The Heart

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Air pollution may raise atherosclerosis, heart disease death risk

New research examines the link between exposure to air pollution and the risk of coronary artery calcification among Chinese adults.
woman with mask on her face
A new study provides additional evidence that pollution may affect our cardiovascular health.

Studies have linked air pollution with the risk of developing a range of conditions, from neurological disorders such as Parkinson's disease and Alzheimer's to diabetes and atherosclerosis, which is the hardening of the arteries.

For instance, early last month, Medical News Today reported on a study by researchers at the University at Buffalo School of Public Health and Health Professions in New York, which linked long-term exposure to air pollution with the risk of atherosclerosis in six cities across the United States.

Now, the same lead author, Meng Wang, has carried out similar research in China, making this new study the first to examine pollution and coronary artery calcification among Chinese adults.

Wang and team set out to examine whether "air pollution and proximity to traffic" correlate with coronary artery calcium score, a key marker of atherosclerosis.

Atherosclerosis refers to the buildup of plaque inside the artery walls, which, over time, may lead to serious cardiovascular conditions, such as high blood pressure, heart disease, and heart attacks.

Wang and team published their findings in the journal JAMA Network Open.

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Studying air pollution and artery health

Wang and colleagues examined data on 8,867 Chinese people aged between 25 and 92 years. The participants all had suspected coronary heart disease, and the team recruited them in 2015–2017.

The researchers assessed the coronary artery calcium and coronary heart disease score of each participant and excluded anyone who had had a myocardial infarction, stenting procedure, or coronary artery bypass surgery in the past. They also excluded those for whom the data on risk factors and exposure to pollution were insufficient.

Wang and team estimated the annual levels of pollution at the participants' residences by calculating their nitrogen dioxide, ozone, and fine particulate matter levels using a standard geostatistical prediction model.

In this case, fine particulate matter (PM2.5) describes particles with an aerodynamic diameter smaller than 2.5 micrometers that are very easy to inhale.

Particulate matter, or particle pollution, refers to "a mixture of solid particles and liquid droplets," including "dust, dirt, soot, or smoke," that can be present in the air and that a person cannot see with the naked eye.

In the new study, the researchers also estimated the participants' proximity to traffic, looking at the distance of their residences from nearby roads.

Pollution may raise heart disease death risk

The research revealed that for each nitrogen dioxide increase of 20 micrograms per cubic meter (μg/m3), the risk of a high coronary artery calcium score rose by 24.5%.

Additionally, for each increase of 30 μg/m3 of PM2.5 that the participants had exposure to in their apartments, there was an increase of 27.2% in the coronary artery calcium score.

"This finding should contribute to an understanding of air pollutant effects worldwide, providing both much-needed, locally generated data and supportive evidence to inform the air pollution standard-setting process on a global scale," comments Wang.

"This study may provide evidence that coronary atherosclerosis is a pathological pathway through which air pollution exposure increases risk of death from coronary heart disease."

Meng Wang

The lead author goes on to explain: "Atherosclerosis is a lifelong process. As such, the effects of air pollution exposure on atherosclerosis are likely to be chronic."

"Since more than 40% of all deaths are attributable to cardiovascular disease, the potential contribution of air pollutants to cardiovascular disease in China is very large," says the researcher, suggesting that "the current air pollution standard may need to be reevaluated."

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Top 13 high potassium foods

Potassium is an important nutrient for many body processes. Bananas are a well-known source of potassium, but many other foods contain just as much — if not more — of this nutrient.

Potassium is an electrolyte that helps regulate fluid and blood levels in the body. Many fruits and vegetables are excellent sources of potassium. Meat, milk, yogurt, and nuts are also good sources.

According to the Centers for Disease Control and Prevention (CDC), a diet high in potassium and low in sodium — an electrolyte in table salt and processed foods — can lower blood pressure and reduce the risk of heart disease and stroke.

The adequate intake (AI) of potassium for adults is currently 3,400 milligrams (mg) per day for men and 2,600 mg for women.

According to the Office of Dietary Supplements (ODS), the daily value (DV) of potassium — the daily intake that the Food and Drug Administration (FDA) recommend — will increase to 4,700 mg in January 2020.

Bananas contain 422 mg of potassium per medium fruit. In this article, we take a look at other good sources of potassium according to the ODS and the 2015–2020 Dietary Guidelines for Americans.

1. Dried apricots Dried apricots on a table which are a food high in potassium
Dried apricots are a good source of iron, antioxidants, and potassium.

Several dried fruits are high in potassium. Apricots are a bright orange fruit that people may eat either fresh or dried.

Half a cup of dried apricots contains 1,101 mg of potassium. These fruits also provide other key nutrients, such as iron and antioxidants.

When purchasing dried apricots, a person should look for those that contain no added sugar. They can eat dried apricots as a snack or add them to salads or main meals.

2. Potatoes Potatoes are an excellent source of potassium. Baked potatoes with the skin still on are the best option, as much of a potato's potassium is in the skin. One medium baked potato with skin contains 941 mg of potassium. By eating a baked potato with salt-free seasoning, a person can avoid extra sodium. French fries are usually lacking in nutrients and contain added fat from oil and the frying process, making them a less healthful option. Fries also typically contain high amounts of sodium, which can counteract the benefits of potassium. 3. Leafy greens Leafy greens are some of the most nutritious foods available. One study found that eating a serving per day of leafy green vegetables may help slow age-related cognitive decline. Leafy green vegetables are low in calories and contain many vitamins and minerals. Most also provide a good amount of potassium. For instance: A cup of cooked Swiss chard contains 962 mg of potassium. A cup of cooked amaranth leaves contains 846 mg. A cup of cooked spinach contains up to 838 mg. Thank you for supporting Medical News Today 4. Lentils cooked red lentils in a wooden bowl on table with garlic and chilies
Lentils contain potassium, fiber, and protein. Lentils are a small, round legume. They contain plenty of fiber and are also rich in protein. One cup of cooked lentils contains 731 mg of potassium. Lentils make a good addition to soups or stews. People looking for a quicker option can use canned rather than dried lentils. However, it is important to rinse canned lentils well before use to remove any sodium. 5. Prunes and prune juice Prunes are dried plums. Due to their high fiber content and other chemical properties, many people use prunes or prune juice to help relieve constipation. Juice companies usually make prune juice by adding water back into the prunes, cooking them, and then filtering out the solids. There are 707 mg of potassium in one cup of canned prune juice, while half a cup of dried prunes contains 699 mg. 6. Tomato puree or juice Fresh tomatoes offer several health benefits. To get more potassium, though, it is best to use concentrated tomato products, such as tomato puree or tomato juice. Half a cup of tomato puree contains 549 mg of potassium, and a cup of tomato juice contains 527 mg. Fresh tomatoes also contain potassium, with one medium raw tomato containing 292 mg. People often use tomato puree in cooking, for example, adding it to pasta sauces. Canned or bottled tomato juice is also suitable to use in many recipes, or people can drink it. 7. Certain fruit and vegetable juices Some varieties of juice contain high amounts of potassium. However, many health organizations recommend that people avoid juices with added sugar. Whole fruit contains more fiber than juice and often more nutrients as well. Still, 100% juice can be part of a healthy diet in limited amounts, according to the American Heart Association and the Dietary Guidelines for Americans. The following juices are high in potassium, containing the following amounts per cup: carrot juice (canned): 689 mg passion fruit juice: 687 mg pomegranate juice: 533 mg orange juice (fresh): 496 mg vegetable juice (canned): 468 mg tangerine juice (fresh): 440 mg 8. Raisins Raisins are another type of dried fruit that is high in potassium. Raisins are a popular snack food. Half a cup of raisins contains 618 mg of potassium. For the most healthful type, opt for raisins that contain only dried grapes with no added sugar, coatings, or other ingredients. 9. Beans Beans come in many sizes, shapes, and colors. Most contain a high amount of fiber, some protein, and a good dose of potassium. Kidney beans are red, kidney-shaped legumes that people often use in soups, chili, or as a side dish of baked beans. A cup of canned kidney beans contains 607 mg of potassium. Many other beans are also high in potassium. The amounts per half cup serving are as follows: adzuki beans: 612 mg white (cannellini) beans: 595 mg lima beans: 478 mg great northern beans: 460 mg black beans: 401 mg canned refried beans: 380 mg navy beans: 354 mg 10. Milk and yogurt People typically think of dairy products, such as milk and yogurt, as being rich sources of calcium. However, some dairy products are also a good way to add more potassium to the diet. Studies suggest that in the United States, milk is the top source of potassium among adults. A cup of 1% milk contains 366 mg. Many people also get their potassium from tea and coffee. An 8-ounce (oz) cup of brewed black coffee contains 116 mg of potassium, which would classify it as a low potassium food, but adding creamers and milk raises the potassium content considerably. Other dairy products also contain potassium. For instance, one cup of plain nonfat yogurt contains up to 579 mg. 11. Sweet potatoes sweet potato wedges
Sweet potatoes are rich in potassium. Sweet potatoes have orange flesh and a sweeter flavor than white potatoes. Their orange color means that they provide more beta carotene than other potatoes, but they also contain potassium. A baked sweet potato with the skin still on contains 542 mg of potassium. For the most healthful option, a person should eat baked or microwaved sweet potatoes without added sugar. It is also best to avoid canned sweet potatoes that the manufacturers have packaged in syrup. Thank you for supporting Medical News Today 12. Seafood Fish and shellfish contain heart-healthy omega-3 fats. The American Heart Association recommend eating fish (particularly fatty fish) at least twice a week. Certain types of seafood are also good sources of potassium. Wild Atlantic salmon and clams lead the way with 534 mg of potassium per 3-oz serving. The same serving size of other types of seafood high in potassium offers: mackerel: up to 474 mg halibut: 449 mg snapper: 444 mg rainbow trout: up to 383 mg 13. Avocado Avocado is a buttery fruit that contains a variety of nutrients, including heart-healthy monounsaturated fat and vitamins C, E, and K. Avocados also contain nearly 5 grams of fiber in half a cup. Avocados are a good source of potassium, providing 364 mg in a half-cup serving. People can eat avocados raw in salads, as dips, or on toast. They also work well in cooked meals, such as pasta dishes. What about potassium supplements? Some people may wonder about using supplements to boost their potassium intake. Only a few studies have investigated the effects of potassium supplements, and some suggest that the body can absorb potassium as well from supplements as it can from food. However, the ODS say that in many dietary supplements, manufacturers limit the amount of potassium to 99 mg — only about 3% of a person's DV — due to safety concerns about drugs that contain potassium. People with kidney problems should be cautious about consuming too much potassium, as this can lead to hyperkalemia, or high levels of potassium in the blood. Potassium from food, however, does not cause harm in healthy people who have normal kidney function. When the kidneys are functioning well, any excess potassium from food dissolves in water and leaves the body in the urine. Summary If a person eats a diet rich in vegetables, fruits, and legumes, they should get enough potassium in their diet. It is beneficial to balance this by eating low amounts of high sodium foods, such as processed foods and fast food. This dietary approach can not only help keep potassium at a healthy level, but it may help people obtain a variety of other vitamins and nutrients that occur in whole foods and contribute to better health.
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Switching off this enzyme reversed prediabetes in mice

Targeting the body's ceramide chemistry in a subtle way could lead to the development of safe new treatments for type 2 diabetes, heart disease, and other metabolic conditions.
image of dna code on screen in foreground, scientists working in the background
Scientists have reversed prediabetes by switching off a certain enzyme.

