The Heart

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What too much sleep can do to your health

New research finds that both insufficient and excessive sleep may raise the risk of cardiovascular problems and premature death.
person in bed waking up with their hand on their face
New research finds that sleeping too much can raise the risk of early death and cardiovascular problems.

The Centers for Disease Control and Prevention (CDC) report that a third of the United States population does not get enough sleep.

The CDC also warn that sleep deprivation raises the risk of various chronic conditions such as diabetes, cardiovascular disease, obesity, and depression.

But, according to new research appearing in the European Heart Journal, sleeping too much may affect health just as negatively as sleeping too little.

Chuangshi Wang, a doctoral candidate at McMaster University in Ontario in Canada, and Peking Union Medical College at the Chinese Academy of Medical Sciences in China, is the lead author of the new paper.

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Wang and colleagues examined the sleeping habits of more than 116,000 people aged between 35 and 70 years who had enrolled in the Prospective Urban Rural Epidemiology (PURE) study.

In their analysis, the researchers also included information about the participants' socioeconomic status, lifestyle habits, physical activity, diet, use of various medications, and family history of chronic conditions.

Overall, 4,381 people died and 4,365 people had a heart attack or stroke during the 8-year follow-up period of the PURE study.

The analysis by Wang and her team revealed that people who regularly slept more than the recommended 6–8 hours a night were more likely to die prematurely or develop cardiovascular disease.

More specifically, the risk of premature death or cardiovascular conditions was 5 percent higher for people who slept 8–9 hours than for people who slept the recommended amount.

Those who slept 9–10 hours were 17 percent more likely to die or develop heart and blood vessel conditions. Similarly, people who regularly slept more than 10 hours were 41 percent more likely to die prematurely or develop cardiovascular problems.

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Also, the study found a 9 percent higher risk of the outcomes mentioned above among those who slept 6 hours or less. However, the authors caution that this increase was not statistically significant.

Wang comments on the findings, saying, "Our study shows that the optimal duration of estimated sleep is six to eight hours per day for adults."

"Given that this is an observational study that can only show an association rather than proving a causal relationship, we cannot say that too much sleep per se causes cardiovascular diseases," she cautions.

"However, too little sleep could be an underlying contributor to death and cases of cardiovascular disease, and too much sleep may indicate underlying conditions that increase risk."

Corresponding author Dr. Salim Yusuf, who is the principal investigator of the PURE study, and a professor of medicine at McMaster, also comments on the findings.

"The general public should ensure that they get about six to eight hours of sleep a day. On the other hand, if you sleep too much regularly, say more than nine hours a day, then you may want to visit a doctor to check your overall health."

Dr. Salim Yusuf

"For doctors," continues Dr. Yusuf, "including questions about the duration of sleep and daytime naps in the clinical histories of your patients may be helpful in identifying people at high risk of heart and blood vessel problems or death."

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What is a pescatarian diet?

In the pescatarian diet, a person's main source of animal protein comes from fish and other seafood, such as shrimp.

Eating a diet consisting mainly of plant-based foods has a variety of health benefits, which the addition of fish and fish products may enhance.

However, some types of fish may absorb mercury from their environment, so certain people may need to limit their intake.

In this article, we look at the potential health benefits of a pescatarian diet and what people can eat on this kind of diet.

Health benefits of the pescatarian diet The pescatarian diet has many health benefits. Below, we cover some of these benefits. Heart health Pescatarian diet salmon
Eating fish provides omega-3 fatty acids, some of which are integral for healthy living.

Eating fish, especially fatty fish, provides increased long-chain omega-3 fatty acid intake. An omega-3 fatty acid is an unsaturated fat that can be beneficial to people, and some omega-3s are integral for healthy living.

People who eat fish have lower blood pressure, a lower risk of abnormal heart rhythms, and fewer fatal heart attacks than those who do not include fish in their diet.

Apart from fish, the pescatarian diet consists mainly of plant foods. According to one 2017 analysis, people who have a diet high in vegetables and other plant foods have a reduced risk of coronary heart disease.

The study authors say that the heart health benefits of a plant-based diet include improved blood lipids and lower blood pressure.

The same research concludes that a vegetarian diet could reverse atherosclerotic plaques when combined with exercise and stress management.

Atherosclerosis occurs when plaque builds up in the arteries. This causes the arteries to harden, narrow, and restrict the blood flow.

Cancer

A pescatarian diet may also protect people against colorectal cancers, or cancers that affect the colon and rectum.

According to a 2015 study, colorectal cancers are the second leading cause of cancer deaths in the United States.

The study used data from a cohort of over 77,650 people and found that the pescatarian diet had a strong protective effect against colorectal cancers.

Diabetes and inflammation

Following a plant-based diet can reduce the risk of type 2 diabetes and metabolic syndrome.

Metabolic syndrome includes conditions such as insulin resistance, high blood pressure, and obesity.

There is also evidence that omega-3s present in fatty fish may reduce inflammation, though this evidence comes from trials of supplements.

Plant-based diets are high in anti-inflammatory and antioxidant agents, such as flavonoids. These are natural compounds present in plants. Flavonoids have a range of anti-inflammatory and antidiabetic properties.

A 2016 study, again looking at different dietary patterns among more than 77,000 people in the U.S., found that people following a pescatarian diet had the highest flavonoid intake of all those taking part.

Thank you for supporting Medical News Today Environmental and animal welfare benefits Some people choose vegetarian diets because they disagree with factory farming practices or killing animals for food. For people concerned about animal welfare, the pescatarian diet may be a little more suitable. This is because some scientists argue that fish cannot feel pain. A 2015 study concluded that although fish can experience psychological stress, they lack the neural network necessary to experience pain. The pescatarian diet may also appeal to those who want to eat foods from what they perceive to be sustainable farming practices. Is a pescatarian diet sustainable? Pescatarian diet fish farming
While some see farming fish as a solution to over-fishing, it can still damage water ecosystems. The pescatarian diet is more sustainable than factory farming of mammals or birds, but it does have some environmental issues. Some people believe that the farming of pigs and ruminants, such as cattle, sheep, and goats, can harm the environment. Both groups emit greenhouse gases, with ruminants producing methane gas and pigs producing ammonia. On a global scale, these gases contribute to global warming. Also, large-scale deforestation for grazing and agriculture makes the greenhouse gas issue worse. Although fish do not produce greenhouse gases, fishing and fisheries represent a challenge to water ecosystems. For example, eating wild line-caught fish is not necessarily better for the environment than eating farmed fish, and the trawlers used to catch trawler-caught fish can affect ocean ecosystems in many ways. Some people see farming fish as a solution to over-fishing and depleted fish stocks, and the practice has grown rapidly over the past few years. However, in certain circumstances, fish farming can: damage water ecosystems introduce invasive species use wild fish for feed cause overcrowding cause disease The pescatarian diet may also be expensive or difficult to maintain when people live some distance from coastlines or fresh waterways. Some people may also find it hard to access sustainably sourced tinned fish. What can someone following the pescatarian diet eat? Listed below are some suggestions for sources of fish that a person on a pescatarian diet can eat: canned sardines canned salmon canned tuna fish sticks frozen salmon, trout, and herring frozen shrimp fresh fish, such as salmon, pollock, catfish, and sardines fresh shellfish, such as shrimp, clams, and scallops Other foods to include are: fruit vegetables cereals and whole grains, including oats, bulgar wheat, amaranth, corn, and rice food containing grain products pseudo grains, such as quinoa and buckwheat, which are gluten-free legumes, including kidney beans, pinto beans, and peas legume products, including tofu and hummus nuts and nut butters seeds, such as flaxseeds, hemp seeds, and chia eggs and dairy, if lacto-ovo-vegetarian If a person follows a strict pescatarian diet and avoids consuming eggs and dairy, they might need to check their calcium intake and consider taking supplements. Thank you for supporting Medical News Today 1-day meal plan Here, we give examples of recipes for meals that a person might consider when choosing a pescatarian diet: Breakfast Pescatarian diet sardines on crosti
Sardines are an excellent source of protein and omega-3s. Sardines on crostini Sardines are an excellent source of omega-3s. Using spinach to make a pesto spread on the crostini provides a source of vitamin C and vitamin A. The vitamin C helps increase the amount of iron a person absorbs. This recipe uses canned sardines, but it is also possible to use fresh sardines or anchovies. Starting the day with protein increases the feeling of fullness, and the pesto adds healthful greens that are a source of iron. Lunch Classic baked falafel Tahini is good source of plant protein and omega-3s. Chickpeas are also a good source of plant protein and fiber. Add a healthful Mediterranean salad to this recipe to create a filling lunch. Dinner Roasted salmon with shallot grapefruit sauce Salmon provides omega-3s essential fatty acids. Strong-flavored fish go very well with citrus fruits such as grapefruit. The addition of grapefruit to this recipe also adds vitamin C and fiber, and it counts toward the 2 servings of fruit that a person should eat per day. Disadvantages of a pescatarian diet Heavy metal and pollutants in marine fish is a global issue. With 92 percent of fish consumed by humans being marine fish, mostly from coastal fisheries, there is a risk of contamination. Mercury is present in the atmosphere and bodies of water and, because of this, nearly all fish may be a source of mercury. For most people, the mercury present in fish is not a risk, explain the U.S. Food and Drug Administration (FDA). However, they advise women considering becoming pregnant, women who are pregnant, nursing mothers, and young children not to eat specific fish. Fish to avoid include: shark sword fish king mackerel tilefish Fish low in mercury include: canned light tuna salmon pollock shrimp catfish Thank you for supporting Medical News Today Summary A pescatarian diet may be healthful and carries health benefits, as long as people avoid fish with high levels of mercury. However, this diet may not be as sustainable as some people think. Plant-based diets can help a person maintain a healthy weight, and they also may help with weight loss when necessary. A pescatarian diet may also be more healthful than some diets that rely on calorie deficits to reduce weight. People may find that canned tuna and sardines, as well as smoked fish, are the easiest foods to obtain and eat. These are full-flavored options, but frozen white fish and fish sticks are more delicately flavored options. Where possible, people may wish to try to buy fresh fish from sustainable sources. A useful website that can help is Seafood Watch.
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Snoring can worsen heart function, especially in women

Both snoring and obstructive sleep apnea could lead to earlier impairment of cardiac function in women, according to a new study.
Woman snoring
A recent study unlocks the health issues linked to snoring.

