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Category: cardiovascular health

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What if a doctor said you could avoid years of taking medication (and all their side effects and cost), better heart health, and avoid a heart attack by adopting some lifestyle changes. Could you do it? Would you? How to avoid 4 out 5 heart attacks, from Medical Xpress:

Healthy lifestyle choices may dramatically reduce risk of heart attack in men

Following a healthy lifestyle, including maintaining a healthy weight and diet, exercise, not smoking and moderating alcohol intake, could prevent four out of five coronary events in men, according to a new study publishing today in the Journal of the American College of Cardiology.

While mortality from heart disease has declined in recent decades, with much of the reduction attributed to medical therapies, the authors said prevention through a healthy lifestyle avoids potential side effects of medication and is more cost effective for population-wide reductions in coronary heart disease. 

For the study, researchers examined a population of 20,721 healthy Swedish men aged 45-79 years of age and followed them for 11 years. Lifestyle choices were assessed through a questionnaire exploring diet, alcohol consumption, smoking status, level of physical activity and abdominal adiposity (belly fat). Men in the study with the lowest risk were non-smokers, walked or cycled for at least 40 minutes per day, exercised at least one hour per week, had a waist circumference below 95 centimeters, consumed moderate amounts of alcohol, and followed a healthy diet with a regular consumption of fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains and fish.

The researchers found a clear reduction in risk for heart attack for each individual lifestyle factor the participants practiced. For instance having a low-risk diet together with a moderate alcohol consumption led to an estimated 35 percent lower risk of heart attack compared to the high-risk group, those who practice none of the low-risk factors.

Men who combined the low-risk diet and moderate alcohol consumption with not smoking, being physically active and having a low amount of abdominal fat, had 86 percent lower risk. Researchers found similar results in men with hypertension and high cholesterol levels.

The burden of cardiovascular disease could be significantly reduced through programs targeted to men and promoting low-risk lifestyle choices. Even in those who take medication, an additional reduction in risk for chronic heart disease has been observed in those with a healthy lifestyle.

From John M., a cardiac electrophysiologist, who expressed his frustration with unnecessary heart disease, and commented on this study on drjohnm.org:

Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease.

Let’s be clear and honest: Lifestyle-related disease is largely unnecessary.

These days, there is so much unnecessary disease that caregivers, especially cardiologists, rarely see it. We look past the obesity right to the cholesterol number and ECG. And then we pull out the prescription pad for the guideline-directed pills. Just typing that causes me angst.

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More research on the benefits of exercise. From Medical Xpress:

An hour of moderate exercise a day may decrease heart failure risk

In a new study reported in the American Heart Association journal Circulation: Heart Failure, researchers say more than an hour of moderate or half an hour of vigorous exercise per day may lower your risk of heart failure by 46 percent. Heart failure is a common, disabling disease that accounts for about 2 percent of total healthcare costs in industrialized countries. Risk of death within five years of diagnosis is 30 percent to 50 percent, researchers said.

Swedish researchers studied 39,805 people 20-90 years old who didn't have heart failure when the study began in 1997. Researchers assessed their total- and leisure time activity at the beginning of the study and followed them to see how this was related to their subsequent risk of developing heart failure. They found that the more active a person, the lower their risk for heart failure. 

From Medical Xpress:

Workers who exercise lower health risks, cost less

Get moving: just 20 minutes of exercise a day dramatically lowers the risk of diabetes and heart disease, even for employees with a high risk of developing those conditions.

A University of Michigan study looked at the impact of exercise on 4,345 employees in a financial services company that had just started a workplace wellness program. Roughly 30 percent of employees were high risk and suffering from metabolic syndrome, a dangerous cluster of risk factors associated with diabetes and heart disease. Overall, about 34 percent of U.S. adults have metabolic syndrome.

The study found that when the high-risk employees accumulated the government-recommended 150 minutes of moderate-intensity exercise a week, their health care costs and productivity equaled that of healthy employees who didn't exercise enough, said Alyssa Schultz, a researcher at the Health Management Research Center in the U-M School of Kinesiology.

