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What is dependent edema?

Edema is the term used to describe the swelling that results from excess fluid that is trapped in the tissues of the body. Dependent edema is caused by the effects of gravity and occurs when fluid pools in the lower parts of the body, including the feet, legs, or hands.

This article discusses the causes and symptoms of dependent edema, as well as the available treatment options.

Fast facts on dependent edema: The main symptom of dependent edema is swelling of the lower body parts. Dependent edema happens when gravity pulls blood toward the feet. The treatment for dependent edema will vary, and it may not be curable.
Causes Pain in leg and foot caused by dependent edema, woman sitting on couch holding her calf in pain.
A problem in the veins may cause dependent edema, which is characterized by symptoms such as swollen and shiny skin.

Gravity pulls blood toward the parts of the body that are closest to the ground. For example, edema may occur in the feet, but people who are bedbound may experience edema in the buttocks.

Usually, the blood is pumped back from feet toward the heart by the veins and the motion of the muscles. When this system malfunctions, the lower body parts begin to fill up with excess fluid, causing the swelling and puffiness of edema.

According to the American Family Physician, one of the primary causes of dependent edema is a problem with the veins, although muscular issues may also contribute.

What are the symptoms? Signs and symptoms of this condition include: difficulty putting on shoes and socks due to swelling shiny skin stretched-looking skin To differentiate between dependent edema and one of the other types of edema, apply gentle pressure to the affected area. If dents appear on the skin, which is known as pitting, it suggests dependent edema. Thank you for supporting Medical News Today Warning signs to look out for Doctor in patient's home discussing report.
Those with dependent edema will need to monitor their skin health, and ensure they are aware of the warning signs. People with dependent edema should be vigilant when it comes to their skin health because they are at increased risk of skin infections. When the skin stretches and breaks, it becomes more vulnerable to infections such as cellulitis, which is a bacterial skin infection that can spread rapidly to other body parts. If anyone observes any signs of a serious skin issue, seek emergency medical attention. Symptoms include: a feeling that the skin is hot pus-like drainage redness slow-healing wounds swelling The risk of skin infection can be reduced by keeping the skin around the affected areas clean and moisturizing the skin regularly. What are the treatment options? If there is an underlying cause for the dependent edema, then treating the condition may resolve the edema. Sometimes, these conditions are not curable such as in the case of heart failure, so people may need to manage the edema to limit its symptoms and reduce the risk of complications. A person can implement some lifestyle changes to help manage dependent edema: Elevate the affected body parts Because gravity causes dependent edema, elevating the affected area to above heart level allows the excess fluid to drain toward the heart. If edema affects the feet, for example, lying down and propping up the legs with cushions can help. Use compression stockings or bandages If the feet or legs are affected, wearing compression socks or leg sleeves can stop the collection of fluid in the tissues. Compression bandages are also available to wrap other areas of the body. Manually move body parts People who cannot move their arms or legs should try manual mobility. This involves moving the immobile body part, perhaps with the hands or with the assistance of another person. This type of movement can encourage the muscles to pump blood and fluids more efficiently, which can prevent fluid buildup and reduce the edema. A doctor can advise on specific exercises that may further reduce swelling. Reduce salt intake A high-salt diet can increase water retention, which increases the likelihood of edema. Discuss salt intake with a doctor or dietitian. Massage Massage may move excess fluid out of the affected area. Using firm pressure, stroke the skin in the direction of the heart. Never use pressure that causes pain. Skin hygiene Keep the skin clean and moisturized to prevent cracks, scrapes, and cuts, which can lead to infection. Foot protection If edema occurs in the feet, wear suitable shoes that do not restrict blood flow but that protect the feet from injury and infection. What are the complications? Dependent edema can lead to some complications, such as: difficulty walking discolored, thick skin pain and stiffness reduced blood circulation stretched, itchy, or tender skin ulcers varicose veins Thank you for supporting Medical News Today Other types of edema periorbital edema image credit klaus d peter 2008 br
Periorbital edema is a type of edema that affects the eye.
Image credit: Klaus D Peter (2008) Dependent edema is just one type of edema. Others include: Cerebral edema: A severe condition that involves excess fluid in the brain. This type of edema is most commonly caused by trauma, a tumor, or a burst blood vessel. Lymphedema: A swelling in the arms and legs that is usually caused by damage to the lymph nodes. It may be as a result of cancer or cancer treatments. Macular edema: Caused by an increase of fluid in the macula of the eye. Pedal edema: This occurs when fluid builds up in the feet and legs. This typically affects older adults and pregnant women. Peripheral edema: This usually affects the legs, feet, and ankles. It can indicate a problem in the kidneys, lymph nodes, or circulatory system. Pulmonary edema: Characterized by excess fluid in the air sacs of the lungs. It can lead to breathing difficulties. Outlook Some causes of dependent edema are curable, and the edema may resolve once the underlying condition is treated. However, other causes have no cure. However, there are some steps that a person can take to reduce symptoms and the risk of complications. Using elevation, compression, movement, and keeping the skin clean can offer relief to many people with dependent edema. It is always important to discuss dependent edema and its symptoms with a doctor, who can best advise a person on the most effective treatment options for their condition.
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Gout drug could help treat heart failure

Drug repurposing is one of the fastest and most effective routes to new medical treatments. Researchers reveal how such a strategy may yield a new treatment for heart failure.
an illustration representing a heart problem
Researchers suggest that the gout drug probenecid may help to treat heart failure.

In a new study, the team found that probenecid — which is a drug commonly used to treat gout — improved heart function in a small number of individuals with heart failure.

First study author Nathan Robbins — from the University of Cincinnati College of Medicine in Ohio — and colleagues recently reported their findings in the Journal of the American Heart Association.

Heart failure is a condition that arises when the heart is unable to pump oxygen-rich blood well enough to support other organs.

It is estimated that heart failure affects around 5.7 million adults in the United States, and around 50 percent of people who have the condition die within 5 years of being diagnosed.

Though there is no cure for heart failure, treatments exist that help to manage the condition. Some of these treatments, such as a left ventricular assist device (LVAD), concentrate on improving the heart's function.

An LVAD is a battery-powered device surgically implanted into the patient's heart. It draws in blood from the left ventricle of the heart, before transporting it to the aorta, or the artery that distributes blood to the rest of the body.

In their new study, Robbins and team reveal how probenecid may offer a noninvasive alternative to such treatments, after finding that the gout drug improved the heart-pumping action of people with heart failure.

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'From bench to bedside'

The researchers tested probenecid on 20 people of an average age of 57 years, all of whom had heart failure.

As part of the double-blind, randomized, placebo-controlled study, all the participants either took probenecid or a placebo over 4-week periods between June 2013 and April 2015.

Subjects' ejection fraction, or the heart's ability to pump blood, was measured by echocardiogram. Other measures of heart function included an electrocardiogram and a 6-minute walk test.

Compared with the placebo, the researchers found that probenecid led to improvements in ejection fraction.

"This is the first time," states Robbins, "probenecid has been used in heart failure patients and we showed it increases the ejection fraction in patients with heart failure. It was exciting to be able to see this medicine work from the bench to the bedside."

"We were quite happily surprised it improved the two main ways in how the heart functions," adds study co-author Dr. Jack Rubinstein, of the Department of Internal Medicine at the University of Cincinnati. "It improves how the heart contracts and how it relaxes."

Importantly, the drug was found to cause no significant adverse effects in the subjects. "We know that it was very likely to be safe because the medicine had been taken by people of all ages for decades," says Dr. Rubinstein. "It has a very strong safety profile."

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'A new way of treating heart failure'

When the researchers tested the drug on heart cells taken from mice, they found that it improves the heart's use of calcium, which is a key player in heart muscle contraction.

While larger clinical trials are needed to determine the efficacy of probenecid for heart failure, the researchers believe that their results show promise.

"The repercussions are potentially significant — if we are able to confirm this experiment in larger studies with longer-term follow-up, this could present a new way of treating heart failure for which there are limited medical therapies available."

Dr. Jack Rubinstein

"Left ventricular assist devices, pacemakers, heart transplants, and medications are available to treat heart failure patients, but outcomes for patients with heart failure are still worse than outcomes for the vast majority of cancer patients," Dr. Rubinstein adds.

"That's what we want to effectively change."

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What causes pain under my left breast?

Unexpected pain can occur under the left breast for reasons that range from problems with digestion through to heart conditions. Some can be treated at home, but some can be medically more serious.

There are some organs in the upper left region of the body that could be the source of the pain. These include the stomach, heart, lungs, ribs, colon, pancreas, and spleen.

Doctors often group the most common causes of pain under the left breast into two main categories: digestive and heart-related.

This article looks at the different causes of pain under the left breast, their symptoms, and the treatment options available.

Is pain under the left breast a heart attack? Man holding his chest with pain under left breast
The pain of a heart attack tends to occur in the center of the chest.

As the heart is situated slightly to the left of the midline in the upper body, pain under the left breast can sometimes indicate a heart problem.

According to the American Heart Association, when pain does occur during a heart attack, it commonly happens in the center of the chest, lasts longer than a few minutes, and can return after fading.

Heart attack pain can cause a very strong, uncomfortable, crushing pressure or squeezing sensation, or it may feel like very bad heartburn. Some people may not experience any or only mild chest pain; this is more common in women, older people, and those with diabetes.

Other symptoms include:

profuse sweating nausea or vomiting shortness of breath heavy, weak shoulders or arms severe pain traveling to the arm, jaw, neck, back, and elsewhere in the body dizziness a strong sense of anxiety or impending doom

Treatment

If someone suspects a heart attack, they should call an ambulance immediately. While waiting, they should rest, and if they are not intolerant to aspirin, they should take an adult-dose tablet (300 milligrams) to help thin the blood.

Further treatment options will depend on when symptoms started and how soon the person having the attack can access the first stage of care.

If the cause of the attack is found to be a blocked coronary artery, the doctor may recommend a procedure called an angioplasty to open a blocked or severely narrowed coronary artery with a balloon and possibly place a stent.

