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Best supplements for lowering blood pressure

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cardiomyopathy is a disease that involves a weakened heart muscle. The condition makes it difficult for the heart to pump blood throughout the body.

According to the Centers for Disease Control and Prevention (CDC), cardiomyopathy may occur in as many as 1 in 500 people, but it frequently goes undiagnosed. Cardiomyopathy can develop over time, or a person may have the disease from birth.

Keep reading to learn more about cardiomyopathy, including its symptoms, causes, and treatment.

There are a few types of cardiomyopathy, including the following:Dilateda female runner experiencing shortness of breath because of cardiomyopathyShare on PinterestA person with cardiomyopathy may experience shortness of breath and heart palpitations.

Dilated cardiomyopathy is the most common form of the disease. It typically occurs in adults between the ages of 20 and 60 years.

The disease often starts in the left ventricle, but it can eventually also affect the right ventricle.

Dilated cardiomyopathy can affect the structure and function of the atria, too.

Hypertrophic

Hypertrophic cardiomyopathy is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening or "hypertrophy" of these fibers. The thickening makes the chambers of the heart stiff and affects blood flow. It can also increase the risk of electrical disturbances, called arrhythmias.

According to the Children's Cardiomyopathy Foundation, it is the second most common form of cardiomyopathy in children. In about one-third of affected children, diagnosis occurs before the age of 1 year.

Restrictive

Restrictive cardiomyopathy occurs when the tissues of the ventricles become rigid and cannot fill with blood properly. Eventually, it may lead to heart failure. It is more common in older adults and can result from infiltrative conditions — those involving the accumulation of abnormal substances in bodily tissues — such as amyloidosis.

Arrhythmogenic

In arrhythmogenic cardiomyopathy, fibrotic and fatty tissue replaces the healthy tissues of the right ventricle, which may cause irregular heart rhythms. In some cases, this process can also occur in the left ventricle.

According to research in the journal Circulation Research, arrhythmogenic cardiomyopathy increases the risk of sudden cardiac death, especially in young people and athletes. It is a hereditary genetic condition.

Learn more about some other types of heart disease here.

In some cases, usually mild ones, there are no symptoms of cardiomyopathy.However, as the condition progresses, a person may experience the following symptoms with varying degrees of severity:fatigueshortness of breathswelling of the legs and anklesheart palpitationsdizzinessfaintingThe cause of cardiomyopathy is not always clear, but there are some known risk factors.For example, conditions that lead to inflammation or damage of the heart can increase a person's risk of cardiomyopathy.Heart failure, which can occur as a result of a heart attack or other conditions, can also cause cardiomyopathy.Additional risk factors include:Doctors will carry out a physical exam and diagnostic tests to confirm cardiomyopathy.They are likely to use one or more of the following diagnostic tests:Chest X-ray: A chest X-ray helps determine whether the heart has become enlarged, which is a sign of certain health conditions.Electrocardiogram (EKG): An EKG measures the electrical activity of the heart, including how fast it is beating. It also shows whether the heart rhythm is regular or abnormal.Echocardiogram: An echo uses sound waves to create a moving image of the heart. It shows the shape and size of the heart.Cardiac catheterization: A catheterization checks the flow of blood through the heart's chambers.The intention of cardiomyopathy treatment is to control symptoms, slow the progression of the condition, and prevent sudden cardiac death. The type of treatment may depend on the severity of the symptoms and the form of cardiomyopathy.Usually, treatment includes a combination of the following:Lifestyle changesLifestyle changes can help reduce the severity of conditions that may have led to cardiomyopathy. More healthful lifestyle habits may also slow the progression of the disease.Lifestyle changes may include following a healthful diet, which involves limiting the intake of trans fats, saturated fats, added sugar, and salt.Read about 16 foods for a healthy heart here.Managing stress, quitting smoking, and staying physically active are also beneficial for people with cardiomyopathy.The quantity and intensity of beneficial physical activity may vary. It is essential to discuss exercise programs with a doctor or another healthcare professional before starting one.MedicationsUsually, medications are part of a cardiomyopathy treatment plan. Some types of drugs that doctors may prescribe include:Beta-blockers: Beta-blockers slow the heart rate, meaning that the heart has to work less hard.Blood thinners: Blood thinners help decrease the risk of blood clots developing.Diuretics: Diuretics remove excess fluid from the body. This fluid may accumulate when the heart does not pump efficiently.Blood pressure drugs: Angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and angiotensin receptor-neprilysin inhibitors help lower blood pressure and interrupt the stress receptors that become activated in people with cardiomyopathy.Antiarrhythmics: Antiarrhythmics are medications that prevent abnormal heart rhythms.Implanted devicesTreatment may also include different types of implanted devices. The specific device depends on the symptoms. Implanted devices include:Pacemaker: After its surgical implantation beneath the skin near the chest, a pacemaker delivers electrical impulses to the heart, causing it to beat at a normal rate.Implantable cardioverter-defibrillator: This device also delivers an electric shock to the heart when it detects an abnormal, potentially unstable heart rhythm. The electrical impulse returns the heart rhythm to normal.Left ventricle assist device (LVAD): The LVAD assists the heart in pumping blood throughout the body. When cardiomyopathy has severely weakened the heart, this device is helpful while a person is waiting for a heart transplant.Cardiac resynchronization device: This implanted device helps coordinate the contractions of the left and right ventricles of the heart to improve heart function.SurgeryWhen symptoms are severe, surgery might be an option. Some possible surgical procedures for cardiomyopathy include:Septal myectomyThis surgery treats hypertrophic cardiomyopathy with obstruction of blood flow. It involves removing part of the septum that is protruding into the left ventricle. Removing the thickened tissue improves blood flow out of the heart.Heart transplantPeople with certain forms of cardiomyopathy with advanced heart failure might be eligible for heart transplantation. However, a heart transplant is an extensive process for which not everyone qualifies.Cardiomyopathy is a serious medical condition that requires treatment.Without treatment, the disease may progress and become life threatening.Anyone who has a strong family history of cardiomyopathy or experiences one or more of the symptoms of this disease should see a doctor. An earlier diagnosis may improve a person's outlook.Cardiomyopathy is a disease that involves the weakening of the heart muscle.There are various forms of cardiomyopathy, including dilated cardiomyopathy, which is the most common.Treatment for cardiomyopathy depends on the extent of the symptoms, as well as the form of the disease.Treatment usually consists of lifestyle changes and medications. Additional treatment in more severe cases may include implanted devices or surgery.
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How does air pollution affect our health?

