D., a professor of psychology at the University of California, Davis, told the American Heart Association, “Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life. It can lower blood pressure and improve immune function...grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol and have higher rates of medication adherence.”

If optimism doesn’t always come easy to you, you’re not alone. Psychologists believe we have a natural tendency to fixate on negative information as a way to avoid it in the future. It’s a phenomenon known as “negativity bias.” Practicing gratitude is a powerful way to counteract this inclination. Best of all, it’s easy to get started. Your new habit can be as simple as writing down what you’re grateful for every day. 

When you look closely, these unconventional risk factors aren’t really that surprising. They each relate to foundational heart-healthy lifestyle choices such as managing stress, eating healthy foods, and staying active. This advice aligns with the CDC’s guidance, which outlines six essential strategies for living a heart-healthy lifestyle. 

If you’re concerned about your heart, the CDC recommends learning about your family’s health history and talking to your healthcare provider about your risk. Together you can create an action plan that’s best for you. If your doctor prescribes medication to treat high cholesterol, high blood pressure, or diabetes, the CDC stresses the importance of taking it as directed. 

Alto’s expert pharmacists will always be available via in-app message or phone to answer questions about dosage instructions or side effects, and we’d be happy to bring your medications to your doorstep for free. Your heart-healthy lifestyle does not have to include standing in line at the pharmacy or worrying about refills. We’ll take care of the details so you can focus on cooking a healthy breakfast or walking your dog. 

Blood pressure is one critical way the heart maintains its happy, healthy medium. In this article we'll explore how to manage high blood pressure and what you can do to maintain healthy blood pressure.

The Lowdown on Healthy Blood Pressure

Blood is constantly flowing through every part of your body, propelled by the beating of your heart. Though this hardworking muscle is only about the size of your fist, it contracts sixty to eighty times per minute, sending oxygen-rich blood to the farthest reaches of your body and back. 

Like any finely-tuned machine, the heart requires balance to remain in optimal condition. If it doesn’t pump hard enough, its vital job doesn’t get done. But if it starts working too hard, it runs the risk of tiring and eventually giving out. Blood pressure is one critical way the heart maintains its happy, healthy medium.

Blood pressure is the force of the blood as it moves through the body. It’s important because we need blood to deliver the oxygen and nutrients that nourish our tissues along with antibodies and white blood cells for immunity. Blood pressure also helps us remove the waste products of our metabolism, like carbon dioxide and toxins from the liver and kidneys. 

The heart creates blood pressure with every contraction, but there are other forces at work as well. Blood keeps moving through the network of blood vessels in our bodies because of differences in pressure in our continuously narrowing arteries, veins, and capillaries. It’s similar to what occurs with multi-function showerheads. The amount of water flowing through your pipes remains the same, but a more narrow flow exerts more pressure while a widened spray feels more gentle.  

The initial, most substantial pressure comes from the heart, and the arteries’ structure helps maintain it as the blood continues to flow. 

A blood pressure reading measures two forces. Systolic pressure is the force that occurs as blood flows out of the heart and into the arteries. Diastolic pressure is the force created when the heart fills with blood as it rests between beats. 

These forces are measured using a sphygmomanometer, or what many of us know as the inflatable arm cuff that healthcare providers use during checkups. 

The cuff is inflated enough to stop the pulse, and a reading is taken. When the pulse returns, the cuff is allowed to deflate slowly, and another reading is taken. The numbers are expressed in terms of the pressure it takes to move mercury around a tube against gravity, a unit called millimeters of mercury (mm Hg). Your healthcare provider will give your reading as two figures—systolic pressure first and the diastolic pressure second—such as “140 over 80 mm Hg.” 

The National Institutes of Health advises that normal blood pressure for most adults is below 120 mm Hg systolic and 80 mm Hg diastolic. While both readings provide important information, “high blood pressure” typically refers to systolic pressure, the first number in your blood pressure reading. 