"Snoring" refers to a sleeping pattern in which a person breathes while emitting a snorting or grunting sound.

The National Sleep Foundation suggest that 90 million people in the United States snore.

Snoring might become more dangerous as people age, and it can also lead to heart disease.

There are different types of sleep apnea, but the most common is called obstructive sleep apnea (OSA). At least 18 million U.S. adults have sleep apnea.

This condition affects breathing patterns while sleeping, causing a person to stop breathing and start again repeatedly. About half of people who snore loudly have OSA.

When OSA occurs, the muscles in the throat that are responsible for keeping the airway open actually prevent the flow of air.

According to a new study presented recently at the annual meeting of the Radiological Society of North America — held in Chicago, IL — snoring and OSA may lead to earlier impairment of cardiac function in women than in men.

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Sleep apnea and heart disease?

It is unclear whether or not sleep apnea directly causes heart disease, but some specialists believe that people with sleep apnea are at risk of developing hypertension, or high blood pressure.

Many people who have sleep apnea also have co-existing diseases. This is one of the reasons why it is harder to establish a direct link between sleep apnea and heart disease.

According to the American Heart Association (AHA), some people living with sleep apnea and high blood pressure who received treatment for sleep apnea also saw their blood pressure drop. Such findings show a possible link between hypertension and sleep apnea.

OSA is also associated with obesity, which is a risk factor for heart disease.

Obesity contributes to sleep apnea, and the sleep deprivation that sleep apnea causes can give rise to further obesity, in the long-term. As a person gains more weight, the throat muscles that keep the airway open relax, and sleep apnea becomes more serious.

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Women who snore may be at greater risk

The researchers analyzed data associated with cardiac parameters in relation to diagnosed OSA and self-reported snoring using data from the UK Biobank.

The UK Biobank is an international health resource, open to researchers, that aims to improve the prevention, diagnosis, and treatment of diseases.

The data were of 4,877 participants who had received a cardiac MRI scan. The scientists divided them into three groups: those with OSA, those with self-reported snoring, and those with neither.

When the researchers compared the snoring group with the group without sleep disorders, they found a striking difference in the left ventricular mass in women compared with men.

Increased left ventricular mass means that the heart needs to work harder to fulfil the body's needs.

These patterns in people who self-reportedly snore may be an indication of undiagnosed OSA.

"We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement."

Researcher Dr. Adrian Curta

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OSA may be vastly underdiagnosed

The researchers also found that the number of diagnosed OSA cases in the study was extremely low, suggesting that OSA may be underdiagnosed across the board.

Dr. Curta, a radiology resident at Munich University Hospital in Germany, urges people who snore to get screened for OSA and those with OSA to seek treatment.

"I would encourage people who snore to ask their partner to observe them and look for phases during sleep when they stop breathing for a short while and then gasp for air," says Dr. Curta.

He continues, "If unsure, they can spend the night at a sleep lab where breathing is constantly monitored during sleep and even slight alterations can be recorded."

The team now hopes to conduct more research to fully understand the sex differences linked to snoring and OSA.

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Infections could trigger cardiovascular disease

Researchers find a higher risk of coronary events during the 3 months after an infection. The body's immune response, they suggest, may explain why infections "trigger" heart attack and stroke.
woman sneezing
Scientists encourage everyone to have their flu shots this year, as simple influenza viruses may trigger cardiovascular events.

The term cardiovascular disease (CVD) covers a range of conditions: from heart attack and heart disease to stroke, hypertension, and heart failure.

As many as 84 million people in the United States are living with one of the conditions above, and 2,200 people die every day as a result.

Several factors may raise the risk of cardiovascular conditions. Some of these factors are modifiable, such as smoking, high cholesterol, and high blood pressure. Other factors, such as sex, race, age, and family history, cannot be modified.

However, there are also a number of "acute" risk factors, or triggers, that can lead to CVD. Some research has linked urinary infections and pneumonia, for instance, with the risk of having heart attacks and stroke.

A new study, published in the Journal of the American Heart Association, zooms in on the link between infections and adverse cardiovascular events.

Dr. Kamakshi Lakshminarayan, a neurologist and associate professor of epidemiology at the University of Minnesota in Minneapolis, is the senior author of the study.

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Studying infections and coronary events risk

Dr. Lakshminarayan and colleagues examined 1,312 people who had had a coronary event such as a heart attack, or myocardial infarction, and compared them with 727 people who had had an ischemic stroke.

The study included both outpatients and people who were hospitalized to receive treatment for their infection.

The researchers looked for infections that these people developed up to 1–2 years before the cardiovascular event. The most commonly reported infections were urinary tract infections, pneumonia, and respiratory infections.

Overall, the study found that approximately 37 percent of the participants with heart disease had developed an infection in the 3 months leading up to the coronary event. Among people with stroke, this number was almost 30 percent.

In the first 2 weeks after having an infection, the risk of a stroke or a heart attack was the highest.

Though the analysis found this link among both inpatients and outpatients, people who received care in the hospital were more likely to have a coronary event.

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Immune response may elicit coronary events

Although the study was observational, the scientists speculate on the mechanism that may explain the results.

During an infection, explains Dr. Lakshminarayan, the body's immune system produces more white blood cells to fight it off. However, this immune response also makes small blood cells, called platelets, stickier.

In a healthy body, the role of platelets is to bind to a damaged blood vessel and create a blood clot. This is very useful for accidental cuts, for example, but too many platelets, or platelets that are too sticky, can raise the risk of blood clots.

"The infection appears to be the trigger for changing the finely tuned balance in the blood and making us more prone to thrombosis, or clot formation," says Dr. Lakshminarayan. "It's a trigger for the blood vessels to get blocked up and puts us at higher risk of serious events like heart attack and stroke."

"One of the biggest takeaways is that we have to prevent these infections whenever possible [...] and that means flu shots and pneumonia vaccines, especially for older individuals."

Dr. Kamakshi Lakshminarayan

In an accompanying editorial, Juan Badimon — who was not involved in the research — explains why the risk of a coronary event may have been higher in the hospitalized group. He says that for these people, the infection might have been more severe.

"And if the infection is that severe, we can assume a stronger inflammatory response will result in a higher cardiovascular risk," he said in an interview.

Badimon is a professor of medicine and the director of the atherothrombosis research unit at Mount Sinai School of Medicine's Cardiovascular Institute in New York City, NY.

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Exercise may prevent heart attacks in otherwise healthy people

New research published in the European Heart Journal suggests that even people with no signs of cardiovascular disease should exercise to prevent a heart attack. Cardiorespiratory fitness can be a predictor of future problems, warn the researchers.
woman exercising on a treadmill
Even fit and healthy people should exercise regularly to keep heart disease at bay.

Heart disease remains the leading cause of death among men and women in the United States, responsible for the deaths of around 610,000 people each year.

Coronary artery disease is the most common form of heart disease, which often results in a heart attack.

However, even healthy people might be at risk of a heart attack, new research points out.

Even if someone has no signs of cardiovascular problems, low cardiorespiratory fitness may predict future heart disease. For this reason, healthy individuals should exercise regularly to keep heart disease at bay.

Jon Magne Letnes, Ph.D., of the Norwegian University of Science and Technology (NTNU) in Trondheim, is the lead author of the new paper.

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Studying cardiorespiratory fitness levels

Letnes and colleagues analyzed the cardiorespiratory fitness of 4,527 "healthy and fit" individuals who enrolled in the large HUNT3 study in 2006–2008.

As part of the study, the participants ran on a treadmill while wearing an oxygen mask and a heart rate monitor. The researchers measured the participants' cardiorespiratory fitness, which is the body's ability to supply the muscles with sufficient oxygen during a workout.

The standard measure of cardiorespiratory fitness is VO2max — that is, "the maximum amount of oxygen the body can use during a specified period of usually intense exercise." This depends on a person's weight, as well on the health and strength of their respiratory system.

The scientists also had access to data about the participants' smoking status, alcohol intake, family history of heart disease, physical activity, body mass index (BMI), blood pressure, and cholesterol levels.

Letnes and team followed the participants for almost 9 years.

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'Exercise as preventive medicine'

Over the 9-year follow-up period, only 147 (3.3 percent) of the participants developed heart disease, died from it, or required coronary artery bypass graft. This is a surgical procedure that unclogs the arteries and releases the blood flow to the heart.

However, Letnes and colleagues also found that better cardiorespiratory fitness correlated with a decreased cardiovascular risk — including the risk of a heart attack — throughout the study period.

Bjarne Nes, a researcher at the NTNU and the corresponding author of the study, sums up the findings, saying, "We found a strong link between greater fitness and reduced risk of a coronary event during the 9 years of follow-up in a very healthy sample of adults."

"In fact, the participants who were in the 25 [percent] of those with the highest cardiorespiratory fitness had nearly half the risk compared [with] those in the 25 [percent] with the lowest fitness levels."

Bjarne Nes

More specifically, the risk of experiencing heart problems dropped by 15 percent with every metabolic equivalent. This is a unit of measurement that expresses the "cost of physical activities as a multiple of the resting metabolic rate."

"This indicates that greater cardiorespiratory fitness protects against both chronic and acute heart and blood vessel problems," says Nes. "Even a small increase in fitness could have a large impact on health."

The study's lead author adds that the study should "encourage the use of exercise as preventive medicine. A few months of regular exercise may be an efficient way of reducing the cardiovascular risk."

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What an exotic fish can do for human heart health

People with heart failure experience heart cell loss that can damage the heart muscle to such an extent that they need a transplant. One species of exotic fish, the tetra fish, has the amazing ability to repair its own heart. Can we apply this mechanism to healing human hearts?
tetra fish
The tetra fish can regenerate heart tissue following heart damage.

The tetra fish is a type of freshwater fish hailing from regions of South America and southern North America. Many tetra species are popular with aquarium owners due to their unique coloring and the fact that they are fairly easy to keep.

