The Heart

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Exercise may help people with cardiovascular disease the most

New research comparing the benefits of exercise for healthy people versus people with cardiovascular disease found that the latter may benefit the most from being physically active.
person running on country road
A study shows, for the first time, that people with cardiovascular disease benefit more from exercise than healthy people.

Existing evidence shows that staying physically active can help a person live longer and that regular exercise can help prevent many chronic conditions, including cardiovascular disease.

However, no studies had looked at how exercise really benefits individuals who already have cardiovascular disease.

Now, for the first time, researchers — many from Seoul National University, in South Korea — have compared the effects of exercise on the risk of death in a cohort of healthy participants and a cohort of participants with preexisting cardiovascular disease.

The study revealed that individuals with cardiovascular disease seemed to benefit more from exercise than healthy individuals — and the more they exercised, the better.

The team, led by Dr. Sang-Woo Jeong, published the findings in the European Heart Journal last week and also presented them at the European Society of Cardiology (ESC) Congress 2019, held in Paris, France.

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14% death risk reduction over 6 years

Dr. Jeong and colleagues analyzed the data of 441,798 participants, who were part of the Korean National Health Insurance Services Health Screening Cohort.

Of these, 131,558 participants had preexisting cardiovascular disease, while 310,240 were healthy. All of the participants were aged 40 or over, with an average age of 60. All had taken part in a health screening program between 2009 and 2015 and had provided information about their levels of physical activity.

In their analysis, the researchers also had access to follow-up data for nearly 6 years, as well as information regarding death and its cause, accessed through the Korean National Death Index.

The participants provided information on their levels of physical activity via surveys that asked them to report how often they had been physically active in the past week. In this case, physical activity referred mainly to instances of aerobic exercise and did not include daily activities, such as housework.

The researchers converted these data into units of metabolic equivalent task minutes per week (MET-mins/week), which allowed them to quantify levels of activity.

Dr. Jeong and the team found that, after the 6-year follow-up period, the participants with cardiovascular disease had benefitted more from physical activity than the healthy participants.

More specifically, for every 500 MET-mins/week, healthy individuals saw a 7% reduction in premature death risk, while those with cardiovascular disease saw a 14% death risk reduction.

Among healthy individuals, those who saw the most benefits were those who undertook 0–499 MET-mins/week of exercise. The benefits were less significant for healthy people who undertook 500–1,000 MET-mins/week, only increasing again after the 1,000 MET-mins/week landmark.

As for participants with cardiovascular disease, once more, individuals who undertook 0–499 MET-mins/week of exercise saw the most significant benefits. However, in this cohort's case, risk reduction continued to rise beyond the 500 MET-mins/week point.

Yet, at the same time, the researchers noted that almost 50% of all participants exercised very little, and about 25% of participants reported no physical activity.

"We found that approximately half of the people in the study did not reach the recommended level of leisure-time physical activity, and a quarter had a totally sedentary lifestyle," says Dr. Jeong.

"People with cardiovascular disease had lower levels of physical activity than those without, but the more exercise people did, the lower their risk of death during the 6 years of follow-up. The main new finding of this study is that people with cardiovascular disease benefit from a physically active lifestyle to a greater extent than healthy people without cardiovascular disease," Dr. Jeong explains.

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How to reach desired activity levels

As to why individuals with cardiovascular disease derive greater benefits from exercise than healthy individuals, the researchers can only make conjectures.

"There may be several plausible explanations for why people with [cardiovascular disease] benefited the most from exercise. First, sedentary lifestyle is a well-known risk factor for [cardiovascular disease]. Patients with [cardiovascular disease] may have had sedentary lifestyles, and thus, changing their lifestyle to become more physically active may be more beneficial," notes study co-author Dr. Si-Hyuck Kang.

"Secondly," he adds, "a number of previous studies have shown that physical activity helps control cardiovascular risk factors such as blood pressure, cholesterol, and blood glucose. The benefit of physical activity in secondary prevention may come by better controlling such risk factors."

"Lastly, patients with [cardiovascular disease] usually have higher levels of systemic inflammation than those without [this condition], and there is evidence that physical activity lowers systemic inflammatory levels," Dr. Kang explains.

The researcher also goes on to advise that doctors encourage individuals with cardiovascular problems not to give up on exercise and explain just how physical activity can benefit health.

"The 2016 ESC guideline for primary prevention recommends healthy adults of all ages should perform at least 150 minutes a week of moderate intensity or 75 minutes a week of vigorous intensity aerobic physical activity, or an equivalent combination," Dr. Kang notes.

"One way you can achieve 500 MET-minutes a week is to do brisk walking for 30 minutes, five times a week. If you are very busy [...], the other way to achieve approximately 500 MET-minutes a week is to do vigorous physical activity, such as climbing hills with no loads, for 75 minutes, once a week."

Dr. Si-Hyuck Kang

"You can achieve 1,500 MET-minutes a week by doing brisk walking for 30 minutes, five times a week, plus climbing hills for 2.5 hours, once a week," Dr. Kang also suggests.

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Heart health: Focus on healthful foods rather than diet type

New research finds that the type of diet a person follows is not as important as simply making sure it includes healthful foods.
close up of man chopping vegetables
When it comes to cardiovascular health, the type of diet is less important than 'simply eating healthful foods,' researchers say.

Most people know that eating a healthful diet is crucial for keeping our heart and our cardiovascular system healthy. But which diet is best?

Researchers at Beth Israel Deaconess Medical Center (BIDMC) in Boston, MA, set out to compare the effects of three diets on heart disease risks.

Each of the three diets followed the DASH pattern while focusing on one main macronutrient: carbohydrates, proteins, or unsaturated fats.

In the carbohydrates-rich diet, around 58% of kilocalories came from carbs; the protein-rich diet replaced 10% of kilocalories from carbs with protein; and the unsaturated fat diet replaced 10% of kilocalories from carbs with unsaturated fats, for example, from avocados, nuts, and fish.

Dr. Stephen Juraschek, Ph.D., an assistant professor of medicine at BIDMC and Harvard Medical School, is the corresponding author of the study.

Dr. Juraschek and team examined the effect of the three diets on cardiovascular risk factors, such as systolic blood pressure, low density lipoprotein (LDL) cholesterol, C-reactive protein levels — a marker of inflammation — and high-sensitivity troponin, which is "a marker of subclinical cardiac injury."

The researchers published their findings in the International Journal of Cardiology.

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Juraschek and team obtained their data from the so-called OmniHeart trial, a randomized intervention that followed 150 participants over 6 weeks. The average age of the participants was 54 years, 45% were women, and 55% were African American.

The researchers measured the cardiovascular risk factors at the beginning and end of each diet and compared the effects between the diets.

All three diets used the DASH dietary model, which emphasizes the consumption of vegetables, fruits, whole grains, fish, poultry, and beans.

In comparison with the baseline, the analysis revealed that all three diets had positive and prompt effects on heart health, as they all lowered the markers of inflammation and cardiac injury.

However, changing the composition of the macronutrients did not make a difference, suggesting that it does not matter whether the diet is high or low in healthful fats or carbs, but that the most important factor for improving heart injury is the general healthfulness of the diet.

"[T]hese findings suggest that a health[ful] diet, regardless of macronutrient profile, can directly mitigate subclinical cardiac damage and inflammation beyond traditional risk factors," write the researchers.

Juraschek sums up the significance of the findings, saying, "It's possible that macronutrients matter less than simply eating health[ful] foods."

"Our findings support flexibility in food selection for people attempting to eat a healthier diet and should make it easier," he continues.

"With the average American eating fewer than 2 servings of fruit and vegetables a day, the typical American diet is quite different from any of these diets, which all included at least 4 to 6 servings of fruits and vegetables a day."

"There are multiple debates about dietary carbs and fat, but the message from our data is clear: Eating a balanced diet rich in fruits and vegetables, lean meats, and high in fiber that is restricted in red meats, sugary beverages, and sweets, will not only improve cardiovascular risk factors but also reduce direct injury to the heart."

Dr. Stephen Juraschek

"Hopefully, these findings will resonate with adults as they shop in grocery stores and with health practitioners providing counsel in clinics throughout the country."

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Could bone-like particles in blood contribute to artery clogging?

Scientists have discovered that blood circulating around the body contains bone-like particles. They found the particles in blood samples from healthy humans and rats.
illustration of blood vessels
New research finds bone-like particles in the blood vessels.

They suggest that the bone-like particles could be evidence of ossification in bone marrow vessels.

The team also proposes that the particles may contribute to conditions such as atherosclerosis, a process that causes plaques, or deposits of fats and other substances, to build up inside arteries.

A recent paper in the journal Microcirculation gives a detailed account of the study.

Although most of the bone-like particles were very small, a significant proportion were large enough "to block small blood vessels throughout the vascular tree," write the authors.

The study follows previous research that uncovered a process in bone marrow whereby blood vessels "progressively and theoretically convert into bone tissue with advancing age."

That finding was the work of Rhonda D. Prisby, Ph.D., an associate professor of kinesiology at the University of Texas at Arlington, who is also the lead and corresponding author of the new study.

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Bone-like particles and vascular calcification

Prisby wondered if the processes of ossification in bone marrow blood vessels could give rise to bone-like particles that are capable of entering the bloodstream.

"By examining seemingly unrelated images and linking the details of them together," says Prisby, "I was able to posit the presence of bone-like particles in the blood."

Therefore, for the new investigation, she and colleagues used ultra-high microscopy to examine ossified bone marrow blood vessels in more detail.

They also "sought to confirm, characterize, and quantify the presence of [bone-like particles] in peripheral whole blood samples from humans and rats."

Cardiovascular diseases are the leading cause of death worldwide and were responsible for around 31% of all global deaths in 2016, according to the World Health Organization (WHO).

