A new way of using blood pressure-lowering medications could prevent more than a fourth of heart attacks and strokes – up to 180,000 a year – while using less medication overall, a new study has found.

Individualizing treatment recommendations using patients’ risk of heart disease after considering multiple factors – such as age, gender and whether or not the patient smokes – is a more effective way to treat patients than current methods.

According to authors, current medical guidelines use a one-size-fits-all treatment approach based on target blood pressure values that leads to some patients being on too many medications and others are on too little.

Researchers found that a person’s blood pressure level is often not the most important factor in determining if a blood pressure medication will prevent these diseases – but common practice is to base treatment strictly on blood pressure levels.

Lead author Jeremy Sussman, M.D., M.Sc., assistant professor of internal medicine in the Division of General Medicine at the U-M Medical School and research scientist at the Center for Clinical Management Research at the VA Ann Arbor Healthcare System, said that drugs that lower blood pressure are among the most effective and commonly used medications in the country, but we believe they can be used dramatically more effectively.

He said that the purpose of these medications is not actually to avoid high blood pressure itself but to stop heart attacks, strokes and other cardiovascular diseases.

Sussman asserted that they should guide use of medications by a patient’s risk of these diseases and how much adding a new medication decreases that risk – not solely on their blood pressure level.

He found that people who have mildly high blood pressure but high cardiovascular risk receive a lot of benefit from treatment, but those with low overall cardiovascular risk do not.

The study has been published in the medical journal, Circulation.

Source: article.wn.com

A new study has revealed that taking care of your gums by brushing, flossing, and regular dental visits could keep heart disease at bay.

 Researchers at Columbia University’s Mailman School of Public Health have shown for the first time that as gum health improves, progression of atherosclerosis slows to a clinically significant degree.

Artherosclerosis or the narrowing of arteries through the build-up of plaque is a major risk factor for heart disease, stroke, and death.

“These results are important because atherosclerosis progressed in parallel with both clinical periodontal disease and the bacterial profiles in the gums. This is the most direct evidence yet that modifying the periodontal bacterial profile could play a role in preventing or slowing both diseases,” Moise Desvarieux, MD, PhD, lead author of the paper and associate professor of Epidemiology at the Mailman School, said.

The researchers followed 420 adults as part of the Oral Infections and Vascular Disease Epidemiology Study ( INVEST), a randomly sampled prospective cohort of Northern Manhattan residents. Participants were examined for periodontal infection.

Overall, 5,008 plaque samples were taken from several teeth, beneath the gum, and analyzed for 11 bacterial strains linked to periodontal disease and seven control bacteria.

Fluid around the gums was sampled to assess levels of Interleukin-1a, a marker of inflammation. Atherosclerosis in both carotid arteries was measured using high-resolution ultrasound.

Over a median follow-up period of three years, the researchers found that improvement in periodontal health—health of the gums—and a reduction in the proportion of specific bacteria linked to periodontal disease correlated to a slower intima-medial thickness (IMT) progression, and worsening periodontal infections paralleled the progression of IMT.

Results were adjusted for potential confounders such as body mass index, cholesterol levels, diabetes, and smoking status.

There was a 0.1 mm difference in IMT change over three years among study participants whose periodontal health was deteriorating compared with those whose periodontal health was improving.

Previous research has shown that a .033 mm/year increase in carotid IMT (equivalent to approximately 0.1 mm over three years) is associated with a 2.3-fold increased risk for coronary events.

“When it comes to atherosclerosis, a tenth of a millimeter in the thickness of the carotid artery is a big deal. Based on prior research, it appears to meet the threshold of clinical significance,” Tatjana Rundek, MD, PhD, a co-author of the study and professor at the University of Miami whose lab read the carotid ultrasounds, said.

Source: http://bit.ly/1fgmyTJ

We all know we’re supposed to exercise daily, but precious few of us do. And it only seems to get harder with age.

There’s a reason to try harder, though. Tacking more years of good health on to your life may be as simple as mowing the lawn more often and engaging in other everyday physical activities.

Researchers in Sweden measured the health of almost 4,000 60-year-olds in the late 1990s. A dozen years later, they checked back in. The people who had been active but not “exercising” at age 60 had a 27 percent lower risk of heart attack and stroke over that time, and a 30 percent lower risk of death.

The most active people also had trimmer waists, and better HDL cholesterol, triglycerides and blood glucose levels, considered risk factors for heart disease and diabetes.

That’s compared to people who are sedentary, which tends to become more common as people age.

What kind of activity does it take to get those kinds of numbers? Things like mowing the lawn, housework, fix-it projects, and gardening, bicycling, for a nice Scandinavian touch, “gathering mushrooms or berries.”

