Tag Archives: heart disease

The “step test”: If you can complete this simple 60-second test, it means you’re heart is in good shape

Credit: Pxhere.

Climbing a flight of stairs puts a considerable amount of demand on the heart, which is why some cardiologists have been using a “step test” to evaluate their patient’s heart health for decades. Sometimes, the patient may be asked to perform the test during a consultation since every hospital or clinic has some stairs. It’s simple and free, unlike other diagnosis methods that can be cumbersome and cost money. But is the step test really that effective? New research seems to suggest so.

Researchers at the European Society of Cardiology (ESC) recruited 165 volunteers who have known or suspected coronary artery disease, which causes chest pain or shortness of breath during strenuous exercise. First, the volunteers were asked to walk or run on a treadmill, with the intensity gradually increasing until exhaustion. This initial trial allowed the researchers to calculate each participant’s exercise capacity, measured as metabolic equivalents (METs).

Vigorous physical activity like climbing stairs raises the demand for blood and oxygen to your extremities. The body deals with this demand by increasing the output of blood the heart pumps, which can happen in two ways: either by increasing the rate at which the blood is pumping (this explains why your heart rate jumps during exercise) or by increasing the amount of blood that’s pumping out of the left ventricle. The MET level is linked to the amount of oxygen the heart uses, which in turn depends on the heart rate and blood pressure. As such, the MET level is a useful indicator when determining the risk of a cardiac event, such as a stroke, in the next 10 years.

After a brief rest after their treadmill trial, the patients had to climb four flights of stairs (60 stairs) hastily without stopping, but not at a running pace. The time it took each patient to finish climbing the stairs was compared to their METs. Those who could climb the stairs in less than 45 seconds had METs between 9 and 10. Previously, studies showed that 10 METs during exercise are linked with a low mortality rate (less than 1% per year or 10% in 10 years). In contrast, those who took 1.5 minutes or longed to climb the stairs had less than 8 METs, which is associated with a mortality rate of 2% to 4% per year, or 30% in 10 years.

The researchers also scanned the patients’ hearts while they performed the treadmill test. These images showed if the heart worked normally during the exercise and whether or not there’s a likelihood of coronary artery disease. When the researchers compared these images to the step test results, they found that 58% of patients who took more than 1.5 minutes to climb the stairs had abnormal heart function. In contrast, just 32% of those who completed the stairs in less than a minute had abnormal heart function during the treadmill examination.

Previously, a 2018 study performed by the same authors that involved more than 12,000 participants who had to walk up three to four flights of stairs found those who couldn’t complete the task quickly enough had nearly three times the mortality rate from heart disease five years later than those who could.

The fact that a day-to-day activity, such as climbing stairs, can be so closely linked to results obtained from testing in a laboratory is pretty great news. It means we can also employ the step test mindfully and then visit a cardiologist if we catch ourselves short of breath or exhausted.

“The stairs test is an easy way to check your heart health,” said study author Dr. Jesús Peteiro, a cardiologist at University Hospital A Coruña, Spain. “If it takes you more than one-and-a-half minutes to ascend four flights of stairs, your health is suboptimal, and it would be a good idea to consult a doctor.”

“The idea was to find a simple and inexpensive method of assessing heart health,” said Dr. Peteiro. “This can help physicians triage patients for more extensive examinations.”

Heart disease is the leading cause of death for both men and women in the United States, with coronary heart disease being the most common type of heart disease. When coronary arteries cannot supply the necessary amount of blood to the heart due to the buildup of plaque, there is a high risk of heart failure and stroke.

The ESC recommends at least 150 minutes a week of moderate aerobic physical activity or 75 minutes a week of vigorous aerobic physical activity to strengthen the heart and lower the risk of heart disease.

As many as 1 in 5 COVID-19 patients experience life-threatening heart complications. Here’s why

Although COVID-19 is primarily a respiratory illness, the effects of the viral infection cascade into other organs, including the gastrointestinal tract, kidneys, liver, and heart.

A new study focused specifically on how COVID-19 can affect the heart, finding that cardiovascular-related complications are worrisome in a large percentage of patients.

Credit: Wikimedia Commons.

Cardiologists from across the world, from China to Italy to New York, have documented how many COVID-19 patients go on to develop heart problems, with many succumbing to cardiac arrest. As many as one in five COVID-19 patients develop cardiac damage, which can lead to heart failure and death.