Thank you for supporting Medical News Today Other heart-related causes 1. Angina When the heart muscle does not receive enough oxygen in the coronary artery blood supply, the resulting pain under the left breast or in the center of the chest is known as angina. Associated symptoms include an uncomfortable feeling in the shoulders, arms, neck, jaw, or back. Angina pain can also feel like indigestion, and a person may also experience sweating, light-headedness, nausea, or shortness of breath. Treatment Angina is a possible symptom of severe underlying heart disease, so anyone experiencing symptoms of angina should seek medical attention immediately. A doctor may prescribe medication, such as beta-blockers, ACE-inhibitors, statins, or aspirin. 2. Pericarditis The heart is surrounded and protected by a thin, layered, fluid-filled membrane called the pericardium. It can become inflamed due to infection or a disorder where the body's immune system attacks itself. Symptoms of acute pericarditis include: sharp, stabbing pain under the left breast or in the chest pain in one or both shoulders pain worsening when taking a deep breath or lying down on the back feeling hot, sweaty, feverish, light-headed, and short of breath Treatment Immediate treatment for pericarditis may include an OTC anti-inflammatory medication, such as ibuprofen and rest until feverish symptoms decrease. If a person experiences severe pain, a doctor may prescribe a steroid, such as prednisone. If the condition is severe, the person may need to say in the hospital for monitoring. Prevention While acute pericarditis typically cannot be prevented, getting treated quickly and following a prescribed treatment plan will reduce the chance of the acute pericarditis recurring or becoming a long-term condition. Digestive causes 3. Gastritis When the stomach's lining becomes inflamed, this is known as gastritis. Not everyone will experience symptoms, but a sharp, stabbing or burning pain under the left breast is a potential clue that gastritis may be present. The pain can also be accompanied by heartburn, feeling sick, vomiting, and bloating. Treatment For mild symptoms, changing the diet and lifestyle can ease pain under the left breast. Over-the-counter (OTC) medications, such as antacids, can help reduce stomach acid. Home remedy options include: reducing alcohol intake eating smaller portions more often, as opposed to one big meal cutting out dairy, spicy, fried, or acidic foods, and caffeinated drinks cutting down or giving up tobacco smoking reducing high intake of OTC non-steroidal anti-inflammatory drugs (NSAIDs) eating foods high in fiber and plant nutrients If the pain is caused by or related to the presence of the bacterium called Helicobacter pylori, the doctor may prescribe a course of antibiotics and medicine that reduces the production of stomach acid. 4. Pancreatitis Pancreatitis is inflammation of the pancreas. Acute pancreatitis has symptoms that include: sudden, severe pain under the left breast and in the upper center part of the abdomen nausea and vomiting rapid pulse fever Chronic pancreatitis, where the condition worsens over time, has symptoms including: frequent or prolonged episodes of pain under the left breast that can spread to the back nausea and vomiting oily, pale-looking stools diarrhea Treatment Treatment for chronic pancreatitis ranges from pain management, using increasing strengths of medication, to surgery if pain under the left breast is still severe. For acute pancreatitis, immediate treatment includes: intravenous fluids to aid in hydration and ensure the body's other organs have good blood flow no eating for 24-48 hours, then following a high-calorie diet to support healing giving intravenous pain medication or antinausea medication 5. Heartburn Man suffering from heartburn which may cause pain under left breast
Heartburn may cause a pain under the left breast. When stomach acid travels back up the food pipe, it causes a burning sensation in the mid-chest and throat, and sometimes pain under the left breast. Heartburn can be a symptom of indigestion and stomach acid issues. Symptoms include: a tight, burning sensation in the upper chest or throat that sometimes travels under the left breast and the jaw a bitter taste in the mouth pain under the left breast or in the chest while lying down or just after eating Treatment Self-help treatment options for mild heartburn include not eating big meals, not lying down to sleep right after eating, and raising one's pillow, so the head is higher than the waist when sleeping. This may help prevent stomach acid from traveling up the food pipe. OTC medications such as antacids are a first medical option to try. Thank you for supporting Medical News Today Other causes 6. Pleurisy The lungs are surrounded by a layered membrane called the pleura. If the pleura surrounding the left lung become inflamed due to infection or another cause, the resulting pain will develop under the left breast. More severe causes of pleurisy include rheumatoid arthritis and lung cancer. The most common symptom of pleurisy is a sharp chest pain when taking a deep breath, but it can also be accompanied by: pain in the shoulder a dry cough shortness of breath The pain can get worse when the person walks around, coughs, or sneezes. Treatment Rest is highly recommended. Lying on the side of the pain can help relieve pain symptoms. If a person experiences particularly severe chest pain, they should seek immediate treatment from a doctor, who may prescribe NSAIDs or other pain-relieving medication. A doctor may also carry out further tests, such as blood tests, a chest X-ray, a chest CT scan. They may also take a small sample of pleural lung tissue for biopsy. Pleurisy caused by a viral infection often gets better after a few days, but a bacterial infection will require antibiotic therapy. Prevention The best way to prevent severe cases of pleurisy is early intervention. 7. Spleen The spleen can cause pain under the left breast if it is enlarged or if it bursts following an injury. Symptoms of an enlarged spleen include: tenderness and pain under the left breast feeling uncomfortable when eating even just a small meal anemia and extreme tiredness bleeding easily A burst spleen typically will cause: pain under the left breast or ribs, and tenderness when touched bleeding dizziness and fast heart rate Treatment If a person suspects a burst spleen, they should go immediately to the emergency room. Bleeding can be life-threatening if left untreated. A doctor will check for an enlarged spleen by feeling the abdomen and may recommend further testing through blood testing or imaging, such as an abdominal ultrasound, CT scan, or MRI scan. Underlying conditions, such as chronic liver disease and subsequent cirrhosis, can affect and interact with the spleen. A doctor will prescribe medication when medical therapy is possible to treat splenic or liver disease. Surgery is only required if underlying causes cannot be diagnosed clearly, or if complications arise from the enlarged or damaged organ. Prevention People should aim to keep the spleen safe when playing sport by wearing protective sporting equipment. Always wearing the seatbelt when in the car is also advised. As cirrhosis can be caused by excessive or long-term high alcohol intake, cutting down is recommended. 8. During pregnancy pregnant lady holding her stomach with pain under left breast
As the uterus grows it may cause pain under the left breast. Soreness and pain experienced under the left breast during pregnancy are often caused by pressure from the top of the uterus as it grows, or if the baby is kicking or punching the expectant mother. The pain can be worse when leaning forward. Muscles and other tissues will stretch as the baby grows, and this can also cause pain under the breasts. The expectant mother's body is changing during pregnancy, and the internal organs will be pushed and moved as the baby grows. The mother's body chemistry may also change, and other causes of pain under the left breast during pregnancy can include: heartburn with stomach acid reflux the rib cage changing position to allow space for the baby in the abdomen When to see a doctor Some conditions can be treated at home with rest and OTC medication, but people should seek medical attention straight away if: the chest is injured the pain under the left breast is unexpected symptoms of pain and tightness do not get better with rest shortness of breath, feeling sick, or profuse sweating accompanies the pain Thank you for supporting Medical News Today Outlook Pain under the left breast is often frightening to experience. As there are several organs in this area of the body, the earlier the cause of the pain can be diagnosed, the more likely that treatment and recovery will be successful. A heart attack is not the most common reason for pain under the left breast, but it is always better to have the symptoms checked out, especially if other symptoms of a heart attack are present. Many causes of pain under the left breast can be prevented through making changes to several everyday lifestyle choices. Following a healthful diet, getting regular exercise, lowering or cutting out tobacco smoking, reducing alcohol intake, keeping weight down, and reducing stress can all help.
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Stroke risk may depend on your height as a child

People who were very short as children may have to pay closer attention to their cerebrovascular health. A new study suggests that it is these people who are more at risk of having a stroke in adulthood.
stroke written in red lettering on wooden blocks
Could we look to childhood height to predict stroke risk in adulthood?

Stroke is an event that occurs when the blood supply to the brain is obstructed or otherwise impaired, so that the brain does not receive enough oxygen for it to function correctly.

There are two main types of stroke. These are ischemic, which is caused by a blood clot or an otherwise blocked artery, or hemorrhagic, which is characterized by blood leaks in the brain.

The Centers for Disease Control and Prevention (CDC) estimate that around 6.5 million adults in the United States have had a stroke. It is the currently fifth most common cause of death nationwide.

Known risk factors for stroke include age, hypertension, heart disease, diabetes, obesity, habitual drinking and smoking, and a family history of stroke or cardiovascular disease.

New research from the Bispebjerg and Frederiksberg Hospital and the University of Copenhagen, both in Denmark, may have uncovered a new and surprising risk factor: an individual's height during childhood.

Senior study author Jennifer L. Baker — who is affiliated with both of the institutions named above — and colleagues worked out that adults who had a shorter-than-average height as children were more likely to experience a stroke as adults.

The researchers' findings have now been published in the journal Stroke.

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We should focus on modifiable factors

Baker and team conducted a prospective study in which they analized the relevant data — sourced from the Copenhagen School Health Records Register — of 372,636 children from Denmark. They were all born between 1930 and 1989 and were evaluated once every 3 years — at age 7, 10, and 13.

The researchers found that both boys and girls who were 2–3 inches (roughly 5–7 centimeters) shorter than the average height considered normal for their age were more likely to have a stroke later in life than their peers.

More specifically, both boys and girls were more at risk of ischemic stroke in adulthood, and boys in particular had a heightened risk of hemorrhagic stroke later on.

Baker and colleagues explain that there are many reasons why some children may not reach the average height, as expected.

One cause may be genetic factors, but equally important to a child's development is the mother's diet during the course of her pregnancy, and the child's diet throughout their years of growth.

Other reasons behind stunted growth include infection and being exposed to psychological stress. Fortunately, the researchers point out, most of these factors can be prevented, which could also help to reduce a person's risk of experiencing stroke.

"[I]n addition to being genetically determined," write the study authors, "adult height is a marker of exposures affecting childhood growth [...], of which many are modifiable and all are thought to affect the risk of stroke."

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Shared fundamental mechanisms?

Moreover, the researchers saw that in high-income countries, the rates of stroke cases and stroke-related mortality were dwindling where the higher adult height rates were on the rise. This was especially true for female populations.

Baker and colleagues surmise that this may be because physical growth and the development of stroke conditions may be determined by overlapping underlying biological mechanisms.

