Tag Archives: heart attack

The difference between cardiac arrest and heart attack

While these two terms are used quite interchangeably, they denote different medical events. A heart attack (myocardial infarction) is a circulation problem that involves blood flow being blocked from reaching the heart. During cardiac arrest, an electrical problem causes the heart to stop beating and needs to be restarted.

Image credits Peggy and Marco Lachmann-Anke.

We’ve all heard these terms at one point or another. Because they’re both serious conditions and quite similar in symptoms, we also tend to lump them together and treat them as synonyms. That being said, however, they are not the same thing, and they are not interchangeable.

So let’s dive into the differences between them.

Heart attacks

These occur when one of the coronary arteries supplying oxygenated blood to a section of the heart gets blocked. If this blockage isn’t cleared quickly, cells in the affected area of the heart start dying due to a lack of oxygen. This effect builds up over time so the longer an individual goes without treatment, the more damage accumulates in tissues in that part of their heart.

Blockages are typically caused by build-ups of fat, either cholesterol (that’s why your doctor is so insistent you lower it), or a series of other substances.

While symptoms can definitely be immediate and intense (such as feelings of pressure, tightness, or intense pain in the chest), they can also occur over time, up to weeks in advance of an actual heart attack. There is also quite a large degree of variation in regards to the symptoms of various patients. Women can have different symptoms than men; some patients have no symptoms at all. Angina (recurrent chest pain or pressure) triggered by physical activity and relieved by stress is the most common and earliest warning sign of heart attack.

That being said, it’s important to act quickly in case you’re experiencing these symptoms or think you’re having a heart attack. Call emergency services even if you’re not sure you’re having a heart attack, as every minute matters. Emergency services personnel can begin treatment the moment when they arrive; getting to the hospital by yourself would take a lot longer. They can also provide resuscitation in case a patient’s heart has stopped completely.

Cardiac arrest

Unlike a heart attack, cardiac arrest occurs suddenly and very often without warning. It involves an abrupt loss of heart function and can be extremely dangerous.

It is caused by an electrical malfunction in the heart which produces arrhythmia (irregular heartbeat). Due to this disruption, blood flow to the brain, lungs, and other organs is disrupted — and with it, the flow of oxygen as well. The lack of oxygen supply to the brain can render a person unconscious in mere seconds and stop heart function completely. Victims of cardiac arrest can die within minutes without treatment.

Symptoms of cardiac arrest include dizziness, loss of consciousness, and shortness of breath. Cardiac arrest events can happen in individuals who may or may not have been diagnosed with heart disease. It may be reversed, however, if CPR is performed on the patient, and a defibrillator is used to restore a normal heart rhythm within a few minutes.

If someone near you is experiencing cardiac arrest, first call emergency services. Then, get an automated external defibrillator (AED) if one is available; if not, begin performing CPR on the patient. If two people are available, one should begin CPR immediately, while the other handles the call and retrieves an AED. If AED solutions are available, they must be used as quickly as possible.

It may be needed that you perform CPR on the patient for a longer period of time. If that’s the case, don’t worry. Hands-only CPR to the beat of “Stayin’ Alive” can double or even triple a victim’s chances of survival — hang in there!

Your belly fat is increasing the risk of a heart attack

For some time, researchers have identified abdominal obesity as an important risk factor for having a heart attack.

Now, new findings suggest that heart attack survivors who carry excessive belly fat around their waist are at an increased risk for a second or third heart attack. The risk for a subsequent stroke or heart attack was significant despite medication that is supposed to control cardiovascular health.

Credit: Pixabay.

Extra pounds and strokes go hand in hand. But belly fat, in particular, was much less studied.

Before the research team in Europe performed this study, the association between abdominal obesity and the risk of a subsequent heart attack or stroke was largely unknown.

“Patients are typically put on a stringent medical treatment regimen after their first attack to prevent second events (called secondary prevention),” said study author Dr. Hanieh Mohammadi of the Karolinska Institute, Stockholm, Sweden. “Secondary prevention works through reducing risk factors associated with heart attack and stroke such as high blood sugar, lipids and blood pressure. It was previously unknown whether abdominal obesity is a risk factor for recurrent events among patients on secondary prevention treatments.”

The study involved more than 22,000 patients, part of the SWEDEHEART registry, whose medical condition was followed after their first heart attack for a median of 3.8 years.

In this cohort, 78% of men and 90% of women had abdominal obesity, defined as a waist circumference of 94cm or more for men and 80cm or above for women.

Remarkably, the results suggest that abdominal obesity was associated with fatal and non-fatal heart attacks and strokes, regardless of other risk factors such as smoking, diabetes, hypertension, blood pressure, and body mass index, but also independent of any secondary prevention treatment. In other words, belly fat is an individual risk factor, no necessarily connected to being overweight.

What’s more, waist circumference was found to be a more important predictor of subsequent heart attacks than overall obesity.

Abdominal obesity is closely linked with conditions that accelerate the clogging of arteries, but also conditions that caused increased blood pressure, high blood sugar, and insulin resistance.

“Our results, however, suggest that there may be other negative mechanisms associated with abdominal obesity that are independent of these risk factors and remain unrecognised,” Mohammadi added. “In our study, patients with increasing levels of abdominal obesity still had a raised risk for recurrent events despite being on therapies that lower traditional risk factors connected with abdominal obesity – such as anti-hypertensives, diabetes medication and lipid lowering drugs.”

