The Heart

Here you will find a selection of RSS feeds and blog entries

Cardiovascular deaths on the rise in the US

According to the American Heart Association (AHA), nearly half of all adults in the United States have cardiovascular disease. It caused more deaths in 2016 than previous years, despite rates of cardiovascular deaths having declined worldwide.
man having his blood pressure taken
The amended hypertension guidelines explain the high prevalence of cardiovascular disease in the U.S., say the AHA.

Heart disease is the leading cause of mortality in the United States, followed closely by cancer and chronic respiratory diseases.

In fact, heart disease causes almost 1 in 4 deaths in the U.S.

Staying abreast of the latest statistics on the prevalence of this condition is key for prevention.

Physicians, governmental organizations, and patients alike can benefit from information on heart disease death rates and risk factors that stave off cardiovascular conditions.

In this context, the American Heart Association (AHA) have just published their 2019 updated Heart and Stroke statistics in the journal Circulation.

The report is a compilation of the latest statistics on the prevalence of cardiovascular disease both in the U.S. and across the globe. The AHA worked in collaboration with the National Institutes of Health (NIH) and other governmental organizations to put the report together.

According to the report, about 48 percent of all U.S. adults — or almost half of the adult population — are living with a form of cardiovascular disease.

Cardiovascular disease is an umbrella term for several conditions, including atherosclerosis, heart disease, heart failure, stroke, heart attack, arrhythmia, and heart valve problems.

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Hypertension and cardiovascular risk

The updated AHA report found that in the U.S., cardiovascular deaths have increased significantly in recent years, despite the fact that across the globe, the number of cardiovascular deaths has declined.

Specifically, in the U.S., 840,678 cardiovascular deaths were registered in 2016, a number that has gone up from 836,546 deaths in 2015.

However, worldwide, 17.6 million people died from a cardiovascular condition in 2016, compared with 17.9 million in 2015.

Importantly, the recently reported high prevalence of cardiovascular disease is mainly due to the fact that the definition of what constitutes high blood pressure has changed.

According to the AHA's updated 2017 hypertension guidelines, a reading of 130/80 millimeters of mercury (mm Hg) or above counts as high blood pressure, whereas previously this reading was 140/90 mm Hg.

Dr. Ivor J. Benjamin, the president of the AHA and the director of the Cardiovascular Center at the Medical College of Wisconsin in Milwaukee, comments on the importance of high blood pressure for cardiovascular risk.

"As one of the most common and dangerous risk factors for heart disease and stroke," he states, "this overwhelming presence of high blood pressure can't be dismissed from the equation in our fight against cardiovascular disease."

"Research has shown that eliminating high blood pressure could have a larger impact on [cardiovascular] deaths than the elimination of all other risk factors among women and all except smoking among men."

Dr. Ivor J. Benjamin

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Fewer people smoke and more are exercising

The recent report also notes some encouraging improvements in risk reduction. The proportion of teenagers who do not smoke, for example, has increased by almost 20 percent in 1999–2016.

Meanwhile, 94 percent of adolescents aged 12–19 did not smoke in 2015–2016, whereas only 76 percent did not smoke in 1999–2000.

Additionally, the number of teenagers aged 12–17 who smoked in the past month decreased by two-thirds between 2002 and 2016.

Approximately 80 percent of adults did not smoke in 2015–2016, and the number of male adults who smoke has dropped from 51 percent in 1965 to 16.7 percent in 2015. Also, 34 percent of females smoked in 1965, while only 13.6 percent smoked in 2015.

Finally, the report also mentions that the rate of physical inactivity has declined, as more and more U.S. individuals are engaging in various types of exercise.

Namely, over half of U.S. students engage in muscle-strengthening exercise on 3 days per week or more, and the number of physically inactive adults has dropped by over a third between 2005 and 2016.

However, the report authors warn that obesity and sleep deprivation remain significant risk factors for cardiovascular disease and other chronic conditions. The rates of obesity in the U.S. are still high, as are the number of adults who do not get enough sleep.

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Eating fried foods could increase death risk, study warns

A new study featuring in The BMJ cautions that women over 50 who regularly eat fried foods may be increasing their own death risk.
plate of fried fish
Are you a fan of fried foods? If you eat them too frequently, you may increase your death risk, researchers warn.

Many studies have shown that eating fried foods on a frequent basis can lead to unwanted health consequences.

Research has provided evidence that eating fried foods can affect cardiovascular health and heighten the risk of type 2 diabetes.

In a new study on women over the age of 50 years from the United States, investigators from the University of Iowa in Iowa City, IA have found that overindulging in fried foods can increase a person's risk of death from multiple causes.

The researchers also looked at which fried foods are likely to be the most dangerous for health. A study paper reporting the findings now appears in The BMJ.

The research team worked with data from 106,966 women between the ages of 50 and 79 years who joined the Women's Health Initiative (WHI) study between 1993 and 1998. The researchers had access to follow-up information through to February 2017.

Over the course of the study, 31,588 participants died. Of these deaths, 9,320 were due to heart problems, 8,358 were cancer-related, and 13,880 had associations with other causes.

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8 percent higher all-cause death risk

As part of the WHI study, the participants filled in questionnaires detailing their dietary habits. They reported on their specific intake of a variety of fried foods and their total consumption of these foods, which the researchers split into three categories:

fried chicken fried fish, fish sandwich, and fried shellfish, such as shrimp or oysters other fried foods, such as french fries, tortilla chips, or tacos

The research team's analysis confirmed that there was a correlation between eating fried foods on a regular basis and an increased risk of death from any cause. The association was also strong for death relating to heart problems.

After accounting for modifying factors, including lifestyle, diet quality, income, and education level, the investigators found that participants who reported eating at least one serving of fried food per day had an 8 percent higher risk of death than those who did not eat fried foods.

The researchers then looked at the effect of specific fried foods. They found that eating at least one serving of fried chicken per day led to a 13 percent heightened risk of death from all causes and a 12 percent higher risk of death relating to heart problems compared with eating no fried foods at all.

Eating at least one serving of fried fish or shellfish a day led to a 7 percent increase in the risk of death from any cause and a 13 percent higher risk of death from heart-related problems.

However, the research team did not identify a link between eating fried foods and the risk of cancer-related death.

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A modifiable risk factor

The investigators also note that the women who were most likely to consume fried foods on a regular basis were in the younger age range (50–65 years old). They also tended not to be white and to have lower education levels, a lower income, and an overall poorer quality diet. Many of them were also smokers.

Following their present findings, the study authors conclude that:

"Reducing the consumption of fried foods, especially fried chicken and fried fish/shellfish, may have clinically meaningful impact across the public health spectrum."

However, they warn that their results may not apply across different populations because their research was an observational study focusing specifically on women from the U.S.

Moreover, the researchers acknowledge that, even though they accounted for many potential modifying factors in their study, it remains possible that there may be "unidentified confounders" that they did not include in their analysis.

Still, they note that in this study, they "have identified a risk factor for cardiovascular mortality that is readily modifiable by lifestyle."

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What to know about a slow heart rate

A person's heart rate generally slows with age and while resting. However, athletes may also have slow heart rates. Anyone with concerns about their heart rate should talk to a doctor for help in determining whether bradycardia suggests a problem.

Heart rate changes with a person's activity level. During intense physical exertion, the heart has to pump faster and harder, so the rate goes up.

In most adults, a slow heart rate is below 60 beats per minute (bpm). However, athletes and people who are asleep may have a heart rate of below 60 bpm.

Symptoms Person having their pulse measured by nurse for bradycardia
Bradycardia can cause a heart rate of less than 60 bpm.

The primary symptom of bradycardia is a slow heart rate. Some people have no other symptoms.

Other people do experience symptoms. In these cases, a slow heart rate is more likely to be due to a serious issue.

Some common bradycardia symptoms include:

feelings of exhaustion and weakness fainting or dizziness confusion shortness of breath trouble breathing when working out

When a serious medical condition causes bradycardia, and a person does not seek treatment, more severe symptoms may appear.

Those include:

Thank you for supporting Medical News Today Measuring heart rate A person can find out their heart rate by taking their pulse. To accurately test for a slow heart rate, a person must measure their resting heart rate. To achieve this, they must avoid checking the pulse shortly after exercising or waking up. To check the pulse, a person should sit in a comfortable and relaxed position and feel for the pulse at the wrist. If unable to locate the pulse at the wrist, they should try feeling for the pulse on the side of their neck. To work out their heart rate, the person counts heartbeats for 10 seconds, then multiplies the number by six. For a more accurate pulse, the person can count the number of beats for a full minute. This figure is the resting pulse. If the number is lower than 60, a person has bradycardia. Children and young people have more rapid heart rates than adults. In young people, normal heart rates are as follows: Newborns: 100 to 180 bpm Infants: 80 to 150 bpm Children ages 2 – 6: 75 to 120 bpm Children ages 6 – 12: 70 to 110 bpm A slow heart rate in a child, especially a newborn, is a medical emergency. What are the causes? Woman athlete by the sea in outdoor swimmer wetsuit, going swimming.
People who engage in intense cardiovascular activity may have a slow heart rate, as their hearts are efficient. Some people have only moderate bradycardia. Others only experience occasional bradycardia. Although it is vital that anyone with a slow heart rate seeks medical guidance, not everyone will require treatment. When bradycardia causes no other symptoms, and when a person does not have an underlying condition, a slow heart rate may be a harmless or minor issue. The heart rate tends to decline with age, which means older people may experience episodes of bradycardia. While this is typical, it still warrants investigation by a doctor. Exercise strengthens the heart. Athletes, especially those who engage in intense cardiovascular activity, tend to have more efficient hearts. This may slow their pulse because their heart does not have to pump as hard or as fast to supply blood to the rest of their body. Some medical conditions may also cause a slow heart rate. These include the following: Problems with the heart's natural pacemaker The heart's natural pacemaker, or sinoatrial node, helps regulate heartbeat. Problems affecting this can cause a person's heart to beat unusually slow or fast, which doctors call tachycardia. A condition that doctors call sick sinus syndrome refers to problems with the natural pacemaker. Typically, another heart health problem, such as scar tissue in the heart, complications of diabetes, or coronary artery disease, causes these problems. Other heart electrical issues The heart communicates by sending electrical signals. For example, one chamber of the heart sends electrical signals to another, telling it how and when to squeeze blood into the next chamber. The pacemaker helps regulate this electrical system. If the heart is not able to send the correct electrical signals, due to a blockage or heart disease, it can cause bradycardia. Complete heart block is a type of electrical issue that makes it impossible for electrical signals to travel from the atria — the top two chambers of the heart — to the ventricles, which are the bottom two chambers. In complete heart block, the top two chambers may have totally different rhythms to the bottom two. Metabolic problems Some metabolic disorders can slow the heart rate. One of the most common is hypothyroidism, in which the thyroid does not produce enough thyroid hormones. Hypothyroidism can affect the health of the blood vessels, which may slow the heart rate. People with hypothyroidism may also have a high diastolic blood pressure — a diastolic measurement identifies the pressure in the arteries between heartbeats, and is the bottom number on a blood test reading. A person has a high diastolic blood pressure if the test shows a reading above 80. Thyroid disorders are common and may affect young and otherwise healthy people. Between 4 and 10 percent of people in the United States have hypothyroidism. Heart disease Damage to the heart from congestive heart failure, coronary artery disease, previous heart attacks, and other heart problems may affect the heart's electrical system, making the heart pump more slowly and less effectively. Heart medication Some medications, including medications for heart disease and high blood pressure, may lower heart rate. Beta-blockers, which doctors prescribe for a rapid heart rate and some other heart conditions, may also slow heart rate. People taking a new medication who experience symptoms of bradycardia should contact a doctor. Oxygen deprivation Doctors use the term hypoxia when the body cannot get enough oxygen, which may slow down the heart rate. Hypoxia is a medical emergency, and it can occur when a person is choking or having a severe asthma attack. Chronic medical conditions, such as chronic obstructive pulmonary disease, may also cause hypoxia. When hypoxia lowers the heart rate, it is essential to treat the underlying cause. Thank you for supporting Medical News Today When to see a doctor A person should speak to a doctor if they notice their heart rate is slow.
A person should speak to a doctor if they notice their heart rate is slow. When a baby has a low pulse, a parent or carer should take them to the emergency room. Adults and children who have a low pulse and experience severe symptoms, such as chest pain or fainting, should also go to the hospital. A person should see a doctor for bradycardia when: they experience an unexplained change in heart rate that lasts for several days they have bradycardia and other heart health risk factors, such as diabetes or smoking they have heart disease and bradycardia they experience bradycardia and other symptoms, such as fainting spells they experience episodes of bradycardia and tachycardia Treatment options A doctor may not always need to treat a slow heart rate. However, when a slow heart rate causes serious health problems or when heart disease slows the heart, it is essential that people receive treatment. An artificial pacemaker, which is an electrical device that a doctor inserts into the heart to promote regular rhythms, can help. Depending upon the cause, a doctor might also recommend: changing heart medications taking medication to treat thyroid or other metabolic disorders making lifestyle changes, such as eating a low-fat diet, doing more exercise, or quitting smoking monitoring heart rate or blood pressure frequently Thank you for supporting Medical News Today Takeaway Heart disease is the leading cause of death in the U.S., accounting for 1 out of every 4 deaths. It is crucial that a person takes any changes in heart health, blood pressure, or pulse seriously. However, a slow heart rate is not always a reason for concern. In many cases, a slow heart rate is merely a variation of normal. It may even be a sign of heart health and indicate good levels of fitness. Only a doctor can evaluate an individual's cardiovascular risk factors. People should see a doctor for guidance and reassurance.
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What are macadamia nuts good for?