This was the suggestion that scientists made after finding that they could reverse prediabetes in mice with obesity by silencing an enzyme responsible for the final step of ceramide production.

Deactivating the enzyme, called dihydroceramide desaturase 1 (DES1), lowered levels of ceramide in the body, they note in a recent Science paper about their work.

Switching off DES1 also prevented mice on a high fat diet from developing fatty liver and insulin resistance. These two conditions are prime risk factors for heart disease and diabetes.

DES1 controls the conversion of dihydroceramide into ceramide with a small chemical shift of two hydrogen atoms. This subtle alteration effectively inserts a "double bond into the backbone" of the lipid molecule.

Previous investigations had already suggested that reducing ceramide levels could potentially reverse metabolic disease and diabetes. However, the methods that they used would result in severe side effects.

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'Ceramides as the next cholesterol'

The new study takes the research in a more promising therapeutic direction. It suggests that it could be possible to reduce ceramide levels in a safe way with a small, well timed tweak to the process of ceramide production.

"Our work," says co-senior study author Prof. Scott A. Summers, department chair of Nutrition and Integrative Physiology at the University of Utah in Salt Lake City, "shows that ceramides have an influential role in metabolic health."

"We're thinking of ceramides as the next cholesterol," he adds.

Scientists are still finding out how lowering the ceramides affects the body. However, there is evidence, Prof. Summers argues, of a link between ceramides and metabolic disease.

He says that some doctors are already carrying out tests of ceramide levels as a way to assess people's risk for heart disease.

"Ceramides contribute to the lipotoxicity that underlies diabetes, hepatic steatosis [fatty liver], and heart disease," note the authors of the new study.

If ceramides can be a cause of disease, what purpose do they serve in the body? The researchers investigated this question by assessing the impact of ceramide on metabolism.

Ceramide pros and cons

In a 2013 study into DES1 and ceramides, Prof. Summers and his co-authors discussed how obesity could increase metabolic disease risk, and how ceramides contribute.

The theory is that in people with obesity, the body's tissues receive an abundance of lipids that they cannot store, and this leads to a buildup of "fat-derived molecules that impair tissue function."

Prof. Summers and his colleagues discovered that ceramides set off a number of processes that increase fat storage in cells. In addition, they disrupt the ability of cells to get energy from sugar, or glucose.

The lipids also slow down the processing of fatty acids. They do this in two ways: by getting the liver to store more fatty acids, and by reducing fat burning in tissues.

Ceramides also have other functions. One of these is to strengthen cell walls.

Prof. Summers therefore suggests that because increasing fat storage raises ceramide levels, it would seem that ceramides have a role in protecting cells from rupturing during times of plenty, when the body increases its fat stores.

However, in the case of obesity, ceramide appears to take on the role of a toxic lipid.

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Obese mice had improved metabolic health

In the recent study, the researchers lowered ceramide levels in mice by shutting off the last step of ceramide synthesis. To accomplish this, they genetically engineered mice in which they could switch off the gene for DES1 in adult animals.

They developed two ways of switching off DES1: globally and selectively. In the global approach, they silenced DES1 in the whole body. In the selective approach, they switched off the enzyme in selective locations, such as in the liver or fat cells.

When they switched off DES1 to lower ceramides in extremely obese mice with insulin resistance and fatty liver, they found that either approach worked. The animals' metabolic health improved, even though they remained obese.

Their livers got rid of fat, and their insulin and glucose responses were as sharp as those of healthy, lean mice. After 2 months of observation, the animals remained in good health.

Prof. Summers explains that although the mice did not shed any weight, their bodies had changed the way that they processed nutrients.

In another set of experiments, the team found that reducing ceramide levels before placing the mice on high fat diets stopped the animals from gaining weight and developing insulin resistance.

"We have identified a potential therapeutic strategy that is remarkably effective and underscores how complex biological systems can be deeply affected by a subtle change in chemistry."

Prof. Scott A. Summers

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These diets and supplements may not really protect the heart

Doctors often recommend certain dietary interventions — such as following a Mediterranean-type diet or cutting salt intake — in the interest of protecting heart health. On top of this, many individuals believe that dietary supplements will help them stay healthy.
image of healthy foods vs supplements
Can supplements and dietary interventions protect the heart? Not according to a new meta-analysis.

Common knowledge has it that diet and lifestyle play an important role in supporting a person's physical health and overall well-being.

That is why doctors may advise their patients to modify their diets and lifestyle habits by making them more conducive to good health.

In particular, dietary interventions can allegedly help individuals safeguard their cardiovascular health, preventing heart disease and events such as strokes.

Dietary guidelines for people in the United States advise that people adhere to healthful diets, such as a vegetarian diet or the Mediterranean diet, which is rich in vegetables, legumes, and lean meat.

On a related note, many individuals believe that taking dietary supplements can enhance different aspects of their health, including heart health, although recent studies have contradicted this assumption.

Now, a meta-analysis by researchers from different collaborating institutions — including The Johns Hopkins School of Medicine in Baltimore, MD, West Virginia University in Morgantown, and Mayo Clinic in Rochester, MN — suggests that many interventions and even more supplements may have no protective effect for the heart, and some may even harm cardiovascular health.

The review — the first author of which is Dr. Safi Khan from West Virginia University — appears in Annals of Internal Medicine.

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In their research, Dr. Khan and team analyzed the data from 277 randomized controlled trials that had involved almost 1 million participants between them. They looked at the effects of 16 nutritional supplements and eight dietary interventions on cardiovascular health and mortality.

The supplements that they took into consideration were: selenium, multivitamins, iron, folic acid, calcium, calcium plus vitamin D, beta carotene, antioxidants, omega-3 long-chain polyunsaturated fatty acids, and vitamins A, B complex, B-3, B-6, C, D, and E.

The dietary interventions included: modified dietary fat, reduced salt (in people with normal and high blood pressure), reduced saturated fat, Mediterranean diet, reduced dietary fat, higher intake of omega-6 polyunsaturated fatty acids, and higher intake of omega-3 alpha-linolenic acid.

Dr. Khan and colleagues did find that some of these interventions had a positive effect. For instance, eating less salt may reduce the risk of premature death in people with a normal blood pressure, although only with moderate certainty.

Moreover, they concluded that omega-3 long-chain polyunsaturated fatty acids protected against heart attacks and coronary heart disease and that there was an association between folic acid intake and a slightly lower risk of stroke, but all with only low certainty.

At the same time, however, other supplements and interventions seemed to either have no effect or be downright harmful.

The researchers found that taking multivitamins, selenium, vitamin A, vitamin B-6, vitamin C, vitamin D, vitamin E, calcium, folic acid, and iron did not significantly protect against cardiovascular problems and early death. They also noted that following a Mediterranean diet, reducing saturated fat intake, modifying fat intake, reducing dietary fat intake, and increasing the quantity of dietary omega-3 and omega-6 were not beneficial.

In fact, people who took calcium and vitamin D supplements together actually had a higher risk of experiencing a stroke, although only with moderate certainty.

However, in their paper, the investigators admit that "these findings are limited by suboptimal quality of the evidence." They are referring to the fact that, due to the different methodologies of the studies that they assessed, they "could not analyze interventions according to important subgroups, such as sex, body mass index [BMI], lipid values, blood pressure thresholds, diabetes, and history of [cardiovascular disease]."

Yet, they argue that their current review paves the way to better care and stronger research into the helpfulness and value of different dietary interventions:

"This study can help those who create professional cardiovascular and dietary guidelines modify their recommendations, provide the evidence base for clinicians to discuss dietary supplements with their patients, and guide new studies to fulfill the evidence gap."

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The authors of the accompanying editorial, doctors Amitabh Pandey and Eric Topol, both from the Scripps Research Translational Institute in La Jolla, CA, also emphasize that the quality of the data in many studies assessing the effects of dietary interventions and supplements on heart health can be questionable.

"[D]ifferences in geography, dose, and preparation — most studies rely on food diaries, which are based on a person's memory of what they consumed — raise questions about the veracity of the data," they write.

"Perhaps, however, the biggest difference that needs to be considered in the future is the individual," they add, advising that future research should pay more attention to the differences among participants.

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Sitting at home or at work: Which is worse for heart health?

New research has found that not all forms of sedentariness are equal when it comes to the extent to which they put heart health at risk.
couple watching tv
Sitting on the couch, watching TV could increase heart risk more than sitting at a desk doing office work.

We already know that a sedentary lifestyle, in which a person sits down for long periods every day and gets little exercise, is bad for health in general and heart health in particular.

However, in a new study, researchers from the Vagelos College of Physicians and Surgeons at Columbia University in New York City, NY, have found that there is a difference between occupational sitting (sitting at work) and leisure time sitting (sitting at home, watching TV).

The researchers worked specifically with a cohort of African American people, aiming to fill a gap in the research to date, which has primarily focused on white Europeans. Nevertheless, they believe that despite the specificity of the study cohort, the findings could apply to everyone, regardless of ethnicity.

And, the investigation revealed a — perhaps surprising — distinction: The time that a person spends sitting on the couch at home, watching TV, is much more likely to increase their risk of heart problems than the time they spend sitting at work.

"Our findings show that how you spend your time outside of work may matter more when it comes to heart health," explains study author Keith Diaz, Ph.D.

The solution to this problem may be to spend more time being not just active, but intensely active, the researcher notes.

"Even if you have a job that requires you to sit for long periods of time, replacing the time you spend sitting at home with strenuous exercise could reduce your risk of heart disease and death," says Diaz.

Diaz and team explain their findings and suggest a possible explanation for these results in a study paper that appeared yesterday in the Journal of the American Heart Association.

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Chilling on the couch raises risk by half

The researchers analyzed data for a cohort of 3,592 participants who had enrolled in the Jackson Heart Study, a community-based study focused on the causes of cardiovascular, renal, and respiratory diseases among African Americans.

All of the participants lived in Jackson, MS, and the health and lifestyle data available about them covered a period of 8.5 years. The information included how much time the participants spent sitting at work, as well as how much time they spent watching TV versus exercising in their spare time.

