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Heart health: Are women getting incorrect treatment?

Recent research suggests that ignoring sex-specific risk factors of heart disease has resulted in women having a higher risk of dying from heart failure than men.

Two women having funShare on PinterestDifferences between men and women may mean that the latter do not receive the right treatment for heart conditions.

A review published in Nature Medicine reveals an alarming failure to successfully treat cardiometabolic disorders, such as diabetes, heart disease, and stroke, in women.

The authors urge health services to consider the biological differences between men and women when treating heart disease.

The review, by Prof. Eva Gerdts, of the University of Bergen, in Norway, and Prof. Vera Regitz-Zagrosek, of the Charité Universitätsmedizin Berlin, in Germany, compares the common risk factors for both sexes.

"Men and women have different biologies, and this results in different types of the same heart diseases. It is about time to recognize these differences."Prof. Eva GerdtsThe authors summarize the results of over 18 major studies that have explored the causal factors of heart disease in each sex.The overwhelming finding was that women are more at risk of receiving the wrong treatment because health service professionals fail to spot symptoms or risk factors that are unique to women.Obesity at the heart of itRecent research has substantiated fears that the global rise in cardiometabolic disorders is linked to obesity. Meanwhile, fresh evidence suggests that obesity and associated damage to the heart occur differently in men and women.Global figures show that obesity in women is on the rise, and as Prof. Gerdts' review explains, women store fat differently from men. The mechanisms behind this process combine to create an increased risk of type 2 diabetes and heart disease."If we see this from a life span perspective, we can see that obesity increases with age and that this trend is greater for women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease," explains Prof. Gerdts.The estrogen advantageThe hormone estrogen works to impede metabolic syndrome by preventing connective tissue from forming in the heart. This also helps keep blood pressure stable.But the decrease in estrogen that occurs during menopause can increase the risk of arterial stiffening and subsequent disease. This helps explain an increase in hypertension among women over 60. In men, meanwhile, hypertension is more common before the age of 60.Lifestyle risks increase with ageSocioeconomic status and lifestyle factors also play a role in cardiovascular risk discrepancies.The researchers highlight the fact that, around the world, women are more likely to experience low levels of education, low income, and joblessness, and that studies have associated each of these factors with diabetes and depression — two major contributing factors for heart disease.Meanwhile, the adverse effects of unhealthful habits, such as smoking — which is on the rise in women — multiply as we age. This can lead to high blood pressure, which can cause heart failure if a person does not receive treatment. "For women, the effects of risk factors such as smoking, obesity, and high blood pressure increase after menopause," says Prof. Gerdts. What can we do?Prof. Gerdts hopes to incite action among the medical community; she calls for healthcare providers to place more emphasis on sex differences when treating cardiometabolic disorders."Heart disease remains among the most common cause of death and reduced quality of life in women. Medically speaking, we still do not know what the best treatment for heart attack or [heart] failure is in many women. It is an unacceptable situation."Prof. Eva GerdtsThe present study highlights an imbalance in available research, in an effort to pave the way for further work.The outlook is promising if we consider that cardiac arrest — which is more common in men — is now treatable and preventable. If the same resources and research were applied to the factors that put women at risk of heart failure, perhaps similarly effective interventions could be developed in the near future.In the meantime, it is important for healthcare providers to help women in high-risk groups lower their blood pressure, reduce the risk or effects of obesity, and put quitting smoking at the top of their list of 2020 goals, if necessary.
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Best supplements for lowering blood pressure

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High blood pressure is a common issue. A person can reduce their blood pressure by following a healthful diet, exercising, and avoiding smoking. Can taking dietary supplements, including vitamins, minerals, or herbs, also help?

According to the American Heart Association (AHA), nearly half of all adults in the United States have high blood pressure, also called hypertension.

Having hypertension increases a person's risk of heart failure, heart attacks, and strokes.

Leading a healthful lifestyle can reduce blood pressure. This includes eating a healthful, low-salt diet, getting regular exercise, maintaining a healthy weight, not smoking, and limiting the intake of alcohol. For some people, doctors also recommend medication that lowers blood pressure.