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Air pollution appears to cause or contribute to a variety of health conditions. The effects of air pollution on a person's health can range from mild breathing difficulties to severe cardiovascular issues, including heart disease and stroke.

Harmful gases and particles in the air come from a range of sources, including exhaust fumes from vehicles, smoke from burning coal or gas, and tobacco smoke.

There are ways to limit the effects of air pollution on health, such as avoiding areas with heavy traffic. However, significant change relies on improvements to air quality on a global scale.

In this article, we discuss how air pollution can affect a person's health.

air pollutants coming out of a car exhaust pipe that may have negative health effects on the bodyShare on PinterestAvoiding areas with heavy traffic may help limit the effects of air pollution on health.Air pollution consists of small particles that can be natural or artificial.The range of possible pollutants means that air pollution can affect people both outdoors and indoors.Outdoor air pollution consists of:particles from burning coal and gasharmful gases, such as nitrogen oxides or sulfur dioxidetobacco smokeground-level ozoneIndoor air pollution consists of:household chemicalsharmful gases, such as carbon monoxide or radonbuilding materials, such as lead or asbestospollenmoldtobacco smokeAccording to the World Health Organization (WHO), the pollutants that pose the highest risk to a person's health are:particulate matter (particle pollutants), which comprises suspended solids and liquid dropletsnitrogen dioxidesulfur dioxideozoneShort-term exposure to air pollution, such as ground-level ozone, can affect the respiratory system because the majority of the pollutants enter the body through a person's airways.Short-term exposure to air pollution may lead to respiratory infections and reduced lung function. It may also aggravate asthma in people with this condition.Exposure to sulfur dioxide may cause damage to the eyes and respiratory tract, as well as irritating the skin.Research into the long-term health problems that air pollution can cause is ongoing. Research has linked air pollution to serious health problems, adverse birth outcomes, and even premature death.Chronic obstructive pulmonary diseaseExposure to particle pollutants may cause chronic obstructive pulmonary disease (COPD). According to the WHO, air pollution causes 43% of COPD cases and deaths worldwide.COPD is a group of diseases that cause breathing-related difficulties, such as emphysema and chronic bronchitis. These diseases block the airways and make it difficult for a person to breathe.There is no cure for COPD, but treatment can help reduce symptoms and improve quality of life.Lung cancerAccording to the WHO, air pollution causes 29% of all lung cancer cases and deaths.Particle pollutants are likely to contribute to this figure significantly as their small size allows them to reach the lower respiratory tract.Cardiovascular diseaseResearch shows that living in an area with higher levels of air pollution may increase the risk of death from stroke. Air pollution may trigger stroke and heart attacks.A 2018 review notes that the Global Burden of Disease Study estimated air pollution to be responsible for 19% of cardiovascular deaths in 2015. It was also the cause of about 21% of deaths due to stroke and 24% of deaths from coronary heart disease.Preterm deliveryAccording to research that featured in the International Journal of Environmental Research and Public Health, exposure to polluted air can make pregnant women more likely to experience preterm delivery.The researchers found that the chance of preterm delivery lessened with decreased exposure.According to research by the International Agency for Research on Cancer, outdoor air pollution is a carcinogen, meaning that it may cause cancer.Polluted air contains separate particles and chemicals, each of which has a different effect on health.Particle pollutantsParticle pollutants consist of a combination of different particles in the air.Due to the small size of these particles, they can reach the lungs and raise the risk of lung and heart disease.They may also cause a worsening of symptoms in people with asthma.Ground-level ozonePollutants react with sunlight to create ground-level ozone. Smog consists largely of ozone and is a key trigger of asthma symptoms.Carbon monoxideAccording to a 2016 article, if the levels of carbon monoxide are lower than 2%, this gas does not appear to affect a person's health.However, if the levels are higher than 40%, carbon monoxide may be fatal.The symptoms of carbon monoxide poisoning may include:weaknessdizzinesschest painvomitingconfusiona headacheIf a person suspects that they are experiencing carbon monoxide poisoning, they should move to an area with fresh air and seek immediate medical help.Sulfur dioxideSulfur dioxide is a byproduct of burning fossil fuels, such as coal and oil.It can cause eye irritation and make a person more vulnerable to developing respiratory tract infections, as well as cardiovascular disease.Nitrogen dioxideNitrogen dioxide is present in vehicle exhaust emissions. Gas and kerosene heaters and stoves also produce large amounts of this gas.Exposure to nitrogen dioxide may lead to respiratory infections. Typically, inhaling nitrogen dioxide causes wheezing or coughing, but it may also lead to headaches, throat irritation, chest pain, and fever.People can reduce their exposure to air pollutants by limiting the amount of time that they spend in areas with poor air quality. It is important to be aware of possible air pollutants both outdoors and indoors.Outdoor air pollutionGovernments, businesses, and individuals can all help in minimizing air pollution. Reducing emissions from vehicles and the levels of pollutants in the atmosphere may improve the quality of the air.A person can also check the current air quality by using the AirNow website. This government service monitors air quality across the United States.The site provides information on air pollution levels, which it color codes according to their potential effect on health. If the rating is orange or above, people can help protect their health by:avoiding walking beside busy roadsexercising for less time outdoors or using an indoor venue insteadstaying indoors until air quality improvesIndoor air pollutionA person can reduce indoor air pollution by ensuring that buildings are clean and ventilated.Dust, mold, and pollen may all increase the risk of respiratory problems.Radon gas can build up in homes that developers built on land that has uranium deposits. Radon gas can cause lung cancer.A person can check for radon in the home by using a radon test kit. Alternatively, they can hire a professional to take this measurement for them.Radon test kits are available to purchase in stores and online.A person can use a carbon monoxide detector to monitor the carbon monoxide levels in their home or workplace.Carbon monoxide detectors are available to purchase in stores and online.Air pollution can be harmful to a person's health. It may cause respiratory and cardiovascular conditions.A person can reduce the likelihood of health problems by checking the air quality in their local areas and being aware of any existing health conditions.Carbon monoxide can be fatal. If a person thinks that they have carbon monoxide poisoning, they should get into fresh air and seek medical help immediately. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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What is water brash?