High blood pressure, also known as hypertension, is a condition that occurs when the force of the blood flowing through a person’s arteries is consistently above 130 over 80. The added pressure forces the heart to work harder and can stretch or injure the blood vessels. It also speeds the build-up of harmful plaque that can block blood flow, increasing blood pressure even further.

Over time, high blood pressure can lead to life-threatening issues like heart disease, heart attack, and stroke. It can also damage major organs such as your heart, brain, kidneys, and eyes. According to the CDC, high blood pressure usually has no early warning signs or symptoms. Getting your blood pressure checked regularly by your healthcare provider is the only way to determine whether your blood pressure is too high. 

It’s critical to detect high blood pressure early because it can be treated, usually through heart-healthy lifestyle changes with or without prescription blood pressure medications. Your healthcare provider can determine the right treatment plan for you. 

The American Heart Association encourages everyone to know their blood pressure numbers and adopt a more heart-healthy lifestyle. Impactful changes include eating a well-balanced diet that limits salt, staying physically active, taking steps to manage stress, reducing alcohol, and eliminating smoking. 

Even if you don’t have high blood pressure, eating less salt is one of the best choices you can make for your heart. Though sodium is essential for life, consuming too much salt pulls water into the bloodstream, increasing the volume of your blood. More blood flowing through your blood vessels exerts greater pressure on your heart. 	

The American Heart Association recommends that everyone limit their sodium intake to 1,500 mg/day. The biggest sodium culprits in the average American diet often don’t emerge from the salt shaker on the table. Processed or prepackaged foods like soups, cold cuts, bread, and frozen meals are major sources of excess salt because they often contain sodium-based preservatives and additives to enrich their flavor. It’s not always easy to determine by looking at their labels, however, there are several sodium-containing compounds to watch out for in the ingredient list, such as sodium benzoate, sodium tripolyphosphate, and monosodium glutamate (MSG). 

Start to make a habit of looking at labels while you grocery shop and choosing low-sodium options when possible. The American Heart Association created this sodium fact sheet to help you make heart-healthy choices. 

If your doctor determines that your blood pressure is too high, you’re certainly not alone. According to the CDC, nearly half of American adults have hypertension. If blood pressure medications become part of your treatment plan, we’d be happy to connect you with one of our pharmacists, who are specialists in heart medications. Plus, our free hand-delivery means you’ll never have to plan an extra trip to the pharmacy. With a few healthy lifestyle changes and the support of your doctor and pharmacy, your life doesn’t have to miss a beat. 

Your thyroid makes the hormones that regulate your metabolism. In this article we'll share tips for supporting your thyroid health as well as what to do when your thyroid is out of balance.

All About the Thyroid

The thyroid is a small butterfly-shaped gland located at the base of your throat. It’s part of the endocrine system—a series of glands that produce and regulate hormones. Hormones are chemical messengers that “tell” certain cells and organs what to do, influencing nearly all of the body’s functions. 

Your thyroid makes the hormones that regulate your metabolism: thyroxine (T4) and triiodothyronine (T3). Metabolism is the process by which your body converts food into energy,  facilitating vital functions such as blood circulation, breathing, and cell repair. Without the thyroid, the body could not break down protein, fats, and carbohydrates for fuel. 

The thyroid gland does not simply act on its own. It receives signals from the pituitary gland, the body’s “master gland,” which is located at the base of the brain and regulates vital body functions. The pea-sized pituitary gland sends its instructions through a hormone called thyroid-stimulating hormone (TSH). TSH levels rise and fall in the blood, telling the thyroid the exact amount of each hormone to secrete. Hormone levels within the body are a delicate balancing act, and several disorders can arise if the thyroid overproduces (hyperthyroidism) or underproduces (hypothyroidism) T4 and T3. 

With hyperthyroidism, the thyroid gland makes too many hormones, accelerating the body's metabolism, which can cause unintentional weight loss and a rapid or irregular heartbeat. According to the Mayo Clinic, other symptoms may include increased appetite, nervousness or anxiety, sweating, fatigue, and difficulty sleeping. Without treatment, hyperthyroidism can lead to serious complications, including heart conditions like congenital heart failure, eye problems, and osteoporosis. 