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Basic report: 12132, Nuts, macadamia nuts, dry roasted, without salt added. (2018, April). Retrieved from

Del Gobbo, L. C., Falk, M. C., Feldman, R., Lewis, K., & Mozaffarian, D. (2015, December 1). Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: Systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. The American Journal of Clinical Nutrition, 102(6), 1347–1356. Retrieved from

Duckett, S. K., Volpi-Lagreca, G., Alende, M., & Long, N. M. (2014, November 20). Palmitoleic acid reduces intramuscular lipid and restores insulin sensitivity in obese sheep. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 7, 553–563. Retrieved from

Garg, M. L., Blake, R. J., Wills, R. B. H., & Clayton, E. H. (2007, June). Macadamia nut consumption modulates favourably risk factors for coronary artery disease in hypercholesterolemic subjects. Lipids, 42(6), 583–587. Retrieved from

Guzmán, D. C., Brizuela, N. O., Herrera, M. O., Olguín, H. J., García, E. H., Peraza, A. V., & Mejía, G. B. (2016). Oleic acid protects against oxidative stress exacerbated by cytarabine and doxorubicin in rat brain [Abstract]. Anti-Cancer Agents in Medicinal Chemistry, 16(11), 1491–1495. Retrieved from

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Selvaraju, T. R., Khaza'ai, H., Vidyadaran, S., Mutalib, M. S. A., & Vasudevan, R. (2014, November). The neuroprotective effects of tocotrienol rich fraction and alpha tocopherol against glutamate injury in astrocytes. Bosnian Journal of Basic Medical Sciences, 14(4), 195–204. Retrieved from

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Viguiliouk, E., Kendall, C. W. C., Mejia, S. B., Cozma, A. I., Ha, V., Mirrahimi, A., ... Sievenpiper, J. L. (2014, July 30). Effect of tree nuts on glycemic control in diabetes: A systematic review and meta-analysis of randomized controlled dietary trials. PloS One, 9(7). Retrieved from

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Stair-climbing exercise 'snacks' boost health

Time is no longer an excuse for not exercising, as new research finds that even a few minutes of stair climbing at intervals every day is enough to improve cardiovascular and overall health.
woman exercising on stairs
New research finds that even brief bouts of stair climbing can bring unexpected health benefits.

Several recent studies have pointed out the many health benefits of short bursts of exercise.

For instance, a review of existing studies, which Medical News Today reported on, shows that an acute period of exercise can immediately protect the heart against future ischemic episodes.

Results of another recent study indicate that 10 minutes of physical activity is enough to give the brain a boost, improving attention, working memory, and cognitive flexibility, among other mental skills.

Now, research suggests that even intervals of stair climbing that last a few minutes, with recovery periods between, can improve cardiorespiratory health.

Martin Gibala, Ph.D., a professor of kinesiology at McMaster University in Hamilton, Canada, is the senior author of the new study, which appears in the journal Applied Physiology, Nutrition, and Metabolism.

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Prof. Gibala and the team set out to investigate whether sprint interval training — that is, short bouts of intense exercise separated by a few minutes of recovery, amounting to about 10 minutes in total — can improve cardiorespiratory fitness.

Cardiorespiratory fitness refers to "the ability of the heart, lungs, and vascular system to deliver oxygen-rich blood to working muscles" during intense physical exercise.

Research has suggested that greater respiratory fitness brings several health benefits, including better cardiovascular health, improved insulin resistance, and a lower risk of premature death.

For the current study, a group of 12 sedentary young participants climbed three flights of stairs three times a day, with 1–4 hours of recovery between sessions.

The participants engaged in this regimen three times a week for 6 weeks, while a control group of 12 age-matched, sedentary individuals did not exercise.

At the end of the intervention period, cardiorespiratory fitness "was higher in the climbers [...] suggesting that stair-climbing 'snacks' are effective in improving cardiorespiratory fitness," report the authors.

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The climbers were also stronger at the end of the intervention, and they performed better in a maximal cycling test, compared to the controls.

"We know that sprint interval training works, but we were a bit surprised to see that the stair snacking approach was also effective," says study co-author Jonathan Little, Ph.D., an assistant professor of kinesiology at the University of British Columbia in Okanagan, Canada.

"Vigorously climbing a few flights of stairs on your coffee or bathroom break during the day seems to be enough to boost fitness in people who are otherwise sedentary," Little explains.

"The findings make it even easier for people to incorporate 'exercise snacks' into their day," Prof. Gibala adds.

"Those who work in office towers or live in apartment buildings can vigorously climb a few flights of stairs in the morning, at lunch, and in the evening and know they are getting an effective workout."

Prof. Martin Gibala, Ph.D.

In the future, the team plans to test the effects of various exercise "snacking" regimens, varying the duration of the recovery intervals. They also wish to study the effects of these bouts of exercise on blood pressure and blood sugar.

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What is a stent? Everything you need to know

A stent is a tiny tube that a doctor places in an artery or duct to help keep it open and restore the flow of bodily fluids in the area.

Stents help relieve blockages and treat narrow or weakened arteries. Doctors may also insert stents in other areas of the body to support blood vessels in the brain or ducts that carry urine and bile.

A stent is usually a mesh-like metal tube, although fabric stents are also available. Sometimes, doctors will use dissolvable stents coated in medication as a temporary solution.

In this article, learn about why doctors use stents, as well as the benefits and possible risks.

Uses Doctor holding up heart stent
A stent can open up blood vessels with plaque blockages.

One of the most common uses for a stent is to open up a blood vessel that has a plaque blockage.

Plaque is a buildup of cholesterol, fat, and other substances found in the blood. When this plaque collects in the bloodstream, it sticks to the walls of the arteries.

Over time, this buildup narrows the arteries, limiting the amount of fresh blood that can reach the body.

A buildup of plaque in the arteries is a cause of coronary heart disease. Over time, people with narrowed arteries may begin to notice warning symptoms, such as chest pain. If people with the condition do not receive treatment, they may be at a higher risk of complications, such as a heart attack or stroke.

If the artery is at risk of collapsing or becoming blocked again, doctors may recommend inserting a stent to keep it open.

Doctors put a stent into an artery in a procedure known as a percutaneous coronary intervention (PCI), or angioplasty with stent.

During PCI, doctors will insert a catheter into the artery. The catheter has a small balloon with a stent around it on one end.

When the catheter reaches the point of the blockage, the doctor will inflate the balloon. When the balloon inflates, the stent expands and locks into place. The doctor will then remove the catheter, leaving the stent in place to hold the artery open.

A doctor will decide whether or not to insert a stent based on a few factors, such as the size of the artery and where the blockage occurs.

Doctors may also use stents for:

