The Heart

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What to know about angioplasty

Angioplasty is a medical procedure that opens up a blocked or narrowed artery around the heart. It is a standard treatment for narrowed or blocked arteries in this area of the body.Doctors also refer to angioplasty as percutaneous coronary intervention, or PCI.During angioplasty, a surgeon inserts a tube into an artery in the groin or wrist. They then thread the tube towards the affected artery around the heart. Finally, they insert a balloon or stent (metal tube) to open the artery.Doctors perform more than 1.2 million angioplasties a year in the United States, according to the American College of Cardiology.Here, we give an overview of angioplasty or PCI, including its uses, types, risks, procedure, and recovery.
surgeon performing angioplastyShare on PinterestAn angioplasty may help reduce chest pain, or angina.In the term angioplasty, "angio" means blood vessel, and "plasty" is opening up.In PCI, the "P" stands for percutaneous or "through the skin" while coronary refers to the location of blood vessels around the heart.Angioplasty is a conventional treatment for coronary heart disease (CHD) and heart attacks (acute coronary syndrome).In these conditions, there is a buildup of plaque, or atherosclerosis, on the walls of the arteries. As plaque accumulates, the arteries narrow and can become blocked.In a heart attack, the plaque may rupture, spilling cholesterol into an artery, potentially leading to a clot that stops blood flow.During a standard angioplasty, the doctor makes an incision in the groin or wrist and inserts a tube, or catheter, into an artery.Next, they thread the catheter upwards and into the affected blood vessel around the heart.Usually, the catheter contains an inflatable balloon that displaces the plaque or clot, effectively opening up the artery.Doctors use live X-rays and a contrast dye to guide the catheter and assess the arteries they need to treat.Compared with heart surgery, angioplasty is a minimally invasive as it does not involve opening up the chest.Doctors may recommend angioplasty to:treat an abnormal stress testincrease blood flow to the heartreduce chest pain, or anginaimprove blood supply to the heart muscle during or after a heart attacksupport more activity for people with chest pain
There are two main types of angioplasty:Balloon angioplasty, which involves using the pressure of an inflating balloon to clear plaque that is blocking an artery. This is rarely done alone except in cases when doctors are unable to place a stent in the required position.Stent placement in the artery, which involves a tube, or stent, made out of wire mesh. Stents help to prevent an artery narrowing again after angioplasty.Stents may be made of bare metal or have a coating of medication. When they include medication, they are called drug eluting stents (DES) and are less likely to plug up again.DES are now used almost exclusively with very little use of bare metal stents.Research from 2018 estimates that doctors in the U.S. implant over 1.8 million stents each year.
Angioplasty is a minimally invasive procedure, but it is still surgery, and people must follow their doctor's instructions carefully beforehand.People need to inform their doctor about any medications and supplements they are taking. In some cases, they may need to stop taking these drugs, especially blood thinners, before the procedure.Also, an individual may need to avoid food or drinks for several hours before the angioplasty procedure as doctors will need to sedate them.Kidney tests may be needed beforehand, too, as the contrast dye that the surgeons use can affect kidney function.Before beginning angioplasty, a healthcare professional will clean and numb the area where the catheter enters the body, usually the groin but sometimes the wrist.Next, a doctor inserts the catheter into the artery and directs it towards the coronary artery, watching its progress on an X-ray feed.Once the catheter is in position, the doctor injects a contrast dye through the artery, which helps identify blockages around the heart. Once they locate the blockages, the doctor inserts a second catheter and a guidewire, usually with a balloon at the tip.When the second catheter is in position, the doctor inflates the balloon, which pushes the plaque buildup away and opens up the artery. The surgeon may insert a stent to keep the artery propped open.According to the American Heart Association, angioplasty can take anywhere from 30 minutes to a few hours. The person may need to stay in hospital overnight.On the whole, angioplasty is a safe procedure without complications.One estimate says the rate of complications is 5 in every 100 people, with fewer in large institutes that specialize in angioplasty.Although complications from angioplasty are rare, they can include:prolonged bleeding from the catheter insertion site in the groin or wristdamage to blood vessels, kidneys, or arteriesan allergic reaction to the dyechest painarrhythmia, or abnormal heart rhythma blockage that requires an emergency bypassblood clotstrokeheart attacka tear or damage to artery or major blood vesseldeathOlder individuals have a higher risk of complications from angioplasty, as do those with the following conditions:There is also a chance of the artery becoming blocked with plaque again through a process called restenosis, plaque shift, or stent thrombosis, which is a clot in the stent.When angioplasty is complete, the cardiologist removes the catheters and bandages. Soreness, bruising, and possibly bleeding are common around the area where catheters entered the body.Typically, a person will recover in the hospital for a few hours or overnight before going home. They must not drive as they may still have sedative medications in their system. They will also have restrictions on lifting for about a week afterward.People can often return to work within a week, but their doctor will advise on how active they can be and when.The follow-up visit after angioplasty is a key aspect of the treatment. The doctor will review the individual's recovery, adjust medications as they need, and develop an ongoing treatment plan for their cardiovascular health.Angioplasty is a standard, minimally invasive procedure that doctors use to unblock clogged arteries and improve blood flow in the heart. Doctors frequently recommend angioplasty to treat acute heart problems. It is generally a safe procedure, although arteries can become blocked again, and there is a small risk of significant complications in some cases.
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Peas and beans: Can they improve heart health?

A recent review and meta-analysis focus on the role of legumes in heart health. Taking data from multiple studies and earlier analyses, the authors conclude that legumes might benefit heart health but that the evidence is not overwhelming.

Selection of legumesShare on PinterestA new analysis looks at the links between legume intake and heart health.

It is a no-brainer that nutrition plays a pivotal role in health. At one end of the spectrum, it is common knowledge that eating a diet that is high in sugar, salt, and fat increases the risk of poorer health outcomes.

At the other end, eating a balanced diet that is rich in fresh fruits and vegetables is likely to reduce the risk of certain conditions.

However, drilling down to the effect of individual foods on specific conditions is notoriously difficult.

The authors of a recent review in Advances In Nutrition have taken up that gauntlet. They wanted to understand how legumes, which include beans, peas, and lentils, affect heart health.

In particular, they focused on cardiovascular disease (CVD) risk and CVD mortality. CVD includes coronary heart disease, myocardial infarction, and stroke. They also investigated legume consumption in relation to diabetes, hypertension, and obesity.Study co-author Dr. Hana Kahleova, from the Physicians Committee for Responsible Medicine in Washington, DC, explains why investigating heart health is such a pressing matter, stating that "[c]ardiovascular disease is the world's leading — and most expensive — cause of death, costing the United States nearly 1 billion dollars a day."Why legumes?Legumes are rich in fiber, protein, and micronutrients but contain very little fat and sugar. Due to this, as the authors of the current study explain:"The American Heart Association, Canadian Cardiovascular Society, and European Society for Cardiology encourage dietary patterns that emphasize intake of legumes" to reduce levels of low-density lipoprotein (LDL, or bad) cholesterol, lower blood pressure, and manage diabetes.Recently, the European Association for the Study of Diabetes commissioned a series of systematic reviews and meta-analyses. Using the results of these studies, they hope to update current recommendations on the role of legumes in preventing and treating cardiometabolic diseases.In the current review, the authors compared data on people with the lowest and highest intake of legumes. They found that "dietary pulses with or without other legumes were associated with an 8%, 10%, 9%, and 13% decrease in CVD, [coronary heart disease], hypertension, and obesity incidence, respectively."However, they found that there was no association between legume intake and the incidence of myocardial infarction, diabetes, or stroke. Similarly, they identified no relationship between legumes and mortality from CVD, coronary heart disease, or stroke.Although the team identified a positive relationship between consuming higher quantities of legumes and a reduced risk of certain cardiovascular parameters, the authors' conclusions are still relatively muted. They write:"The overall certainty of the evidence was graded as 'low' for CVD incidence and 'very low' for all other outcomes."They continue, "Current evidence shows that dietary pulses with or without other legumes are associated with reduced CVD incidence with low certainty and reduced [coronary heart disease], hypertension, and obesity incidence with very low certainty."Nutritional difficultiesOne of the primary issues that scientists face when investigating nutrition and health is residual confounding. For instance, if someone eats more legumes than average, they might also eat more vegetables in general. Conversely, someone who eats few legumes might eat less fruit and vegetables overall.If this is the case, it is difficult to pin any measured benefits on the legumes, specifically. They might simply be due to the increase in plant food overall.Similarly, someone who eats particularly healthfully might also be more likely to exercise. Understanding whether the legume, the overall dietary patterns, or the entire lifestyle influences any given health outcome is verging on impossible.Another problem centers around self-reporting food intake. Human memory, as impressive as it is, can make mistakes. One paper on this topic states that self-reports of food intake "are so poor that they are wholly unacceptable for scientific research."Studies attempt to minimize the influence of these factors as much as possible, but it can be challenging. As the authors explain, "Despite the inclusion of several large, high quality cohorts, the inability to rule out residual confounding is a limitation inherent in all observational studies."Despite the difficulties, overall, the authors believe that increasing legume intake could improve the heart health of the population of the United States."Americans eat less than one serving of legumes per day, on average. Simply adding more beans to our plates could be a powerful tool in fighting heart disease and bringing down blood pressure."Co-author Dr. Hana KahleovaAlthough those studying nutrition and disease face many challenges, it is important to continue this line of investigation. Currently, in the U.S., 1 in 4 deaths relate to cardiovascular disease. If a simple change in diet could reduce the risk even a small amount, it might make a significant difference at the population level.
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Sleep loss may contribute to heart disease in those with low incomes

People who are in a precarious financial position have an increased risk of cardiovascular disease. New research reveals that chronic sleep loss may contribute to this risk in the context of social inequality.

older man unable to sleepShare on PinterestShort sleep may help explain why people with low incomes are at higher risk of heart disease, especially in the case of men.

Last year, research featured in the journal Circulation of the American Heart Association explained that individuals with low socioeconomic status are more likely to develop cardiovascular disease than those who are in a less precarious financial condition.

And as recently as April of this year, a study published in The Lancet: Global Health found that people living in low income countries face a higher risk of cardiovascular disease.

Many biological and psychosocial factors can explain the link between low socioeconomic status and a higher risk of heart problems, such as anxiety and high blood pressure.