But why is a respiratory virus having such a strong effect on the heart?

About half of all hospitalized coronavirus patients have at least one underlying chronic disease, the most common being cardiovascular disease. So far, data suggests that those with heart disease are potentially ten times more likely to die of the infection that patients without heart problems.

It’s rather unclear whether these heart problems are caused by the virus itself or a byproduct of the body’s immune reaction. Now, the new study authored by Chinese researchers attempts to dispel some of these confusions by how the coronavirus attacks the heart.

A complicated virus

After conducting a systematic review of COVID-19 hospitalized cases in China, the researchers found that the infection can damage heart tissue in three primary ways: directly infecting heart muscle, enhancing stress on already weakened cardiovascular systems, and inflammation.

Damage to the heart can trigger certain well known COVID-19 symptoms in critical cases, such as respiratory failure and hypoxemia (insufficient oxygen in the blood). As a consequence, patients can then experience arrhythmias, heart attacks, and cardiac arrest, the researchers wrote in the journal Frontiers in Cardiovascular Medicine.

The most dangerous outcome seems to be hyper-inflammation that can trigger cytokine storm — an immune system overreaction that can lead to organ failure.

“Inflammation plays an important role in the development and complications of cardiovascular diseases and we have seen that COVID-19 patients with greater signs of an inflammatory response are more likely to suffer serious cardiovascular events and are at greater risk of dying,” Professor Shuyang Zhang, lead author of this research from the Department of Cardiology at the Peking Union Medical College Hospital Beijing, China, said in a statement.

Zhang and colleagues also studied various cardiovascular anti-inflammatory therapies that are currently under clinical trials. But although there are some positive signs that drugs like hydroxychloroquine and azithromycin can improve cardiovascular outcomes, they can also go the other way, increasing the risk of cardiovascular impairment.

Therefore, the authors advise caution and warn against the use of pre-clinical drugs in a hospital setting for treating COVID-19 patients. More research is thus desperately needed to figure out what treatments have real potential.

“Considering that these drugs may be essential in the clinical management of COVID-19 patients, especially the anti-viral agents, cardiovascular protective strategies are urgently needed to improve the overall prognosis.”

“We hope our study provides useful information to the global community hoping to improve the clinical management of COVID-19 during this pandemic.”

In the meantime, patients with a known history of cardiovascular disease should exert extra caution. Impeccable hygiene and social distancing are paramount in this case.

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.”

Credit: Pixabay.

Viagra-like drug might be effective agaist heart failure

Credit: Pixabay.

Credit: Pixabay.

Sometimes drugs that are designed to treat a certain disease can unexpectedly work for other conditions as well. According to a new study from the University of Manchester, Tadalafil — a drug from the same class as the famous Viagra, which meant to treat erectile dysfunction — seems to slow or even reverse heart failure.

Heart failure is a chronic disease that requires lifelong management. It occurs when the heart is too weak to pump enough blood through the body. When cells aren’t supplied with enough oxygen and nutrient-rich blood, the body can’t function normally, resulting in fatigue, shortness of breath, and coughing. When the condition sets in, even mundane activities such as walking or climbing stairs can become difficult.

At first, the heart tries to compensate for its inadequate pumping rate in several ways, including enlarging, developing more muscle, pumping faster, narrowing the blood vessels, and diverting blood supply away from less important tissue. These measures only temporarily mask the problem since heart failure worsens in time until the compensation mechanisms no longer work. These measures also explain why it usually takes years for a patient to realize that their heart has stopped functioning properly. Often, the diagnosis comes too late — the disease has five-year survival rates lower than most common types of cancer.

Most treatments for heart failure are ineffective, which is why the new study from the University of Manchester is so exciting.

Human trials and epidemiological studies showed that Tadalafil, known by the brand name Cialis in the US, might effectively treat heart failure. Professor Andrew Trafford and colleagues performed a new study that investigated this relationship more closely. The team administered the drug to sheep with heart failure, whose condition was induced by pacemakers. Shortly after the first dose, the progression of the disease was stopped and, in some cases, the drug even managed to reverse the effects of heart failure. The dose received by the sheep was similar to the dose humans take in order to treat erectile dysfunction.

“This discovery is an important advance in a devastating condition which causes misery for thousands of people across the UK and beyond,” said Professor Trafford.

