Heart Health

Active seniors can lower heart attack risk by doing more, not less

Active elderly people go hill walking in the Trossachs National Park, Scotland. Image shot 04/2010. Exact date unknown.

Maintaining or boosting your physical activity after age 65 can improve your heart’s electrical well-being and lower your risk of heart attack, according to a study in the American Heart Association journal Circulation.

In heart monitor recordings taken over five years, researchers found that people who walked more and faster and had more physically active leisure time had fewer irregular heart rhythms and greater heart rate variability than those who were less active.

Heart rate variability is differences in the time between one heartbeat and the next during everyday life.

“These small differences are influenced by the health of the heart and the nervous system that regulates the heart,” said Luisa Soares-Miranda, Ph.D., lead author of the study and a researcher at the Harvard School of Public Health in Boston and the Faculty of Sport at the University of Porto in Portugal. “Early abnormalities in this system are picked up by changes in heart rate variability, and these changes predict the risk of future heart attacks and death.”

The researchers evaluated 24-hour heart monitor recordings of 985 adults (average age 71 at baseline) participating in the community-based Cardiovascular Health Study, a large study of heart disease risk factors in people 65 and older.

During the study, they found:

The more physical activity people engaged in, the better their heart rate variability.
Participants who increased their walking distance or pace during the five years had better heart rate variability than those who reduced how much or how fast they walked.
“Any physical activity is better than none, but maintaining or increasing your activity has added heart benefits as you age,” Soares-Miranda said. “Our results also suggest that these certain beneficial changes that occur may be reduced when physical activity is reduced.”

The researchers calculated that the difference between the highest and lowest levels of physical activity would translate into an estimated 11 percent lower risk of heart attack or sudden cardiac death.

“So if you feel comfortable with your usual physical activity, do not slow down as you get older — try to walk an extra block or walk at a faster pace,” Soares-Miranda said. “If you’re not physically active, it is never too late to start.”

Co-authors are Jacob Sattelmair, Ph.D.; Paulo Chaves, M.D., Ph.D.; Glen Duncan, Ph.D.; David S. Siscovick, M.D., M.P.H.; Phyllis K. Stein, Ph.D.; and Dariush Mozaffarian, M.D., Dr.P.H. Author disclosures are on the manuscript.

The National Heart, Lung, and Blood Institute, National Institute of Neurological Disorders and Stroke and National Institute on Aging funded the research.

Source: News room

High-fibre diet ‘benefits heart attack patients’

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If you have had a heart attack, eat plenty of fibre because it may improve your long-term chances of recovery, say US researchers.

Heart-attack survivors were more likely to be alive nine years later if they followed a high-fibre diet, a study in the British Medical Journal found. Every 10g-per-day increase in fibre intake was linked with a 15% drop in death risk during the study.

Dietary fibre may improve blood pressure and cholesterol, experts say. On average, most people in the UK get about 14g of fibre a day, against a target of at least 18g. US experts recommend up to 38g a day.

Fruit, such as bananas and apples, root vegetables, such as carrots and potatoes, wholemeal bread, cereals and bran are all good sources of dietary fibre. A jacket potato and baked beans contain about 10g of fibre; two slices of wholemeal bread about 4g.

Breakfast cereals
A low-fibre diet is associated with constipation and gut diseases, such as diverticulitis and bowel cancer, but it may also have implications for heart health, say US researchers.

The Harvard School of Public Health team analysed data from two large US studies involving more than 4,000 men and women who had survived a first heart attack and had provided information about their usual diet via questionnaires.

They were followed for an average of almost nine years after their heart attacks, during which time 682 of the women and 451 of the men died.

Chances of survival appeared to be linked with fibre intake, which was mostly from breakfast cereals. The one in five who ate most fibre had a 25% lower chance of dying from any cause during the nine years after their heart attack compared with the fifth who ate the least.

The high-fibre group was 13% less likely to have a fatal heart attack. The researchers say the findings point to a simple lifestyle step that people could take, alongside their medication, to improve their long-term health prospects.