"It was a real surprise, the level of protection physical activity gave to people with metabolic syndrome," Schultz said. 

Research done in mice, but may apply to humans. From Science Daily:

How physical exercise protects the brain from stress-induced depression

Physical exercise has many beneficial effects on human health, including the protection from stress-induced depression. However, until now the mechanisms that mediate this protective effect have been unknown. In a new study in mice, researchers show that exercise training induces changes in skeletal muscle that can purge the blood of a substance that accumulates during stress, and is harmful to the brain.

"In neurobiological terms, we actually still don't know what depression is. Our study represents another piece in the puzzle, since we provide an explanation for the protective biochemical changes induced by physical exercise that prevent the brain from being damaged during stress," says Mia Lindskog, researcher at the Department of Neuroscience at Karolinska Institutet.

 

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Another study finding health benefits from eating dairy foods (vs not eating any dairy foods).

From Science Daily: A heart-felt need for dairy food: Small serving beneficial, large not necessary

A daily small serve of dairy food may reduce the risk of heart disease or stroke, even in communities where such foods have not traditionally formed part of the diet according to new research.

A study of nearly 4000 Taiwanese, led by Emeritus Professor Mark Wahlqvist from Monash University's Department of Epidemiology and Preventive Medicine and the Monash Asia Institute, considered the role increased consumption of dairy foods had played in the country's gains in health and longevity.

"We observed that increased dairy consumption meant lower risks of mortality from cardiovascular disease, especially stroke, but found no significant association with the risk of cancer," Professor Wahlqvist said.

Milk and other dairy foods are recognised as providing a broad spectrum of nutrients essential for human health. According to the study findings, people only need to eat small amounts to gain the benefits.

"Those who ate no dairy had higher blood pressure, higher body mass index and greater body fatness generally than other groups. But Taiwanese who included dairy food in their diet only three to seven times a week were more likely to survive than those who ate none."

For optimal results, the key is daily consumption of dairy foods -- but at the rate of about five servings over a week. One serving is the equivalent to eight grams of protein: a cup of milk, or 45 grams of cheese. Such quantities rarely cause trouble even for people considered to be lactose intolerant, Professor Wahlqvist said.

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Good news! From Science Daily:

Taking short walking breaks found to reverse negative effects of prolonged sitting

Three easy -- one could even say slow -- 5-minute walks can reverse harm caused to leg arteries during three hours of prolonged sitting, researchers report. Sitting for long periods of time is associated with risk factors such as higher cholesterol levels and greater waist circumference that can lead to cardiovascular and metabolic disease. When people sit, slack muscles do not contract to effectively pump blood to the heart. Blood can pool in the legs and affect the endothelial function of arteries, or the ability of blood vessels to expand from increased blood flow.

The researchers were able to demonstrate that during a three-hour period, the flow-mediated dilation, or the expansion of the arteries as a result of increased blood flow, of the main artery in the legs was impaired by as much as 50 percent after just one hour. The study participants who walked for 5 minutes each hour of sitting saw their arterial function stay the same -- it did not drop throughout the three-hour period. Thosar says it is likely that the increase in muscle activity and blood flow accounts for this.

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The great effects (especially for hemorrhagic stroke) were found in people eating just 1 1/2 portions of fresh fruit daily. The amazing part is that 6.3% admitted to never consuming fruit. From Science Daily:

Fruit consumption cuts cardiovascular disease risk by up to 40 percent

Daily fruit consumption cuts the risk of cardiovascular disease (CVD) by up to 40 percent, according to research. The findings from the seven-year follow-up study of nearly a half million people in the China Kadoorie Biobank found that the more fruit people ate, the more their risk of CVD declined.

Dr Du said: "CVD, including ischaemic heart disease (IHD) and stroke, is the leading cause of death worldwide. Improving diet and lifestyle is critical for CVD risk reduction in the general population but the large majority of this evidence has come from western countries and hardly any from China."

The current study included 451 681 participants with no history of CVD and not on anti-hypertensive treatment at baseline from the China Kadoorie Biobank(1) conducted in 10 different areas of China, 5 rural and 5 urban. Habitual consumption of fruit was recorded at baseline according to five categories: never, monthly, 1-3 days per week, 4-6 days per week, daily.