But in a new study, researchers affiliated with the Lifepath Consortium — a research consortium aiming to understand better how socioeconomic differences impact health — have gathered evidence that poor sleep may significantly contribute to the risk of cardiovascular disease in people at a financial disadvantage.The team reports and explains the new findings in a study paper that features in the journal Cardiovascular Research. In the study paper, the researchers outline why they were interested in the potential link between socioeconomic status, sleep duration, and heart disease, explaining that:"First, individuals who experienced social adversity across the life-course report sleep-related problems more frequently [...] In particular, people working in shifts, living in deprived neighborhoods, or who have experienced adversity in childhood show an increased prevalence of sleep-related disorders. Second, inadequate sleep has been associated with an increased risk of cardiovascular disease."In the current study, the investigators analyzed data from a total of 111,205 participants across eight different cohorts from four countries: France, the United Kingdom, Switzerland, and Portugal.The team split the participants into different socioeconomic categories — low, middle, or high income — based on the participants' occupation, as well as the occupation of each participant's father.Thanks to medical exams and self-reported measures, the researchers also had access to the participants' history of coronary heart disease and cardiovascular events. The investigators also looked at measures of sleep duration, categorizing them as recommended sleep (6–8.5 hours per night), long sleep (over 8.5. hours per night), and short sleep (fewer than 6 hours per night).To understand how, and if sleep loss was likely to contribute to cardiovascular problems in people of different incomes, the researchers used mediation analysis, a specialized statistical method.The researchers' findings indicated that insufficient sleep might play a role in the heightened risk of cardiovascular disease in people of lower socioeconomic status. However, the impact seemed to vary by biological sex.The researchers note that short sleep likely explains 13.4% of the link between occupations associated with lower socioeconomic status and coronary heart disease in men.Although women in lower socioeconomic groups also get heart disease, it does not appear to be linked to sleep in the same way as in men. The researchers hypothesize that this may be because most women already face a much higher burden of responsibilities outside of their professional occupation that independently affects their sleep and their health.According to study co-author Dusan Petrovic from the University Centre of General Medicine and Public Health in Lausanne, Switzerland, "Women with low socioeconomic status often combine the physical and psychosocial strain of manual, poorly paid jobs with household responsibilities and stress, which negatively affects sleep and its health-restoring effects compared to men."Based on the study findings, the researchers argue that societies must address many issues that lie at their cores in order to help every single one of their members to achieve adequate sleep as much as possible."Structural reforms are needed at every level of society to enable people to get more sleep," advises Petrovic."For example, attempting to reduce noise, which is an important source of sleep disturbances, with double glazed windows, limiting traffic, and not building houses next to airports or highways."Dusan Petrovic
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Sinus tachycardia: Everything you need to know

Tachycardia is when the heart beats faster than normal. There are different types of tachycardia, depending on the cause. Sinus tachycardia is when the sinus node, which is the natural pacemaker of the heart, fires electrical impulses abnormally quickly.People can have either normal or inappropriate sinus tachycardia. Normal sinus tachycardia refers to a physiological increased heart rate that occurs in response to specific factors, such as stress, exercise, or a fever.Inappropriate sinus tachycardia has no known cause. People who have it may have an increased heart rate all of the time, even at rest.In this article, we discuss sinus tachycardia, including its symptoms, types, causes, and treatment options.
a woman getting her heart rate checked to make sure she doesn't have Sinus tachycardiaShare on PinterestA person with sinus tachycardia may experience irregular heartbeats.Sinus tachycardia refers to an increased heart rate that exceeds 100 beats per minute (bpm). The sinus node, or sinoatrial node, is a bundle of specialized electrical cells in the right upper chamber of the heart.These cells act as the natural pacemaker of the heart by sending electrical impulses to the surrounding tissue. These impulses cause the heart to contract.A properly functioning sinus node regulates the rhythm and speed of a person's heart. A normal heart rate should usually be 60–80 bpm at rest, but it can sometimes range between 60 and 100 bpm, according to the American Heart Association.In people with a heart rate that exceeds 100 bpm, the sinus node is sending electrical signals at a faster-than-normal rate.
Sinus tachycardia occurs when the heart rate is above 100 bpm.In addition to a fast heart rate, people with sinus tachycardia may experience the following symptoms:
People can develop sinus tachycardia for different reasons. The underlying cause will determine the likely outcome of a person with this condition.The types of sinus tachycardia are:Normal sinus tachycardia, which occurs when the heart rate increases due to an identifiable reason, such as exercise, stimulants, or emotional distress.Inappropriate sinus tachycardia (IST), which has no identifiable cause. People who have IST may experience an increased heart rate while resting. IST can be the result of an inappropriately high "set point" for the heart.According to the authors of a 2017 case report, doctors can sometimes misdiagnose IST as a symptom of mental health conditions, such as depression.Most of the time, sinus tachycardia is a normal response of the cardiovascular system to triggers that increase the heart rate. Normal sinus tachycardia may occur as part of the body's response to certain conditions, such as intense physical activity or emotional distress.During exercise, the heart rate typically increases as it needs to pump more oxygen to the muscles.Emotional stress or anxiety can trigger an increase in neurotransmitters, such as dopamine and epinephrine, which make the heart beat faster.Other potential causes of normal sinus tachycardia include:Less common causes of sinus tachycardia include:damage to cardiac tissuethyroid problemsanemiaIST typically occurs without a known cause.A doctor can diagnose sinus tachycardia by reviewing a person's medical history, performing a physical examination, and carrying out other medical tests.Other tests that a doctor can use to diagnose sinus tachycardia include:If a doctor needs more information about how a person's heart functions, they may ask the individual to use a wearable medical device called a Holter monitor for at least 24 hours.The basic diagnostic criteria for IST include:having a resting heart rate higher than 100 bpm and an average resting heart rate above 90 bpm during Holter monitoring for 24 hoursincreased heart rate and heart palpitations that result in emotional distressTreatments for sinus tachycardia vary depending on the underlying cause, but they usually involve a combination of lifestyle changes, medication, and, in very rare instances, surgery.Doctors address the underlying cause or condition when treating normal sinus tachycardia and do not often treat the tachycardia itself. Treating IST can be more challenging.Treatments for sinus tachycardia may include:reducing caffeine intakequitting smoking and avoiding other sources of nicotineexercising regularlydrinking enough waterconsuming less than 2,300 milligrams of sodium per daySinus tachycardia is usually a benign condition, but if it is persistent, it can lead to weakness of the heart over time. Doctors refer to this as tachycardia-induced cardiomyopathy. Sometimes, a doctor may prescribe medications, such as beta-blockers, calcium channel blockers, or ivabradine, to reduce the heart rate and treat symptoms.In a small clinical study, researchers gave people with ITS ivabradine twice a day for 6 months. Ivabradine reduced the participants' average daytime heart rate from 103 bpm to 84 bpm.A doctor may recommend more invasive forms of treatment, such as catheter ablation, for people with IST who do not respond to lifestyle changes or medication.Catheter ablation delivers heat to the portions of heart tissue that cause rapid or irregular heartbeats. This procedure can help return the heart rate to normal. However, every procedure has complications, and people may still experience recurring tachycardia after catheter ablation.People can discuss the risks and benefits of catheter ablation with a doctor.Tachycardia occurs when the heart beats more than 100 times per minute, whether at rest or with exercise. People develop sinus tachycardia when the sinus node in the heart sends electrical impulses more quickly than normal.It can occur as a result of a particular trigger, such as exercise, caffeine, or stress. However, sinus tachycardia without a physiologic trigger can be a result of an arrhythmia called inappropriate sinus tachycardia.Treatments for sinus tachycardia focus on lowering the heart rate to normal by treating the underlying cause, such as infection or low blood pressure. Doctors may also recommend lifestyle changes, medications, and medical procedures, such as catheter ablation.People who have sinus tachycardia can learn more about their treatment options by speaking with a doctor. A doctor can offer advice on ways to improve overall cardiovascular health to lower the resting heart rate.
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Heart attack protein may raise early death risk

New research finds that raised levels of a protein called troponin are a "highly clinically meaningful" indicator of death risk, regardless of age or underlying cause.

doctor listening to patient's heartShare on PinterestA protein that functions as a heart attack biomarker may indicate early death risk, new research suggests.

Heart disease is responsible for 1 in 4 deaths in the United States, with more than 600,000 people dying as a result of this condition each year.

Coronary heart disease is particularly common, claiming at least 370,000 lives annually. Heart attacks are also widespread, with 735,000 adults in the U.S. experiencing one every year.

The medical community recognizes the protein troponin as a biomarker for diagnosing heart attacks. Furthermore, previous studies have found a link between higher troponin levels and plaque rupture, acute coronary obstruction, and poorer myocardial perfusion — a measure of how well blood circulates through the heart.

Troponins are regulatory proteins that play a key role in the heart's muscle contractions.

Now, new research finds that even a slight increase in the levels of this protein is consistently associated with a higher risk of death among all age groups.Amit Kaura is the lead author of the new research and a clinical research fellow at Imperial College London in the United Kingdom. His and his team's findings appear in the BMJ.Kaura and colleagues examined the data of more than 250,000 people in an effort to gauge the link between age, troponin level, and mortality.Between 2010 and 2017, doctors had measured the troponin levels of each of the study participants, whose ages ranged from 18 years to over 90 years. The scientists clinically followed these individuals for 3 years.Overall, the researchers found a dose-response link between high levels of troponin in the blood and early death risk, meaning that the higher the troponin levels were, the higher the risk of death. This association held regardless of age.When looking specifically at different age groups, the analysis revealed that young adults — that is, those between the ages of 19 and 29 years — with raised troponin levels were 10 times more likely to die than those whose blood did not have elevated levels of the protein.The risk declined gradually with age, with people over the age of 90 years with raised troponin levels being 1.5 times more likely to die than others of a similar age.However, almost half of the participants with high troponin levels who were over 80 years of age died within 3 years, note the researchers, confirming the notion that high troponin levels signal a higher likelihood of dying.Finally, the results also revealed a paradox: In people who had experienced a heart attack, extremely high levels of troponin were linked with a lower death risk.The researchers explain that this may be because a higher proportion of these participants were suitable candidates for an operation that improves blood flow to the heart.Overall, the authors conclude, "A positive troponin result is, therefore, highly clinically meaningful, regardless of age, with the excess mortality associated with a raised troponin level being heavily concentrated in the first few weeks."The findings, say the researchers, emphasize the fact that troponin levels may be a useful tool for assessing longevity, even in those who have not had a heart attack.Furthermore, the research team is currently working on a clinical trial to examine whether cardiovascular treatments such as statins improve the heart health of those with raised troponin levels.Kaura comments on the findings, saying, "There have been many advances in treating heart disease, yet it remains the leading cause of death in the U.K. and around the world.""This is the first study to address the implications of raised troponin in a real-world large sample of patients across a wide range of ages," the researcher adds."Doctors will be able to use this information to help identify the risk of early death in patients who have a troponin level measured; this could lead to interventions at a much earlier stage in a wider group of patients than are currently treated."Amit Kaura
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Blood pressure chart: Ranges and guide

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Maintaining optimal blood pressure plays an essential role in reducing the risk of serious health problems, such as heart attacks, heart failure, and stroke.