People with gastroesophageal reflux disease may experience a symptom called water brash. Water brash occurs when a person produces an excessive amount of saliva that mixes with stomach acids that have risen to the throat.

A person experiencing water brash can get a bad taste in their mouth and feel heartburn. Doctors sometimes refer to water brash as pyrosis idiopathica, acid brash, or hypersalivation.

Water brash is different than regurgitation — in which a mixture of stomach acids and, sometimes, undigested food comes up into the esophagus (food pipe) — due to the excessive salivation that it involves.

Keep reading to learn more about water brash, including the associated symptoms, possible causes, and treatment options.

a woman experiencing heart burn due to water brashShare on PinterestA person with water brash may experience heartburn.Water brash is a typical symptom of gastroesophageal reflux disease (GERD).GERD is a common condition of the digestive system. According to experts, the prevalence of GERD is increasing in many developing countries.GERD symptoms, including water brash, may have a significant effect on work productivity and many other aspects of day-to-day life.In people with water brash, the salivary glands tend to produce too much saliva. The excess saliva can combine with stomach acids and cause heartburn. People describe heartburn as a burning sensation behind their chest bone. Sometimes, a person may also get a sour taste in their mouth.Regurgitation is a more common symptom of GERD than water brash.GERD symptoms occur because the normal mechanisms that prevent stomach acid from rising into the esophagus fail to function correctly. In many cases, this is because the lower esophageal sphincter is not working properly.Another mechanism that can fail is the function of the phrenico-esophageal ligament. This ligament, which attaches the esophagus to the diaphragm, affects the movements of these structures during swallowing. If the ligament weakens, people can experience symptoms of GERD, including water brash.Research suggests that people with GERD may produce excess saliva due to the presence of acid in the esophagus, which activates the esophagosalivary reflex.To test this theory, researchers administered either saline solution or an acid solution into the esophagus of 15 volunteers. They noticed an increase in the production of saliva in response to the acid.Saliva is less acidic than the contents of the stomach. Therefore, the increased production of saliva that occurs with water brash may help reduce the acidity of the stomach contents.People can try to manage their GERD symptoms, including water brash, with over-the-counter (OTC) medications. A local pharmacist or another healthcare professional can offer them advice on the best treatment.If the symptoms are severe or last longer than 2 weeks, a person should consult a doctor. Some people may need a referral to a gastroenterologist.The treatment for GERD will often help provide relief from water brash. The goals when treating GERD include:relieving and preventing symptomsimproving quality of lifedecreasing esophagitis, which is the inflammation of the esophaguspreventing or treating any complications of GERDDepending on the frequency and severity of a person's symptoms, doctors may recommend one or a combination of the following medications:antacidsproton pump inhibitorshistamine-2 receptor antagonistsMaking lifestyle changes can often help relieve symptoms of GERD. These may include:avoiding large meals close to bedtimequitting smoking, if applicableachieving and maintaining a moderate body weightavoiding foods and drinks that trigger symptoms, such as spicy foods, greasy foods, and alcoholLearn more about what to eat to prevent symptoms of GERD.Several other home remedies can help alleviate symptoms of GERD. Read about them here.The most common symptoms of GERD are heartburn and stomach acids coming up into the esophagus. People sometimes describe heartburn as chest pain or burning under the breastbone.Regurgitation is another common symptom. It occurs in 80% of people with GERD, with its severity varying among individuals.People describe regurgitation as a sour taste or the feeling of fluid moving up and down in the chest.The third most common symptom of GERD is difficulty swallowing. About 50% of people with GERD report experiencing food sticking in the chest or not going down the esophagus properly.Other, less frequent symptoms of GERD include:When a person experiences heartburn, they may first try managing their symptoms with OTC medications. If these remedies do not provide relief, the person should consult a doctor.Anyone experiencing severe symptoms that affect their quality of life should seek medical attention.People should also seek medical attention if GERD symptoms:last longer than 3 months with severe or nighttime heartburnpersist after taking OTC medications, which may include antacids, histamine-2 receptor antagonists, or proton pump inhibitorscontinue when taking prescription-strength histamine-2 receptor antagonists or proton pump inhibitorsIt is also advisable for someone to see a doctor if they experience:new onset of heartburn or regurgitation between the ages of 45 and 55 yearsblood in the vomit or stoolanemia (iron deficiency)voice hoarseness, wheezing, coughing, or chokingunexplained weight losscontinuous nausea, vomiting, or diarrheaIt is important to be aware that the symptoms of GERD may seem almost identical to the symptoms of a heart condition. Anyone with suspected GERD symptoms who also has any of the following symptoms must seek emergency medical attention:chest pain radiating to the shoulder, arm, neck, or jawprofuse sweatingshortness of breathPregnant and breastfeeding women should also speak with a doctor before taking an OTC heartburn medication.Children under the age of 12 years should not take OTC antacids or histamine-2 receptors without their parents or caregivers taking them to see a doctor first.People younger than 18 years should avoid taking OTC proton pump inhibitors without speaking to a doctor.Water brash is a symptom of GERD. People with water brash produce excessive amounts of saliva. When the saliva combines with stomach acids, a person may experience heartburn and a sour taste in their mouth.Researchers suggest that the excessive production of saliva is a result of stomach acids stimulating a reflex pathway between the esophagus and the salivary glands.Treating GERD should resolve water brash, which can affect a person's quality of life.Depending on the severity and frequency of a person's symptoms, doctors may recommend lifestyle changes or a combination of dietary changes and medications.
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Wet coughs: What to know

A wet cough is a type of cough that brings up fluid, such as phlegm. This is the opposite of a dry cough, which does not produce any fluid.