Diaz and team found that people who reported sitting and watching TV for 4 or more hours each day had a 50% higher risk of cardiovascular problems and premature death compared with individuals who sat in front of the television for 2 hours or less per day.

However, the same increase in risk did not apply when the hours of sitting took place at work — participants who sat for extended periods in the office did not have a higher cardiovascular risk than those who spent little time sitting at work.

The fix? The researchers suggest that replacing some TV downtime with moderate to vigorous exercise could counteract the increase in cardiovascular risk. In fact, they noted that individuals who sat watching TV for 4 or more hours each day but also did 150 minutes or more of exercise per week did not have a heightened risk of heart health issues or premature death.

When possible, opt for movement

It is unclear why leisure time sitting is potentially more harmful than occupational sitting, but the investigators believe that fully uninterrupted sitting might explain the distinction.

"It may be that most people tend to watch television for hours without moving, while most workers get up from their desk frequently," says Diaz.

Another possible explanation may simply be the timing of leisure time sitting. "The combination of eating a large meal, such as dinner, and then sitting for hours could also be particularly harmful," adds the researcher.

Although the study suggested that leisure time sitting trumps occupational sedentariness when it comes to health risk increases, its authors point out that any type of sedentariness has the potential to harm health.

Thus, Diaz continues, while "[w]e recognize that it isn't easy for some workers, like truck drivers, to take breaks from sitting, [...] everyone else should make a regular habit of getting up from their desks."

The takeaway from the current research, this author points out, is that "what you do outside of work may be what really counts" when it comes to safeguarding well-being. Moreover, he stresses that any and all activity is important — what matters is to get up and move a little.

"More research is needed, but it's possible that just taking a short break from your TV time and going for a walk may be enough to offset the harm of leisure time sitting. Almost any type of exercise that gets you breathing harder and your heart beating faster may be beneficial."

Keith Diaz, Ph.D.

In the future, the researchers want to conduct further studies to try to find out exactly what makes sitting in front of the TV such an important risk factor for cardiovascular problems.

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Statins may double the risk of type 2 diabetes

New research finds an elevated risk of type 2 diabetes among people who take statins in an effort to lower their cholesterol levels and keep heart disease at bay.
woman looking at bottle of pills
Among statins' unwanted effects may be an increased risk of type 2 diabetes, new research suggests.

Many people take statins to lower cholesterol and reduce the risk of cardiovascular events, such as coronary heart disease and heart attacks. In the United States, about 83% of people between 40 and 59 years of age who take cholesterol-lowering medication are taking statins.

Although statins are effective at staving off cardiovascular disease, some previous trials have suggested that they may raise the risk of diabetes.

A new study, led by Victoria Zigmont, a graduate researcher in public health at The Ohio State University in Columbus, further explores this link. The findings, which appear in the journal Diabetes Metabolism Research and Reviews, suggest that statins may indeed raise the risk for this chronic condition.

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Statins and a heightened diabetes risk

Zigmont and team examined the health records of 4,683 men and women who were diabetes-free at the start of the study but were at risk of heart disease. Of the total number of participants, 16% — or 755 people — were taking prescription statins at the start of the study, in 2011. The study ended in 2014.

Zigmont and team accounted for confounders such as gender, age, ethnicity, education, cholesterol and triglyceride levels, body mass index (BMI), waist circumference, and how many times the participants visited their doctors.

The analysis revealed that people who took statins were more than twice as likely to receive a diabetes diagnosis than those who did not take the medication. Additionally, people who took statins for longer than 2 years were more than three times as likely to develop diabetes.

"The fact that increased duration of statin use was associated with an increased risk of diabetes — something we call a dose-dependent relationship — makes us think that this is likely a causal relationship," explains Zigmont.

Additionally, the analysis revealed that those who took statins had a 6.5% higher risk of elevated blood sugar, as checks determined by HbA1c values.

"That said, statins are very effective in preventing heart attacks and strokes. I would never recommend that people stop taking the statin they've been prescribed based on this study, but it should open up further discussions about diabetes prevention and patient and provider awareness of the issue."

Victoria Zigmont

Study strengths and limitations

The researchers note some of the strengths of their study, such as having a large study sample of almost 5,000 people and using "real world" data from doctors. Also, having access to biometric measurements meant the researchers could consider and adjust for values before statin use.

Using pharmacy data allowed the researchers to "accurately measure statin class and intensity," but a weakness of the study is that researchers could not account for the participants' compliance with their prescriptions.

Also, the study is limited to "insured individuals who are routinely monitored by a healthcare provider," and so the researchers are unable to generalize about their results beyond this group. Furthermore, all participants were white.

Finally, the researchers could not account for other medications that the participants might have taken, nor did they consider other health habits, such as smoking status or alcohol use. Similarly, the researchers were unaware whether the participants had prediabetes at the start of the study or not.

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How calcium in coronary arteries can predict future heart health

According to one new study, having high levels of calcium in the coronary arteries could be responsible for detrimental changes to the structure of the heart.
Heart anatomy model
A new study investigates calcium and heart disease.

"Heart disease is the leading cause of death for men and women," according to the Centers for Disease Control and Prevention (CDC).

Being able to identify people at risk is therefore a crucial public health issue.

One way to determine a person's risk of heart disease, stroke, or heart attack is by looking at their coronary artery calcium (CAC) levels.

Calcium plays a number of roles in the body, including keeping bones healthy. However, calcium present in coronary arteries can lead to the accumulation of plaque.

Over time, this calcified substance can cause atherosclerosis, or a narrowing of the arteries. Atherosclerosis restricts blood flow and oxygen supply to vital organs, potentially resulting in a heart attack or stroke.

High cholesterol levels can indicate that a person is at risk; but scientists can also test CAC levels directly.

Using a CT scan to take numerous sectional pictures of the heart, doctors can see specks of CAC. A person's scores tend to range from zero to over 400. The higher the score, the higher the risk of developing cardiovascular disease.

Cholesterol guidelines from 2018 recommend a CAC scan for people ages 40–75 whose risk status is "uncertain," note the American Heart Association (AHA).

A new study, the results of which now appear in the journal Circulation: Cardiovascular Imaging, has examined the CAC scores of younger people and drawn some interesting conclusions.

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Heart abnormalities

The scientists used data from almost 2,500 people to track CAC and heart structure differences between young adulthood and middle age. Women made up 57% of the group, and 52% of participants were white.

They took data from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which began in the 1980s with the aim of identifying young adult risk factors for cardiovascular disease.

"We looked at early adulthood to middle age because this is a window in which we can see abnormalities that might not be causing symptoms, but could later increase the risk of heart problems," explains study co-author Dr. Henrique Turin Moreira.

The researchers compared test results from years 15 and 25 of the CARDIA study period. At the 25-year mark, the average age of the group was around 50.

When it came to their CAC results, 77% of participants had a score of zero in year 15 of the study. However, in year 25, this had dropped to 72%.

A number of factors were linked to a rise in CAC scores, including being older, being male, being black, smoking, having higher cholesterol levels, and having higher systolic blood pressure.

Middle-aged people who had higher CAC scores also showed a 9% increase in left ventricular volume and a 12% increase in left ventricular mass.

When the left ventricle changes in this way, the heart has to put more effort into pumping blood. This, in turn, leads to a thickening of the heart, which increases the risk of heart failure.

The study authors also note that these abnormalities were more significant among black people. For these people, every one-unit change in their CAC score correlated with quadruple the increase in their left ventricular mass.

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Future implications

It is unclear why people exhibited such differences depending on their race. Dr. Moreira explains that it could be "due to genetic factors or perhaps greater exposure to cardiovascular risk factors that usually appear earlier" in black people.

What that do already know, however, is that black people are already more likely to develop cardiovascular disease. Although just 43% of white women and 50% of white men have cardiovascular disease, it affects 57% of black women and 60% of black men.

Further research, explains Dr. Moreira, will be needed to "examine the link between coronary artery calcium and heart health" — especially in relation to race. However, documenting the relationship between CAC and heart failure risk factors in a younger age group is significant.

"Given the burden of morbidity and mortality associated with heart failure, these are important findings," says Dr. Salim Virani, a co-author of the AHA's 2018 cholesterol guidelines.

"Prior studies from this cohort have also shown that a better risk factors profile in young adulthood is associated with much lower CAC and therefore, these results further highlight the importance of primordial prevention and risk factor modification in early adulthood."

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What to know about cardiac muscle tissue

Cardiac muscle tissue, or myocardium, is a specialized type of muscle tissue that forms the heart. This muscle tissue, which contracts and releases involuntarily, is responsible for keeping the heart pumping blood around the body.

The human body contains three different kinds of muscle tissue: skeletal, smooth, and cardiac. Only cardiac muscle tissue, comprising cells called myocytes, is present in the heart.

In this article, we discuss the structure and function of cardiac muscle tissue. We also cover medical conditions that can affect cardiac muscle tissue and tips for keeping it healthy.

What is cardiac muscle tissue? Senior man running in the park
A person can strengthen cardiac muscle tissue by doing regular exercise.

Muscle is fibrous tissue that contracts to produce movement. There are three types of muscle tissue in the body: skeletal, smooth, and cardiac. Cardiac muscle is highly organized and contains many types of cell, including fibroblasts, smooth muscle cells, and cardiomyocytes.

Cardiac muscle only exists in the heart. It contains cardiac muscle cells, which perform highly coordinated actions that keep the heart pumping and blood circulating throughout the body.

Unlike skeletal muscle tissue, such as that which is present in the arms and legs, the movements that cardiac muscle tissue produces are involuntary. This means that they are automatic, and that a person cannot control them.