The WHO also estimate that, in 2016, 17.9 million people died of cardiovascular diseases, the majority of them from heart attack and stroke.

Vascular calcification is a complex and dynamic process — involving several mechanisms — that deposits calcium in the walls of blood vessels.

The process hardens the vessels, reduces their elasticity, and raises the risk of cardiovascular diseases and deaths from such diseases.

Probing the process of vascular calcification

In their study paper, Prisby and colleagues explain that the processes of vascular calcification are unclear. However, scientists suspect that the processes involve several types of cell in the vessel wall and the tissue that surrounds it.

The authors give an example involving smooth muscle cells. These cells in the vessel wall can transition from a contractile type to a bone-generating type and thence to a form that is "noncontractile, migratory, and proliferative."

This and other examples suggest that vascular calcification can start inside blood vessels.

Given that bone marrow vessels also undergo calcification, but most of the research literature on vascular calcification describes that which occurs outside the skeleton, the team decided to investigate further.

The purpose of the new study was to describe the features of bone marrow blood vessels that had become bone-like and to confirm what the team suspected — that the bloodstream contains bone-like particles, likely as a result.

The researchers used advanced microscopy techniques to examine human bone marrow blood vessels. These methods revealed two types of bone-like vessels: "transitioning" and "ossified."

They observed how transitioning vessels had bone-like particles stuck to their surfaces, meaning that, in theory, the particles could "gain access to and circulate within the blood."

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'Sharp tips and edges'

As well as examining human bone marrow vessels, the researchers examined blood samples from younger and older healthy human volunteers and rats.

They found bone-like particles in samples from both species. In neither species did age appear to make a difference to the percentage of bone-like particles.

Although most of the bone-like particles had a diameter no bigger than 15 micrometers, some were bigger and "of sufficient size to serve as emboli."

Prisby suggests that scientists should consider the potential role of bone-like particles when studying the processes of vascular calcification, heart attack, and stroke.

"Some of the ossified particles have sharp tips and edges that could damage the lining of blood vessels. This damage could initiate events leading to atherosclerosis [...] which can restrict blood flow over time."

Rhonda D. Prisby, Ph.D.

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Deaths to heart related conditions rising in the US

Progress against cardiovascular disease appears to be slipping in the United States as a new study reveals total related deaths rising since 2011.
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Being easily fatigued may signal future heart problems

People who are easily winded by very light exercise could be at more of a risk for heart disease than others who do not experience the same level of tiredness, recent research finds.
senior woman walking her dog
Finding light physical exercise exhausting may be a sign of future heart disease, says a new study.

The study, appearing in the Journal of the American Heart Association, looked at a participant pool of 625 individuals with an average age of 68 years.

The study team found that those who tired easily had an overall higher chance of developing cardiovascular disease.

First, the researchers calculated each person's 10-year risk of heart disease or stroke, using two different formulas.

Then, 4.5 years later, they assessed each participant with a test that consisted of "an extremely slow walk." Each person had to walk for 5 minutes on a treadmill set at a pace of 1.5 miles per hour. This exercise test was to examine their "fatigability."

After studied all the data, the researchers found that those who had higher cardiovascular risk scores from years ago were more likely to report that this simple physical task was exhausting.

"Even if you're exhausted because you have a newborn at home, this would be considered a very easy task," says study author Jennifer Schrack, an associate professor in the epidemiology department at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD.

"It should be very light exertion. When people think the effort is more than very light, that's informative."

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Risks of cardiovascular disease on the rise

Cardiovascular disease (CVD) is the leading cause of death worldwide, according to the World Health Organisation (WHO). While the current numbers of deaths due to CVD are high, experts believe they will increase over the next 15 years from 17.9 million in 2016 to over 23.6 million in 2030 around the world.

The American Heart Association (AHA) estimate there are 85.6 millions of people in the United States with more than one type of CVD, and approaching half of these adults are 60 years old or above.

CVD is a broad term that can refer to several different conditions. There are several ways to reduce the chances of developing CVD.

Eating well is a significant part of having a healthy cardiovascular system. This means consuming foods that are low in saturated fat, trans fats, and sodium. It is also vital to include fruits and vegetables, whole grains, fatty fish if not vegetarian or vegan, nuts, legumes, and seeds.

Also, it is crucial to be physically active. The WHO goal for maintaining a healthy heart is to do at least 150 minutes each week of moderate anerobic exercise, such as brisk walking.

Many people break this up into five 30-minute sessions each week. Alternatively, they can swap this regime for 75 minutes of high-intensity aerobic exercise, such as jogging or running.

Implications of the study

Dr. Salim Virani, a cardiologist at Michael E. DeBakey VA Medical Center and a professor of cardiology at Baylor College of Medicine in Houston, who did not participate in the study, voiced one criticism of this latest investigation.

He notes that the researchers did not measure "fatigability" at the beginning of the study, which would have allowed them to compare the two tests 4.5 years later.

However, Schrack says that people can use this symptom as a sign that they should pay more attention to their cardiovascular health and possibly make changes that could reduce their risk of CVD.

"People don't like to hear, 'Eat right and exercise.' These are two of the biggest pieces of public health advice, and we say it relat[ing] to almost every condition. But it's so true."

Jennifer Schrack

"People who are able to maintain their weight, maintain their activity level, tend to have [fewer] effects of fatigue and certainly less cardiovascular risk over time," concludes Schrack.

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Blood pressure in our 30s and 40s has lasting impact on brain health

A new study followed adults from their mid-30s into their early 70s. It shows an association between blood pressure changes in early adulthood and midlife and brain changes at the endpoint of the study.
Blood pressure linked to brain health
At what age should we start monitoring people's blood pressure?

High blood pressure, or hypertension, is a risk factor for cardiovascular disease, stroke, and kidney disease.

With around 15–20% of our blood going to the brain, the National Institute of Aging (NIA), part of the National Institutes of Health (NIH), explain that "the blood flow that keeps the brain healthy can, if reduced or blocked, harm this essential organ."

A recent study, which Medical News Today featured earlier this month, indicates that intensive blood pressure treatment in mid-life — or lowering of systolic blood pressure to below 120 millimeters of mercury (mm Hg) — is linked to fewer white matter lesions in the brain in later life.

White matter lesions are a sign of blood vessel damage in the brain and are a hallmark sign of aging and a risk factor for cognitive decline.

In the United Kingdom, routine blood pressure monitoring starts around 40 years of age.

Yet, researchers from University College London in the U.K., and colleagues, suggest this should start earlier. They are basing this view on the findings of their latest study on the long term effects of blood pressure on brain health.

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Changes in blood pressure

Dr. Jonathan M. Schott, a professor in clinical neurology and a consultant neurologist, is the senior's study author. The team published their findings in The Lancet Neurology.

Dr. Schott and his colleagues used data from 502 individuals from the Insight 46 dataset, a neuroscience study that is part of the U.K.'s Medical Research Council National Survey of Health and Development, a large birth cohort study of people born in the U.K. in 1946.

The team had blood pressure measurements from all participants when they were 36, 43, 53, 60–64, and 69 years old. None of the volunteers had dementia when they had their brains scanned using PET-MRI imaging around 70 years of age.

The results showed that between ages 36 and 43, as well as from 43 to 53, there was an association between greater than normal increases in blood pressure and a smaller brain volume later in life.

In those with higher blood pressure changes between ages 36 and 43, there was also evidence of a smaller volume of the hippocampus at age 70.

Dr. Schott also found an association between having high blood pressure at 53 years of age and a 7% increase in white matter lesions in the brain at the time of the brain scans.

Similarly, he was able to link a greater than expected increase in blood pressure between the ages of 43 and 53 to a 15% increase in the same lesions.

However, the team found no effect of blood pressure on cognitive ability or beta-amyloid, both hallmarks of Alzheimer's Disease.

Monitor blood pressure 'even before mid-life'

"Our research builds on existing evidence around the role of blood pressure and subsequent brain pathology," Dr. Schott comments on the findings.

"We found that higher and rising blood pressure between the ages of 36 and 53 had the strongest associations with smaller brain volume and increases in white matter brain lesions in later life," he continues. "We speculate that these changes may, over time, result in a decline in brain function, for example, impairments in thinking and behavior, so making the case for targeting blood pressure in mid-life, if not earlier."

In an accompanying comment, Lenore J Launer, a senior investigator in the Laboratory of Epidemiology and Population Science at NIA, writes:

"Although there are several major translational efforts to more completely understand the complexity of blood pressure–cognitive-related outcomes, the association between blood pressure and vascular brain pathology is unlikely to be a chance finding."

"Millions of individuals have unhealthy blood pressure. Immediate attention should be given to efforts to control blood pressure through clinical services and public health interventions, and to alleviate the barriers to delivery and uptake of these public-health messages."

Lenore J Launer

"As increases in blood pressure and higher blood pressure between the ages of 36 and 53 seem to have a detrimental effect on brain health in later life, these findings reinforce the need for monitoring blood pressure even before mid-life," concludes study co-author Josephine Barnes.

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Study links insomnia genes to heart disease, stroke risk

Scientists used data from more than 1.6 million people to link insomnia genes to a higher risk of heart disease and stroke but not atrial fibrillation.
Insomnia link to heart disease
Does insomnia contribute to heart disease, or is heart disease a contributing factor for insomnia?

Heart disease is the leading cause of death in the United States, with stroke coming in at number five.

Maintaining a healthy heart is central to preventing heart or cardiovascular disease (CVD), and our sleep is part of this strategy.

The Centers for Disease Control and Prevention (CDC) advise that "most adults need at least 7 hours of sleep each night."

But what links sleep to our hearts?

Experts have previously identified associations between poor sleep and heart disease.

Earlier this year, Medical News Today featured a study that identified a significantly greater risk of death from heart disease in people who had high blood pressure together with insomnia and stress.

So, what can another study add to the picture?