The researchers clarify that these findings are important less in terms of determining risk factors for stroke, and more in terms of understanding some of the root causes of this adverse health event.

That being the case, they suggested that further research should be dedicated to identifying the exact reasons why childhood height is associated with a heightened risk for stroke in later life.

"Our study suggests that short height in children is a possible marker of stroke risk and suggests these children should pay extra attention to changing or treating modifiable risk factors for stroke throughout life to reduce the chances of having this disease."

Jennifer L. Baker

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Cholesterol-removing gene may prevent heart disease

Heart disease is the leading cause of death for men and women in the United States, which highlights the urgent need for new strategies to prevent the condition. Researchers may be one step closer to meeting this need, after locating a gene that assists in the clearance of excess cholesterol from blood vessels.
a human heart and DNA strands
Researchers reveal how a gene called MeXis helps to clear cholesterol from blood vessels.

The gene — known as MeXis — was previously believed to sit under the umbrella of "selfish" genes, or those thought to be functionless because they fail to produce proteins.

But the new study shows that MeXis does not need to produce proteins to be useful. Instead, it makes molecules known as long-coding RNAs (IncRNAs).

These IncRNAs regulate the expression of a protein that removes cholesterol from the arteries.

High cholesterol is a major risk factor for heart disease.

Lead study author Dr. Tamer Sallam, the co-director of the Center for Cholesterol Management at the University of California, Los Angeles (UCLA), and his colleagues recently reported their new findings in the journal Nature Medicine.

According to the Centers for Disease Control and Prevention (CDC), around 610,000 people in the United States die from heart disease every year.

Coronary artery disease (CAD), which is also called coronary heart disease, is the most common form of heart disease, accounting for around 370,000 deaths annually. CAD is caused by the accumulation of plaque in the arteries.

Over time, plaque buildup can block the arteries and reduce the flow of blood to the heart, which is a process known as atherosclerosis. This can lead to chest pain, or angina, irregular heartbeat, heart attack, and heart failure.

High cholesterol — more specifically, high low-density lipoprotein (LDL) cholesterol — is a major risk factor for heart disease. When we consume too much cholesterol from our diet, it can accumulate in the arteries.

In the new study, Dr. Sallam and colleagues discovered how the MeXis gene helps to remove excess cholesterol from the arteries, potentially opening the door to a new strategy for heart disease prevention.

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With their new study — which was conducted using mice — the researchers sought to learn more about the molecular events that play a role in atherosclerosis.

They identified MeXis as a key player; plaque accumulation in the blood vessels of rodents without the gene was almost double that of mice with normal levels of MeXis.

Upon further investigation, the team found that MeXis activates the expression of a protein called Abca1 through the production of IncRNAs. The role of Abca1 is to remove excess cholesterol from the blood vessels.

It was found that increasing MeXis levels in the rodents led to an increase in the removal of cholesterol from blood vessels, which makes MeXis a potential candidate for heart disease prevention and treatment.

What is more, the findings may open the door to other genes that play a role in heart health.

"What this study tells us is that lncRNAs are important for the inner workings of cells involved in the development of heart disease," says senior study author Dr. Peter Tontonoz, of the David Geffen School of Medicine at UCLA.

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"Considering many genes like MeXis have completely unknown functions," he explains, "our study suggests that further exploring how other long non-coding RNAs act will lead to exciting insights into both normal physiology and disease."

In future research, the team plans to find out more about the mechanisms of MeXis, how its activity can be modified, and whether it could hold up as a target for heart disease prevention.

"The idea that lncRNAs are directly involved in very common ailments such as plaque buildup within arteries offers new ways of thinking about how to treat and diagnose heart disease."

Dr. Tamer Sallam

"There is likely a good reason why genes that make RNAs rather than proteins exist," Dr. Sallam continues. "A key question for us moving forward is how they may be involved in health and disease."

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Obesity: You don't have to lose weight to be fit

New research suggests that people who are obese can enjoy good cardiovascular health as long as they keep physically fit. Also, for those with severe obesity, keeping fit may be just as important as losing weight.
woman on treadmill
Can you have a healthy heart while overweight? A new study suggests that if you keep physically fit, you can.

"You can get fit," explains study leader Jennifer L. Kuk, who is an associate professor from the School of Kinesiology and Health Science at York University in Toronto, Canada, "without losing weight and have health benefits."

She and her team investigated the relationship between cardiorespiratory fitness and markers of cardiovascular health in individuals with mild to severe obesity.

Prof. Kuk explains that exercising for a total of 150 minutes per week — as recommended in national guidelines — is generally equivalent to losing less than half a pound in weight.

But this level of physical activity can bring considerable improvements in health for people with severe obesity.

"You really have to disconnect the body weight from the importance of fitness," she urges.

The researchers report their findings in a paper that was recently published in the journal BMC Obesity.

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Overweight and obesity

The World Health Organization (WHO) define overweight and obesity as "abnormal or excessive fat accumulation that may impair health."

Body mass index (BMI) is a "crude measure" of obesity calculated by dividing a person's weight in kilograms by the square of their height in meters. Overweight is defined as having a BMI of 25 or higher, and obesity is defined as having a BMI of 30 or higher.

Using these measures, researchers have found that being overweight or obese likely puts people at higher risk for cardiovascular and other diseases, such as diabetes and cancer.

In the United States, more than two thirds of adults are overweight, including around a third who are obese.

As well as eating habits, there several other factors that play a role in overweight and obesity — such as genes, medical conditions, and being physically inactive.

Evidence suggests that more physical activity is needed to lose weight than is required to benefit health.

The new study is among the first to show that exercise may be even more important for people who are in the severely obese category — that is, those whose BMI exceeds 40.

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Study assessed fitness and metabolic health

Prof. Kuk and colleagues analyzed data on 853 people who were attending a weight management clinic in Southern Ontario.

All participants underwent clinical exams, gave blood samples, and performed a "maximal treadmill test," during which cardiovascular and respiratory measures were recorded to assess fitness.

The team used three categories of obesity: mild (a BMI lower than or equal to 34.9), moderate (a BMI of 35–39.9), and severe (a BMI of 40 or higher).

From the blood tests, they assessed a range of metabolic risk factors — including blood pressure, triglycerides, high-density lipoprotein cholesterol, and blood glucose.

The results showed that of those with mild obesity, 41 percent were considered fit, compared with 25 percent and 11 percent of those with moderate and severe obesity, respectively.

Participants considered fit were more likely to be younger (age 48, on average, compared with 51), be female, and have a lower BMI (36, on average, compared with 41).

Higher blood pressure, higher levels of triglycerides and glucose, and lower levels of high-density lipoprotein cholesterol were more prevalent in the moderate and severely obese participants.

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'Important health benefits' for severely obese

The group whose members were classed as severely obese was the only group in which level of fitness seemed to make a significant difference to health measures.

For instance, the least fit 20 percent of the group were more likely to have higher levels of glucose and triglycerides as well as high blood pressure, whereas this was less of an issue in the fitter 80 percent of severely obese participants.

Also, the authors note that higher fitness was "associated with smaller waist circumferences, with differences between high and low fitness being larger in those with severe obesity than mild obesity."

It would seem, therefore, that if you are severely obese, avoiding being in the least fit 20 percent might be enough to make a significant difference to health.

The study authors suggest that their findings reveal the "potentially important health benefits of having a high fitness level, particularly for those with severe obesity."

This is in line with previous studies that have shown that you need to do a lot more exercise to lose weight than to improve health.

However, the researchers believe that their study is the first to support the idea that being fit might make more of a difference to health in people with severe obesity than losing weight.

"In my practice," says study co-author Dr. Sean Wharton, an adjunct professor at York University, "I see many patients who are looking for different results."

"There are some patients that want to significantly improve their health and others that are only looking for an aesthetic goal," he explains.

"When it comes to health, this study reinforces the notion that people don't need to lose weight to be healthy."

Dr. Sean Wharton

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What is anasarca?

Anasarca is general swelling of the whole body that can occur when the tissues of the body retain too much fluid. The condition is also known as extreme generalized edema.

Accumulation of fluid may occur due to any illnesses and conditions that change the proteins of the body, affect the balance of fluids, or create abnormalities in the blood vessels or lymphatic system.

Often, if anasarca is present, it is a sign of severe organ damage or illness.

Definition of anasarca Doctor looking at medical clipboard to diagnose anasarca
Anasarca is a symptom of a condition, and may be diagnosed with a physical assessment.

It is helpful to understand that anasarca is not a disease itself. Instead, it is a symptom or result of a medical condition.

Anasarca is different than typical edema. Almost everyone experiences swelling at some time, which can be due to a variety of causes, such as an injury, dehydration, or a minor side effect of medication.

In many instances, swelling or edema may only affect a specific part of the body, such as the feet, hands, or legs.

But with anasarca, the swelling involves the whole body and is considered severe. For example, the swelling is often so severe it makes movement difficult.