A new study suggests that they are now also popular with researchers, although for an entirely different reason. Most species of tetra fish are able to heal their own hearts following heart damage.

Dr. Mathilda Mommersteeg, an associate professor at the University of Oxford in the United Kingdom, recently led a team of researchers who were striving to understand how tetra fish are able to regenerate heart tissue.

The team looked at two different subspecies of tetra fish, Astyanax mexicanus, that are native to Mexico. One of these subspecies lives in rivers, is beautifully colored, and can heal its own heart.

Fish belonging to the other subspecies, known as the "blind cave tetra," populate the waters of the Pachón cave in Mexico. These fish have not only lost their color and their eyesight, neither of which serves them in the darkness of the cave, but they no longer have the ability to regenerate heart tissue.

In a recent study, Dr. Mommersteeg's team has compared the genetic profiles of the two types of tetra fish in order to understand what genetic features may be responsible for the self-healing abilities.

The findings of the study, which the British Heart Foundation supported, appear in the journal Cell Reports.

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The gene that drives heart repair

Dr. Mommersteeg's team analyzed and compared the genetic profiles of both kinds of fish. In doing so, they identified three areas on their genomes that were relevant to the ability to regenerate damaged heart tissue.

In further analyzing these genetic areas, the researchers were also able to identify the genes that were the most important for heart regeneration.

When they compared the activity of these genes in the river tetra and the blind cave tetra following heart damage, the scientists saw that two genes, lrrc10 and caveolin, had increased activity only in the river tetra.

"A real challenge until now was comparing heart damage and repair in fish with what we see in humans. But, by looking at river fish and cave fish side by side, we've been able to pick apart the genes responsible for heart regeneration," says Dr. Mommersteeg.

Previous research in mice has shown that lrrc10 is linked to a heart condition called dilated cardiomyopathy, in which the heart becomes excessively enlarged and is no longer able to pump blood properly. The results of further studies have suggested that lrrc10 plays a key role in heart cell contraction and expansion.

To confirm that this gene is also involved in the regeneration of damaged heart tissue, the researchers behind the current study turned to zebrafish, another freshwater species that is popular among aquarists. Like the tetra fish, zebrafish also have the ability to regenerate heart tissue if necessary.

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New hopes for future treatments

In the second part of their study, the researchers blocked lrrc10 gene expression in zebrafish. These animals became unable to effectively repair heart damage. This, the researchers say, indicates that lrrc10 is indeed responsible for heart regeneration.

"It's early days, but we're incredibly excited about these remarkable fish and the potential to change the lives of people with damaged hearts," Dr. Mommersteeg remarks.

In the future, the research team hopes to learn more about the mechanisms behind the ability to heal damaged heart tissue. They want to use this knowledge to repair heart tissue in people facing problems with this organ, such as heart failure.

Heart failure often occurs due to a heart attack, during which the heart muscle becomes damaged and progressively loses cells, which scar tissue replaces. This process can render the heart unable to function correctly, and, as a result, many people with severe heart failure require a heart transplant.

However, if tetra fish can teach us how to heal the heart, transplants may become less of a necessity in the future.

"These remarkable findings show how much there is still to learn from the rich tapestry of the natural world," says Prof. Metin Avkiran, an associate medical director at the British Heart Foundation.

"It's particularly interesting that the ability of the river fish to regenerate its heart may arise from an ability to suppress scar formation. We now need to determine if we can exploit similar mechanisms to repair damaged human hearts."

Prof. Metin Avkiran

"Survival rates for heart failure have barely changed over the last 20 years, and life expectancy is worse than for many cancers. Breakthroughs are desperately needed to ease the devastation caused by this dreadful condition," he adds.

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Heart attacks increasingly common in young women

New research finds a worrying trend in the incidence of heart attacks in recent decades. The results indicate that young women are more likely than young men to need hospitalization for heart attacks, as well as to develop other cardiometabolic conditions.
young woman holding her chest
More and more young women develop heart disease, and doctors should pay more attention to women, say the authors of a new study.

Cardiovascular disease — an umbrella term that covers different types of conditions that affect the heart or blood vessels, including coronary heart disease, stroke, congenital heart defects, and peripheral artery disease causes about 1 in 3 deaths in the United States.

Also, cardiovascular disease accounts for almost 836,546 deaths each year, making it the "leading killer of both women and men" in the U.S.

However, there are sex differences in the prevalence of some cardiovascular events, such as coronary heart disease — a cardiovascular condition that can ultimately lead to heart attacks.

An established body of research has shown that coronary heart disease is more prevalent among men at any age, which may have led to the common perception that "heart disease is a man's disease."

However, more recent studies have started to point out an "alarming" trend, which is a steady increase in the number of young women who die of coronary heart disease.

Now, new research, presented at the American Heart Association's Scientific Sessions meeting in Chicago and subsequently published in the journal Circulation, adds to the mounting evidence that heart attacks are increasingly common among young women.

Dr. Sameer Arora, a cardiology fellow at the University of North Carolina School of Medicine, Chapel Hill, is the lead author of the study.

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Heart attacks no longer an old man's disease

Dr. Arora and colleagues examined data on almost 29,000 people aged 35–74 years old who doctors admitted to hospital for acute myocardial infarction between 1995 and 2014.

The researchers found that the proportion of young patients who doctors admitted to the hospital for a heart attack "steadily increased, from 27 [percent] in 1995–1999 to 32 [percent] in 2010–2014."

The study also found that this increase was even more substantial in women. Namely, 21 percent of the heart attack hospital admissions were of young women at the beginning of the study, but this proportion jumped to 31 percent by the end.

Additionally, the research revealed that young women were less likely than young men to receive cardiovascular treatments, such as antiplatelet drugs, beta blockers, coronary angiography, or coronary revascularization.

Finally, young women were at a higher risk of hypertension, diabetes, and chronic kidney disease compared with young men.

The study's lead author comments on the findings, saying, "Cardiac disease is sometimes considered an old man's disease, but the trajectory of heart attacks among young people is going the wrong way [...] It's actually going up for young women."

"This is concerning," continues Dr. Arora. "It tells us we need to focus more attention on this population."

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A 'wake-up call to male physicians'

Dr. Arora explains why cardiologists and other healthcare professionals need to pay more attention to women's cardiovascular health.

"Traditionally, coronary artery disease is seen as a man's disease, so women who come to the emergency department with chest pain might not be seen as high-risk," he says.

"Also, the presentation of heart attack is different in men and women. Women are more likely to present with atypical symptoms compared to men, and their heart attack is more likely to be missed."

Dr. Ileana L. Piña, a cardiologist and professor of medicine and epidemiology at the Montefiore Medical Center in New York City, also chimes in on the findings.

She says that the results are "another wake-up call to physicians, especially male physicians" to take better care of women's heart health.

"The number one killer of women is not breast cancer or uterine cancer; the number one killer of women is heart disease [...] And, until we pay attention to this, these kinds of figures are going to keep coming up."

Dr. Ileana L. Piña

Dr. Piña, who was not involved in the research, says that traditional gender roles, which continue to prevail, may stop women from looking after their health.

"It's hard when a woman is working two jobs and taking care of the family, too," Dr. Piña says.

"[Women will] do anything for their families, but they often leave themselves for last. We need to teach women to change their health attitude and take care of themselves," she warns.

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Vitamin D, fish oil supplements of little benefit to heart health

Two new randomized trials challenge the view that vitamin D and fish oil supplements hold any real benefit in the fight against chronic conditions, such as cancer and heart disease.
man taking fish oil supplements
Do fish oil supplements really protect the heart?

The results of the first and second trial were presented at Scientific Sessions, held by the American Heart Institute (AHA) in Chicago, IL, and published in the New England Journal of Medicine.

Vitamin D and fish oil supplements have lately been the subject of much hype in the medical research community, mass media, and among the general public, due to their alleged benefits in combatting cancer and heart disease.

For example, recent studies in mice found that vitamin D benefits heart cells and suggested that the vitamin may prevent cardiovascular blockages.

Other studies identified persistent links between a lack of vitamin D and the development of breast cancer and bowel cancer.

Experts also believe that omega-3 fatty acids — which are in seafood, some nuts, and seeds — benefit the heart. The AHA, for example, recommend an intake of at least 2 servings of fish every week for optimal cardiovascular health.

As a result, many Americans have turned to omega-3 fish oil supplements to stave off heart disease. A survey carried out by the National Institutes of Health (NIH) found that almost 19 million Americans are taking fish oil supplements.

But do vitamin D and fish oil supplements really work?

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Vitamin D, fish oil no better than placebo

The two new studies were randomized, placebo-controlled trials led by Dr. JoAnn E. Manson, the chief of the division of preventive medicine at the Brigham and Women's Hospital in Boston, MA.

The trials examined the effect of a daily intake of vitamin D and omega-3-containing fish oils on the prevention of heart disease and cancer.

The studies involved almost 26,000 healthy adult participants, 20 percent of whom were African-American. None had a history of heart disease or cancer. The men in the study were at least 50 years old, and the women were at least 55.

Some participants took a daily dosage of 2,000 international units of vitamin D and 1 gram of fish oil.

Other participants received the same dosage of vitamin D plus a placebo, and others took the same daily dosage of fish oil with a placebo. The final group received two dosages of placebos.

Dr. Manson and the team followed the participants for 5 years. By the end of the study period, they had found no overall benefits.

In the first trial, they conclude:

"Supplementation with [omega-3] fatty acids did not result in a lower incidence of major cardiovascular events or cancer than placebo."

In the second trial, they surmise that "Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo."

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Does fish oil stave off heart attacks?

Dr. Manson and the team did find a link between fish oil and a lower risk of heart attacks, particularly among people who did not eat fish regularly, as well as among African-Americans.

Overall, fish oil supplements reduced the risk of a heart attack by approximately 28 percent. Among African-Americans, fish oil supplements lowered this risk by 77 percent, compared with participants who took only a placebo.

Finally, the researchers found that no supplement involved in the trial led to severe side effects, such as bleeding, excessive calcium, or gastrointestinal problems.

The New England Journal of Medicine also published an editorial related to the trials. In it, authors Dr. John F. Keaney and Dr. Clifford J. Rosen warn that the trials' "positive" results regarding fish oil supplementation and heart attack risk "need to be interpreted with caution."

