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Category: cardiovascular health

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Air pollution is harmful on so many levels for all of us, (See recent Dec.post on harmful air pollution effects on pregnancy.) From Reuters Health:

Heart experts warn of air pollution dangers

Air pollution should be one of the avoidable heart risk factors - just like smoking and excess fat - that doctors warn patients to steer clear of, according to a new statement from 20 heart experts.

Citing pollution’s heavy toll on cardiovascular health, the panel urges people to take steps to protect themselves from breathing heavy traffic fumes or industrial air pollution whenever possible, and public officials to pass laws to reduce air pollution.Air pollution causes more than 3 million deaths worldwide each year and causes 3.1 percent of all cases of disability, Storey and his coauthors write in the European Heart Journal.

Air pollution is also ninth most important on a list of modifiable heart-disease risk factors - ranking above low physical activity, high-salt diet, high cholesterol and drug use, the authors point out.

Although gaseous air pollutants can be dangerous too, Storey said, airborne particles are the biggest contributor to cardiovascular disease because they cause inflammation of the lungs and enter the circulation, inflaming blood vessels, provoking clots and causing heart rhythm disturbances.

Particulate matter includes coarse particles from road dust, construction work and industrial emissions and fine particles from traffic, power plants and industrial and residential burning of oil, coal or wood for heating. The bulk of particulate air pollution is made up of these fine particles, known as PM2.5, that are less than 2.5 micrometers - about one fifth the size of visible dust. In 2013, the U.S. Environmental Protection Agency lowered the 24-hour exposure limit to an average of 12 micrograms.

European studies have found that PM2.5 levels are often markedly higher near heavy traffic zones compared to elsewhere in the same city, and that the levels can more than double during rush hours, according to the position statement.

Some of the authors’ advice for people to protect themselves is as simple as walking, cycling and using public transportation instead of driving cars, and exercising in parks or gardens, rather than near busy roads. And everyone should avoid being outside when pollution is highest, though this is especially important for infants, elderly and people with heart problems, the authors say.People who live in heavily polluted areas should also consider ventilation systems with filtration in their homes, since a large portion of outdoor pollution can penetrate buildings.

The use of fossil fuels for heating and energy should also be decreased, according to the statement.

Studies have shown even short-term exposure to high PM2.5 levels increases deaths from heart disease and respiratory disease, and that people living in places with high PM2.5 have an 11 percent greater risk of dying from heart attacks, strokes and heart failure than those who live in cleaner areas.

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Feeling younger than your chronological age is good! From Science Daily:

Feeling younger than actual age meant lower early death rate for older people, study finds

Turns out, feeling younger than your actual age might be good for you. Older people who felt three or more years younger than their chronological age had a lower death rate compared with those who felt their age or who felt more than one year older than their actual age, researchers found.

Self-perceived age can reflect assessments of health, physical limitation and well-being in later life, and many older people feel younger than their actual age, according background information in the report. Authors Isla Rippon, M.Sc., and Andrew Steptoe, D.Sc., of the University College London, examined the relationship between self-perceived age and mortality.

The authors used data from a study on aging and included 6,489 individuals, whose average chronological age was 65.8 years but whose average self-perceived age was 56.8 years. Most of the adults (69.6 percent) felt three or more years younger than their actual age, while 25.6 percent had a self-perceived age close to their real age and 4.8 percent felt more than a year older than their chronological age.

Mortality rates during an average follow-up of 99 months were 14.3 percent in adults who felt younger, 18.5 percent in those who felt about their actual age and 24.6 percent in those adults who felt older, according to the study results. The relationship between self-perceived age and cardiovascular death was strong but there was no association between self-perceived age and cancer death.

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Think of incense burning as indoor air pollution, with some of the same chemicals and particulates as cigarettes. From Environmental Health Perspectives:

Ritual Risk: Incense Use and Cardiovascular Mortality

Numerous studies have examined exposures to indoor combustion products such as secondhand smoke and emissions from burning of solid fuels. However, only a few have examined incense burning as a potential health threat, even though incense is commonly used for religious and ritual purposes in China, Taiwan, Singapore, India, and Middle Eastern nations.1,2In this issue of EHP, investigators report an association between long-term incense use and increased cardiovascular mortality.1

The study used data from the Singapore Chinese Health Study, which enrolled a cohort of 63,257 Chinese adults aged 45–74 years between 1993 and 1998. The authors identified cardiovascular deaths of cohort members via a nationwide death registry, checking the registry yearly through 31 December 2011.