In some cases, the type of cough a person has can help indicate its cause. This is because some underlying conditions produce mainly wet coughs, while others produce mainly dry coughs.

Read on to learn about some other differences between wet and dry coughs, as well as their potential causes. This article also outlines the various treatment options available for a wet cough.

a woman doing a wet cough into her hand .Share on PinterestA person with a respiratory infection may experience a wet cough.Coughing is a reflex that occurs in response to irritation in the throat or lungs. It is the body's way of removing irritants such as fluid and phlegm.A wet cough occurs when fluid in the airways triggers the coughing reflex. Another name for a wet cough is a productive cough, since it produces phlegm.A wet cough can occur for a variety of reasons. Some potential causes include:respiratory infectionschronic lung conditionsa heart conditionSometimes, a wet cough is accompanied by other symptoms, such as:shortness of breathwheezingbubbling, popping, or rattling sounds, called "crackles"continuous, low-pitched, snore-like sounds, called "rhonchi"pink tinged phlegmThese symptoms can provide a clue as to what is causing the wet cough.Various disease processes affect the lungs in different ways. A wet cough indicates that there is fluid in the airways. With a dry cough, however, there is little to no fluid in the airways. Therefore, a dry cough does not produce phlegm.Some conditions may produce either a wet cough or a dry cough. Other conditions may produce mainly one or mainly the other, but with both potentially present.Causes of a wet coughSome typical causes of a wet cough include:A respiratory infectionA wet cough often occurs as a result of a respiratory infection. Various types of respiratory infection can lead to an increase in mucus, including:Other potential symptoms of a respiratory infection include:BronchiectasisThe bronchial tubes carry air in and out of the lungs. Bronchiectasis is a condition in which the surface tissue of the bronchial tubes becomes thick, floppy, and scarred, with a widening of the tube diameter as a result of chronic inflammation.This results in excess mucus production, which can trigger a wet cough. Excess mucus production, leading to a buildup within the bronchial tubes, also increases the risk of a lung infection.Some other potential symptoms of bronchiectasis include:wheezingbreathlessnessfatiguecoughing up blood or blood stained phlegmchest painjoint painclubbing of the fingertipsChronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) is an umbrella term for a group of chronic and progressive lung conditions. Some of these include:Some forms of COPD cause damage to the tiny air sacs within the lungs, while others affect the bronchial tubes, the bronchioles, or both.Some symptoms of COPD include:a wet coughwheezingshortness of breathtightness in the chestCongestive heart failureCongestive heart failure (CHF) occurs when the heart has difficulty pumping blood throughout the body. When this ineffective pumping occurs on the left side of the heart, it causes fluid to leak into the air sacs within the lungs. The result is a wet cough, crackles, and wheezing.According to the American Heart Association (AHA), CHF may produce pink tinged mucus. Some additional symptoms may include:shortness of breathfatigueswelling of the legs or feet, due to right sided heart failure causing poor circulationCauses of a dry coughA dry cough differs from a wet cough in that it does not produce any fluid or mucus. It generally develops in response to irritation or inflammation of the airways.Some common causes of a dry cough include:gastroesophageal reflux diseaseasthmapulmonary fibrosiscertain medicationsPeople with a persistent wet cough may seek treatments to suppress it. However, suppressing a wet cough can lead to a buildup of mucus in the air passages of the lungs. This can lead to further complications, such as breathing difficulties and infection.Instead of suppressing it, wet cough treatments typically aim to improve cough efficiency, thereby helping people clear the airways.Other treatments aim to clear phlegm and associated irritation in the back of the throat.If the cough is due to an underlying medical condition, a doctor will prescribe specific treatments for that condition.Treatments to improve cough efficiency and clear phlegmSome of the treatments below help improve cough efficiency. Others decrease mucus in the back of the throat, thereby reducing the need to cough.Expectorants and mucolyticsExpectorants and mucolytics are medications that thin the mucus and make it less sticky. This makes it easier for people to cough it up.These medications work best for people who have a wet cough but are having difficulty getting the phlegm up.Airway clearance devicesAirway clearance devices, such as the oscillating positive expiratory pressure (PEP) device, use pressure and vibration to help shift phlegm from the airways during exhalation. This helps improve cough efficiency.A 2014 review investigated the efficacy of PEP therapy in the treatment of stable bronchiectasis. The review included seven studies involving a total of 146 participants. The researchers found that PEP therapy improved cough effectiveness and sputum expectoration when compared with no treatment.Gargling with salt waterGargling with salt water is an easy home remedy that may help alleviate a wet cough. The salt water may decrease mucus in the back of the throat, thereby reducing the need to cough.A range of different salt water recipes are available. Most, including that of the American Dental Association, recommend mixing half a teaspoon of salt with 8 ounces of warm water. People should consider gargling this a few times per day to reduce phlegm.Specific treatmentsThe treatment options for a wet cough also depend partly on the cause. Some more specific treatments include:AntibioticsAntibiotics are helpful for a wet cough that occurs due to a bacterial infection.One 2017 review found that taking appropriate antibiotics helps improve the resolution of a chronic wet cough among children with bacterial bronchitis.Medications to treat CHFPeople who experience a wet cough due to CHF may receive drugs called diuretics, which help relieve fluid retention. This, in turn, can reduce the amount of fluid in the lungs, which can help alleviate a wet cough.People who have CHF may also receive drugs to:In some cases, a wet cough may signal a serious underlying health condition, such as a lung or heart disease. If a person is in any doubt as to the cause of a wet cough, they should make an appointment to see their doctor.People should see a doctor as soon as possible if they experience any of the following symptoms alongside a cough:foul-smelling phlegmgreen, yellow, or pink tinged phlegmcoughing up bloodswelling in the legs, feet, or anklesa wet cough that lasts more than a few dayssignificant fever or chillsPeople who experience the following symptoms should seek emergency medical attention:bluish skin or nailslabored breathingconfusion or loss of consciousnesschest painA wet cough occurs as a result of excess fluid or mucus in the airways. A range of conditions can cause a wet cough, including respiratory infections, chronic lung conditions, and CHF.Once a doctor has diagnosed the underlying cause of a wet cough, a person can begin appropriate treatment.The treatment will depend partly on the cause of the wet cough. Medications such as mucolytics and expectorants can help remove mucus from the lungs. Antibiotics can help treat bacterial respiratory infections, while specific CHF medications will be necessary to treat the symptoms of heart failure.People should see a doctor if they are in any doubt as to the cause of their wet cough.
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5 healthful living factors extend disease-free life