Keep reading for more information about blood pressure and what are normal and abnormal readings.

a blood pressure chart infographic

Blood pressure refers to the force that blood puts on the walls of the blood vessels as the heart pumps blood. Healthcare professionals measure blood pressure in millimeters of mercury (mm Hg).

Doctors can use blood pressure as an indicator of a person's heart health. People with high blood pressure — or hypertension — are at risk of developing heart problems and damage to the walls of the blood vessels.

Low blood pressure — or hypotension — is a sign of good health, but can be abnormal in certain situations, such as during severe infection.

If blood pressure falls too low, it can cause people to feel dizzy or light-headed and, in extreme cases, can compromise blood flow to the organs.

Severe hypotension can increase the risk of organ damage and fainting due to the loss of oxygen-rich blood.

Typically, a person can keep their blood pressure in the normal range by maintaining a healthy weight through a healthful diet that limits alcohol and salt intake, and by exercising regularly. If they are having trouble with blood pressure, a doctor may be able to prescribe medication to help regulate it.

There are two numbers in a blood pressure reading. People often call these the upper (systolic) and lower (diastolic) numbers.Systolic is the top number on the reading and is the higher one. Diastolic is the lower number.A person should keep these numbers within the normal range to prevent either hypertension or hypotension. We describe the healthy ranges for systolic and diastolic readings below.According to the American Heart Association, a healthy blood pressure range is:systolic: less than 120diastolic: less than 80If a person has the following numbers, they have low blood pressure:systolic: 90 or belowdiastolic: 60 or belowLower blood pressure is especially common in athletes and young people.A person has elevated blood pressure if their readings are:systolic: 120–129diastolic: less than 80A person with elevated blood pressure is not yet hypertensive and can take steps to help prevent progression to hypertension.Actions include:reducing sodium intakeexercising more frequentlylosing weighttreating other conditions that may be contributing, such as sleep apnealimiting alcohol intaketaking medications that target blood pressureThe three stages of hypertension are:In stage 1 hypertension, the numbers will range between:systolic: 130–139 ordiastolic: 80–89In stage 2 hypertension, the numbers will range between:systolic: 140 or higher ordiastolic: 90 or higherFinally, if a person has hypertension crisis, the numbers will read:systolic: 180 or higherdiastolic: 120 or higherThese numbers are for adults. A parent or caregiver should talk to a child's doctor about healthy ranges for children, as age, weight, and sex can all affect these numbers.If a person has hypertension, their blood pressure is too high.When a person is hypertensive, they are at an increased risk of developing conditions, such as:In most cases, there are no symptoms of high blood pressure.However, a person who is experiencing a hypertension crisis due to elevated blood pressure levels may experience the following symptoms:difficulty speakingchest painback painchange in vision or blurry visionshortness of breath due to fluid in the lungsnumbness or weaknessheadacheAnyone experiencing these symptoms should seek immediate medical treatment.When a person has severe hypotension, their blood pressure is too low.Though many doctors often stress the importance of lowering blood pressure, it is possible for someone's blood pressure to be too low.People with very low blood pressure may experience the following symptoms:faintingdizziness/lightheadednessnauseaheart palpitationsfatigueblurry visioninjury from falling or loss of consciousnessorgan damage in severe casesPeople's blood pressure is partially due to factors they cannot control, such as:However, there are also many steps a person can take to prevent high blood pressure. These include:eating a healthful diet that includes fruits, vegetables, lean proteins, and complex carbohydratesexercising regularly, particularly cardio workouts, such as walking, cycling, or runningnot smokinglimiting alcohol consumptionrestricting consumption of processed foodslimiting sodium intake to less than 2,000 grams dailytreating sleep apneamanaging and regulating diabetesreducing weight if overweighttaking steps to reduce stressIf a person experiences any symptoms of critical hypertension, they should seek immediate medical attention to prevent serious complications.A person should also receive regular blood pressure readings at check-ups with their doctor or other healthcare professionals.However, a person can also take their blood pressure at home using an over-the-counter blood pressure monitor. If the blood pressure reader indicates a person has high or low blood pressure, they should talk to their doctor.Blood pressure monitors are available in pharmacies and online.Blood pressure is one indicator of a person's heart health. If the pressure is too high, it can lead to serious health complications and potentially death.Though not all causes of elevated blood pressure are preventable, a person can reduce their risk of complications by managing their lifestyle and minimizing risk factors for developing high blood pressure.Anyone concerned about high or low blood pressure should speak to a doctor. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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The link between insomnia and cardiovascular disease

Sleeping problems can affect both mental and physical health. Now, a large-scale analysis in China highlights how insomnia might lead to potentially life threatening cardiovascular diseases.

man having trouble sleepingShare on PinterestNew research points to concerning links between insomnia and cardiovascular problems.

Insomnia is a relatively widespread problem. When a person has insomnia, they often struggle to fall asleep or stay asleep. Some people experience both.

Around 1 in 4 adults in the United States experience short-term, or acute, insomnia every year, according to research carried out at the University of Pennsylvania, PA. Acute insomnia typically means that a person experiences sleep problems for just a short period, perhaps due to stress or worry.

Approximately three-quarters of these people return to their regular sleeping patterns. Others, however, go on to develop chronic insomnia.

Chronic insomnia refers to a person who experiences problems sleeping for at least 3 nights a week for no less than 3 months.

Both acute and chronic insomnia can result in daytime drowsiness, concentration and memory problems, and a lack of energy.But studies have found more worrying links. One recent analysis, appearing in Sleep Medicine Reviews, linked insomnia to the onset of depression, anxiety, and alcohol misuse. Other studies have found a relationship between insomnia and heart disease.Now, authors of a new study, published in Neurology, point out that previous research has failed to define insomnia correctly and has included people who may not have the disorder. So they set out to find a stronger association.Tracking insomniaThe results of the new paper suggest that identifying insomnia, particularly in young people, may reduce cardiovascular disease risk later on in life.The researchers used data from the China Kadoorie Biobank, which investigates and tracks the leading causes of chronic diseases in China.The participants, aged between 30 and 79, had no history of heart disease or stroke when the study commenced.In the new study, the researchers analyzed three symptoms of insomnia, where the symptoms lasted at least 3 days a week. The symptoms were: problems falling asleep or staying asleep, waking too early, or struggling to focus during the day because of disrupted sleep.The data show that 11% of the participants reported trouble falling or staying asleep, and 10% had problems with waking up early. Only 2% of the participants reported having focusing issues during the day.The researchers followed all of the volunteers for about a decade. During that time, they identified 130,032 incidences of heart attack, stroke, and comparable diseases.A higher chance of cardiovascular diseaseAfter taking into account other risk factors, such as smoking and alcohol consumption, researchers identified several significant findings.The new study identified that the participants who reported experiencing all three insomnia symptoms had an 18% increased chance of developing cardiovascular diseases compared with those who did not experience the symptoms.Those who reported trouble focusing during the day were 13% more likely to develop heart attack, stroke, and comparable diseases than people who did not have problems focusing.Researchers identified that the people who found it difficult to fall asleep or stay asleep had a 9% higher chance of developing these diseases, while those who woke up too early were 7% more likely to experience a stroke, heart attack, or similar.Despite these results, the researchers point out that they have not established a cause and effect between insomnia and cardiovascular illnesses. The findings simply highlight an association between the two.Notably, this link "was even stronger in younger adults and people who did not have high blood pressure at the start of the study," says study author Dr. Liming Li of Beijing's Peking University in China.The researchers note that the participants in the study self-reported their symptoms of insomnia, which may mean the data are not entirely accurate. However, further analyses, enlisting medical professionals to track symptoms of insomnia rather than relying on self-reporting, would strengthen the relationship."These results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it's possible that we could reduce the number of cases of stroke, heart attack, and other diseases later down the line."Dr. Liming Li
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Atrial fibrillation: Height could predict risk

Researchers from the University of Pennsylvania have found that people who are taller also have a higher risk of developing atrial fibrillation, a common heart condition, and that there may be a genetic link.

image of tall and short person standing next to each otherShare on PinterestBeing tall can make a person more prone to atrial fibrillation, new research confirms.

Atrial fibrillation is a condition characterized by an abnormal heartbeat — the heart may beat too fast, too slow, or the beats may be irregular.

According to the Centers for Disease Control and Prevention (CDC), around 2.7–6.1 million people in the United States have atrial fibrillation.

Though some people are unaware that they have it, due to a lack of obvious symptoms, atrial fibrillation can increase a person's risk of stroke.

Meanwhile, over 750,000 people end up in the hospital each year because of this heart problem, as per CDC data.