Most population studies look for associations, but they cannot pinpoint cause and effect. While it may make sense to many people that poor sleep causes poor heart health, there is little data to confirm which is the chicken and which is the egg.

A new study aims to do just that.

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Using Mendelian randomization

Susanna Larsson, an associate professor of cardiovascular and nutritional epidemiology at the Karolinska Institute in Stockholm in Sweden, and Dr. Hugh Markus, a professor of stroke medicine at the University of Cambridge in the United Kingdom, published their analysis this week in the journal Circulation.

What sets this study apart from others is the use of Mendelian randomization (MR). This method uses genetic markers to investigate whether a risk factor can cause a particular disease.

A person inherits genetic markers, which will not change during their lifetime. Therefore, the technique works under the assumption that a disease cannot modify these markers. This allows scientists to look at causation.

Earlier this year, a large scale genetic analysis using data from 1.3 million people identified 956 genes across 202 locations in our genome that have a link to insomnia.

Larsson looked at a group of genetic variants called single nucleotide polymorphisms (SNPs) from this dataset and any potential ties to heart health. SNPs are mutations that only change one base in a particular genetic sequence.

This analysis allowed her to measure the odds of cardiovascular disease risk associated with an individual's genetic propensity toward insomnia.

Larsson used publicly available data from large association studies of people with various forms of heart disease.

Specifically, her analysis included 184,305 individuals from a coronary artery disease study, 394,156 from a heart failure study, 588,190 from an atrial fibrillation study, and 438,847 from a stroke study. The majority of the study participants were of European ancestry.

In those individuals with the insomnia genetic variants, the odds of developing coronary artery disease were 12% higher than in those without the SNPs. For heart failure, the odds were 16% higher, and for all types of stroke combined, they were 7% higher.

There was no change in the odds of developing atrial fibrillation in people with the insomnia SNPs.

"In conclusion, this MR study indicates that liability to insomnia is associated with a modest increased risk of CVD," Larsson and Dr. Markus write in the paper.

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Strengths and weaknesses

Larsson and Dr. Markus explain in the paper that one of the strengths of their analysis lies in the large dataset that they used.

On the other hand, one of the shortcomings is that while MR can help identify cause and effect, in this case, the data do not prove that insomnia itself is the cause of CVD.

"Thus, our findings may not necessarily mean that insomnia itself is a cause of CVD. We cannot rule out that there are other causal pathways leading to insomnia that cause CVD," they explain.

Another weakness is that the SNPs that the researchers used in this analysis only account for 2.6% of the genetic variance that occurs in insomnia, meaning that they only contribute a small amount to the likelihood of a person developing insomnia.

In fact, Larsson did not know which of the study participants who had heart disease also experienced insomnia.

Nevertheless, this study adds to the wider picture linking sleep habits to heart health.

"It's important to identify the underlying reason for insomnia and treat it."

Susanna Larsson

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Intense light may boost heart health

A novel use of intense light therapy may help decrease the tissue damage experienced during heart attacks, reveals new research in mice.
woman holding her chest
New research introduces a potential novel therapy for heart attacks.

The study, out of the University of Colorado and appearing in the journal Cell Reports, shows that exposing lab mice to intense light for a week improved their outcomes after heart attacks.

The research also suggests that this procedure could benefit humans, and the researchers outline the reason why.

"We already knew that intense light can protect against heart attacks, but now we have found the mechanism behind it," says the study's senior author Dr. Tobias Eckle, professor of anesthesiology at the University of Colorado School of Medicine in Aurora.

Boosting specific gene protects heart

In the study, the researchers discovered that intense light influences the functions of the PER2 gene, which is expressed by a part of the brain that controls circadian rhythms.

By boosting this gene through intense light therapy, the researchers discovered that the mice's heart tissue received extra protection when it experienced issues with oxygen, such as during a heart attack.

Additionally, this intense light also heightened cardiac adenosine, which is a specialized chemical that helps with blood flow regulation. In concert, both benefits helped protect heart health.

Also, when they studied the mice, the researchers found that being able to physically perceive light was vital, as blind mice experienced no benefits from the intense light.

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Humans had similar benefits

The next step was to see if humans could benefit from light therapy. The researchers worked with healthy human volunteers and exposed them to 30 minutes of intense light.

On five consecutive mornings, the researchers exposed the participants to 10,000 lumens of light and drew blood several times.

The researchers found that PER2 levels increased in response to light therapy in the human participants as it did in the mice. They also reported that the human volunteers saw a decreased level of plasma triglycerides and improved metabolism.

Dr. Eckle explained that light plays an essential part in human health, not only in regulating the circadian rhythm but in cardiovascular health as well.

He adds that according to prior studies, more people throughout the U.S. experience heart attacks during the darker months of winter, even in states that traditionally get more sunshine, such as Hawaii and Arizona.

Heart disease and its impact on U.S. adults

Heart disease is widespread throughout the United States. Around 610,000 people die from heart disease every year, which accounts for 1 out of every 4 deaths.

Coronary heart disease is the most common form of heart disease, and around 735,000 people in the U.S. experience a heart attack annually.

While most people know that chest pain is a sign of a heart attack, other less obvious signs include shortness of breath, upper body pain, nausea, cold sweats, lightheadedness, and discomfort in the arms, back, neck, jaw, or upper stomach.

There are many ways that people can reduce their risk of developing heart disease, such as eating better and exercising more. However, it is vital that research to discover new ways to protect the cardiovascular system continues.

This study using intense light highlights how something seemingly unrelated to heart health can have such protective benefits.

This study could have a significant impact on the treatment of heart patients in the future. Eckle says that "if the therapy is given before high risk cardiac and non-cardiac surgery, it could offer protection against injury to the heart muscle which can be fatal."

Eckle believes there are other possibilities, too, adding that "drugs could also be developed that offer similar protections based on these findings."

"However, future studies in humans will be necessary to understand the impact of intense light therapy and its potential for cardio protection."

Dr. Tobias Eckle

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Apple cider vinegar pills: Health claims and evidence

Apple cider vinegar is a type of fermented vinegar made from apples. Pills made from apple cider vinegar make this sour liquid easier to consume. People who promote natural health products claim that this vinegar offers numerous health benefits.

Apple cider vinegar (ACV) pills contain a dehydrated form of the vinegar. Some brands of ACV pills may include other ingredients, such as cayenne pepper or ginger.

This article outlines the scientific research on apple cider vinegar (ACV) for a range of different ailments. We also discuss the risks and potential side effects of ACV.

Claimed benefits a woman about to swallow some Apple cider vinegar pills
There is little research into the health benefits of ACV pills.

Proponents of ACV claim that it offers numerous health benefits. We list some of the most popular claims below.

However, people should note that most research into ACV involves the vinegar in liquid form.

Very little information is available about ACV in pill form, and any findings relating to liquid ACV may not translate to ACV pills.

Controlling yeast and other fungi

People who promote ACV claim that it may help treat certain types of fungal infection, such as Candida infections. Candida is the fungus responsible for vaginal yeast infections and oral thrush. Candida inside the mouth can also infect dentures.

A 2014 study found that a denture soak containing 4% ACV could prevent Candida from sticking to dentures.

The 30-minute denture soak also did not affect the surface roughness of the dentures, nor did it change their color. This suggests that a denture soak containing ACV may be a safe and effective way to prevent fungal infections of dentures.

However, there is no evidence to suggest that ACV pills would have this effect.

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Lowering cholesterol and reducing heart disease risk

Lipids are fatty substances in blood and body tissues. High levels of specific lipids in the blood can increase the risk of cardiovascular disease.

Supporters of ACV claim that it can lower the levels of blood lipids that damage health, such as triglycerides and low density lipoprotein (LDL) cholesterol, or "bad" cholesterol.

A 2011 animal study investigated the effects of ACV in rats that ate a high cholesterol diet. Researchers found that ACV lowered the rats' triglyceride levels. However, ACV also raised levels of LDL cholesterol and high density lipoprotein (HDL) cholesterol, or "good" cholesterol.

So far, studies on ACV and heart disease have focused on animals. It is therefore not possible to conclude the effects of ACV on human health.

However, current research suggests that the benefits do not outweigh the risks. Many experts believe that lifestyle changes and medication are probably more effective.

Treating or preventing bacterial infections

A 2018 study found that ACV has antimicrobial properties that are effective against various strains of bacteria. This suggests ACV may be useful as a bacterial disinfectant. However, using ACV to treat wounds can irritate and even burn the skin.

Controlling blood glucose and diabetes

a man eating lunch at a table.
Consuming ACV at mealtimes may help people with metabolic disorders.

Some people claim that ACV can cure diabetes. While there is no evidence to support this claim, several small studies suggest that ACV may help to control blood glucose.

A 2017 meta-analysis found that consuming ACV at mealtimes helped lower post meal blood glucose and insulin levels. This was the case for people with metabolic disorders, as well as healthy controls.

ACV may, therefore, be useful alongside standard treatments for diabetes. However, scientists need to carry out further research to confirm these effects.

Supporting weight loss

Some smaller studies suggest that ACV may improve weight loss. A 2018 randomized controlled trial found that taking ACV could increase weight loss among people consuming a reduced calorie diet (RCD).

Researchers divided the participants into two groups. The first group consumed a RCD along with 30 milliliters (ml) of ACV per day, and the second group followed the RCD only. After 12 weeks, the researchers compared the two groups.

Participants in the first group showed significant reductions in body weight, hip circumference, appetite, and the amount of fat surrounding the internal organs.

This data does not point to ACV alone as a remedy for weight loss. However, it does suggest that it might help people following an RCD lose more weight.

Reducing blood pressure

Supporters of ACV claim that the vinegar may lower blood pressure. One small animal study investigated this claim. The study involved feeding either ACV or acetic acid to rats with high blood pressure. Acetic acid is the main therapeutic component of ACV.