According to a new study, a combination of healthful lifestyle choices, such as maintaining a healthy weight, not smoking, and regularly exercising, can significantly extend the number of years that an individual avoids disease.

Woman eating appleShare on PinterestA healthful lifestyle doesn't just extend life; it extends disease-free life.

On average, we are living longer lives; however, as people grow older, many live with diseases, such as heart disease, cancer, and diabetes. As lifespan extends, so does the risk of developing chronic illnesses.

Scientists have firmly established that lifestyle factors can make a significant difference to the risk of disease and length of life, overall. These factors include physical activity, smoking, alcohol consumption, diet, and weight.

The authors explain that "[s]tudies have shown that smoking, inactivity, poor diet quality, and heavy alcohol consumption contribute up to 60% of premature deaths and 7.4–17.9 years' loss in life expectancy."Although this is well known, little research has examined how a combination of lifestyle factors impacts the length of time an individual will be disease-free.To answer this question, a group of researchers took data from two sources; firstly, the Nurses' Health Study, which included information from 73,196 female nurses. Secondly, they gained access to data from the Health Professionals Follow-up Study, which included the data from 38,366 male health professionals. They published their findings in the BMJ.Lifestyle and health over timeThe scientists calculated a lifestyle score from 0–5 for each participant. They calculated this score by assessing five low risk lifestyle factors — healthy weight, never smoking, exercising for at least 30 minutes each day, moderate alcohol intake, and a good quality diet.Researchers had followed the participants for many years and recorded diagnoses and deaths from cancer, type 2 diabetes, and cardiovascular disease. As part of their analysis, the scientists accounted for a range of factors, including family medical history, age, and race.The authors of the recent study found that women aged 50 who did not adopt any of the five low risk lifestyle factors could expect to live without cancer, diabetes, and heart disease for a further 24 years. However, those who followed four or five of these factors could expect an additional 34 disease-free years.Men aged 50 who did not incorporate any of the low risk lifestyle factors into their lives could expect to live an extra 24 years free of chronic diseases. However, those whose lifestyle included four or five low risk factors had around 31 years of disease-free life.Men who smoked more than 15 cigarettes each day, and anyone with obesity had the lowest amount of disease-free life expectancy after 50. The authors summarize:"[W]e observed that adherence to a low risk lifestyle was associated with a longer life expectancy at age 50 free of major chronic diseases of approximately 7.6 years in men and 10 years in women compared with participants with no low risk lifestyle factors."Improving survivalThe scientists also found that men and women with four or five low risk lifestyle factors who received a diagnosis of cancer, cardiovascular disease, or type 2 diabetes lived longer than individuals with the same diagnoses who did not have any low risk factors. As the authors explain:"A healthful lifestyle not only decreased the risk of incident cancer, cardiovascular disease, and type 2 diabetes but also improved the survival after diagnosis of those diseases."The authors are quick to note that the study is observational, so it is not possible to conclude a causal relationship. Also, lifestyle factors were self-reported, which, as the authors write, means that "measurement errors are inevitable."Even though the scientists controlled for a wide range of factors, there is always a possibility that unmeasured factors might account for the results.However, the scientists had access to detailed information from each participant at multiple times over a substantial followup period; overall, they conclude:"Public policies for improving food and the physical environment conducive to adopting a healthful diet and lifestyle, as well as relevant policies and regulations (for example, [the] smoking ban in public places or trans­ fat restrictions) are critical to improving life expectancy, especially life expectancy free of major chronic diseases."
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Chest pain and leg pain: Are they connected?

Leg pain and chest pain do not typically occur together. However, there is a connection between leg pain and heart health, so a person may experience both of these symptoms at the same time.

If a person is experiencing chest pain, they should seek medical attention immediately as it may indicate a heart attack.