That last one got me thinking of my 92-year-old dad, who gathered 15 pounds of chanterelle mushrooms just a few weeks ago near his home in Oregon. Dad also mows the lawn, cleans the gutters and fixes the roof. He grows roses, tomatoes and grapes, too.

You could say he does this because he’s cheap. He’s a child of the Great Depression after all. Or maybe he’s just restless. Either way, he’s in good shape, or if he’s jogged even once in his life, it’s news to me.

Other recent studies on non-mushroom-gatherers have found similar health benefits for the kind of simple daily activity that doesn’t require Spandex pants, including walking or biking for transportation instead of driving.

The Swedish researchers also looked at people who were doing the kind of moderate-to-vigorous activity that we’re all supposed to be doing for 150 minutes a week, according to federal guidelines. Regular exercisers had better blood pressure numbers than non-exercisers. When it came to cardiovascular health and risk of death, they didn’t lower their risk any more than the active non-exercisers, unless they were getting a lot of high-intensity exercise, more than 30 minutes three times a week.

The study was published online in the British Journal of Sports Medicine.

This study doesn’t prove that being active is what made these people healthier, of course. It could be they were more active because they were healthier to begin with and then stayed that way. But the researchers tried to account for that by excluding people who already had heart disease and other health problems.

Other recent reports showing that being sedentary is pretty much a death sentence, mowing the lawn sounds less like a chore and more a gift of life.

Source: http://inagist.com/all/395295874374701056/

Strokes are increasingly hitting younger people and the incidence of the crippling condition worldwide could double by 2030, warns the first global analysis of the problem.

Though the chances of a stroke jump dramatically with age, the growing number of younger people with worrying risk factors such as bulging waistlines, diabetes and high blood pressure means they are becoming increasingly susceptible.

Worldwide, stroke is the second-leading cause of death after heart disease and is also a big contributor to disability.

Most strokes occur when a clot blocks the blood supply to the brain. Patients often experience symptoms including a droopy face, the inability to lift their arms and garbled speech. If not treated quickly, patients can be left with long-term side effects, including speech and memory problems, paralysis and the loss of some vision.

Scientists combed through more than 100 studies from 1990 to 2010 studying stroke patients across the world and also used modeling techniques when there wasn’t enough data. They found the incidence of stroke has jumped by a quarter in people aged 20 to 64 and that those patients make up almost one-third of the total number of strokes.

Researchers said most strokes still occur in the elderly and that the numbers of people suffering strokes are still increasing as the world’s population ages.

“Some of the increase we will see in strokes is unavoidable because it has to do with people aging, but that doesn’t mean we should give up,” said Majid Ezzati of Imperial College London, one of the study’s authors. Ezzati said countries should focus on reducing smoking rates further, aggressively controlling blood pressure and improving eating habits.

Ezzati said developing countries such as Iran and South Africa that have set up national systems to monitor maternal and child health are a good model for similar initiatives that could help keep stroke risk factors, such as high blood pressure, in check.

Ezzati and colleagues found the death rate from strokes dropped 37 percent in developed countries and 20 percent in developing countries, largely because of better diagnosis and treatment.

Stroke prevalence was highest in East Asia, North America, Europe and Australia. It was lowest in Africa and the Middle East —though researchers said people in those regions may be dying of other ailments before they get old enough to have a stroke.

In the U.S., doctors have already noted an alarming increase in strokes among young and middle-aged Americans, while the number has been dropping in older people.

The research was paid for by the Bill & Melinda Gates Foundation and published online Thursday in the journal Lancet.

“Young people think stroke is only a problem of the elderly, but we need to educate them,” said Dr. Yannick Bejot of the University Hospital of Dijon in France, who co-wrote an accompanying commentary. He added that using illegal drugs such as marijuana and cocaine also boosts the chance of a stroke.

“If young people understood how debilitating a stroke is, maybe they would change their behavior,” he said.

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Aseem Malhotra says saturated fat is not a problem, low-fat products are often full of sugar and statins are over-prescribed

Butter, cheese and even red meat are not as bad for the heart as has been maintained, a cardiologist has said in a leading medical journal, adding that it is time to “bust the myth” of saturated fat.

Aseem Malhotra, interventional cardiology specialist registrar at Croydon University hospital, London, also argues that statins have been over-prescribed because of the government’s obsession with lowering cholesterol in an attempt to reduce heart disease – and that the side-effects outweigh the benefits for millions of people who take them every day.

Trans-fats found in many fast foods, bakery goods and margarine are indeed a problem, Malhotra writes in the British Medical Journal. But saturated fats in milk, cheese and meat are another matter.

The insistence that saturated fat must be removed from our diet has paradoxically, he says, increased the risk of cardiovascular disease. “Recent prospective cohort studies have not supported significant association between saturated fat intake and cardiovascular risk,” he argues. “Instead, saturated fat has been found to be protective.”