Over the seven year follow up period there were 19 300 cases of IHD and 19 689 strokes (14 688 ischaemic and 3562 haemorrhagic). Some 18% of participants consumed fruit daily and 6.3% never consumed fruit. The average amount of fruit eaten by the daily consumers was 1.5 portions (~150g).

The researchers found that compared to people who never ate fruit, those who ate fruit daily cut their CVD risks by 25-40% (around 15% for IHD, around 25% for ischaemic stroke and 40% for haemorrhagic stroke). There was a dose response relationship between the frequency of fruit consumption and the risk of CVD.

Dr Du said: "Our data clearly shows that eating fresh fruit can reduce the risk of cardiovascular disease, including ischaemic heart disease and stroke (particularly haemorrhagic stroke). And not only that, the more fruit you eat the more your CVD risk goes down. It does suggest that eating more fruit is beneficial compared to less or no fruit."

The researchers also found that people who consumed fruit more often had significantly lower blood pressure (BP). Eating fruit daily was associated with 3.4/4.1 mmHg lower systolic/diastolic BP compared to those who never ate fruit. 

In a separate analysis, the researchers examined the association of fruit consumption with total mortality and CV mortality in more than 61,000 patients from the China Kadoorie Biobank who had CVD or hypertension at baseline. They found that compared to those who never ate fruit, daily consumers of fruit cut their overall risk of death by 32%. They also reduced their risks of dying from IHD by 27% and from stroke by around 40%.

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Several more articles on the benefits of exercise. From Science Daily:

Train your heart to protect your mind

Exercising to improve our cardiovascular strength may protect us from cognitive impairment as we age, according to a new study. "Our body's arteries stiffen with age, and the vessel hardening is believed to begin in the aorta, the main vessel coming out of the heart, before reaching the brain. Indeed, the hardening may contribute to cognitive changes that occur during a similar time frame," explained the first author of the study. "We found that older adults whose aortas were in a better condition and who had greater aerobic fitness performed better on a cognitive test. We therefore think that the preservation of vessel elasticity may be one of the mechanisms that enables exercise to slow cognitive aging."

The researchers worked with 31 young people between the ages of 18 and 30 and 54 older participants aged between 55 and 75. This enabled the team to compare the older participants within their peer group and against the younger group who obviously have not begun the aging processes in question. None of the participants had physical or mental health issues that might influence the study outcome.

The results demonstrated age-related declines in executive function, aortic elasticity and cardiorespiratory fitness, a link between vascular health and brain function, and a positive association between aerobic fitness and brain function. "Although the impact of fitness on cerebral vasculature may however involve other, more complex mechanisms, overall these results support the hypothesis that lifestyle helps maintain the elasticity of arteries, thereby preventing downstream cerebrovascular damage and resulting in preserved cognitive abilities in later life."

From Science Daily:

Physically fit kids have beefier brain white matter than their less-fit peers

A new study of 9- and 10-year-olds finds that those who are more aerobically fit have more fibrous and compact white-matter tracts in the brain than their peers who are less fit. 'White matter' describes the bundles of axons that carry nerve signals from one brain region to another. More compact white matter is associated with faster and more efficient nerve activity.

The analysis revealed significant fitness-related differences in the integrity of several white-matter tracts in the brain: the corpus callosum, which connects the brain's left and right hemispheres; the superior longitudinal fasciculus, a pair of structures that connect the frontal and parietal lobes; and the superior corona radiata, which connect the cerebral cortex to the brain stem."All of these tracts have been found to play a role in attention and memory," Chaddock-Heyman said. 

From Science Daily:

Exercise may protect older women from irregular heartbeat

Increasing the amount or intensity of physical activity can cut the chances of older women developing a life-threatening irregular heartbeat, according to new research. Researchers found that post-menopausal women who were the most physically active had a 10 percent lower risk of developing atrial fibrillation (AF), compared to women with low levels of physical activity, even if they were obese. Obesity is an important risk factor for atrial fibrillation.