The higher the waist circumference, the greater the risk of a subsequent heart attack — and this relationship was stronger and more linear in men. In women, this relationship plotted a U-shaped graph, meaning that mid-range waist circumference was the least risky.

“Some studies have suggested that abdominal obesity may be more directly associated with the evil visceral fat (fat that sits around your organs) in men compared to women. In women it is thought that a greater portion of the abdominal fat is constituted by subcutaneous fat which is relatively harmless,” Dr. Mohammadi said, explaining why results differ so much between the sexes.

The findings, which were published in the European Journal of Preventive Cardiology, highlight the dangers of abdominal fat, which all people should strive to reduce to the best of their ability. After their first stroke, many patients feel more confident about their health outcomes because they start taking medication. But this study shows that if they have significant abdominal fat, they are still subjected to considerable risk of heart attack and stroke regardless of how many drugs they take.

Eating a healthy diet and regularly exercising are the best ways to reach an optimal waist circumference.

Both too much and too little sleep increase heart attack risk

A new study that included nearly half a million participants strikingly found that sleep duration plays a crucial role in whether or not a person is at risk of a heart attack — even if a person exercises, doesn’t smoke, or has no genetic predisposition to cardiovascular disease. In particular, the researchers found that too much sleep, as well as too little sleep, boosts the risk of having a heart attack.

Credit: Pixabay.

The researchers at the Massachusetts General Hospital and the University of Manchester analyzed a dataset of 461,000 individuals aged 40 to 69, part of UK biobank, who had no prior history of heart attack or heart disease. The participants’ health was tracked over a period of seven years.

Those who slept less than six hours a night were 20% more likely to have a heart attack than those sleeping 6 to 9 hours.

The fact that sleep deprivation and low quality sleep are linked to negative health outcomes is, by now, no surprise. Study after study has linked poor sleep to anxiety, depression, obesity, diabetes, and heart disease.

But what was surprising about this study was that people who slept more than nine hours per night were 34% more likely to suffer a heart attack than the participants who slept 6 to 9 hours — that’s a significantly higher risk than the sleep-deprived.

The farther people fell outside the 6 to 9-hour range, the higher the recorded risk of having a heart attack. People who slept for only 5 hours had a 52% risk of heart attack, whereas those who slept 10 hours nightly were twice as likely to have one than normal sleepers.

Shockingly, these effects held true even when taking into account more than 30 other factors, including physical activity, mental health, and socioeconomic status. In other words, sleep duration influenced the risk of having a heart attack independently of other lifestyle factors — and genes were no exception either.

“This gives us even more confidence that there is a causal relationship here—that it is sleep duration, not something else, influencing heart health,” said Celine Vetter, co-author of the new study and an assistant professor of physiology at the University of Colorado Boulder.

It’s not clear why sleep duration is such a big contributing factor to heart disease. Some explanations suggest that sleeping too little can affect arteries, bone marrow, as well as lead to poor lifestyle choices such as eating low-quality food. In contrast, sleeping too much may boost inflammation in the body.

There’s some good news, though. The study suggests that sleeping for a reasonable number of hours can be one of the most impactful things you can do to avoid heart disease.

“It’s kind of a hopeful message, that regardless of what your inherited risk for heart attack is, sleeping a healthy amount may cut that risk just like eating a healthy diet, not smoking, and other lifestyle approaches can,” said lead author Iyas Daghlas, who is a medical student at Harvard.

“Just as working out and eating healthy can reduce your risk of heart disease, sleep can too,” said Vetter.

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

Gene mutation may explain why humans are so prone to heart attacks

The loss of NeuG5c in humans (retained in other primates) increases atherosclerosis risk by multiple mechanisms. Credit: Kunio Kawanishi.

Heart attacks are very common among both humans and chimpanzees, our closest living relatives. However, the causes of sudden cardiac arrest are very different in the two species. For instance, naturally occurring heart attacks due to atherosclerosis — the clogging of arteries due to fatty deposits — is virtually non-existent in other mammals. A new study suggests that the mutation of a gene 2-3 million years ago in our ancestors may explain humans’ high risk for cardiovascular disease.

An estimated 17.9 million people died from CVDs in 2016, representing 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke.

Nissi Varki, a professor of pathology at the University of California San Diego School of Medicine, and colleagues were intrigued by the prevalence of atherosclerosis — which accounts for one-third of all deaths worldwide due to heart disease. Blood cholesterol, a sedentary lifestyle, old age, obesity, and smoking are all known risk factors that can lead to clogged arteries, but in roughly 15% of cases, none of these factors apply. Even vegetarians with an active lifestyle are prone to heart attacks while our evolutionary relatives are not. Why is that?

In their new study, the researchers engineered mice to be deficient in a sialic acid sugar molecule called Neu5Gc. Previously, the same team found that Neu5Gc deficiency promotes inflammation and cancer progression in mice.

Varki and colleagues found that mice who lost the CMAH gene that produces Neu5Gc had a much higher risk of developing atherogenesis compared to control mice, who retain the gene. A human-like elimination of CMAH caused an almost 2-fold increase in the severity of atherosclerosis, the researchers added.

Writing in the journal PNAS, the UC San Diego scientists say that the gene was likely inactivated by a mutation that occurred a few million years ago in a hominin ancestor. The loss of the gene seems to have also produced other changes in human physiology, including an enhanced ability to run long distances as well as reduced fertility.