blood vessels in the brain or aorta that are at risk of an aneurysm bronchi in the lungs that are at risk of collapse ureters, which carry urine from the kidneys into the bladder bile ducts, which carry bile between the organs and small intestine Thank you for supporting Medical News Today Risks Surgeon looking at screen in operating theatre
A surgeon can explain the risks and benefits of PCI. PCI carries a small risk of complications, which include: bleeding from the catheter insertion site an infection an allergic reaction damage to the artery from inserting the catheter damage to the kidneys irregular heartbeat In some cases, restenosis may occur. Restenosis is when too much tissue grows around the stent. This could narrow or block the artery again. Doctors may recommend forms of radiation therapy or opt to insert a medication-coated stent to slow the growth of the tissue. People at risk of complications include: A stent can cause blood clotting, which may increase the risk of heart attack or stroke. The National Heart, Lung, and Blood Institute state that about 1 to 2 percent of people who have stented arteries develop a blood clot at the site of the stent. Doctors will usually prescribe one or more drugs to prevent clotting. Anti-clotting medications may carry their own risks and can cause irritating side effects, such as rashes. In rare cases, a person's body may reject the stent, or they may have an allergic reaction to the material in the stent. Anyone who has a known reaction to metals should talk to their doctor about alternatives. What to expect The surgeon will discuss the procedure with a person in advance, but it can help to know what to expect. Before the surgery A doctor will advise individuals on how they should prepare for a stent procedure. They will give them information on when to stop eating and drinking, as well as when to start or stop taking medications before the procedure. Anyone who has any other health conditions, such as diabetes or kidney disease, must tell their doctor. The doctor may then have to consider some additional steps. Doctors may also give the person prescriptions to fill before having the stent inserted, as they will need to start taking the medications as soon as the procedure is complete. During the surgery According to the National Heart, Lung, and Blood Institute, a stent procedure only takes about an hour and does not require general anesthesia. The person remains awake during the entire process so can hear any instructions the doctors may have. Doctors will administer medication to help the person relax. They will also numb the area where they insert the catheter. Most people do not feel the catheter threading through the artery. They may, however, feel a bit of pain as the balloon expands and pushes the stent into place. After placing the stent, doctors deflate the balloon and remove the catheter. They bandage the area where the catheter entered the skin and put pressure on the bandage to help prevent bleeding. After the surgery Most people will need to stay in the hospital for at least one night after having the procedure. This allows hospital staff to monitor the person. During the hospital stay, a nurse will regularly check the person's heart rate and blood pressure. They may also change the dressings or clean the wound. The person may leave the hospital the following day if there are no complications. As the insertion site heals, it will bruise and may develop into a small knot of tissue, which is normal. The area may remain tender for at least a week. Thank you for supporting Medical News Today Recovery Patient in hospital bed.
A person may have to rest for about a week after surgery. A successful stent surgery should reduce symptoms, such as chest pain and shortness of breath. Many people may be able to return to work and most normal activities within a week of a successful stent surgery. During recovery, doctors will prescribe antiplatelet drugs to help prevent blood clots from forming near the stent. Aspirin is an antiplatelet drug that a person will need to take daily for an indefinite period after having a stent inserted. Doctors may also recommend a drug called a P2Y inhibitor. P2Y inhibitors include clopidogrel, ticagrelor, and prasugrel. They will also provide the person with special recovery instructions, such as avoiding strenuous work or exercise while the body heals. Long-term use Most stents remain in the artery permanently to keep it open and prevent collapse and potentially life-threatening complications. Some stents are temporary. Doctors may use stents coated in particular medications that help break down plaque or prevent it from building up in the area. These stents will dissolve over time. While a stent may relieve symptoms, such as chest pain, it is not a cure for other underlying issues, such as atherosclerosis and coronary heart disease. Even with a stent, a person with these conditions may need to take steps to prevent further complications. Doctors will recommend healthy lifestyle changes after inserting a stent to help prevent plaque building up in the body. These recommendations often include: eating a healthful diet exercising regularly maintaining a healthy weight quitting smoking and tobacco use reducing stress Stents are often just one part of treatment. Doctors may also prescribe medications for any underlying conditions. If anyone experiences any bothersome side effects, it is best to talk to a doctor. They may recommend alternative medications or change the dose to help relieve side effects. Do not stop taking any medications without consulting a doctor first, however. Thank you for supporting Medical News Today Outlook Doctors commonly insert stents to widen arteries and prevent complications from coronary heart disease and other conditions. While a stent may provide relief, it is only one part of a treatment program. Even with a stent, it is possible for severe complications to occur. Always follow a doctor's advice about medications and recovery.
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Exercise can halve heart attack risk in healthy people

New research, appearing in the European Heart Journal, suggests that lack of physical activity can drastically increase the risk of a heart attack in the long-term, even if there are no symptoms at present.
woman stretching before running
Exercise that raises the heart rate, such as running, may cut heart attack risk by half, suggests a new study.

Cardiorespiratory fitness describes the body's ability to deliver oxygen to the muscles when we are engaged in physical activity. Specifically, the term refers to "the efficiency of the heart, lungs and vascular system."

A significant body of research has linked cardiorespiratory fitness with a variety of positive health outcomes, ranging from preventing cardiovascular disease and all-cause mortality to staving off diabetes and improving insulin resistance.

However, most of these previous studies have relied on the participants' self-reported levels of fitness.

New research uses more precise methods of measuring cardiorespiratory fitness and highlights another one of its benefits.

Higher fitness levels can halve the risk of heart attack, the new study finds. Conversely, suggest the researchers, poor fitness levels can raise future risk even in the absence of warning symptoms in the present.

Bjarne Nes, from the Norwegian University of Science and Technology's Cardiac Exercise Research Group in Trondheim, is the corresponding and last author of the study.

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Studying fitness levels and heart attack risk

Nes and his colleagues analyzed the cardiorespiratory fitness of more than 4,500 people who took part in an extensive health survey called HUNT3.

None of the participants had a history of cardiovascular disease, lung disease, cancer, or high blood pressure at the start of the study.

Just over 50 percent of the participants were women, and more than 80 percent of all of them were at "low risk" of developing cardiovascular disease over a 10-year period.

The scientists used a "gold-standard method" — or maximum oxygen uptake — to directly measure the participants' fitness levels.

Maximum oxygen uptake refers to the maximum amount of oxygen the body can absorb during exercise. According to Nes, it is "the most precise measure of fitness."

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High fitness halves the risk of heart attack

By the end of the study, 147 of the participants had heart attacks or had developed angina pectoris — two conditions caused by blocked or narrowed coronary arteries.

The analysis by the researchers revealed a correlation between declining cardiovascular risk and increased fitness levels.

"Even among people who seem to be healthy, the top 25 percent of the most fit individuals actually have only half as high a risk as the least fit 25 percent," reports Nes.

Furthermore, even a small improvement in cardiorespiratory fitness saw significant benefits for heart health. Namely, each fitness increase of 3.5 points correlated with a 15 percent lower risk of heart attack or angina.

"We found a strong link between higher fitness levels and a lower risk of heart attack and angina pectoris over the 9 years following the measurements that were taken," says Nes.

"We know that patients with low oxygen uptake are at increased risk of premature death and cardiovascular disease," he continues.

"Our study shows that poorer fitness is an independent risk factor for coronary artery disease, even among healthy women and men who are relatively fit."

Bjarne Nes

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'Use training as preventive medicine'

Dr. Jon Magne Letnes, the study's first author, also further comments on the findings. "Our results should encourage people to use training as preventive medicine," Dr. Letnes says.

"A few months of regular exercise that gets you out of breath can be an effective strategy for reducing the risk of cardiovascular disease."

Dr. Letnes explains that cardiorespiratory fitness offers insights into so much more than just endurance to exercise.

"Fitness isn't just a measure of how much you've trained in your life, but it also tells you what kind of genes you have," he says.

"Other factors like obesity may also affect fitness. So we measure a lot of the body's functions, and from other studies, we know that both genes and physical activity play a role in how your heart and blood vessels function," Dr. Letnes explains.

The study's first author thinks doctors should consider fitness measurements when evaluating heart disease risk.

"Although it may be inconvenient and difficult to measure oxygen uptake at the doctor's office, some simple and relatively accurate calculators exist that can provide a good estimate of fitness and disease risk," he advises.

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What are the benefits of golden milk?

Golden milk is a traditional Indian drink that people make with turmeric, which gives it a yellow or gold hue. People also call golden milk "turmeric milk."

To make golden milk, a person must warm up nondairy milk with turmeric, cinnamon, ginger, and other spices.

Many of these spices contain antioxidants or have anti-inflammatory properties. In this article, learn about the benefits of golden milk and how to make it.

Benefits The potential benefits of golden milk include: 1. Reducing inflammation Golden milk turmeric tea in glass on wooden table
People make golden milk with various spices, such as turmeric and cinnamon.

Golden milk's ingredients, which are ginger, cinnamon, and turmeric, contain anti-inflammatory properties. Reducing inflammation can help prevent or manage conditions including:

A person may reduce inflammation by adding golden milk to their regular diet. For example, a small study of 45 participants showed that consuming 500 milligrams (mg) of curcumin was as effective as taking 50 mg of a common arthritis medication at reducing inflammation. Curcumin is the active component in turmeric.

2. Preventing cell damage

Curcumin also has antioxidant properties. Some studies have shown that antioxidants can help a person's body repair cell damage and help reduce the risk of many illnesses.

For example, one 2015 study found that antioxidants in foods and spices have a positive effect on reducing cell damage.

3. Improving mood

There is evidence to suggest that curcumin can help improve mood in people who consume it regularly.

A small study consisting of 60 participants found that taking curcumin supplements could help reduce symptoms in people with major depressive disorder. Those taking both curcumin and antidepressant drugs saw the most significant improvement.

However, more research is necessary to determine its efficacy and the right doses, as the authors of the study also said that the results were not statistically significant.

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4. Supporting brain function and improving memory

Some older studies have suggested that turmeric may help improve brain function, but more recent research is necessary to fully prove its effectiveness.

Ginger and cinnamon, the ingredients in golden milk, have shown some promise in animal studies.

For example, one study looked at cinnamon's effect on preserving specific proteins related to Parkinson's disease. These proteins are protective against its symptoms, such as memory loss and tremors.

The study showed promising results, but studies in human are necessary to fully show how effective cinnamon is for improving brain function.

5. Preventing heart disease

Woman drinking hot drink from mug in cafe.
Benefits of golden milk include improving mood and lowering the risk of heart disease.

The three major ingredients in golden milk have all shown some promise in helping reduce the risk of heart disease.

However, the studies tend to be small and limited. Also, the amount of each ingredient present in golden milk may not be enough to fully show the benefits found in research.

One small study showed that those taking curcuminoids had a lower incident rate of myocardial infarction events, such as heart attack, after coronary artery bypass surgery.

The rate fell from 30 percent in the placebo group to about 13 percent in the curcuminoid group. More research is still needed to prove these findings, however.

6. Possibly reducing the risk of cancer

Older studies on ginger, cinnamon, and curcumin show that they may have some effects on reducing the risk of cancer.

While many alternative health sites repeat these claims, most studies are:

limited older done in test tubes not definitive

It is unlikely that the small amounts of these spices in golden milk would have an impact on cancer risk. However, more research is necessary to find definitive results.

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7. Lowering blood sugar levels

Similarly to possibly reducing the risk of cancer, more research is necessary to show that the ingredients in golden milk can help lower blood sugar.

Some research has found that consuming ginger may help reduce fasting blood sugar in people with type 2 diabetes.

A 2017 double-blind placebo-controlled trial supported these results. The scientists divided 50 participants with type 2 diabetes into two groups. For 10 weeks, one group took 2,000 mg of ginger per day, while the other group took a placebo.

At the end of the trial, the researchers found that the ginger had significantly reduced the participants' fasting blood sugar levels.

8. Boosting the immune system

People tend to use golden milk to help fight common illnesses, such as the cold.

One review of studies found that curcumin contains antibacterial, antiviral, and antifungal properties that can help a person better fight infections.

Ginger and cinnamon are also common home remedies for colds and flus.

9. Improving bone health

Many enriched plant-based milks contain vitamin D and calcium, which are very beneficial to bone health.

Calcium is a necessary nutrient for maintaining bone health. Vitamin D helps the body absorb calcium from foods.

People tend to make golden milk using nondairy milks such as coconut milk. For this reason, people should be sure to find enriched versions that contain additional nutrients to gain this benefit.

10. Aiding digestion

The ginger present in golden milk may help aid digestion. Ginger is a common home remedy for nausea and vomiting.

Research supports this. For example, one study in people with chemotherapy-induced nausea found ginger to be an effective and low-risk way to reduce symptoms.