Victoria Taylor, of the British Heart Foundation, said: “High-fibre foods are a key part of a healthy balanced diet, and this study suggests they may have a particular benefit for heart-attack survivors.

“We can’t say for sure what caused the fibre benefit seen here, but we do know that, on average, we’re not getting enough fibre in our diets. “Fibre comes from a range of foods, including fruit and veg, beans and lentils, and also from cereal products, which this study found to be particularly beneficial.

“To get more fibre, you can make simple swaps, such as trading white bread for wholegrain versions or opting for higher-fibre breakfast cereals, like porridge or muesli.”

Source: BBC

Too much running could actually kill you sooner

Training to run a marathon has got to be one of the healthiest things you can do, right? Maybe not: A new study found that “moderate” runners lived longer than people who don’t exercise at all — and people who run lots of miles

The study involved 3,800 runners who supplied info on their heart risk factors and their use of NSAIDs like ibuprofen; almost 70% of the group clocked more than 20 miles a week. The findings were presented Sunday, but have yet to be published in a peer-reviewed journal. According to the results, how much should you run? One cardiologist who reviewed the data suggests you no more than 2.5 hours per week, spread out between two or three sessions consisting of slow or moderately-paced running.

It’s not clear why too much running might be bad for longevity, but the study appears to rule out factors like prior cardiac risk (linked to things like high blood pressure, high cholesterol, diabetes, family history, and smoking) or excessive use of NSAIDs (which have been linked to heart problems).

One doctor who’s also a running coach tells NBC San Diego that extreme exercise can actually “cause some scarring of the heart.” And another recent study found that male marathon runners had more plaque in their coronary arteries—which can lead to a heart attack—than non-runners, Pioneer Press reports. Again, it’s not clear why, but one researcher notes, “It is plausible, not proof by any stretch, that metabolic changes when running could be moderately toxic to arteries.”

Source: KSDK

Smokers may show heart disease much younger than nonsmokers

A smoker’s coronary artery disease is likely to be as advanced as that of a non-smoker who is 10 years older when both show up at the hospital with a heart attack, according to a new study.

Researchers looked at nearly 14,000 patients hospitalized with blockages in arteries supplying the heart muscle and found smokers were more likely than nonsmokers to die within a year.

Despite their being younger, and otherwise healthier, the smokers’ heart arteries were in a condition similar to those of nonsmokers 10 years older.

“We saw smokers presenting the disease at age 55 and nonsmokers presenting the same disease at 65,” said Dr. Alexandra Lansky, a researcher on the study.

Smoking can cause blood clots, which often get lodged in the rigid and narrow arteries that have already been clogged by the buildup of cholesterol and fat deposits, according to Lansky and her colleagues.

Although the fat buildup and stiffening of the artery walls, known as atherosclerosis, becomes more likely with age for everyone, the clots caused by smoking worsen the blockages.

That makes smokers more likely to have a heart attack at a younger age, but less likely to have the other conditions, known as comorbidities, that go along with aging, such as diabetes and high blood pressure.

“Smoking accelerates the manifestation of coronary disease but in the absence of these comorbidities,” Lansky told Reuters Health.

Past research has identified a “smoker’s paradox” – because smokers are younger, with fewer other health problems, when they had a heart attack, they were more likely to recover it. Or so it seemed.

“We wanted to look at longer-term effects of smoking rather just the short term effect,” Lansky said.

The researchers analyzed medical records for 13,819 patients, almost 4,000 of them smokers, hospitalized with chest pain or a heart attack caused by a blocked coronary artery.

The study team organized the data to match the smokers and nonsmokers by age, weight, comorbidities and other risk factors.

When compared to nonsmokers with similar overall health, the smokers were ten years younger, on average, and more likely to have already been treated with blood thinners – suggesting they had already experienced problems with blood flow.

Imaging of the coronary artery showed the smokers’ had atherosclerosis comparable to the nonsmokers ten years their senior, the researchers report in the journal JACC: Cardiovascular Interventions.