They continue, noting that other large randomized trials of omega-3 fatty acids do not support these findings.

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What happens during atrial fibrillation?

Atrial fibrillation or A-fib is a condition where the heart has an irregular rhythm. It is caused by a malfunction in the conduction of electricity in the upper chambers or atria of the heart.

A range of conditions that can cause changes in the electrical conduction system of the heart or the muscle around it can contribute to the disorder.

Lifestyle choices, including an inactive lifestyle, smoking, and consuming alcohol in large amounts, can trigger episodes of A-fib.

In this article, we explore the factors that can contribute to triggering A-fib or a person developing the condition.

Heart tissue changes heart tissue
Changes in heart tissue can lead to the abnormal rhythms characteristic of A-fib.

When a person's heart is in its normal sinus rhythm, a signal is sent from a spot in the right atrium, called the sinoatrial (SA) node.

This signal travels down specific conduction pathways and spreads uniformly through the atria first and then the two lower chambers of the heart known as the ventricles.

This process causes the heart to squeeze and pump out blood in a sequence that equates to one heartbeat.

The signal occurs and is conducted through the heart in a stepwise, uniform way so that the heart beats regularly.

In A-fib, the SA node does not work correctly, so the signal to start a heartbeat comes from elsewhere in the atrium.

In this scenario, the signal cannot travel down the usual conduction paths, so it travels all over the heart tissue, chaotically. This causes the heartbeat to be irregular.

Thank you for supporting Medical News Today Characteristics and conditions A number of factors can increase the risk of having A-fib. It occurs more frequently in men and after they reach the age of 65 years old. Conditions that increase the risk for A-fib include: These factors increase the risk of having A-fib, although people can also experience the irregular rhythms of A-fib without having any them. Triggers In one type of A-fib known as paroxysmal A-fib, the episodes can be very short and come and go. Some lifestyle choices can trigger an episode of this type of A-fib. Possible triggers include: large amounts of caffeine, such as in coffee or energy drinks, especially if a person is unused to it large amounts of alcohol, particularly during binge drinking emotional or situational stress recreational stimulant drugs, such as cocaine and methamphetamine smoking tobacco products A-fib is more likely to happen when a person has an infection, such as pneumonia, and in the days following surgery, especially heart or lung surgery. Thank you for supporting Medical News Today Takeaway Changes in electrical signaling in the heart and surrounding tissues that control the heartbeat are at the root of A-fib. Many medical conditions can increase the risk of having A-fib, especially those that involve the heart. Other diseases can also increase the risk, including COPD, hyperthyroidism, and high blood pressure. Triggers can set off episodes of A-fib, including stress and excessive caffeine. If people have concerns about an irregular heartbeat, they should arrange to see their doctor as soon as possible. Q: How do I treat or manage A-fib if the doctor cannot find the cause? A: The treatment for A-fib depends on the type of A-fib you have, not the factors that may be increasing your risk of getting it. If you do have a condition that puts you at increased risk of A-fib, treating that condition may reduce the number of episodes of A-fib you have. Depending on the type of A-fib you have and what your symptoms are, one of two choices of treatment are available. Your doctor will either try to convert back to a regular rhythm or prescribe medications to control the heart rate along with medication to prevent blood clots from forming. Nancy Moyer, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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What are the types of atrial fibrillation?

Atrial fibrillation is a type of arrhythmia, or irregular heartbeat, that often causes the heart to beat at an abnormally fast rate. Doctors need to determine which type of atrial fibrillation a person has to choose the best treatment option for them.

The three main types of atrial fibrillation (A-fib) are paroxysmal, persistent, and long-term persistent. Doctors also categorize A-fib as either valvular or nonvalvular.

In some cases, A-fib may not cause any symptoms, so a doctor might only discover it when testing for other conditions. In some people, it will present with symptoms. The presence of symptoms is not a factor in the classification of A-fib.

In this article, we discuss the different types of A-fib.

Paroxysmal atrial fibrillation arrhythmia
There are several types of A-fib that differ in the length of episode.

A paroxysm is a sudden episode of a disease or symptom.

In paroxysmal A-fib, the irregular rhythm starts suddenly and resolves without treatment within 7 days. The episode may only last a few seconds before it stops on its own.

A person with this type of A-fib will have no noticeable symptoms and may not require treatment to control their heart rhythm. However, a doctor will often prescribe anticoagulation medications to make it harder for the blood to form clots. These drugs may help prevent a stroke.

Episodes occur intermittently at irregular intervals in paroxysmal A-fib.

Approximately half of all cases of A-fib are paroxysmal.

Thank you for supporting Medical News Today Persistent atrial fibrillation The episodes in persistent A-fib are continuous and last for more than 7 days. While these episodes may resolve without treatment, a person with persistent A-fib often needs to receive medication or undergo a procedure to restore their heart rhythm. They may take medication to slow the heart rate. Usually, a doctor also issues anticoagulants to prevent blood clots. Medications that help control the heart rate include beta-blockers and calcium channel blockers. In addition to antiarrhythmic medications, there are several procedures that a doctor may use to restore a regular heartbeat in people with persistent A-fib. These include cardioversion, which involves issuing a small electric shock, and catheter ablation, in which the surgeon destroys the heart tissue that is responsible for the irregular rhythm. Long-term persistent atrial fibrillation This type of A-fib was formerly called permanent A-fib. When medications, cardioversion, catheter ablation, and other methods are unable to convert A-fib back to a normal rhythm, and it seems unlikely that this conversion will be possible, doctors refer to the condition as long-term persistent A-fib. People with this diagnosis will have agreed with their doctor to stop attempting the conversion. However, a doctor might still issue medication to control a person's heart rate and prevent blood clots. Thank you for supporting Medical News Today Nonvalvular and valvular A-fib If A-fib is nonvalvular, this means that a heart valve issue, such as mitral stenosis or a replacement valve, is not the cause of the condition. Conversely, in people with valvular A-fib, an issue with a heart valve is responsible for the arrhythmia. Any of the three types of A-fib can be either valvular or nonvalvular. It is vital that doctors determine whether or not the heart valves are responsible for a person's A-fib before deciding on a treatment plan. Newer medications for preventing blood clots are available, but the United States Food and Drug Administration (FDA) has not approved them as a safe and effective treatment for nonvalvular A-fib. Takeaway Atrial fibrillation is an arrhythmia. There are several different types of A-fib, which vary in the length of arrhythmia episodes and in how they respond to treatment. Paroxysmal A-fib lasts for between a few seconds and 7 days, while persistent A-fib lasts for more than 7 days. Long-term persistent A-fib is continuous and does not respond to treatment. Doctors also classify A-fib as valvular or nonvalvular according to whether or not the heart valves are causing the arrhythmia. Q: How do I know which type of A-fib I have? A: Doctors classify A-fib according to how long an episode lasts. Each type of A-fib may or may not cause symptoms, and you might not know that you have this condition if you do not experience any symptoms.If your episodes last for only a few seconds or up to 7 days, the A-fib is paroxysmal. Episodes lasting longer than 7 days indicate persistent A-fib. When A-fib does not respond to attempts to convert it to a regular rhythm, it is called long-term persistent A-fib. Nancy Moyer, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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What is atrial fibrillation?

Atrial fibrillation is an abnormal heart rhythm, also known as an arrhythmia. Blood flow from the top chambers of the heart to the bottom chambers varies from beat to beat, and the heart cannot pump blood to the rest of the body efficiently.

The Centers for Disease Control and Prevention (CDC) estimate that between 2.7 and 6.1 million people currently have A-fib.

Age is a key risk factor for developing the disorder. According to the CDC, 9 percent of people over the age of 65 years have A-fib in the U.S., but only two percent under 65 years have it.

The heartbeat usually starts from one spot in the right atrium, the upper-right chamber of the heart. However, people with A-Fib have a heartbeat that triggers from multiple spots, which means both atria and the ventricles, or lower chambers, beat at their own pace.

The arrhythmia may or may not produce symptoms. Recognizing and treating A-Fib early in its development can greatly improve the chances of avoiding complications.

Symptoms chest pain man
Chest pain is a symptom of A-fib, if symptoms occur at all.

A-Fib may not cause any symptoms at all, and, when there are symptoms, they may only occur intermittently.

Often the heart rate is higher than usual with AFib, but this depends on how many signals get from the atria to the ventricle.

Common symptoms include:

palpitations, or the feeling of an irregular heartbeat breathlessness, particularly when lying flat chest pain or pressure low blood pressure dizziness, light-headedness, and fainting

People who do not have symptoms will not be aware of A-fib, so it goes untreated. The first sign of A-fib might be a complication, such as a stroke or heart failure.

Keep a close eye on the symptoms and when they occur or change in severity. Make a note of them for your doctor. This will help them make the diagnosis and decide on the best treatment.