He adds that it may depend on what sort of foods the saturated fat comes from. Dairy products contain vitamin D, a lack of which has been linked to increased heart disease, and calcium and phosphorus, which may have blood pressure lowering effects. Eating processed meat has been linked to higher rates of heart disease and diabetes, but not red meat.

Malhotra says people have wrongly embraced low-fat products thinking they are better for their health or will help them lose weight, when many are full of sugar. “Last week I saw one patient in her 40s who had had a heart attack,” he told the Guardian. “She said she had gained about 20kg in the last six months. She had been drinking five low-fat drinks a day.”

He calculated that each 450ml flavoured milk drink contained about 15 teaspoons of sugar, which meant she had consumed 75 teaspoons of sugar each day.

He tells his patients that butter and cheese – though not processed cheese – are better for them than low-fat spreads and that the odd steak will not hurt. Rather than take statins, he said, people with cardiovascular risks should eat a Mediterranean diet, rich in olive oil, fruit, vegetables, fish and nuts. He pointed to a recent study that showed that adopting a Mediterranean diet after a heart attack is three times more effective in preventing further illness than statins.

“In the UK eight million people take statins regularly, up from five million 10 years ago,” he writes. “With 60 million statin prescriptions a year, it is difficult to demonstrate any additional effect of statins on reduced cardiovascular mortality over the effects of the decline in smoking and primary angioplasty [a technique used by doctors to widen the arteries].”

In the original trials carried out by drug firms, only one in 10,000 patients given statins suffered a minor side-effect. But among 150,000 patients in a “real world” study – people who had been routinely given statins by their GP – 20% had side-effects that were so unacceptable to them that they stopped taking the pills, including muscle pains, stomach upsets, sleep and memory disturbance, and erectile dysfunction.

Neither Public Health England nor the British Heart Foundation agreed with Malhotra’s argument. Peter Weissberg, medical director at the British Heart Foundation, said: “Studies on the link between diet and disease frequently produce conflicting results because, unlike drug trials, it’s difficult to undertake a properly controlled, randomised study. However, people with highest cholesterol levels are at highest risk of a heart attack and it’s clear that lowering cholesterol, by whatever means, lowers risk.”

“Cholesterol levels can be influenced by many factors including diet, exercise and drugs, in particular statins. There is clear evidence that patients who have had a heart attack, or who are at high risk of having one, can benefit from taking a statin. But this needs to be combined with other essential measures, such as eating a balanced diet, not smoking and taking regular exercise.”

Alison Tedstone, director of diet and obesity at Public Health England, said: “PHE recommends that no more than 11% of person’s average energy intake should come from saturated fats, as there is evidence to show increased levels of saturated fats can raise blood cholesterol levels, in turn raising the risk of cardiovascular disease.

“The government’s advice is based on a wealth of evidence. The BMJ article is based on opinion rather than a complete review of the research.

“Evidence specifically linking sugar to cardiovascular disease is limited; however, on average the population needs to reduce its sugar intake. Eating more calories than we need, irrespective of whether they come from sugar or fat, over time leads to weight gain. Being overweight or obese increases the risk of heart disease, stroke, and type 2 diabetes.”

But Malhotra got support from those who think sugar is a leading cause of obesity and heart disease. Robert Lustig, paediatric endocrinologist at the University of San Francisco and author of Fat Chance: The Bitter Truth about Sugar, said: “Food should confer wellness, not illness. Real food does just that, including saturated fat. But when saturated fat got mixed up with the high sugar added to processed food in the second half of the 20th century, it got a bad name. Which is worse, saturated fat or added sugar? The American Heart Association has weighed in – the sugar many times over. Plus added sugar causes all of the diseases associated with metabolic syndrome.

Instead of lowering serum cholesterol with statins, which is dubious at best, how about serving up some real food?”

Source:

Scientists have developed a new technology that uses grated carrot to obtain natural compounds which they claim have the potential to prevent cancer, flu, cardiovascular diseases and neuro degenerative conditions.

Researchers from the FEMSA Center of Biotechnology at Technologic of Monterrey (ITESM) designed the technique, which also allows them to obtain shikimic acid – a substance which is a raw material used to produce antiviral drugs for influenza.

Currently the production of bioactive compounds in plants is accomplished by genetic engineering; however, this new process employs an alternate technique in which the tissue is stressed by cutting and applying herbicides.

The project, lead by Daniel Alberto Jacobo Velazques, won the National Award in Food Science and Technology (PNCTA) 2012 in the Technology Professional in Food category.

The award has been given and organised for 37 years by the National Council of Science and Technology (CONACYT) and the Mexican Industry of Coca-Cola.