Hypothyroidism occurs when the thyroid isn’t making enough hormones, and symptoms may not be noticeable at first. Common symptoms of hypothyroidism may include increased sensitivity to cold, fatigue, constipation, weight gain, and dry skin. If left unchecked, the condition can eventually lead to obesity, joint pain, infertility, and heart disease.

Both conditions can be treated, often through the use of synthetic hormones or anti-thyroid medications. If you’re concerned about thyroid health, your healthcare provider can administer a blood test to check your thyroid hormone levels and recommend the appropriate treatment. 

Eating a nutritious, well-rounded diet is essential for thyroid health. Many vitamins and minerals support the thyroid, and iodine is chief among them. This trace mineral is an essential building block of thyroid hormones, but our bodies don’t produce it. Therefore, we need to consume iodine in foods such as iodized salt, seafood, seaweeds, egg yolks, dairy products, and lima beans.

It’s important not to go overboard, however. Consuming iodine in excess can negatively affect hormone levels in some individuals. Iodine deficiency is rare in the United States, so if you’re eating a varied diet, you’re likely within the range of the recommended 150 micrograms per day. 

Selenium is another critical mineral for thyroid function that can be found in brazil nuts, fish, meat, poultry, and fortified cereals and grains. Just like with iodine, selenium deficiency in the U.S. is rare, and it can be detrimental to go too far over the recommended 200 micrograms per day. 

Both the Mayo Clinic and Harvard Health recommend eating a variety of healthy foods rather than focusing too heavily on specific foods or supplements for thyroid health. If you have any concerns about your intake of essential nutrients, talk with your doctor about taking a multivitamin with minerals.

A Word of Caution about Thyroid Supplements

Your endocrine system maintains a very precise balance of hormone levels. For that reason, it’s not a good idea to experiment with your hormone health on your own. According to Cleveland Clinic endocrinologist Christian Nasr, MD, taking over-the-counter iodine supplements could result in getting more than the recommended daily value, which may leave you worse off than before. “The effect of iodine supplements can vary by person, causing the thyroid to produce either too much or too little hormone,” he cautioned.

Consumer Reports also issued a warning about thyroid supplements, reporting that many have been found to contain thyroid hormones derived from animal glands—and there’s often no indication on the labels. When researchers randomly tested ten “thyroid support” supplements, they found that nine contained “clinically relevant” levels of thyroid hormones, in some cases at levels that rivaled prescription thyroid medications. Researchers concluded that these supplements posed a “potential danger to public health.” 

Keep in mind that dietary supplements are not reviewed for safety or effectiveness by the FDA, so it’s best to talk with your healthcare provider before beginning a new over-the-counter supplement. Taking “thyroid support” supplements could alter your hormone levels in unpredictable ways and have undesirable health consequences. If you’re at all concerned about your thyroid health, consult your doctor so you can have your hormone levels tested and begin a prescribed treatment plan. 

A healthy thyroid contributes to feeling energized and ready to live life to the fullest. If your doctor determines that your hormone levels are out of balance, taking medication can restore your vitality. Once you develop a treatment plan, we’d be happy to take over the details of managing your medications. We’ll drop them off at your doorstep for free, and your prescription information will always be at your fingertips through our desktop and mobile apps. Plus, our pharmacists will only be a phone call, text message, or in-app chat away if you have questions about side effects or which foods to avoid eating around dosage time. 

Want to learn more about a better pharmacy experience with Alto? Our care team and endocrinology specialists are available to answer your questions from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends; reach out by in-app secure messaging or phone.

Managing your health during the pandemic is a long game. Here are five important heart health strategies to put into play during the COVID-19 pandemic.

Your Heart Health Playbook During COVID-19

What We Know about Heart Health and COVID-19

We mostly hear about how COVID-19 affects the lungs. But any serious viral infection can put stress on the heart by forcing it to work faster and harder as the body mobilizes to defend itself. Even more troubling, COVID-19 infection can cause blood clots in the heart’s arteries or attack and weaken the heart muscle itself. 