Thank you for supporting Medical News Today Treatment of anasarca It is essential to find out what is causing anasarca to treat it accurately. For example, if kidney disease is causing anasarca, treatment is needed to assist kidney function. Also, doctors often prescribe medications to treat the severe swelling. Diuretics Doctors often prescribe drugs called diuretics. Diuretics work by helping the kidneys release more salt into the urine, which causes the release of more fluid through urination. The two main types of diuretics prescribed for anasarca include potassium-sparing and loop diuretics. Diuretics are either taken by mouth or given through an intravenous line (IV). The choice of diuretic, the dose, and the route of administration vary according to the severity of the swelling and the underlying condition that is causing anasarca. Albumin Albumin is a protein made by the body that is necessary for a variety of important functions, including balancing fluid. In cases of poor nutrition and certain serious medical conditions, the level of albumin can become too low. When this occurs fluid from the bloodstream is pushed out into the tissues causing swelling. In some cases, replacing albumin can help correct this problem. Recovery A doctor may recommend additional home treatments to speed recovery. Monitoring fluid and salt intake is important to prevent any swelling from getting worse. Salt can increase fluid retention, which is why people who have severe edema need to reduce their salt intake. What are the causes? intravenous fluids applied through drip attached to machinery equipment.
When intravenous fluids are administered excessively, it may increase the risk of anasarca. Anasarca can develop due to a variety of causes. Some conditions that may lead to anasarca are widespread, while others are considered rare. The most common causes of anasarca include: Excess administration of intravenous fluids: Intravenous fluids are often administered in the hospital to treat several conditions, such as shock, dehydration, and infection. But if the body cannot adapt to the fluids given, it can lead to severe edema Kidney disease: When kidney function is impaired, fluid is not removed from the body adequately, which can cause anasarca. Cirrhosis: Cirrhosis can occur due to liver failure. Liver disease can cause changes in the hormones that affect fluid regulation in the body. When the liver does not work as efficiently as it should, it can cause fluid to leak into the tissues. Malnutrition: Malnutrition, specifically protein deficiency in the diet, can cause fluid to accumulate in the tissues. In extreme cases, it can lead to anasarca. Poor heart function: When the muscle of the heart does not work correctly, it affects how well the heart pumps blood throughout the body. If the heart is not pumping efficiently, it can cause fluid to build up in the tissues. Allergic reaction: Swelling of the body can occur due to an allergic reaction. In severe reactions, anasarca can develop. Less common causes include: Capillary leak syndrome Capillary leak syndrome occurs when protein and fluid leak out of the blood vessels into the tissues of the body. The cause is not well understood, but it is believed to be due to inflammation and blood vessel injury. It has been shown to occur in relation to some medications and toxins. According to one case study, capillary leak syndrome can develop as a result of certain cancer medications, such as gemcitabine. Another case was reported following a snakebite. A side effect of medication Various medications can lead to anasarca. The most common types of medication that might cause swelling include steroids and blood pressure drugs, such as amlodipine. Discontinuing the medication will often resolve symptoms of anasarca as indicated in this case report. Thank you for supporting Medical News Today Anasarca symptoms Anasarca in leg and foot causing swelling.
Anasarca causes obvious swelling of the body. In some cases, when the skin is pressed an indentation will remain after pressure is released. The main symptom of anasarca is swelling of the body. The swelling is obvious, and the skin may look shiny and stretched. Sometimes, swelling is so extreme that a person has difficulty moving. Swelling can become so severe that fluid will leak out directly from the skin. This is known as weeping edema. Pitting edema may also develop. Pitting edema occurs when pressure is applied to the swollen skin, and a dimple or indentation remains after the pressure is released. The swelling often causes additional symptoms including: trouble walking if the legs are swollen difficulty lifting arms increased heart rate aching joints difficulty breathing A life-threatening complication of anasarca can also develop if fluid accumulates in the lungs. Fluid in the lungs is called pulmonary edema, and it can quickly become an emergency. Signs of pulmonary edema include chest pain, shortness of breath, and coughing. How is anasarca diagnosed? A doctor can usually make a diagnosis of anasarca after a physical exam; and if the edema is severe, a doctor can often recognize it instantly. However, determining the underlying cause of anasarca requires further tests. A blood test is often the first step in making a diagnosis of anasarca. Blood is tested to check the function of organs including the heart, lungs, liver, and kidneys. A doctor will also take a medical history to help determine whether any underlying medical conditions are causing the fluid retention. A doctor may also recommend other diagnostic tests, such as an echocardiogram, a chest X-ray, and a stress test to evaluate heart and lung function. Thank you for supporting Medical News Today Takeaway Anasarca often occurs due to severe organ damage or illness. It may interfere with a person's ability to perform everyday activities and can greatly decrease their quality of life. But with proper treatment, swelling can often be reduced. Although medication can help treat the condition, anasarca might return if the underlying cause cannot be corrected. The outlook for people with anasarca often depends on identifying the cause. In many instances, by the time anasarca has developed, the underlying condition has progressed to a critical state. Treating problems with the heart, lungs, kidneys, and liver early on is the best chance of preventing and controlling anasarca in many cases.
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How traffic noise may contribute to heart disease

Researchers have uncovered the mechanism underlying the role of traffic and other environmental noise in the development of heart disease.
view of road at night
How does environmental noise contribute to heart disease risk?

The idea that heart disease may be caused by traffic noise could strike you as unlikely at first.

But growing evidence is linking environmental noise to the development of heart conditions including arterial hypertension, stroke, heart failure, and coronary artery disease.

Although healthcare providers will focus on traditional risk factors when they diagnose, prevent, and treat heart disease, ever more evidence is supporting the notion that risk factors in the physical environment may contribute to heart disease, as well.

Several studies have demonstrated an association between an increased risk of heart disease and traffic noise. However, these studies have previously been unable to pinpoint the mechanisms that may be active in noise-induced heart disease.

Now, the Journal of the American College of Cardiology has published a review investigating the potential mechanisms by which environmental noise may contribute to heart disease.

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What mechanism drives the association?

To understand what mechanism may drive the association between environmental noise and heart disease, researchers from the Department of Internal Medicine at University Medical Center Mainz of Johannes Gutenberg University in Germany have conducted a review of the available scientific literature.

They assessed recent evidence of the link between heart disease and environmental noise and reviewed studies that investigated how the nonauditory effects of noise might impact the cardiovascular system.

Also, they reviewed studies on the effects of noise on the nervous system and those investigating adverse effects of noise on animals as well as humans.

From the evidence evaluated in their review, the study authors suggest that the mechanism at play could be a stress response in the nervous system that is activated by exposure to noise. The stress response prompts a surge of hormones, which damages the blood vessels.

The authors also connect noise with oxidative stress — an imbalance between the production of free radicals and the body's ability to nullify their effects — and problems with the blood vessels, nervous system, and metabolism.

These associations, the researchers conclude, add weight to the idea that traffic or aircraft noise contributes to hypertension, diabetes, and other risk factors for heart disease.

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New noise reduction strategies are needed

Having assessed some of the existing strategies used around the world to lower the impact of noise, the researchers propose that low-noise tyres and air traffic curfews could make positive contributions to environmental noise reduction.

They emphasize that new noise reduction strategies are sorely needed.

"[A]s the percentage of the population exposed to detrimental levels of transportation noise are rising, new developments and legislation to reduce noise are important for public health."

Lead study author Thomas Münzel, director of the Department of Internal Medicine

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Who is most at risk after a heart attack?

A study investigates which people are most at risk of premature death due to cardiovascular disease after having a heart attack. One biomarker may help healthcare providers to personalize their predictions.
human heart illustration
Researchers uncovered the biomarker that can tell practitioners who is most at risk of negative outcomes after a heart attack.

Acute coronary syndrome (ACS) describes a range of cardiovascular conditions that are characterized by a sudden and dangerous reduction of blood flow to the heart.

ACS can also, in some cases, lead to a major heart attack.

So far, the known risk factors for ACS include age (it is most common in people over 65), gender (with men being more at risk than women), and medical history (with diabetes, hypertension, and high cholesterol being the main culprits).

Recently, researchers from the University of Sheffield in the United Kingdom set out to investigate whether or not there are any biomarkers that could predict an elevated risk of ACS in people who have already been through a heart attack.

Lead researcher Prof. Robert Storey — from the university's Department of Infection, Immunity and Cardiovascular Disease — and his team noticed that blood plasma might provide practitioners with the clue they need to detect the possibility of cardiovascular disease.

Their findings were published in the European Heart Journal.

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Prof. Storey and colleagues analyzed data from 4,354 participants in the PLATelet inhibition and patient Outcomes trial to "evaluate the safety and efficacy of treatment" with two different blood-thinning drugs used to prevent the formation of blood clots.

The participants all had a form of ACS and had been admitted to hospital for a heart attack.

For the purpose of the new study, blood samples were collected from these participants upon their discharge from hospital. Next, the scientists analyzed the blood plasma — or the yellowish liquid that holds blood cells together — to see if it could provide any indication as to what might put people at increased risk of ACS.

The researchers focused on two biomarkers:

"maximum turbidity," or the maximum density of a blood plasma clot, which is known as a "fibrin clot" after the plasma protein that keeps it together "clot lysis time," or the time that it takes for a clot to dissolve

"We [...] aimed to study fibrin clot properties in plasma samples collected from ACS patients at hospital discharge and explore the relationship between those characteristics and subsequent clinical outcomes," the researchers write.

First, Prof. Storey and team adjusted for known ACS risk factors, so as to ensure the solidity of the study's findings.

After these adjustments, the researchers concluded that the participants for whom it took the longest to dissolve a clot had a 40 percent higher risk of experiencing another heart attack or dying prematurely due to cardiovascular disease.

"We have made huge strides over the last two decades in improving prognosis following heart attacks but there is still plenty of room for further improvement," notes Prof. Storey.

He continues, "Our findings provide exciting clues as to why some patients are at higher risk after heart attack and how we might address this with new treatments in the future."

The team explains that the current findings indicate that drugs that will help blood clots dissolve faster in people with a naturally long clot lysis time could improve the health outcomes for those already living with ACS.

"We now need to press ahead with exploring possibilities for tailoring treatment to an individual's risk following a heart attack and testing whether drugs that improve clot lysis time can reduce this risk."

Prof. Robert Storey

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How yoga can help to manage metabolic syndrome

People who practice yoga — who are also known, at least in the Western world, as "yogis" — always rave about how yoga could benefit the body and mind. But what does the science say? A new study investigates, focusing on how yoga affects people with metabolic syndrome.
woman in yoga pose
Not all of us can stand on our heads, but practicing yoga regularly can do wonders for our cardiometabolic health.

Here at Medical News Today, we've been reporting on several studies showcasing the variety of ways in which yoga might benefit our health.

For instance, some studies have suggested that yoga boosts brain health and cognition, as well as improves thyroid problems and relieves the symptoms of depression.

It has also been suggested that practicing yoga can help men to enlarge their prostate or even overcome erectile dysfunction, as well as help those with diabetes to manage their symptoms.

So, it seems that yoga is good for almost everything. That being said, most of the above-mentioned studies are observational — meaning they cannot draw any conclusions about causality — and few studies have looked at the mechanisms that may have underlined the findings.

But a new study — which has been published in the Scandinavian Journal of Medicine & Science in Sports and led by Dr. Parco M. Siu, from the University of Hong Kong in China — investigated the effect of yoga on cardiometabolic health.

The results not only found that it benefits people with metabolic syndrome, but they also revealed the mechanisms behind such benefits.

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Metabolic syndrome is a condition frequently associated with type 2 diabetes and heart disease. In the United States, it is estimated that approximately 34 percent of the adult population live with the condition.