In this article, we explore the link between leg pain and heart health. We also look at diagnosis, treatment, and when to seek help.

a woman holding her knee because she has leg pain and not chest pain.Share on PinterestA person with PAD may experience leg pain.Sometimes, leg pain can indicate that a person is at risk of developing heart disease.Peripheral artery disease (PAD) occurs when the peripheral arteries become narrow, and fatty deposits start to build up.According to the findings of a 2014 study, people with PAD have a higher lifetime risk of dying from a cardiovascular event.The most common symptom of PAD is painful muscle cramps in the thighs, hips, or calves when a person is exercising, walking, or climbing stairs.Other symptoms include:poor nail growtherectile dysfunctiona decrease in temperature in the lower leg or feetwounds on the feet or toes that heal slowlyIt is normal to experience pain after cardiac surgery. Sometimes, people also report experiencing leg pain after cardiac surgery. This pain usually occurs if surgeons take a vein graft from the leg.According to researchers, moderate-to-severe chronic pain still affects 11.8% of people 12 months after cardiac surgery.While pain following cardiac surgery is typical, a person should talk to a doctor if the pain seems to be getting worse instead of better over time, or if it remains severe.A doctor will consider all of a person's symptoms when diagnosing potential causes of pain.If a person is experiencing significant levels of pain after surgery, and the pain is persistent, they should talk to a doctor.They should also talk to a doctor if they experience symptoms of infection after surgery, such as warmth, redness, swelling, or drainage from the incision sites.PADDoctors will diagnose PAD by carrying out a physical examination, which may include:Ankle-brachial index test: Blood pressure measurements in the arm and ankle can indicate potential blockages.Doppler and ultrasound imaging: This method shows the arteries using sound waves and measures the flow of the blood.Imaging studies of the heart's blood vessels: These include CT scans and angiography.Chest painIf a person is experiencing chest pain, a doctor will first try to establish whether they have had a heart attack.A doctor may perform a variety of tests to diagnose a heart attack, including:electrocardiogram (EKG)X-rayechocardiogramCT scanexercise stress testA doctor may also take blood tests to check whether the levels of certain enzymes that indicate that the heart is under stress have become elevated.Learn more about the possible causes of chest pain here.The type of treatment for chest and leg pain will depend on the underlying cause.PADTreatment for PAD tends to focus on preventing the disease from progressing and reducing the symptoms.People can help prevent and treat PAD by:Pain after cardiac surgeryAs pain after surgery might affect a person's recovery, the doctor may prescribe a combination of pain relievers, including opioids and nonsteroidal anti-inflammatory drugs (NSAIDS).A doctor may also use other treatment methods, such as transcutaneous electrical nerve stimulation and regional anesthesia.If a person has developed an infection at the surgical site, a doctor may prescribe antibiotics after cleaning the wound.Chest painIf a person has experienced a heart attack, a doctor may consider a variety of treatments, including:People experiencing chest pain, leg pain, or both should speak to a doctor in the following situations.PADA person should see a doctor if they experience any symptoms of PAD.According to the National Heart, Lung, and Blood Institute, even if a person is not experiencing symptoms of PAD, they should still see a doctor if they are:under 50 years of age and have diabetes and one or more risk factors for atherosclerosis, which include high blood pressure and obesityare aged 50 years or older and have a history of diabetes or smokingare aged 70 years or olderPain after cardiac surgeryA person should see a doctor if they are experiencing symptoms of infection following cardiac surgery, or if the pain does not lessen.Heart attackNew-onset chest pain is almost always a concerning symptom, and a person should not ignore it. If they experience chest pain, they should seek emergency medical attention.The symptoms of a heart attack can vary among individuals, but a person may experience:pressure or pain in the chest or upper portion of the stomachnauseapain in the arms, back, or stomach that can go downwardshortness of breathunexplained and extreme fatiguevomitingChest pain and leg pain are two symptoms that do not typically appear together. However, they can co-occur if a surgeon takes a vein graft from a person's leg as part of cardiac surgery or if a person has peripheral artery disease.A person should see a doctor if they have chest pain or persistent or severe leg pain.Even if a person is not experiencing a cardiac event, they may require medical treatment to reduce their symptoms and prevent the likelihood of their medical condition worsening.
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Is it bronchitis or pneumonia?

Bronchitis is inflammation of the bronchial tubes in the lungs, while pneumonia causes inflammation in the air sacs of the lungs, which doctors call the alveoli.

Both infections affect breathing and can cause intense pain and coughing, but there are some important differences between them.

Read on to learn more about the differences in symptoms, causes, diagnosis, and how to treat both conditions.