More than three-quarters of the participants reported currently using incense, and another 13% were former users. Most had used incense daily for at least 20 years, typically keeping it burning intermittently throughout the day. The authors estimated that current long-term incense users had a 12% increased risk of cardiovascular mortality compared with former and never users, including a 19% increased risk for stroke and a 10% increased risk for coronary heart disease.1

Previous studies reported concentrations of volatile organic compounds and particulate matter in incense emissions similar to those in cigarette smoke.3,4 Others showed that long-term exposure to incense smoke increased blood vessel inflammation and affected blood flow in rats.5 In vitro studies have indicated adverse impact to human coronary6 and lung cells.4 

 In contrast with outdoor air pollution, incense exposure may be easier for an individual to avoid, but Yeatts says education will be needed to help people understand the risks of these exposures, similar to educational campaigns about cigarette smoking.Koh published an earlier prospective study that found an association between incense use and upper respiratory cancer.7

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This would be a major shift in advice. Take note: they found the benefits outweighed the cons only in women starting from the age of 65 and above. From Science Daily:

Cons of regular low-dose aspirin to stave off serious illness in women outweigh pros

The pros of giving healthy women regular low-dose aspirin to stave off serious illness, such as cancer and heart disease, are outweighed by the cons, suggests a large study.

But the balance begins to shift with increasing age, and limiting this form of primary prevention to women aged 65 and above, was better than not taking aspirin at all, or treating women from the age of 45 onwards, say the researchers.

They base their findings on almost 30,000 healthy women, who were at least 45 years old and taking part in the Women's Health Study.Participants were randomly assigned to take either 100 mg of aspirin or a dummy tablet (placebo) every other day, to see whether aspirin curbed their risk of heart disease, stroke, and cancer.

Compared with placebo, regular aspirin was linked to a lower risk of heart disease, stroke, bowel cancer, and in some women, other cancers, but only marginally so.And this slight health gain was trumped by the prevalence of internal gastrointestinal bleeding, which affected two thirds of the women  taking the non-steroidal anti-inflammatory drug.

The risk of gastrointestinal bleeding rose with age, but so too did the drug's impact on lowering the risk of bowel cancer and cardiovascular disease, with the balance appearing to tip in favour of the drug for women aged 65 and above..The researchers calculated that over 15 years, 29 over-65s would need to be treated with aspirin to prevent one case of cancer or heart disease/stroke...But they conclude that blanket treatment "is ineffective or harmful in the majority of women with regard to the combined risk of cardiovascular disease, cancer and major gastrointestinal bleeding."

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From Medical Xpress:

Obesity may shorten life expectancy up to eight years

'Tis the season to indulge. However, restraint may be best according to a new study led by investigators at the Research Institute of the McGill University Health Centre (RI-MUHC) and McGill University. The researchers examined the relationship between body weight and life expectancy. Their findings show that overweight and obese individuals have the potential to decrease life expectancy by up to 8 years. The study, published in the current issue of The Lancet Diabetes and Endocrinology, further demonstrates that when one considers that these individuals may also develop diabetes or cardiovascular disease earlier in life, this excess weight can rob them of nearly two decades of healthy life.

Dr. Grover and his colleagues used data from the National Health and Nutrition Examination Survey (from years 2003 to 2010) to develop a model that estimates the annual risk of diabetes and cardiovascular disease in adults with different body weights. This data from almost 4,000 individuals was also used to analyze the contribution of excess body weight to years of life lost and healthy years of life lost.

Their findings estimated that individuals who were very obese could lose up to 8 years of life, obese individuals could lose up to 6 years, and those who were overweight could lose up to three years. In addition, healthy life-years lost were two to four times higher for overweight and obese individuals compared to those who had a healthy weight, defined as 18.5-25 body mass index (BMI). The age at which the excess weight accumulated was an important factor and the worst outcomes were in those who gained their weight at earlier ages.

"The pattern is clear - the more an individual weighs and the younger their age, the greater the effect on their health," Dr. Grover adds. "In terms of life-expectancy, we feel being overweight is as bad as cigarette smoking."

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Based on the study results, the researchers suggest that even older couples in bad marriages could benefit from marriage counseling.From Science Daily:

Bad marriage, broken heart?