Dr. Siu and his colleagues previously conducted research that found lower blood pressure and a smaller waist circumference among those who undertook yoga for 1 year. Therefore, in the new study, the researchers wanted to examine the effect of 1 year of yoga in people with metabolic syndrome.

To this end, they randomly assigned 97 participants with metabolic syndrome and high-normal blood pressure to either a control group or a yoga group.

"Participants in the control group were not given any intervention but were contacted monthly to monitor their health status," write the researchers, whereas, "Participants in the yoga group underwent a yoga training program with three 1-hour yoga sessions weekly for 1 year."

The scientists also monitored the patients' sera for so-called adipokines — or signaling proteins that are released by the fat tissue, telling the immune system to release either an inflammatory or anti-inflammatory response.

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The study authors summarize their findings, saying, "[The] results demonstrated that 1-year yoga training decreased proinflammatory adipokines and increased anti-inflammatory adi- pokine in adults with [metabolic syndrome] and high-normal blood pressure."

"These findings support the beneficial role of yoga in managing [metabolic syndrome] by favorably modulating adipokines," add the researchers.

The results of the study suggest that yoga could be a worthwhile lifestyle intervention that could decrease inflammation and help people with metabolic syndrome to manage their symptoms.

Dr. Siu also comments on the study's results, saying, "These findings help to reveal the response of adipokines to long-term yoga exercise, which underpins the importance of regular exercise to human health."

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What you should know about white coat syndrome

White coat syndrome is the name given to a disorder in which a person develops high blood pressure when they are around doctors, who often wear white coats.

Some people who usually have normal blood pressure find that it spikes when they visit the doctor. This condition is called white coat hypertension or the white coat effect. While white coat syndrome may make the blood pressure read higher than it is, the effect may be a sign of an underlying blood pressure condition.

A thorough diagnosis is vital to begin any necessary treatments.

Hypertension Doctor wearing a white coat may trigger white coat syndrome
A spike in blood pressure when a person visits a doctor may be caused by white coat syndrome.

Hypertension or high blood pressure is a condition where the force of the blood against the walls of the arteries in the body is too high.

Normal blood pressure levels are around 120/80 millimeters of mercury (mmHg). Doctors usually define hypertension as a blood pressure reading of anything above 140/90 mmHg.

According to the Centers for Disease Control and Prevention (CDC), about 32 percent of American adults have high blood pressure.

While the exact causes of high blood pressure are not known, there is a variety of factors that can increase the risk of hypertension, such as:

obesity lack of physical activity lifestyle choices, such as smoking or drinking too much alcohol a high-stress lifestyle too much salt intake a family history of high blood pressure older age thyroid disorders sleep apnea kidney disease genetics

Managing these risk factors may help some people keep their blood pressure in the healthy range.

However, white coat hypertension is high blood pressure that typically occurs only at the doctor's office or other medical center and may have something to do with nervousness or anxiety surrounding the office.

A recent study posted to the journal Hypertension noted that somewhere between 15 and 30 percent of people with high blood pressure at the doctor's office might be affected by white coat hypertension.

Thank you for supporting Medical News Today Blood pressure person having their blood pressure measured. May have white coat syndrome
Some doctors suggest that white coat hypertension may be a precursor to hypertension. While white coat hypertension may cause a spike in the blood pressure, not all doctors are convinced this is the only cause of a person's high blood pressure. Some believe white coat hypertension is a precursor to actual hypertension. Stress and anxiety may play a role in high blood pressure, so people with white coat hypertension may still be more at risk for issues caused by blood pressure. In fact, a study posted to the Journal of the American College of Cardiology found that people who had white coat hypertension were also more likely to experience cardiovascular issues. It is essential, therefore, that doctors find a way to accurately diagnose a person's blood pressure and start any treatment that is necessary. Treating white coat syndrome Treating white coat syndrome can be tricky, as it can be hard for doctors to get an accurate reading of the blood pressure to determine if someone has hypertension. Typically, doctors do not prescribe chemical medicines to treat someone with high blood pressure based on one high reading. This could lead to problems, such as hypotension, where a person's blood pressure drops too low, which causes its own set of issues. Instead, doctors will want to take multiple readings. They may refer individuals to a blood pressure clinic, or ask them to use an at-home blood pressure monitor. A proper diagnosis is crucial to help treat or prevent hypertension. Diagnosis Diagnosing someone with white coat syndrome may be challenging, as it is often difficult to get an accurate reading. If the initial reading is high, a doctor will typically ask the person to come back in a few weeks for another reading. However, a person who has white coat syndrome is likely to experience high blood pressure the second time. In these cases, doctors may recommend that the person take their blood pressure readings somewhere else, using a home blood pressure monitor or an ambulatory blood pressure monitor. An ambulatory blood pressure monitor is a device that a person typically wears for 1 or 2 days. The device measures the blood pressure at various times throughout the day. The difference between the machines may just be a matter of personal choice. These monitors allow the user to take their blood pressure readings from the comfort of their own home and send the results to their doctor. Thank you for supporting Medical News Today Preventing white coat syndrome Senior lady meditating to help alleviate white coat syndrome
Relaxation techniques, such as breathing exercises and meditation, may help to calm people down. Worrying over whether or not the blood pressure will spike may be enough to cause the blood pressure to spike during the reading. Trying some of the following may help prevent white coat syndrome: Relaxation techniques Some relaxation techniques, such as breathing exercises or meditation may help people who are worried about their blood pressure to calm down before going into the doctor's office. One exercise involves counting things using the senses. For instance, a person could count three things they can see in the room, two things they can hear, and one thing they can touch. This exercise may help the person focus less on what is worrying them and more on what is around them. Move if necessary A doctor's office can be an intimidating place filled with nurses, receptionists, and doctors all busy going about their routine. Anyone affected by this activity could ask to move to a quiet room. Take a moment If still feeling nervous when it is their turn to see the doctor, a person might stop and take a moment to relax. Taking a few deep breaths may help calm the nerves. Relaxing for a few moments may help give a more accurate reading. Complications The primary complication of white coat syndrome is hypertension itself. Many people may believe that a fear of doctors or anxiety about the office visit causes their high blood pressure. However, the current research indicates that white coat syndrome may be an indication of future hypertension. Takeaway A thorough diagnosis is key to understanding what is causing the hypertension. Managing stress and anxiety levels may help in some cases so the doctors can get a good reading of a person's blood pressure. White coat syndrome may put a person at risk for cardiovascular issues, and not all doctors think the condition is harmless. Anyone who thinks they have white coat hypertension should see a doctor for a thorough diagnosis. Some people may need to take their blood pressures at home; others may be referred to a blood pressure clinic where they will undergo multiple tests over a period.
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Which women are most at risk of stroke?

A paper published this week outlines stroke risk factors that are specific to women. The authors hope that increasing awareness will help identify people who should be monitored more closely.
Woman patient with woman doctor
A new review examines stroke risk factors in women.

Strokes kill an estimated 140,000 people in the United States each year. That accounts for around 1 in 20 deaths.

Breaking that statistic down further, someone dies of stroke in the U.S. every 4 minutes.

Such a huge health concern has garnered significant interest from health authorities, governmental bodies, and scientists.

Over the years, studies have found a range of risk factors associated with stroke. For instance, risk of stroke increases with age, and individuals with high blood pressure, heart disease, or diabetes also have increased risk.

Ethnicity makes a difference, too — strokes occur more often in African American adults than in white, Hispanic, or Asian American adults, for instance.

Certain lifestyle factors also play their part — activities such as smoking tobacco, drinking alcohol, taking certain illegal drugs, being obese, and eating an unhealthful diet are all known to take their toll.

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Women and stroke risk

One risk factor for stroke that many people are not aware of is sex — women are more likely to experience stroke than men. They are also more likely to die as a result. Every year, around 425,000 women have a stroke, which is 55,000 more than men.

The reason for the increased risk and mortality is not fully fleshed out, but a study published in the journal Stroke this week takes an in-depth look and fills in some of the blanks.

The new study paper is part of a special edition of the journal that focuses specifically on women's health, which is timed to coincide with the American Heart Association's (AHA) Go Red month.

The corresponding author of the new study, Dr. Kathryn Rexrode — from the Brigham and Women's Hospital Department of Medicine in Boston, MA — explains the importance of this study.

"As women age," she notes, "they are much more likely to have a stroke as a first manifestation of cardiovascular disease rather than heart attack. We want to better understand susceptibility: why do more women have strokes than men? What factors are contributing and disproportionately increasing women's risk?"

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Female-specific stroke risk factors

Dr. Rexrode and her team took a deep dive into the existing literature. They wanted to get a fuller understanding of the risk factors for stroke that are unique to women. They concluded that the following were most significant:

starting periods before the age of 10 starting menopause before the age of 45 having low dehydroepiandrosterone levels taking oral estrogen or combined oral contraceptives

Also, women who had a history of pregnancy-related complications, such as gestational diabetes, hypertension during or just after pregnancy, and preeclampsia, had an increased risk.

Other factors that, according to the team, need further investigation include taking transdermal estrogen or progestogen-only contraception.

Many U.S. women fit into the categories above, but it is important to note that only a small fraction of those who have one or more of them will experience a stroke. It is awareness that is key.

"These women should be monitored carefully, and they should be aware that they are at higher risk, and motivated to adhere to the healthiest lifestyle behaviors to decrease the risk of hypertension and subsequent stroke."

Dr. Kathryn Rexrode

As an extension to the study, the researchers looked at potential stroke risk factors for transgender people. It is common for them to be prescribed anti-androgens, estrogens, or a combination of the two.

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Although there is the potential that this could alter the level of stroke risk, to date, the literature is too sparse to make any solid conclusions.

As stated above, the importance of this work is to raise awareness of the subgroups of women who might be at a greater risk of stroke in later life. It might mean that a closer eye can be kept on certain individuals who slot into a number of the higher-risk categories.

Because there is still much ground to cover, more research will be needed to firm up and extend these conclusions. Now, as ever, limiting modifiable risk factors should be everyone's priority.

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Cell phone radiation: Could high exposure cause tumors?

High exposure to radiofrequency radiation resulted in tumors in tissue around the nerves in the hearts of male rats, but not of female rats or male or female mice, according to preliminary conclusions of two studies.
a woman using a cell phone
Two new studies have investigated the effects of cell phone radiation on the health of rodents.