an infographic showing the symptoms of bronchitis vs Pneumonia
Acute bronchitis, the infectious form of which affects most people with the disease, is only very rarely fatal. Chronic bronchitis, however, can slowly destroy lung function and may become life threatening.CausesBronchitis is the inflammation of the bronchial tubes, which carry air from the trachea, or windpipe, into and through the lungs.Acute bronchitis has distinct forms that vary, depending on the causes:Viral bronchitis: Viral infections cause most cases of bronchitis. A person may develop a cough or trouble breathing after a virus, such as the common cold or flu.Bacterial bronchitis: Bacterial infections can also cause bronchitis. A person may suddenly develop breathing difficulties or notice breathing problems following another illness.Fungal infections occasionally cause bronchitis.Other causes: Besides infection, exposure to substances that irritate the lungs, such as tobacco smoke, dust, fumes, vapors, and air pollution can also cause bronchitis.Chronic bronchitis causes ongoing inflammation of the airways. It is a type of chronic obstructive pulmonary disease (COPD).SymptomsThe symptoms of bronchitis are similar, regardless of which type causes the disease. However, chronic bronchitis does not go away, although symptoms can wax and wane.Viral and bacterial bronchitis typically last anywhere from a few days to a few weeks. Some symptoms include:severe coughing, often producing mucusclear, green, or yellow mucusfever or chillswheezing or trouble breathing, especially when lying downfeelings of fullness or tightness in the chestsore throatLearn more about the symptoms of bronchitis here.TreatmentSince most cases of acute bronchitis are viral, they will not respond to antibiotics.The following treatment options may help:restdrinking plenty of fluidsover-the-counter pain relieverscough medicationA humidifier can also ease coughing at night. When a bacterial infection causes bronchitis, a doctor may recommend antibiotics.Chronic bronchitis, on the other hand, is not curable. However, a number of interventions can help a person breathe more easily.Some doctors might recommend inhalers, oxygen, pulmonary rehabilitation therapy, or other medications to help reduce inflammation in the airways.Both acute and chronic bronchitis are more common in people who smoke. Quitting smoking can reduce the risk of bronchitis and prevent further damage to the airways.Read about some home remedies for bronchitis here.Risk factorsChronic bronchitis can lead to serious complications, including death from heart or lung damage. Over time, a person's body may not be able to get enough oxygen from the blood, damaging organs and potentially causing other illnesses.Chronic bronchitis also greatly increases the risk of pneumonia and can make it more difficult for a person's body to fight pneumonia.Acute bronchitis does not usually cause serious complications. However, in a person with a weak immune system, it may lead to other infections, including pneumonia and sepsis.Chronic lower respiratory diseases, including bronchitis, claimed 160,201 lives in the United States in 2016.Pneumonia is a very serious health condition and can be bacterial, viral, or fungal. In 2017, there were 49,157 deaths from pneumonia in the U.S.CausesPeople with chronic medical conditions may repeatedly get pneumonia. Many people develop pneumonia after a viral infection. It is also possible to get pneumonia after bronchitis.Some vaccinations can reduce the risk of pneumonia. The pneumococcal vaccination, for example, can help prevent pneumococcal pneumonia. This type of pneumonia is common among older people and those with weakened immune systems.SymptomsThe symptoms of pneumonia are very similar to those of bronchitis. They include:severe coughing, producing mucusyellow, green, or blood tinged mucusfevershortness of breathchest pain that may feel sharp or stabbingfatigue and low energysore throatSome symptoms that may help distinguish pneumonia from bronchitis include:confusion in some people, especially seniorsrapid, shallow breathing instead of wheezingnausea and vomiting, particularly in children and babiesloss of appetitechills and muscle achesTreatmentThe best form of treatment for pneumonia depends on the type of pneumonia a person has. Antibiotics can treat bacterial pneumonia, and antifungals can treat fungal pneumonia, but there is no specific treatment for viral forms.Some other strategies that may help include:taking pain relievers to reduce pain and control a person's feverdrinking plenty of fluidsgetting lots of restusing a humidifier or steam to help loosen mucusavoiding smokingWhile some people find relief from cough medicine, coughing is an important way for the body to get rid of infections. An individual should talk to a doctor before using cough medicine.Some people with pneumonia may need supportive care in the hospital. Intravenous fluids and medication for other symptoms, such as high fever, may help a person to recover faster.Read about some home remedies that may help to ease the symptoms of pneumonia here.Risk factorsPneumonia ranges in severity from relatively mild to life threatening when breathing becomes very difficult. It is more dangerous in babies, young children, seniors, and people with other illnesses.Pneumonia can decrease blood oxygen and damage the organs. People with pneumonia may die from respiratory failure, shock, sepsis, and lung abscesses.The same infections that cause bronchitis may also cause pneumonia. Moreover, chronic bronchitis is a risk factor for developing pneumonia and other serious infections.A person with a previous diagnosis of one type of infection may still develop another infection. It is crucial to watch out for changing or worsening symptoms.The symptoms of the two diseases are virtually indistinguishable to most people. Only a doctor can conclusively diagnose the cause of breathing difficulties.Both bronchitis and pneumonia can be severe and life threatening. It is important not to self-diagnose either condition and take all breathing symptoms seriously.People should see a doctor if:they have difficulty breathingit feels impossible to stop coughingthey have a very high feversymptoms of pneumonia or bronchitis do not get better with treatment, or symptoms get better and then returnthey have another chronic illness and breathing difficultiesa baby or young child gasps for air, has irregular breathing, or cannot catch their breathBreathing issues can quickly worsen. If a doctor is unable to see a person with suspected bronchitis or pneumonia within a day, a person must go to the emergency room or seek urgent care.Bronchitis and pneumonia are both highly treatable, especially when a person seeks treatment as soon as symptoms appear.Both conditions have very similar symptoms, which is why people often confuse these diseases. In most cases, a person will not be able to tell the difference without a diagnosis from a doctor or other healthcare professional.Prompt medical care can save lives, prevent lost time with family and friends, and help people get back to their normal life, as soon as possible.
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Common pesticide linked to increased mortality risk

A recent study has concluded that exposure to a common pesticide increases the risk of all-cause mortality and cardiovascular mortality. Although the study has limitations, its authors call for urgent follow-up.

Man using pesticide sprayShare on PinterestPyrethroids are among the most common pesticides.

The study focused on a class of pesticides called pyrethroids. People use these chemicals in agriculture and for residential pest control. Pyrethroids also appear in a range of household products.

As the authors of the new study paper explain, pyrethroids are present in "household and garden insecticides, pet sprays and shampoos, lice treatments, and mosquito repellents."

Pyrethroids account for around 30% of all pesticides in use worldwide. Also, because people phased organophosphates out for residential use, their use of pyrethroids has risen sharply in recent decades.

Pyrethroids can enter the body via inhalation, ingestion, or absorption into the skin. Once inside, the body breaks them down into metabolites and excretes them in urine within a few hours.