Thank you for supporting Medical News Today Complications A-fib can cause potentially life-threatening health issues. Blood clots Blood can pool in the atria if the heart is not beating regularly. Blood clots can form in the pools. A segment of a clot, called an embolus, might break off and travel to different parts of the body through the bloodstream and cause blockages. An embolus can restrict blood flow to the kidneys, intestine, spleen, brain, or lungs. A blood clot can be fatal. Stroke A stroke occurs when an embolus blocks an artery in the brain and reduces or stops blood flow to part of the brain. The symptoms of a stroke vary depending on the part of the brain in which it occurs. They can include weakness on one side of the body, confusion, and vision problems, as well as speech and movement difficulties. Stroke is a key cause of disability in the U.S. and the fifth most common cause of death, according to the CDC. Heart failure A-fib can lead to heart failure, especially when the heart rate is high. When the heart rate is irregular, the amount of blood flowing from the atria to the ventricles varies for each heartbeat. The ventricles may therefore not fill up before a heartbeat. The heart fails to pump enough blood to the body, and the amount of blood waiting to circulate the body instead builds up in the lungs and other areas. A-fib can also worsen the symptoms of any underlying heart failure. Cognitive problems A study in the Journal of the American Heart Association showed people with AFib have a higher long-term risk of cognitive difficulties and dementia that have no link to reduced blood flow in the brain. Risk factors Certain factors increase the risk of developing AFib. These include: Age: The older a person is, the higher the risk of AFib becomes. elderly couple
Age is an important factor in the development of A-fib. Hypertension: Long-term high blood pressure can add strain to the heart and increase the risk of A-fib Pulmonary embolism: A blood clot in the lung increases the risk of A-fib. Heart disease: People with the following conditions have a higher risk of A-fib: Excessive alcohol consumption: Men who have more than two drink a day and women who have more than one drink daily are at increased risk of A-fib . Family members with AFib: A family history of the disease increases the risk of getting it. Other chronic conditions: Other long-term medical problems, including thyroid problems, asthma, diabetes, and obesity, may contribute to the risk of AFib. Sleep apnea: People with this condition, especially when it is severe, have a higher risk of developing AFib. Surgery: A-fib commonly occurs directly after receiving heart surgery. Thank you for supporting Medical News Today Prevention Controlling the factors that increase the risk of AFib may help prevent it. Manage the diet: A heart-healthy diet can help prevent AFib and other heart diseases. The DASH diet, which the American Heart Association (AHA) promotes, has shown protective effects on heart health. Abstaining from harmful substances: Tobacco, alcohol, and some illicit drugs, like cocaine, can damage the heart. With or without a diagnosis of A-fib, eliminating tobacco and mood-altering substances and moderating alcohol is vital for protecting the heart. This is also important in a person who already has A-fib. Stress management: Stress can increase blood pressure and heart rate, which makes the heart work harder. Managing stress levels can help to prevent the progression and development of A-fib. Breathing exercises, mindfulness, meditation, and yoga can all help reduce stress. Exercise: A physically active lifestyle has profound effects on cardiac health and can help strengthen the heart, reducing the risk of AFib and other heart conditions. Treatment The treatment of A-Fib aims to improve symptoms and reduce the risk of complications. For some people, converting the heart back to a normal rhythm is the best option. For others, the doctor deems it better to leave the irregular rhythm in place and prescribe medication to control a high heart rate and prevent the formation of blood clots. In addition to recommending a healthy lifestyle, a doctor will determine the most appropriate treatment depending on symptoms, other conditions they have, and overall health. Medications For AFib, medications are used to control the heart rate, prevent clots from forming. Sometimes medications or a procedure is used to try to restore a regular rhythm. Preventing clots When a doctor thinks the best option is to let someone stay in AFib, they may prescribe anticoagulant medications, or blood-thinners. These medications make it harder for blood to clot. However, stopping bleeding becomes more difficult in a person who takes these medications. The doctor will weigh the risk of developing a clot against the risk of falling and causing a bleed in the brain. Pacemaker
The surgeon might install a pacemaker to moderate heart rhythm. These medications include: warfarin direct-acting oral anticoagulants (DOACs), including rivaroxaban, apixaban, and edoxaban Elderly people with an increased risk of falling often use aspirin but also have a high risk of forming a clot. Aspirin reduces clotting factor but not to the same extent as other medications, so any bleeding is easier to manage. People taking warfarin or other anti-clotting agents should advise any medical professional treating them of their current medications, especially if they will be having a procedure or surgery or have been in an accident. While taking anticoagulants, make sure the doctor knows about any planned or existing pregnancy or any signs of bleeding, such as: very large bruises nausea and light-headedness vomiting blood coughing up blood unusually heavy menstrual flow gums that bleed regularly bloody or black stool blood in the urine sudden back pain that is very severe Take blood thinners exactly as the doctor advises for the best chance of preventing a clotting-related complication and avoiding excessive thinning of the blood. Managing heart rate If the heart rate is high, bringing it down is important to avoid heart failure and reduce the symptoms of A-Fib. Several medications can help by slowing conduction of the signals that tell the heart to beat. These include: beta-blockers, such as propranolol, timolol, and atenolol calcium-channel blockers, such as diltiazem and verapamil digoxin Normalizing heart rhythm Instead of putting a person on blood thinners and heart rate-controlling medicine, doctors may try to return the heart rhythm to normal using medication. This is called chemical or pharmacologic cardioversion. Medications called sodium channel blockers, such as flecainide and quinidine, and potassium channel blockers, such as amiodarone and sotalol, are examples of medications that help to convert A-fib to regular heart rhythm. Procedures When a person does not tolerate A-fib medication needed for someone who has an irregular heart rhythm or doesn't respond to pharmacologic cardioversion, surgical and non-surgical procedures can be used to control the heart rate or try to convert to a regular rhythm to help prevent complications from A-fib. Options for converting A-fib to a regular rhythm include: Electrical cardioversion: The surgeon delivers an electric shock to the heart, which briefly resets the abnormal rhythm to a regular beat. Before carrying out cardioversion, they will often perform an echocardiogram by inserting a scope down the throat to produce an image of the heart to make sure no clots are present in the heart. If they find a clot, a doctor will prescribe anticoagulant medication for several weeks to dissolve it. Cardioversion will then be possible. Catheter ablation: This destroys the tissue that is causing the irregular rhythm, returning the heart to a regular rhythm. The surgeon may need to repeat this procedure if the A-fib returns. The surgeon sometimes destroys the area in which the signals travel between the atria and ventricles. This stops the A-fib, but the heart can no longer send a signal to orchestrate a beat. In these instances, the surgeon will then fit a pacemaker. Surgical ablation: The heart tissue that is causing the irregular rhythm can also be removed in an open-heart surgery called a maze procedure. A surgeon will often carry out this procedure alongside a heart repair. Pacemaker placement: This device instructs the heart to beat regularly. A surgeon will sometimes place a pacemaker in a person with intermittent A-fib that only occurs intermittently. When a doctor feels that another condition is responsible for the A-fib, such as hyperthyroidism or sleep apnea, they will treat the underlying condition alongside the arrhythmia. Thank you for supporting Medical News Today Takeaway A-fib is a disorder that causes an irregular heart rhythm. It occurs more often after the age of 65 years and may or may not cause symptoms. The condition can lead to a stroke when blood pools in the heart and forms a clot that travels to the brain. Lifestyle adjustments that can help to prevent A-fib include a heart-healthy diet, limiting alcohol intake, not smoking, and getting regular exercise. There are two treatment options. A doctor might allow an irregular rhythm to continue but control the heart rate and prescribe an anticoagulant to help prevent a stroke. Alternatively, the doctor might try to convert the irregular rhythm back to a regular one with medication or a procedure. Q: If A-Fib does not show symptoms, how can I take steps to stop it before it causes complications? A: The first step is recognizing you have it. Without symptoms, you won’t know you have A-fib unless your doctor finds it while listening to your heart during an examination or while testing for a different health issue. Increase the odds of finding A-fib by regularly visiting your doctor for ongoing or preventative care. Once you have AFib, unless it stops spontaneously on its own, the only way to avoid complications is through appropriate treatment. Nancy Moyer, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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How does a doctor diagnose atrial fibrillation?

Atrial fibrillation is a heart disorder that causes an irregular heart rhythm known as arrhythmia. It can often make the heart beat faster, which can reduce the blood supply to the rest of the body. Early diagnosis helps reduce the risk of severe complications, such as stroke or heart failure.

A doctor may perform one or more tests to diagnose atrial fibrillation (A-fib).

The doctor will look for signs of A-fib as well as any underlying conditions that might be causing arrhythmia and possible complications.

Sometimes a doctor will refer someone to a cardiologist, who is a specialist in heart disease.

In this article, we look at some of the tests and procedures doctors use to confirm a diagnosis of A-fib, as well as identifying possible causes and complications of the condition.

Medical history A-fib diagnosis cardiogram
A doctor will diagnose A-fib after taking a medical history and carrying out some tests, including a cardiogram.

Firstly, a doctor will ask an individual about their medical history to determine whether they have any risk factors for A-fib.

They will ask about eating habits, exercise routine, whether a person smokes tobacco or uses illicit drugs, and how often they drink alcohol.

They will also ask if there is a family history of A-fib, as people with a family member who has the disorder have an increased risk of having A-fib themselves.

The medical history might help a doctor identify whether a person has any potential signs of A-fib, or symptoms of other conditions that could be causing A-fib.