“This study provides further confirmation, adds mechanistic details and demonstrates that Tadalafil could now be a possible therapy for heart failure,” he added.

Tadalafil is known to block the activity of an enzyme called Phosphodiesterase 5 (PDE5S), whose role is to regulate how tissue responds to hormones like adrenaline. Trafford and colleagues found that in sheep affected by heart failure, the drug triggers a cascade of chemical reactions that restores the heart’s ability to respond to adrenaline. For instance, breathlessness due to heart failure is caused by the inability of the heart to respond to adrenaline and this symptom disappeared in the sheep that were given Tadalafil.

The drug also increased the heart’s ability to pump blood around the body. However, despite the promising results, the researchers advise people that they shouldn’t self-medicate and ought to always consult with their doctors before taking new medication.

“Viagra-type drugs were initially developed as potential treatments for heart disease before they were found to have unexpected benefits in the treatment of erectile dysfunction. We seem to have gone full-circle, with findings from recent studies suggesting that they may be effective in the treatment of some forms of heart disease—in this case, heart failure,” said Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation.

The findings appeared in the journal Scientific Reports.

Just one daily sugary drink is enough to dramatically increase your risk of premature death

Hopefully, most people are aware that sugary drinks such as soda or energy drinks aren’t exactly healthy — to put it lightly. However, a new study suggests that consuming even a single sugary drink a day can dramatically increase a person’s risk of premature death from heart disease. The risk was especially pronounced for women.

Credit: Pixabay.

Researchers at the Harvard T. H. Chan School of Public Health analyzed two datasets of 80,647 women and 37,717 men working in the healthcare sector, running from 1980 to 2014. Every two years, each participant had to answer a series of questionnaires that evaluated their lifestyle and health.

After adjusting for diet and other lifestyle factors, the researchers found that the more sugary drinks a person consumes during a given time frame, the higher the risk of an early grave.

Compared to those who drank a sugary drink once per month, individuals who consumed one to four sugary drinks per month had a 1% increased risk of premature death. However, the risk jumped dramatically with just a few added drinks. Those who drank two to six sugary beverages per week had a 6% increase, one to two a day saw a 14% increase, while two or more drinks led to a 21% increase.

The risk was even worse for early death from cardiovascular disease (CVD). Those who drank two or more sugary drinks a day had a 31% higher risk of early death from cardiovascular disease. Each additional serving was linked with a 10% increased higher risk of CVD-related death.

“Our results provide further support to limit intake of sugar-sweetened beverages (SSBs) and to replace them with other beverages, preferably water, to improve overall health and longevity,” said Vasanti Malik, research scientist in the Department of Nutrition and lead author of the study.

Previously, studies showed that sugary drinks — such as soft drinks, fruit drinks, energy drinks, and sports drinks — are the single largest source of added sugar in Americans’ diet. Although doctors recommend consuming no more than 10% of daily calories from added sugars, many people overindulge. Sugary drink intake is especially growing in developing countries as more and more people move to cities and due to aggressive beverage marketing.

“These findings are consistent with the known adverse effects of high sugar intake on metabolic risk factors and the strong evidence that drinking sugar-sweetened beverages increases the risk of type 2 diabetes, itself a major risk factor for premature death. The results also provide further support for policies to limit marketing of sugary beverages to children and adolescents and for implementing soda taxes because the current price of sugary beverages does not include the high costs of treating the consequences,” Walter Willett, a Harvard professor of epidemiology and nutrition, said in a statement.

The researchers also looked at the risks of consuming artificially sweetened beverages, finding that replacing soda with diet soda was linked to a lower risk of premature death. This may be due to the “reverse causation” effect — that is, the people may have switched to diet drinks because of their existing heart disease risks. But that’s not to say that artificially sweetened beverages are totally safe. Intaking more than 4 diet sodas a day was associated with a higher risk of mortality among women. Previously, researchers from the Albert Einstein College of Medicine in New York found that women over the age of 50 who consumed two or more artificially sweetened diet beverages were 31% more likely to have a clot-based stroke and 29% more likely to have heart disease.

The findings appeared in the journal Circulation.

Two or more diet sodas a day may increase risk of stroke

A comprehensive study of women over 50 shows that dieting done wrong can lead to unwanted healthy outcomes. Drinking two or more Diet Cokes a day was associated with a 16% increase in the risk of early death, researchers reported.