Thank you for supporting Medical News Today How to make it Golden tea is traditionally dairy-free, with almond milk being a popular ingredient.
Golden milk is traditionally dairy-free, with almond milk being a popular ingredient. Golden milk is available online, in health stores, and in some grocery stores. However, a person can easily make golden milk at home. To make golden milk, a person will need: ½ cup nondairy milk, such as coconut or almond milk 1 tsp turmeric 1 tbsp grated fresh ginger or 1/2 tsp ginger powder 1/2 tsp ground cinnamon 1 pinch ground black pepper (optional) 1 tsp honey Combine all the ingredients in a pot. Next, bring the mixture to the boil, then reduce to a simmer. Let the mixture simmer for about 10 minutes or until it is fragrant. To serve, strain the mixture through a fine strainer to remove the spices. Golden milk will keep in the refrigerator for around 5 days. Summary Golden milk may have several health benefits and has few risks unless a person is allergic to one of its ingredients. For those interested in trying it, they can make their own recipe at home or buy a premade mixture. It is worth noting that although golden milk may have health benefits, it is not a replacement for medical treatments. 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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What are the benefits of oatmeal?

Oatmeal is a very popular breakfast food that consists of oats and a liquid, such as water, cow's milk, or plant-based milk. Full of nutrients and fiber, oats are one of the most nutritious whole-grain foods that a person can consume.

Oats offer many science-backed health benefits, including:

In this article, we list the potential benefits of oatmeal and provide its nutritional information. The benefits include:

1. Providing antioxidants benefits of oatmeal
Oatmeal contains high levels of antioxidants, which can improve blood flow in the body.

Oatmeal contains high levels of antioxidants.

Specifically, it contains polyphenols, which are plant-based compounds that are rich in avenanthramides.

Avenanthramides are a type of antioxidant that exists almost exclusively in oats.

Avenanthramides can benefit people by:

2. Improving insulin response and reducing blood sugar Oatmeal contains a soluble fiber called beta-glucan that can help improve insulin response and possibly reduce blood sugar too. People with type 2 diabetes may find that incorporating oatmeal into their diet helps them manage their blood sugar levels, as long as they do not add extra sugar to the dish. A review of research on the benefits of oatmeal for people with type 2 diabetes found that oatmeal has a positive effect on blood sugar control. The authors stated that more research is necessary to test the safety of oatmeal for people with type 1 diabetes. 3. Providing plenty of vitamins and minerals Oatmeal is a nutrient-rich food that contains many vitamins and minerals while being low in calories. Eating low-calorie foods that are high in nutrients can provide a person with the nutrients that their body needs while helping them lose weight or maintain a healthy weight. Oatmeal contains: Thank you for supporting Medical News Today 4. Improving cholesterol levels benefits of oatmeal cholesterol
Eating oatmeal can reduce total cholesterol levels. There is some evidence to back up the claim that oatmeal can support healthy cholesterol levels due to its beta-glucan content. A 2014 review determined that oatmeal can reduce total cholesterol levels if people consume 3 grams (g) or more of beta-glucan a day. According to the research, beta glucan decreased low-density lipoprotein cholesterol, or "bad cholesterol," but did not affect high-density lipoprotein cholesterol, or "good cholesterol." 5. Promoting healthful bacteria in the digestive tract The beta-glucan in oatmeal forms a gel-like substance when it mixes with water. This solution coats the stomach and digestive tract. The coating feeds good bacteria in the gut, which increases their growth rate and can contribute to a healthy gut. A small study examining oatmeal's effect on bacterial growth found that it could have a positive effect. 6. Managing weight Oatmeal is rich in soluble fiber, so people tend to feel full more quickly after eating it than they do after consuming other foods. Feeling full can help a person reduce their portion size and achieve their weight loss goals. Researchers looking at the effect of oatmeal on appetite concluded that it increased fullness and decreased the desire to eat for the next 4 hours. 7. Reducing the risk of asthma Asthma is a common condition that often develops during childhood. There is some evidence to suggest that specific foods can be a risk factor for developing asthma, while others may reduce the risk. For example, a study of 3,781 children determined that those who ate oats as one of their first foods were less likely to develop asthma by the age of 5 years. Other foods that may reduce the risk include: wheat rye barley cereals fish eggs Thank you for supporting Medical News Today 8. Relieving constipation Constipation is a common gastrointestinal problem that affects almost everyone at some point. The fiber in oatmeal can help keep waste in the gastrointestinal tract moving, which can relieve or prevent constipation. Nutrition benefits of cup of oatmeal
One cup of cooked oatmeal contains 5.94 g of protein. Oatmeal includes several key nutrients. According to the United States Department of Agriculture, one cup of cooked oatmeal contains: 166 calories 5.94 g of protein 4.00 g of dietary fiber 3.56 g of fat How to make oatmeal Oatmeal is available in several different varieties, including: oat groat steel-cut crushed rolled Oat groat takes the longest to cook, as it comprises whole oats. Steel-cut, crushed, and rolled oats take less time to prepare. Unless the packaging says otherwise, people can make oatmeal by boiling the oats in cow's milk, plant-based milk, or water. Cooking times will vary and can range from 10 to 60 minutes. To cook oatmeal, a person should follow the instructions on the packaging. The steps will usually involve: bringing 1.5 cups of milk or water to the boil stirring in one-half of a cup of oats reducing the heat to medium simmering for 10 to 20 minutes for steel-cut, crushed, or rolled oats simmering for 50 to 60 minutes for oat groat stirring in additional optional ingredients, such as spices or sweeteners Although instant varieties of oatmeal usually cook very quickly, they are also the most processed. Instant oatmeal often contains added sugar and preservatives. Summary Oatmeal is one of the most nutritious breakfast foods. It may help a person lose weight, reduce their risk of heart disease, and lower their blood sugar levels. It is best to choose varieties of oatmeal that are less processed and to limit added sugars.
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Metoprolol tartrate vs. metoprolol succinate

Metoprolol tartrate and metoprolol succinate are different salt forms of the same active ingredient, metoprolol. Although these medications are similar, they have slightly different uses and effects.

Metoprolol belongs to a class of drugs called beta-blockers. These drugs work by slowing down a person's heart rate and lowering their blood pressure.

Doctors often prescribe beta-blockers for people with cardiovascular conditions or those who have had a heart attack. Both metoprolol tartrate and metoprolol succinate are prescription-only drugs.

In this article, we explore the differences and similarities between these two drugs.

Uses Woman taking a pill
Metoprolol tartrate and metoprolol succinate can both treat high blood pressure and angina.

Doctors prescribe metoprolol tartrate to treat people with the following health conditions:

They use metoprolol succinate to treat the following health conditions:

Both drugs are effective in treating people with high blood pressure and angina. However, doctors prescribe only metoprolol tartrate to prevent further heart attacks in people who have already experienced a heart attack. For heart failure, they prescribe only metoprolol succinate.

Forms and dosage The appropriate dosage of both metoprolol tartrate and metoprolol succinate depends on a person's condition and how well that condition responds to the medication. Metoprolol tartrate Metoprolol tartrate is available either as an immediate-release tablet, as an intravenous injection, or in liquid form. People using the immediate-release tablet may need to take it several times a day, and doctors advise that they do so either with or directly after a meal. The recommended dosage of metoprolol tartrate ranges between 100–450 milligrams (mg) daily. One full dose of the intravenous injection provides 15 mg of the drug. If an individual tolerates this dose, the doctor may recommend that they switch to using metoprolol tartrate tablets instead. Metoprolol succinate Metoprolol succinate is available as an extended-release tablet, which means that people only have to take one tablet a day. The initial dosage of metoprolol succinate ranges from 25–100 mg per day. If the person experiences no problems on the initial dosage, a doctor may increase the dosage to a maximum of 200 mg per day. Thank you for supporting Medical News Today Who might benefit from these medications? A person may benefit from taking metoprolol tartrate if they have: experienced a heart attack high blood pressure angina Metoprolol succinate may benefit people who have: high blood pressure angina class II or III heart failure Side effects Woman with a headache and fatigue at her desk
Side effects of metoprolol tartrate can include fatigue and dizziness. Although beta-blockers are generally safe and effective drugs, they may cause unwanted side effects in some people. However, the side effects of metoprolol tartrate and metoprolol succinate are usually mild and temporary. Side effects of metoprolol tartrate can include: Side effects of metoprolol succinate can include: very low blood pressure dizziness difficulty sleeping fatigue difficulty breathing depression sexual dysfunction rash constipation nausea vomiting dry mouth rash Risks While metoprolol tartrate and metoprolol succinate are both generally very safe, people may experience problems if they abruptly stop taking them. Suddenly stopping beta-blockers can lead to worsening chest pain, increased blood pressure, and heart attack. If someone wishes to end their treatment, they should speak to a healthcare professional first. A doctor will usually advise people to lower the dosage gradually over 2 weeks. People who have diabetes may need to take care when taking any form of metoprolol medication because it can conceal symptoms that indicate low blood sugar, such as a rapid heartbeat. However, research has shown that beta-blockers can help control high blood pressure in people with diabetes. Beta-blockers can also affect how the heart responds to general anesthesia. A doctor may recommend temporarily withdrawing from beta-blocker treatment before undergoing major surgery. People should always consult their doctor before stopping or starting any new medications or supplements. Thank you for supporting Medical News Today Drug interactions Metoprolol tartrate and metoprolol succinate contain the same active ingredient, so these medications have similar drug interactions. People should inform a healthcare professional if they are taking any other prescription or over-the-counter drugs or supplements. Metoprolol tartrate and succinate can interact with a range of medications, including: Blood pressure drugs: amlodipine (Norvasc) hydralazine (Apresoline) ephedrine guanethidine betanidine clonidine Heart condition medications: digoxin (Lanoxin) furosemide (Lasix) quinidine gluconate Antipsychotics: haloperidol (Haldol) chlorpromazine (Thorazine, Largactil) fluphenazine (Prolixin) Antidepressants: phenelzine (Nardil) selegiline (Eldepryl) escitalopram (Lexapro) fluoxetine (Prozac) paroxetine (Paxil) Other medications: atorvastatin calcium (Lipitor) aspirin abiraterone acetate (Zytiga) acetaminophen (Tylenol) ergot alkaloid fingolimod (Gilenya) guaifenesin (Theocon Elixir, Brondelate) insulin glargine (Lantus) sildenafil (Viagra) Summary Metoprolol tartrate and metoprolol succinate belong to a class of drugs known as beta-blockers. Both drugs are different salts of the same active ingredient, metoprolol. However, despite being similar, they do have different uses. Both drugs are effective in treating people with high blood pressure and angina. However, doctors prescribe metoprolol tartrate for people who have had a heart attack and metoprolol succinate to treat individuals with type II and III heart failure. The two medications share similar drug interactions, so it is essential that people make their doctor aware of any medications or supplements that they are currently taking. Both forms of medication also share similar warnings. People should not stop taking these medications abruptly as this can lead to worsening symptoms and even heart attacks in some people. People with diabetes should take care when using beta-blockers because these medications can mask some symptoms of low blood sugar.
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Personal income may increase risk of heart disease

Income levels, if they are unstable, can easily turn into a stressor. However, the volatility of personal income could be having a more serious effect on people's heart health.
Money heart
Does how much money we earn affect cardiovascular health?