According to some sources, natural treatments and dietary supplements can help reduce hypertension. Do these supplements work, and are they safe?

In this article, we investigate the research into supplements for lowering blood pressure, exploring their effectiveness, risks, and alternatives.

a woman in a shop looking for the Best supplements for lowering blood pressureShare on PinterestA person should talk to their doctor before taking supplements to lower blood pressure.

Some evidence suggests that certain supplements could help lower blood pressure. However, most of the relevant studies have been of low quality or included small sample sizes.

Doctors do not routinely recommend supplements for hypertension. According to the AHA, "There are no special pills, vitamins, or drinks that can substitute for prescription medications and lifestyle modifications."

The AHA recommend talking to a doctor before taking any supplement to lower blood pressure because supplements may not work as advertised, and some can raise blood pressure.

The following sections look at the evidence behind some common supplements that people take to reduce high blood pressure.

Potassium is a mineral that plays a key role in regulating blood pressure. When too much salt, or sodium, in food increases a person's blood pressure, potassium clears the sodium from the body.Sodium causes high blood pressure because it stops the kidneys from removing water from the body efficiently. Carrying excess water leads to a hike in blood pressure.Potassium helps reduce blood pressure in two ways:by causing the body to get rid of more sodium in the urineby relaxing the walls of blood vesselsAuthors of a 2017 review of studies report that potassium supplements could help decrease both systolic and diastolic blood pressure.The effect was strongest in people who had high-sodium diets, people who had a low intake of potassium before the study, and people who were not taking blood pressure medication.However, potassium supplements can be harmful for people with kidney disorders. As with any supplement, it is a good idea to consult a doctor before trying a potassium supplement.The AHA do recommend eating high-potassium foods to help manage blood pressure. These include:dried apricotsspinachtomatoesavocadosmushroomsprunes or prune juicefat-free or low-fat yogurt or milkMagnesium is another mineral that plays an important role in regulating blood pressure. It supports many processes in the body, including muscle and nerve function, the immune system, and protein synthesis.Authors of a 2016 review conclude, after having analyzed the results of 34 trials, that magnesium supplements can reduce blood pressure. They say that taking 300 milligrams (mg) of magnesium per day for 1 month may increase magnesium levels enough to lower high blood pressure.The recommended dietary allowance of magnesium for adults is 310–420 mg.According to the Office of Dietary Supplements (ODS), a diet rich in magnesium may also reduce the risk of stroke, heart disease, and type 2 diabetes.Foods rich in magnesium include:almondsspinachcashewspeanutsblack beansavocadospotatoesbrown ricefat-free or low-fat yogurtDietary fiber is important for keeping the heart and gut healthy. Eating enough dietary fiber can help lower:cholesterol levelsblood pressurethe risk of cardiovascular diseaseA 2018 review reports that some dietary fiber supplements may lower both diastolic and systolic blood pressure. A 2005 review suggests that supplementing the diet with about 12 grams of fiber per day could help reduce blood pressure by a small amount.The Food and Drug Administration (FDA) recommend consuming 25 grams of fiber per day and note that most people in the U.S. do not eat this amount.Adding plenty of healthful high-fiber foods to the diet can help, and fiber supplements can be a good alternative.High blood pressure can be particularly