“The increased risk appears to be driven by multiple factors, including hyperactive white cells and a tendency to diabetes in the human-like mice,” said Ajit Varki, who is a Professor Of Medicine and Cellular And Molecular Medicine at UC San Diego and co-author of the new study.

Intriguingly, in an experiment where genetically modified mice lacking the CMAH gene were fed a diet analogous to red meat (Neu5Gc-rich, high-fat), the rodents suffered a further 2.4-fold increase in atherosclerosis. This massive increase could not be pinned to blood fats or sugars.

“The human evolutionary loss of CMAH likely contributes to a predisposition to atherosclerosis by both intrinsic and extrinsic (dietary) factors,” wrote the authors, “and future studies could consider using this more human-like model.”

Study finds risk of heart attacks rises nearly 40 percent on Christmas Eve

Credit: Flickr, Simon Matzinger.

Credit: Flickr, Simon Matzinger.

Do you know that the risk of a heart attack increases on Christmas Eve around 10 p.m.? This is especially true among older or sicker people.

Recent publication from the SWEDEHEART group

A new study in Sweden was published using data from a national database that collects information about all acute cardiac patients in the country, known as SWEDEHEART. The BMJ publication by a team of investigators from Lund University (Moman A Mohammad, Sofia Karlsson, Jonathan Haddad, Björn Cederberg, Sasha Koul, David Erlinge), Danderyd’s University Hospital (Tomas Jernberg), Uppsala University (Bertil Lindahl), and Örebro University (Ole Fröbert) analyzed data on 283,014 heart attacks that took place in the country between 1998 and 2013. As previous studies have, they found that heart attacks happened more frequently in the early morning hours (before 8 am) and on Mondays. They also noted that the risk of heart attacks spiked during the holiday season, with a peak at 10 pm on Dec. 24 — the day when most Swedes hold their Christmas family gatherings. Heart attacks were 37% more likely to happen on Christmas Eve than during the control period and 20% more likely on New Year’s Day. Throughout the week between Christmas and New Year, heart attack risks were 15% higher than other days of the month of December.

So why is this happening?

“We do not know for sure but emotional distress with acute experience of anger, anxiety, sadness, grief, and stress increases the risk of a heart attack,” said researcher David Erlinge, of Lund University’s Department of Cardiology. “Excessive food intake, alcohol, long distance traveling may also increase the risk.”

Increased salt and sugar intake from all the holiday parties or getting less sleep and exercise could be the culprits. It is possible that family members visiting relatives after a long time apart, find them in a poor health condition and decide to admit them to hospitals. Similarly, people might delay reporting symptoms and seeking care to not disrupt the holiday celebrations which is why we would expect lower cases before Christmas than afterwards. However, the absence of any decline before or after Christmas means that these behavioral aspects are not the main contributing factors to the observed peak of myocardial infarction on Christmas.

Is this phenomenon only in Sweden?

Sweden is not the only country where this phenomenon has been observed. In 2004, cardiologists in Los Angeles, California noted an increase in heart attacks and other acute cardiac episodes during the period between Christmas and New Year’s Eve. Researchers suggest that this association could be explained by the possibility that people often delay medical treatments or doctor appointments during the holiday season. Likewise, a publication in the European Journal of Epidemiology showed that myocardial infarction rates went up in Kuwait, a predominantly Muslim country during Islamic holidays.

Avoid the “Merry Christmas Coronary” and “Happy New Year Heart Attack” 

All these studies remind us of the importance to check in with our doctor if we haven’t, especially before the holiday season and notably if you have risk factors for heart disease. Don’t spend the “most wonderful time of the year” in a hospital. Learn the symptoms of heart attack: chest pain, shortness of breath, sweating, and nausea. Women, however, may experience different symptoms including abdominal pain, pain in one or both arms, and unusual fatigue.

Heart Attack Signs and Symptoms | US CDC

That cold, gloomy weather you hate? It might give you a heart attack

A new study found that when the weather is cold and cloudy, more people have heart attacks.

The study was carried out in Sweden and tracked over 280,000 patients between February 2017 and April 2018 — it was the largest study of its kind, and the data is quite robust.

Weather data was available for some 274,000 patients, including mean, minimum, and maximum air temperature, wind velocity, sunshine duration, atmospheric air pressure, air humidity, snow precipitation, rain precipitation, and change in air temperature.

The researchers were looking for any patterns connecting heart attack rates with any atmospheric conditions. Results showed that lower temperature, higher wind speeds, and less sunshine are all connected with heart attack rates — but the strongest connection was with temperature.

The incidence of heart attacks was highest on days where temperatures were below 0 Celsius (32 F) and declined significantly when temperatures rose above freezing levels. Overall, a decrease from 20C to -1C (68 to 30F) was associated with a 14% increased in heart attack risk. For wind speed, an increase from 0 to 36 miles per hour, led to a 7% risk increase, while a shift from 10 hours without clouds to a fully cloudy day caused heart attack risk to go up by 11%. A few other studies have previously reported similar findings with regard to air temperature, most of these studies have been geographically limited, whereas this a nationally-wide sample (though for Sweden, which might not be representative for other parts of the globe).

Now, the more interesting question is that of causality: is the bad weather actually causing the risk, or is it a mere correlation-not-causation relationship?

David Erlinge, professor of cardiology at Lund University in Sweden and leader of the study, says that it is plausible for the cold weather to actually cause the heart attacks.

“Cold and windy weather leads to a contraction of blood vessels in the skin to conserve energy and temperature,” said Erlinge. “That increases the workload of the heart, increasing the risk of a heart attack.”