It is often expected that a person's income will constantly rise until they reach retirement age.

However, this isn't always the case. In fact, incomes have become so unpredictable that their volatility has reached an all-time high since 1980.

When a person's income fluctuates, it can alter many other factors in their life.

It can affect everything from mental health to diet, which could result in potentially serious health problems.

A new study suggests that personal income may even be associated with an increased risk of heart disease and death.

What is most surprising is that this link is present in relatively young people. We know this because an ongoing study has been tracking the health of young people living in four cities around the United States for nearly 3 decades.

The Coronary Artery Risk Development in Young Adults (CARDIA) study started in 1990. The four cities are Minneapolis, MN, Chicago, IL, Oakland, CA, and Birmingham, AL. Each participant was aged 23–35 years when the researchers first examined them.

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The risk of low income

The researchers behind the new study analyzed data from the CARDIA study to see whether there was a link between income fluctuations and risk of cardiovascular events as well as death. They first studied income levels taken from five assessments in 1990–2005.

They defined income volatility as a percentage change from one income figure to the next. They also looked at income drop, or an income decrease of 25 percent or more from the previous assessment figure.

They then tracked the number of people who experienced cardiovascular events — both fatal and non-fatal — or died of any cause in 2005–2015.

There were 106 cardiovascular events and 164 deaths. The team took into account factors such as pre-existing heart risk and sociodemographic background.

The results, now published in the journal Circulation, found that substantial fluctuations in personal income were associated with a higher risk of death and cardiovascular diseases in the decade following this income change.

The highest levels of income volatility were linked with almost double the risk of death and over double the risk of conditions such as strokes, heart failure, or heart attacks.

These findings were all compared with those of people who fell into a similar category but who had less of an alteration in their personal income.

Some people were more likely to experience high income volatility. Such people included women, African-American people, those who are unemployed, people who are not married, people who smoke, those with less than a high school education, and people with signs of depression.

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Why money matters

Lead study author Tali Elfassy, Ph.D., at the University of Miami Miller School of Medicine in Florida, says that income volatility "presents a growing public health threat, especially when federal programs, which are meant to absorb unpredictable income changes, are undergoing continuous changes, and mostly cuts."

"While this study is observational in nature and certainly not an evaluation of such programs, our results do highlight that large negative changes in income may be detrimental to heart health and may contribute to premature death."

Tali Elfassy, Ph.D.

It is not clear what exactly prompts income volatility to result in an elevated risk of cardiovascular problems, death, or both. It could be that fluctuations in a person's income result in unhealthful behaviors, such as excessive alcohol consumption, a lack of exercise, stress, and high blood pressure.

All of these things are linked to lifespan and cardiovascular health.

The researchers hope that other scientists will carry out further research to understand the cause of this newly found association. They list biologic and psychosocial pathways as being two potential reasons to explore.

They also see these findings as a way to more effectively screen people, especially those who are younger, for cardiovascular disease risk.

However, these results cannot currently be applied to all identities. Other ethnic groups and people living outside of cities will also need to be studied to see whether the same association is present.

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20 ways to lose weight safely

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Heart failure: Flu vaccine could save lives

People with heart failure are more susceptible to flu complications than other people. However, a new study has revealed that flu vaccinations may have a significant impact on lifespan.
Vaccine flu older adult
The importance of the flu vaccine receives a further boost in a new study.

Most doctors, scientists, and other medical professionals consider flu vaccinations to be a safe and effective way of protecting people against influenza, or the flu.

The vaccine, usually given in the form of an injection, contains small amounts of deactivated flu viruses.

These viruses are not harmful in this state but do trigger the human body to produce antibodies to fight against them. This means that the next time the virus enters the body, it can produce the same response quickly.

The Centers for Disease Control and Prevention (CDC) advise that everyone over the age of 6 months has a flu vaccination. However, certain individuals are more at risk of experiencing flu-related complications or even death.

This includes people over 65 years old and over, those who are pregnant, and those who have medical conditions, such as heart disease.

A new study has examined just how much of an impact a flu shot can have on the survival rate of people diagnosed with heart failure. This group of individuals are often older and are also likely to have a range of other health issues. For these people, getting the flu can be a severe problem.

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The analysis

A team of researchers from the University of Copenhagen in Denmark analyzed data from a total of 134,048 Danish people who had recently received a diagnosis of heart failure. The researchers gathered the data from several national registries that store information on hospital diagnoses, prescriptions, and causes of death.

Each person born in Denmark receives a unique personal identification number, and this number allowed researchers to follow particular people for 12 years, from 2003 to 2015.

Many findings from the study came to light. The data analysis, now published in the American Heart Association's journal Circulation, firstly showed that the number of people getting flu vaccinations had increased.

In 2003, 16 percent of people with heart failure had the flu vaccine. In 2015, this had risen to 52 percent of people.

The researchers also found a link between flu vaccinations and "an 18 percent reduced risk of premature death." This reduction existed even after taking other factors, such as medications, other health issues, and financial situations, into account.

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The importance of vaccines

The research also identified the importance of having regular flu shots. For example, having an annual flu vaccination after a diagnosis of heart failure showed a 19 percent reduction in cardiovascular death and all-cause death compared to those who did not get vaccinated.

Having the flu shot less than once a year resulted in an 8 percent reduction in the risk of cardiovascular death and "a 13 percent reduced risk of all-cause death" when compared to people who had never had the vaccination.

The final factor that the researchers identified was the timing of the flu vaccination. The team found a reduction in the number of cardiovascular and all-cause deaths when people received the vaccine at the beginning of the flu season, which is usually around September or October, rather than in November and December, for example.

Heart failure's future

Scientists expect heart failure to become an increasing problem in future years, making these results potentially useful for a human population that is now living longer. One limitation of this research, however, is that the scientists only studied people newly diagnosed with heart failure. Lead author of the study Daniel Modin says:

"While this research only looked at patients with newly diagnosed heart failure, the protection from a flu shot likely benefits any patient with heart failure."

Daniel Modin

He continues, "I hope that our study can assist in making physicians and cardiologists who care for patients with heart failure aware of how important influenza vaccination is for their patients. Influenza vaccination may be regarded as a standard treatment in heart failure similar to medications."

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How does yo-yo dieting affect our heart health?

Sticking to a strict diet can be challenging, so our eating patterns can fluctuate wildly. A new study looks at how these changes might impact cardiovascular health.
Avocado heart
How does eating well intermittently affect our heart?

As we roll into 2019, many people will be trying out new diet regimes.

For many of us, sticking to a nut-filled, burger-free, fish-heavy Mediterranean-style diet will only last a matter of days before we return to the realms of cheesecake and cheese boards.

Though eating right over the long-term reduces the risk of cardiovascular problems, we know much less about how a fluctuating dietary regime impacts our heart health.

Because so many people choose a diet and then gradually stray from it, researchers are interested in how yo-yo dieting might influence markers of cardiovascular disease.

A team led by Prof. Wayne Campbell, of Purdue University in West Lafayette, IN, set out to investigate. The scientists recently published their findings in the journal Nutrients.

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Altering eating patterns periodically

To investigate, the scientists inspected data from two previous studies into dietary interventions carried out by the same group of researchers at Purdue University.

The participants of these studies followed one of two eating patterns: a Mediterranean diet or a Dietary Approaches to Stop Hypertension (DASH) diet.

Lead study author Lauren O'Connor explains these two eating patterns, saying, "Our DASH-style eating pattern focused on controlling sodium intake, while our Mediterranean-style focused on increasing healthy fats. Both eating patterns were rich in fruits, vegetables, and whole grains."

Participants followed their eating pattern for 5 or 6 weeks. After this period, the scientists assessed their cardiovascular risk by measuring a range of parameters.

These included blood pressure and levels of fats, glucose, and insulin in the blood.

Following the 5–6 weeks of dieting, participants went back to their standard eating patterns for a further 4 weeks. Then, after another cardiovascular assessment, they were restarted on DASH or Mediterranean diet plans for an additional 5–6 weeks. Finally, they had one more checkup at the end of this period.

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A cardiometabolic 'rollercoaster'

The analysis showed that, as expected, the cardiovascular markers improved when the individual stuck to the diet. Then, once they had returned to a less healthful eating regime, the biomarkers became less favorable again.

Then, once the healthful diets were restarted, the metabolic markers once again improved.

The key message is that only a few weeks of healthful eating can make measurable improvements to markers of cardiovascular health, but at the same time, it does not take long before they return to their unhealthy state once a person terminates their healthful diet.

"These findings should encourage people to try again if they fail at their first attempt to adopt a healthy eating pattern," Prof. Campbell says. "It seems that your body isn't going to become resistant to the health-promoting effects of this diet pattern just because you tried it and weren't successful the first time."

More research will be needed to explore whether yo-yo dieting has an impact on long-term health.

Some studies have shown that losing and gaining weight again in a cycle, or weight cycling, could cause stress to the cardiovascular system. However, the evidence is certainly not overwhelming, and some scientists question whether weight cycling has any adverse effects at all.

Overall, the results are bittersweet; they show that just a few weeks of dietary change can produce measurable improvements in health markers. On the flip side, after just a few weeks following the abandonment of a new diet, those benefits are lost.

However, if a person restarts their healthful eating plan, the benefits can be won back in the same short amount of time. As such, Prof. Campbell's message is one of stubborn persistence:

"The best option is to keep the healthy pattern going, but if you slip up, try again."

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Taquicardia: Causas, síntomas y tratamientos

La taquicardia se define como la frecuencia cardíaca más rápida de lo normal cuando estamos en reposo, normalmente superior a las 100 pulsaciones por minuto. Puede ser peligrosa dependiendo de la causa subyacente y del nivel de esfuerzo que necesite el corazón para trabajar.

Es posible que algunas personas con taquicardia no presenten síntomas o complicaciones. Sin embargo, esta enfermedad incrementa de forma significativa el riesgo de sufrir un accidente cerebrovascular, un paro cardíaco repentino e incluso la muerte.

¿Qué es la taquicardia? Diagram of the heart
El corazón se compone de dos ventrículos y dos arterias. La taquicardia aparece cuando los latidos son demasiado rápidos.

La taquicardia alude a la frecuencia cardíaca más rápida de lo normal cuando estamos en reposo.

En general, un corazón adulto en reposo late entre 60 y 100 veces por minuto. Cuando un individuo padece taquicardia, las cavidades superiores o inferiores del corazón laten mucho más rápido.

Cuando el corazón late muy rápido, bombea de forma menos eficiente y se reduce el flujo sanguíneo del resto del cuerpo, incluyendo el corazón.

Como consecuencia, los músculos del corazón o el miocardio necesitan más oxígeno. Si esto persiste, las células miocárdicas privadas de oxígeno pueden morir, ya que necesitan oxígeno, y esto deriva en un ataque cardíaco.