Although many well-intended people use low-calorie sweetened drinks to lose weight, this may put their health at risk. According to the researchers, such beverages are associated with a higher risk for stroke and heart disease.

The research team, led by Dr. Yasmin Mossavar-Rahmani from the Albert Einstein College of Medicine in the Bronx, New York, analyzed data on 81,714 post-menopausal women, whose average age was 50 to 79 at the start of the study. The participants were tracked for an average of 12 years.

Women who consumed two or more artificially sweetened diet beverages were 31% more likely to have a clot-based stroke and 29% more likely to have heart disease. Among the participants, African-American women formed the most vulnerable group.

“Many well-meaning people, especially those who are overweight or obese, drink low-calorie sweetened drinks to cut calories in their diet. Our research and other observational studies have shown that artificially sweetened beverages may not be harmless and high consumption is associated with a higher risk of stroke and heart disease,” said Mossavar-Rahmani.

The study, performed by the American Heart Association and American Stroke Association, was observational, meaning that the researchers could not directly prove that sweetened drinks cause stroke and heart problems through a causal link. We also don’t yet know which artificial sweeteners may be harmful and which may be harmless. Previously, studies established a link between diet beverages and stroke, dementia, Type 2 diabetes, obesity, and metabolic syndrome, suggesting that zero-calorie drink may be just as bad as sugary ones. A 2017 study found that diet soda might even hurt the brain.

“Unfortunately, current research simply does not provide enough evidence to distinguish between the effects of different low-calorie sweeteners on heart and brain health. This study adds to the evidence that limiting use of diet beverages is the most prudent thing to do for your health,” said Rachel K. Johnson, Ph.D., R.D., professor of nutrition emeritus

There is still much research to be done in order to investigate the effects of low-calorie sweetened beverages on our health. In the meantime, evidence so far suggests that the most prudent thing to do is to avoid them. Perhaps the best choice for a non-calorie drink is water.

The findings were reported in the journal Stroke

Most Americans aren’t really healthy, study finds

A study which analyzed data from 1988 to 2014 found that most Americans have suboptimal health.

Unfortunately, there’s not much reason for optimism from this study.

Researchers from the UCLA and the University of Washington scrutinized data from the National Health and Nutrition Examination Survey (NHANES) to assess the cardiovascular health of Americans, as well as disparities by race, ethnicity, and nativity (foreign-born vs U.S.-born). The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. In this study, researchers assessed the participants’ overall cardiovascular health from seven parameters: blood pressure, cholesterol, hemoglobin A1c, body mass index, physical activity, diet, and smoking.

They found that overall, less than half of Americans over 25 can boast optimal health: 40 percent for whites, 25 percent for Mexican Americans, and 15 percent for African Americans. Interestingly, although there is still a large disparity between whites and non-whites, the disparity has decreased in time, largely because whites have become less healthy — not because other ethnicities have become healthier.

So, as George A. Mensah, MD, from the National Institutes of Health (NIH), points out in an accompanying editorial, the narrowing of disparities is no cause for celebration. Mensah suggests that the cardiovascular health and prevention and control of related risk factors should be a key focus for the NIH.

According to the CDC, every year, 735,000 Americans have a heart attack — and 610,000 people die of heart diseases. Heart diseases are the leading cause of death for most people in the United States, including African Americans, Hispanics, and whites — only for American Indians or Alaska Natives and Asians or Pacific Islanders, heart disease is second to cancer.

The best way to improve overall health and reduce the risk of cardiovascular disease is through a healthy diet and regular exercise. Studies have shown that as little as 15 minutes of exercise per day can do wonders for your body, though logging a bit more is better.

In terms of nutrition, it’s not about following a strict diet — just reducing the level of baked foods (especially chips, biscuits, and cakes), processed foods, and red meat (pork, beef, and lamb), and replacing them with healthy fruits, vegetables, and legumes, can do wonders for your heart, as well as your waistline.

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

Buy art not cocaine.

Scientists successfully undo cocaine-induced cardiovascular damage in mice

Researchers at the Miller School of Medicine, University of Miami, discovered a potential new pathway to treat the devastating effect of cocaine on the cardiovascular system. They found out that excess levels of reactive oxygen species (ROS), molecules known to be found in the aortas of hypertensive animals and humans, are also involved in cocaine-related cardiovascular disease.