The rats that received the acetic acid showed more significant reductions in blood pressure compared with the other rats. These rats also had lower levels of renin in the blood. Renin is an enzyme that is involved in increasing blood pressure.

The researchers suggest that the acetic acid in the vinegar was responsible for reducing renin levels, which in turn, caused the drop in blood pressure.

ACV may indirectly lower blood pressure by helping people lose weight. However, there is no evidence that ACV alone causes weight loss.

As a result, people who are concerned about weight or blood pressure should focus on dietary and lifestyle changes. People can also talk to their doctor about medical treatments.

Thank you for supporting Medical News Today Risks and side effects For most people, ACV is safe in moderate doses. However, being an acid, drinking ACV may erode tooth enamel. It may also cause stomach discomfort, especially in people with a history of reflux or ulcers. Very high doses can injure the throat. Because ACV can affect blood glucose levels, some people, including those who take insulin and those with a with a history of low blood sugar, should check with a doctor before taking ACV. Most of the evidence for ACV side effects come from individual case reports rather than well controlled clinical trials. For this reason, doctors cannot be sure about which side effects a person might experience, or at what dosage. As a result, it is essential to start with a low dose and monitor any side effects. People with chronic health conditions should see a doctor before trying ACV. Dosage a woman deciding what to buy from a pharmacy shelve.
ACV supplements are available in a range of concentrations. Most research on ACV has focused on its liquid form, and not on pills. As such, the ideal dosage is unclear. The Food and Drug Administration (FDA) have not approved ACV. Different manufacturers may sell the supplement in a range of concentrations. It is essential to follow the manufacturer's instructions and do not exceed the recommended dosage. Many studies have looked at ACV dosages of around a tablespoon per day. Much higher dosages may increase the risk of side effects and injury. Thank you for supporting Medical News Today Summary ACV pills are generally safe for healthy people to use. They are not a replacement for medications to lower blood pressure or cholesterol. However, they may complement prescription medications and increase the effects of a healthful diet. ACV also possesses antibacterial and antifungal properties, which may protect against certain bacterial and fungal infections. As with all supplements, talk to a doctor who is knowledgeable about supplements before trying ACV pills. Apple cider vinegar pills are available to purchase in stores and online. 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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Plant based diet may reduce cardiovascular death risk by 32%

New research adds to the mounting body of evidence that eating more plant based foods and fewer animal ones may contribute to a healthy heart and cardiovascular system.
person chopping vegetables
Eating more vegetables and less meat contributes to a healthy heart, new research suggests.

Not only is eating fewer animal products good for the planet, but it is also good for your health, as more and more studies suggest.

Particularly, a growing body of evidence is showing that a plant based diet could benefit cardiovascular health.

By way of example, one such recent study found that eating more plant based foods slashes the risk of heart failure by 40%, while another one found that a vegetarian diet cuts the risk of heart disease death by the same percentage.

Now, a new study appearing in the Journal of the American Heart Association strengthens these findings, as researchers find that eating more vegetables, legumes, nuts, and whole grains and fewer animal products correlate with a much lower risk of dying of a heart attack or other serious cardiovascular event.

Casey M. Rebholz, Ph.D., who is an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, is the lead author of the new study.

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Studying dietary intake and heart health

Rebholz and colleagues examined data from 12,168 middle aged people who had enrolled in the Atherosclerosis Risk in Communities (ARIC) study. The ARIC project clinically followed the participants between 1987 and 2016.

The researchers in the latest study categorized the participants' diet using four diet indexes: "In the overall plant based diet index and provegetarian diet index," they explain, "higher intakes of all or selected plant foods received higher scores."

"[I]n the healthy plant based diet index, higher intakes of only the healthy plant foods received higher scores," while "in the less healthy plant based diet index, higher intakes of only the less healthy plant foods received higher scores."

The researchers applied three Cox proportional hazards models to calculate hazard ratios and assess "the association between plant based diet scores and incident cardiovascular disease, cardiovascular disease mortality, and all cause mortality."

25% lower risk of death from any cause

The findings reveal that the participants who had the highest intake of plant based foods and scored the highest on the indexes were 16% less likely to have a cardiovascular condition — such as a heart attack, stroke, or heart failure — when the researchers compared them with adults who consumed the smallest amount of plant based foods.

High plant based food consumers were also 25% less likely to die from any cause and had a 32% lower risk of dying from a cardiovascular condition.

"While you don't have to give up foods derived from animals completely, our study does suggest that eating a larger proportion of plant based foods and a smaller proportion of animal based foods may help reduce your risk of having a heart attack, stroke or other type of cardiovascular disease," says the lead researcher.

"There might be some variability in terms of individual foods, but to reduce cardiovascular disease risk, people should eat more vegetables, nuts, whole grains, fruits, legumes, and fewer animal based foods."

Casey M. Rebholz

Dr. Mariell Jessup, the chief science and medical officer of the American Heart Association (AHA), who was not involved in the study, also comments on the results.

She says, "The [AHA] recommend[s] eating a mostly plant based diet, provided the foods you choose are rich in nutrition and low in added sugars, sodium (salt), cholesterol and artery clogging saturated and trans fats."

"For example, French fries or cauliflower pizza with cheese are plant based but are low in nutritional value and are loaded with sodium (salt). Unprocessed foods, like fresh fruit, vegetables, and grains, are good choices," Dr. Jessup explains.

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Study strengths and limitations

The study's lead researcher also points out that this is one of the first studies to examine this association in the general population. By contrast, most previous research has found cardiovascular benefits for plant based diets in smaller populations, such as vegetarians.

Also, the "findings are pretty consistent with previous findings about other dietary patterns, including the Dietary Approaches to Stop Hypertension, or DASH diet, which emphasize the same food items," Rebholz adds.

However, the study has some limitations, such as the self-reported nature of the dietary intake.

Also, the ARIC study measured the dietary intake of plant based and animal based foods decades ago, say the scientists, so the measurements may not reflect the modern food industry.

Finally, the study cannot prove causation.

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Do rising obesity levels explain cardiovascular mortality trends?

For decades, deaths caused by cardiovascular events, such as stroke, had been on the decline in high income countries. Recently, however, this decline has come to a halt, and some countries are even experiencing rising rates of stroke and heart disease-related deaths. Why?
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In some high income countries, cardiovascular-related mortality rates are increasing, and researchers are wondering why this is happening.

"In high income countries, the very substantial decline in [cardiovascular] mortality over the past half-century has been a major, yet often unheralded, global public health achievement."

This is what Prof. Alan Lopez and Tim Adair, Ph.D. write in the introduction to a new study paper, published in the International Journal of Epidemiology. The journal reviews current trends in mortality associated with stroke, heart disease, and other cardiovascular diseases (CVD).

Prof. Lopez and Adair, from the University of Melbourne in Parkville, Australia, note that "recent evidence from national vital statistics systems in these countries suggests that the long term decline in CVD and specifically heart disease mortality may be stagnating, with rates even rising in some populations, particularly at ages [of under] 75 years."

The researchers looked at vital statistics recorded from 2000 onwards in 23 high income countries. These are Australia, France, Japan, Spain, Austria, Germany, the Netherlands, Sweden, Belgium, Greece, New Zealand, Switzerland, Canada, Ireland, Norway, United Kingdom, Denmark, Israel, the Republic of Korea, the United States, Finland, Italy, and Singapore.

These statistics all came from the World Health Organization (WHO) Mortality Database and included mortality rates related to cardiovascular events.

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Obesity trends may play key role

Lopez and Adair found that the rate of decline in CVD-related mortality has slowed down 'considerably' in 12 of the high income countries they investigated in their study. This, in particular, was the case for adults aged 35–74.

Moreover, the most recent data show that CVD death rates have increased for females in the U.S. and Canada over the last year. In Australia, the U.K., and New Zealand, the decline in cardiovascular mortality has slowed down from year to year.

So, why are people once more at an increased risk of premature death due to events such as stroke and heart disease, even in the richer countries of the world?

Prof. Lopez and Adair have a theory. They believe that part of the answer lies in the ever increasing rates of obesity that coincide with the trends in stroke and heart disease mortality.

"Each of these countries has very high levels of obesity. In Australia, close to one-third of adults are obese," notes Prof. Lopez.

"These increases in obesity levels mean that a significant portion of the population has been exposed to the cardiovascular disease risks associated with being overweight for several decades," he continues.

However, not all high income countries face an obesity epidemic. For instance, the researchers point out that Italy and France report the lowest number of cases of obesity among the 23 countries featured in the current study.

A threat to future life expectancy rates

This is why the researchers believe that obesity may only be one part of the problem. The rest may come down to the prevalence of other risk factors for cardiovascular problems, such as smoking, high blood pressure, and high cholesterol.

"Obesity, of course, is likely to be only a partial explanation; Italy and France, where the deceleration in [cardiovascular] mortality in recent years is among the most notable [...], each has below-average obesity levels but higher smoking prevalence among both men and women," the researchers write in their paper.

Going forward, the two authors suggest that countries should invest more in inputting preventive strategies and advising their citizens on the most healthful lifestyle choices.

"In order to combat this, significant investment in preventive health measures is needed, particularly those aimed at increasing physical activity, improving diet and reducing obesity," says Adair.

"Failure to address these issues could confirm the end of the long term decline in cardiovascular disease deaths and threaten future gains in life expectancy."

Tim Adair, Ph.D.

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Is diet soda bad for you? Know the health risks

Many people choose diet soda so that they can enjoy a sweet and bubbly drink without consuming hundreds of calories or getting a hefty dose of sugar.

However, numerous studies have found a link between drinking too much diet soda and having serious health conditions, including diabetes, fatty liver, dementia, heart disease, and stroke.

In this article, learn about the links between diet soda and health, as well as whether it is more healthful than regular soda.