Thank you for supporting Medical News Today Physical examination The most obvious physical sign of A-fib is an irregular heart rhythm. The doctor will also check how fast the heart is beating by taking a person's pulse. The speed of their pulse indicates their heart rate. The doctor can also listen to the rhythm and rate of the heart with a stethoscope. A doctor will look for other physical indications of a problem with heart function. They will check for signs of any complications of A-fib, such as heart failure. The doctor will check for signs of any conditions that can cause or contribute to A-fib, such as hyperthyroidism, which is an overactive thyroid. Testing There are several tests that doctors can perform to diagnose A-fib, find the cause of A-fib, or identify any complications of it. Electrocardiogram: This records the electrical activity of the heart, and doctors commonly use it for diagnosing A-fib. When someone has A-fib, the ECG will identify an "irregularly irregular" rhythm, which means the heartbeat is random and irregular, with no pattern at all. This is a typical sign of A-fib. stress test
An exercise stress test can help demonstrate heart activity while under duress. Holter monitoring: This is a portable ECG monitor that a person wears to record their heart rhythm and rate over a more extended period while they carry out their daily activities. A person usually wears it for 24 to 48 hours. It is an effective way to document A-fib that occurs intermittently or has no symptoms. Event recorder: Similar to a Holter monitor, a person wears an event recorder for weeks or even months. The individual wearing the monitor pushes a button to start recording whenever they experience symptoms. This allows the doctor to examine the heart rate and rhythm when the symptoms occur and make an accurate diagnosis. This is an effective test for someone who only has the arrhythmia intermittently. However, a person must experience symptoms to know when to start recording, which is not always the case. Echocardiogram: This test uses a device called a transducer that sends sound waves to produce a moving picture of the heart, helping to highlight any blockages, such as blood clots. When a doctor places the transducer on the outside of the chest, it is called a transthoracic echocardiograph (TTE). If the transducer sits on a scope that a doctor then inserts into the esophagus, it is known as a transesophageal echocardiograph (TEE). A TEE produces a clearer image. Some other tests that look for causes or complications of A-fib include: Blood tests: These help identify potential causes of A-fib, such as hyperthyroidism. They can also highlight whether a person has other conditions that may affect A-fib, such as anemia or problems with kidney function. Chest X-Ray: This creates an image of the chest, including the heart and lungs. An X-ray can highlight whether a person has any heart problems, such as heart failure that has caused fluid to build up in the lungs or enlarged the heart. A stress or exercise test: The doctor conducts an ECG while the person engages in a physical activity, such as running on a treadmill. This test can show if A-fib is reducing blood supply to the heart. Tilt-table test: A doctor may perform a tilt-table test if an ECG or Holter monitor do not reveal arrhythmia but the person still experiences symptoms, such as fainting or dizziness. The test checks a person's heart function and blood pressure as the table moves them from a prone to an upright position. If the test shows low blood pressure changes when a person is in an upright position, this may indicate that the brain is not receiving enough blood. Electrophysiology: If a doctor diagnoses a person with arrhythmia, they may recommend an electrophysiologic test. This is an invasive test that involves threading a catheter through a blood vessel into the chambers of the heart. The catheter stimulates the heart and records where the abnormal impulses come from, how fast they are, and which important conduction pathways they bypass. Once a doctor has determined what is causing the arrhythmia, they can recommend treatments to try to correct it. Thank you for supporting Medical News Today Takeaway A-fib can lead to serious complications, but several tests are available to confirm the diagnosis and detect complications. A doctor will ask about a person's medical history, including exercise routine and diet. They will also perform a physical examination, checking for signs and complications of both A-fib and any underlying conditions. They might also perform several tests, including an ECG, take an X-ray of the chest, measure heart activity during exercise, or provide a take-home device to measure heart rate and rhythm over an extended period. Once a doctor has diagnosed arrhythmia, treatments are available to try to stop it. Q: Does A-fib ever go undetected after visiting a doctor for a diagnosis A: A doctor should be able to detect A-fib when they listen to your heart or take your pulse because they can hear and feel the irregular heartbeat. In the unlikely event that a doctor orders an electrocardiogram (ECG) or echocardiogram without listening to your heart, these tests would pick up any signs of A-fib. A doctor cannot identify A-fib if they do not check your heart or pulse. If you experience any symptoms of potential A-fib, such as a fast heartbeat, dizziness, confusion, or chest pains during activity, your doctor will check your heart or pulse. A doctor will not automatically check your heart if you go to see them for something unrelated to your heart, such as a mild skin rash. This means A-fib could remain undetected. Nancy Moyer, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Heart attack: Some risk factors affect women more

Some of the main factors that can predispose a person to heart attack include smoking cigarettes, having high blood pressure and high cholesterol, being overweight, and having diabetes. Whom do these risk factors affect the most, however?
womans heart concept illustration
How do risk factors for heart attack impact men vs. women? A new study weighs in.

During a heart attack, or myocardial infarction, the heart stops functioning normally.

This is because its blood supply is cut off, often by a blood clot.

According to the Centers for Disease Control and Prevention (CDC), someone in the United States experiences a heart attack every 40 seconds, and each year, around 790,000 people go through such an event.

The current stance is that men are more at risk of heart attack compared with women, while women's risk increases after going through menopause.

However, researchers from the George Institute for Global Health at the University of Oxford in the United Kingdom have now conducted a study that indicates that women may be more affected by certain risk factors for heart attack than men.

In the study paper, which now appears in The BMJ, the team reports that a smoking habit, diabetes, and high blood pressure render women even more vulnerable than men to heart attacks.

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The researchers analyzed the data of 471, 998 participants, of whom 56 percent were women. The participants were aged 40–69, and they had no history of cardiovascular disease.

In the first instance, the investigators' findings were not surprising. They confirmed that both men and women are at heightened risk of heart attack if they smoke, have diabetes, have high blood pressure, or have a body mass index (BMI) of over 25, which indicates an unhealthy weight or potential obesity.

Also unsurprisingly, men who smoked 20 or more cigarettes per day had more than twice the risk of experiencing a heart attack compared with men who had never smoked. However, the surprise came when the researchers looked at the data of female participants.

Women who smoked had a more than three times higher risk of heart attack than women who had never smoked. The researchers refer to this as "excess risk."

Women with high blood pressure and diabetes (both type 1 and type 2) also had an increased risk. However, the excessive increase in risk did not apply to women with a high BMI.

More specifically, the researchers found that high blood pressure was tied to an over 80 percent increase in relative risk in the case of women compared with men.

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With type 1 diabetes, women had an almost thrice as high relative risk of heart attack as men, and for type 2 diabetes, women had a 47 percent higher relative risk.

"Overall, more men experience heart attacks than women. However, several major risk factors increase the risk in women more than they increase the risk in men, so women with these factors experience a relative disadvantage," explains lead researcher Dr. Elizabeth Millett.

When looking at how the risk of heart attack changed with age, the researchers found that the hazards associated with smoking and high blood pressure decreased with age for both men and women.

Yet the excess risk associated with women remained consistent, regardless of age.

"These findings highlight the importance of raising awareness around the risk of heart attack women face, and ensuring that women as well as men have access to guideline-based treatments for diabetes and high blood pressure, and to resources to help them stop smoking."

Dr. Elizabeth Millett

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Broken heart syndrome: How complications affect death risk

New research finds that people who develop cardiogenic shock as a complication of broken heart syndrome have an increased risk of death, both in the short-term and in later years.
senior having a heart attack
Broken heart syndrome may feel very similar to a heart attack.

Stressful life events can sometimes put a strain on the heart, quite literally.

A large-scale study from 2018, for example, has confirmed that psychological distress caused by anxiety or depression can boost a person's risk of a heart attack and stroke.

The link between depression and cardiovascular disease is not new. Recently, however, researchers have identified biochemical pathways behind the association, and stress appears to play a key mediating role.

One adverse cardiovascular event that can result from intense stress is broken heart syndrome, a rare condition that mimics the symptoms of a heart attack. It tends to affect women more commonly than men.

People with broken heart syndrome — also called takotsubo cardiomyopathy or stress-induced cardiomyopathy — experience sudden, intense chest pain, along with shortness of breath. Although this can feel similar to a heart attack, the syndrome does not cause blocked arteries.

Instead, part of the heart enlarges and does not pump correctly. Some researchers believe that stress-induced hormones, produced in response to extremely stressful emotions, such as intense grief, anger, or surprise, cause this effect.

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Although broken heart syndrome can be life-threatening, most people fully recover within weeks.

However, 1 in 10 people develop complications such as cardiogenic shock — which occurs when the heart cannot pump enough blood to the rest of the body.

New research has examined the risk of premature mortality among people who developed cardiogenic shock as a result of broken heart syndrome.

The leader of the team was Dr. Christian Templin, Ph.D., the head of acute cardiac care at University Hospital Zurich's University Heart Center in Switzerland.

He will present the findings at Scientific Sessions 2018, held by the American Heart Association (AHA) in Chicago, IL.

The new study will also appear in Circulation, the journal of the AHA.

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Dr. Templin and the team accessed information from the largest database relevant to broken heart syndrome: the International Takotsubo Registry.

The researchers studied information about 198 people who developed cardiogenic shock as a result of the syndrome. They compared this with data from 1,880 people who had the syndrome but not the complication.

The average age of the former group was 63.4 years, while that of the latter was 67.2 years.

Results revealed that, in people who developed cardiogenic shock, physical stress was more than twice as likely to have caused broken heart syndrome.

The stressful event may have been an asthma attack or a surgical procedure, for example.

Also, the patients with cardiogenic shock were more likely to die in the hospital and more likely to have died within 5 years of developing the syndrome.

Specifically, 23.5 percent of the study population with cardiogenic shock died in the hospital, compared with only 2.3 percent of those who had not developed the complication.

An arrhythmia, an abnormality in the heart's left ventricle, and a history of diabetes or smoking were also more prevalent in the group with cardiogenic shock. Diabetes and smoking are common risk factors for heart disease.

Finally, the results showed that the patients with cardiogenic shock were more likely to survive the initial episode if they received cardiac mechanical support.

The study's lead author comments on the findings, saying, "The history and parameters that are easily detectable on admission to the hospital could be helpful to identify broken heart syndrome patients at higher risk of developing cardiogenic shock. For such patients, close monitoring could reveal initial signs of cardiogenic shock and allow prompt management."

"For the first time, this analysis found [that] people who experienced broken heart syndrome complicated by cardiogenic shock were at high risk of death years later, underlining the importance of careful long-term follow-up, especially in this patient group."

Dr. Christian Templin, Ph.D.

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A natural pigment can help decrease cardiovascular risk

According to new evidence, anthocyanin — a pigment present in a variety of fruits and vegetables — could help lower the risk of cardiovascular disease when ingested in high quantities.
assortment of berries
A plant pigment may help keep cardiovascular problems at bay, find the authors of a recent systematic review.

Cardiovascular diseases affect the well-being of many people across the globe. In the United States alone, around 84 million people have some type of cardiovascular problem.

According to the World Health Organization (WHO), cardiovascular diseases are "the number one cause of death globally," and one key strategy for lowering cardiovascular risk is to encourage people to follow healthful diets.

Plenty of fruits and vegetables should be a dietary staple when it comes to looking after heart and blood vessel health, as these foods are filled with essential nutrients.

However, some specific fruits and vegetables may help keep cardiovascular diseases at bay. This is what the authors of a new systematic review featured in the journal Critical Reviews in Food Science and Nutrition have concluded.

The investigators — based at Northumbria University in Newcastle-upon-Tyne, United Kingdom — focused on studies looking at the beneficial properties of anthocyanins, which are natural pigments that lend many fruits and vegetables their reddish, purple, or bluish colors.

Some types of fruit with high anthocyanin content include acai berries, blackberries, raspberries, blueberries, some cherries, and some grapes. Eggplants, some sweet potatoes, and red cabbage also contain this pigment.

Anthocyanins are also a class of flavonoids, which are natural antioxidants that act at the cell level and have a protective effect against cellular degeneration.

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The researchers identified and analyzed 19 prospective cohort studies looking at the effect of anthocyanins on the health of the heart and the circulatory system.