Buy art not cocaine.

Image credits Dave O / Flickr.

ROS are a type of unstable molecules that contain oxygen and rapidly react with other chemical molecules in a cell. An excess of reactive oxygen species inside cells may cause DNA, RNA, and protein damage, and can lead to cell death.

Scientists discovered that cocaine activates the molecule microRNA (miR)-30c-5p, increasing ROS levels in the circulatory system. The team also found that by blocking the activation of miR-30c-5p, they could dramatically reduce damage to the cardiovascular system.

“The biggest surprise to us was that the modulation of a single miRNA-mRNA pathway could have such a profound effect on cardiovascular function,” says Chunming Dong, M.D., study senior author and professor of medicine at the University of Miami.

“This also suggests that targeting this one pathway may have significant therapeutic benefit, which is an exciting possibility.”

The team performed their research using mice. They injected the animals with cocaine and assessed their circulatory health: the mice had high blood pressure, excess levels of ROS, and stiff blood vessels. All these are markers of cardiovascular disease. Researchers also observed a buildup in the miR-30c-5p molecule. When scientists administered cocaine but treated the mice with antioxidants, they managed to inhibit the excessive accumulation of miR-30c-5p and the mice showed no changes in blood pressure, vessel elasticity, or ROS levels.

Doctor Dong says that this is the first study to identify the role of miR-30c-5p in cocaine-related cardiovascular disease. He also notes that the study has some limitations due to the fact that the experiments were only conducted on mice. His research team plans to examine human patients as well, to see if this targeted pathway is viable.

The paper was published in the journal Hypertension, on February 26, 2018.

Valentine’s Day Special: The Broken Heart Syndrome

Via Pixabay/dimitriwittmann

I guess every one of us has an idea of what a broken heart feels like. The loneliness, the confusion, the anger and despair, and the chronic feeling of emptiness, are all states our society is already used to. Maybe the fast-paced rhythm of our lives, our focus on careers, jobs and financial independence has diminished our love interests. Or, maybe we have just become more superficial due to fast hook-ups on the internet. Maybe we forgot how to love, or maybe we are just not willing to risk our emotional wellbeing by allowing someone to become part of our lives.

Maybe our standards are too high, maybe we expect too much of someone and give almost nothing in return, or maybe we feel entitled to live a fairytale love story and end up not making any effort to really get to know and fully accept another human being at our side.

Or, maybe we are afraid of being abandoned or rejected by someone we have feelings for — all of us being caught up in this neverending, absurd, non-realistic partner chasing.

But when we do break down our ice-cold walls, when we accept another fellow human to enter our hearts, when we easily sacrifice our needs for someone else’s, we learn to love. And there is nothing more beautiful and fulfilling than love.

But there is an unforeseen disadvantage to it, and that is called the broken heart syndrome.

First described in Japan in the ’90s, this curious condition is not yet fully understood. What scientists know is that it’s triggered by powerful emotional and physical stressors and it affects the heart muscle, which loses the ability to contract normally.

The disease is known by many names: stress cardiomyopathy, Takotsubo cardiomyopathy (from the Japanese word takotsubo –“octopus trap,” because the left ventricle takes on a shape resembling a fishing pot), or apical ballooning syndrome. 

Even though it was first described in men in Japan, the condition affects almost exclusively women (90%) past the age of 60. Menopause is thought to be a serious risk, estrogen levels dropping significantly during this period. Research shows that up to 5% of women evaluated for heart attacks actually have this disorder. Studies carried out on rats whose ovaries had been removed, showed that the ones given estrogen while under stress had less left-ventricle dysfunction and higher levels of some heart protective-substances.

Doctors think that high levels of stress hormones (for example, adrenaline) affect the heart, triggering alterations in heart muscle cells or coronary blood vessels (or both) that prevent the left ventricle from contracting effectively. The symptoms perfectly mimic a heart attack.

Luckily, most cases have a full recovery but there are some fatal ones.

Its love-linked reputation is also real. The death of a loved one, love quarrels, domestic violence, divorces, even break-ups, have been reported as emotional stressors. Other stressful events, as anxiety, public speaking, financial loss, illnesses or accidents, severe pain or even surprise birthday parties have been identified as triggers.

I don’t know if we’ll all be so lucky as to find our one true love, or if this concept really exists, but I think broken heart syndrome can also be a metaphor for the fragility of the human soul.