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Sounds like exercising in moderation has health benefits for all people, while "to excess" can be problematic. From Science Daily:

Contrary to popular belief, more exercise is not always better

There is strong epidemiological evidence of the importance of regular physical activity, such as brisk walking and jogging, in the management and rehabilitation of cardiovascular disease and in lowering the risk of death from other diseases such as hypertension, stroke, and type 2 diabetes. The Physical Activity Guidelines for Americans recommends about 150 minutes per week of moderate-intensity exercise or about 75 minutes of vigorous-intensity exercise. But there is clear evidence of an increase in cardiovascular deaths in heart attack survivors who exercise to excess.

Paul T. Williams, PhD, of the Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, and Paul D. Thompson, MD, of the Department of Cardiology, Hartford Hospital, Hartford, CT, studied the relationship between exercise and cardiovascular disease-related deaths in about 2,400 physically active heart attack survivors. This study confirmed previous reports indicating that the cardiovascular benefits for walking and running were equivalent, as long as the energy expenditures were the same (although when walking, as compared to running, it will take about twice as long to burn the same number of calories).

Remarkable dose-dependent reductions in deaths from cardiovascular events of up to 65% were seen among patients who were running less than 30 miles or walking less than 46 miles per week. Beyond this point however much of the benefit of exercise was lost, in what is described as a reverse J-curve pattern.

In the same issue, investigators in Spain report on a meta-analysis of ten cohort studies aimed at providing an accurate overview of mortality in elite athletes. The studies included over 42,000 top athletes (707 women) who had participated in a range of sports including football, baseball, track and field, and cycling, including Olympic level athletes and participants in the Tour de France.

"What we found on the evidence available was that elite athletes (mostly men) live longer than the general population, which suggests that the beneficial health effects of exercise, particularly in decreasing cardiovascular disease and cancer risk, are not necessarily confined to moderate doses," comments senior investigator Alejandro Lucia, MD, PhD, of the European University Madrid, Spain. 

"Extrapolation of the data from the current Williams and Thompson study to the general population would suggest that approximately one out of twenty people is overdoing exercise," comments James H. O'Keefe, MD, from the Mid America Heart Institute in Kansas City, MO... Along with co-authors Carl "Chip" Lavie, MD, and Barry Franklin, PhD, he explains that "we have suggested the term 'cardiac overuse injury' for this increasingly common consequence of the 'more exercise is better' strategy." 

O'Keefe, Franklin and Lavie point out that a weekly cumulative dose of vigorous exercise of not more than about five hours has been identified in several studies to be the safe upper range for long-term cardiovascular health and life expectancy, and that it may also be beneficial to take one or two days a week off from vigorous exercise, and to refrain from high-intensity exercise on an everyday basis. They propose that individuals from either end of the exercise spectrum (sedentary people and over-exercisers) would probably reap long-term health benefits by changing their physical activity levels to be in the moderate range.

"For patients with heart disease, almost all should be exercising, and generally most should be exercising 30-40 minutes most days, but from a health stand-point, there is no reason to exercise much longer than that and especially not more than 60 minutes on most days," says Lavie, who is a cardiologist at the John Ochsner Heart and Vascular Institute, New Orleans, LA. 

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This research review suggests that 5 servings a day of fruits and vegetables has the best health benefits. They surprisingly did not find that fruit/vegetable consumption was protective against cancer. But the authors point out that other studies of cancer and fruit/vegetable consumption have also been inconsistent, and this might be partly explained if certain fruits and vegetables only have effects on certain cancers. From Medical Daily:

An Apple A Day Keeps The Doctor Away? Actually It's 5 Apples, And They Keep Death Away

A review of the eating habits of more than 800,000 people seems to discredit the old maxim about "an apple a day." In fact, five servings of fruit and vegetables offers the best health benefits, particularly against heart disease, and reduces your chances of dying for any reason.

After calculating the odds, researchers write in the Journal of Epidemiology and Community Health that "the risk of all-cause mortality was decreased by 5 percent for each additional serving a day of fruit and vegetables." But, contrary to other reports, they found the benefits drop off after five servings, at which point, they wrote, "we observed a threshold." Previous studies have said seven fruit and vegetable servings is the optimum number.