harmful during pregnancy, when doctors call it gestational hypertension. If a woman does not receive treatment for this issue, it can lead to complications such as preeclampsia, stroke, preterm delivery, and low birth weight.A 2018 study found that taking supplements containing folic acid lessened the risk of gestational hypertension and preeclampsia.Folic acid is a B vitamin, and getting enough of this vitamin during pregnancy can help prevent birth abnormalities. The Centers for Disease Control and Prevention (CDC) recommend that women who may become pregnant take 400 micrograms of folic acid per day.Many prenatal vitamins contain folic acid, which is also available as a standalone supplement.In people who are not pregnant, researchers have yet to determine whether folic acid has any effect on high blood pressure.Coenzyme Q10 (CoQ10) is a natural substance that occurs in the body and plays an important role in cell chemistry. It helps the cells produce energy.Some scientists believe that this supplement can reduce blood pressure by acting as an antioxidant and preventing fatty deposits from forming in the arteries.However, according to the ODS, "The small amount of evidence currently available suggests that CoQ10 probably doesn't have a meaningful effect on blood pressure." Also, the organization notes, research into the benefits for heart disease has been inconclusive.A 2016 Cochrane review found that taking CoQ10 supplements did not significantly affect blood pressure, compared with placebo. The researchers conclude that definitively determining the effects will require further well-conducted studies.According to the National Center for Complementary and Integrative Health, several other supplements may help lower blood pressure, including:cocoagarlicflaxseedgreen or black teaprobioticsroselle (Hibiscus sabdariffa)fish oil, or others that include omega-3 fatty acidsThe authors note, however, that evidence for the effects of these supplements is limited, and they may lower blood pressure only slightly, if at all.People should be wary of any claim that a supplement can significantly lower high blood pressure.Supplements are not regulated by the FDA, and their quality and contents can vary.Speak to a doctor before taking any dietary supplement. Some can have adverse effects and may interact with medications, including those for high blood pressure.A doctor can advise about possible benefits and side effects, and they may recommend a more reliable brand.A person with hypertension will benefit from avoiding substances that can raise blood pressure, including:alcoholcaffeineoral contraceptivesnonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofensystemic corticosteroidsantidepressantssome antipsychoticsIn most cases, high blood pressure is preventable and controllable. People can often manage their blood pressure by:consuming less sodiumeating less fat, especially saturated fathaving a diet rich in fresh fruits and vegetablesstaying physically activeavoiding smokingtreating sleep apnea, if presentIf these changes are not enough, a doctor may recommend taking medication that will help reduce high blood pressure.Learn more about natural ways to lower blood pressure here.High blood pressure is a common issue. Some scientific evidence suggests that certain supplements, including potassium, magnesium, and folic acid, could lower blood pressure.However, official organizations recommend lifestyle changes and, when appropriate, antihypertension medication instead.Talk to a doctor before taking any nutritional supplements.SHOP FOR SUPPLEMENTSThe supplements in this article are available to purchase over the counter. People can choose from a range of products in drug stores, health stores, and online. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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Study sets blood pressure target for people over 80