Shift work

Working graveyard shifts puts your heart at risk

Studies have time and time again shown sleep deprivation puts people at various health risks, from heart disease to diabetes. Those who work odd hours in shifts are the most vulnerable, concludes a study which followed people who slept very little.

Shift work

Credit: Pixabay

Researchers at the University of Chicago enlisted 26 healthy, young adults and divided them into two groups. Participants from both groups were allowed to sleep for only five hours each day for a whole week. The differences between the two being one half had to sleep during normal nighttime hours, while the other half slept during the day mimicking the sleep patterns of shift works.

During this whole time, the researchers measured the participants’ blood pressure, heart rate variability and norepinephrine, a stress hormone that’s a marker for high blood pressure.

Though sleep deprivation has been linked to hypertension by previous studies, this wasn’t the case here. Hypertension likely would have been seen in participants if the study period lasted more.

Everyone, however, experienced heightened heart rate during the day, with those who slept during the day most seeing the highest rate. The group that slept during the day also had higher levels of norepinephrine and less heart rate variability at night when they were awake. Reduced heart variability is linked with cardiovascular risk.

The most worrisome trend was seen during the slow-wave sleep, a phase where the body’s restoration occurs. During this phase, blood pressure and heart rate go down, allowing the body to recover, but the study showed sleep restriction actually increased the heart rate during this critical phase.

Study’s lead researcher Dr. Daniela Grimaldi says because sleep-wake and feeding cycles are not in coordination with the internal clock, shift workers might not fully benefit from the restorative cardiovascular effects of nighttime sleep.

The obvious solution is to get a day time job, but if this isn’t an option researchers advise shift workers eat healthy, exercise more often and sleep more, even if it’s at day time.

air pollution

Decade-long study shows how air pollution is killing you

A decade-long study of thousands of Americans has found direct evidence of how air pollution causes heart disease. The link between the two has been established a long time ago, but it’s only now that the biological mechanisms have been explained thoroughly.

air pollution

Credit: Pixabay

The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) followed 6,000 Americans living in six states over ten years. For each participant, researchers calculated the exposure to particle matter that is less than 2.5 microns (PM 2.5), as well as nitrogen oxide, nitrogen dioxide and soot. The calculations were based on air pollution measurements taken in the participants’ communities, as well as directly at their homes.

Then, each participant underwent regular CT scans between 200 and 2012 to determine the amount of calcium deposits in their arteries.

PM 2.5 is small that you can’t see it with the naked eye, but when bulked these create haze — the main cause of reduced visibility in the United States. Being so small, the particles also easily enter the body, ending up in the lungs and even the bloodstream. Nitrogen dioxide inflames the lining of the lungs, and it can reduce immunity to lung infections.

The study found that for every 5 µg/m3 higher concentration of PM2.5 or 35 parts per billion higher concentration of oxides of nitrogen, participants had a 4 Agatston units/year faster rate of progression of coronary artery calcium scores. An Agatston score of 0 is normal (little risk of heart disease in the next 3 to 5 years), but “in this population, coronary calcium increased on average by 24 Agatston units per year (SD 58), and intima-media thickness by 12 μm per year (10), before adjusting for risk factors or air pollutant exposures,” the researchers noted. Eventually, this leads to hardened arteries causing atherosclerosis, which in turn causes heart attacks.

“The study provides important new information on how pollution affects the main biological process that leads to heart disease,” said Dr. Joel Kaufman, the lead author of the paper published in The Lancet.

“The evidence supports worldwide efforts to reduce exposures to ambient air pollutants,” Kaufman said.

“This was the most in-depth study of air pollution exposures ever applied to a large study group specifically designed to examine influences on cardiovascular health,” he added.

Previously, ZME Science reported air pollution is responsible 3.3 million premature deaths worldwide.

  • About 6 percent of all global deaths each year occur prematurely due to exposure to ambient air pollution. That’s higher than previously estimated not 10 years ago.
  • In 2050, 6.6 million people are projected to die prematurely from air pollution.
  • Air pollution kills more than HIV and malaria combined.
  • China has the most air pollution fatalities numbering 1.4 million, followed by India with 645,000 and Pakistan with 110,000.
  • In the US (2010), 54,905 fatalities were accounted to smog and soot. This ranks the country 7th on the air pollution fatality list.
  • For industrial nations, farming takes a surprisingly large share of the soot and smog pollution. For instance, in the US, agriculture caused 16,221 of those deaths, second only to 16,929 deaths blamed on power plants. But in  Europe, Russia, Japan and South Korea, agriculture was found to be the prime cause of the soot and smog deaths.