Thank you for supporting Medical News Today How does cardiac muscle tissue function? The heart also contains specialized types of cardiac tissue containing "pacemaker" cells. These contract and expand in response to electrical impulses from the nervous system. Pacemaker cells generate electrical impulses, or action potentials, that tell cardiac muscle cells to contract and relax. The pacemaker cells control heart rate and determine how fast the heart pumps blood. How is it structured? Cardiac muscle tissue gets its strength and flexibility from its interconnected cardiac muscle cells, or fibers. Most cardiac muscle cells contain one nucleus, but some have two. The nucleus houses all of the cell's genetic material. Cardiac muscle cells also contain mitochondria, which many people call "the powerhouses of the cells." These are organelles that convert oxygen and glucose into energy in the form of adenosine triphosphate (ATP). Cardiac muscle cells appear striated or striped under a microscope. These stripes occur due to alternating filaments that comprise myosin and actin proteins. The dark stripes indicate thick filaments that comprise myosin proteins. The thin, lighter filaments contain actin. When a cardiac muscle cell contracts, the myosin filament pulls the actin filaments toward each other, which causes the cell to shrink. The cell uses ATP to power this contraction. A single myosin filament connects to two actin filaments on either side. This forms a single unit of muscle tissue, called a sarcomere. Intercalated discs connect cardiac muscle cells. Gap junctions inside the intercalated discs relay electrical impulses from one cardiac muscle cell to another. Desmosomes are other structures present within intercalated discs. These help hold cardiac muscle fibers together. What conditions affect it woman with shortness of breath holding chest in pain looking out of window
Difficulty breathing or shortness of breath may be a symptom of cardiomyopathy. Cardiomyopathy refers to a group of medical conditions that affect cardiac muscle tissue and impair the heart's ability to pump blood or relax normally. Some common symptoms of cardiomyopathy include: difficulty breathing or shortness of breath fatigue swelling of the legs, ankles, and feet inflammation in the abdomen or neck irregular heartbeat heart murmurs dizziness or lightheadedness Factors that can increase a person's risk of cardiomyopathy include: A heart attack due to a blocked artery can cut off the blood supply to certain areas of the heart. Eventually, the cardiac muscle tissue in these areas will start to die. The death of cardiac muscle tissue can also occur when the heart's oxygen demand exceeds the oxygen supply. This causes the release of cardiac proteins such as troponin into the bloodstream. Read more about how raised troponin levels can indicate heart damage here. Some examples of cardiomyopathy include: Dilated cardiomyopathy Dilated cardiomyopathy causes the cardiac muscle tissue of the left ventricle to stretch and the heart's chambers to dilate. Hypertrophic cardiomyopathy Hypertrophic cardiomyopathy (HCM) is a genetic condition in which the cardiomyocytes are not arranged in a coordinated fashion and are instead disorganized. HCM can interrupt blood flow out of the ventricles, cause arrhythmias (abnormal electrical rhythms), or lead to congestive heart failure. Restrictive cardiomyopathy Restrictive cardiomyopathy (RCM) refers to when the walls of the ventricles become stiff. When this happens, the ventricles cannot relax enough to fill with an adequate amount of blood. Arrhythmogenic right ventricular dysplasia This rare form of cardiomyopathy causes fatty infiltration in cardiac muscle tissue in the right ventricle. Transthyretin amyloid cardiomyopathy Transthyretin amyloid cardiomyopathy (ATTR-CM) develops when amyloid proteins collect and form deposits in the walls of the left ventricle. The amyloid deposits cause the ventricle's walls to stiffen, which prevents the ventricle from filling with blood and reduces its ability to pump blood out of the heart. This is a form of RCM. Tips for healthy cardiac muscle tissue Children playing basketball
Children should do 60 minutes of moderate- to high-intensity physical activity each day. Doing regular aerobic exercise can help strengthen the cardiac muscle tissue and keep the heart and lungs healthy. Aerobic activities involve moving the large skeletal muscles, which causes a person to breathe faster and their heartbeat to quicken. Doing these types of activities often can train the heart to become more efficient. Some examples of aerobic exercises include: running or jogging walking or hiking cycling swimming jumping rope dancing jumping jacks climbing stairs The Department of Health and Human Services (DHHS) make the following recommendations in their Physical Activity Guidelines for Americans: Children aged 6–17 years old should do 60 minutes of moderate- to high-intensity physical activity each day. Adults aged 18 years and older should do 150 minutes of moderate-intensity, or 75 minutes of high-intensity, aerobic exercise each week. Pregnant women should try to do at least 150 minutes of moderate-intensity aerobic activity per week. The DHHS also suggest that a person should try to spread aerobic activity throughout the week. Adults with chronic conditions or disabilities can replace aerobic exercise with at least two muscle-strengthening sessions per week. Thank you for supporting Medical News Today Summary Cardiac muscle tissue is a specialized, organized type of tissue that only exists in the heart. It is responsible for keeping the heart pumping and blood circulating around the body. Cardiac muscle tissue, or myocardium, contains cells that expand and contract in response to electrical impulses from the nervous system. These cardiac cells work together to produce the rhythmic, wave-like contractions that is the heartbeat. Regular aerobic exercise can help strengthen cardiac muscle tissue and lower the risk of heart attack, stroke, and other cardiovascular conditions.
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Atrial fibrillation may raise dementia risk by 50%

A large study concludes that atrial fibrillation does, indeed, raise the risk of dementia even in people who did not have a stroke and that anticoagulants may reduce this risk.
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An irregular heartbeat may be a sign of A-fib, which may, in turn, raise dementia risk.

Atrial fibrillation (A-fib) is a condition in which the heart beats irregularly. More specifically, the atria of the heart — the chambers that receive blood and pump it out to the heart's ventricles and the rest of the body — beat at an irregular rhythm.

A-fib is the most common form of arrhythmia, affecting between 2.7 and 6.1 million adults in the United States.

Previous research has shown that people with A-fib have a higher risk of dementia, and also that people can take blood thinners to reduce this risk.

New research confirms that the above is true, even in people who never experienced a stroke. The new study is the largest of its kind ever conducted.

Boyoung Joung, who is a professor of cardiology and internal medicine at Yonsei University College of Medicine in Seoul, Republic of Korea, is the leading author of the paper, which appears in the European Heart Journal.

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A-fib raises dementia, Alzheimer's risk

In the new research, Prof. Joung and team examined 262,611 adults aged 60 and older who did not have A-fib or dementia at baseline, in 2004.

The scientists accessed the data from the Korea National Health Insurance Service Senior cohort and followed the study participants until 2013.

During the study period, 10,435 participants developed A-fib. Of these, 24.4% also developed dementia. However, only 14.4% of the participants without A-fib developed dementia.

"We found that the people who developed atrial fibrillation had a 50% increased risk of developing dementia compared [with] those who did not develop the condition," reports Prof. Joung.

"[T]his increased risk remained even after we removed those who suffered a stroke from our calculations. This means that among the general population, an extra 1.4 people per 100 of the population would develop dementia if they were diagnosed with atrial fibrillation. The risk occurred in people aged younger and older than 70 years."

Prof. Boyoung Joung

"We also found that atrial fibrillation increased the risk of Alzheimer's disease by 30% and more than doubled the risk of vascular dementia," continues Prof. Joung.

How blood thinners can help

"However, among people who developed atrial fibrillation and who took oral anticoagulants, such as warfarin, or non-vitamin K anticoagulants, such as dabigatran, rivaroxaban, apixaban, or edoxaban, the risk of subsequently developing dementia reduced by 40% compared [with] patients who did not take anticoagulants."

On the point of anticoagulants, or blood thinners, Prof. Joung thinks that "non-vitamin K anticoagulants, which have a significantly lower risk of cerebral hemorrhage than warfarin, may be more effective than warfarin in terms of dementia prevention and this will be answered by an ongoing clinical trial."

The researcher also thinks that more investigations are necessary to determine "whether aggressive rhythm control, such as catheter ablation, helps to prevent dementia."

"Our study suggests that the strong link between atrial fibrillation and dementia could be weakened if patients took oral anticoagulants. Therefore, doctors should think carefully and be readier to prescribe anticoagulants for atrial fibrillation patients to try to prevent dementia."

Prof. Gregory Lip, study co-author

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Strengths and limitations of the study

The researchers explain that this is the largest study of its kind due to the high number of participants and the long follow-up period.

"With these large figures, we can be sure of our findings," comments study co-author Gregory Lip, who is a professor of cardiovascular medicine at the University of Liverpool, United Kingdom.

"We also believe that our results can be applied to other populations too, as they confirm similar findings of a link between atrial fibrillation and dementia in studies of people in Western and European countries," adds Prof. Lip.

The authors caution that the research only shows a link between A-fib and dementia but does not suggest causality.

However, they speculate that a possible mechanism behind the association could be that people with A-fib often have altered blood vessels in the brain, which may have been the result of symptomless ministrokes.

Such brain damage may, over time, lead to dementia, suggest the researchers. Prof. Joung and team go on to point out further limitations to the study.

For instance, they note that they could not identify whether the study participants had paroxysmal or persistent A-fib. Also, A-fib can take place without any noticeable symptoms, so the study may have omitted some cases.

Also, the scientists did not know whether the patients were receiving treatment for A-fib and suggest that successful treatment may have affected dementia risk differently. They also lacked information on the participants' blood pressure. Finally, the researchers say, there may have been "unidentified confounding factors" that they did not account for.

Prof. Joung concludes, "Dementia is an untreatable disease, and so prevention is important."

"This study confirms that atrial fibrillation is a risk factor for the development of dementia. Therefore, the prevention of atrial fibrillation may be a means to reduce the incidence of dementia."

Prof. Boyoung Joung

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What is end-diastolic volume?

End-diastolic volume is the amount of blood that is in the ventricles before the heart contracts. Doctors use end-diastolic volume to estimate the heart's preload volume and to calculate stroke volume and ejection fraction. These different measurements indicate the health of a person's heart.

In this article, we explain what end-diastolic volume is and how doctors use it. We also discuss some conditions that can affect end-diastolic volume.

What is it? End diastolic volume is the measure of blood in the left or right ventricle before the heart contracts.
End-diastolic volume is the measure of blood in the left or right ventricle before the heart contracts.

End-diastolic volume refers to the quantity of blood in the left or right ventricle at the end of diastole, just before systole starts.

The heart consists of four chambers: two atria and two ventricles. The chambers contain valves that open and close in sequence so that blood flows in one direction through the atria and ventricles.

The veins carry oxygen-poor blood into the right atrium, which connects to the right ventricle. From here, the heart pumps blood into the lungs for oxygenation.

The newly oxygenated blood enters the left atrium and flows into the left ventricle, which contracts, forcing blood up through the aorta. The aorta is the largest artery in the body, and it supplies the entire body with oxygen-rich blood.

Diastole occurs when the heart muscle relaxes, and the chambers fill with blood. Blood pressure decreases during diastole.

Systole occurs when the ventricles contract, pushing blood out of the right ventricle into the lungs and out of the left ventricle to the rest of the body. Blood pressure increases during systole.