Aurículas, ventrículos y circuitos eléctricos del corazón

El corazón humano se compone de cuatro cavidades:

Aurículas: Son las dos cavidades superiores. Ventrículos: Son las dos cavidades inferiores.

Podemos distinguir entre aurícula derecha e izquierda, así como ventrículo derecho e izquierdo.

El corazón tiene un marcapasos natural llamado nodo sinoauricular, se localiza en la aurícula derecha y produce impulsos eléctricos. Cada una de ellas desencadena un latido del corazón individual.

Los impulsos eléctricos continúan hacia el nodo sinoauricular (SA), un grupo de células. El nodo SA disminuye las señales eléctricas y luego los envía hacia los ventrículos.

Al retrasar las señales eléctricas, el NSA puede dejar tiempo a los ventrículos para que se llenen de sangre. Cuando los músculos de los ventrículos reciben las señales eléctricas, se contraen y bombean sangre a los pulmones o a resto del cuerpo.

Cuando hay un problema con las señales eléctricas, se produce una latido más rápido de lo normal, por lo que el individuo sufrirá taquicardia.

Causas Generalmente, la taquicardia se causa por la alteración en los impulsos eléctricos y normales que controlan el bombeo del corazón (la velocidad a la que bombea nuestro corazón). Las situaciones o enfermedades que aparecen a continuación son posibles causas: Una reacción a ciertos medicamentos Anormalidades congénitas del corazón El consumo excesivo del alcohol El consumo de cocaína y otras drogas recreativas El desequilibrio de los electrolitos Una enfermedad cardíaca, lo que provoca un mal suministro sanguíneo y daña los tejidos cardíacos, como por ejemplo, la cardiopatía isquémica, la valvulopatía cardíaca, la insuficiencia cardíaca, la miocardiopatía, los tumores o las infecciones La hipertensión Una glándula tiroidea hiperactiva El consumo del tabaco Algunas enfermedades pulmonares Algunas veces, el médico no puede identificar la causa exacta de la taquicardia. Tratamiento [Heart on an ECG]
Existen diferentes maneras para tratar la taquicardia. Las opciones de tratamientos varían dependiendo de la causa que ha provocado la enfermedad, la edad y la salud general de la persona que sufre taquicardia, además de otros factores. El objetivo del tratamiento es identificar la causa de la taquicardia. Cuando se pueda diagnosticar un tratamiento, el médico puede intentar reducir la velocidad, prevenir episodios posteriores de taquicardia y reducir el riesgo de complicaciones. En algunos casos, todo lo que se necesita es tratar la causa. En otras ocasiones, no se encuentran causan subyacentes, por lo que el médico tiene que buscar terapias diferentes. Maneras de ralentizar el latido del corazón acelerado Maniobras vagales El nervio vagal ayuda a regular el latido de nuestro corazón. Las maniobras que afectan a este nervio incluyen la tos, la hinchazón (como si defecara) y la aplicación de una compresa fría en la cara del paciente. Medicación Los fármacos antiarrítmicos pueden administrarse de forma oral o por inyección. Restablecen el latido normal del corazón y se llevan a cabo en el hospital. Los fármacos disponibles restablecen el ritmo normal del corazón o controlan la velocidad del mismo. A veces, el individuo necesitará tomar más de un medicamento de este tipo. Cardioversión Los electrodos se utilizan para administrar una descarga eléctrica en el corazón. Esto afecta a los impulsos eléctricos del corazón y restablece el ritmo normal. Este procedimiento se lleva a cabo en un hospital. Thank you for supporting Medical News Today Prevención Existen ciertas medidas para evitar que el latido del corazón se vuelva demasiado rápido o que se convierta en un problema de salud. Ablación con catéter por radiofrecuencia Los catéteres se introducen en el corazón por los vasos sanguíneos. Los electrodos en los extremos del catéter se calientan para poder extirpar o dañar las pequeñas zonas del corazón responsables del latido anómalo. Medicamentos Cuando se toman con regularidad, los medicamentos antiarrítmicos pueden evitar la taquicardia. El doctor puede recetar otros fármacos en combinación con estos, por ejemplo, bloqueadores de los canales, como diltiazem (Cardizem) y verapamilo (Calan), o bloqueadores beta, como propranolol (Inderal) y esmolol (Brevibloc). Desfibrilador cardioversor implantable (DCI) Es un dispositivo que monitoriza de forma continua el latido del corazón y se implanta a través de una operación en el pecho. El DCI detecta cualquier anomalía en los latidos y envía impulsos eléctricos para restablecer el ritmo normal del corazón. Cirugía Algunas veces, se necesita la cirugía para eliminar una parte del tejido. El cirujano puede crear un patrón de tejido cicatrizante, ya que es un mal conductor de la electricidad. Generalmente, este procedimiento solo se utiliza cuando se han recetado otras terapias y no han sido efectivas, o si la persona sufre otro tipo de enfermedad cardíaca. Warfarina La warfarina dificulta que la sangre se coagule. Se le administra a las personas que tienen un riesgo alto o moderado de desarrollar un accidente cerebrovascular o un infarto cardíaco. Aunque este procedimiento incrementa el riesgo de sangrado, se receta para los pacientes cuyo riesgo de sufrir un accidente cerebrovascular o un infarto es bastante superior al riesgo de padecer una hemorragia. Síntomas Entre los distintos signos y síntomas de la taquicardia, podemos encontrar: dolor de pecho; confusión; mareos/vértigos; baja presión arterial; aturdimiento; palpitaciones; dificultad para respirar; debilidad repentina, o desmayos. En algunos casos con taquicardia, no es nada frecuente que el individuo presente síntomas. En dichas circunstancias, sólo se puede descubrir la enfermedad cuando el paciente se somete a un análisis físico. Posibles complicaciones El riesgo de sufrir complicaciones depende de muchos factores, como: la gravedad; el tipo; la frecuencia cardíaca; la duración, o depende de si existen o no otras enfermedades cardíacas. Las complicaciones más comunes incluyen: Coágulos sanguíneos: Incrementan de forma significativa el riesgo de sufrir un infarto cardíaco o un accidente cerebrovascular. Insuficiencia cardíaca: Si no se controla la enfermedad, el corazón se debilitará, lo que podría derivar en una insuficiencia cardíaca. Esto ocurre cuando el corazón no bombea sangre por todo el cuerpo de forma adecuada. En estos casos, pueden verse afectados el lado izquierdo, el derecho o ambos. Desmayos: La persona con latidos cardíacos rápidos podría perder la conciencia. Muerte súbita: Generalmente, se relaciona con la taquicardia o la fibrilación ventricular. Tipos Los tipos más frecuentes de taquicardia incluyen: Fibrilación auricular Algunas veces, la actividad eléctrica puede aumentar desde la aurícula izquierda en lugar del nódulo sinoauricular. Esto provoca que las cavidades adquieran una frecuencia alta e irregular, lo que se llama fibrilación auricular. Un episodio de fibrilación auricular puede durar entre unas horas y muchos días y, algunas veces, no desaparece sin tratamiento. La mayoría de los individuos con fibrilación auricular presentan anomalías en el corazón relacionadas con la enfermedad. Aleteo auricular La aurícula late rápido, pero de forma regular. Suele ocasionarse debido a un problema en la aurícula derecha. Las contracciones de la aurícula se debilitan por la alta frecuencia cardíaca. Un episodio de aleteo auricular puede durar unas horas o algunos días. A veces, no desaparece sin tratamiento. En algunas ocasiones, suele aparecer debido a una complicación en la operación, pero también puede causarse por algunas alteraciones de la enfermedad cardíaca. Normalmente, las personas que padecen aleteo auricular también experimentan fibrilaciones. Taquicardias supraventriculares (TSV) Se refieren a cualquier ritmo cardíaco acelerado y originado por el tejido ventricular. Los ciclos cardíacos anómalos suelen estar presentes al nacer y crean un bucle de señales superpuestas. Un episodio de TSV puede durar desde unos segundos hasta varias horas. Taquicardia ventricular Las señales eléctricas y anómalas en los ventrículos provocan una rápida frecuencia cardíaca. La elevada velocidad no permite que los ventrículos se dilaten y se contraigan de forma adecuada, lo que provoca un mal suministro sanguíneo en el cuerpo. Este tipo de taquicardia suele ser una enfermedad que pone en peligro la vida del paciente y necesita tratarse como una urgencia médica. Fibrilación ventricular Los ventrículos no consiguen dilatarse de forma normal, lo que provoca un mal suministro sanguíneo por el cuerpo. Si el ritmo cardíaco normal no se restablece de forma rápida, la circulación sanguínea se detendrá y causará la muerte. Las personas con enfermedades cardíacas subyacentes o aquellos que han padecido traumas serios causados por la luz podrían experimentar fibrilación ventricular. Thank you for supporting Medical News Today Factores de riesgo ECG print out
Un electrocardiograma muestra la actividad eléctrica del corazón. El riesgo de taquicardia aumenta si el individuo presenta una enfermedad que daña los tejidos cardíacos o tensiona el corazón. Los factores que aparecen a continuación se relacionan con el riesgo alto de sufrir taquicardia: Edad: Las personas con más de 60 años presentan un riesgo superior de experimentar taquicardia, en comparación a los jóvenes. Genética: Los individuos que tengan familiares con taquicardia u otros problemas relacionados con el ritmo cardíaco tienen mayor riesgo de desarrollar la enfermedad. Otros factores potenciales incluyen: una enfermedad cardíaca; ansiedad; el consumo regular de grandes cantidades de cafeína y alcohol; presión arterial elevada; estrés mental; el consumo del tabaco, o el uso recreativo de medicamentos. Diagnóstico Normalmente, el médico puede diagnosticar taquicardia por medio de algunas preguntas relacionadas con los síntomas, con la realización de un análisis físico o con algunas pruebas. Entre ellas, encontramos: Electrocardiograma (ECG) Se utilizan electrodos en la piel para medir los impulsos eléctricos del corazón. Esta prueba también mostrará cualquier enfermedad cardíaca previa que pueda contribuir a la taquicardia. Ecocardiograma Un ecocardiograma es un tipo de investigación ultrasónica. Al rebotar los sonidos en las estructuras corporales y registrar los ecos, se produce una imagen en movimiento del corazón. Esto puede ayudar a buscar anomalías congénitas o estructurales que jueguen un papel fundamental en la taquicardia. Análisis de sangre Ayudan a determinar si existen problemas de tiroides u otras sustancias que contribuyan a la taquicardia. Monitor de Holter La persona con taquicardia lleva un dispositivo portable que registra todos los latidos cardíacos. Se coloca por debajo de la ropa y registra la información sobre la actividad eléctrica del corazón mientras el individuo realiza actividades normales durante 1 o 2 días. Registrador de eventos Este dispositivo es similar al monitor de Holter, pero no registra todos los latidos cardíacos. Encontramos dos tipos: Un tipo usa un teléfono para transmitir señales desde el registrador mientras que la persona está experimentando los síntomas. El otro se usa todo el tiempo durante una gran temporada. A veces, se puede llevar durante un mes. Este registrador de eventos es bueno para diagnosticar las alteraciones del ritmo que aparecen en momentos aleatorios. Estudio electrofisiológico o EF Se trata de una prueba invasiva, no dolorosa y no quirúrgica que puede determinar el tipo de arritmia, su origen y la respuesta potencial al tratamiento. La prueba se lleva a cabo en un laboratorio EF y la realiza un electrofisiólogo. Gracias a este estudio es posible reproducir las arritmias problemáticas en un entorno controlado. Prueba de la mesa inclinada Si el individuo experimenta desmayos, mareos o aturdimientos y ni el ECG ni el monitor de Holter revelaron arritmias, se puede realizar una prueba de este tipo. Consiste en monitorizar la presión sanguínea, el ritmo cardíaco y la frecuencia cardíaca mientras que el paciente se incorpora. En cuanto los reflejos funcionen de forma correcta, la frecuencia cardíaca y la presión sanguínea se modificarán cuando el paciente se coloque en posición vertical. El objetivo es asegurarse de que el cerebro consigue un suministro adecuado de sangre. Si los reflejos no son los adecuados, los desmayos y los síntomas asociados tendrían explicación. Radiografía de tórax Las imágenes de la radiografía ayudan al médico a comprobar el estado del corazón y los pulmones. También se podrían detectar otras enfermedades que explican la taquicardia. Complicaciones Las complicaciones de la taquicardia incluyen: desmayos y mareos; cansancio y fatiga, o dificultad para respirar. También pueden derivar en: coágulos de sangre y un mayor riesgo de ataque cardíaco o accidente cerebrovascular, o insuficiencia cardíaca, cuando el corazón ya no puede bombear la sangre con eficacia. En algunos casos, podría provocar la muerte súbita. Traducido por Carmen María González Morales Revisado por Brenda Carreras Leer el artículo en Inglés
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Recalled 'weight history' can predict heart failure risk