Your hand shake is an indicator of your heart’s health

You can find out a lot about a man by his handshake – about his personality, his feelings towards you, or… his heart health. According to a new Canadian study, a firm handshake is a reliable indicator of good health; they actually want to use handshake tests as initial ways to gauge the risk of heart attack and stroke.

Image via MorgueFile.

 

The study analyzed 140,000 patients aged between 35 and 70 in 17 countries, monitoring their health over 4 years. The first thing they noticed was a national variation in grip strength – Swedes have the firmest handshakes, while Pakistanis have the limpest. They then established a baseline; the average grip strength was 300 newtons, the force it takes to lift 30.6 kgs off the ground. Every 50­-newton drop below this was associated with a 16 per cent rise in the mortality risk, and in particular, a 17 percent risk of mortality risk associated with heart disease. In other words, the limper your hand shake tends to be, the more likely you are to suffer heart issues.

Does that mean that Swedes for example have much better hearts than Pakistanis? Well, I couldn’t find any data to directly back up that idea, but overall stroke rates have declined sharply in Sweden over the past 25 years, as have the dangers associated with strokes. Meanwhile, the Pakistani population has one of the highest risks of coronary heart disease (CHD) in the world. So for those two extremes, statistical data seems to back up this study.

Scientists actually believe that handshakes can be used as inexpensive methods of identifying someone’s risk of a heart disease. Of course, this is nowhere near as accurate as an actual test, but it seems to be a very good indicator.

“Doctors or other healthcare professionals can measure grip strength to identify patients with major illnesses such as heart failure who are at particularly high risk of dying from their illness,” said Darryl Leong, an assistant professor of medicine at McMaster University in Hamilton, Ontario, who led the investigation.

But the handshakes have to be corrected for several factors, including size, weight, muscular mass and ethnicity. More research is also needed to understand exactly why this correlation happens – it’s clearly connected to the blood supply to the hand muscles, but the exact mechanism is still somewhat a mystery.

tall and short people

Shorter people are more likely to get heart disease – every inch counts

The same genes that are responsible for height have been linked to heart disease as well, according to British researchers who found shorter people are at a greater risk. For every 2.5 inch difference in height, the chance of contracting a heart disease increases by 13.5 percent. In other words, a 5-foot-tall person has an average 32 percent higher risk of heart disease than a person who’s 5-foot 6-inches tall, according to the researchers.

tall and short people

Credit: Pixgood

The team made in-depth genetic analyses of 18,000 people and identified a number of genes that play a role in human growth and development. Some of these, however, are linked with heart disease. This is something that has long been presumed, but only now confirmed with tantalizing evidence.

“We found that people who carry those genetic variants that lower your height and make you shorter are more likely to develop coronary heart disease,” said Dr. Nilesh Samani, a professor of cardiology and head of the department of cardiovascular sciences at the University of Leicester in England.

Yet, while they’ve found an association, the exact cause and effect relationship has yet to be identified. Doctors are now speculating what might be happening. It may be the case that some of these genes are affecting the growth of   cells in the artery walls and the heart, making them more prone to clogging ( atherosclerosis). Other genes appear to be linked to inflammation in the body, which is another risk factor for heart disease, Dr. Ronald Krauss, director of atherosclerosis research at Children’s Hospital Oakland Research Institute in California who was not involved in the study.

Interestingly, the effect of height on heart disease risk may be gender-specific. “We found a clear-cut effect in men, but we didn’t see a clear-cut effect in women,” Samani said, adding that significantly fewer women in the study could have affected the statistics which appeared in the New England Journal of Medicine.

Rural-area-51169eccc4674_hires

Heart Disease affects Urban and Rural Dwellers Alike

According to a study from Women’s College Hospital and the Institute for Clinical Evaluative Sciences (ICES), Canada, it doesn’t matter whether you live in a rural or urban setting when it comes to heart disease – the risk if the same for both environments. The general consensus is that those living in rural areas are at a disadvantage as far as heart disease treatment is concerned, since they have less access to specialized facilities and turn out less regularly for checkups. The findings, however, show once a patient leaves the hospital their overall health outcomes are similar regardless of where they live.