Draft reports on the two studies by the National Toxicology Program (NTP), which is part of the National Institutes of Health (NIH) in the United States, were released recently, pending a review by external experts that is scheduled to take place March 26–28. Members of the public may also submit comments.

The reports contain the remaining results of two large "toxicology and carcinogenesis" studies — one conducted in rats and the other in mice — of the effects of radiofrequency radiation (RFR) emitted by cell phones.

"The levels and duration of exposure," explains Dr. John Bucher, a senior scientist with the NTP, "to RFR were much greater than what people experience with even the highest level of cell phone use, and exposed the rodents' whole bodies."

High frequency radiation — like X-rays and gamma rays — and some higher energy ultraviolet radiation are known as ionizing radiation because they can knock out electrons and other charged particles from within atoms. They carry enough energy to damage DNA inside cells, which can give rise to cancer.

However, RFR is at the lower energy end of the spectrum and is not able to knock out charged particles and alter atomic structure, but it can cause atoms and molecules to vibrate. It generates heat if absorbed in large amounts by food, tissues, and other materials that hold water.

Thus, although RFR is not the type of radiation that can cause cancer by damaging DNA, there have been concerns that it might alter tissue in other ways that could lead to cancer.

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Rats, mice exposed to different RFR levels

The NTP researchers note that the "predominant source of human exposure to RFR occurs through the use of cellular phone handsets."

For their studies, they constructed special chambers, in which they exposed the rats and mice to different levels of RFR.

Exposure occurred in a pattern of 10 minutes on, 10 minutes off, for a total of just over 9 hours per day and went on for 2 years.

Dr. Bucher says that 2 years of age in a rat or mouse is about 70 years of age in a human.

The RFR exposure levels ranged from around the maximum that is legally allowed for cell phones in the U.S. to around four times that level.

The animals were exposed to the same "frequencies and modulations" as those of 2G and 3G signals that are used to make voice calls and send texts in the U.S. Later generations of RFR — such as 4G, 4G-LTE, and 5G — use different frequencies and modulations.

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Schwannomas found in hearts of male mice

The tumors that the NTP researchers found in the hearts of male rats are of a type called schwannoma, which develops from the Schwann cells that form the protective and supportive tissue that surrounds peripheral nerves. This type of tumor is rarely cancerous.

The results showed that the incidence of schwannomas in the hearts of male rats went up as the animals were exposed to RFR levels that were "beyond the allowable cell phone emissions."

The researchers also found that these levels of RFR led to unusual patterns of damage in heart tissue in both male and female rats.

However, they found little evidence of health problems resulting from RFR exposure in mice.

Dr. Bucher says that the results "should not be directly extrapolated to human cell phone usage," but also notes that the tumors that they saw "are similar to tumors previously reported in some studies of frequent cell phone users."

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'Conclusions still require careful discussion'

Dr. Otis W. Brawley, of the American Cancer Society (ACS), notes that while the preliminary results are "bound to create a lot of concern, [...] the evidence for an association between cell phones and cancer is weak, and so far, we have not seen a higher cancer risk in people."

"But," he continues, "if you're concerned about this animal data, wear an earpiece."

He also points out that in response to questions at a recent press conference, Dr. Bucher said that the new data has not altered his own use of cell phones, and he has not advised his family to change their use of them either.

In a statement about the new data, Dr. Jeffrey Shuren, director of the Center for Devices and Radiological Health at the Food and Drug Administration (FDA), urges that the "conclusions still require careful discussion," and notes that their understanding is that the evidence is "mostly equivocal, or ambiguous," as to whether the RFR exposures "actually caused cancer in these animals."

He also highlights some "unusual findings" of the studies, including the fact that the rats that were exposed to RFR lived longer than the control rats that were not.

For those who are nevertheless concerned about exposure to RFR from cell phone use, the ACS advise that they keep the antenna away from the head — for example, by using speakerphone mode or a hands-free device — and send text messages in preference to making voice calls, except while driving.

Other ways to limit cell phone use include spending less time talking on them and using a landline instead, if available.

"Cell phone technologies are constantly changing, and these findings provide valuable information to help guide future studies of cell phone safety."

Dr. John Bucher

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Vitamin D-3 could 'reverse' damage to heart

By probing the effect that vitamin D-3 has on the cells that make up the lining of blood vessels, scientists at Ohio State University in Columbus have identified for the first time the role that the "sunshine vitamin" plays in preserving cardiovascular health.
vitamin d supplements in heart
The 'sunshine vitamin' has been shown to preserve heart health.

In a paper published in the International Journal of Nanomedicine, they describe how they used nanosensors and a cell model to identify the molecular mechanisms that vitamin can D-3 trigger in the endothelium, which is the thin layer of tissue that lines blood vessels.

It was previously believed that the endothelium served no other purpose than to act as an inert "wrapper" of the vascular system, allowing both water and electrolytes to pass in and out of the bloodstream.

However, advances over the past 30 years have revealed that the endothelium acts more like an organ that lines the whole of the circulatory system from the "heart to the smallest capillaries," and whose cells carry out many unique biological functions.

Changes to the endothelium have been linked to several serious health problems, including high blood pressure, insulin resistance, diabetes, tumor growth, virus infections, and atherosclerosis, which is a condition wherein fatty deposits can build up inside arteries and increase the risk of heart attack and stroke.

Vitamin D-3 has role beyond bone health

The new study suggests that vitamin D-3 — a version of vitamin D that our bodies produce naturally when we expose our skin to the sun — plays a key role in preserving and restoring the damage to the endothelium that occurs in these diseases.

Some other natural sources of vitamin D-3 include egg yolks and oily fish. It is also obtainable in the form of supplements. Vitamin D-3 is already well-known for its role in bone health.

"However," explains senior author Tadeusz Malinski, a professor in the department of chemistry and biochemistry, "in recent years, in clinical settings people recognize that many patients who have a heart attack will have a deficiency of D-3."

"It doesn't mean that the deficiency caused the heart attack," he adds, "but it increased the risk of heart attack."

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Nanosensors probed effect of D-3 on cells

For their study, Prof. Malinski and colleagues developed a measuring system using nanosensors, or tiny probes that are 1,000 times smaller than the thickness of human hair and can operate at the level of atoms and molecules.

They used the nanosensors to track the impact of vitamin D-3 on molecular mechanisms in human endothelial cells that had been treated to show the same type of damage that occurs from high blood pressure.

The findings suggest that vitamin D-3 is a powerful trigger of nitric oxide, which is a molecule that plays an important signaling role in the control of blood flow and the formation of blood clots in blood vessels.

The researchers also found that vitamin D-3 significantly reduces oxidative stress in the vascular system.

They note that their study "provides direct molecular insight to previously published observations that have suggested that vitamin D-3 deficiency-induced hypertension is associated with vascular oxidative stress." The effects of vitamin D-3 were similar in both Caucasian and African American endothelial cells.

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Could D-3 reverse cardiovascular damage?

The study authors note that while their findings came from tests performed on a cellular model of high blood pressure, "[T]he implications of the influence of vitamin D-3 on dysfunctional endothelium is much broader."

They suggest that vitamin D-3 has the potential to significantly reverse the damage that high blood pressure, diabetes, atherosclerosis, and other diseases inflict on the cardiovascular system.

"There are not many," Prof. Malinski adds, "if any, known systems which can be used to restore cardiovascular endothelial cells which are already damaged, and vitamin D-3 can do it."

"This is a very inexpensive solution to repair the cardiovascular system. We don't have to develop a new drug. We already have it."

Prof. Tadeusz Malinski

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Migraine a 'risk factor' for cardiovascular disease

A new study brings some concerning news for the millions of us who experience migraine attacks; scientists found that migraine may increase the risk of heart attack, stroke, and other forms of cardiovascular disease.
a woman with a migraine
Migraine may increase the risk of cardiovascular disease, say researchers.

Based on these findings, the researchers — at Aarhus University Hospital in Denmark as well as Stanford University in California — say that migraine should be considered as a risk factor for cardiovascular disease.

Study co-author Henrik Toft Sørensen, from the Department of Clinical Epidemiology at Aarhus University Hospital, and colleagues recently reported their results in The BMJ.

As the Migraine Research Foundation point out, migraine is "not just a bad headache." Instead, it is a debilitating condition characterized by a recurring, severe pain on one or both sides of the head.

Migraine may also be accompanied by other symptoms, including dizziness, nausea, vomiting, sensitivity to light, and visual problems. When visual or other sensory problems occur, this is referred to as "migraine with aura."

It is estimated that migraine affects around 39 million people in the United States. Migraine attacks can last from anywhere between 4 and 72 hours, and more than 90 percent of those who experience migraine are unable to carry out their day-to-day activities as a result.

But according to Sørensen and team, migraine may pose more serious problems.

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Cardiovascular risk heightened by migraine

Previous research has indicated that people with migraine — especially women — may be more likely to experience cardiovascular problems than those without migraine.

For the study, Sørensen and his team wanted to learn more about the link between migraine and cardiovascular disease, which is an umbrella term for conditions that affect the heart and blood vessels, such as stroke, heart attack, atrial fibrillation, or irregular heart rate, and heart failure.

The scientists gathered data from the 1995–2013 Danish National Patient Registry, which included 51,032 people with migraine. For each person with migraine, the team matched 10 people without migraine who were the same age and sex. This gave them a total of 510,320 migraine-free subjects.

Compared with people who did not experience migraine, the study revealed that people with migraine were more likely to have a heart attack, stroke, or atrial fibrillation over 19 years of follow-up.

In detail, the researchers found that 25 in every 1,000 people with migraine had a heart attack, compared with 17 in every 1,000 migraine-free adults.

For every 1,000 people with migraine, 45 had an ischemic stroke — caused by a blood clot in the brain — compared with 25 in every 1,000 migraine-free subjects.

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Atrial fibrillation occurred in 47 of every 1,000 people with migraine, compared with 34 in every 1,000 people without migraine.

Incidence of heart failure was similar in both groups, the researchers report, and no significant link was found between migraine and peripheral artery disease.

Women with migraine and people who had migraine with aura were found to have the greatest risks of stroke, heart attack, and atrial fibrillation, and the associations were strongest in the first year after migraine diagnosis.