Anyone who is already managing high blood pressure or heart disease should take the potential for damage to their cardiovascular system seriously. Just don’t let vigilance and caution spiral into fear. While the gravity of the link between COVID-19 and cardiovascular health should not be understated, there are proactive ways you can support your heart and protect yourself from infection. 

Remember—managing your health during the pandemic is a long game. It’s crucial that you continue to take your medications as prescribed and receive necessary medical care. With this in mind, here are five important heart health strategies to put into play during the COVID-19 pandemic.

Five Heart Health Strategies During COVID-19

For months now you’ve been wearing a mask, social distancing, and avoiding crowded areas whenever possible. We know it hasn’t been easy, but keep it up. According to Penn Medicine cardiologist Helene Glassberg, MD, “The number one thing is to continue what you're doing, which is staying at home when possible, practicing safe distancing, and seeking medical attention if you're having problems.” Dr. Glassberg also recommends exercising caution as states experiment with loosening restrictions, advising, “Stay the course for as long as you can to stay well.”

There have been conflicting news reports involving some blood pressure medications and COVID-19. Despite what you might have read, don’t stop taking your medications without consulting your doctor. Not only is that never a good idea, but several recent studies indicate that there is no cause for concern when it comes to these medications. 

The confusion stemmed from the fact that two common classes of blood pressure drugs, known as angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), affect the same pathways in the body that the coronavirus takes to reach the lungs and the heart. Multiple types of both medications are available—commonly prescribed ACE inhibitors include lisinopril, captopril, and benazepril, while common ARBs include losartan, valsartan, and azilsartan. 

For a while, experts were unsure if these shared pathways meant that these medications might either help or harm people with the virus. According to Harvard Health, three different studies have found no evidence of harm for people infected with COVID-19 who continue to take ACE inhibitors and ARBs. While there is still research to be done, experts recommend that people already taking these medications should continue to do so. 

The same advice goes for any medications or lifestyle interventions that your doctor has prescribed. If anything, it is more important than ever to remain diligent with your cardiac care plan and stay in communication with your doctor. 

The prospect of sitting in the waiting room at the doctor’s office can be anxiety-provoking right now. While avoiding the doctor might feel like a safe choice in the short-term, skipping your appointments or ignoring symptoms could mean putting yourself at risk of serious health issues like heart attack and stroke, and increasing the danger of complications should you be exposed to COVID-19. 

Talk with your doctor about what safety measures have been put in place to protect you from COVID-19 exposure during your visits. Together you can assess the risks and create a plan to continue monitoring your blood pressure and heart health. Telehealth, which allows you to meet with your doctor via phone or video, may be an option and is often covered by insurance. 

If you pair virtual doctor visits with free hand-delivery of your prescription medications through Alto, you can avoid both the waiting room and long lines at the pharmacy. Transferring your prescriptions to Alto is easy and free—we’ll take care of the work for you. We’ll ask you to choose a convenient delivery window, and one of our couriers will bring your medications straight to your door at no additional cost. We can even provide completely contactless delivery if you prefer. 

Don’t Drop the Ball on Your Healthy Habits

Even though we’ve been at it for months, staying motivated to keep up healthy habits from home can still be a struggle. The stress and anxiety so many of us are feeling right now may affect our energy levels or cause us to lose interest in our usual activities. When facing distressing news reports or personal hardship, it’s tempting to self-soothe in various unhealthy ways. It’s okay to indulge sometimes, but try not to slide too far into less healthy coping mechanisms for the sake of your heart and your emotional well-being.

Cooking heart-healthy meals at home can boost your overall wellness and serve as a creative outlet. The American Heart Association created this resource for making smart shopping choices on a budget and offers a library of recipes to suit any skill level or craving. Staying active is equally important. If you find it difficult to work out from home, try thinking outside the box of what you’d normally consider fitness. For example, giving your kitchen a good scrub will get your heart rate up, and seeing your countertops sparkle will most likely relieve some stress. If you prefer to keep it simple, a brisk walk around your neighborhood is an effective choice that can help you feel connected to your community from a safe distance. 