Before the adjustments for age and other health conditions, the smokers and nonsmokers were about equally likely to survive the first 30 days after hospitalization, and smokers were about 20 percent less likely to die within a year.

But once smokers and nonsmokers with similar health profiles were compared to each other, the smokers were 37 percent more likely to die within the first year.

“What makes it novel, is that we are showing that if you come in, your chance of survival is already reduced, as a smoker,” Lansky said.

The findings are not surprising, according to Dr. Robert Giugliano, a cardiologist at Brigham and Women’s Hospital in Boston.

“Nonetheless, the public does need to know that there is now even more evidence that smoking is bad for your health, accelerates the process of atherosclerosis (so smokers have heart and vascular disease on average 10 years early than non-smokers), and leads to worse outcomes compared to non-smokers of a similar age,” said Giugliano, who also teaches at Harvard Medical School.

Dr. Elliot Antman, also of Brigham and Women’s Hospital and Harvard, said it would be interesting to follow the patients for longer than a year to see what happened to survival rates among smokers who quit.

Antman was not surprised by the findings either. “I always suspected this was the case but it is nice to see the data,” he told Reuters Health.

“There just aren’t many healthy people in their 80’s who smoke regularly . . . if you want to live a healthy, long life, smoking stacks the odds against you,” Giugliano said.

Source: reuters

Cheap drug boon for treating heart attack patients

An early treatment of heart-attack patients with a cheap drug holds promise to reduce health care expenditure to a great extent, researchers hope.

A six-month follow-up data of a trial showed that patients who received this treatment during emergency transit to hospital had much smaller amounts of dead heart muscle than those randomly assigned to receive no treatment.

The proportion of patients with a severely deteriorated heart contractile function is much less (60 percent) in the group that received the cheap drug named metoprolol.

“Early treatment with metoprolol also significantly reduced the rate of hospital readmission for chronic heart failure, and massively reduced the need to implant a cardioverter-defibrillator,” said lead investigator Borja Ibanez, a cardiologist at the Hospital Clinico San Carlos in Spain.

The possibility to reduce so dramatically the number of cases of chronic heart failure with such a cheap procedure could generate enormous savings for health services, Ibanez from CNIC (Spanish national cardiovascular research centre) noted.

This is one of the first studies to reveal extraordinary benefits from very early intervention -in this case with metoprolol – during the first contact with the emergency medical services.

An initial estimate indicates that if half the heart-attack patients in Europe received early treatment with this cheap drug, the savings in treatment for heart failure alone could exceed ?10 billion a year.

The study was published in the Journal of the American College of Cardiology.

Source: business standard

Study to Test If Chocolate Pills Can Prevent Heart Attacks

For those who believe in the power of chocolate comes the start of a new study. Researchers will look into whether certain ingredients in dark chocolate can help prevent heart attacks and strokes.

But before you start digging into your stash of chocolate, know that researchers won’t be handing out thousands of candy bars to participants.

The study, which will include 18,000 men and women, will focus on bio-active nutrients found in the cocoa bean, without all the extra ingredients such as sugar, found in chocolate candies.

Testers will be given dark chocolate pills that contain 750 milligrams of cocoa flavanols, naturally occurring plant-based nutrients found in chocolate. And unfortunately for them, the pills won’t actually taste like candy.

According to Dr. JoAnn Manson, one of the study’s lead researchers, in previous studies, cocoa flavanols have been shown to reduce blood pressure and improve cholesterol levels.

Participants at the Brigham and Women’s Hospital in Boston and the Fred Hutchinson Cancer Research in Seattle will be given two capsules a day of the cocoa flavanols or dummy pills for four years.

The study is sponsored by Mars Inc., the company behind M&M’s and Milkyway bars and the National Heart, Lung and Blood Institute. Mars Inc. has been researching cocoa flavanols for the past 20 years and already sells CocoaVia cocoa extract capsules containing 250 mg of flavanols.