Asking older adults how much they weighed in the past can help to predict their risk of heart failure, according to recent research.
senior woman receiving heart from women's hands
New research found that asking seniors how much they weighed in their 20s and 40s accurately predicted heart failure risk.

Ideally, doctors treating older people would have ready access to accurate weight histories from lifelong medical records.

In reality, however, medical records tend not to accompany people as they change their primary care doctors.

After studying more than 6,000 older adults, researchers from the Johns Hopkins School of Medicine in Baltimore, MD, concluded that just asking older individuals how much they weighed when they were 20 and 40 years old could help predict their risk of heart failure.

"Self-reported lifetime weight," they write in a report of the study that features in the Journal of the American Heart Association, "is a low-tech tool easily utilized in any clinical encounter."

While unlikely to be as accurate as clinically recorded weight, they found that self-reported weight, over and above current body mass index (BMI), could be a good predictor of heart failure risk.

Obesity and heart failure

Previous studies have shown that the more years that individuals spend with obesity, the more likely they are to have a higher risk of heart failure.

"That is why," explains senior study author Dr. Erin D. Michos, who is an associate professor of medicine, "measuring a person's weight at older ages may not tell the whole story about their risk."

There is mounting evidence that individuals who have only recently developed obesity are overall in less danger compared with counterparts who have a history of obesity, she adds.

Heart failure, also known as congestive heart failure, is a severe condition. It develops when heart muscle gradually weakens and stiffens until it cannot pump enough oxygen- and nutrient-rich blood to the body's organs and tissues.

The Centers for Disease Control and Prevention (CDC) estimate that around 5.7 million people have heart failure in the United States, where the condition contributed to 1 in 9 deaths in 2009.

Around half of those diagnosed with heart failure do not live more than 5 years following diagnosis.

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A practical way to obtain weight history

In the routine assessment of heart disease and heart failure risk, doctors bring together measures of cholesterol, blood pressure, diet, BMI, and family history of cardiovascular disease.

Dr. Michos notes that while it is useful to have the current BMI measure when making such an assessment in older adults, having a weight history would be even more helpful.

So, she and her team set out to investigate if there might a practical way of obtaining a weight history that is good enough to inform routine clinical assessment.

They used data from the Multi-Ethnic Study of Atherosclerosis (MESA) on 6,437 people living in six different states in the U.S. The individuals, of which 53 percent were female, had joined the study during 2000-2002 when their average age was 62 years.

Regarding ethnic composition, the cohort was around 39 percent white, more than 26 percent African-American, 22 percent Hispanic, and just over 12 percent Chinese-American.

At the start of the study, the participants had filled in questionnaires that asked them about their weight when they were 20 and 40 years old.

During an average follow-up of 13 years, there was a total of five in-person visits that included weight measurement.

The investigators converted the weight measurements into BMI by dividing the weight in kilograms by the square of the height in meters. They classed BMIs under 25 as normal, between 25 and under 30 as overweight, and 30 and above as being in the obesity range.

Weight history tied to heart failure risk

During the follow-up, 290 individuals had developed heart failure. Another 828 had experienced heart attacks, strokes, or other conditions due to arterial plaque buildup, or had died because of one of these conditions.

Dr. Michos says that, as they expected, there was a link between the weight measures that came from the follow-up visits and the risk of developing heart failure.

For every 5 kilograms per square meter of extra BMI, the risk of developing heart failure went up by 34 percent. This was after accounting for other possible risk factors, such as smoking, age, exercise, diabetes, and blood pressure.

However, further analysis also revealed that reporting having had obesity at age 20 was linked to an above threefold risk of heart failure. Reporting having had obesity at age 40 was tied to a twofold risk.

These risks were in comparison to those who reported having BMIs in the normal range at those two ages.

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Doctors should ask about weight history

The team notes that self-reporting can be subject to bias from imperfect memory, but they suggest that most older adults have a reasonable ability to recall how much they weighed when they were younger.

They propose that just asking about weight history can be a help. And yet, while it is an easy thing to incorporate into routine clinical assessments, most doctors don't ask the question.

Dr. Michos calls for further research on how best to include self-reported weight history in clinical practice and electronic health records.

"Our findings emphasize the importance of lifelong maintenance of a healthy weight, as greater cumulative weight from young adulthood is more risky to heart health."

Dr. Erin D. Michos

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Mediterranean diet reduces cardiovascular risk by a quarter

A recent study has put the Mediterranean diet to the test once more, attempting to unpick the molecular mechanisms that produce its benefits.
Mediterranean diet couple dinner
More good news for advocates of the Mediterranean diet.

Inspired by the traditional eating patterns of people from Greece, Italy, and Spain, the Mediterranean diet can seemingly do no wrong.

In a nutshell, the diet is rich in plants and olive oil but low in meat and sugary products.

Over the years, studies have concluded that this eating pattern lowers the risk of various health issues, including coronary heart disease and stroke.

Studies have even concluded that the Mediterranean diet might extend lifespan in older adults as well as reduce the risk of Parkinson's and Alzheimer's.

Evidence is mounting for its health benefits, but scientists still do not know exactly how these benefits come about.

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The Mediterranean black box

A new study published in JAMA Network Open asks the following question: "Is the Mediterranean diet [...] associated with lower risk of cardiovascular disease (CVD) events in a [United States] population, and, if so, what are the underlying mechanisms?"

As corresponding study author Dr. Samia Mora explains, "While prior studies have shown benefit for the Mediterranean diet on reducing cardiovascular events and improving cardiovascular risk factors, it has been a black box regarding the extent to which improvements in known and novel risk factors contribute to these effects."

To investigate, the scientists took data from the Women's Health Study. Lead study author Shafqat Ahmad, Ph.D., led researchers from Brigham and Women's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health — all in Boston, MA.

In all, they had access to the health records and dietary habits of 25,994 women, all of whom were healthy at the start of the study. The researchers followed them for a maximum of 12 years.

The researchers measured the levels of 40 biomarkers, including lipids, inflammation, glucose metabolism, and lipoproteins. They split the participants into three groups — low, middle, and upper intake — depending on how strictly they adhered to the Mediterranean diet.

They were particularly interested in cardiovascular events, such as stroke and heart attack. They found that:

In the low intake group, 4.2 percent of women had a cardiovascular event. In the middle intake group, 3.8 percent of women had a cardiovascular event. In the upper intake group, 3.8 percent of women had a cardiovascular event.
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This marks the first long-term study in a U.S. population to explore the impact of the Mediterranean diet on CVD. The authors conclude:

"[H]igher [Mediterranean diet] intake was associated with approximately one-quarter lower risk of CVD events over a 12-year follow-up period."

The authors also note that this effect size is equivalent to that present in people who take statins, which are common drugs that doctors prescribe to lower cardiovascular risk.

Mediterranean metabolites

Next, they dived into the metabolic data to see if they could find any patterns. They discovered that variation in metabolites related to inflammation accounted for 29 percent of the reduction in CVD risk.

Glucose metabolism and insulin resistance accounted for 27.9 percent, body mass index (BMI) for 27.3 percent, and blood pressure for 26.6 percent.

The team also noted relationships between a number of other metabolites, including lipids, but these were less pronounced.

Dr. Mora says, "In this large study, we found that modest differences in biomarkers contributed in a multifactorial way to this cardiovascular benefit that was seen over the long-term."

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Once again, the Mediterranean eating pattern seems to have come up trumps; and now we know that its benefits are most likely due to the way it interacts with inflammation pathways, glucose metabolism, and insulin resistance.

Of course, there are some limitations to the study. For instance, as the authors explain, CVD risk could have been influenced by as-yet-unknown metabolic factors that the scientists did not measure in this study.

Also, the dietary information that they analyzed relied on the participants keeping a food diary, which comes with a potential for human error. However, the size of this study and the detailed information about biomarkers make this a relatively reliable research endeavor.

As evidence in favor of the Mediterranean diet mounts, its popularity is sure to continue climbing.

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Red meat raises heart disease risk through gut bacteria

Scientists have uncovered further evidence of how a diet rich in red meat interacts with gut bacteria to raise the risk of heart disease.
two hands cutting red meat with knife and fork
A diet rich in red meat may affect heart disease risk by triggering the production of certain metabolites in the gut.

They found that people who ate red meat as their main source of protein for 1 month had levels of trimethylamine N-oxide (TMAO) that were two to three times higher than those in people who got their protein primarily from white meat or non-meat sources.

Gut bacteria produce TMAO as a byproduct when they feed on certain nutrients during digestion.

Previous studies have implicated high circulating levels of TMAO in the development of artery-blocking plaques and raised risk of heart-related conditions.

In the recent research, scientists at the Cleveland Clinic in Ohio uncovered two mechanisms through which a diet rich in red meat raises TMAO levels.

It appears that not only does frequent consumption of red meat enhance gut bacteria production of TMAO, but it also reduces elimination of the compound through the kidneys.

The European Heart Journal has published a report on the study and its findings.

"This is the first study of our knowledge," says senior study author Dr. Stanley L. Hazen, who chairs the Department of Cellular and Molecular Medicine in the Cleveland Clinic's Lerner Research Institute, "to show that the kidneys can change how effectively they expel different compounds depending on the diet that one eats — other than salts and water."