What is diet soda? a can of diet soda which is bad for you
Diet soda may contain artificial sweeteners rather than sugar.

Diet soda is soda that mimics the taste of traditional soda but provides less or no sugar.

Diet soda uses artificial sweeteners, such as saccharin or aspartame, to achieve the same sweet taste.

Soda manufacturers often claim that diet soda is more healthful than regular soda and that it is an ideal choice for people trying to lose weight. Consequently, many people see diet soda as a better choice.

Thank you for supporting Medical News Today Is diet soda bad for you? A growing body of evidence suggests that diet soda consumption correlates with an increased risk of a wide range of medical conditions, notably: heart conditions, such as heart attack and high blood pressure metabolic issues, including diabetes and obesity brain conditions, such as dementia and stroke liver problems, which include nonalcoholic fatty liver disease Many studies of people who drink soda have been extensive and spanned many years. However, few studies have fully controlled for other risk factors that might lead to chronic health issues, such as being overweight or having a sedentary lifestyle. Therefore, they may not account for the fact that people who drink soda might have more health issues independent of their beverage choices. For example, a person might be drinking diet soda because they have a high body mass index (BMI) and are trying to lose weight. Or, people who regularly drink soda may be more likely to eat certain types of food, which may pose health risks. Researchers do not know exactly why diet sodas may increase the risk of disease. Some believe that diet sodas might damage blood vessels or cause chronic inflammation. Diet sodas may also undermine health by changing other habits. A 2012 study suggests that diet soda may change how the brain responds to sweet flavors by affecting dopamine, a neurotransmitter that plays a role in pleasure, motivation, and reward. Frequently drinking diet soda might cause a person to crave more sweets, including both sweet snacks and more soda. What the research says a researcher doing some lab work
Research has not found a definitive link between artificial sweeteners and cancer. Many studies have linked diet soda consumption to worse health outcomes. The researchers behind a 2017 study gathered data that indicated a link between diet soda and the risk of stroke and Alzheimer's disease. The study involved 2,888 people over the age of 45 years. The results showed that drinking one diet soda per day almost tripled a person's risk of stroke and Alzheimer's disease. A 2014 study of 2,037 male Japanese factory workers found that men who drank diet soda were more likely to develop diabetes than those who did not. The correlation held even after adjusting for family history, age, BMI, and lifestyle factors. Early research suggested that there might be a link between artificial sweeteners and cancer. However, subsequent research has either found no link or called into question data that initially linked artificial sweeteners to cancer. So, while there are plenty of reasons to avoid diet soda, cancer risk may not be among them. Health benefits of diet soda Drinking diet soda does not provide any direct health benefits. However, it may offer some people a way to reduce their consumption of sugary beverages. People who wean themselves off sweetened sodas by drinking diet sodas can significantly reduce their sugar intake. They can then begin to transition to more healthful drinks, such as sparkling water. Some analysts, especially those with ties to the soda industry, insist that there is no compelling evidence directly linking soda to poor health. Others insist that diet soda remains a healthful alternative to traditional soda, despite the evidence to the contrary. The authors of a 2016 analysis noted that 26 studies found no link between soda consumption and worse health outcomes. However, those studies had received funding from companies in the soda industry. This fact, the authors of the study argue, suggests that the soda industry is "manipulating contemporary scientific processes to create controversy and advance their business interests at the expense of the public's health." How to cut down man drinking coffee
Coffee may be a more healthful caffeinated drink than diet soda. To cut down on diet soda, a person needs to understand why they drink soda and then find a viable alternative. For some people, soda offers a quick caffeine jolt. Switching to coffee or tea may be a good alternative as both of these drinks provide several health benefits. The best choice is unsweetened coffee or tea. Milk can offer some sweetness without the extra sugar. People who like bubbly carbonated drinks can find the same fizzy quality in seltzer water, or carbonated water. Unflavored, unsweetened seltzer waters do not contain artificial sweeteners and are typically calorie free. If the appeal of soda is in its sweetness, a person can try indulging in natural foods instead. Sweet whole fruits, such as peaches, mangoes, apples, and berries, offer a quick dose of natural sugar without many of the health risks of soda. Enjoying diet soda in moderation is less harmful than drinking it daily. People who cannot or do not wish to quit drinking diet soda can still reduce their risk of health issues by drinking less of it. Thank you for supporting Medical News Today Summary Research has linked a wide range of health risks to drinking diet soda. Despite it being a low or zero calorie beverage, it may still increase the risk of conditions such as diabetes and obesity. Diet soda offers no health benefits other than functioning as a tool that people can use to wean themselves off regular soda. While the precise relationship between diet soda and medical conditions is uncertain and requires more research, it is clear that people should not see diet soda as a healthful alternative to sugary drinks.
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Stopping statins may increase cardiovascular risk

A large new study following thousands of participants found that older people who stop taking statins have a significantly increased risk of hospital admission due to cardiovascular problems.
older man taking medication
New research suggests that interrupting statin use may increase the risk of poor cardiovascular health in older people.

Statins are a class of drugs that people take to keep their blood cholesterol levels under control.

Aside from this, they also have another use — that of protecting against heart disease and other cardiovascular conditions and events.

However, statins' effectiveness in protecting the heart health of older individuals has remained a matter of debate.

Knowing this, Dr. Philippe Giral, from Pitié-Salpêtrière Hospital in Paris, France, and a team of specialists set out to investigate how giving up statins could affect the health of healthy individuals aged 75 years and over.

"A particularly relevant practical question is whether existing statin therapy can be stopped in older people with no history of cardiovascular disease," write Dr. Giral and colleagues in their study paper, which appeared today in the European Heart Journal.

"This issue," the researchers add, "currently concerns a large proportion of the population over the age of 75 years, as well as large numbers of people under the age of 75 years, currently taking evidence-based treatment with statins and reaching ages for which only limited evidence of efficacy is available."

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In the current study, the team analyzed the health information of 120,173 participants living in France. All of these individuals reached the age of 75 years between 2012 and 2014, had no history of cardiovascular disease, and had been taking statins regularly in the 2 years prior to joining the study.

The team followed the participants' health developments over a maximum of 4 years, with an average follow-up period of 2.4 years.

During this time, the researchers noted that 17,204 individuals (14.3% of the total number of participants) stopped taking statins altogether for at least 3 months. In total, 5,396 (4.5%) of the study participants had to go to the hospital due to cardiovascular issues.

The researchers found that people who stopped taking statins had a 33% increase in the risk of requiring hospital admission for cardiovascular problems.

More specifically, older people who discontinued statin use had a 46% higher risk of experiencing heart problems and a 26% higher risk of experiencing a vascular event, such as a stroke.

"We estimated that an extra 2.5 cardiovascular events per 100 people would occur within 4 years among those who discontinued their statins at the age of 75 years compared to those who continued taking their statins," notes Dr. Giral.

Based on the study findings and the team's ensuing estimates, Dr. Giral advises older individuals not to halt their statin treatment later in life. Equally, the researcher suggests that doctors encourage their patients to continue taking any prescribed statins as a preventive therapy.

"To patients, we would say that if you are regularly [taking] statins for high cholesterol, we would recommend you don't stop the treatment when you are 75. To doctors, we would recommend not stopping statin treatment given for primary prevention of cardiovascular diseases in your patients aged 75."

Dr. Philippe Giral

While they say that the current study's findings provide some evidence to support the importance of statin use well into older age, the authors also caution that their investigation was observational. Thus, it shows an association between interrupting the use of statins and an increased risk of cardiovascular events.

Future work needs to determine whether this relationship is truly causational, the researchers note. Nevertheless, they believe that the current research can contribute to improving general guidelines regarding the use of statins as a preventive therapy.

"While we wait for results from randomized controlled trials, carefully conducted observational studies such as this can provide useful information for doctors and patients and can contribute to establishing more precise guidelines on the use of statins for primary prevention in the elderly," says co-author Prof. Joël Coste.

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Both blood pressure numbers may predict heart disease

According to new research, both high systolic and high diastolic blood pressure can lead to heart attack and stroke.
nurse taking patient's blood pressure
New research suggests that both blood pressure readings are equally important.

Heart disease and stroke are the leading causes of death worldwide. In the United States, more than 600,000 people die of heart disease every year. According to the Centers for Disease Control and Prevention (CDC), nearly one-quarter of deaths due to cardiovascular disease are preventable.

Blood pressure readings are critical for analyzing and monitoring blood pressure. These tests record blood pressure using two measurements: systolic and diastolic blood pressure. Understanding these numbers is key to controlling blood pressure.

The systolic pressure shows how much pressure the blood places on the arteries when the heart beats, while the diastolic blood pressure shows the pressure while the heart is resting between beats. The American Heart Association (AHA) advise that blood pressure numbers below 120/80 millimeters of mercury (mm Hg) are normal.

When readings range from 120–129 mm Hg systolic and less than 80 mm Hg diastolic, the person has elevated blood pressure. Hypertension occurs when blood pressure is consistently over 130 mm Hg systolic or more than 80 mm Hg diastolic.

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Which number is more important?

When doctors evaluate the risk of high blood pressure, they usually pay more attention to systolic blood pressure, which they consider a major risk factor for cardiovascular disease in older adults.

Decades of research have indicated that high systolic blood pressure is more likely than diastolic pressure to predict heart disease, but now, a new study finds that both numbers in blood pressure readings have a strong association with heart attack and stroke risk.

Researchers at Kaiser Permanente, a healthcare company in Oakland, CA, carried out the study, which appears in the New England Journal of Medicine.

The research involved more than 36 million blood pressure readings from 1.3 million people. The results challenged previous findings and showed the importance of both systolic and diastolic blood pressure.

"This research brings a large amount of data to bear on a basic question, and it gives such a clear answer," says Kaiser Permanente stroke specialist Dr. Alexander C. Flint, who is the lead author of the study.