Another explanation could have a lot to do with our habits: when it’s cold outside, we’re more likely to be sick and less likely to do things which are good for our heart, like taking a walk. Perhaps it’s something to do with being indoor rather than outdoor, perhaps it’s something to do with the time of the year — while the paper does speculate on this, it doesn’t study it directly.

However, this study adds to knowledge on the role of weather as a potential trigger of myocardial infarction. Erlinge also adds that they also looked at pollution data, but surprisingly, pollution did not seem to be a relevant factor in this context.

The study has been published in JAMA.

Lead exposure might be responsible for 10 times more premature deaths than previously thought

A new study suggests that lead exposure may be responsible for nearly 10 times more deaths in the United States than previously thought.

Credit: Wikipedia.

Scientists have discovered that nearly 412,000 deaths each year in the US can be attributed to lead contamination. That number is ten times higher than the Institute for Health Metrics and Evaluation at the University of Washington in Seattle had previously reported.

“Today, lead exposure is much lower because of regulations banning the use of lead in petrol, paints and other consumer products, so the number of deaths from lead exposure will be lower in younger generations. Still, lead represents a leading cause of disease and death, and it is important to continue our efforts to reduce environmental lead exposure,” explained Professor Bruce Lanphear, from Simon Fraser University in Canada.

Lanphear and colleagues estimated that 28.7% of heart disease-related premature deaths in the US could be caused by lead exposure, which comes to a total of 256,000 deaths annually. 

Researchers used data from the Third National Health and Nutrition Examination Survey, which monitored 14,289 US adults for 20 years. Of the 4,422 participants who died by 2011, approximately 18% of them could have been saved by reducing blood lead concentrations to 1.0 micrograms per deciliter.

Compared to those with low lead blood concentrations, people with high lead levels (over 6.7 micrograms) had the risk of premature death from any cause increased by 37%, the risk of cardiovascular death increased by 70%, and double the risk of death from ischemic heart disease.

“Our study calls into question the assumption that specific toxicants, like lead, have ‘safe levels’, and suggests that low-level environmental lead exposure is a leading risk factor for premature death in the USA, particularly from cardiovascular disease,” Professor Lanphear said in a statement.

Lead exposure can contribute to cardiovascular disease by various pathways. Lead affects the epithelial cells of the blood vessels, which increases the chances of developing plaques that can then cause a heart attack. Lead contamination also leads to kidney damage, which causes high blood pressure and probably acts synergistically with plaque formation.
Also, if you live near an airport, your blood lead levels will be a little higher than if you live farther away due to the lead found in the aviation gas used in single piston jets.

“Estimating the contribution of low-level lead exposure is essential to understanding trends in cardiovascular disease mortality and developing comprehensive strategies to prevent cardiovascular disease. Currently, low levels of lead exposure are an important, but largely ignored risk factor for deaths from cardiovascular disease,” said Professor Lanphear.

The team admits that the study’s principal limitation is that the research relied heavily on one blood concentration measurement taken at the beginning of the study period, almost 20 years ago.
“Our reliance on a single blood test as opposed to serial blood tests means that we have underestimated the impact of lead exposure on cardiovascular disease,” Lanphear said. “There are some things in the study design itself that we really couldn’t change.”

The team urges the retirement of lead-contaminated housing, lead-laden jet fuels, lead water pipes, and the reduction of emissions from smelters and lead battery facilities.

“We’ve made tremendous progress in reducing these exposures in the past four to five decades,” Lanphear added. “But our blood levels are still 10 to 100 times higher than our pre-industrial ancestors,” Lanphear concludes.

Scientific reference: Bruce Lanphear , Stephen Rauch, Peggy Auinger, Ryan W Allen , Richard W Hornung. Low-level lead exposure and mortality in US adults: a population-based cohort studyThe Lancet Public Health, 2018 DOI: 10.1016/S2468-2667(18)30025-2

Google AI can now look at your retina and predict the risk of heart disease

Google researchers are extremely intuitive: just by looking into people’s eyes they can see their problems — cardiovascular problems, to be precise. The scientists trained artificial intelligence (AI) to predict cardiovascular hazards, such as strokes, based on the analysis of retina shots.

The way the human eye sees the retina vs the way the AI sees it. The green traces are the pixels used to predict the risk factors. Photo Credit: UK Biobank/Google

After analyzing data from over a quarter million patients, the neural network can predict the patient’s age (within a 4-year range), gender, smoking status, blood pressure, body mass index, and risk of cardiovascular disease.

“Cardiovascular disease is the leading cause of death globally. There’s a strong body of research that helps us understand what puts people at risk: Daily behaviors including exercise and diet in combination with genetic factors, age, ethnicity, and biological sex all contribute. However, we don’t precisely know in a particular individual how these factors add up, so in some patients, we may perform sophisticated tests … to help better stratify an individual’s risk for having a cardiovascular event such as a heart attack or stroke”, declared study co-author Dr. Michael McConnell, a medical researcher at Verily.

Even though you might think that the number of patients the AI was trained on is large, AI networks typically work with much larger sample sizes. In order for neural networks to be more accurate in their predictions, they must analyze as much data as possible. The results of this study show that, until now, the predictions made by AI cannot outperform specialized medical diagnostic methods, such as blood tests.

“The caveat to this is that it’s early, (and) we trained this on a small data set,” says Google’s Lily Peng, a doctor and lead researcher on the project. “We think that the accuracy of this prediction will go up a little bit more as we kind of get more comprehensive data. Discovering that we could do this is a good first step. But we need to validate.”