Older couples in a bad marriage -- particularly female spouses -- have a higher risk for heart disease than those in a good marriage, finds the first nationally representative study of its kind.

Liu analyzed five years of data from about 1,200 married men and women who participated the National Social Life, Health and Aging Project. Respondents were aged 57-85 at the beginning of the study...Liu set out to learn how marital quality is related to risk of heart disease over time, and whether this relationship varies by gender and/or age. Among her findings:

Negative martial quality (e.g., spouse criticizes, spouse is demanding) has a bigger effect on heart health than positive marital quality (e.g., spousal support). In other words, a bad marriage is more harmful to your heart health than a good marriage is beneficial.

The effect of marital quality on cardiovascular risk becomes much stronger at older ages. Over time, the stress from a bad marriage may stimulate more, and more intense, cardiovascular responses because of the declining immune function and increasing frailty that typically develop in old age, Liu said.

Marital quality has a bigger effect on women's heart health than it does on men's, possibly because women tend to internalize negative feelings and thus are more likely to feel depressed and develop cardiovascular problems, Liu said.

Heart disease leads to a decline in marital quality for women, but not for men. This is consistent with the longstanding observation that wives are more likely to provide support and care to sick husbands, while husbands are less likely to take care of sick wives.

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Two studies that talk about a healthy diet and health benefits.From Science Daily:

Home cooking a main ingredient in healthier diet, study shows

People who frequently cook meals at home eat healthier and consume fewer calories than those who cook less, according to new Johns Hopkins Bloomberg School of Public Health research."When people cook most of their meals at home, they consume fewer carbohydrates, less sugar and less fat than those who cook less or not at all -- even if they are not trying to lose weight," says Julia A. Wolfson, MPP, a CLF-Lerner Fellow at the Johns Hopkins Center for a Livable Future and lead author of the study.The findings also suggest that those who frequently cooked at home -- six-to-seven nights a week -- also consumed fewer calories on the occasions when they ate out.

Wolfson and co-author Sara N. Bleich, PhD, an associate professor in the Department of Health Policy and Management at the Bloomberg School, analyzed data from the 2007-2010 National Health and Nutrition Examination Survey from more than 9,000 participants aged 20 and older... The researchers found that 8 percent of adults cooked dinner once or less a week and this group consumed, on an average day, 2,301 total calories, 84 grams of fat and 135 grams of sugar. Forty-eight percent of participants cooked dinner six to seven times a week and they consumed 2,164 calories, 81 grams of fat and 119 grams of sugar on an average day.

The research found blacks are more likely to live in households where cooking occurs less frequently than whites; and individuals who work more than 35 hours a week outside the home also cook less often.

From Medical Xpress:

Healthy diets are good for the kidneys

A healthy diet may help protect the kidneys, according to two studies that will be presented at ASN Kidney Week 2014 November 11¬-16 at the Pennsylvania Convention Center in Philadelphia, PA. Dietary modifications may be a low-cost, simple intervention to reduce the burden of chronic kidney disease (CKD). 

A higher-quality diet, as measured using 3 different scoring systems for dietary qualities known to reduce the risk of cardiovascular disease, was associated with a 16% to 23% reduced risk of needing dialysis or dying from kidney problems. Higher-quality diets included those high in fruits, vegetables, and unsaturated fats. The researchers also found that high sodium intake (average of 4.7g g/day) was linked with an increased risk of needing dialysis or dying from kidney problems, but no benefit was seen for low sodium intake (average 2.0 g/day) compared with moderate intake. In contrast, high potassium intake was associated with a reduced future risk.

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Get your omega-3 fatty acids from either fish or flaxseed (or other seeds).From Science Daily:

Nothing fishy about health benefits of plant-based omega-3 fatty acid

Increasing the amount of omega-3s in your diet, whether from fish or flax, will likely decrease your risk of getting heart disease, according to Penn State nutritionists. A substantial amount of evidence exists supporting the heart-health benefits of eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA), marine-derived omega-3 fatty acids. However, much less evidence exists to demonstrate the positive effects of alpha-linolenic acid (ALA), a plant-based omega-3 fatty acid.

EPA and DHA can be found in seafood and fish oil, and are often consumed in the form of dietary supplements. ALA is found in flaxseed and its oil, vegetable oils, and some nuts, and is now available in supplement form. EPA and DHA have been available for much longer. Other sources of ALA, EPA and DHA are fortified foods such as orange juice, eggs, peanut butter, margarine and bread, among others. While there are many other omega-3 fortified foods in the market place, most are relatively low in omega-3 fatty acids.