No difference in heart disease prevalence between urban and rural

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Credit: pxleyes.com

Heart disease, such as coronary heart disease, heart attack, congestive heart failure, and congenital heart disease, is the leading cause of death for men and women in the U.S.  The most common cause of heart disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself. This is called coronary artery disease and happens slowly over time and it’s the major reason people have heart attacks.

[AMAZING] Pig heart grafted to baboon abdomen survives for more than a year

The researchers  examined the records of more than 38,000 people with chronic ischemic heart disease living in either urban or rural areas. The key behavioral differences when it comes to heart disease between the two demographics, as identified by the researchers, were that rural people:

  • Had fewer specialist visits
  • Visited hospital emergency departments more frequently for care
  • Were prescribed statins less often
  • Were tested less frequently for cholesterol and blood sugar levels
  • Experienced a similar risk of hospitalization and death

Despite this discrepancy in access to health care facilities, this did not affect any of the two groups significantly, as reported in the journal Circulation: Cardiovascular Quality and Outcomes.

“From our study, we know that people with heart disease in rural areas tend to rely heavily on emergency departments for their care because of a lack of outpatient access to family doctors and specialists,” said Dr. Bhatia, also a scientist at ICES. “Yet, despite an increase in emergency department admissions in rural areas, we didn’t see worse health outcomes for these individuals.”

You can help reduce your risk of heart disease by taking steps to control factors that put you at greater risk:

  • Control your blood pressure
  • Lower your cholesterol
  • Don’t smoke
  • Get enough exercise

Healthy habits dramatically reduce risk of dementia, diabetes and heart disease

A study which monitored the health habits of 2,235 men over a 35-year period has found that exercise significantly reduces the risk of dementia.

It may seem like common sense, but it can never be emphasized too much: a healthy lifestyle ensures a longer… healthier life – it’s basically as simple as that. Published by researchers from Cardiff University, the study is the longest of its kind to probe the influence of environmental factors in chronic disease. They found 5 major behaviors that are crucial to a disease-free lifestyle: taking regular exercise, non-smoking, a low bodyweight, a healthy diet and a low alcohol intake.

As the picture says, the people who follow at least 4 of these 5 behaviors experienced a 60 per cent decline in dementia and cognitive decline – with exercise being the strongest mitigating factor. Exercise alone ensures a 70% percent decline in diabetes and heart diseases.

“The size of reduction in the instance of disease owing to these simple healthy steps has really amazed us and is of enormous importance in an aging population,” said Principle Investigator Professor Peter Elwood from Cardiff University’s School of Medicine. “What the research shows is that following a healthy lifestyle confers surprisingly large benefits to health – healthy behaviours have a far more beneficial effect than any medical treatment or preventative procedure.

“Taking up and following a healthy lifestyle is however the responsibility of the individual him or herself. Sadly, the evidence from this study shows that very few people follow a fully healthy lifestyle. Furthermore, our findings reveal that while the number of people who smoke has gone down since the study started, the number of people leading a fully healthy lifestyle has not changed,” he added.

However, the survey they carried in Wales showed that less than one per cent of people in Wales follow a completely healthy lifestyle; on the other end of the spectrum, five percent of them follow none of these healthy habits – pretty worrying figures. Professor Elwood continued, explaining what a huge impact positive changes could have:

“If the men had been urged to adopt just one additional healthy behaviour at the start of the study 35 years ago, and if only half of them complied, then during the ensuing 35 years there would have been a 13 per cent reduction in dementia, a 12 per cent drop in diabetes, six per cent less vascular disease and a five per cent reduction in deaths.”

Just to make it clear – studies such as this one are not redundant. As I already said, people need to be shown, as much as possible, that a healthy lifestyle is incredibly important and can never be understated. There are so many things that we used to take for granted as a “normal part of aging” – now we know that things don’t necessarily have to be that way.

Christopher Allen, Senior Cardiac Nurse at the British Heart Foundation, which part-funded the study, said:

“The results of this study overwhelmingly support the notion that adopting a healthy lifestyle reduces your risk of cardiovascular disease and dementia. These findings will hopefully go a long way in encouraging people to carefully consider their lifestyle and how it will impact on their health in later years.”

Via Cardiff University.