Recent research has shown that cases of atrial fibrillation have been on the rise, forecasting an "epidemic." But if people know that they are at risk of developing this condition, they can take steps to prevent it. They can also be better prepared to manage it, if it does develop.Some recognized risk factors for atrial fibrillation include high blood pressure, obesity, diabetes, and heart disease, as well as some nonclinical factors, such as being older and being of European descent.Now, a new study from Penn Medicine — a combined effort of the University of Pennsylvania Health System and the university's Perelman School of Medicine, in Philadelphia — suggests that being tall may be another risk factor for atrial fibrillation."Our findings suggest it may be beneficial to incorporate height into risk-prediction tools for [atrial fibrillation]," says lead study author Dr. Michael Levin.He and colleagues will present their findings later this week at the American Heart Association's 2019 Scientific Sessions, in Philadelphia, PA.The researchers report that for every 1-inch increase relative to average height — which they give as 5 feet and 7 inches, or approximately 1 meter and 70 centimeters — a person's risk of atrial fibrillation increases by approximately 3%.However, this finding is not surprising, since past observational studies have also suggested an association between height and atrial fibrillation risk.The issue that most interested the research team was whether there might be a causal relationship between height and atrial fibrillation risk.To answer this question, the researchers analyzed genetic data from two large databases. One was that of the Genetic Investigation of Anthropometric Trials consortium. The investigators accessed this database to analyze the genes of 700,000 participants, looking for genetic variants associated with increased height.The other was the database of the Atrial Fibrillation Genetics consortium, which allowed the researchers to analyze the genetic information of over 500,000 people, searching for genetic variants linked to a higher risk of atrial fibrillation.Putting two and two together, the investigators found that many of the genetic variants associated with increased height were also linked to a higher risk of atrial fibrillation.This relationship remained in place, even after the investigators adjusted for confounding factors, including heart disease, high blood pressure, and diabetes, which led the team to conclude that there may be a causal relationship between height and atrial fibrillation risk.This notion was backed up by further analysis: When the researchers analyzed the data of an additional cohort of almost 7,000 participants enrolled in the Penn Medicine Biobank, they once more saw that a person's height, as well as genetic variants specifically associated with increased height, were strongly linked to an increased risk of atrial fibrillation.Once again, these associations remained in place, even after the team adjusted for confounding factors, such as other known risk factors for atrial fibrillation.These findings have led the study authors to suggest that, going forward, medical professionals may want to start including height on their list of important risk factors to consider in the context of heart health."While current guidelines advise against widespread screening for [atrial fibrillation], our findings show that a certain group of patients — specifically very tall patients — may benefit from screening."Dr. Michael LevinSenior author Dr. Scott Damrauer adds that "These analyses show how we can use human genetics to help us better understand causal risk factors for common disease.""They also illustrate how we can combine summary-level statistics from large published studies with individual-level data from institutional biobanks to further our understanding of human disease," Dr. Damrauer explains.
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Listening to music while driving may help calm the heart

Driving can be very stressful, particularly if you are stuck in heavy traffic or are an inexperienced driver, and this stress will eventually take its toll on the heart. However, researchers now confirm that there is a simple fix for this problem: listening to the right music while driving.

woman drivingShare on PinterestIf we listen to relaxing music while driving, this may help relieve stress and protect the heart, a new study suggests.

Past research has shown that experiencing frequent psychological stress can be a significant risk factor for cardiovascular disease, a condition that affects almost half of those aged 20 years and older in the United States.

One source of frequent stress is driving, either due to the stressors associated with heavy traffic or the anxiety that often accompanies inexperienced drivers.

Does this mean, though, that people who drive on a daily basis are set to develop heart problems, or is there a simple way of easing the stress of driving?

According to a new study by researchers from São Paulo State University in Marília, Brazil, Oxford Brookes University in the United Kingdom, and the University of Parma in Italy, there is.

In a study paper that features in the journal Complementary Therapies in Medicine, the researchers report the encouraging results of a study involving inexperienced drivers, noting that listening to music while driving helps relieve the stress that affects heart health."We found that cardiac stress in the participants in our experiment was reduced by listening to music while they were driving," says principal investigator Prof. Vitor Engrácia Valenti.For their study, the researchers recruited five female volunteers between the ages of 18 and 23 years who were in good health, were not habitual drivers — they drove no more than twice a week — and had received their driver's license 1–7 years before the start of the study."We opted to assess women who were not habitual drivers because people who drive frequently and have had a license for a long time are better adapted to stressful situations in traffic," explains Prof. Valenti.The researchers asked the volunteers to take part in two different experiments. On one day, the participants had to drive for 20 minutes during rush hour on a 3 kilometer route in one of the busiest parts of the city of Marília. On this day, the participants did not play any music in the car as they were driving.On another day, the volunteers had to go through the same motions, with one exception: This time, they listened to instrumental music while driving.In both instances, the participants drove cars that were not their own. This measure was necessary, the investigators explain, to make sure that there was no reduction in stress due to the volunteers being familiar with the cars."To increase the degree of traffic stress, we asked them to drive a car they did not own. Driving their own car might help," says Prof. Valenti.To measure the effect of stress on the heart in each experimental condition, the investigators asked the participants to wear heart rate monitors able to record heart rate variability in real time.The activity of two key systems — the sympathetic nervous system and the parasympathetic nervous system — influences heart rate variability. The sympathetic nervous system is responsible for regulating the flight or flight response, which is the automatic bodily reaction to stressful, anxiety-inducing situations. Meanwhile, the parasympathetic nervous system is responsible for "rest and digest" processes."Elevated sympathetic nervous system activity reduces heart rate variability, whereas more intense parasympathetic nervous system activity increases it," explains the lead investigator.The researchers then analyzed the measurements that they had collected through the heart rate monitors on the two occasions. They found that when the participants had listened to music while driving under stressful conditions, they had higher heart rate variability than when they had driven under stressful conditions without any music."Listening to music attenuated the moderate stress overload the volunteers experienced as they drove," says Prof. Valenti.To readers who may be wondering why the researchers turned specifically to female participants in their study, the lead investigators explain that, at this stage, they wanted to be able to rule out the potential influence of sex-specific hormones."If men, as well as women, had participated, and we had found a significant difference between the two groups, female sex hormones might have been considered responsible," notes Prof. Valenti.The results of the small-scale experiments, the researchers argue, suggest that listening to relaxing music could, indeed, be an easy way of preventing stress levels from escalating and affecting the heart when someone finds themselves stuck in traffic."Listening to music could be [...] a preventive measure in favor of cardiovascular health in situations of intense stress, such as driving during rush hour."Prof. Vitor Engrácia Valenti
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Is there a link between muscle mass and cardiovascular risk?

A new study has found a link between lower muscle mass and a higher risk of cardiovascular events — at least in males aged 45 and over. This association, the research indicates, is valid even for males with no history of heart disease.

physiotherapist working with older manShare on PinterestMuscle mass loss is linked to a higher risk of cardiovascular problems in males aged 45 and over.

Some loss of skeletal muscle mass occurs naturally as people age. This process especially affects males.

In fact, research shows that after the age of 30, muscle mass tends to decrease by 3–5% per decade in males.

People can prevent and minimize this loss by staying active. If they do not, it may contribute to poor health and well-being.

Some past studies have suggested that people with cardiovascular disease who experience higher loss of muscle mass also have a higher risk of premature death.However, to date, little to no research has looked into the possible associations between muscle mass and cardiovascular risk in people without preexisting heart or circulatory problems.Now, specialists from the Centro de Investigación Biomédica en Red de Salud Mental in Madrid, Spain, the University of Canberra in Australia, and the University of Athens in Greece have conducted a study with the aim of filling in that research gap.The new study — the results of which appear in the Journal of Epidemiology & Community Health, and whose first author is Stefanos Tyrovolas — has analyzed the data of a cohort of male participants aged 45 and over covering a follow-up period of 10 years.Its findings suggest that, in males at least, maintaining muscle mass may help keep cardiovascular problems at bay.The team analyzed the medical information of 2,020 participants — of whom half were male and half were female — over a period of 10 years. All but one of the particpants were aged 45 and over, and all were free of heart disease at baseline.At baseline, the participants provided data regarding their lifestyle choices, such as diet and exercise, as well as measurements of circulating blood fats, systemic inflammation biomarkers, weight, and blood pressure.The researchers explain that all these values are important, since they can affect a person's risk of cardiovascular problems. In addition to these data, the investigators also calculated the participants' skeletal muscle mass adjusted in accordance with every individual's weight and height.Over the 10 year follow-up period, the researchers recorded 272 cardiovascular events — both fatal and nonfatal — that included stroke and minor stroke. These cases all occurred among the working sample of 1,019 participants who had been 45 or over at baseline.The team found that males were about four times more likely to develop cardiovascular disease than females. Moreover, they saw a link between lower muscle mass volume and a higher risk of cardiovascular problems in the case of males.At the other end of the spectrum, males with the highest muscle tissue volume at baseline had an 81% lower risk of events such as stroke and heart attack, compared with those with the lowest muscle mass at the start of the study period.The team also found that males with the highest muscle tissue volume at baseline had a lower prevalence of other risk factors for cardiovascular issues, such as high blood pressure, diabetes, or obesity.It remains unclear why the association between cardiovascular problems and muscle mass was significant only in the case of males, though the researchers hypothesize that hormonal differences between males and females as they age may explain the discrepancy.Although the authors admit that their observational study cannot establish any cause and effect relationships, they maintain that its findings "point to the importance of [skeletal muscle mass] preservation in relation to [cardiovascular disease] risk."In their study paper, they conclude that:"The prevention of [skeletal muscle mass] decline, which is becoming increasingly prevalent among middle-aged and older populations, may constitute an effective means of promoting [cardiovascular] health."
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Which jobs affect women's heart health the most?

Some occupations are likely to affect female heart health more negatively than others, but which ones? This question is what one new study set out to answer.

health care professional at workShare on PinterestFemales in some professions face a higher risk of developing heart health problems than others, according to a new study.

Heart problems are a widespread health issue, especially among older populations.

And while researchers know that several lifestyle factors can increase the risk of heart disease — including an unhealthful diet, lack of physical activity, and smoking — there is one risk factor that does not receive as much attention as it perhaps deserves, namely, someone's occupation.

Recent studies have shown that it is possible to link a person's occupation with an increased risk of heart disease or other cardiovascular problems.

For instance, one study that researchers conducted on a cohort from Japan found that individuals in managerial positions, regardless of industry, face a higher risk of heart diseaseHowever, the Centers for Disease Control and Prevention (CDC) note that it remains unclear just how occupational risk factors may contribute to heart problems, and they encourage further research in this area.At this year's American Heart Association's (AHA) Scientific Sessions — which takes place in Philadelphia, PA, between November 16–18 — Bede Nriagu and colleagues from Drexel University in Philadelphia will present research adding to the evidence that certain types of work have an association with heart disease.In their presentation at the Scientific Sessions, the researchers will explain which occupations show links with a higher risk of health problems in females, according to their study.The researchers looked for possible associations between heart health status and different occupations in a cohort of more than 65,000 females whose average age was 63 years, and who had already experienced menopause. The team accessed these participants' data through the Women's Health Initiative study.As part of their research, the investigators classified the participants according to the AHA's cardiovascular health measurements.These metrics look at lifestyle factors, such as smoking status, weight, physical activity, and nutrition, plus health risk factors, including total cholesterol, blood pressure, and fasting blood sugar. The research team also took into consideration 20 of the most common occupations among the participants.In total, the researchers noted that almost 13% of the females in the study cohort had poor cardiovascular health. They also found an association between specific jobs and an increased risk of heart health problems in these individuals.More specifically, women who performed social work were 36% more likely to experience heart health problems than those with other occupations, and retail cashiers had a 33% higher risk of cardiovascular issues.Nurses, psychiatrists, and home health aides had an up to 16% higher likelihood of developing heart problems. Among these, nurses, in particular, had a 14% higher risk of cardiovascular problems.Yet the team also found an association between some occupations and a lower risk of cardiovascular health issues.Thus, female real estate brokers and sales agents had a 24% lower risk of heart problems than those in other lines of work, while administrative assistants had an 11% lower risk of cardiovascular issues.These associations remained in place after the researchers made adjustments for confounding factors, such as the participants' age, marital status, education, and race."Several of the professions that had high risk of poor cardiovascular health were health care providers, such as nurses and home health aides. This is surprising because these women are likely more knowledgeable about cardiovascular health risk factors," notes Nriagu."We interpret this to mean that it's important to look beyond individual factors, such as health knowledge, to better understand the context of health care and other jobs that negatively impact cardiovascular health in women."Bede NriaguThe researchers argue that looking at the current finding, doctors may want to start considering their patients' occupations when they assess their risks of cardiovascular problems.
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Late evening eating may compromise women's heart health

New research finds that eating more calories in the evening is associated with poorer cardiovascular health in women.

woman eating in front of computerShare on PinterestEating more of the day's calories after 6 p.m. is linked with poorer heart health in a new study.