In total, these studies presented data collected from over 602,000 individuals from across the U.S., Europe, and Australia, and their authors monitored participants for periods between 4 and 41 years.

In the new review, the team focused on how dietary anthocyanin intake compared with the incidence of heart disease and cardiovascular events, including stroke, heart attacks, and death due to heart disease-related causes.

They found that individuals who had the highest anthocyanin intake had a 9 percent lower risk of developing coronary heart disease and an 8 percent lower risk of death due to heart disease, when compared with peers who integrated the fewest anthocyanin sources in their diets.

"Our analysis is the largest, most comprehensive evaluation of the association between dietary anthocyanin intake and the risk of cardiovascular disease," notes study co-author Prof. Glyn Howatson, from the Department of Sport Exercise and Rehabilitation at Northumbria University.

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"Evidence has been growing in recent years to suggest that these natural plant compounds might be especially valuable for promoting cardiovascular health," he adds.

However, the researchers also warn that the benefits that anthocyanins seem to provide may not apply across populations. This is because, when the scientists tried differentiating the links between the pigment and cardiovascular risk based on location, they noticed that the association only remained significant for groups based in the U.S.

Thus, the researchers suggest that anthocyanins may be particularly relevant for cardiovascular health in the context of North American dietary habits.

This review, the authors also disclose, received financial support from the Cherry Marketing Institute, a nonprofit organization funded by U.S.-based tart cherry growers and processors.

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Mediterranean diet: New evidence of its heart-healthy benefits

New research adds to the list of the Mediterranean diet's potential cardiovascular benefits. The results suggest that fish and vegetables trigger the production of a gut-derived metabolite that reduces signs of hypertension and heart abnormalities in rats.
mediterranean food on a plate
A diet rich in fish and vegetables triggers a heart-healthy compound, new research indicates.

Various recent studies have hailed the health benefits of the Mediterranean diet, which mainly consists of vegetables, fish, and whole grains.

Results of some studies have linked the diet with good cardiovascular health and a longer lifespan, and some research has suggested that it helps protect against health issues, such as diabetes and stroke.

Researchers believe that the heart-healthy benefits of the Mediterranean diet result from the quantity of monounsaturated fats, which increase levels of "good" cholesterol and improve its functioning.

New research adds to the list of reasons why the Mediterranean diet may be good for the heart.

The results indicate that a compound called trimethylamine N-oxide (TMAO) reduced cardiac fibrosis, or the thickening of the heart, and signs of heart failure in rodents. Other studies have associated the compound with eating seafood and vegetables.

Tomasz Huć, of the Medical University of Warsaw in Poland, is the first author of the paper, which was just published in the American Journal of Physiology — Heart and Circulatory Physiology.

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Studying TMAO and heart health in rats

Blood levels of TMAO increase after consuming foods that are high in the compound, such as fish, seafood, and vegetables. The liver also produces TMAO with the help of gut bacteria, explain the researchers.

As Huć and his colleagues note, the role of TMAO in the cardiovascular system has been unclear, with several studies yielding contradictory results.

Some studies suggest that TMAO has a harmful effect on the cardiovascular system, while others indicate that the compound has protective effects in animal models.

Huć and his team set out to study the effects, using a model of rats that were predisposed to hypertension. One group of rodents received a low dosage of TMAO, which was added to their drinking water, while another group received no supplemental TMAO.

The dosage was high enough, however, to increase the amount of TMAO in the blood to four or five times normal levels.

The rats received supplementation for either 12 weeks or 56 weeks. The researchers compared them with a control group of rodents that were not genetically predisposed to developing high blood pressure.

Between weeks 7 and 16 of the rats' lives, the team measured their blood pressure and left ventricular end-diastolic pressure.

The researchers also used echocardiography to assess the structure and functioning of the rodents' hearts and electrocardiography to monitor their heartbeats.

Because previous studies point to an inverse correlation between TMAO levels and kidney function, the researchers also examined the rats for signs of kidney damage.

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How TMAO protects the heart

The dosage of TMAO did not appear to affect the development of hypertension in rodents predisposed to the condition.

In fact, the condition of the rats' hearts improved, even after taking TMAO supplementation for 56 weeks. Huć and his colleagues explain:

"[A] four- to fivefold increase in plasma TMAO does not exert negative effects on the circulatory system. In contrast, a low-dose TMAO treatment is associated with reduced cardiac fibrosis and [markers of] failing heart in spontaneously hypertensive rats."

"Our study provides new evidence for a potential beneficial effect of a moderate increase in plasma TMAO on pressure-overloaded heart," the authors continue.

The researchers note that fully understanding the effects of TMAO on the cardiovascular system will require further studies.

However, a person could indirectly conclude from these findings that a Mediterranean diet rich in fish and vegetables may benefit the heart.

While some older studies indicate that the body makes TMAO in response to the intake of beef and eggs and that the compound has a harmful effect, Huć and his team pay heed to the evidence that TMAO is produced after the ingestion of fish, seafood, and vegetables.

They acknowledge that "it seems that a fish-rich and vegetarian diet, which is beneficial or at least neutral for cardiovascular risk, is associated with a significantly higher plasma TMAO than red meat- and egg-rich diets, which are considered to increase the cardiovascular risk."

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What hookah smoking can do to your blood vessels

New research is suggesting that hookah smoking can impair the endothelial function of blood vessels, which is a key indicator of cardiovascular health.
hookah smoking
Hookah smoking may harm your blood vessels, shows a recent study.

More and more people are giving up smoking, and they are sensible to do so.

Cigarette smoking is "the leading preventable cause of death in the United States," according to the Centers for Disease Control and Prevention (CDC), with cigarettes causing over 480,000 yearly deaths.

However, as the use of regular cigarettes is declining, more and more people are turning to alternatives that many perceive as safer, such as electronic cigarettes or hookah smoking.

However, is hookah smoking truly safe? Several recent studies suggest that the answer is "no." For example, a study that Medical News Today covered in 2016 found that a single session of hookah smoking delivers 10 times the amount of carbon monoxide present in a regular cigarette.

Another more recent study found that hookah, also known as shisha, smoking can stiffen the arteries to a degree comparable with that which normal cigarettes can achieve.

Arterial stiffness is a predictor for stroke, and so is the enlargement of the aorta, which is another effect that hookah smoking was found to have.

Now, new research presented at the American Heart Association's (AHA) Scientific Sessions 2018 — which took place in Chicago, IL — adds to the evidence that suggests hookah smoking may indeed harm cardiovascular health.

Mary Rezk-Hanna, Ph.D., an assistant professor at the University of California, Los Angeles School of Nursing, is the lead author of the study.

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Studying the effects of hookah smoking

Rezk-Hanna and colleagues examined 30 young, healthy adults before and after they took part in a session of hookah smoking. The participants were 26 years old, on average.

The team examined the participants' blood levels of nicotine before and after the smoking session and measured their exhaled carbon monoxide levels and a marker of artery function called flow-mediated dilation of blood vessels.

The latter measure describes the dilation, or widening, of blood vessels when blood flow increases. Flow-mediated dilation is a measure of the endothelial function of arteries, and many consider endothelial dysfunction to be "the initial phase of the atherosclerotic process."

In this study, the researchers compared the results of these measures with the effects of one normal cigarette in age-matched people who smoke regular cigarettes.

Also, Rezk-Hanna and team took the same measurements before and after hookah smokers were asked to use an electronic device to vape a mixture of carbon monoxide gas that mimicked the effects that people normally get from charcoal-heated hookah smoking.

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How hookah smoking may harm the arteries

The researchers revealed that exhaled carbon monoxide levels were nine to 10 times higher in charcoal-heated hookah smoking than in electronically heated hookah or regular cigarette smoking. Nicotine levels, however, were equally high across all smoking sessions.

Also, the study discovered that flow-mediated dilation was higher after charcoal-heated hookah smoking, while electronically heated hookah or traditional cigarette smoking lowered flow-mediated dilation. A lower flow-mediated dilation indicates endothelial dysfunction.

The researchers explain that the main difference between charcoal-heated and electrically heated hookah is that charcoal briquettes produce high levels of carbon monoxide.

This chemical, in turn, dilates blood vessels, which, the authors speculate, might mask the damaging effects of charcoal-heated hookah smoking on endothelial function.

So, hookah smoking may harm blood vessel function in the same way as cigarette smoking.

"Hookah is the only form of tobacco product that uses burning charcoal briquettes to heat the flavored tobacco in the water pipe. So, in addition to toxic substances from tobacco and nicotine, hookah smoke exposes users to charcoal combustion products, including large amounts of carbon monoxide."

Mary Rezk-Hanna, Ph.D.

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Can this Amazonian diet offer a solution to heart disease?

In the United States, hundreds of thousands of people die every year from causes related to heart disease. Cardiovascular health is a fragile asset, but one population from the Bolivian Amazon seems to possess the secret to a life free of heart disease. What is it?
rice plantain and beans
Researchers map out the diet that may have rendered a Bolivian people 'immune' to heart disease.

According to the Centers for Disease Control and Prevention (CDC), approximately 610,000 people die because of heart disease-related problems each year in the United States.

At global level, cardiovascular diseases caused around 31 percent of all deaths in 2016 alone, the World Health Organization (WHO) note.

The main modifiable factor that specialists focus on when it comes to prevention strategies against heart disease is diet.

American Heart Association (AHA) guidelines indicate that to keep heart disease at bay, a person should follow a diet that is rich in fruit, vegetables, whole grains, and oily fish.

Is this the best diet for the heart? A team of anthropologists from the University of California–Santa Barbara has recently decided to look for clues among the peoples of the Bolivian Amazon.

One particular population, called the Tsimane, are remarkable in that they almost never develop heart disease, and only very rarely do they have hypertension, unhealthful cholesterol levels, obesity, or type 2 diabetes.

The researchers thought that one key factor in the Tsimane's seeming imperviousness to heart disease might be their diets. The Tsimane, the investigators note, have so far been minimally influenced by globalization trends.

Their food tends to come from natural sources, and they purchase very little produce from markets. In this respect, the Tsimane differ from their neighbors, the Moseten, with whom they share the same language but not the same diets and lifestyles.

