The Heart

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The link between insomnia and cardiovascular disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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