Thank you for supporting Medical News Today How do doctors use it? Doctors use end-diastolic volume to evaluate the condition of a person's heart and their general health. A doctor can measure end-diastolic volume using the following tests: Echocardiogram. In this noninvasive procedure, doctors use ultrasound technology to create detailed images of a person's heart. Left heart catheterization. This procedure involves threading a thin, flexible tube called a catheter through a large blood vessel and into the heart. Doctors can use the catheter to take blood samples and measure the pressure and oxygen content in the four chambers of the heart. Doctors use end-diastolic volume to calculate several different measurements of heart function, which we discuss below. Sometimes, they specifically use left ventricular end-diastolic volume, which is the amount of blood that is present in the left ventricle before contraction. Preload Doctors use left ventricular end-diastolic volume to estimate cardiac preload, which is how much the cardiac fibers of the ventricle stretch before contraction. Doctors are unable to test preload directly, so they use end-diastolic volume as a close estimate. Stroke volume Doctors use both end-diastolic volume and end-systolic volume to calculate stroke volume. End-systolic volume is the amount of blood remaining in the ventricle at the end of systole, after the heart has contracted. Stroke volume is the quantity of blood that the heart pumps out of the left ventricle with each beat. The formula for stroke volume is: Stroke volume = end-diastolic volume - end-systolic volume. According to a large 2017 study, normal stroke volume ranges are: 48.2–114.3 milliliters (ml) for people aged 18 to 29 years 39.1–98.5 ml for people aged 30 to 59 years 39.7–115.3 ml for people aged 60 years or older Ejection fraction Ejection fraction refers to the proportion of blood that leaves the left ventricle during systole relative to the end-diastolic volume. Essentially, it is the percentage of blood that the heart pumps out of the left ventricle during each beat. Doctors use ejection fraction to determine how well the heart is pumping blood and to help diagnose heart failure. The calculation for ejection fraction is: Ejection fraction = (stroke volume / end-diastolic volume) x 100. According to the American Heart Association, a healthy ejection fraction ranges between 50% and 70%. What conditions affect it? Certain health conditions can affect end-diastolic volume. These include: Cardiomyopathy A doctor may recommend an echocardiogram to measure end-diastolic volume.
A doctor may recommend an echocardiogram to measure end-diastolic volume. Cardiomyopathy is an umbrella term for medical conditions that affect the heart muscle. These conditions can cause the heart muscle to thicken, enlarge, or lose its elasticity. Cardiomyopathy affects the heart's ability to pump blood around the body, which can lead to an irregular heartbeat, heart failure, and other serious complications. There are several different types of cardiomyopathy. In people with dilated cardiomyopathy, the ventricles become enlarged, which increases the end-diastolic volume. Enlargement of the heart muscle can cause the ventricle walls to thicken, causing a condition called hypertrophic cardiomyopathy. This thickening can affect blood flow out of the left ventricle, which can lead to an increase in end-diastolic volume. Thank you for supporting Medical News Today Mitral valve regurgitation Mitral valve regurgitation occurs when blood leaks backward through the mitral valve, which connects the left atrium and ventricle. The left atrium may enlarge to accommodate the extra blood leaking through the mitral valve. An enlarged left atrium can lead to complications, such as atrial fibrillation, an irregular heartbeat, heart failure, and stroke. Summary End-diastolic volume is a useful indicator of a person's heart health. Doctors use end-diastolic volume to estimate preload and calculate the heart's stroke volume and ejection fraction. Certain conditions may affect end-diastolic volume, including cardiomyopathy and mitral regurgitation.
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Coronary heart disease may speed up cognitive decline

It is natural for a person's memory and thinking abilities, or cognitive function, to wane as they age — even if they are in good health. However, the rate of cognitive decline can speed up if they experience heart attack or angina, according to new research.
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Cognitive decline may speed up after a heart attack or angina.

Studies that have explored the links between circulation problems and cognitive decline have tended to focus on conditions that affect the blood supply to the brain, such as stroke.

Few of these earlier studies, however, have looked at the long-term links between incident coronary heart disease (CHD), such as heart attack and angina, and cognitive decline.

The recent Journal of the American College of Cardiology study is unique; it tracked cognitive decline both before and after incident CHD.

"Incident CHD," its authors conclude, "is associated with accelerated cognitive decline after, but not before, the event."

They suggest that the findings highlight the long-term relationship between cognitive decline and CHD.

Lead and corresponding study author Wuxiang Xie, Ph.D., says that because there is not yet a cure for dementia, it is important to detect and treat the brain condition as early as possible in order to delay its progression.

"Even small differences in cognitive function can result in an increased risk of dementia in the long-term," explains Xie, who holds research posts at Peking University Clinical Research Institute in China and in the School of Public Health at Imperial College London in the United Kingdom.

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Narrow arteries reduce blood supply

CHD, or coronary artery disease, can develop when the arteries that feed the heart become narrow and obstruct blood flow.

The arteries become narrow because fatty deposits, or plaques, build up inside their walls. Medical professionals call this process atherosclerosis.

The reduction in blood flow causes heart muscle to receive less oxygen, increasing the likelihood of a heart attack. The reduction in blood supply can also cause chest pain, or angina.

CHD is the leading cause of death worldwide, according to the World Health Organization (WHO). In 2016, it was responsible for more than 9 million deaths.

Xie and his colleagues believe that their study is one of the largest to investigate cognitive decline in the years before and after receiving a diagnosis of CHD.

Their analysis took in data from 7,888 participants, aged 50 and older, from the English Longitudinal Study of Aging (ELSA).

CHD and cognitive decline

The ELSA collected data twice per year between 2002 and 2017. None of the participants had a history of heart attack, angina, or stroke or a diagnosis of dementia or Alzheimer's disease at the start of the study period.

The researchers excluded people who did not complete all the cognitive assessments or who had a stroke during the median follow-up of 12 years.

Over the follow-up period, the participants underwent three tests of cognitive function, which the researchers conducted in eight waves. The tests assessed verbal memory, semantic fluency, and sense of time, or "temporal orientation."

During the study period, 5.6% of the participants experienced angina or heart attacks. Everyone in this group demonstrated a more rapid decline in cognitive function in the three tests compared with those who did not experience a CHD event.

Those who developed angina showed a faster decline in the tests of temporal orientation, while verbal memory and semantic fluency declined more rapidly in those who experienced heart attacks.

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The study authors note that they "found that incident CHD was significantly associated with faster rates of post-CHD-diagnosis cognitive decline, but not with cognitive changes in the years before or short-term changes following the event."

Speculating on the findings, they suggest that the reduction in oxygen to the brain is the likely reason for the link between CHD and faster cognitive decline.

Previous research linked CHD to interruptions of blood supply to the brain, or cerebral microinfarcts. Such links suggest that CHD might promote small vessel disease, which is a major contributor to dementia in older adults.

"Heart attack and angina patients need careful monitoring in the years following a diagnosis."

Wuxiang Xie, Ph.D.

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Low fruit and vegetable intake may account for millions of deaths

Findings from a new study suggest that inadequate consumption of fruits and vegetables may be a major factor in heart disease death.
very few vegetables on a plate
Not eating enough fruits or vegetables may have dire consequences for cardiovascular health.

Fruits and vegetables are rich in vitamins, fiber, potassium, magnesium, and antioxidants.

A diet that includes fruits and vegetables can lower blood pressure, reduce the risk of heart disease and cancer, and improve digestive health.

Previous research — part of the Harvard-based Nurses' Health Study and Health Professionals Follow-up Study — confirmed that a diet containing lots of fruits and vegetables can even lower the risk of heart disease and stroke.

After analyzing these results and combining them with findings from other studies, researchers estimated that the risk of heart disease is 20% lower among individuals who eat more than five servings of fruits and vegetables per day, compared with those who eat fewer than three servings per day.

The United States Department of Agriculture recommend that adults eat at least 1.5 to 2 cups per day of fruit and 2–3 cups per day of vegetables. According to another study by the Centers for Disease Control and Prevention (CDC), only around 1 in 10 adults meet these guidelines.

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The global impact of inadequate nutrition

Now, a new study — the results of which the researchers presented at Nutrition 2019, the American Society for Nutrition annual meeting in Baltimore, MD — suggests that a low fruit intake can cause 1 in 7 deaths from heart disease, and that a low vegetable intake can cause 1 in 12 deaths from heart disease.

Analyzing data from 2010, researchers found that low fruit consumption resulted in almost 2 million deaths from cardiovascular disease, while low vegetable intake resulted in 1 million deaths. The global impact was more significant in countries with a low average consumption of fruits and vegetables.

The data suggest that low fruit consumption results in more than 1 million deaths from stroke and more than 500,000 deaths from heart disease worldwide every year, while low vegetable intake results in about 200,000 deaths from stroke and more than 800,000 deaths from heart disease per year.

"Our findings indicate the need for population-based efforts to increase fruit and vegetable consumption throughout the world," says study co-author Victoria Miller, a postdoctoral researcher at the Friedman School of Nutrition Science and Policy at Tufts University in Medford, MA.

Tracking death toll by region, age, and sex

The researchers tracked the death toll by region, age, and sex using diet surveys and food availability data of 113 countries. They combined these with data on causes of death in each country and data on the cardiovascular risk linked to low fruit and vegetable intake.

The findings showed that fruit intake was lower in South Asia, East Asia, and Sub-Saharan Africa, while vegetable consumption was lower in Central Asia and Oceania. Countries in these regions have low average fruit and vegetable intakes and high rates of deaths from heart disease and stroke.

When the researchers analyzed the impact of inadequate fruit and vegetable consumption by age and sex, they found that the biggest impact was among young adults and males. Miller adds that females tend to eat more fruits and vegetables.

"These findings indicate a need to expand the focus to increasing availability and consumption of protective foods like fruits, vegetables, and legumes — a positive message with tremendous potential for improving global health."

Senior study author Dariush Mozaffarian, Friedman School of Nutrition Science and Policy

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Heart disease death: 'White coat hypertension' may double risk

New research suggests that untreated 'white coat hypertension' may be a major risk factor for heart disease and heart disease-related death.
doctor taking a patient's blood pressure
Blood pressure may spike when a doctor performs the reading.

White coat hypertension describes a disorder in which a person develops high blood pressure only in the presence of doctors.

Some doctors and researchers believe that white coat hypertension is a sign of underlying anxiety. Others, however, think that it may precede and contribute to the development of actual hypertension.

In the United States, more than 100 million people are living with high blood pressure, or hypertension, which is a contributor to heart attack and stroke.

Experts define high blood pressure as a top reading of at least 130 millimeters of mercury (mm Hg) or a bottom reading of 80 mm Hg or higher.

New research finds that white coat hypertension is in itself a significant risk factor for heart disease and cardiovascular death, just like hypertension.

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Specifically, untreated white coat hypertension may increase the risk of dying from heart disease by more than 100%, according to a new paper that the Annals of Internal Medicine recently published.

Dr. Jordana B. Cohen, who is an assistant professor in the division of Renal-Electrolyte and Hypertension at the University of Pennsylvania School of Medicine in Philadelphia, is the lead author of the research.

"Studies suggest that about one in five adults may have white coat hypertension. Our findings underscore the importance of identifying people with this condition."

Dr. Jordana B. Cohen

Dr. Cohen and colleagues carried out a meta-analysis of 27 observational studies, which included more than 60,000 participants in total. Each of the studies examined the health risks that correlated with white coat hypertension and had a follow-up period of at least 3 years.

Two investigators independently extracted the data from these studies and assessed their quality.

The researchers found that participants who had untreated white coat hypertension were 36% more likely to have heart disease, 33% more likely to die prematurely from any cause, and 109% more likely to die of heart disease.