Lowering an older person's systolic blood pressure to 120 mmHg or lower reduces the risk of heart disease, but increases the chance of kidney changes.

doctor taking blood pressureShare on PinterestOlder adults may need different guidelines for maintaining healthy blood pressure, new research suggests.

In the United States, over half of the people aged 60 and over have high blood pressure, or hypertension, and maintaining one's blood pressure at healthy levels can be crucial.

The American College of Cardiology and American Heart Association (ACC/AHA) guidelines recommend a systolic blood pressure of no higher than 130 milligrams of mercury (mmHg) for those over 65.

However, by the time many people reach 85 years old, they have developed health issues. The U.S. Department of Commerce estimate that by 2050, 10% of adults in the U.S. will be 85 or older. A team of researchers has now completed an exploration of blood pressure recommendations for these individuals.

Their study appears in the Journal of the American Geriatrics Society.Using the SPRINT study for new guidelinesThe study's findings come from a randomized trial of 1,167 participants.Researchers gathered information from the Systolic Blood Pressure Intervention Trial (SPRINT). They included data from individuals who had experienced strokes, heart attacks, changes in kidney function, cognitive impairment, quality of life reduction, or who had died.About 27% of them had a history of heart disease. The majority had three or more chronic health conditions.The mean age of the participants was 84, with about 3% older than 90. More than half of those included were regularly taking five or more medications.The average baseline systolic blood pressure of the participants was approximately 142 mmHg. The researchers randomly divided the participants into two equal groups, with one group receiving assistance in getting their systolic readings below 140 mmHg.The researchers sought to determine if a more aggressive control of high blood pressure would benefit people's health, lower their risk of heart disease events, cognitive decline, or death, or increase health risks in any way.The scientists were also interested in seeing if cognitive or physical impairments would affect the benefits of any lower systolic measurement.To these ends, the second group received what researchers considered "intensive" treatment to bring their systolic reading down below 120 mmHg.What the study foundThe group who had achieved systolic levels of 120 mmHg or less did see a lowered risk of heart disease events, and a lower likelihood of mild cognitive impairment.The development of dementia was about the same in both groups.People in the 120 mmHg group also saw an increased incidence of non-major, but still significant, changes to their kidney function, including hospitalizations for kidney damage. However, most people recovered.The researchers were also concerned about the potential for falls due to very low blood pressure. Falls often lead to complications in the elderly that can be fatal. However, results showed that this level of blood pressure did not increase a person's chances of falling.The researchers also looked at the benefits of intensive blood pressure control according to each participant's level of cognitive function at the start of the trial.Those with stronger cognitive function to begin with experienced a greater reduction in the risk of heart disease and death.Although those with impaired function did not gain as much benefit, there was no indication that the lower systolic level increased their risk of heart disease or death.A mixed resultThe complexities of healthcare in older adults often involve the acceptance of risk, with doctors and patients seeking a benefit vs. risk balance to determine the best course of treatment.This study identifies a situation in which reducing the chance of heart disease or impaired cognitive function may well outweigh the increased risk of changes to kidney function.
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Marathon running may reverse a risky part of the aging process

People have long been aware of the benefits of exercise. Now, a new study finds that one particular aspect of fitness — that is, training for a specific goal — may be particularly advantageous.

seniors runningShare on PinterestA new study has shown that training for and running a marathon can reverse vascular aging.

The value of goal-oriented exercise ties directly into the aging process. As a person gets older, their arteries are more likely to stiffen.

Aerobic exercise can reduce arterial stiffening, which the medical community sees as a predictor of cardiovascular events.

However, it is difficult for doctors to recommend a form of fitness that is likely to work for everyone.

Recent findings, however, suggest that training for and running a marathon could be an excellent choice for people looking to improve their cardiovascular health.

A total of 138 people running in the 2016 and 2017 London Marathons participated in the study, which appears in the Journal of the American College of Cardiology.

Training for the marathonNone of the participants had completed a marathon before, and none had any significant medical history or preexisting heart disease.They were also all running a maximum of 2 hours a week before starting the study.Just over half of the participants were female, with the average age of the group being 37 years.The researchers advised each of the runners to follow the marathon's Beginner's Training Plan, which consists of about three runs every week for 17 weeks leading up to the race.As the weeks went on, the weekly exercise became more intense.A 4 year reductionBefore the participants began their marathon training, the research team measured their blood pressure and aortic stiffness using cardiovascular magnetic resonance.The researchers calculated the biological age of each individual's aorta using their actual age and the aortic stiffness measurements from three levels of the artery.They then took the same measurements between 1 and 3 weeks after the marathon.An analysis of the average finish times of 27,000 runners suggested that the participants were running between 6 and 13 miles a week in training.Of the participants, the men took an average of 4.5 hours to complete the race while the women took 5.4 hours.When the researchers compared the measurements from before and after the race, they found that both blood pressure and aortic stiffness had reduced in the first-time marathon runners.Notably, the changes in aortic stiffness were equivalent to a 4 year decrease in vascular age.Interestingly, older male runners who were slower and had a higher baseline blood pressure gained the most from the training regimen and race.Never too late to changeSenior author Dr. Charlotte H. Manisty, who works at the Institute of Cardiovascular Science at University College London and Barts Heart Centre in London, United Kingdom, comments on the findings:"Our study shows it is possible to reverse the consequences of aging on our blood vessels with real-world exercise in just 6 months." Dr. Charlotte H. Manisty"These benefits were observed in overall healthy individuals across a broad age range," she adds, "and their marathon times are suggestive of achievable exercise training in novice participants."People with greater arterial stiffness and hypertension may benefit even more from this form of exercise, although future studies would need to test this theory.However, it is not possible to conclude that exercise alone produced the above effects.The more healthful lifestyle choices that often accompany marathon training, such as a better diet and sleeping pattern, may have had a part to play.It is also possible that some participants adopted a different training regimen to the recommended plan, meaning that further research will need to take a standardized approach.Nevertheless, the findings highlight "the importance of lifestyle modifications to slow the risks associated with aging, especially as it appears to never be too late as evidenced by our older, slower runners," Dr. Manisty states.
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Stroke: Smoking both traditional and e-cigarettes may raise risk