The study's senior author is Dr. Deepak L. Bhatt, executive director of Interventional Cardiovascular Services at Brigham and Women's Hospital and professor of medicine at Harvard Medical School — both in Boston, MA.

Large amounts of data reveal the answer

Dr. Flint explains that previous research has influenced cardiology guidelines, which have focused primarily on systolic pressure to predict the risk of heart disease. Some experts even argue that it might be possible to ignore the diastolic number.

The new study is the largest of its kind. The findings confirmed that systolic pressure has a greater effect, but they also demonstrated that both systolic and diastolic pressure can predict the risk of heart attack or stroke.

The researchers analyzed the effects of systolic and diastolic hypertension on a variety of adverse outcomes, such as "myocardial infarction, ischemic stroke, or hemorrhagic stroke," over 8 years and found that both components independently predicted heart attack and stroke.

The recently updated American College of Cardiology and AHA guidelines now recommend more closely monitoring people at increased risk of high blood pressure. The findings of the new study that both systolic and diastolic hypertension have an effect at the lower threshold of 130/80 mm Hg support this change.

The National Institutes of Health's Systolic Blood Pressure Intervention Trial (SPRINT) has also produced similar results.

"This analysis, using a very large amount of longitudinal data, convincingly demonstrates that both are important, and it shows that in people who are otherwise generally healthy, lower blood pressure numbers are better."

Dr. Deepak L. Bhatt

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A guide to antioxidant foods

Antioxidants are compounds that may help delay or even prevent cell damage in the body. When a person consumes them in large amounts, antioxidants may help defend the body against oxidative stress from potentially harmful free radicals, which are unstable atoms.

When free radicals build up in a person's blood, they can create oxidative stress. Oxidative stress may increase the risk of developing cancer, heart disease, and many other chronic illnesses and health problems.

Many healthful foods contain antioxidants. If a person consumes some or all of these foods regularly, they may increase their antioxidant levels, potentially helping them prevent the damage that doctors associate with oxidative stress.

In this article, we list some of the most healthful foods that a person can eat to boost the antioxidants in their diet.

1. Blueberries a plate of blueberries, which are amongst the group of good antioxidant foods
Blueberries have a high antioxidant content.

Blueberries are rich in nutrients while also being low in calories. A 2017 study showed that wild blueberries contain a large number of antioxidants.

Studies on blueberries have shown that these fruits have beneficial effects as a result of their antioxidant content. For example, the authors of a review of animal studies concluded that antioxidants in blueberries might have medicinal uses for neurological conditions, including those that relate to aging.

A 2016 review examined the anthocyanins that occur naturally in blueberries and other plant materials. Anthocyanins belong to a group of chemicals that have antioxidant and anti-inflammatory actions. They are responsible for many of the bright colors of fruits and vegetables.

The review found that anthocyanins may help prevent high levels of low density lipoprotein (LDL), or bad, cholesterol, as well as lowering the risk of heart disease and decreasing a person's blood pressure.

2. Dark chocolate Good quality dark chocolate has high levels of nutrients and antioxidants. Researchers have linked dark chocolate to a range of potential health benefits, including: One review of 10 studies involving close to 300 participants showed that dark chocolate helps reduce both upper and lower blood pressure measurements. The authors noted, however, that future research needs to determine how much dark chocolate a person should eat for these benefits and investigate its effect on other metabolic conditions. 3. Artichokes Artichokes provide lots of nutrients and antioxidants. Research suggests that they may help lower people's cholesterol levels and improve their gut health. One study looking at the medicinal use of artichokes over time noted that artichoke consumption can be good for gut, liver, and heart health. Another study showed that chemicals in artichokes had an antioxidant effect on LDL cholesterol in laboratory tests. Therefore, regularly consuming artichokes may contribute to lowering a person's risk of cardiovascular diseases and other related conditions. How people prepare artichokes makes a difference to their antioxidant levels. One study compared boiling, frying, and steaming to see how each affected the antioxidant levels. The results showed that steaming increased the effectiveness of the antioxidants by 15 times while boiling increased it eightfold. Researchers believe the reason for this is that boiling and steaming break down the cell walls, making the antioxidants more accessible. Thank you for supporting Medical News Today 4. Pecans Pecans offer high levels of good fat, calories, minerals, and antioxidants. One study showed that the body can absorb antioxidants from pecans, increasing their levels in the blood. It also found that eating raw pecans helps lower the blood levels of oxidized LDL cholesterol, which may mean that these nuts help prevent heart disease. 5. Strawberries Strawberries are rich in antioxidants, vitamins, and minerals. Strawberries owe their red color to anthocyanins, which have antioxidant powers. A 2016 review showed that taking anthocyanin supplements reduced the levels of LDL cholesterol in participants with high cholesterol. By lowering LDL cholesterol levels, anthocyanins may help prevent heart disease. People can consume raw strawberries as a snack or as part of a salad or other dish. Although strawberries are an ingredient in some baked goods, these products are rarely healthful and are not a good choice for people trying to lose weight. 6. Red cabbage Red cabbage contains many nutrients, including vitamins A, C, and K plus several antioxidants. Red cabbage, like strawberries and red kale, contains anthocyanins. In addition to giving the vegetable its red color, this group of antioxidants helps promote heart health, prevent cancer, and reduce inflammation. According to one study, anthocyanins have the following health benefits: anti-inflammatory anticancer diabetes maintenance and management promote weight control prevent heart disease However, more research is still necessary to determine the health effects of eating red cabbage. A person can eat red cabbage as part of a salad or as a cooked vegetable. 7. Raspberries Raspberries are an excellent source of many antioxidants. They also contain manganese, vitamin C, and dietary fiber. Evidence suggests that the antioxidants present in raspberries may help destroy certain cancer cells. For example, in one laboratory study, researchers found that the antioxidants and some other compounds in raspberries helped kill breast, colon, and stomach cancer cells in a test tube. In the case of breast cancer, the researchers attributed some 50% of the cancer cell destruction to the antioxidant effects of the raspberry extract. A more recent review of studies showed that the compounds in black raspberries might slow the progression of cancerous tumors. However, most of the research on raspberries has involved experiments in test tubes. Consequently, researchers need to carry out studies involving people to judge the effectiveness of eating raspberries in preventing disease. 8. Beans a bowl of Pinto beans
Research has shown that pinto beans could help in suppressing certain types of cancer. Beans are an excellent source of protein and dietary fiber. Some beans, such as pinto beans, are also high in antioxidants. Pinto beans contain a plant flavonoid called kaempferol, which may help suppress cancer cell growth and reduce inflammation. Several studies link kaempferol to the suppression of specific cancers, including: Despite these promising studies, researchers do not know much about the antioxidant effect of kaempferol in humans. To date, they have primarily carried out studies in animals and test tubes. However, as beans have several potential health benefits, it is a good idea for people to include them as part of their regular diet. 9. Purple or red grapes Purple and red grape varieties contain vitamin C, selenium, and antioxidants. Two of the antioxidants that occur in grapes, namely anthocyanin and proanthocyanin, may help protect a person from heart disease or cancer. However, there is a need for additional research to show the exact effects that eating grapes has on heart health and cancer risk. 10. Spinach Spinach is a green, leafy vegetable full of vitamins, minerals, and antioxidants. It is low in calories, making it an excellent choice as an addition to salads and entrees. Zeaxanthin and lutein are two of the antioxidants in spinach that may promote eye health. They help prevent damage from ultraviolet (UV) rays and other harmful light waves. A review of studies on lutein and zeaxanthin noted that lots of studies have investigated their role in age-related macular degeneration. The authors also suggested how people could get more of these antioxidants in their diets, naming dark leafy greens, eggs, and pistachios as sources. 11. Beets Beets are vegetables that contain antioxidants belonging to a class of pigments called betalains. Betalains may help prevent colon cancer and digestive issues. Beets are also a source of dietary fiber, iron, folate, and potassium. These substances may help with suppressing inflammation. One review noted that betalains show promise for reducing free radicals and helping prevent cancer. However, research has not yet determined the effectiveness of eating beets for these benefits. Thank you for supporting Medical News Today 12. Kale Kale is rich in vitamins A, C, and K, and it contains several antioxidants. Red kale may offer more than green kale because it contains anthocyanins, which are antioxidants that help promote heart health. 13. Orange vegetables sweet potatoes on a table.
Orange vegetables may help prevent heart disease and cancer. Several orange vegetables contain vitamin A and other nutrients. These vegetables contain large amounts of phytochemicals that can help with heart disease and cancer prevention. Some examples of orange vegetables with high antioxidant levels include: sweet potatoes carrots acorn squash butternut squash There is limited evidence to suggest how best to serve orange vegetables. Often, people cook them, but a person can eat some varieties, such as carrots, raw as a snack or part of a salad. Summary There are many common foods that people can eat to increase the number of antioxidants that they consume. The antioxidants in these foods may help promote heart and eye health, prevent cancer, and protect against other common diseases that scientists associate with harmful free radicals. However, researchers still need to understand the extent to which each of these foods helps people acquire higher levels of antioxidants. They also need to determine how effective each is in disease prevention.
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How an ancient mutation may predispose humans to heart disease

Humans are the only mammals to naturally develop atherosclerosis, a narrowing of the arteries that can fuel heart disease. Researchers link this to the loss of a single gene in our ancestors around 2–3 million years ago.
Woman with heart disease
Why do humans develop atherosclerosis?

Heart disease is the leading cause of death worldwide. In the United States, more than 600,000 people die due to the condition each year.

Coronary heart disease is the most common type of heart disease. The underlying cause is atherosclerosis, which is a hardening of the arteries that supply the heart due to a buildup of plaque.

Dr. Ajit Varki, a distinguished professor of medicine and cellular and molecular medicine at the University of California San Diego in La Jolla, has a long standing interest in how atherosclerosis develops in humans.