Treated white coat effect, however, did not correlate with higher cardiovascular risk. Dr. Cohen and colleagues conclude:

"Untreated [white coat hypertension], but not treated [white coat effect], is associated with an increased risk for cardiovascular events and all-cause mortality. Out-of-office [blood pressure] monitoring is critical in the diagnosis and management of hypertension."

"We believe individuals with isolated in-office hypertension — those who are not taking blood pressure medication — should be closely monitored for transition to sustained hypertension, or elevated blood pressure both at home and the doctor's office," emphasizes Dr. Cohen.

She goes on to add that this "pressing need" for constant monitoring is a "nationwide" concern, as are the lifestyle changes that people should make for better cardiovascular health.

"Simultaneously, we advise individuals with untreated white coat hypertension to engage in lifestyle modifications, including smoking cessation, reduction in their alcohol intake, and making improvements to their diet and exercise regimen."

"We also caution providers not to overtreat individuals with white coat hypertension who are already on blood pressure medication, as this could lead to dangerously low blood pressures outside of the office and unnecessary side effects from medication," concludes Dr. Cohen.

Finally, the authors also point to some limitations of their analysis, noting the insufficient number of studies that evaluated isolated cardiac outcomes. Also, the studies did not contain enough information about the participants' race and ethnicity.

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3 interventions could prevent millions of cardiovascular deaths

Millions of people die prematurely each year due to noncommunicable diseases, some of the most common of which are cardiovascular diseases. New research from Harvard suggests that three tried and tested interventions could prevent many of those deaths if implemented through global policies.
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Three global interventions could prevent millions of deaths over the next couple of decades.

According to the World Health Organization (WHO), 17.9 million deaths worldwide each year are due to cardiovascular disease, accounting for an estimated 31% of yearly global deaths.

The WHO note that heart attacks and strokes account for about 85% of these deaths.

In a new study, researchers from the Harvard T. H. Chan School of Public Health in Boston, MA, have pinpointed three well-known, verified interventions that have the potential to prevent a significant number of such premature deaths at a global level.

More specifically, the Harvard T. H. Chan investigators estimate that the three public health interventions combined could help extend the lives of 94 million people over 25 years, from 2015 through to 2040.

However, the team notes that for this very achievable goal to become a reality, policymakers across the world have to commit to implementing the recommended measures.

"Focusing our resources on the combination of these three interventions can have a huge potential impact on cardiovascular health through 2040," argues the study's lead author Goodarz Danaei, who is an associate professor of global health at Harvard T. H. Chan.

Danaei and colleagues explain their findings in an open-access study paper that appears in the journal Circulation.

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In their analysis, the researchers used data on mean blood pressure levels, as well as sodium (salt), and trans fat consumption in populations from different countries. They accessed this information via population health surveys and country-wide estimates, looking at available data and projections covering a period of 25 years, from 2015 through 2040.

The team found that three "well-known interventions," namely: lowering blood pressure, reducing sodium intake, and eliminating trans fat from one's diet could have an important beneficial effect in terms of preventing millions of premature, cardiovascular event-related deaths worldwide.

The researchers believe that boosting the reach of treatments for high blood pressure to 70% of the world's population could save an estimated 39.4 million people. They also estimate that reducing salt consumption by 30% could prevent an estimated 40 million deaths, as well as decrease blood pressure rates in populations around the world.

This, the researchers explain, is important because high blood pressure is a top risk factor for the development of cardiovascular disease. Finally, they note that cutting the intake of trans fat, which is present in many fast food products and can endanger heart and vascular health, could extend the lives of 14.8 million people, according to the new study.

Danaei and team note that over half of all the premature deaths these interventions would prevent, as well as two-thirds of deaths delayed before the age 70, would most likely be among men. Should there be a global commitment to implementing these interventions, the regions that would see the most benefits would be East Asia, the Pacific, South Asia, and some countries in sub-Saharan Africa.

"Overall, this study indicates that these [three] interventions have enormous potential to save lives. However, scaling up these interventions to global populations is a huge challenge," the researchers write in their study paper.

Countries all over the world would have to dedicate extra resources to providing antihypertensive (blood pressure-lowering) medication, promote education about the risks associated with too much sodium intake, and update and push out new and better health policies.

These goals are entirely achievable, the investigators emphasize. Other programs have already demonstrated this. One such program, tested by Kaiser Permanente in Northern California, was able to increase blood pressure control to 90% among its patients between 2001–2013.

"These are realistic goals that have been shown to be attainable on smaller scales. We need the commitment to scale up the programs to achieve them globally."

Goodarz Danaei

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What is the normal range for troponin levels?

Troponin refers to a group of proteins that help regulate the contractions of the heart and skeletal muscles. High troponin levels can indicate a problem with the heart.

The heart releases troponin into the blood following an injury, such as a heart attack. Very high troponin levels usually mean that a person has recently had a heart attack. The medical term for this attack is myocardial infarction.

In this article, we discuss what troponin is, why doctors test troponin levels, and what the normal range is. We also cover the causes and treatment of high troponin levels and what to expect during the test.

What is troponin? Blood test for troponin levels
A doctor may test troponin levels if a person is experiencing possible symptoms of a heart attack.

Troponin refers to three different proteins. Troponin C binds calcium and transports troponin I so that muscles can contract. Troponin T binds troponin proteins to muscle fibers.

The heart is essentially a muscle, and damage to the heart causes it to release troponin into the bloodstream. Troponin levels in the blood are normally very low, but injuries to the heart can cause the levels to increase significantly.

Troponin tests typically measure levels of troponin I or troponin T in the blood as a way to check for heart damage.

Thank you for supporting Medical News Today Why do doctors test troponin levels? A troponin test can help detect an injury to the heart. A doctor may order the test if a person is experiencing possible symptoms of a heart attack, such as: chest pain shortness of breath a rapid heart rate lightheadedness fatigue A doctor will not use elevated troponin levels alone to diagnose a heart condition. They will also take into account the person's other symptoms and may use other diagnostic tools, such as a physical examination or an electrocardiogram (ECG). Troponin testing, however, allows a doctor to assess the extent of any heart damage, which can guide treatment decisions and help determine if current treatments are effective. What is the normal troponin range? Troponin levels are usually so low that standard blood tests are unable to detect them. Even small increases in troponin can indicate some damage to the heart. Significantly raised levels of troponin, particularly if they rise and fall over a series of hours, are a strong indication of a heart injury. The range for normal troponin levels can vary between laboratories, so it is best to discuss the results with the doctor who ordered the test. Laboratories measure troponin in nanograms per milliliter of blood (ng/ml). The University of Washington's Department of Laboratory Medicine provides the following ranges for troponin I levels: Normal range: below 0.04 ng/ml Probable heart attack: above 0.40 ng/ml Having a result between 0.04 and 0.39 ng/ml often indicates a problem with the heart. However, a very small number of healthy people have higher than average levels of troponin. So, if the result is in this range, a doctor may check for other symptoms and order further tests before making a diagnosis. According to Lab Tests Online, many labs in the United States are now using a high-sensitivity version of the troponin test, which the Food and Drug Administration (FDA) approved in 2017. This newer test can detect elevated troponin levels earlier than previous versions. Doctors usually order a series of troponin tests to monitor how a person's levels are changing over time. Causes of high troponin levels troponin T test
Elevated troponin levels may result from sepsis, kidney failure, heart failure, or a traumatic injury to the heart. Very high levels of troponin typically indicate that a person has had a heart attack, which can occur if the blood supply to some of the heart muscle suddenly becomes blocked. Lower but elevated troponin levels may point to another diagnosis. Some causes of elevated troponin levels can include: sepsis, which is a severe and potentially life-threatening reaction to an infection entering the bloodstream kidney failure or chronic kidney disease heart failure chemotherapy-related damage to the heart pulmonary embolism heart infection myocarditis, which is inflammation of the heart heart damage from using recreational drugs, such as cocaine a traumatic injury to the heart, such as from a sudden, hard blow to the chest Treatment for high troponin levels High troponin levels are a symptom, not a diagnosis, so treatment will focus on finding and addressing the underlying cause. Very high levels of troponin usually indicate that a person has recently had a heart attack. Treatment for a heart attack depends on whether the blockage preventing blood flow to the heart is partial or complete. Some common treatments of a heart attack include: clot-dissolving medications coronary angioplasty, which is a procedure that involves threading a small balloon into the coronary artery to open up the blockage the insertion of a stent — a wire mesh tube — to prop open a blocked blood vessel during an angioplasty bypass surgery, which involves a surgeon creating new pathways for blood to travel to the heart muscle ablation, which is a treatment that destroys certain heart cells using radio waves To prevent the risk of further heart attacks, a doctor will usually recommend lifestyle changes, such as quitting smoking, losing weight, getting more exercise, and eating a more healthful diet. Treatments of other causes of high troponin levels may be different from treatments of a heart attack. Thank you for supporting Medical News Today What happens during the test? A troponin test is a simple blood test, and a healthcare professional will usually take the blood sample from the arm. Blood tests are generally very safe and quick. To take the blood sample, the healthcare professional usually begins by wrapping a band around the person's upper arm. Tightening this band causes the blood vessels to swell, making it easier to draw the blood. The healthcare professional will then insert a needle into a blood vessel and withdraw some blood. The needle may cause a short, sharp sensation, but many people feel little or no pain. It is important for a person to inform the healthcare professional if they feel dizzy or nauseous after giving the sample. Sitting for 5–10 minutes and drinking a glass of water or sugary juice can help relieve dizziness and nausea. A doctor may request additional blood samples over the course of a few hours. Summary Doctors use troponin tests to assess whether there is damage to a person's heart. Very high levels of troponin can indicate a recent heart attack. Doctors usually order troponin testing if they suspect that a person has had a recent heart attack. Higher than normal levels of troponin can also indicate other injuries and conditions that affect the heart. However, doctors do not use elevated troponin levels alone to diagnose a heart condition. They will also take into account the person's other symptoms and may order further tests, such as an ECG. Treatment for high troponin levels depends on the underlying cause. For people having a heart attack, treatment may involve emergency procedures to open the blocked artery.
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Tomato juice: Could 1 cup per day keep heart disease at bay?

Researchers have recently investigated the potential benefits of tomato juice on cardiovascular risk. Although the team reported reductions in blood pressure and cholesterol levels, the results are not entirely convincing.
Bottles of tomato juice
Can tomato juice protect against cardiovascular disease?

Cardiovascular diseases are responsible for the most deaths in the United States.

People can modify certain risk factors, such as smoking, but it is impossible to modify others, such as age.

So, as the population ages, finding ways of reducing cardiovascular risk is of growing importance.

Nutrition is vital for good health, and heart health is no exception. Now, one new study has asked whether regular consumption of unsalted tomato juice might be a cost-effective intervention.

The study authors explain how the tomato "contains a variety of bioactive compounds, such as carotenoid, vitamin A, calcium, and gamma‐aminobutyric acid, which may play a role in maintaining physical and psychological health, including the prevention of [cardiovascular disease]."