A team at George Mason University, Fairfax, VA, has uncovered another electronic cigarette health concern. This time, it relates to stroke risk.

young adult smoking e-cigShare on PinterestYoung adults who use e-cigarettes may put themselves at stroke risk.

In recent years, the popularity of e-cigarettes has soared.

A 2016 study found that 10.8 million adults in the United States were current e-cigarette users. It is common for people to switch from traditional cigarettes to the e-variety because they think they are a healthier option.

But newly issued health warnings have pointed to the potential risks of smoking e-cigarettes. In June 2019, the U.S. saw an outbreak of lung injuries associated with e-cigarettes.

Experts believe that vitamin E acetate — an ingredient found in some e-cigarettes containing THC — may be the link.

In December 2019, the Centers for Disease Control and Prevention (CDC) reported that more than 2,500 individuals from the U.S., Puerto Rico, and the U.S. Virgin Islands were hospitalized or died as a result of using vapes, e-cigarettes, or associated products.Recent studies, albeit small-scale, have found both benefits and risks to e-cigarettes.One study that appears in PNAS found that nicotine from e-cigarette smoke caused lung cancer in mice as well as precancerous growth in the bladder.However, a second study, appearing in the Journal of the American College of Cardiology, noted a significant improvement in vascular health within a month of a traditional smoker switching to e-cigarettes.A trend among the youngDespite their nicotine content, the variety of e-cigarette flavors available has led to the products becoming a trend among young adults. There is also a concern this habit could lead to conventional cigarette smoking.Equally worrying findings have come from a new study that appears in the American Journal of Preventive Medicine. The study found that young adults smoking both traditional and e-cigarettes face a significantly higher risk of stroke.Using data from the 2016-17 Behavior Risk Factor Surveillance System (BRFSS), the study examined smoking-related responses from a total of 161,529 people aged between 18 and 44.Just over half of the respondents were female, with 50.6% identifying as white and just under a quarter identifying as Hispanic.The team calculated the adjusted odds ratios for strokes among those who currently smoked, former smokers who now used e-cigarettes, and people who used both."It's long been known that smoking cigarettes is among the most significant risk factors for stroke," says lead investigator Tarang Parekh from George Mason University."Our study shows that young smokers who also use e-cigarettes put themselves at an even greater risk."Tarang ParekhAn important message and a 'wake-up call'The study identified that young adults who smoked both traditional and e-cigarettes were almost twice as likely to have a stroke compared with conventional cigarette smokers.This risk rose to almost three times as likely when compared with non-smokers. Results also showed there was no clear advantage to switching from traditional cigarettes to e-cigarettes.However, people using e-cigarettes who had never smoked before did not display an increased stroke risk. This may be down to factors including young age and normal heart health.This study relied on self-reported data, which is a limitation. However, the findings prove the need for large-scale, long-term studies to confirm which detrimental health effects e-cigarettes are causing and which ingredients are responsible."This is an important message for young smokers who perceive e-cigarettes as less harmful and consider them a safer alternative," Parekh states.According to Parekh, the results are "a wake-up call" for policymakers to urgently regulate e-cigarette products "to avoid economic and population health consequences.""We have begun understanding the health impact of e-cigarettes and concomitant cigarette smoking, and it's not good."Tarang Parekh
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