Evidence is accumulating that meal times can impact cardiometabolic health.

One recent study, for example, showed that eating meals earlier in the day can help people lose weight, while eating later in the day may promote weight gain and slow down metabolism.

These studies also showed that later mealtimes raise inflammatory markers that are usually associated with diabetes and heart disease.

Other studies, in mice and human participants, showed that setting strict mealtimes can help control blood sugar levels.

Now, new research adds to this mounting evidence and suggests that eating more calories in the evening may negatively affect women's cardiovascular health.The new research is preliminary and will be presented at the American Heart Association's (AHA's) Scientific Sessions 2019, which is taking place in Philadelphia, PA.Nour Makarem, Ph.D., an associate research scientist at the Columbia University Vagelos College of Physicians and Surgeons, in New York, is the lead author of the study.Studying eating patterns and heart healthMakarem and colleagues recruited 112 healthy women, who were 33 years old, on average, to participate in the study. The researchers examined the participants' cardiovascular health at baseline and 1 year later using Life's Simple 7 — a measure of cardiovascular health that comprises seven modifiable risk factors, as established by the AHA.Life's Simple 7 account for blood pressure, cholesterol, blood sugar, physical activity, diet, weight, and smoking status. Based on these factors, the researchers calculated a cardiovascular health score for each participant. The women also used food diaries on their cell phones to track and report how much, what, and when they ate for 1 week at baseline and another week 12 months later.The researchers used the data from the electronic diaries to calculate the relationship between cardiovascular health and the timing of the meals.Fewer late calories may boost heart healthThe research revealed that participants who consumed more calories after 6 p.m. tended to have poorer cardiovascular health.In fact, for each 1% increase in caloric intake after 6 p.m., the cardiovascular health score declined. Blood pressure and body mass index tended to rise, and blood sugar control tended to be poorer. The analysis yielded similar results for every 1% increase in calories after 8 p.m.Hispanic women, in particular — who made up 44% of the participants — had higher blood pressure when they ate more calories in the evening.The study's lead author comments on the findings saying, "So far, lifestyle approaches to prevent heart disease have focused on what we eat and how much we eat.""These preliminary results indicate that intentional eating that is mindful of the timing and proportion of calories in evening meals may represent a simple, modifiable behavior that can help lower heart disease risk."Nour Makarem, Ph.D.The lead researcher also points out that for the findings to be more reliable, they would have to be replicated in a larger sample and in different populations.Dr. Kristin Newby, a professor of medicine and cardiology at Duke University, in Durham, NC, who was not involved in the research, comments on the results."I think it's an important study," she says. "It's foundational more than definitive at this point, but I think it provides some really interesting insights into an aspect of nutrition and how it relates to cardiovascular risk factors that we really haven't thought about before."
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What are the effects of lowering blood pressure targets?

In 2017, the American Heart Association (AHA) lowered the threshold for what constitutes hypertension. However, what is the impact of this, and is implementing these new guidelines cost effective? Two new studies set out to investigate.

doctor taking blood pressureShare on PinterestNew research examines the effects of lowering hypertension thresholds.

According to the AHA, around 103 million adults in the United States have high blood pressure. They expect that this number will continue to rise.

Meanwhile, the Centers for Disease Control and Prevention (CDC) estimate that around 1,100 people die of a condition related to hypertension each day, including heart disease and stroke. These are some of the leading causes of death in the U.S.

The healthcare costs of hypertension are not negligible, either. The CDC suggest that hypertension results in almost $50 billion per year in costs, including the price of medications and missed days of work.

What are some of the measures that people with high blood pressure and healthcare professionals can take to prevent these adverse outcomes and increase lifespan? In 2017, the AHA recommended lowering blood pressure thresholds and treating people at risk more intensively.

Now, two new studies — both of which featured at the AHA's Scientific Sessions 2019, which takes place in Philadelphia, PA — have investigated the costs and benefits of treating hypertension more intensively, and of tailoring treatment according to degrees of cardiovascular risk.

Better blood pressure control lengthens lifeDr. Muthiah Vaduganathan, an instructor of medicine at Harvard Medical School and an associate physician at Brigham and Women's Hospital — both in Boston, MA — is the lead author of the first study.Dr. Vaduganathan and team used data from the well-known Systolic Blood Pressure Intervention Trial (SPRINT).The SPRINT examined the effects of lowering systolic blood pressure readings to a target of 120 milligrams of mercury (mm Hg) instead of the usual 140 mm Hg.The trial followed 9,361 participants, all of whom were over the age of 50 and at high cardiovascular risk. The SPRINT followed them for 6 years and concluded that lowering blood pressure targets reduced the risk of cardiovascular problems — such as heart attack, stroke, heart failure, and cardiovascular death — by 25%.The participants were at high risk of heart disease if they had had a cardiovascular disease that was not stroke, scored highly on the 10 year cardiovascular risk score, had chronic kidney disease, or were older than 75.For the new study, the researchers analyzed the data to project the lifespans of the participants who underwent intensive hypertension treatment to lower blood pressure to a target of 120 mm Hg. They compared these projected lifespans with those of participants who received the standard treatment that aimed for a blood pressure of lower than 140 mm Hg.The study revealed that intensive blood pressure treatment increased lifespan by 4–9%, compared with standard care."In contrast with the oldest patients, middle-aged patients had the greater absolute benefit because they start with a longer expected lifespan and can receive the intensive treatment over a longer period of time," explains Dr. Vaduganathan.Dr. Mitchell S. V. Elkind — the AHA president-elect and chair of the Advisory Committee of the American Stroke Association — comments on the results. He says, "This analysis of the [SPRINT] suggests that [there are] additional years of life that can be added by more aggressive control of blood pressure."He adds, "When you tell people that lowering their blood pressure is going to reduce their chance of having a stroke or a heart attack by 25%, which is what [the SPRINT] showed," the question that naturally ensues is "what does that number mean, in real terms?""This analysis suggests that for a man who is 50 years old, lowering blood pressure to [the lower] targets could extend your lifespan by 3 years, on average." Dr. Mitchell S. V. Elkind"High blood pressure has been implicated as one of the reasons for stalled progress in reducing heart disease-related deaths in the United States," Dr. Vaduganathan says. "These data reinforce that tighter blood pressure control, especially when started earlier in life, may meaningfully prolong lifespan."New guidelines to treat an extra 5.2 millionThe second study examined the best way to implement the new blood pressure guidelines issued by the American College of Cardiology (ACC) and the AHA.These new guidelines lowered blood pressure thresholds to define hypertension as anything from 130/80 mm Hg to 140/90 mm Hg.The new guidelines also recommend medication treatment for people with a blood pressure reading of 130/80 mm Hg to 139/89 mm Hg if they have a history of heart attack or stroke, or if they have a high 10 year risk of experiencing such an event.Joanne M. Penko — a research data analyst at the University of California, San Francisco — is the lead author of this second study.To assess the cost effectiveness of implementing the new guidelines, Penko and colleagues looked at healthcare costs and quality-adjusted life years (QUALY). They used the Cardiovascular Disease Policy Model, a well-known computer simulation model, to estimate healthcare costs over a 10 year period.Compared with the 2003 guidelines, the analysis revealed, the "2017 ACC/AHA guidelines would treat 5.2 million more adults 35–84 years of age, intensify treatment in another 11.7 million, and prevent about 257,000 [cardiovascular] events over 10 years."Intensifying treatment pays off over a 10 year period for men aged 65–84 and women aged 75–84 who already have cardiovascular disease. For others, however, the costs outweigh the benefits.Furthermore, treating people at high cardiovascular risk who had not had cardiovascular disease would only be intermediately cost effective for adults whose blood pressure readings are 140/90 mm Hg or higher at baseline. It would not be cost effective at all for those whose blood pressure readings are 130/80 mm Hg to 139/89 mmHg."Previous studies have shown that compared with no treatment, treating high blood pressure according to the 2003 Seventh Report is cost effective over 10 years," Penko says. "We were surprised to learn in our study that wasn't the case for all patients indicated for medication treatment in the 2017 guidelines.""The study's findings suggest an incremental approach to implementing the 2017 ACC/AHA hypertension guidelines, first focusing limited resources on treating the oldest, highest-risk adults to intensive blood pressure goals."Joanne M. Penko
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Local vehicle exhaust may raise stroke risk

Even in environments with low air pollution, long term exposure to traffic exhaust near people's homes may heighten their risk of stroke, according to a new study from Sweden. The culprit appears to be a fine particle air pollutant called black carbon.
cars in a traffic jam
Exposure to exhaust fumes may raise the risk of stroke, new research suggests.

The researchers came to this conclusion after investigating links between exposure to different types of particulate matter and rates of heart disease and stroke in three cities in Sweden.

They report their findings in a recent Environmental Health Perspectives study paper.

The authors write that they observed "few consistent associations" between heart disease and stroke and different types of particulate matter and their sources.

"However," they conclude that "long term residential exposure to locally emitted [black carbon] from traffic exhaust was associated with stroke incidence."

Dr. Petter L. S. Ljungman is first author of the study paper and an associate professor at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden.

"This study," he says, "identifies local traffic exhaust as a risk factor for stroke, a common disease with great human suffering, high mortality and significant costs to society."

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Black carbon and particulate matter

Black carbon is a sooty material that comes from burning fossil fuels. According to the United States Environmental Protection Agency (EPA), it is a significant component of fine particle air pollution.

Vehicle and other engines that run on gas and diesel and power plants that run on coal and other fossil fuels emit black carbon along with other particulate matter.

Road traffic is the primary source of black carbon emissions in cities.