Atherosclerosis in brief

The main driver of cardiovascular disease is atherosclerosis, which occurs when plaque builds up within blood vessels. As time goes on, plaque becomes harder, narrowing the arteries.

Atherosclerosis begins when the endothelium, or the inside surface of blood vessels, sustains damage.

This damage can occur for a number of reasons, some of which are high blood pressure, diabetes, and levels of cholesterol in the blood. If a person can control these three factors, they could significantly reduce their risk of atherosclerosis and other cardiovascular conditions.

The authors of the recent study published a similar study in 2015. In their previous work, they concluded that drinking unsalted tomato juice over 8 weeks reduced the levels of triglycerides in the blood of middle-aged women. Triglycerides are a type of fat; high levels of these fats contribute to atherosclerosis.

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Another look at tomato juice

Their previous results prompted the scientists to widen their net and assess whether tomato juice might also benefit other cardiovascular risk factors, such as high blood pressure and lipid and glucose metabolism, over a longer period.

This time, they also wanted to measure the benefits of tomato juice in people of different ages and sexes. The scientists published their findings in the journal Food Science & Nutrition.

According to its authors, "the current study is the first to investigate the effects of tomato or tomato product intake on cardiovascular disease risk markers over the course of a year and over a wide age range."

At this point, it is important to note that the authors received a research grant from the Kikkoman Corporation to conduct both this study and the previous one.

The Kikkoman Corporation manufacture a range of soy sauces but also hold the exclusive marketing rights to the Del Monte brand in Asia, where the company "manufactures and markets tomato-based goods."

1 cup each day

In total, the scientists recruited 184 men and 297 women as participants. For 1 year, all participants had access to as much unsalted tomato juice as they wanted; the average was around 215 milliliters per day per person, which is slightly less than 1 cup.

At the beginning and end of the study, the scientists measured a range of factors, including blood pressure, levels of triglycerides and cholesterol in the blood, and fasting plasma glucose.

They analyzed data from the 94 participants who had hypertension or prehypertension (elevated blood pressure not high enough for the person to receive a diagnosis of hypertension).

Their blood pressure was significantly lower after 1 year of consuming tomato juice. Average systolic blood pressure dropped from 141.2 to 137.0 millimeters of mercury (mm Hg). Also, average diastolic blood pressure dropped from 83.3 to 80.9 mm Hg.

According to the American Heart Association's (AHA) guidelines, this change in blood pressure would move the average participant from hypertension stage 2 down to hypertension stage 1.

These effects were similar for both men and women and people of all ages.

No change for glucose or triglycerides

The researchers also assessed glucose metabolism in 62 participants with untreated impaired glucose tolerance; however, there were no significant improvements for these people.

In a subgroup of 127 participants with abnormal lipid levels in their blood, there were no changes to triglycerides or high-density lipoprotein (HDL), or "good," cholesterol.

However, they did see a significant drop in the level of low-density lipoprotein (LDL), or "bad," cholesterol. LDL is a risk factor for atherosclerosis.

Importantly, using a questionnaire, the researchers ensured that the participants' lifestyles had not changed significantly over the year, which might account for these beneficial changes.

Sizable limitations

The study has a number of significant limitations; aside from the source of its funding, the study only recruited a relatively small number of participants. In the blood pressure analysis group specifically, there were only 94 individuals.

It is also worth noting that the participants were all residents of Kuriyama, Japan. Therefore, it is possible that the results might not apply to other populations or ethnicities.

Also, the researchers did not have access to the participants' other dietary habits; in some cases, it might be possible that when a participant introduced a glass of tomato juice, it replaced a less healthful snack.

Therefore, it could be the removal of the snack that generated the health benefits, rather than the juice itself.

Also, when the scientists checked for lifestyle changes between the beginning and end of the study, only around half of the participants had completed the questionnaire. It is quite possible that during those 12 months, some people made significant changes to their levels of exercise or food intake.

That being said, these are not the first studies to examine whether tomato products could reduce cardiovascular risk. For instance, as one meta-analysis of 21 studies concluded:

"The available evidence on the effects of tomato products [on cardiovascular] risk factors supports the view that increasing the intake of these has positive effects on blood lipids, blood pressure, and endothelial function."

The cardiovascular benefits of tomato juice are gathering evidence. However, the new study is not powerful enough to prompt a change in drinking habits; we may need to wait a little longer before we can draw reliable conclusions.

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Cardiovascular disease: 7 simple steps that lower future risk

Maintaining good cardiovascular health — as the American Heart Association define it — over an extended period helps lower the risk of cardiovascular disease in the future.
woman's hands forming a heart symbol against pink background
New research gives important clues on how to protect heart health.

This is the main takeaway of a study which now appears in the journal JAMA Network Open.

Using the best evidence available, the American Heart Association (AHA) developed the so-called Life's Simple 7 — a collection of factors that can help predict and protect a person's heart health.

"Life's Simple 7" consists of four "modifiable behaviors" — that is, things you can do to lower your chances of developing heart diseases. These are: quitting smoking, maintaining a healthy weight, eating healthfully, and being physically active.

The AHA also includes three measures: blood pressure, cholesterol, and blood sugar. Keeping these in check, suggest the AHA, and following the four behaviors above reduces the risk of dying from stroke or cardiovascular disease (CVD).

The AHA suggest assessing each metric and behavior and grading them as "poor," "intermediate," and "ideal." So, the AHA would deem a behavior such as smoking regularly as "poor," having smoked in the past year as "intermediate," and quitting smoking or not smoking at all as "ideal."

"Only about 2% of people in the United States and other countries meet all the ideal requirements for these seven factors," explains Dr. Xiang Gao, who is an associate professor of nutritional sciences and director of the Nutritional Epidemiology Lab at Pennsylvania State University.

Dr. Gao is the last and corresponding author of the new study, which aimed to see if sticking to these seven steps over time will lower a person's future risk of CVD.

The fact that so few people meet AHA's criteria, Dr. Gao continues, "raises the question of whether improving these metrics is related to lower future risk of CVD. It should, but no one had the data to support this idea."

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To find out, Dr. Gao and team examined data from 74,701 Chinese adults who took part in the Kailuan Study. The study participants answered questionnaires about their overall health and took part in various clinical tests three times between 2006 and 2010.

The researchers gathered this information and analyzed how it related to the incidence of CVD in the following years.

In 2006–2010, the researchers identified five heart health patterns that the study participants followed. "[A]bout 19% of participants were able to maintain a better cardiovascular health score over the 4 years," reports Dr. Gao.

"We found that those people had a 79% lower chance of developing heart disease in the future than people who maintained a low cardiovascular health score."

The researchers say that they obtained the same results when they looked at stroke and heart attack risk.

"We also examined whether improving cardiovascular health score over time affected future risk of CVD," Dr. Gao continues.

"We found that improvement of overall cardiovascular health over time related to lower future CVD in this population, even for those with poor cardiovascular health status at the beginning of the study."

Dr. Xiang Gao

Finally, the researchers also ran several tests repeatedly, each time removing one of the seven health factors. They did so to see if one health factor was more important than the others, but found no significant difference in risk prediction when they removed a single measure.

"This suggests that overall cardiovascular health is still the most important thing and that one factor isn't more important than the others," Dr. Gao says. "It also helps confirm that these seven metrics are valid and a very useful tool for developing a strategy for cardiovascular disease prevention."

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Is coffee bad for the heart or not?

Studies on coffee consumption variously claim that coffee harms the arteries, that it protects the heart, or that it has no effect on cardiovascular health. New research on thousands of participants weighs in again on the link between this favorite beverage and heart health.
coffee cup in a heart made from coffee beans
New findings suggest that even heavy coffee drinkers may have nothing to worry about when it comes to cardiovascular health.

Does coffee harm, protect, or have no effect on heart health and the vascular system?

For years, scientists have been trying to answer these questions, since coffee is such a favorite beverage around the world.

While some studies warn that drinking coffee can increase a person's risk of cardiovascular events, others suggest that it can help maintain heart health and blood vessel function.

Some research has suggested that regularly drinking a lot of coffee contributes to aortic stiffness — this is when the aorta, which is the largest blood vessel in the human body, becomes less and less flexible. Aortic stiffness can contribute to the risk of cardiovascular disease.

At the same time, other evidence has indicated that drinking more than three cups of coffee a day can protect against atherosclerosis, a condition in which plaque builds up inside the arteries, preventing blood from flowing normally.

Now, a new study conducted by researchers from the Queen Mary University of London in the United Kingdom has found that even people who drink a significant amount of coffee each day do not experience arterial stiffness, meaning that coffee does not increase their risk of cardiovascular problems in this way.

Lead author Prof. Steffen Petersen and colleagues presented the study's findings yesterday at the annual British Cardiovascular Society (BCS) Conference in Manchester, U.K.

The British Heart Foundation, a registered charity based in the U.K. that supports research about heart and circulatory conditions, funded the study.

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Same results across all groups

In the new study, the research team analyzed the data of 8,412 participants recruited via the U.K. Biobank Imaging Study. At the BCS Conference, the team explained that the participants agreed to undergo cardiovascular magnetic resonance imaging and other specialist assessments to allow the investigators to determine the state of their cardiovascular function.

The participants also self-reported how much coffee they typically drank on a day-to-day basis. Following these reports, the investigators then categorized the participants into three groups, according to their coffee consumption habits:

people who drank one or fewer cups of coffee a day those who drank between one and three cups of coffee per day those who drank more than three cups of coffee per day

In their final analysis, Prof. Petersen and team excluded individuals who drank more than 25 cups of coffee per day, as well as those who had cardiovascular disease at baseline.

When comparing measurements of arterial stiffness between the three groups, the researchers found no differences between moderate and heavy coffee drinkers (those who drank between one and three or more than three cups of coffee per day, respectively) and those who had one cup off coffee or less per day.

These results, the investigators say, suggest that even drinking significant amounts of coffee is unlikely to have an ill effect on arterial health, so it may not negatively influence heart health and vascular function.

"Despite the huge popularity of coffee worldwide, different reports could put people off from enjoying it. Whilst we can't prove a causal link in this study, our research indicates coffee isn't as bad for the arteries as previous studies would suggest," explains study coauthor Kenneth Fung.

These findings remained in place after the investigators adjusted for possible factors contributing to arterial stiffness, including age, biological sex, ethnicity, smoking status, alcohol consumption, height, weight, eating habits, hypertension (high blood pressure), high cholesterol, and diabetes.

What should and what shouldn't we believe?

The researchers also noted that moderate and heavy coffee drinkers were more likely to be male, habitual smokers, and frequent drinkers of alcohol.