The deep learning applied to photos of the retina and medical data works like this: the network is presented with the patient’s retinal shot, and then with some medical data, such as age, and blood pressure. After seeing hundreds of thousands of these kinds of images, the machine will start to see patterns correlated with the medical data inserted. So, for example, if most patients that have high blood pressure have more enlarged retinal vessels, the pattern will be learned and then applied when presented just the retinal shot of a prospective patient. The algorithms correctly discovered patients who had great cardiovascular risks within a 5-year window 70 percent of the time.

“In summary, we have provided evidence that deep learning may uncover additional signals in retinal images that will allow for better cardiovascular risk stratification. In particular, they could enable cardiovascular assessment at the population level by leveraging the existing infrastructure used to screen for diabetic eye disease. Our work also suggests avenues of future research into the source of these associations, and whether they can be used to better understand and prevent cardiovascular disease,” conclude the authors of the study.

The paper, published in the journal Nature Biomedical Engineering, is truly remarkable. In the future, doctors will be able to screen for the number one killer worldwide much more easily, and they will be doing it without causing us any physical discomfort. Imagine that!

Being married might just save your life — if you suffer from heart diseases

A surprising new study showed that marriage is an unexpected factor affecting the survival rate of people suffering from heart attacks.

A family can get you through a lot of rough times — including a heart attack.

The massive study analyzed just under 1 million patients, of which 25,287 had a previous heart attack, 168,431 had high blood pressure, 53,055 had high cholesterol, and 68,098 had type 2 diabetes mellitus. For the purpose of the study, participants were defined as single, married, divorced, or widowed and followed up until 2013 for mortality.

Immediately, an intriguing correlation emerged: married patients were 14% more likely than single patients to survive a heart attack. Similar figures stood for patients who also had high cholesterol, high blood pressure, or diabetes. Although the importance of having a spouse for support has been suggested in previous studies, this is by far the largest of its kind.

Dr Paul Carter, lead author of the study said:

“Marriage, and having a spouse at home, is likely to offer emotional and physical support on a number of levels ranging from encouraging patients to live healthier lifestyles, helping them to cope with the condition and helping them to comply to their medical treatments. Our findings suggest that marriage is one way that patients can receive support to successfully control their risk factors for heart disease, and ultimately survive with them.”

Similarly, people who were divorced seem to fare worse than the average.

“The nature of a relationship is important and there is a lot of evidence that stress and stressful life events, such as divorce, are linked to heart disease,” added Dr Carter. “With this in mind, we also found that divorced patients with high blood pressure or a previous heart attack had lower survival rates than married patients with the same condition.”

This raises an interesting question — is it something specific to heart attacks, or does it carry out to all serious illnesses? Previous studies have indicated that marriage (or a serious relationship) also raises the odds of cancer survival, so it seems quite safe to say that having a person to rely on can make a big difference.

However, it’s unclear exactly how this support manifests itself. It could be the mental aspect that does all the difference, or it could be that married people are more likely to stick to a healthy regimen and avoid risk factors.

The findings were presented at the ESC Cardio conference and have not yet been peer reviewed.

Sonogram baby.

Air pollution wrecks our DNA, makes us more susceptible to heart failure

Exposure to air pollution carries dire risks even for those still floating blissfully in the womb. A new paper comes to explain why this happens, and documents the chemical processes that lead to later-life heart failure susceptibility for exposed babies.

Sonogram baby.

Image credits MIKI Yoshihito / Flickr.

We’ve known for some time now that gestational exposure to airborne particles contained in diesel exhaust can lead to an increase in the risk of heart failure later in life. But we didn’t really know why. I mean, air pollution is never a good thing, but we usually think of it as clogging up lungs or just choking the oxygen out of us — not something that will kill us ten, twenty, thirty years from now.

But exposure to airborne particles resulted from burning diesel fuel seems to have longer-lasting effects, even for unborn babies,  a team of researchers from the University of Washington School of Public Health reports. Their work identified the specific DNA methylation (a chemical process which can inactivate lengths of DNA code) and gene expression effects exposure to these particles has on cardiac health.

“Our study adds to the large body of evidence that air pollution exposure has significant harmful effects on the cardiovascular system, and extends these findings to show the effects of this exposure on the developing heart — effects that can last for decades,” said Michael T. Chin, M.D., Ph.D., associate professor of medicine at the University of Washington School of Medicine’s Center for Cardiovascular Biology in Seattle.

Mouse science

The team used four groups of mice for their work. Two (group 1 and 3) of them were gestationally exposed to filtered air and then went under the scalpel for sham or transverse aortic constriction (TAC) surgery. The other two (groups 2 and 4) were gestationally exposed to diesel exhaust particles and then underwent either sham or TAC surgery. None of the groups were exposed to diesel-associated particles after birth. Sham surgeries are surgical procedures that don’t have any actual therapeutic goal. Sometimes also called “placebo surgeries,” they’re performed in double-blind studies to ensure the results aren’t caused by the surgical procedure itself, but by the object of the researcher’s work.

Samples harvested from all four groups allowed the team to compare how particle exposure impacted heart tissue gene expression. In the end, they identified three candidate genes that were expressed differently in group 4 (diesel-exposed and TAC surgery), which developed the worst heart failure rate among all the groups in the study. Further analysis of these genes showed that one, in particular, suffered heavy chemical modifications following exposure. This gene, miR133a-2, had “decreased methylation”, they report.