Scientists have tied black carbon inhalation to respiratory conditions, cancer, cardiovascular disease, and birth abnormalities.

Dr. Ljungman and colleagues from Karolinska Institutet and other research centers in Sweden used data on 114,758 people who were participants in other studies that had collected information about cardiovascular risk factors from examinations and questionnaires.

The participants, who lived in three cities in Sweden, were healthy and middle-aged at recruitment. The study period started in 1990 and lasted for around 20 years. The dataset included the history of the participants' residential addresses over the period.

Over the 20 years of follow-up, 5,166 individuals developed ischemic heart disease, and 3,119 experienced strokes.

Using emissions databases and dispersion models, the team estimated how much each type of emission source contributed to particulate matter, including black carbon, at specific residential addresses.

The sources that they included in the analysis were traffic exhaust, road wear, and residential heating. They included data for two grades of particulate matter: coarse, which includes particles under 10 micrometers (10μm) in diameter (PM10), and fine, which includes particles under 2.5 μm in diameter (PM2.5). Black carbon counts as PM2.5.

Black carbon and raised stroke risk

The analysis revealed that the risk of stroke went up by 4% for every additional 0.3 micrograms per cubic meter (μg/m3) of black carbon air pollutant from traffic exhaust.

The researchers found no link to stroke for black carbon emissions from residential heating.

Also, they observed no links between total levels of PM10 and PM2.5 particulate matter and either heart disease or stroke.

"There was some evidence," note the authors, "of an association between PM2.5 specifically from local emissions of residential heating and incidence of [ischemic heart disease] that warrant further investigation."

In their study background, the authors refer to research that has linked long term exposure to PM2.5 particles and atherosclerosis, the clogged artery condition that raises the risk of heart disease and stroke.

The residential areas that the new study covered were in the cities of Gothenburg, Stockholm, and Umeå. The annual averages during the study period for PM2.5 particulate matter in these cities ranged from 5.8 to 9.2 μg/m3. This range is below the 25 μg/m3 threshold in current EU standards.

Although the EU mention black carbon as a component of PM2.5 particulate air pollution, they have no specific threshold for black carbon.

"Black carbon from traffic exhaust could be an important measure to consider when assessing air quality and health consequences."

Dr. Petter L. S. Ljungman

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Atherosclerosis: Scientists identify new protein target in immune cells

The inflammatory condition atherosclerosis, where fatty, waxy deposits build up in arteries, raises the risk of stroke, heart attack, and cardiovascular disease. Now, using mice and human samples, scientists have shown for the first time that a protein in cells called macrophages promotes the disease.
scientist examining something under microscope
New research finds a protein in immune cells that may be responsible for atherosclerosis.

Macrophages are a large group of cells that do many different jobs and abound in all tissues of the body. Their diverse functions include tissue repair and immunity.

Earlier studies had already shown that macrophages in the immune system absorb excess cholesterol and that too much of the waxy substance causes the cells to transform into foam cells.

When heavy with cholesterol, foam cells are bigger than macrophages and can deposit in artery walls and cause blockages.

Scientists have also been studying a protein called Tribbles Pseudokinase 1 (TRIB1) in connection with cardiovascular disease. They have detected it in macrophages in arterial deposits in mice, and they have also linked variants of the protein's coding gene to increased risk of atherosclerosis in human populations.

The new Science Advances study plugs a gap in the research on macrophages and TRIB1 in relation to atherosclerosis. It is the first to show that TRIB1 in macrophages decides how much cholesterol the cells can carry when they transform into foam cells.

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The importance of cell specific expression

The new finding is significant not only because it offers a potential fresh treatment target for atherosclerosis, but also because it reveals how protein expression by specific cells contributes to cardiovascular disease.

"The role of TRIB1 in macrophages has remained elusive for some time," says first study author Jessica M. Johnston, Ph.D., of the Department of Infection, Immunity, and Cardiovascular Disease at the University of Sheffield in the United Kingdom.

"Our research," she adds, "provides the missing link and highlights the importance of cell specific expression in cardiovascular disease."

Other members of the international team include senior study author Endre Kiss-Toth, professor of cell signaling at the University of Sheffield, and colleagues from other centers in the U.K., the United States, and Hungary.

The study reveals that higher levels of TRIB1 promoted atherosclerosis by increasing specific receptors for taking up cholesterol in macrophages. In contrast, decreasing TRIB1 by reducing expression of its coding gene, reduced disease.

The researchers used various mouse models of human disease to test the effect of high and reduced levels of TRIB1. Data on samples from human cohorts also confirmed links between TRIB1 and cholesterol uptake.

"Collectively," write the authors, "our studies reveal an unexpected beneficial effect for selectively silencing [the gene for TRIB1] in arterial plaque macrophages."

Targeting cholesterol laden foam cells

Prof. Kiss-Toth suggests that building on the findings could help to identify which people with cardiovascular disease might benefit most from treatment that targets the formation of cholesterol laden foam cells.

Atherosclerosis raises the risk of various cardiovascular diseases and events such as stroke and heart disease, depending on which arteries it affects and how it progresses.

Atherosclerotic deposits, or plaques, can accumulate and either partially or completely block large and medium arteries that supply oxygen- and nutrient-rich blood to the heart, pelvic area, brain, legs, arms, and kidneys.

Coronary artery disease, angina, carotid artery disease, peripheral artery disease, and chronic kidney disease are some of the conditions that can arise from blood supply restriction due to vessel blockage.

However, the plaques also pose a direct risk of heart attack or stroke because, as they grow, there is a greater chance that a piece may break off and travel to the heart or brain.

"Studying the genetics of cardiovascular disease in large human populations has revealed that TRIB1 contributes to its development. However, this is the first time that its role in immune cells has been directly addressed, thus uncovering a new mechanism by which arterial disease develops."

Prof. Endre Kiss-Toth

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What to know about heart murmurs

A heart murmur is an abnormal sound that the blood makes as it moves through the heart. Doctors can hear a heart murmur through a stethoscope. Murmurs can be benign or indicate a serious heart condition.Research estimates that heart murmurs affect up to 72% of children. Most often, the murmur will go away with age. However, some may live with a heart murmur into adulthood.In adults, meanwhile, some heart diseases — including heart valve disease — can cause heart murmurs.In this article, we describe the two types of heart murmur, their causes, and some treatment options.
a doctor checking for a heart murmur with a stethoscopeShare on PinterestA doctor may check for a heart murmur with a stethoscope.Heart murmurs result from vibrations, or turbulence, that blood causes when it flows through the heart. It produces sounds that doctors can hear through a stethoscope.When heart valves open and close, they make a "valve sound." However, valves that do not open or close normally can cause blood to leak backward or prevent blood from flowing forward, which can create a sound called a murmur.Blood that moves very quickly through the heart can also create a type of murmur called a "flow murmur."There are two main types of heart murmur: innocent and abnormal. Flow murmurs are a type of innocent murmur.Innocent, or benign, heart murmurs occur when no structural abnormality or heart condition is present. Abnormal heart murmurs, meanwhile, occur where an underlying heart condition is causing the symptom.A person with a heart murmur should seek professional evaluation by a doctor to determine if their murmur is innocent or needs additional testing and monitoring.Innocent heart murmurInnocent heart murmurs can sometimes disappear over time without the need for treatment, such as if it is due to a high blood flow.Other times, the murmur may be due to minor valve dysfunction, which health professionals can monitor without needing to suggest significant intervention.People with innocent heart murmurs can live a relatively normal life. They can usually exercise and take part in sports without any problems.Abnormal heart murmurAbnormal heart murmurs indicate an underlying heart condition. These are less common than innocent heart murmurs and can either continue into adulthood or occur for the first time in adulthood.Abnormal heart murmurs in adults are usually associated with heart valve disease.
There are many possible causes of heart murmurs.People can categorize murmurs according to what causes them:Flow murmurs: Exercise, pregnancy, and anemia can all cause a high blood flow, as can hyperthyroidism, fever, and rapid growth spurts. This could lead to an innocent murmur.Valve disease-related murmurs: Problems with a valve in the heart, such as aortic stenosis or a bicuspid aortic valve, can lead to a heart murmur.Murmurs due to ventricular problems: Conditions that affect the ventricles and the flow of blood through them, such as functional mitral regurgitation, may cause a murmur.Murmurs due to complications of other conditions: Some conditions that affect the heart, such as endocarditis and lupus, may also cause a heart murmur.Murmurs related to congenital heart disease: Problems with the heart that are present from birth, such as a hole in the heart, can result in a murmur.People with abnormal heart murmurs may have congenital heart disease or a heart valve disease.Heart valve disease is the result of a defect in the heart's structure. Some of these conditions can be present at birth or acquired.Heart defects can affect the following parts of the heart:the aortic valve, which can be bicuspid (two leaflets) instead of tricuspid (three leaflets)the pulmonary valvethe atrial septum, which separates the atriathe ventricular septum, which separates the ventriclesAnother heart defect is a patent ductus arteriosus. This occurs when the opening between the aorta and pulmonary artery does not close after birth, as it should.When heart valve defects occur in adults, heart murmurs can be the result of age, tumors, or infections. For example, calcium can build up in the heart valves with age. This reduces the opening of the valves, making it harder for blood to pass through them.Sometimes, the aortic valve becomes dilated or stretched and stops working properly. This causes blood to leak backward, producing a heart murmur. Doctors call this condition aortic regurgitation.It is also possible to develop infective endocarditis. This is a bacterial infection of the lining of the heart, which can also affect the valves. The growth of bacteria will narrow the opening of the valves and affect blood flow through them.Another condition that can affect the heart is chronic rheumatic heart disease. People with this condition have chronic inflammation in the heart valves, which affects the function of the valves and therefore the blood flow through those valves.Tumors can also form on a heart valve. Tumors in other parts of the heart, such as the left atrium, can cause a heart murmur by affecting the blood flow through the heart.Other conditions that can cause heart murmurs, include:
Share on PinterestA person with an abnormal heart murmur may experience dizziness.People with heart murmurs may not experience any symptoms.Others, specifically with abnormal heart murmurs, may experience symptoms depending on the underlying cause.For example, people can experience:shortness of breathdizzinessfaintingbluish skinchronic coughpalpitationsswelling in the legs or abdomenA newborn baby may have:difficulty feedingstunted growtha bluish hue to the skin during feeding or activitybreathing difficultiesexcessive fussinessDoctors will listen to the heart with a stethoscope. They will also check for abnormal breathing patterns and any changes in skin color.They may also need to run other tests for heart function, including measuring blood pressure, the amount of oxygen in the blood, and pulse rate. Also, doctors will usually use an echocardiogram to take pictures of the heart valves.They will then provide a grade for every heart murmur. The grading system for murmurs that occur when the heart is squeezing is 1–6, where 1 is very faint and 6 is very loud. For murmurs that occur when the heart relaxes, the grading system is 1 to 4.Doctors also need to determine the duration of the heart murmur and its exact location in the heart.On rare occasions, the following procedures are also necessary:cardiac catheterizationchest X-raystress echocardiogramThese tests help doctors determine the cause of the heart murmur, as well as its intensity, its severity, and whether or not it is causing symptoms.Share on PinterestA doctor may prescribe ACE inhibitors to reduce blood pressure.Heart murmurs are usually innocent. These do not typically require treatment or further testing.Abnormal heart murmurs, however, are a symptom of an underlying condition that may require treatment.Doctors will recommend treatments that reduce blood pressure to improve blood flow across the valve, reduce damage to the valve, or both. For example, people may require medications such as:ACE inhibitorsanti-arrhythmic medicationsantibioticsanticoagulantsbeta-blockers or calcium channel blockerswater pillsvasodilatorsDoctors may prescribe single medications or a combination of several.Some people will require surgery to repair a defective valve. However, some people with mild heart valve disease may never require surgery.That said, if the heart valve defect begins to significantly affect blood flow through the heart, cause symptoms, or increase pressure in the heart, a valve repair or replacement might be necessary.Innocent heart murmurs are benign and do not usually require medical attention. Abnormal heart murmurs, however, signal an underlying heart condition.When treating abnormal heart murmurs, the doctor must first determine the cause. Sometimes, people need surgery to repair a defective valve. Others may not need surgery and will be able to lead a relatively healthy life.Heart valve disease is more common with age. Doctors can help people manage heart murmurs and improve the function of the heart.
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Everything you need to know about ACE inhibitors