The company claims that to get the same amount of CocoaVia flavanols, you’d have to eat one and a half bars of dark chocolate containing 300 calories, 22 grams of fat and 24 grams of sugar.

Source: Los Angeles times

Women Face Delays in Heart Attack Care: Study

Among young and middle-aged adults, men tend to receive faster hospital care than women for heart attacks and chest pains, a new study finds.

Anxiety appeared to be a key factor — women who appeared anxious upon admittance to the hospital tended to have delays in crucial care, the study authors found.

“Patients with anxiety who present to the emergency department with noncardiac chest pain tend to be women, and the prevalence of [heart attack or chest pains] is lower among young women than among young men,” the Canadian researchers said. “These findings suggest that [emergency-room staff] might initially dismiss a cardiac event among young women with anxiety.”

One heart expert wasn’t surprised by the findings.

“It has been shown in multiple trials that there are gender differences in the treatment of heart disease between men and women entering a hospital,” said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City.

“In younger adults, ages 18 to 55, this reality has also shown to be true,” she said. “When women enter a hospital, it is critical that this bias is eradicated.”

In the study, researchers looked at more than 1,100 adults aged 55 or younger treated for heart attack or chest pains — also called angina — at 24 hospitals in Canada, one in the United States and one in Switzerland. The median ages of the patients were 50 for women and 49 for men.

After arriving at the hospital, men underwent electrocardiograms (ECGs) within 15 minutes and clot-dissolving therapy within 21 minutes, compared with 28 minutes and 36 minutes, respectively, for women, the researchers said in the March 17 issue of the Canadian Medical Association Journal.

“Anxiety was associated with failure to meet the 10-minute benchmark for ECG in women but not in men,” said the researchers, led by Dr. Louise Pilote, a professor of medicine at McGill University in Montreal.

Digging deeper, the researchers found that patients with multiple heart attack risk factors and those with heart attack symptoms that were considered outside the norm also faced delays in care.

Steinbaum pointed out the incongruity of some of these findings.

“When analyzed, the women patients were sicker and were more likely to have diabetes, high blood pressure and a family history of heart disease,” she said. “With these multiple risk factors for heart disease, the likelihood of symptoms being heart-related are higher — yet they were not as expeditiously treated for a heart attack.”

“This delay in treatment is critical, especially in the setting of a heart attack, as death rates in patients who have multiple health problems is higher,” Steinbaum said.

Another heart specialist agreed.

“Since women often present with nontypical symptoms when having a heart attack, it is very important that physicians look at younger women, too, to make sure the symptoms they are having do not represent a developing heart attack,” said Dr. Lawrence Phillips, an assistant professor in the department of medicine at NYU Langone Medical Center in New York City.

“One of the most important take-home points from this study is the need to have an electrocardiogram early,” Phillips said. “An ECG is able to, in many cases, diagnose a heart attack as it occurs. By improving the rapidity of this test, we can start needed therapy earlier and, in doing so, save lives.”

Source: web md

Study To Test ‘Chocolate Pills’ For Heart Health

It won’t be nearly as much fun as eating candy bars, but a big study is being launched to see if pills containing the nutrients in dark chocolate can help prevent heart attacks and strokes.

The pills are so packed with nutrients that you’d have to eat a gazillion candy bars to get the amount being tested in this study, which will enroll 18,000 men and women nationwide.

“People eat chocolate because they enjoy it,” not because they think it’s good for them, and the idea of the study is to see whether there are health benefits from chocolate’s ingredients minus the sugar and fat, said Dr. JoAnn Manson, preventive medicine chief at Harvard-affiliated Brigham and Women’s Hospital in Boston.

The study will be the first large test of cocoa flavanols, which in previous smaller studies improved blood pressure, cholesterol, the body’s use of insulin, artery health and other heart-related factors.

A second part of the study will test multivitamins to help prevent cancer. Earlier research suggested this benefit but involved just older, unusually healthy men. Researchers want to see if multivitamins lower cancer risk in a broader population.