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A carb-rich diet

Unlike the Tsimane, who are more sheltered, the Moseten acknowledge outside influences, which have impacted their dietary habits as well as their lifestyles. As a result, the Moseten may also be more at risk of cardiovascular and metabolic diseases when compared with their more isolated "cousins."

"Our prior work," says senior study co-author Prof. Michael Gurven, "showed that the Tsimane have the healthiest hearts ever studied, so naturally there's a lot of interest in understanding why and how."

So, to understand what sets the Tsimane apart and allows them to enjoy such perfect heart health well into old age, the researchers interviewed them about their daily dietary and lifestyle choices.

"We conducted a detailed analysis of the Tsimane diet and then compared it to what modern Americans typically eat, and to the diets that claim to be heart healthy," says Prof. Gurven.

The investigators also compared the Tsimane's choices with those of the Moseten, the people with whom they are most closely related. In total, the team spoke to 1,299 Tsimane and 229 Moseten, and they compiled detailed profiles of the two people's diets.

In the study paper that appears in the American Journal of Clinical Nutrition, the researchers report that the Tsimane's usual diet was high in carbohydrates and protein but low in fat.

The Tsimane diet was high-calorie — amounting to 2,433–2,738 kilocalories per day — and it comprised 64 percent carbs, 21 percent protein, and 15 percent fats.

Perhaps surprisingly, the Tsimane do not appear to eat a variety of foods. Instead, their meals tend to gravitate around a few dietary staples. The researchers say that about two-thirds of calories come from complex carbohydrates, present in foods such as rice and plantain.

Around 16 percent of calories come from fish — of which they eat over 40 different species — and another 6 percent from wild game. The Tsimane buy only 8 percent of their foods from the market.

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The challenge of changing lifestyles

Another surprise, given the lack of great dietary diversity, is that the Tsimane do not have many micronutrient deficiencies. While this people tends to run low on calcium and some vitamins — such as D, E, and K — they absorb a lot of potassium, magnesium, and selenium.

These nutrients, the researchers say, may help boost cardiovascular health, and the Tsimane consume them at levels that are higher by far than the typical amount present in North American diets.

Furthermore, the Tsimane eat almost twice as many fiber-rich foods as the Moseten or U.S. populations. However, the researchers also express the concern that, as globalization trends increase, the Tsimane are slowly giving in to harmful influences from outside of their own society.

So, they found that over the 5-year period during which they conducted the present study, the Tsimane's total energy and carbohydrate intake soared, and many of them have started to add larger quantities of lard, oil, sugar, and salt to their diets.

"This is a key time," says the study paper's lead author, Thomas Kraft. "Roads are improving in the area, as is river transport with the spread of motorized boats, so people are becoming a lot less isolated compared to the past. And it's happening at a pretty rapid pace."

Prof. Gurven goes on to say that, given the opportunity to bulk-buy ingredients such as sugar, it is unsurprising that the Tsimane are, little by little, transitioning to less healthful diets. "Getting calories cheaply with less effort — who wouldn't?" he asks.

Yet, he also adds that the Tsimane's search for higher calorie counts may be due to the fact that they actually lead very active lifestyles.

"[They're] also physically active — not from routine exercise, but from using their bodies to acquire food from their fields and the forest, which is also an important lesson," says Prof. Gurven.

"You can't look at what you're eating irrespective of what you're doing with your body. If you're physically active, you can probably get away with more flexibility in the diet."

Prof. Michael Gurven

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It may only take one energy drink to harm your blood vessels

Is it safe to consume energy drinks in any quantity? From students pulling all-nighters to fitness enthusiasts, many people use these boosters, but a new study suggests that a single energy drink could immediately harm blood vessel function.
colorful energy drink
How do energy drinks affect vascular health? A new study investigates.

According to the National Center for Complementary and Integrative Health (NCCIH), energy drinks are among the most commonly used dietary supplements in the United States.

The NCCIH note, specifically, that men "between the ages of 18 and 34 years consume the most energy drinks," and that "almost one-third of teens between 12 and 17 years drink them regularly."

Because they contain high levels of caffeine, taurine, and other stimulating substances, the safety of energy drinks has always been the subject of intense debate.

For instance, the authors of one study covered by Medical News Today expressed concerns that energy drinks may act as a gateway for illicit drug use. Other research indicates that having too many energy drinks may cause liver damage.

Mostly, however, researchers have been concerned about the impact of energy drinks on cardiovascular health. Reportedly, having more than two such drinks per day may endanger the heart.

Now, specialists from the McGovern Medical School at the University of Texas Health Science Center at Houston are preparing to present evidence that a single energy drink may have serious negative effects on blood vessel function.

Dr. John Higgins and colleagues are due to present their findings next week at the American Heart Association's (AHA) Scientific Sessions 2018, which will be held in Chicago, IL. During the 3-day summit, specialists will present the latest findings and advances related to cardiovascular health and care.

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The study included 44 young, healthy participants. All were medical students in their 20s who did not habitually smoke.

The researchers tested the participants' endothelial (blood vessel) function at baseline, to establish how energy drinks would affect it.

The participants then each had a 24-ounce energy drink. Ninety minutes later, the researchers again performed the endothelial function tests.

At the 90-minute mark, the tests showed that the students had poorer artery flow-mediated dilation than they had before consuming the energy drinks.

Artery flow-mediated dilation indicates blood vessel health. At baseline, it was about 5.1 percent in diameter, on average.

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Following energy drink consumption, this measurement fell to 2.8 percent in diameter. The researchers explain that this indicates acute impairment of blood vessel function.

The authors of the study speculate that the impairment of vascular function may result from a combination of substances typically used in energy drinks, including caffeine, taurine, sugar, and herbal stimulants.

Dr. Higgins and his team explain that it is still unclear whether energy drinks are safe to consume, and in what quantities. They add:

"As energy drinks are becoming more and more popular, it is important to study the effects of these drinks on those who frequently drink them and better determine what, if any, is a safe consumption pattern."

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What are the limitations of BMI?

Body mass index, or BMI, is a useful tool for determining healthful weight, but experts have expressed uncertainty about its reliability.

BMI alone cannot show whether a person's weight is healthful, but using it in combination with other indicators can provide a more complete picture.

Age and sex BMI incorporates height and weight
BMI incorporates height and weight but not body composition, fitness, age, or sex.

For adults ages 20 years and older, BMI incorporates weight and height, but it does not take age or sex into account.

A woman tends to have more body fat than a man with the same BMI. Likewise, an older person tends to have more body fat than a younger person with an equal BMI.

For these reasons, BMI may not give the detail necessary to determine whether a person's weight is healthful.

Thank you for supporting Medical News Today Body composition BMI does not reflect the location or amount of body fat, and these factors can impact health. For example, studies have indicated that people who have fat around the waist and surrounding the abdominal organs may be more at risk of health problems than those with fat in other areas. A 5-year investigation of 1,964 people, published in Scientific Reports in 2017, was one study that confirmed these findings. BMI and health If a person has a high BMI, they are likely to have a high proportion of body fat, especially if their BMI falls in the obesity category. However, it is possible to be "overweight" according to BMI, but have healthful levels of fat. For extremely muscular people, such as athletes and bodybuilders, height and weight measurements alone may not accurately indicate health, because muscle weighs more than fat. A healthy, muscular person may have a BMI in a very high range. Meanwhile, a frail, inactive person may have a low BMI, but more body fat and less lean tissue than is healthful. Thank you for supporting Medical News Today Stages of development Regular BMI cannot accurately indicate the state of a person's health at some stages in life. These include: pregnancy and breastfeeding childhood and adolescence, while a person is still growing For this reason, BMI calculations are different for children and teens. These measurements take age and sex into account. Norm can also vary among people of certain races and ethnicities. Making BMI accurate The National Heart, Lung, and Blood Institute (NHLBI) suggest that an assessment of weight and health risks should incorporate three key measures: BMI waist circumference risk factors for diseases and conditions associated with obesity Waist circumference Waist size may be a useful indicator
Waist size may be a useful indicator of future health risks. If fat accumulates around the waist rather than the hips, a person may have a higher risk of heart disease and type 2 diabetes. This risk increases with a waist size greater than 35 inches for non-pregnant women or greater than 40 inches for men, according to the Centers for Disease Control and Prevention (CDC). To measure their waist, a person should: Place a tape measure around their middle, just above the hip bones and the naval. Take the measurement just after breathing out. Weight, obesity, and health risks The following information, adapted from the NHLBI, may help indicate the risks associated with BMI and waist circumference. The chart shows weight categories according to BMI, and the effects of higher waist circumference on the risks of type 2 diabetes, hypertension, and cardiovascular disease. Classification BMI (kg/m2) Obesity class Waist Waist Men 40 inches or less Women 35 inches or less Men: 40 inches or more Women: 35 inches or more Underweight 18.4 or less Healthful weight 18.5–24.9 Overweight 25.0–29.9 Increased risk High risk Obesity 30.0–34.9 I High risk Very high risk 35.0–39.9 II Very high risk Very high risk Extreme obesity 40.0+ III Extremely high risk Extremely high risk A doctor may also measure body fat composition. Risk factors for obesity-related conditions Being overweight or having obesity can increase the risk to the heart. Taking blood pressure
If a high BMI and large waist size pair with other risks, such as high blood pressure, it might be time to take some action to prevent future problems. The following issues can also increase the risk of developing heart disease, for example. high blood pressure (hypertension) high levels of low-density lipoprotein ("bad") cholesterol low levels of high-density lipoprotein ("good") cholesterol high levels of triglycerides high blood sugar levels a family history of early heart disease physical inactivity cigarette smoking a high consumption of alcohol A doctor will recommend that a person consider losing weight if they: have a BMI of 30 or greater have a BMI of 25–29.9 plus two or more risk factors Thank you for supporting Medical News Today Takeaway If a person has obesity or excess weight plus two or more risk factors, they may be at risk of a number of obesity-related health problems in the future. Losing 5–10 percent of their current weight can reduce the risk of developing these health problems. Some people are overweight but have no other risk factors, such as high cholesterol or high blood pressure. They should follow a healthful and varied diet, and get regular exercise to prevent additional weight gain.
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