Angiotensin converting enzyme, or "ACE" inhibitors, are a type of medication that doctors prescribe to treat high blood pressure, or "hypertension," and other cardiovascular conditions.This article outlines the different ACE inhibitors that are available. We also discuss the effectiveness of ACE inhibitors, along with their potential side effects and risks.
a woman picking up ACE inhibitors from a pharmacy or drug store.Share on PinterestA person may use ACE inhibitors to treat high blood pressure.ACE inhibitors prevent the body from making the hormone Angiotensin II. Ordinarily, this hormone narrows the blood vessels, which causes an increase in blood pressure and forces the heart to work harder.By inhibiting the production of Angiotensin II, ACE inhibitors keep the blood vessels open. This reduces blood pressure and lowers the risk of complications associated with hypertension.Most people take ACE inhibitors orally, but some may administer the drug intravenously.
The U.S. Food and Drug Administration (FDA) list the following types of ACE inhibitor:benazepril (Lotensin)captoprilenalapril (Vasotec)enalaprilatfosinoprillisinopril (Zestril and Prinivil)moexiprilperindoprilquinapril (Accupril)ramipril (Altace)trandolapril
Share on PinterestDoctors may prescribe ACE inhibitors to people with cardiovascular conditions, heart problems, or kidney problems.Doctors mainly prescribe ACE inhibitors to treat the following conditions:A doctor may also prescribe ACE inhibitors to treat or improve some of the symptoms of diabetes and migraine.Doctors consider some of these uses as off-label. Off-label means that the FDA have approved a drug for one condition, but doctors prescribe it to treat something different.
Most people who take ACE inhibitors do not experience side effects. When side effects do occur, they are usually minor.A 2019 review of ACE inhibitors describes some of the more common side effects of ACE inhibitors. The table below outlines these side effects, along with how many people experience them.Side effectPercentage of people affectedDizziness12–19%Low blood pressure, or "hypotension"7–11%Fainting5–7%Elevated levels of urea, nitrogen, and creatine in the blood (a possible sign of kidney problems)2–11%High potassium levels, or "hyperkalemia"2–6%A separate 2019 review notes that around 1–10% of people who take ACE inhibitors may develop a dry cough. If a person cannot tolerate this cough, they should seek their doctor's advice on whether to stop taking the medication.Some people may develop more severe side effects when taking ACE inhibitors. Examples include kidney problems and allergies to the ACE inhibitor. Another severe side effect that can occur is angioedema, which is swelling, typically of the tongue and throat.People who take ACE inhibitors should contact their doctor if they experience any side effects while on the medication. Anyone who has a swelling of the tongue or throat should call 911.ACE inhibitors can help prolong the lives of people who have had heart attacks, and those who have received a diagnosis with heart failure.These drugs can also help people who have high blood pressure due to kidney disease.When treating high blood pressure, a doctor will often combine the ACE inhibitor with another antihypertensive medication to increase the effects of the drug.Doctors have found that calcium channel blockers (CCBs) and thiazide diuretics can work well with ACE inhibitors to lower blood pressure.ACE inhibitors usually do not cause problems when a person takes them as directed.However, pregnant women should not take ACE inhibitors due to a risk of harm to the fetus. These risks include:low amniotic fluid levelskidney problemsabnormal skull developmentdeathPeople who have an allergy to ACE inhibitors should not take the medication.People with the kidney condition bilateral renal artery stenosis (BRAS) should also avoid these drugs. BRAS is a narrowing of the blood vessels within the kidneys. ACE inhibitors can cause worsening kidney function in people with this condition.People who are concerned about the potential risks of ACE inhibitors should talk to their doctor.Share on PinterestA person's age, overall health, and medical history may affect the medication they receive.Beta-blockers and CCBs are two other medications that doctors commonly prescribe to treat heart problems and high blood pressure. Both drugs work differently to ACE inhibitors.Beta-blockers prevent the release of stress hormones. This slows down the heartbeat, which, in turn, reduces the intensity of blood flow around the body.CCBs prevent calcium from interacting with the body's calcium receptors.Ordinarily, calcium plays a role in contracting the muscles within the heart and blood vessel walls. CCBs block the movement of calcium into the blood vessel walls, causing these walls to relax. This reduces blood pressure and allows the heart to receive more oxygenated blood. By blocking calcium movement into the heart muscles, the heart contracts more slowly. This puts less stress on the heart.The type of medication a person receives depends on several factors, including their:ageethnicityoverall healthmedical historyACE inhibitors are one of the more common medications used to lower blood pressure and treat cardiovascular health issues.Most people who take ACE inhibitors do not experience side effects. When side effects do occur, they are generally mild.However, ACE inhibitors are not suitable for everyone. Pregnant women, in particular, should not take these medications.Doctors often prescribe ACE inhibitors alongside other antihypertensive medications. Combined drug treatments can be particularly useful in controlling high blood pressure.
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What are the best ways to eat coconut oil?

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In recent years, coconut oil has gained a lot of attention due to its supposed health benefits. With many options available, people may wonder about the most healthful ways to add coconut oil to their diets and how much to use.

People consume coconut oil in many different ways, including as a cooking oil, as an alternative to butter in baking, and in smoothies. While coconut oil may have health benefits, it is high in saturated fat, and eating too much can be harmful.

In this article, we discuss ways to incorporate coconut oil into the diet and how much may be healthful.

Why eat coconut oil? a jar of coconut oil.
Coconut oil may help promote ketosis.

Saturated fat makes up nearly 90% of coconut oil. However, a medium-chain fatty acid called lauric acid makes up a substantial amount of the fat in this oil — between 48.40% and 52.84%.

Unlike other saturated fats, such as that in butter, lauric acid may have health benefits, including:

However, the researchers behind these and similar studies cannot predict the long term health effects of eating coconut oil.

Read more about the benefits and risks of coconut oil.

People may wonder how much coconut oil to consume for the maximum health benefits and minimum adverse effects.

The following sections look at how much to consume and some ways to include coconut oil in a healthful diet.

Thank you for supporting Medical News Today How much to use While small amounts of coconut oil may have health benefits, people should limit their intake. Coconut oil is a high calorie food that contains mostly saturated fatty acids. Diets high in saturated fatty acids may increase the risk of coronary heart disease. However, researchers have found that 2 tablespoons (tbsp), or 30 milliliters, of coconut oil per day can have beneficial effects. In one small 2017 study, 2 tbsp of coconut oil increased levels of HDL cholesterol, or "good cholesterol," in healthy adults. However, some participants experienced mild diarrhea during the study. According to the United States Department of Agriculture, 1 tbsp, or 13.6 grams (g), of coconut oil contain: calories: 121 kilocalories fat: 13.5 g carbohydrates: 0 g protein: 0 g The 2015–2020 Dietary Guidelines recommend that saturated fats make up less than 10% of a person's daily intake of calories. Based on this recommendation, an adult who consumes 2,000 calories per day should get fewer than 200 of their calories from saturated fats, which equals about 1.5 tbsp of coconut oil per day. People who want to start adding coconut oil to their diets can begin with 0.5 tbsp and increase to 1.5 tbsp per day. Stay in the know. Get our free daily newsletter You’ve got questions. We’ve got answers. Expert, evidence-based advice delivered straight to your inbox to help you take control of your health Your privacy is important to us. 1 . Use it as a cooking oil a woman cooking with coconut oil
A person can use coconut oil as as cooking oil. Coconut oil stays solid at room temperature. Its saturated fatty acids keep it stable at high temperatures, making it an ideal cooking oil. However, compared to other cooking oils, such as canola and soybean oils, coconut oil has a relatively low smoking point of 339.8°F (171°C). This means that it may produce carcinogens after use in continuous deep frying. As a result, people should avoid deep frying foods in coconut oil and instead opt for oils with higher smoking points, such as canola, corn, or soybean oils. For uses other than deep frying, replacing traditional cooking oils with coconut oil is an easy way to incorporate more coconut oil into the diet. Ways to cook with coconut oil include: using it when sauteing or stir-frying vegetables, meat, eggs, or fish mixing it into sauces and salad dressings coating meat or poultry in coconut oil and spices before baking Read more about the most healthful oils for cooking. 2. Bake with it People can make baked goods, such as cookies, cakes, and brownies, using coconut oil. Simply replace the oil that the recipe calls for with melted coconut oil at a 1:1 ratio. Allow any milk and eggs to come to room temperature before mixing them with coconut oil to prevent the batter from clumping. 3. Add it to drinks Another way to enjoy coconut oil is by adding a small amount — about 1–2 teaspoons (tsp) — to drinks, such as coffee, tea, and smoothies. Below are some simple drink recipes featuring coconut oil: Tropical smoothie for one: 1 tbsp of coconut oil half a cup of coconut water 1 to 1.5 cups of mango half a cup of pineapple Combine all ingredients in a blender and blend until smooth. Serve immediately. Coconut matcha latte for one: 1 tsp of coconut oil half a teaspoon of matcha powder a quarter cup of hot water 1 cup of coconut, almond, or oat milk optional: 0.5 to 1 tbsp of honey, maple syrup, or sweetener of choice Instructions: Warm the coconut milk and coconut oil in a pan over medium to high heat. Boil the water. Meanwhile, add the matcha powder to a clean mug. When the water comes to a boil, add it to the matcha and whisk until smooth. When the coconut milk and coconut oil mixture begins bubbling, turn off the heat and stir in the sweetener of choice using a milk wand or whisk. Pour the mixture over the matcha. Serve immediately. When buying coconut oil, be sure to choose pure versions that are intended for human consumption. People can buy coconut oil in supermarkets, health food stores, and online. Thank you for supporting Medical News Today Supplements a woman looking at supplement in a pharmacy
Coconut oil is available in supplement form. People can take coconut oil in capsule form. While supplements may offer convenience and easy dosage control, this is not the best method of consuming coconut oil. Most supplements contain 1–3 g per capsule, and a person would have to take 13 capsules to get the equivalent of 1 tbsp of coconut oil. Try cooking or baking with it instead. If people want to buy coconut oil supplements, these are available in supermarkets, health food stores, and online. Summary Coconut oil contains high quantities of beneficial medium-chain fatty acids, primarily lauric acid. Adding coconut oil to the diet may lead to health benefits. However, coconut oil is rich in saturated fats and a high calorie food. People should get less than 10% of their daily calories from saturated fats. To get any health benefits of coconut oil while minimizing any adverse effects, stick to 1–2 tbsp of coconut oil per day.
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Calcium channel blockers: What to know