The tests were performed on mice so the results may not carry over perfectly to humans. However, our equivalent of miR133a-2, miR133a, has been shown to have “[reduced] expression in both [diabetic and nondiabetic] forms of heart failure, which is consistent with a role in protecting against heart failure,” the team notes. On the other hand, the team found no evidence that Ptprf and Pamr1 suffered any damage from exposure to diesel-associated particles. The two gene expressions “indicates that both […] show significant increases in expression in nondiabetic heart failure compared with controls,” which would be “consistent with a role for these genes in contributing to human heart failure”.

In other words, even gestational exposure to such substances plays a key role in a body’s susceptibility to heart failure later on. So if you’re expecting, taking some time to visit some more pristine areas of the world might do wonders to your baby’s health in the long run.

“From just an experience vantage we all assume diesel and other petroleum combustion products are bad for us. Here is evidence of possibly how bad,” said Thoru Pederson, Ph.D., Editor-in-Chief of The FASEB Journal, which published the work.

The paper “In utero exposure to diesel exhaust particulates is associated with an altered cardiac transcriptional response to transverse aortic constriction and altered DNA methylation” has been published in the journal FASEB.

Study shows Obamacare expanded health insurance, reducing the number of cardiac arrests

Medical scientists have analyzed some of the impacts of the expanded health insurance implemented under the Obama administration — the hotly debated Obamacare. They found that it significantly reduced the incidence of cardiac arrest by 17 percent.

Eric Stecker, M.D., M.P.H., associate professor of cardiology at Oregon Health & Science University’s Knight Cardiovascular Institute in Portland, Oregon. Image credits: Kristyna Wentz-Graff/OHSU.

The US health system is unlike any other in the world — and not in a good way. According to both the United Nations (UN) and the World Health Organization (WHO), the US health care spends more money per capita than any other country, and yet is spectacularly ineffective at providing healthcare. They have fewer physicians and fewer hospital beds per capita than any other developed country, and that only begins to tell the story. The country is a leader in obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides, ranking 42nd out of 224 countries in terms of life expectancy. The state doesn’t provide insurance to people, leaving that to be either a part of an employment deal, or a private health insurance (which often costs absurdly high). According to Gallup, at least 11% of all Americans aren’t covered by any form of health insurance.

Obamacare was signed in 2010, with the purpose of driving better health outcomes and lowering associated costs, as well as lowering the uninsurance rate. Since then, that rate has gone significantly down, and results are starting to show. In a recent study, scientists found that one of the most crippling health issues, cardiac arrest, has gone significantly down. While the incidence remained more or less similar for adults over 65 years old, for adults between 45 and 64 years old, it went down by 17 percent.

“Cardiac arrest is devastating and under-recognized cause of premature death for both men and women older than 45 years,” said study lead author Eric Stecker, M.D., M.P.H., associate professor of cardiology at Oregon Health & Science University’s Knight Cardiovascular Institute in Portland, Oregon. “Health insurance allows people to engage in regular medical care, which is crucial for the prevention of cardiovascular disease and the diagnosis and treatment of conditions that can cause cardiac arrest.”

This is not a small figure. Across the country, an estimated 350,000 cases of out-of-hospital cardiac arrest happen each year. If medical assistance isn’t provided immediately (often requiring CPR), the patient’s life is under grave threat.

The study focused on an area of Oregon, but Mary Fran Hazinsky and Carole R. Myers found similar results in other states. This seems to be a trend that carries out across the entire country, but researchers also highlight that correlation does not imply causation. In other words, the incidence of cardiac arrests is a complex process with many associated factors, and it can be difficult to say with certainty that Obamacare is preventing cardiac arrests — but at the very least, it seems to be doing so.

“The hypothesized relationship between healthcare expansion and decline in [out-of-hospital cardiac arrest] incidence is certainly a timely question that requires further study,” they wrote. “A follow-up study should be based on a framework that looks more broadly at a complement of social and other determinants of health, and accounts for the various dimensions of access, and evaluates access by looking at utilization.”

It’s also important to note that while ‘cardiac arrest’ and ‘heart attack’ are sometimes used interchangeably, they are not by any means the same thing. A heart attack occurs when oxygen-rich blood is not permitted to reach the heart, generally due to a blocked artery. The heart doesn’t usually stop during a heart attack. A cardiac arrest, on the other hand, is triggered by an electrical malfunction in the heart that causes an irregular heartbeat. In mere seconds, the person goes unconscious and the heart stops. Fatality can occur quickly, in minutes.

Because the problem is so often fatal, prevention is key — and this is where Obamacare seems to be improving things. Basically, 17 percent fewer cases can translate into 17 percent fewer lives lost.

“These findings underscore the important role of prevention in the battle against sudden cardiac arrest, which affects almost a thousand Americans every day,” said Sumeet Chugh, M.D., senior author and director of the Heart Rhythm Center at Cedars-Sinai Heart Institute in Los Angeles, who carries a broader study on the effects of Obamacare on cardiac arrests.  “Less than 10 percent of these patients make it out of the hospital alive, so by the time we dial 9-1-1 it is much too late. For this reason, effective primary prevention is vital.”