Several years ago, Dr. Varki and his team noted that while humans are prone to atherosclerosis, other mammals do not develop the condition — unless scientists manipulate their diet or genes in laboratory experiments.

In a new paper, appearing in Proceedings of the National Academy of Sciences of the United States of America, Dr. Varki, along with collaborator Philip Gordts, an assistant professor of medicine, points to a genetic mutation that occurred millions of years ago.

The team describes how this may contribute to our unique predisposition to develop atherosclerosis and, by extension, coronary heart disease.

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Loss of sugar molecule 2–3 million years ago

In a previous paper, Dr. Varki showed that humans — unlike our close relative the chimpanzee — lack a functional version of a gene called CMAH, which stands for cytidine monophosphate (CMP)-N-acetylneuraminic acid (Neu5Ac) hydroxylase.

The protein encoded by the CMAH gene converts a particular molecule called N-acetylneuraminic acid (Neu5Ac) to N-glycolylneuraminic acid (Neu5Gc). Both molecules are sialic acids, a family of sugar molecules which play essential roles in many biological processes.

Dr. Varki's research indicates that human ancestors lost part of their CMAH gene around 2–3 million years ago, leaving modern humans unable to make Neu5Gc. Instead, our cells mostly rely on Neu5Ac as their primary source of sialic acid.

Studying mice that researchers had genetically engineered to lack Cmah, and by extension Neu5Gc, the team saw a 1.9-fold increase in atherosclerosis when they compared them to normal mice.

"The increased risk appears to be driven by multiple factors, including hyperactive white cells and a tendency to diabetes in the human like mice," Dr. Varki comments.

Neu5Gc in red meat and atherosclerosis

In a further set of experiments, Dr. Varki and colleagues tested the effect of a diet high in Neu5Gc on the Cmah deficient mice.

Red meat is a ready source of Neu5Gc, which Dr. Varki's team previously showed causes chronic inflammation in their mouse model.

The researchers saw a 2.44-fold to 3.42-fold increase in atherosclerosis in the Cmah-deficient mice that they fed a diet high in Neu5Gc and fat, in comparison with a diet high in Neu5Ac and fat or a diet high in fat but without sialic acids.

"Human evolutionary loss of CMAH likely contributes to atherosclerosis predisposition via multiple intrinsic and extrinsic [dietary] mechanisms," Dr. Varki comments in the paper.

"Overall, our work may help explain why atherosclerosis and resulting CVD complications are very common in humans, and why these events rarely occur spontaneously in other mammals, in the absence of experimental or dietary manipulation."

Dr. Ajit Varki

Medical News Today asked Dr. Varki how he thought we might reduce our risk of developing atherosclerosis. He suggested that we "realize that, as humans, we are at greatest risk."

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Everything you need to know about coming off statins

Statins are a class of drug that reduces levels of low-density lipoprotein (LDL) cholesterol in the blood. Doctors sometimes refer to this simply as "bad" cholesterol.

Statins are some of the only cholesterol lowering drugs that demonstrably reduce the risk of heart attack and stroke.

This article explores why a person may want to come off statins and the risks of stopping this type of medication. We also provide a list of alternative treatment options.

How statins work A packet of statins, with the front off and three tablets lying on a table.
Statins work by reducing the liver's production of cholesterol.

Statins reduce levels of LDL cholesterol in the blood.

LDL cholesterol is a waxy, fatty substance that builds up in the walls of arteries.

LDL deposits restrict blood flow through the arteries and cause inflammation, which increases the risk of heart attack and stroke.

Statins work in two ways. First, they reduce the liver's production of cholesterol.

Second, they help the liver reabsorb and break down cholesterol that is already in the walls of the arteries. Statins also have anti-inflammatory effects.

Thank you for supporting Medical News Today Why people come off statins A person may want to come off statins for various reasons. Some common examples include: Side effects According to the American College of Cardiology, around 85–90% of people who take statins do not experience any side effects. As with all drugs, however, a small minority of people experience mild to severe side effects when taking statins. The adverse effects that they most commonly experience are muscle problems and a slightly increased risk of type 2 diabetes, which we cover in more detail below. Muscle problems A man sat on the couch with a pain in his lower back.
A person taking statins may experience muscle pains, tenderness, or weakness. Some people who take statins report having muscle pains, tenderness, or weakness. Statins may, in rare cases, damage the muscles. If a person taking statins is having muscle aches, pains, or weakness, and they cannot link these symptoms to an obvious cause, such as exercise or physical labor, they should speak to a doctor. A doctor can test the creatine kinase (CK) levels in their blood. The body releases CK when the muscles are damaged or inflamed. If a person has a high CK level, a doctor may advise stopping statin treatment. Type 2 diabetes Hyperglycemia, or increased blood sugar, is a potential side effect of statins. A person may hesitate about taking statins if they have concerns about their risk of developing type 2 diabetes. A review from 2019 reported a slightly increased risk of newly diagnosed type 2 diabetes among people taking this type of medication. The risk is highest among people with prediabetes. Taking statins increases type 2 diabetes risk by 0.2% for each year that a person takes the medication. In a person with normal baseline blood glucose levels, statins are highly unlikely to cause diabetes. The benefits of taking statins to prevent a cardiac event usually outweigh the risk of developing diabetes. Reduced need Some lifestyle changes can help people manage their cholesterol levels. Examples include exercising regularly, maintaining a healthy weight, and eating a balanced diet. However, people who adopt these lifestyle changes should not assume that they can stop taking statins. To determine whether this is the case, a doctor can use blood tests to check that cholesterol levels are within a healthy range. Pregnancy Women who are pregnant or planning for pregnancy should talk to their doctors about coming off statins. In 2019, the American Heart Association (AHA) published a review that included an investigation of the safety of statins during pregnancy. None of the featured studies had identified a link between statin use and fetal developmental abnormalities. However, the studies had examined very few cases of statin use during pregnancy, so the authors of the review were unable to rule out the risk. Therefore, the AHA caution against the use of statins during pregnancy and breastfeeding. Other side effects Some people have concerns about statins increasing their risk of cancer or dementia or other neurocognitive problems. There is no research to suggest that statins increase these risks. While some people may develop dementia or cancer while taking statins, it is often because their risk of these conditions has increased with age. Risks of coming off statins People who are considering coming off statins should discuss this with their doctors. Stopping statin treatment can be dangerous for certain people, especially those who have a history of stroke, heart attack, or stenting. A 2017 study investigated whether quitting or reducing statin use increased the risk of a second ischemic stroke (IS) in people who had previously been in the hospital for the condition. An IS occurs when a buildup of cholesterol in the arteries restricts blood flow to the brain. The study included a total of 45,151 participants. It found that people who quit taking statins 3–6 months after having an IS were 42% more likely to experience a second stroke within 6–18 months. There was no increased risk for people who continued to take statins at a reduced dose. In a statement to the AHA, the study's lead researcher, Dr. Meng Lee, concluded that doctors should discourage people who have experienced a stroke from coming off statins. Dr. Lee added that reducing the dosage may be an option. How to come off statins safely A male doctor talking to a woman in a green top.
A doctor may suggest replacing statins with another cholesterol lowering drug. Anyone considering coming off statins should first discuss it with their doctor. The doctor may deem it too dangerous and may lower the dosage to a more tolerable level. Taking a lower dosage of statins may mean incorporating another cholesterol lowering drug into the treatment plan. In rare cases, a doctor may suggest stopping statin treatment altogether and replacing it with a different cholesterol lowering drug. A doctor may prescribe any of the following drugs as an alternative to statins: PCSK9 inhibitors PCSK9 is a protein that reduces the liver's ability to absorb LDL cholesterol from the blood. PCSK9 inhibitors bind to and inactivate the protein. This allows the liver to absorb more LDL cholesterol and reduce levels of this type of cholesterol in the blood. Drugs in this class include alirocumab (Praluent) and evolocumab (Repatha). Selective cholesterol absorption inhibitors Selective cholesterol absorption inhibitors (SCAIs) prevent the absorption of cholesterol in the small intestine. These drugs mainly reduce levels of LDL cholesterol. They may also slightly increase the levels of high-density lipoprotein, or "good," cholesterol. One example of an SCAI is ezetimibe (Zetia). Other treatment options Other treatment options include other lipid lowering therapies, which reduce levels of triglyceride fats in the blood. Studies suggest that high levels of triglycerides may increase the risk of stroke, although confirming this will require further research. Examples of lipid lowering drugs and supplements include: Summary Statins reduce LDL cholesterol, lowering the risk of heart attack and stroke. There are many reasons that a person may want to come off statins. Some people experience or are concerned about side effects. Others may feel that they no longer need to take this type of drug. Anyone who wants to stop taking a statin should talk to a doctor. In some cases, coming off these drugs can be dangerous. The doctor may suggest reducing the dosage, combining the statin with another cholesterol lowering drug, or switching to another drug entirely.
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Heart disease: Millions taking daily aspirin without doctor's advice

New research suggests that many adults in the United States who take low dose aspirin daily to prevent heart disease could be at risk of harm.
close up of woman's hands taking aspirin
New research finds that more than 6 million U.S. adults take aspirin to prevent heart disease without a recommendation from their doctor.

The individuals potentially at risk include older adults and those who have or have had peptic ulcers.

Peptic ulcers are open sores that can occur in the stomach and small intestine. These painful lesions, which are prone to bleeding, affect about 10% of people.

The recent study suggests that close to 6.6 million U.S. adults are taking aspirin every day to protect against heart disease without seeking medical advice.

Researchers at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, both in Boston, MA, report these findings in a recent Annals of Internal Medicine paper.

The lead author is Dr. Colin W. O'Brien, who is a fellow at Harvard Medical School and also a senior resident in internal medicine at BIDMC.