Calcium channel blockers are a type of medication that people take to increase the flow of blood and oxygen to the heart. Doctors may prescribe a calcium channel blocker to treat high blood pressure or a variety of heart conditions.

Calcium channel blockers are common medications that have a low risk of complications. In this article, we discuss how these drugs work, as well as their uses and possible side effects.

What is a calcium channel blocker? A man pouring Calcium channel blockers from a pill container into his hands.
A doctor may prescribe calcium channel blockers to treat high blood pressure.

Calcium is necessary for muscle contractions to occur throughout the body. This mineral enters muscle cells through ion channels, which are tiny pores on the surface of the cell. This process is essential for normal bodily functioning.

Calcium channel blockers reduce the amount of calcium that can enter muscle cells in the heart and blood vessel walls via these channels.

In doing this, they lower the pressure in the blood vessels and on the heart.

Thank you for supporting Medical News Today Uses Doctors commonly use calcium channel blockers to treat high blood pressure. These drugs also have a range of other possible uses, such as for: Scientists are currently exploring other potential uses for calcium channel blockers. For example, by reducing high blood pressure, they believe that calcium channel blockers may be able to lower the risk of Alzheimer's disease. Several other types of medication have an effect similar to that of calcium channel blockers. Beta-blockers Beta-blockers slow heart activity by limiting the effects of stress hormones, such as epinephrine and norepinephrine. These medications are effective in lowering blood pressure. Examples of beta-blockers include atenolol (Tenormin) and metoprolol (Lopressor). Researchers have found that both beta-blockers and calcium channel blockers are effective in lowering blood pressure, making them useful treatments for a variety of conditions that affect the heart, including angina and arrhythmia. However, the American Heart Association recommend calcium channel blockers as a first-line pharmacological treatment for high blood pressure in most people and advise that beta-blockers should be a second-choice option. ACE inhibitors a woman speaking to a male pharmacist
ACE inhibitors can help manage a variety of heart conditions. Angiotensin converting enzyme (ACE) inhibitors are another type of medication for high blood pressure and a variety of heart conditions. They relax blood vessels and make it easier for the heart to pump blood around the body. ACE inhibitors work by blocking the enzymes that narrow blood vessels, which allows blood to flow through the vessels without putting as much pressure on them. Examples of ACE inhibitors include lisinopril (Prinivil, Zestril), enalapril (Vasotec), and benazepril (Lotensin). They can cause some common side effects, such as a cough or skin irritation. A doctor may sometimes prescribe an ACE inhibitor with a calcium channel blocker. Stay in the know. Get our free daily newsletter You’ve got questions. We’ve got answers. Expert, evidence-based advice delivered straight to your inbox to help you take control of your health Your privacy is important to us. Types and examples There are two different types of calcium channel blocker, which are called dihydropyridines and nondihydropyridines. Dihydropyridines Dihydropyridines target a specific type of calcium channel in the body. They cause the blood vessels to widen, lowering blood pressure. Examples of dihydropyridines include: amlodipine (Norvasc) felodipine (Plendil) nicardipine (Cardene) nifedipine (Adalat, Procardia) nimodipine (Nimotop) It is sometimes possible for these medications to widen the blood vessels too much, which can result in swelling in the feet and legs. Doctors are careful to prescribe a dosage that reduces the risk of this happening. Doctors may also minimize this risk by prescribing extended release calcium channel blockers. The body absorbs this form of the drug over a longer period, which prevents the blood vessels from widening too much. Nondihydropyridines Nondihydropyridines widen blood vessels in the same way as dihydropyridines. However, they have additional effects on the heart that can help control a rapid heart rate. Currently, there are only two nondihydropyridine medications: verapamil (Calan, Isoptin) and diltiazem (Cardizem). Verapamil specifically targets heart muscle cells, or the myocardium. Doctors use this drug to reduce chest pain as it relaxes blood vessels and reduces the amount of oxygen that the heart requires. Verapamil is also useful for slowing abnormally rapid and potentially dangerous heart rhythms, such as supraventricular tachycardia. Diltiazem is a medication for controlling heart dysrhythmias (rapid or irregular heart rhythms) and lowering blood pressure. In comparison with verapamil, it has a less significant effect on the heart rate. Side effects and risks a man at work yawning at his desk
Fatigue is a possible side effect of calcium channel blockers. Common side effects of calcium channel blockers include: Less commonly, these medications can cause: The rarest side effects that occur with calcium channel blockers include: If a person experiences any of these side effects from taking calcium channel blockers, they should see a doctor. If the side effects are causing serious problems, a doctor may change the prescription or reduce the dosage. Summary Calcium channel blockers are effective and widely used medications for the treatment of high blood pressure and several heart conditions. They work by relaxing blood vessels and reducing pressure on the heart. A range of alternative medications, such as ACE inhibitors and beta-blockers, are available for high blood pressure and heart conditions. They have a similar effect on the body, and doctors may prescribe a combination of these medicines. Calcium channel blockers can cause several side effects, such as fatigue and swelling in the abdomen, feet, and legs. Anyone who experiences worsening side effects should talk to a doctor about changing medications or reducing the dosage.
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Taking blood pressure pills at bedtime best for cardiovascular health

New research suggests that the best time for people with hypertension to take their blood pressure pills is at bedtime rather than in the morning.

woman checking her blood pressureShare on PinterestTaking blood pressure medication at bedtime is most likely to reduce cardiovascular risk, new research suggests.

It appears that not only does this timing result in better blood pressure control, but that it also markedly reduces the risk of cardiovascular death and events such as a heart attack or stroke.

Researchers came to these conclusions after analyzing data from the Hygia Chronotherapy Trial.

Hygia is the largest and longest lasting clinical trial to examine the effects of antihypertensive medication timing on the risk of cardiovascular events.

The investigators behind the present findings randomly assigned 19,084 adults to take the blood pressure pills that their doctors had prescribed either when they woke up in the morning or at bedtime. The participants were of Caucasian Spanish descent, and 8,470 were female.

During an average follow-up of 6 years, all individuals underwent 48-hour ambulatory blood pressure monitoring at least once per year.

"The results of this study," says Ramón C. Hermida, Ph.D., the leader of the Hygia project, "show that patients who routinely take their antihypertensive medication at bedtime, as opposed to when they wake up, have better-controlled blood pressure and, most importantly, a significantly decreased risk of death or illness from heart and blood vessel problems."

Hermida is a professor at the University of Vigo, in Spain, and director of its bioengineering and chronobiology labs.

He and colleagues report the recent findings in the European Heart Journal.

Markedly lower risk of cardiovascular eventsThe new study shows that, compared with individuals who took their blood pressure pills in the morning, those who took them before retiring to bed at night had a 45% lower risk of dying from or experiencing cardiovascular events, such as a heart attack, stroke, or heart failure.The team adjusted the results to remove the effect of potential influencing factors. These factors include sex, age, cholesterol levels, smoking status, and presence of kidney disease or type 2 diabetes.The researchers also examined the effect of medication timing on the risk of certain individual cardiovascular events.These analyses showed that, compared with taking blood pressure pills in the morning, taking them at bedtime can reduce the risk of:death due to heart or blood vessel conditions by 66%coronary revascularization by 40%Coronary revascularization is a procedure that unblocks or widens a vessel that supplies the heart to restore blood flow.No mention of timing in current guidelinesProf. Hermida explains that the current guidelines on how to treat high blood pressure do not mention or give advice about the best time of day to take the pills."Morning ingestion has been the most common recommendation by physicians, based on the misleading goal of reducing morning blood pressure levels," he observes.However, previous findings from the Hygia project have shown that the most significant independent marker of people's cardiovascular risk is their average systolic blood pressure during sleep.This link is independent of blood pressure readings taken during waking hours or at visits to the doctor, notes Prof. Hermida."Furthermore," he adds, "there are no studies showing that treating hypertension in the morning improves the reduction in the risk of cardiovascular disease."A limitation that he and his colleagues highlight is that, because the participants came from one ethnic group, they cannot say how true the findings might be for other populations.Origins of these benefits are unclearPaul Leeson, Ph.D., a professor of cardiovascular medicine at the University of Oxford, in the United Kingdom, was not involved in the trial.He commends the findings and describes the scale, length of follow-up, and effect size as "impressive.""Where the benefit comes from remains unclear," Prof. Leeson observes.Do these effects arise because the drugs improve sleep patterns or because side effects present less of a problem at night? he muses.Or, could it be that overnight blood pressure is a better marker of heart health?Prof. Leeson remarks that other studies looking into the timing of blood pressure medication are about to complete and report findings.It will be interesting to see whether they confirm these recent results and shed any insights on the underlying mechanisms of these effects."This study has the potential to transform how we prescribe blood pressure medication."Prof. Paul Leeson
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