Findings appeared in the Journal of the American Heart Association

Defibrillators and pacemakers might soon use light instead of electricity to restart your heart

Closed chest defribillators (the type of defribillators you see on TV) have been around for decades, and for a good reason – because they get the job done. They’re very effective at restoring normal heart rhythm, but they have a big disadvantage: even with fine tuning of modern devices, they hurt like hell. Researchers now believe they can make it work using light instead of electricity, using genetically engineered light-sensitive stem cells that have been grafted to the heart.

The idea is somewhat similar to the controlled explosions which trigger avalanches – you don’t need to blow up the entire thing, you just need to hit in the strategic places – and this is where the light-sensitive cells come in.  The long term idea is to apply the technology into other major organ systems.


Defibrillation is a common treatment for life-threatening cardiac dysrhythmias. The heartbeat may be too fast or too slow, and may be regular or irregular – and defribillation helps in almost all severe cases. Just like in many fields, computer models did wonders here, revealing that by stimulating in the right place at the right time, much less current needs to be used, and inconveniences like external burns can become a thing of the past. Using these models, they located where to add the new light-sensitive cells, and how many must be used to achieve a desired effect.

A team from John Hopkins recently published a paper in Nature Communications where they describe such a technique based on a computer model. Another group of researchers, from Stanford, have already moved beyond modelling and are preparing to test these ideas in real tissues – and they just received a $600.000 grant to develop their work.

Some 4.000.000 people in the US alone are suffering from some significant degree of heart rhythm abnormality, and many more are suffering from subclinical conditions that would benefit tremendously from this.

Science confirms: Mediterranean diet is really good for heart disease

A Mediterranean diet high in olive oil, nuts, fish and fresh fruits and vegetables helps prevent strokes and other heart issues.

mediterranean diet

Now before you put on your “Captain obvious” t-shirts, you should know that while (many other) previous studies have suggested that people who eat a Mediterranean-like diet have healthier hearts, they haven’t ruled out other differences associated with this type of diet (lifestyle, habits, etc). For the new trial, researchers went for a new strategy, assigning volunteers at risk of heart disease to a Mediterranean or standard low-fat diet for five years, basically singling out the effect of the diet.

“This is good news, because we know how to prevent the main cause of deaths – that is cardiovascular disease – with a good diet,” said Dr. Miguel Angel Martinez-Gonzalez, who worked on the study at the Universidad de Navarra in Pamplona.

He and his colleagues working on the study assigned the 7500 volunteers with heart issues or diabetes to one of three groups. The first two groups were instructed to eat a Mediterranean diet – the first one with extra-virgin olive oil and the other with nuts, both donated for the study, while the third group ate a “control” diet, which emphasized low-fat dairy products, grains and fruits and vegetables.

Over the next five years, they observed that people on both Mediterranean diets were 28 to 30 percent less likely to develop cardiovascular disease than those on the general low-fat diet – which of course, is really good in itself.

“The quality of fat in the Mediterranean diet is very good,” he told Reuters Health. “This good source of calories is replacing other bad sources of calories. In addition, there is a wide variety of plant foods in the Mediterranean diet,” including legumes and fruits as desserts, Martinez-Gonzalez added.

The key, researchers explain, is both what the Mediterranean diet is, and what it isn’t.

mediterranean food health

“I think it’s a combination of what’s eaten and what’s not eaten,” agreed Mozaffarian, who wasn’t involved in the new research.

“Things that are discouraged are refined breads and sweets, sodas and red meats and processed meats. The combination of more of the good things and less of the bad things is important.”, added Dr. Dariush Mozaffarian, who studies nutrition and cardiovascular disease at the Harvard School of Public Health in Boston.


Light smoking doubles the risk of sudden heart failure in women

If you’re a woman who just can’t give up smoking, but you’ve toned it down, even to just one cigarette per day, then don’t think you’ve eliminated the risks; according to a new research published in the Journal of American Heart Association, even very light smoking doubles the risk of heart failure in women, while quitting drops the risks in a few years.

The research tracked the health of 101,000 US nurses over three decades. In people aged 35 or younger, heart problems usually occur due to a genetic predisposition; but in people older, as were most of the studied nurses, heart failure is typically preceded by coronary heart disease, where the heart’s arteries become blocked by fatty deposits.

After taking into consideration the other factors, such as high cholesterol, family history and high blood pressure, Dr Roopinder Sandhu and colleagues found the women who smoked were twice as likely to suffer major heart issues, even if they smoked “light-to-moderate” amounts – between one and 14 cigarettes a day. For every five years of continued smoking, the risk went up by 8%.

Dr Sandhu, of the the University of Alberta, Canada, explains:

“What this study really tells women is how important it is to stop smoking. The benefits in terms of sudden cardiac death reduction are there for all women, not just those with established heart disease. It can be difficult to quit. It needs to be a long-term goal. It’s not always easily achievable and it may take more than one attempt.”

Ellen Mason, senior cardiac nurse at the British Heart Foundation, also appreciated the study:

“This study shows that smoking just a couple of cigarettes a day could still seriously affect your future health. As we approach the new year, many of us will be making resolutions and giving up smoking will be top of the list for lots of people. If you’re thinking of quitting and need a nudge, this research adds to the wealth of evidence that stopping smoking is the single best thing you can do for your heart health.”

second hand smoke study

Bans on smoking result in one-third drop in heart attacks. Linked to second-hand smoke.

second hand smoke study

According to two new studies, after smoking is banned indoors the number of people suffering from heart attacks considerably drops within months. Some of the researchers believe this data offer substantial evidence to the claim that second-hand smoke does in fact affect  people’s health. Besides the obvious health benefit, the researchers argue that preventing second-hand smoke also cuts back on heath care costs dramatically.