Other studies have also made the case for fruits and vegetables as a ward against cancer. This one, led by Professor Frank B. Hu in the Harvard School of Public Health, saw no evidence for that. They did, however, find a "significant inverse association" between a fruit and veggie diet and death by heart disease. "The results support current recommendations to increase consumption to promote health and overall longevity," Hu and his colleagues wrote.

Of course, the authors admit, the studies they looked at may have been corrupted by participants lying or guessing on their diet questionnaires. But one thing this study has going for it is the massive sample size. They looked at 16 papers involving 833,234 people and 56,423 deaths. Most of those deaths — as is the case in the general population — were caused by cardiovascular disease and cancer. The people who lived longest adhered to what's called the Mediterranean diet, which favors carrots and tomatoes to steak and bacon.

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I've been seeing research report after report looking at how our lifestyle determines how we'll age - whether we'll be active and healthy well into our 80s or in terrible shape and dying young. Mind you, these are not "definites" because nothing can give you a guarantee, but they are ways we can improve our odds in living the long and healthy life that we want. From Medical Xpress:

A healthy lifestyle adds years to life

Live longer thanks to fruit, an active lifestyle, limited alcohol and no cigarettes. This is the conclusion of a study by public health physicians at the University of Zurich who documented for the first time the impact of behavioural factors on life expectancy in numbers. 

...Brian Martin and his colleagues from the Institute of Social and Preventive Medicine (ISPM) at the University of Zurich have examined the effects of these four factors – both individual and combined – on life expectancy. An individual who smokes, drinks a lot, is physically inactive and has an unhealthy diet has 2.5 fold higher mortality risk in epidemiological terms than an individual who looks after his health. Or to put it positively: "A healthy lifestyle can help you stay ten years' younger", comments the lead author Eva Martin-Diener.

"The effect of each individual factor on life expectancy is relatively high", states Eva Martin-Diener. But smoking seems to be the most harmful. Compared with a group of non-smokers, smokers have a 57 percent higher risk of dying prematurely. The impact of an unhealthy diet, not enough sport and alcohol abuse results in an elevated mortality risk of around 15 percent for each factor.

According to Martin an unhealthy lifestyle has above all a long-lasting impact. Whereas high wine consumption, cigarettes, an unhealthy diet and physical inactivity scarcely had any effect on mortality amongst the 45 to 55-year-olds, it does have a visible effect on 65 to 75-year-olds. The probability of a 75-year-old man with none of the four risk factors surviving the next ten years is 67 percent, exactly the same as the risk for a smoker who is ten years younger, doesn't exercise, eats unhealthily and drinks a lot.

From Medical Xpress:

Picking up healthy habits in your 30s and 40s can slash heart disease risk

The heart is more forgiving than you may think—especially to adults who try to take charge of their health, a new Northwestern Medicine study has found. When adults in their 30s and 40s decide to drop unhealthy habits that are harmful to their heart and embrace healthy lifestyle changes, they can control and potentially even reverse the natural progression of , scientists found. On the flip side, scientists also found that if people drop  or pick up more bad habits as they age, there is measurable, detrimental impact on their coronary arteries.

For this paper, scientists examined healthy lifestyle behaviors and coronary artery calcification and thickening among the more than 5,000 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who were assessed at baseline (when participants were ages 18 to 30) and 20 years later.The healthy  assessed were: not being overweight/obese, being a nonsmoker and physically active and having low alcohol intake and a healthy diet. 

By young adulthood (at the beginning of the study), less than 10 percent of the CARDIA participants reported all five healthy lifestyle behaviors. At the 20-year mark, about 25 percent of the study participants had added at least one healthy lifestyle behavior. Each increase in healthy lifestyle factors was associated with reduced odds of detectable  and lower intima-media thickness—two major markers of cardiovascular disease that can predict future cardiovascular events. Adulthood is not too late for healthy behavior changes to help the heart."