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TMAO as a predictor of heart disease risk

In previous work, Dr. Hazen and his team had found that TMAO alters blood platelets to raise the risk of thrombosis, or blood clots.

Their work revealed that TMAO modifies calcium signaling in blood platelets. In addition, it showed that platelets respond differently to blood-clotting triggers when blood levels of TMAO are high.

The team proposed that the compound could be a powerful predictor of the risk of heart attack, stroke, and death — even when cholesterol and blood pressure levels are healthy.

Others have since replicated the findings and, like Dr. Hazen and his team, have continued to investigate TMAO and its impact on health.

Research from the University of Leicester in the United Kingdom, for example, demonstrated that people with acute heart failure fared worse if they had higher circulating levels of TMAO.

Clinical trials are also underway to test TMAO as a predictive marker of heart disease risk.

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Red meat diet compared with other diets

The recent study assigned 113 individuals to follow three tightly controlled diets in a random order for 4 weeks each with a "washout diet" preceding the changeover.

The diets differed according to their main source of protein. In the red meat diet, 12 percent of the daily calories came from lean red meat in the form of pork or beef, while in the white meat diet, these calories came from lean white poultry meat.

In the non-meat diet, 12 percent of the daily calorie intake came from "legumes, nuts, grains, [and] isoflavone-free soy products."

In all three diets, protein accounted for 25 percent of the daily calories, and the remaining 13 percent of this protein came from "eggs, dairy, and vegetable sources."

After 4 weeks on the red meat diet, "the majority of" the individuals had raised levels of TMAO in their blood and urine.

On average, compared with levels during the white meat and non-meat diets, blood levels of TMAO during the red meat diet were up to three times higher. For some individuals, the levels were 10 times higher. Urine samples revealed a similar pattern.

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Reduced kidney efficiency

The study also yielded an unexpected result. While on the red meat diet, the study participants' kidneys were less efficient at expelling TMAO.

However, in the 4 weeks after ceasing the red meat diet, their blood and urine levels of TMAO fell.

Dr. Hazen says that the findings show that people can reduce their risk of heart-related problems by changing what they eat.

Gut production of TMAO was lower and kidney elimination was higher when the individuals followed the white meat or non-meat protein diet.

This suggests, says Dr. Hazen, that these types of diet are more healthful for the heart and body.

"We know lifestyle factors are critical for cardiovascular health, and these findings build upon our previous research on TMAO's link with heart disease."

Dr. Stanley L. Hazen

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Statins: Risk of side effects is low, say experts

For most people who take statins to lower cholesterol, the risk of side effects is low compared to the benefits, according to a recent scientific statement.
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New research suggests that the benefits of statins outweigh the risks.

The American Heart Association (AHA) statement applies to those who — according to current guidelines — are at risk of heart attack and ischemic strokes, which are strokes arising from blood clots.

Statins are drugs that reduce low-density lipoprotein (LDL) cholesterol by blocking an enzyme in the liver.

Around a quarter of adults over the age of 40 years old in the United States use statins to reduce their risk of heart attack, ischemic stroke, and other conditions that can develop when plaque builds up in arteries.

However, up to 1 in 10 of individuals taking statins stop using them because they assume that the drug is responsible for symptoms that they experience, although that may not be the case.

"Stopping a statin," says Dr. Mark Creager, who is director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, and former president of the AHA, "can significantly increase the risk of a heart attack or stroke caused by a blocked artery."

The journal Arteriosclerosis, Thrombosis, and Vascular Biology carries a full report on the research that went into the statement.

Within guidelines, 'benefits outweigh risks'

The statement's authors say that trials have proved that statins have had a major effect on reducing heart attacks, strokes, other cardiovascular diseases, and associated deaths.

Further to this, they reviewed a large number of studies and clinical trials that have evaluated the safety and potential adverse effects of statins.

"Over 30 years of clinical investigation," the authors write, "have shown that statins exhibit few serious adverse effects."

They point out that, apart from a few exceptions, it is possible to reverse the adverse effects of statin use. This should be compared, they argue, with the fact that heart attacks and stroke damage the heart or brain permanently, and they can kill.

They list the exceptions as "hemorrhagic stroke and the possible exception of newly diagnosed diabetes mellitus and some cases of autoimmune necrotizing myositis."

"Thus," they conclude, "in the patient population in whom statins are recommended by current guidelines, the benefit of reducing cardiovascular risk with statin therapy far outweighs any safety concerns."

According to the AHA, the current guidelines recommend the use of statins for the following groups:

Those who have experienced heart attack, stroke, transient ischemic attacks, or who have a history of cardiovascular conditions such as angina and peripheral artery disease. Adults aged 40–75 years old whose LDL cholesterol is in the 70–189 milligrams per deciliter (mg/dl) range and whose risk of having a heart attack or stroke in the next 10 years is 7.5 percent or above. Adults aged 40–75 years of age who have diabetes and whose LDL cholesterol is in the range 70–89 mg/dl. Anyone aged 21 years and older with a very high LDL cholesterol level of 190 mg/dl and above.
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'Muscle aches and pains'

People using statins who report side effects most often mention "muscle aches and pains."

However, the research that the statement's authors reviewed reveals that fewer than 1 percent of people who use statins "develop muscle symptoms that are likely caused by statin drugs."

Uncertainty about the causes of any aches and pains, coupled with the fact that they are taking statins, may prompt people to make a link where none exists.

The AHA say that if individuals stop taking their statins for this reason, they may be doing more harm than good by raising their risk of a cardiovascular event.

They urge healthcare providers to "pay close attention to their patients' concerns and help them assess likely causes." They could, for instance, check for blood markers of muscle damage. If they are normal, this could reassure their patients.

Another option is to check vitamin D levels, as insufficiency amounts can also cause muscle aches and pains.

Risk of diabetes and hemorrhagic stroke

There is a slight chance that statins might raise the risk of diabetes, especially in those at higher risk. These include individuals with obesity or whose lifestyle is largely sedentary.

The statement suggests that the absolute risk of being diagnosed with diabetes as a result of using statins is around 0.2 percent per year.

For those who already have diabetes, there could be a slight increase in the amount of glucose in the blood, as their HbA1c measure may reflect.

However, the increase is very small and should not prevent the use of statins, note the AHA.

The research that the statement reviewed did not find that statins increase the risk of a first hemorrhagic stroke, which is a type of stroke that occurs when a blood vessel ruptures.

People with a history of hemorrhagic stroke, on the other hand, may have a slightly higher risk of a further one if they use statins. However, this risk is very small and the overall benefits of statin use in reducing strokes and "other vascular events" outweighs it.

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Risk of other side effects

The statement's authors also looked at evidence that statin use might increase the risk of other conditions. These included damage to peripheral nerves, other neurological effects, damage to the liver, cataracts, and ruptures to a tendon.

They found, however, "little evidence" to support the idea that using statins raised the risk of these conditions.

In rare instances, there could be a side effect called rhabdomyolysis, which is a type of muscle injury that can lead to acute kidney failure. A sign of this can be passing dark urine, so if this happens people should stop taking their statins and see their doctor, say the AHA.

From the reviewed evidence, the statement suggests that rhabdomyolysis is a side effect in less than 0.1 percent of people taking statins.

"In most cases, you should not stop taking your statin medication if you think you are having side effects from the drug — instead, talk to your healthcare provider about your concerns."

Dr. Mark Creager

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Excess belly fat common in those with high heart risk

Excess waist fat is common in many people with a high risk of heart disease and stroke, according to a recent European study.
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New research finds that two-thirds of people at high risk of developing cardiovascular disease have excess belly fat.

The study, called EUROASPIRE V, is a survey of cardiovascular disease prevention and diabetes. It forms part of a European Society of Cardiology research program.

The findings featured recently at the World Congress of Cardiology & Cardiovascular Health in Dubai in the United Arab Emirates.

They revealed that nearly two-thirds of individuals at high risk of cardiovascular disease had excess abdominal fat.

The results also showed that:

Only 47 percent of those taking drugs to reduce high blood pressure were achieving a target of under 140/90 millimeters of mercury, or under 140/85 for those who reported having diabetes. Among individuals using lipid-lowering medication, only 43 percent had reached the low-density lipoprotein (LDL) cholesterol target of under 2.5 millimoles per liter. Many who were not in receipt of treatment for high blood pressure and high LDL cholesterol had those conditions. Only 65 percent of individuals receiving treatment for type 2 diabetes had attained the target blood sugar of under 7.0 percent glycated hemoglobin (HbA1c).

"The survey," says Kornelia Kotseva, chair of the EUROASPIRE Steering Committee and a professor at Imperial College London in the United Kingdom, "shows that large proportions of individuals at high risk of cardiovascular disease have unhealthy lifestyle habits and uncontrolled blood pressure, lipids, and diabetes."

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Individuals with high heart risk

The recent study focuses on "apparently healthy individuals in primary care at high risk of developing cardiovascular disease, including those with diabetes."

Altogether, 78 primary care practices from 16, mainly European, countries took part in the research, which took place during 2017–2018.

They recruited individuals who were under 80 years of age and had no history of coronary artery disease or other conditions arising from atherosclerosis.

However, assessments had shown that they were at high risk of developing cardiovascular disease due to one or more of the following: high blood pressure, high cholesterol, or diabetes.

The researchers used medical records to identify those eligible for the study and invited them for an interview and clinical exam.

The interviewers asked questions about diet, exercise, smoking, and other lifestyle factors.

The analysis included a total of 2,759 people. Of these:

64 percent had central obesity, which is a measure of excess abdominal fat. 37 percent were in the overweight category for body mass index (25.0–29.9 kilograms per square meter). 18 percent were current smokers. 36 percent were achieving the typical guideline physical activity level of at least 30 minutes on 5 days of the week.

The researchers defined central obesity as having a waist size of at least 88 centimeters (34.7 inches) for women and at least 102 centimeters (40.2 inches) for men.

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'GPs need to be more proactive'

Prof. Kotseva urges primary care practitioners to be proactive about looking for cardiovascular risk factors.

They need to probe beyond the risk factors that they are already aware of and "always investigate smoking, obesity, unhealthy diet, physical inactivity, blood pressure, cholesterol, and diabetes," she argues.

Individuals often don't realize that they should be receiving treatment. They may visit their doctor for diabetes care and not know that they also have high blood pressure.

"In our study, many participants with high blood pressure and cholesterol were not being treated," notes Prof. Kotseva.

She suggests that the findings highlight a need for more investment and policy that focuses on prevention.

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The recent news follows that of earlier research that featured at the European Society of Cardiology Congress in April 2018 in Ljubljana, Slovenia.

In that study, researchers from the Mayo Clinic in Rochester, MN concluded that excess belly fat is "bad for the heart," even in individuals whose BMI is in the normal range.

They advised doctors not to assume that having normal BMI means that there is no heart-related issue in an otherwise healthy individual.

A BMI in the normal range does not necessarily indicate normal fat distribution. It is important to measure central obesity as well, to get a better picture of heart risk.

"These data make it clear that more efforts must be made to improve cardiovascular prevention in people at high risk of cardiovascular disease."

Prof: Kornelia Kotseva

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