Omega-3 fatty acids are considered essential for human health, but the body does not produce them -- therefore they must be consumed in order to maintain appropriate levels.

In reviewing existing literature on the subject, the researchers have come to the conclusion that ALA is likely just as effective in preventing cardiovascular disease as EPA and DHA have proven to be, as they report on the current issue of Advances in Nutrition.

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Lasting benefits from lifestyle changes (Mediterranean diet and exercise). From Science Daily:

Mediterranean diets have lasting health benefits

The health benefits of switching to a Mediterranean style diet and upping the amount of time spent exercising for a period of just eight weeks can still be seen a year after stopping the regime, a new study has shown.

The research by Sheffield Hallam University and the University of Lincoln in the UK revealed that the diet and exercise combination leads to improved blood flow in cells in the inner lining of the blood vessels -- called the endothelial cells -- a full 12 months after completing participation in the intervention programme.

Endothelial cells line the interior of the entire vascular system of the human body -- from the large arteries to the smallest capillaries -- and improvements in their function could reduce the risk of people developing cardiovascular disease, the study said.

Researchers believe the long-term health benefits observed after such a short intervention could be due to molecular changes associated with the Mediterranean diet. Traditional Mediterranean cuisine is based on olive oil, fruit, vegetables and salad, fish, legumes, whole grain foods, wine and limited consumption of red meat.

The study focused on healthy people over the age of 50. Participants were originally assessed over an eight-week period.One group was encouraged to eat more vegetables, fruit, olive oil, tree nuts and fresh oily fish, as well as take up a moderate exercise regime, while the other just took up exercise alone.

The results showed more health improvements in the Mediterranean diet group than the exercise only group, which one year later, were still evident despite the lifestyle changes implemented during the study no longer being carefully followed.

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Think lifestyle changes, not medications. From Medical Daily:

Mild Hypertension Should Be Treated With Advice On Lifestyle Changes, Not Medication

In 2013, Dr. Iona Heath, a retired general practitioner published an article in the Journal of  the American Medical Association, in which she spoke about the side effects of overtreatment and overdiagnosis of mild hypertension. Now, in a new study, researchers revisit this idea, saying that unnecessary treatment of mild hypertension in low-risk patients is harming them and putting a burden on health care resources. They also argue that there's a need to reexamine criteria for diagnosing hypertension and treating blood pressure. 

About 40 percent of the world’s population, including 67 million American adults, have hypertension. Over half are classified as having mild hypertension. 

More than half of people with mild hypertension are treated with drugs, but there has been no evidence to suggest that blood pressure-lowering drugs prevent heart attacks. Instead of prescribing drugs to control mild hypertension, the authors urge clinicians to recommend healthier lifestyles to patients, which include exercising, quitting smoking, and decreased alcohol consumption. They also urge clinics to improve the accuracy of blood pressure-measuring instruments and to inform patients about measuring blood pressure at home. 

From Medical Xpress:

Experts raise concern over unnecessary treatment of mild hypertension in low risk people

Lowering the drug threshold for high blood pressure has exposed millions of low-risk people around the world to drug treatment of uncertain benefit at huge cost to health systems, warn US experts in BMJ today. Dr Stephen Martin and colleagues argue that this strategy is failing patients and wasting healthcare resources.

Over half of people with mild hypertension are treated with medication. Yet treating low risk mildly hypertensive patients with drugs has not been proven to reduce cardiovascular disease or death. The authors argue that overemphasis on drug treatment "risks adverse effects, such as increased risk of falls, and misses opportunities to modify individual lifestyle choices and tackle lifestyle factors at a public health level."

And for those over 65 the levels can be even higher. From Science News:

'Mild' control of systolic blood pressure in older adults is adequate: 150 is good enough

A broad review of the use of medications to reduce blood pressure has confirmed that "mild" control of systolic pressure is adequate for adults age 65 or older -- in the elderly, there's no clear benefit to more aggressive use of medications to achieve a lower pressure. Historically, most medical practitioners tried to achieve control of systolic pressure -- the higher of the two blood pressure readings -- to 140 or less. Recently changed guidelines now suggest that for adults over 60, keeping the systolic pressure at 150 or less is adequate, and this extensive analysis confirms that.