"Although our study included individuals who drink up to 25 cups a day, the average intake amongst the highest coffee consumption group was five cups a day. We would like to study these people more closely in our future work so that we can help to advise safe limits," Fung also specifies.

Prof. Metin Avkiran, who is Associate Medical Director at the British Heart Foundation, and who was not involved in the current research, explains that such studies about the relationship between coffee consumption habits and heart health can help individuals make better-informed decisions.

"Understanding the impact that coffee has on our heart and circulatory system is something that researchers and the media have had brewing for some time. There are several conflicting studies saying different things about coffee, and it can be difficult to filter what we should believe and what we shouldn't."

Prof. Metin Avkiran

"This research will hopefully put some of the media reports in perspective, as it rules out one of the potential detrimental effects of coffee on our arteries," Prof. Avkiran says.

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Can blueberries protect heart health?

According to a new study, consuming 1 cup of blueberries each day might improve the metabolic markers associated with cardiovascular risk.
Hands holding blueberries
Blueberries are tasty, but are they good for our hearts?

Blueberries are delicious and nutritious; if they could also lower the risk of heart disease, that would be a bonus.

For that reason, the United States Highbush Blueberry Council helped fund a study to investigate blueberries' potential benefit to heart health.

Researchers from the University of East Anglia in the United Kingdom teamed up with scientists from Harvard University in Cambridge, MA.

In particular, they wanted to understand whether regularly consuming blueberries could alter the metabolic profile of people with metabolic syndrome.

Metabolic syndrome describes a cluster of conditions that include high blood pressure, excess body fat around the waist, high blood sugar levels, and abnormal cholesterol and triglyceride levels. Together, these factors increase the risk of cardiovascular disease and type 2 diabetes.

Currently, metabolic syndrome affects more than one-third of adults in the U.S., with some experts referring to it as a global epidemic.

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Blueberries and anthocyanins

"Previous studies have indicated that people who regularly eat blueberries have a reduced risk of developing conditions including type 2 diabetes and cardiovascular disease," says lead researcher Prof. Aedin Cassidy.

"This," she says, "may be because blueberries are high in naturally occurring compounds called anthocyanins."

Anthocyanins are water soluble pigments that can appear red, black, blue, or purple. These flavonoids are present in the tissues — including the stems, leaves, flowers, roots, and fruits — of many higher plants.

Previous studies have revealed a relationship between increased anthocyanin consumption and reduced mortality risk; others have linked these chemicals to a reduced risk of cardiovascular disease.

However, to date, much of the research has taken place over a relatively short period; in fact, some studies looked at the consumption of just a single portion of blueberries.

There have also been no randomized controlled trials investigating blueberries' potential to protect against disease in a population with a higher risk of developing type 2 diabetes and cardiovascular disease.

Prof. Cassidy says, "We wanted to find out whether eating blueberries could help people who have already been identified as being at risk of developing these sort of conditions."

Testing blueberry powder

To investigate, the team recruited 115 participants, ages 50–75, all of whom were either overweight or obese and had metabolic syndrome. The study ran for 6 months, making it the longest of its kind.

Importantly, the scientists used "dietarily achievable levels" of blueberries rather than expecting the participants to consume an unsustainable and unrealistic amount of blueberries each day.

They split the participants into three groups:

One group consumed 1 cup (150 grams) of freeze-dried powdered blueberries per day. Another group consumed half a cup (75 grams) of freeze-dried powdered blueberries per day. The final group acted as a control group; they received a powder that looked similar to blueberry powder but which primarily contained dextrose, maltodextrin, and fructose.

At the start and end of the trial, the researchers assessed biomarkers for insulin resistance, lipid status, and vascular function. They recently published their findings in the American Journal of Clinical Nutrition.

"We found that eating 1 cup of blueberries per day resulted in sustained improvements in vascular function and arterial stiffness — making enough of a difference to reduce the risk of cardiovascular disease by between 12 and 15%."

Co-lead study author Dr. Peter Curtis

Interestingly, the scientists only saw the benefits in the group consuming 1 cup of blueberries per day — not in those consuming half a cup.

Dr. Curtis believes that this is because "higher daily intakes may be needed for heart health benefits in obese, at-risk populations, compared with the general population."

It is also worth noting that the blueberry intervention did not alter the other parameters the scientists measured. The authors write:

"No favorable effects of the intervention were shown for the primary endpoint [insulin sensitivity] or indices of glucose control. [...] The intervention had no effect on [blood pressure] or other biomarkers of vascular function."

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Explaining the benefits of blueberries

The scientists believe that the cardiovascular benefits they saw are primarily due to the presence of anthocyanins in blueberries.

In the lower intestine, the body metabolizes anthocyanins to produce a range of chemicals; some of these chemicals provide sustenance to the resident gut bacteria and are "likely play a key beneficial metabolic role," say the study authors.

They offer some examples. For instance, some researchers have shown that syringic acid, which is a chemical that the metabolism of anthocyanin produces, benefits vascular endothelial cells in the laboratory.

Similarly, scientists have found that vanillic acid, another breakdown product, reduces hypertension in rats.

Dr. Curtis concludes, "The simple and attainable message is to consume 1 cup of blueberries daily to improve cardiovascular health."

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At this point, it is worth mentioning that other foods contain anthocyanin, including blackcurrants, black and red raspberries, blackberries, red cabbage, plums, red radish, black carrot, and purple potato.

Although this project was the first long-term, placebo-controlled study to look at blueberries and cardiovascular and metabolic health, it is important to remember that only 115 participants completed this trial.

By the end, only 37 participants remained in the group consuming 1 cup of blueberries per day.

Blueberries are likely to be a healthful addition to any diet, as are most other fruits and vegetables. However, scientists will need to carry out larger studies to confirm the clinical benefits of blueberries.

Because the U.S. Highbush Blueberry Council are dedicated to "driving consumer demand," more research is likely to follow.

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Why sleep is essential for health

Getting enough sleep is essential for helping a person maintain optimal health and well-being. When it comes to their health, sleep is as vital as regular exercise and eating a balanced diet.

Modern-day living in the United States and many other countries does not always embrace the necessity for adequate sleep. Yet, it is important that people make an effort to get enough sleep regularly.

The following are some of the many benefits health professional associate with getting a good night's rest.

1. Better productivity and concentration Why is sleep important
Research has linked getting enough sleep to better concentration, productivity, and cognition.

There were several studies that scientists did in the early 2000s that looked at the effects of sleep deprivation.

What the researchers concluded is that sleep has links to several brain functions, including:

concentration productivity cognition

A more recent 2015 study in the Journal of Child Psychology and Psychiatry showed that children's sleep patterns can have a direct impact on their behavior and academic performance.

2. Lower weight gain risk The link between weight gain and obesity and short sleep patterns is not completely clear. There have been several studies throughout the years that have linked obesity and poor sleep patterns. However, a more recent study in the journal Sleep Medicine concludes that there is no link between being overweight and sleep deprivation. This research argues that many previous studies fail to account adequately for other factors, such as: drinking alcohol living with type 2 diabetes level of physical activity education levels long working hours long sedentary time A lack of sleep may affect a person's desire or ability to maintain a healthful lifestyle, but it may or may not be a direct contributor to weight gain. Thank you for supporting Medical News Today 3. Better calorie regulation Similarly to gaining weight, there is evidence to suggest that getting a good night's sleep can help a person consume fewer calories during the day. For example, one study in the Proceedings of the National Academy of Sciences of the United States of America says that sleep patterns affect the hormones responsible for appetite. When a person does not sleep long enough, it can interfere with their body's ability to regulate food intake correctly. 4. Greater athletic performance Why is sleep important athletic performance
Getting a sufficient amount of sleep can boost a person's athletic performance. According to the National Sleep Foundation, adequate sleep for adults is between 7 and 9 hours a night, and athletes may benefit from as many as 10 hours. Accordingly, sleep is as important to athletes as consuming enough calories and nutrients. One of the reasons for this requirement is that the body heals during sleep. Other benefits include: better performance intensity more energy better coordination faster speed better mental functioning 5. Lower risk of heart disease One risk factor for heart disease is high blood pressure. According to the Centers for Disease Control and Prevention (CDC), getting adequate rest each night allows the body's blood pressure to regulate itself. Doing so can reduce the chances of sleep-related conditions such as apnea and promote better overall heart health. 6. More social and emotional intelligence Sleep has links to people's emotional and social intelligence. Someone who does not get adequate sleep is more likely to have issues with recognizing other people's emotions and expressions. For example, one study in the Journal of Sleep Research looked at people's responses to emotional stimuli. The researchers concluded, similarly to many earlier studies, that a person's emotional empathy is less when they do not get adequate sleep. 7. Preventing depression The association between sleep and mental health has been the subject of research for a long time. One conclusion is that there is a link between lack of sleep and depression. A study appearing in JAMA Psychiatry examines patterns of death by suicide over 10 years. It concludes that lack of sleep is a contributing factor to many of these deaths. Another study in the Australian and New Zealand Journal of Psychiatry suggests that people with sleep disorders such as insomnia are likely to show signs of depression. 8. Lower inflammation There is a link between getting adequate sleep and reducing inflammation in the body. For example, a study in the World Journal of Gastroenterology suggests a link between sleep deprivation and inflammatory bowel diseases that affect people's gastrointestinal tract. The study showed that sleep deprivation can contribute to these diseases — and that these diseases, in turn, can contribute to sleep deprivation. Thank you for supporting Medical News Today 9. Stronger immune system Sleep helps the body repair, regenerate, and recover. The immune system is no exception to this relationship. Some research shows how better sleep quality can help the body fight off infection. However, scientists still need to do further research into the exact mechanisms of sleep in regards to its impact on the body's immune system. Sleep recommendations Why is sleep important outdoor walking
Spending more time outside can improve sleep quality. Sleep needs vary from person to person, depending on their age. As a person ages, they typically require less sleep to function properly. According to the CDC, the breakdown is as follows: Newborns (0–3 months): 14–17 hours Infants (4–12 months): 12–16 hours Toddler (1–2 years): 11–14 hours Preschool (3–5 years): 10–13 hours School age (6–12 years): 9–12 hours Teen (13–18 years): 8–10 hours Adult (18–60 years): 7-plus hours Adult (61–64 years): 7–9 hours Adult (65+ years): 7–8 hours As well as the number of hours, the quality of sleep is also important. Signs of poor sleep quality include: Waking in the middle of the night. Still not feeling rested after an adequate number of hours sleep. Some things a person can do to improve sleep quality are: Avoiding sleeping in when you have had enough sleep. Going to bed around the same time each night. Spending more time outside and being more active during the day. Reducing stress through exercise, therapy, or other means. Summary Sleep is a vital, often neglected, component of every person's overall health and well-being. Sleep is important because it enables the body to repair and be fit and ready for another day. Getting adequate rest may also help prevent excess weight gain, heart disease, and increased illness duration.
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