Velazques explained that they activate the carrot’s metabolism using cut stress (grating), and then the carbon flow of its metabolism is modulated by applying an herbicide called glyphosate that inhibits enzymes.

This technique makes it possible to accumulate great amounts of shikimic acid and phenolic compounds in the plant tissue.

“The first four parts of the research have been completed, we have figured out the mechanism by which the carrot produces this compounds when subjected to stress. Now, we look for the optimization of the production so the plant tissue will secrete more of this compounds,” Velazques said.

“Afterwards we’d like to extract them to produce dietary supplements and shikimic acid. The shikimic acid is the raw material that the pharmaceutical industry needs to produce Tamiflu, a useful drug in the treatment against flu,” Velazques added.

Velazques pointed that currently, shikimic acid is extracted from the Star anise, which is only produced in China; in contrast, the carrot is cultivated in many regions across the planet.

Besides the extraction of the shikimic acid, phenolic compounds are obtained, which help to prevent diseases in humans, mostly because its antioxidant potential that aids in the neutralization of free radicals in the blood stream, preventing chronic degenerative diseases.

 

Source:

A pacemaker-like device implanted just under the collar bone can improve sleep in patients with central sleep apnea, scientists say.

The small implant being studied for the treatment of central sleep apnea is showing significant promise, according to Dr William Abraham, director of the Division of Cardiovascular Medicine at The Ohio State University Wexner Medical Center.

Unlike the more common obstructive sleep apnea, in which the airway gets blocked during sleep and causes pauses in breathing, central sleep apnea is more dangerous because the brain’s signals to tell the body to breathe get interrupted.

“Central sleep apnea affects more than a third of heart failure patients and is known to make the condition worse,” Abraham said.

“Unfortunately, we don’t have good treatments available for this type of apnea. Currently, positive airway pressure devices are used, but many patients don’t tolerate it well,” he said.

“One of the concerning features of central sleep apnea is that these patients don’t fit the usual profile of obstructive sleep apnea,” said Dr Rami Khayat, a sleep medicine expert and director of Ohio State’s sleep heart program.

“They generally don’t snore, so they’re tougher to diagnose, and the symptoms of sleepiness and fatigue overlap with symptoms associated with heart failure,” Khayat said.

Abraham and other researchers at 11 centers around the world tested the feasibility, safety and efficacy of a new transvenous phrenic nerve stimulator made by the US-based company Respicardia Inc.

The device resembles a pacemaker in that it delivers a regular signal to stimulate the diaphragm to breathe during sleep.

In the pilot study, 47 patients were implanted with the device and evaluated for six months. The implant was placed below the collar bone and a transvenous stimulator lead was positioned near the phrenic nerve.

After a one-month healing period, the device was turned on and programmed to the patient’s sleep habits.

Source: http://www.indianexpress.com/news/new–pacemaker–device-could-treat-sleep-apnea/1173555/

 

 

A new research has revealed that a biological ability to compensate for the body’s reduced response to insulin could help explain why women typically develop heart disease 10 years later than men.
Lead author, Sun H. Kim, MD, MS, of Stanford University School of Medicine, said that among men and women ages 50 or younger with comparable levels of insulin resistance, their study found women experienced fewer complications than men did.

She said that this ability to deal with the fallout from insulin resistance was no longer present when we examined women who were 51 and older.

Kim asserted that this gender difference may illuminate the ‘female advantage’ – a phenomenon where the onset of cardiovascular disease tends to happen a decade later in women than in men.

The cross-sectional study also examined insulin resistance and cardiovascular disease risk in 468 women and 354 men.

Among participants ages 50 or younger, women had lower blood pressure and fasting blood sugar levels than their male counterparts.

In addition, women had lower levels of triglycerides, fats in the blood that can increase the risk of heart disease and stroke.

The study has been published in The Endocrine Society’s Journal of Clinical Endocrinology and Metabolism (JCEM).

Source: http://timesofindia.indiatimes.com/life-style/health-fitness/health/Women-develop-heart-disease-10-yrs-later-than-men/articleshow/23046807.cms

Exposure to even low levels of arsenic in drinking water and food may increase the risk of developing, and dying from, heart disease, a new study suggests.

In the study, researchers analyzed urine samples from 3,575 American Indians in Arizona, Oklahoma and North and South Dakota, living in regions where arsenic levels in drinking water were “low to moderate,” meaning they were above the limit set by the U.S. Environmental Protection Agency, which is 10 micrograms per liter, but below 100 micrograms per liter.

Urine samples were collected between 1989 and 1991, and the participants were divided into four groups based on the concentration of inorganic arsenic in their urine. (There are two types of arsenic, organic and inorganic, inorganic arsenic is thought to be more toxic)

Source: http://www.livescience.com/39886-arsenic-heart-disease.html