The study will be sponsored by the National Heart, Lung and Blood Institute and Mars Inc., maker of M&M’s and Snickers bars. The candy company has patented a way to extract flavanols from cocoa in high concentration and put them in capsules. Mars and some other companies sell cocoa extract capsules, but with less active ingredient than those that will be tested in the study; candy contains even less.

“You’re not going to get these protective flavanols in most of the candy on the market. Cocoa flavanols are often destroyed by the processing,” said Manson, who will lead the study with Howard Sesso at Brigham and others at Fred Hutchinson Cancer Research Center in Seattle.

Participants will get dummy pills or two capsules a day of cocoa flavanols for four years, and neither they nor the study leaders will know who is taking what during the study. The flavanol capsules are coated and have no taste, said Manson, who tried them herself.

In the other part of the study, participants will get dummy pills or daily multivitamins containing a broad range of nutrients.

Participants will be recruited from existing studies, which saves money and lets the study proceed much more quickly, Manson said, although some additional people with a strong interest in the research may be allowed to enroll. The women will come from the Women’s Health Initiative study, the long-running research project best known for showing that menopause hormone pills might raise heart risks rather than lower them as had long been thought. Men will be recruited from other large studies.

Manson also is leading a government-funded study testing vitamin D pills in 26,000 men and women. Results are expected in three years.

People love vitamin supplements but “it’s important not to jump on the bandwagon” and take pills before they are rigorously tested, she warned.

“More is not necessarily better,” and research has shown surprising harm from some nutrients that once looked promising, she said.

Source: Huffington post

New drug may stop heart attack without side effects

Scientists claim they are a step closer to developing a new drug to stop heart attack in its tracks and reduce the damage caused, without any side effects.

Researchers from the the Monash University in Australia offer new hope to thousands of people who experience heart attacks and heart failure – one of the major causes of death worldwide.

They showed new insights into a specific protein belonging to the family of G protein-coupled receptors (GPCRs).

After successfully combining two molecules, they say they are a step closer to creating a brand new class of drug that is more targeted and could possess minimal side effects.

GPCRs play a role in virtually every biological process and most diseases, including, cardiovascular disease, obesity and diabetes, neuropsychiatric disorder, inflammation and cancer, researchers said.

Almost half of all current medications available use GPCRs to achieve their therapeutic effect.

Current GPCR drugs work either by fully activating or completely blocking receptors, treating the protein like a simple “on-off” switch.

The new research discovered alternative recognition sites on GPCRs that can be targeted by drugs to fine-tune the behaviour of the protein, basically converting the “on-off” switch into a “dimmer switch”.

“Correct dosage has been a serious challenge in clinical trials for A1 receptor drugs. The consequences are serious; a dosage that is too high can stop the heart from beating. Too low, and the drug fails to prevent cell damage. Getting this balance right has been a big problem,” said researcher Peter Scammells.

The study focused on finding new ways to activate the protein, to achieve the beneficial effects (protection) without the side effects (slowing the heart), researchers said.

The study was published in the journal PNAS.

Source: Times of India

Man dies of heart attack caused by … nail biting

It’s a good thing you listened to your mom when she told you not to bite your nails: The bad habit ended up costing one UK man his life.

John Gardener, a 40-year-old amateur football referee, bit his fingernails so badly that they bled—leading to an infection that turned septic and caused a fatal heart attack,

Gardener may have become immune to the pain after years of nail-biting; his doctor says the man’s fingernails were “always in poor condition and … often bleeding,” and he’d lost nearly all feeling in them.

The habit had only gotten worse in recent years, as he also suffered from anxiety and depression. He was admitted to the hospital in September with septicemia, and was initially treated just with antibiotics because he didn’t want to lose his finger, but eight days later, doctors were forced to amputate the tip.

Even so, he died two weeks after being admitted, despite showing signs of improvement and no fever. His surgeon says Gardener’s death was “upsetting and shocking.” His mother insists, “there could’ve been more done to help him.” The family is taking action against the hospital

Gardener, who was also diabetic, had previously had his lower right leg amputated due to leg ulcers.

Source: Fox news