“We should now accept this as fact,” says Richard Hurt, a professor of medicine at the Mayo Clinic who led one of the studies and is on a mission to debunk the tobacco industry’s  arguments that secondhand smoke isn’t a major risk factor for heart disease. Hurt believes his study offers enough evidence to disprove this claim once and for all. During his research, the only risk factor that changed was second-hand smoke. Otherwise, cholesterol and blood pressure stayed the same, while obesity rates actually increased.

“People with known coronary disease should have no secondhand smoke exposure,” Hurt says. “It is too dangerous.”

The study looked at medical diagnoses in Olmsted County, Minn., site of an ongoing study funded by the National Institutes of Health. Residents there were monitored by Hurt and colleagues, for 18 months after a strict  ban on workplace smoking went into effect in 2007. At the end of this period the number of heart attacks there dropped by one-third and sudden deaths from heart attacks decreased by 17 percent, although the researchers themselves admit there weren’t enough deaths overall to make that a reliable number.

In another study, researchers at the University of California, San Francisco looked at 45 studies covering 33 smoke-free laws in the United States and other countries. According to their aggregate findings,  indoor smoking bans were associated with a 15 percent decrease in hospitalization for heart attacks; a 16 percent decrease for stroke; and a 24 percent decrease in hospitalizations for lung diseases like asthma and chronic obstructive pulmonary disease. This translates in a massive financial saving on health care.

“It’s just a gigantic effect,” says Stanton Glantz, director of the Center for Tobacco Control Research and Education at UCSF, and a leader on the study. “There’s nothing else you can do that’s going to have that big an effect that fast.”

In the US there are currently  24 states that don’t have comprehensive smoking bans, while in the rest of the world there are still many countries that either don’t have a firm policy in place or smoking bans aren’t enforced. The first study was published in the journal Archives of Internal Medicine, while the latter appeared in the journal Circulation.

ZME Readers, are you up for indoor smoking bans or do you believe this to consist a violation of one’s freedom rights? Discuss in the comment section below. 


New type of CPR is more effective and easier to perform

The number of people that die from sudden cardiac arrest growing larger and larger every year. Just so you can make an idea, only in America, more people die from sudden cardiac arrest every three days than the people that died in 9/11. Thing is, many of those deaths could be avoided, if local bystanders wouldn’t be bystanders, and would instead perform CPR.

This new type of CPR is called Continuous Chest Compression, was developed by Gordon A. Ewy, MD, and Karl Kern, MD; it’s a hands only method, no mouth to mouth. You also don’t have to be certified to do it, and it’s really really easy to learn. It may very well be the thing that saves a life. Just watch this video:

Is traffic exposure causing heart atacks?

The simple thought of being caught in a horn-honking traffic jam for a couple of hours is definitely a scary one, which would definitely increase the rate of your heartbeat. But, unfortunately, traffic can have much more serious effects on one’s heart, especially now, when a simple drive around the town has become an endurance test. But are our hearts really in danger?

Numerous tests seem to prove so; for example, in Germany researchers found that patients were three times more likely to have been caught in traffic an hour before their attack. As this wasn’t enough, they also noticed that there is a small, but significant risk in having a heart attack six hours after being exposed to traffic.

So what? If you are not a driver, then there should be no reasons to worry…right? Unfortunately not. Even though most patients were drivers, public transportation and even riding a bicycle have made their “victims”. On the whole, time spent in any means of transport seems to increase the chances of a heart attack 3.2 times, which definitely cannot be said to be insignificant. And of course, there are some categories which seem to be the most affected: females, elderly males, the unemployed  and people with a history of angina. Apparently, being part of heavy traffic increases the risk of having a heart attack especially when a certain risk exists.

Even though the study wasn’t aimed at finding the exact causes of the increase in heart attacks, it may be a possibility that the gases emitted by the means of transport; however, the high level of stress cannot be ignored either.

The researchers studied files belonging to patients from Augsburg, Southern Germany between February 1999 and December 2003. 1454 patients were also interviewed in order to find out both which categories were most affected and where they had been in the day of the attack and also what they used to get there. The average age of the participants was 60 and a quarter of them were women.

Other studies conducted before this one had shown that strenuous activities such as playing soccer or intense physical work such as snow shoveling also increased the chances of a heart attack 5 or 6 times in the following hours. 8% of the cases were attributed to traffic, not a large number, but definitely one to be taken into consideration.

The first clues emerged after a first study which included 691 volunteers which took place in 2004. Now, the most important thing to discover is what exactly is the trigger: gases, stress or both?

A surprising fact is related to higher risk of such problems discovered in women (5 times bigger); however, only 325 women were interviewed, so more statistical data would be necessary to effectively draw a conclusion.

A further study is to be conducted, using healthy 120 volunteers fitted with Holter monitors which provide electrocardiograms; exposure to harmful gases and noise will also be monitored. The effects traffic has on diabetics will also be studied.

What is clear is the fact that some measures to improve air quality in urban areas would definitely decrease the risk of heart problems, not to mention lung illnesses.

A few steps have been made. In 1997 the U.S. EPA introduced Ambient Air Quality Standards (NAAQS) in order to educate the public about the levels of air quality; this information can be found here http://www.epa.gov/airnow.

But of course, more is to be made as modern life seems to jeopardize our state of health more than it could have been anticipated. So, a walk in the park?

Source: American Heart Association