These findings remained after accounting for a number of confounding factors, such as body mass index (BMI) and smoking status.

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A 'potent and persistent risk factor'

Sørensen and team note that their study is purely observational, so they are unable to prove cause and effect between migraine and cardiovascular health.

Still, they believe that their findings — combined with those of other studies — indicate that migraine should be deemed a significant risk factor for cardiovascular disease.

"Although the magnitude of the increased cardiovascular risk associated with migraine was fairly small at the individual level," the authors explain, "it translates into a substantial increase in risk at the population level, because migraine is a common disease."

"This suggests that migraine should be considered a potent and persistent risk factor for most cardiovascular diseases in both men and women."

In an editorial linked to the study, Prof. Tobias Kurth — of the Institute of Public Health at Charité – Universitätsmedizin Berlin in Germany — and colleagues say that there is now "plenty of evidence that migraine should be taken seriously as a strong cardiovascular risk marker."

"We urgently need," add the authors, "to determine which specific strategies reduce the additional risk of cardiovascular disease among people with migraine and whether reducing the frequency of attacks has any effect."

"Public research agencies must act quickly by investing in prospective studies to accomplish this goal."

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How to improve circulation

Circulation is the process by which the heart pumps a person's blood around their body. Good circulation is vital to a person's health. So, how can someone improve their circulation?

As the blood circulates, it delivers oxygen and nutrients to the body's cells and takes away waste products.

This article discusses six ways to improve circulation that are supported by scientific evidence.

How to improve circulation Woman improving circulation outside jogging and running through park making heart symbol with her hands.
Avoiding a sedentary lifestyle may help to improve circulation. Jogging and avoiding sitting still for too long are both steps to take.

If a person wants to improve their circulation, there are some obvious places to start. These include:

stopping smoking tobacco products reducing intake of saturated fats trying not to sit still for long periods

In addition, trying one or more of the following may help improve circulation:

1. Maintaining a healthy weight

Maintaining a healthy weight helps promote good circulation. If a person is overweight, it may negatively affect their circulation.

A 2009 study found that losing weight improved circulation for women who were overweight. The participants increased their levels of a protein called adiponectin that is associated with vascular function.

2. Jogging

Regular cardiovascular exercise, such as jogging, supports the health of the circulatory system and improves circulation.

A 2003 review noted that exercise improves the body's ability to take in and use oxygen. It also improves the capacity of blood vessels to dilate, which helps them work more efficiently, allowing the muscles to receive oxygen more easily.

These benefits of exercise improve circulation and mean that daily activities may be less tiring.

3. Practicing yoga

Yoga is a low-impact exercise that is easy to modify for beginners. It involves bending, stretching, and twisting. These movements can help to compress and decompress a person's veins, which may improve circulation.

A 2014 review of evidence published in the European Journal of Preventive Cardiology found yoga was beneficial for the cardiovascular system and a person's metabolism.

A simple yoga position for beginners to try is the downward-facing dog. This helps improve circulation as it puts the hips and heart above the head, allowing gravity to increase blood flow towards the head.

To do the downward-facing dog, a person should:

start on all fours, with shoulders above wrists, and hips above knees breathe in push hips backward and up into the air while exhaling straighten the arms and legs press firmly into the hands breathe deeply, lifting and pressing down each heel in turn to deepen the stretch let the neck relax stay in position for three deep breaths slowly lower hips back into starting position

4. Eating oily fish

The omega-3 fatty acids in oily fish promote cardiovascular health and improve circulation, according to this 2013 study.

Oily fish include:

salmon mackerel sardines tuna

For those who are vegetarian or vegan, kale contains a small amount of omega-3 fatty acid.

Supplements containing omega-3 fatty acids are another option for people who do not eat fish.

5. Drinking tea

The antioxidants in tea promote cardiovascular health and may improve circulation. This is true for both black tea and green tea.

A 2001 study, published in the journal Circulation, found that black tea improves blood vessel health. Healthy blood vessels help improve circulation.

Another study found that green tea consumption is associated with a lower rate of coronary artery disease.

6. Keeping iron levels balanced

Iron is an essential mineral for the circulatory system. It is required to make hemoglobin, one of the major components of red blood cells, which is needed to carry oxygen.

Eating foods rich in iron, such as red meat or spinach, helps the body maintain this essential mineral. However, maintaining a healthful balance is necessary as well.

Too much iron may negatively affect cardiovascular health. A 2013 study found a link between having too much iron in the body and cardiovascular disease in people with high cholesterol and higher waist circumference measurements.

Thank you for supporting Medical News Today Causes and risk factors Person having their blood pressure measured.
Low blood pressure may affect circulation. The health of a person's circulatory system determines how well the blood circulates through their body. The factors that affect this include: Blood pressure Blood pressure is the pressure of the blood on the walls of the blood vessels as it circulates. Blood pressure is measured by "systolic" pressure over "diastolic" pressure. Systolic pressure is the pressure on the blood vessel wall during the heartbeat when the lower chambers of the heart are pumping blood forward. Diastolic pressure is the pressure on the blood vessel wall when the lower chambers of the heart are at rest and filling with blood. According to the American Heart Association, a normal resting blood pressure in an adult is no more than 120 millimeters (mm) of mercury (Hg) systolic and no more than 80 mm for diastolic. This is abbreviated to 120/80 mmHg. People with very low blood pressure may experience poor circulation and other related symptoms. However, having a lower blood pressure measurement is not usually a cause for concern in people with a healthy cardiovascular system. Blood health The blood carries oxygen and nutrients and removes waste and does these jobs best when it is healthy. Healthy blood has the right levels of normal red blood cells, which carry oxygen, white blood cells, and platelets. These components are all made in the bone marrow. Heart health The heart is the muscle responsible for pumping a person's blood around their body. The stronger and healthier a person's heart is, the better their circulation. Blood vessel health Having healthy veins and arteries makes it easier for the blood to pass through them. If a person's lipid or fat or their cholesterol levels are too high or low, the blood vessels can become injured and blocked. Other causes Poor circulation may be a symptom of other underlying health conditions. These include: obesity diabetes mellitus heart conditions conditions affecting the arteries or veins Exercise and other measures to promote cardiovascular health may reduce poor circulation caused by these conditions. Signs and symptoms poor circulation Man with numbness, tingling, and pain holding his hand.
Numbness, tingling, and pain in the arms or legs may be symptoms of poor circulation. If blood flow is reduced to a certain part of a person's body, they may experience the signs and symptoms of poor circulation. The following symptoms mainly occur in the arms or legs. They include: throbbing stinging numbness tingling cramps pain warmth or coolness swelling Thank you for supporting Medical News Today When to see a doctor If a person experiences the symptoms of poor circulation, it is important that they speak to a doctor. A doctor can help diagnose what might be the problem and suggest treatment for any underlying conditions. In addition, they may suggest eating a healthful diet, exercising regularly, and quitting smoking to improve circulation.
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Just 30 minutes of light exercise each day can benefit health

A new study from the Karolinska Institutet in Stockholm, Sweden, suggests that replacing time spent sitting with light-intensity physical activity may benefit health more than previously thought.
walking through forest
New research shows that just a little exercise each day can bring significant benefits.

In the journal Clinical Epidemiology, the authors report how replacing just half an hour of sitting each day with housework, walking, standing, or similar low-intensity activity is linked to a 24 percent reduced risk of death from cardiovascular disease.

These new findings might come as a pleasant surprise, especially to those who assume that only moderate- or vigorous-intensity physical activity can make a sizable difference.

The study is particularly significant because it "objectively assessed" levels of physical activity using motion trackers rather than self-reports from participants.

"Previous studies," says study leader Dr. Maria Hagströmer, a senior lecturer in the Department of Neurobiology, Care Sciences and Society, "asked participants about levels of physical activity, but this can lead to reporting error since it's hard to remember exactly for how long one has been sitting and moving around."

The study also confirms that replacing sedentary time with moderate- or higher-intensity physical activity has an even greater effect on reducing deaths linked to cardiovascular disease.

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'Avoiding inactivity' is also important

The United States Department of Health and Human Services explain that "for substantial health benefits," adults should engage in at least 150 minutes per week of moderate-intensity aerobic exercise, preferably spread through the week in bouts of at least 10 minutes at a time. They suggest "brisk walking or tennis" as examples.

Alternatives to this are 75 minutes per week of vigorous-intensity aerobic exercise or an equivalent mixture of both moderate and vigorous. They give "jogging or swimming laps" as examples of vigorous-intensity activity.

Even more benefit comes from increasing the time spent in aerobic physical activity, as well as by doing muscle-strengthening exercises that "engage all the major muscle groups" on at least 2 days per week.

The U.S. guidelines also state that we should aim to "avoid inactivity," noting that, "[A]dults who participate in any amount of physical activity gain some health benefits." One might therefore be forgiven for assuming that these benefits would be rather small, given the small amount of space dedicated to this advice.

The new findings may bring comfort to those whose reaction to the formal guidelines is, "I can barely find time to do the laundry and sweep the yard, never mind work out for 2.5 hours per week!"

Well, it seems that time spent doing everyday chores instead of sitting also makes a difference — and that difference is bigger than we thought.

The researchers had confirmed the dangers of prolonged sitting in an earlier study that showed that, compared with sitting for under 6.5 hours per day, sitting for more than 10 hours daily was linked to a 2.5 times greater risk of premature death.

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Study used accelerometer data

For the study, the researchers analyzed data on 851 men and women who took part in Sweden's Attitude Behaviour and Change population-based study.

The physical activity data were collected using Actigraph accelerometers and data on deaths and causes of death were gathered from Swedish registries over an average follow-up of 14.2 years.

During the follow-up, 79 of the participants died — 24 from cardiovascular disease, 27 from cancer, and 28 from "other causes."

When they analyzed the activity data against the deaths and causes of death, the researchers found that light-intensity physical activity was tied to a significant 24 percent reduction in risk of death from cardiovascular disease and 11 percent reduction in risk of death from all causes.

Replacing sedentary time with just 10 minutes of either moderate- or vigorous-intensity activity each day was linked to a 38 percent reduced risk of death from cardiovascular disease, while 30 minutes per day was linked to a 77 percent reduction.