"That loss of healthy habits had a measurable negative impact on their coronary arteries," Spring said. "Each decrease in healthy lifestyle factors led to greater odds of detectable  calcification and higher intima-media thickness.

Spring said the healthy changes people in the study made are attainable and sustainable. She offers some tips for those who want to embrace a  at any age:Keep a healthy body weight; Don't smoke; Engage in at least 30 minutes of moderate to vigorous activity five times a week; No more than one alcoholic drink a day for women, no more than two for men; Eat a healthy diet, high in fiber, low in sodium with lots of fruit and vegetables.

From Science Daily:

Adults who lose weight at any age could enjoy improved cardiovascular health

Weight loss at any age in adulthood is worthwhile because it could yield long-term heart and vascular benefits, suggests new research. For the first time, the findings indicate that adults who drop a BMI category -- from obese to overweight, or from overweight to normal -- at any time during adult life, even if they regain weight, can reduce these cardiovascular manifestations. The findings are from a study examining the impact of lifelong patterns of weight change on cardiovascular risk factors in a group of British men and women followed since birth in March 1946. 

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Research reports and articles on the benefits of exercise have been piling up. Here are some worth looking at. From Science Daily:

Sitting too much, not just lack of exercise, is detrimental to cardiovascular health

Cardiologists have found that sedentary behaviors may lower cardiorespiratory fitness levels. New evidence suggests that two hours of sedentary behavior can be just as harmful as 20 minutes of exercise is beneficial.

From Science Daily:

Out of shape? Your memory may suffer

Here's another reason to drop that doughnut and hit the treadmill: A new study suggests aerobic fitness affects long-term memory. "The findings show that lower-fit individuals lose more memory across time," said a co-author. The study is one of the first to investigate young, supposedly healthy adults. 

From Science Daily:

Less exercise, not more calories, responsible for expanding waistlines

Sedentary lifestyle and not caloric intake may be to blame for increased obesity in the US, according to a new analysis. A study reveals that in the past 20 years there has been a sharp decrease in physical exercise and an increase in average body mass index (BMI), while caloric intake has remained steady. 

From Science Daily:

Older adults: Build muscle and you'll live longer

The more muscle mass older Americans have, the less likely they are to die prematurely, new research shows. The findings add to the growing evidence that overall body composition -- and not the widely used body mass index, or BMI -- is a better predictor of all-cause mortality. "In other words, the greater your muscle mass, the lower your risk of death," said the study's co-author. "Thus, rather than worrying about weight or body mass index, we should be trying to maximize and maintain muscle mass."

From Medical Xpress:

Keeping active pays off in your 70s and 80s

Older people who undertake at least 25 minutes of moderate or vigorous exercise everyday need fewer prescriptions and are less likely to be admitted to hospital in an emergency, new research has revealed.

Researchers from the Universities of Bath, Bristol and UWE-Bristol looked at data from 213 people whose average age was 78. Of people studied, those who carried out more than 25 minutes of moderate to vigorous physical activity per day – such as walking quickly, cycling or swimming - received 50 per cent fewer prescriptions than those who were more active over a four to five year period.

Such physical activity leads to a higher metabolism and better circulation, reducing the risk of conditions and diseases common in older age such as high blood presure, type 2 diabetes, coronary heart disease, and strokes.

From Everyday Health:

The Best Anti-Aging Medicine? Exercise

Everyone knows that exercise is good for you — it helps manage weight, improves muscle and bone strength, and even lifts your spirits. It can also add years to your life.“People have been looking for the secret to a long and healthy life for millennia,” said Neil Resnick, MD, chief of the division of geriatrics and director of the University of Pittsburgh Institute on Aging. “It turns out the most powerful intervention is exercise.”

A recent study conducted at Harvard found that exercise can be at least as effective as prescription drugs when it comes to preventing common conditions such as heart disease, stroke, and diabetes.

Exercise at any age is beneficial. From Science Daily:

Seniors who exercise regularly experience less physical decline as they age

Older adults in retirement communities who reported more exercise experienced less physical decline than their peers who reported less exercise, although many adults -- even those who exercised -- did not complete muscle-strengthening exercises, which are another defense against physical decline.