He and his colleagues note that a key message of their findings is that people without a history of cardiovascular disease who are taking aspirin daily to prevent heart attack or stroke should talk to their doctor about whether it is wise for them to continue.

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Revised guidelines

Aspirin works by reducing the stickiness of blood platelets and, therefore, decreasing their ability to clot. However, this same property also raises the risk of bleeding.

Until recently, the medical community supported the daily use of low dose aspirin for the prevention of cardiovascular events — such as heart attack and stroke — by those at higher risk.

The view was that, for those individuals, the benefits outweighed the risks.

However, the publication of three major studies in 2018 revealed that for many people, the dangers of internal bleeding offset the few benefits of aspirin use.

Those findings prompted the American Heart Association and the American College of Cardiology to revise the guidelines on aspirin use for the prevention of cardiovascular disease.

The new guidelines now advise that adults aged 70 years and older should not use daily low dose aspirin for the primary prevention of cardiovascular disease. They define a daily low dose as 75–100 milligrams.

In addition, the guidelines explicitly recommend against daily low dose aspirin for the primary prevention of cardiovascular disease in people of any age who have a raised risk of bleeding.

The recommendations do not apply to individuals who have already experienced a heart attack or stroke or to those who have undergone procedures such as stent insertion or bypass surgery to prevent cardiovascular events.

In a message accompanying the revised guidelines, the American Heart Association advise that unless a doctor prescribes it, people should avoid taking aspirin every day.

Doctors should ask about aspirin use

Dr. O'Brien and colleagues sought to determine the extent of regular aspirin use for the prevention of cardiovascular disease in the U.S.

Their data came from the 2017 National Health Interview Survey and covered adults aged 40 years and older.

They found that 23.4% of adults aged 40 year and older — which equates to about 29 million individuals — who did not have cardiovascular disease reported that they were taking aspirin daily to prevent heart disease.

Of these people, some 6.6 million were doing so without a doctor's recommendation.

The team was equally concerned to find that nearly 50% of those aged 70 years and older with no existing or previous cardiovascular disease were also taking aspirin to prevent heart disease.

The findings also revealed no significant link between lower use of aspirin and a history of peptic ulcers. This result is surprising given that doctors advise against regular use of aspirin if there is a history of peptic ulcer disease.

"Our findings show a tremendous need for healthcare practitioners to ask their patients about ongoing aspirin use and to advise them about the importance of balancing the benefits and harms, especially among older adults and those with prior peptic ulcer disease."

Dr. Colin W. O'Brien

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Paleo diet may be bad for heart health

New research has found that people who follow the Paleolithic, or Paleo, diet have high levels of a blood biomarker tied to heart disease. The finding raises some red flags about this type of diet, which, the researchers suggest, is not balanced enough to ensure good health.
image of steak and salad
Following the Paleo diet could threaten heart health, a new study finds.

The Paleolithic diet — often known as the Paleo diet, for short — claims to emulate what the ancestors of modern humans used to eat.

People who follow a Paleo diet have a high intake of meats, fruits, vegetables, nuts, and seeds, but no dairy, legumes, or whole grains.

This type of diet has been surrounded by controversy, and researchers have been debating whether or not it is safe and healthful.

For example, one study from 2016 suggests that the Paleo diet could protect against heart attacks and cardiovascular disease by raising blood levels of a protective molecule.

Yet, another study from the same year made a completely opposite discovery, concluding that this type of diet led to unhealthful weight gain and raised the risk of diabetes and cardiovascular problems.

Now, research conducted by a team from Australia points to more evidence suggesting that people who follow Paleo diets may be placing their heart health at risk.

The investigators hail from four different research institutions in Australia: the School of Medical and Health Sciences and the School of Science, both at Edith Cowan University, in Joondalup; the School of Molecular and Life Sciences, at Curtin University, in Bentley; PathWest Laboratory Medicine, in Nedlands; and CSIRO Health and Biosecurity, in Adelaide. The researchers' findings appear in the European Journal of Nutrition.

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High levels of heart disease biomarkers

The researchers — led by Angela Genoni, Ph.D. — worked with 44 participants who followed Paleo diets, as well as 47 participants who followed typical diets that met national dietary recommendations.

The follow-up period was over a year, during which the researchers collected biological samples from all the participants, assessed their diets, and compared results between the Paleo cohort and the control group.

Moreover, in order to be more precise in their assessment, the investigators split the participants who followed a Paleo diet into two further groups, according to their specific preferences:

strict Paleolithic (22 participants), including individuals who ate less than one serving per day of grains and dairy pseudo Paleolithic ( 22 participants), including individuals who ate more than one serving of grains and dairy per day

The researchers found that, across Paleo groups, individuals presented heightened blood levels of a compound that specialists associate with heart disease: trimethylamine N-oxide.

Trimethylamine N-oxide first forms in the gut, and its levels depend on a person's diet and the bacteria that populate their gut, among other factors.

"Many Paleo diet proponents claim the diet is beneficial to gut health, but this research suggests that, when it comes to the production of [trimethylamine N-oxide] in the gut, the Paleo diet could be having an adverse impact in terms of heart health."

Angela Genoni, Ph.D.

"We also found that populations of beneficial bacterial species were lower in the Paleolithic groups, associated with the reduced carbohydrate intake, which may have consequences for other chronic diseases over the long term," she adds.

Why Paleo might increase health risks

Genoni and the team argue that people following Paleo diets have such heightened levels of trimethylamine N-oxide because they do not consume whole grains. These are a great source of dietary fiber, and they help reduce a person's risk of cardiovascular problems.

"We found the lack of whole grains [was] associated with [trimethylamine N-oxide] levels, which may provide a link [with] the reduced risks of cardiovascular disease we see in populations with high intakes of whole grains," says Genoni.

"The Paleo diet excludes all grains and we know that whole grains are a fantastic source of resistant starch and many other fermentable fibers that are vital to the health of your gut microbiome," the lead researcher continues.

Moreover, the investigators point out that participants in the Paleo diet groups also had higher concentrations of the gut bacteria — Hungatella — that generate the compound.

"Because [trimethylamine N-oxide] is produced in the gut, a lack of whole grains might change the populations of bacteria enough to enable higher production of this compound," Genoni explains.

"Additionally, the Paleo diet includes greater servings per day of red meat, which provides the precursor compounds to produce [trimethylamine N-oxide]," she notes, "and Paleo followers consumed twice the recommended level of saturated fats, which is cause for concern."

In the conclusion to their study paper, the researchers warn that excluding whole grains from the diet can seriously impact gut health, with implications for heart health, as well. They also argue for the necessity of further studies into the role of vegetables and saturated fats in regulating key biological mechanisms in the gut.

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Higher iron levels may protect arteries but raise clot risk

Having higher natural levels of iron could be both good and bad for cardiovascular health, according to new research. On one hand, it may lower the risk of clogged arteries, but on the other hand, it may raise the risk of blood clots related to reduced flow.
illustration of veins
New research reveals the effects of high iron levels on arterial health.

These were the conclusions of a large study that examined the relationship between people's natural iron levels and three measures of cardiovascular disease: carotid artery wall thickness, deep vein thrombosis (DVT), and carotid artery plaque.

Thickening of the vessel wall and the buildup of plaque in the carotid artery are both signs of atherosclerosis.

DVT occurs when a blood clot, or thrombus, forms in a deep vein. DVT typically affects the leg.

The researchers found that having higher levels of iron appears to raise the risk of DVT yet reduce the risk of carotid plaque. There was "no significant effect" on carotid artery wall thickness.

They report their findings in a recent Journal of the American Heart Association study paper.

"These results," write the authors, "are consistent with previous studies that suggest higher iron status has a protective role in atherosclerosis but increases the risk of thrombosis related to stasis of blood."

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Genetic markers of iron status

The study is one of a series that scientists from Imperial College London in the United Kingdom are leading. In these studies, international teams are using genetic data from 500,000 people to explore links between iron levels and more than 900 conditions.

The researchers are using a tool called Mendelian randomization (MR) to investigate links between people's natural iron levels and disease risk.

The authors of the new study suggest that a strength of MR analysis is that it can overcome some of the problems that observational studies face with potential confounders. These can cloud the analysis of likely causes of the observed effects.

"Indeed," they note, "biomarkers of iron status are implicated in other pathologies, including inflammation, liver disease, renal failure, and malignancy, all of which could affect observational associations with thrombotic disease."

By searching DNA data on nearly 49,000 people of European descent, they found genetic markers that correlate with higher natural levels of iron.

The researchers then used the DNA iron level markers to screen other datasets of tens of thousands of people to find links to carotid artery wall thickness, DVT, and carotid artery plaque.

'Contrasting role' of iron status

Atherosclerosis is a major worldwide cause of conditions that affect blood vessels. It can give rise to heart disease, stroke, and peripheral artery disease.

The process of atherosclerosis begins when cholesterol and other fatty materials deposit in artery walls and develop into atheromas. These can eventually rupture and lead to a local clot.

The clot can partially or completely restrict blood flow and cause a stroke or heart attack, depending on which artery it affects.

The researchers suggest that their findings provide evidence of a "contrasting role" of higher natural iron levels on "different thrombotic disease processes."

Speculating on the implications of these findings, lead and corresponding author Dr. Dipender Gill — of the School of Public Health at Imperial College London — suggests that they open new avenues for further studies.

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These could address many unanswered questions, such as how iron affects cholesterol, influences the formation of blood clots, and promotes artery narrowing.

The new study, like others in the series, only investigated people's natural levels of iron using their genetic markers. It did not investigate the effect of taking iron supplements.

Dr. Gill also says that people should speak to their doctor before they start to take or stop taking iron supplements.

"Iron is a crucial mineral in the body and is essential for carrying oxygen around the body," he explains.

"However, getting the right amount of iron in the body is a fine balance — too little can lead to anemia, but too much can lead to a range of problems including liver damage."

Dr. Dipender Gill

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