"No statistically significant reductions were found for cancer mortality," note the authors.

"This is a unique study, since we've been able to analyze a large number of people with objective measures of physical activity for up to 15 years."

Dr. Maria Hägstromer

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Heart disease: 'Just one cigarette daily' raises risk

After carrying out a fresh review of published studies, researchers urge that smokers quit completely rather than cut down if they want to significantly reduce their risk for cardiovascular disease.
A woman smoking a cigarette
Researchers say smokers should quit the habit completely if they want to reduce their risk of poor heart health.

A BMJ report on the review — led by Allan Hackshaw, a professor at University College London in the United Kingdom — reveals that even if you smoke around one cigarette per day, your risk for stroke and coronary heart disease is "much greater than expected."

He and his colleagues calculated that the risk from smoking about one cigarette per day is around "half that for people who smoke 20 per day."

The findings challenge a widely held view that smoking just a few cigarettes per day is "relatively safe."

Instead, the report concludes that: "No safe level of smoking exists for cardiovascular disease."

'Most preventable cause of premature death'

"Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers," declare the World Health Organization (WHO).

The latest WHO estimates reveal that more than 7 million people worldwide die every year from using tobacco. This figure includes around 890,000 deaths from exposure to second-hand smoke.

In the United States, smoking is the "most preventable cause of premature death," according to the American Heart Association, who state that smoking reduces "tolerance for physical activity and increases the tendency for blood to clot."

Smoking raises the risk of developing many persistent health problems, including atherosclerosis, a condition in which fatty deposits build up inside arteries, thereby raising the risk of stroke and coronary heart disease. Consequently, the risk of heart disease in smokers is double that of non-smokers.

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Risk higher for men, even higher for women

Prof. Hackshaw and colleagues were prompted to carry out their review by occasional single studies and a review of five studies reported 20 years ago that found that the risk of coronary heart disease from smoking fewer than five cigarettes per day was higher than expected.

So, for their systematic review and meta-analysis, they used data from 141 published studies to calculate the risk of coronary heart disease and stroke for those who smoke one, five, and 20 cigarettes per day compared with never-smokers.

Using data from all the studies, they calculated that smoking about one cigarette per day is linked to a 48 percent raised risk of coronary heart disease and a 25 percent raised risk of stroke in men.

However, when they only used data from studies that had adjusted their results to take into account the effect of other factors that can increase these risks, they found that they went up to 74 percent and 30 percent, respectively.

The analysis for women revealed even higher estimates of risk associated with smoking about one cigarette per day: 57 percent for coronary heart disease and 31 percent for stroke.

Again, when analyzing only studies that took into account confounding factors, these figures went up to 119 percent and 46 percent, respectively.

Smoking one or two daily carries large risk

The researchers also drew a comparison between smoking a few and smoking 20 cigarettes per day.

They found that compared with never smoking, smoking about one cigarette per day carries 40–50 percent of the risk for coronary heart disease and stroke that is associated with smoking 20 per day.

"We have shown," they argue, "that a large proportion of the risk of coronary heart disease and stroke comes from smoking only a couple of cigarettes each day."

They suggest that many people may be surprised by these findings. "But there are also biological mechanisms that help explain the unexpectedly high risk associated with a low level of smoking," they add.

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'Only complete cessation is protective'

"Any assumption that smoking less protects against heart disease or stroke has been dispelled," notes Kenneth Johnson, adjunct professor at the University of Ottawa in Canada.

In an editorial linked to the review, he discusses its significance to public health and concludes, "only complete cessation is protective and should be emphasized by all prevention measures and policies."

He urges regulators who are dealing with new "reduced risk" tobacco products to take note because "any suggestion of seriously reduced coronary heart disease and stroke from using these products is premature."

"The take-home message for smokers is that any exposure to cigarette smoke is too much."

Prof. Kenneth C. Johnson

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A hidden culprit? Flu may heighten heart attack risk

Could something as seemingly innocuous as the seasonal flu increase the possibility of a heart attack for people at risk of heart disease? New research suggests that may indeed be the case.
man sneezing
The flu could be particularly harmful to those at risk of heart disease, a new study shows.

Researchers from the Institute for Clinical Evaluative Sciences (ICES) and from Public Health Ontario (PHO) — both in Ontario, Canada — have made a surprising finding, looking at the health risks associated to an influenza diagnosis.

Influenza, usually referred to simply as "the flu," is a contagious disease caused by influenza viruses picked up from the atmosphere, or through close contact with infected individuals. Flu viruses usually infect the nose and throat, causing sneezing, coughing, a sore throat, and sometimes fever.

Lead author of the study, Dr. Jeff Kwong, and a team of researchers from ICES and PHO noted that groups at risk of heart disease seem to have increased chances of experiencing a heart attack in the first week after becoming infected with the flu.

According to the Centers for Disease Control and Prevention (CDC), approximately 735,000 people in the United States experience a heart attack each year.

"Our findings are important because an association between influenza and acute myocardial infarction reinforces the importance of vaccination," Dr. Kwong notes.

The researchers recently published a paper detailing their study's results in the New England Journal of Medicine.

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Respiratory infections as a risk factor

In their study, Dr. Kwong and team analyzed the cases of almost 20,000 adults based in Ontario between 2009 and 2014. These were all cases of influenza, as confirmed by laboratory tests.

Out of this total, the researchers singled out 332 individuals who had been admitted to the hospital to be treated for a heart attack within only a year from getting infected with influenza.

The analysis conducted by Dr. Kwong and colleagues revealed a significant link between a diagnosis of acute respiratory infection — and influenza in particular — and a heightened risk for acute myocardial infarction, or heart attack.

The possibility of experiencing a heart attack is increased sixfold in the first week from the detection of infection with a flu virus and, the researchers note, certain groups are more exposed to this risk than others.

Most vulnerable seem to be seniors (adults aged 65 or older), individuals infected with B strains of the influenza virus, and those who have not previously experienced a heart attack.

An increased risk for heart attack was also noted in the case of individuals affected by other types of respiratory viruses, though the exposure was somewhat less significant.

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At-risk groups should not postpone flu shot

These results confirm the outcomes of previous studies that outlined correlations between getting a flu vaccine and a lower risk of adverse cardiovascular events.

"Our findings, combined with previous evidence that influenza vaccination reduces cardiovascular events and mortality, support international guidelines that advocate for influenza immunization in those at high risk of a heart attack."

Dr. Jeff Kwong

The researchers strongly recommend that we do everything we can in order to prevent infection, by paying particular attention to hygiene and making sure we get the seasonal flu shot.

"People at risk of heart disease should take precautions to prevent respiratory infections, and especially influenza, through measures including vaccinations and handwashing," stresses Dr. Kwong.

Data from the CDC reveal that only 67.2 percent of all U.S. adults aged 65 and over have received a flu shot during the past year.

Dr. Kwong also urges individuals who may be at risk of heart disease to play it safe, and get evaluated for any telling symptoms if they receive a flu diagnosis.

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Exercise may increase lifespan after breast cancer treatment

A new study explains how aerobic and resistance exercise can increase life expectancy for individuals who have successfully finished breast cancer treatment.
woman holding dumbbells
Regular exercise could increase life expectancy for cancer survivors, study shows.

According to National Cancer Institute estimates, there were about 252,710 new diagnoses of breast cancer in the United States in 2017. The life expectancy following treatment for this type of cancer is quite good, with a 5-year survival rate of 89.7 percent.

However, cancer treatment is often associated with the onset of metabolic syndrome, a cluster of related conditions including heart disease, hypertension, obesity, high blood sugar, and insulin resistance. Metabolic syndrome has also been linked to a poorer survival rate among breast cancer survivors.

That is why researchers from the University of Southern California in Los Angeles, CA, have set out to see how post-treatment life expectancy might be prolonged through regular exercise, which can help to tackle or prevent the onset of metabolic syndrome.

"Many people don't know the No. 1 cause of death for breast cancer survivors is heart disease, not cancer," says lead author Christina Dieli-Conwright, explaining why regular exercise might help to increase life expectancy.

The study's findings were published yesterday in the Journal of Clinical Oncology.

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"In breast cancer patients, metabolic syndrome is exacerbated by obesity, a sedentary lifestyle and receipt of chemotherapy," Dieli-Conwright explains.

In their paper, the authors also note that individuals experiencing metabolic syndrome have a 17 percent higher chance of being diagnosed with breast cancer. They may also be more likely to experience cancer recurrence after treatment, and may have a shorter life expectancy.

Taking these considerations into account, the research team hypothesized that adherence to a regular exercise schedule might improve the long-term survival rate by addressing weight gain and its associated disorders.

Dieli-Conwright and team conducted a randomized trial, working with 100 individuals who had successfully undergone breast cancer treatment less than 6 months before the study was due to begin.

At the start of the study, approximately 46 percent of participants were deemed obese, while approximately 77 percent had been diagnosed with metabolic syndrome.

The intervention consisted in three weekly one-on-one training sessions over a period of 4 months, including weight-lifting exercises and a minimum of 150 minutes of moderate aerobic exercise.

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Following the 4-month training program, the participants who engaged in this routine experienced significantly improved health; only 15 percent of them were found to have metabolic syndrome, compared with 80 percent of the study participants in the control group.

The researchers also noted that the women who participated in the fitness program gained muscle mass and shed excess fat, and that regular exercise reduced participants' risk of developing heart disease.

Moreover, fitness program participants also saw a 10 percent decrease in blood pressure and a 50 percent increase in high-density lipoprotein (HDL), or the so-called "good cholesterol," which absorbs other types of cholesterol, carrying them back to the liver to be eliminated from the system.

Dieli-Conwright points out that obesity can cause inflammation, which, in turn, might facilitate tumor growth and cancer recurrence following treatment.

A study Dieli-Conwright conducted last year, in which she looked at blood samples and fat biopsies sourced from 20 cancer survivors with obesity, showed that individuals who engage in regular exercise see less inflammation in blood cells, and they also have a better overall inflammation response.

The researcher stresses the importance of exercise to maintining good health, adding that she and her team are committed to conducting further studies addressing the therapeutic potential of such routines.

"Exercise is a form of medicine. Both of these studies support that idea, and we will continue to conduct studies to supplement traditional cancer therapies."

Christina Dieli-Conwright

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