Unfortunately, heart attacks and strokes don’t take a break when a global pandemic strikes. Do not delay getting emergency medical care because you fear going to the emergency room due to COVID-19. Heart disease is the number one cause of death in the United States, even now, and the hospital is the safest place you can be if you think you are experiencing a heart attack or stroke. Call 911 immediately at the first sign of trouble—the American Heart Association offers this resource for identifying a heart attack or stroke. We also recommend reading our article, “Heart Health Warning Signs to Watch Out For.” 

We are fully prepared to deliver your heart medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are stocked, our couriers are standing by, and our pharmacists are on-call to answer questions and assist with coordinating refills or requesting longer fills. We offer free, contactless delivery with every single prescription so you can rest easy at home knowing that everything you need is on its way. 

Mike McClay has spent the better part of two decades working in Silicon Valley. Here, he chats with software engineer Akash Gupta about the road from Software Engineer to VP, what it’s like to work in digital health, and his best advice to both independent contributors (ICs) and managers. 

Get to Know Alto’s VP of Engineering, Mike McClay

I'd love to first understand a bit about you personally. What do you like to do in your off time? What’s something most people don't know about you?

I grew up in Orange County, which is pretty suburban, so that afforded us a lot of time outdoors as a family. A life goal of mine is to do a solo hike of the John Muir Trail. The route starts in Yosemite Valley and heads south to Mt. Whitney. It’s about 225 miles and typically takes a few weeks to complete.

Currently though, I have a two-year-old and a four-year-old, and we have another baby on the way, so my outdoor activities tend to be much shorter and closer to home. I got into road biking about 10 years ago and transitioned to mountain biking a few years back when my family moved to Marin. Being able to get out onto the local trails a couple times per week is an amazing opportunity to get a great workout in, and unplugging does wonders.

Finally, a ton of family time with my partner and kids. A big reason I decided to join Alto is because it provides a great balance of simultaneously being a high growth startup but it’s also a company that has an eye on culture and achieving work-life balance. At Alto, we're playing to win, and we’ve got a lot of things to get done, but there's a lot of support and representation for people with families with kids. It's nice to be able to work hard towards an incredible mission but also not have to sacrifice too much on the family front; so outside of work, I’m mostly focused on spending quality time with my family getting outdoors, getting to the beach, and things like that.

That's very exciting, having another child on the way. How has COVID-19 impacted your responsibilities of being a VP Engineering and a father?

Life is a lot harder during COVID, though I say that with a fair amount of awareness of the privilege my family and I have. On the home front, we are constantly trying to find that balance of keeping the kids entertained and learning but also doing it in a safe way that protects everyone. My wife and I are pretty fastidious about keeping the house organized and clean but that’s relaxed quite a bit during this time; there’s a lot of resetting of expectations, and I try to do as much as I can to support my wife.

Professionally, probably about half of our engineering team has interviewed and onboarded since the shift to remote work in March, and I’d say we are still iterating and adapting each month to work better in a fully remote environment. It’s been incredible to see our teams adapt to this new style of work, and while it’s not quite the same as our in-person environment was, it’s been really cool to see the team grow and have our organization make a bigger and bigger impact for our patients each month.

Blog

Understanding Chronic Obstructive Pulmonary Disease (COPD)

What Every Woman Should Know About Heart Health

A Guide to Year-Round Wellness

What to Look for in a Prenatal Vitamin

7 Unusual Heart Health Risk Factors

The Lowdown on Healthy Blood Pressure

All About the Thyroid

Your Heart Health Playbook During COVID-19

Get to Know Alto’s VP of Engineering, Mike McClay

Why Kindness May Be the Best Medicine

Heart Health Warning Signs to Watch Out For

Your Top 5 Questions About Heart Health, Answered!

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