Because of this quick turnaround, measuring these metabolites in urine is a reliable way of assessing a person's recent exposure to pyrethroids.Investigating pyrethroidsThese chemicals are popular because they are effective against insects and have no short-term impacts on human health. However, as the authors of the new study explain, "the consequences of chronic exposure to pyrethroids on long-term health outcomes in humans remain to be determined."Some studies, they say, have suggested that pyrethroid exposure "may impair neurodevelopment, interfere with reproductive health, and increase the risk of major chronic diseases, such as diabetes, cardiovascular disease, and Parkinson's disease."The authors also note that earlier studies into the impact of pyrethroids on health have had limitations; to date, there have been no investigations into the links between exposure to these pesticides and mortality. So, the scientists set out to plug these gaps in our knowledge.They have now published their results in JAMA Internal Medicine.To investigate, they took data collected during the National Health and Nutrition Examination Survey. In total, the team had access to information from 2,116 adults aged 20 or older. Each participant provided a urine sample at some point between 1999 and 2002, which provided information about pyrethroid exposure. The researchers followed the participants until 2015.Changes to mortality riskIn total, there were 246 deaths during the trial period. After adjusting for a range of factors — including age, sex, ethnicity, socioeconomic status, dietary and lifestyle factors, smoking status, and body mass index (BMI) — the researchers identified some significant trends.They found that people with the highest levels of pyrethroid metabolite in their urine had a higher risk of death during the follow-up period.Individuals with the highest levels of pyrethroid exposure had a 56% higher risk of dying from any cause than those with the lowest levels of exposure.The researchers also found that those in the highest exposure group had three times the cardiovascular mortality risk of those in the lowest exposure group.Conversely, when the researchers investigated cancer, they found that those in the highest exposure group had a slightly lower risk of dying from it. However, this result was not statistically significant.Overall, the study authors conclude:"In this nationally representative sample of [United States] adults, environmental exposure to pyrethroid insecticides was associated with an increased risk of all-cause and cardiovascular disease mortality."Follow-up neededThe study appears alongside an invited commentary by Steven D. Stellman, Ph.D., and Jeanne Mager Stellman, Ph.D., both of whom are from the Columbia University Mailman School of Public Health in New York City, NY.The authors discuss certain limitations. For instance, the average age of the participants at the end of the study was 57, which is young for assessing pyrethroid's impact on cardiovascular mortality.However, they explain, "Other than cigarette smoking, few, if any, chemical exposures are known to trigger a [threefold] increase in the risk of death from heart disease, especially in [people] younger than 60 years."They also write that "in New York City and elsewhere, aerial spraying for mosquito control to prevent West Nile virus and other vector-borne illnesses is largely based on pyrethroids. This study challenges the assumption that such exposures are safe."For these reasons, they conclude that "the results of this study warrant immediate further investigation."
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Heart attack: New protein therapy may improve recovery

New preclinical research in animal models finds that infusing a specific protein into scar tissue after a heart attack improves and speeds up the recovery of the heart.

doctor listening to patient's heartShare on PinterestResearchers are soon to test a new therapy for improving heart function and recovery after a heart attack.

According to the American Heart Association (AHA), around 605,000 people in the United States have a new heart attack each year, and approximately 200,000 experience a recurrent attack.

Reperfusion, which is a technique that frees up the flow of oxygen to the heart's tissue, is a common form of treatment after a heart attack. However, up to one-quarter of people who undergo reperfusion develop heart failure within a year.

So, researchers led by James Chong — an associate professor at the University of Sydney in Australia — have explored an alternative treatment that targets the scar tissue that forms after a heart attack.

Chong and colleagues evaluated the therapeutic potential of a protein therapy called recombinant human platelet-derived growth factor-AB (rhPDGF-AB).

As its name suggests, rhPDGF-AB is a recombinant growth factor-AB derived from human platelets. Platelets are small blood cells that rush to an injury site when they are needed to help the blood clot and start the healing process.The researchers tested the new treatment in a porcine model of heart attack, and their promising results suggest that the therapy may soon help humans recover from heart attack.The findings appear in the journal Science Translational Medicine.How rhPDGF-AB improves heart functionThe study was a randomized trial. Chong and team assigned 36 pigs to one of three groups:one that received a sham procedure (these five pigs did not have a heart attack)one that received a balloon occlusion of the coronary artery to mimic a heart attack and took a placebo as "treatment" (11 pigs)one that received balloon occlusion and 7 days of intravenous infusion of rhPDGF-AB (11 pigs)Nine of the pigs who experienced a heart attack died before having the chance to receive any treatment.A month after the intervention, the researchers used cardiac MRI and other methods to show that their treatment caused more new blood vessels to form, decreased abnormal heart rhythm, and boosted overall heart function.Specifically, 28 days after the heart attack, the new procedure improved survival by 40% compared with placebo and improved the heart's ejection fraction in the left ventricle — where the heart attack had taken place — by 11.5%."By improving cardiac function and scar formation following a heart attack, treatment with rhPDGF-AB led to an overall increase in survival rate in our study," explains Chong."While the treatment did not affect overall scar size, importantly, we found that rhPDGF-AB led to increased scar collagen fiber alignment and strength. This improved heart function after a heart attack.""This is an entirely new approach with no current treatments able to change scar in this way."James ChongClinical trials in humans to follow very soonChong explains how these findings build on the team's previous work, saying, "Our collaborator Prof. Richard Harvey, from the Victor Chang Cardiac Research Institute [in Darlinghurst, Australia], had previously shown that the protein can improve heart function in mouse models following heart attack.""This project has been developed over more than 10 years, and we now have compelling data in two species for the effectiveness of this treatment."Chong places the findings in the larger context of the rise of heart disease as a leading cause of death:"While we have treatment protocols in place, it's clear that there is an urgent, unmet need for additional treatments to improve patient outcomes, particularly after large heart attacks.""Some further animal studies are required to clarify safety and dosing. Then we can start looking toward clinical trials in humans very soon," says Chong."RhPDGF-AB is clearly a promising therapeutic option and could potentially be used alongside existing treatments to improve heart attack patient outcomes and survival rates."In the future, says Chong, "We [...] hope to further investigate the treatment, including whether it could be used in other organ systems impacted by scar tissue, such as the kidneys."
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Cholesterol levels in young adults can predict heart disease risk

A recent study investigates the relationship between cholesterol levels in young adulthood and cardiovascular risk in later life — with interesting recommendations for further research.

Woman eating a burgerShare on PinterestA recent study looks at the long term impact of high cholesterol levels.

Research has already well documented that high cholesterol levels can lead to heart disease, the leading cause of death in the United States, and stroke, the fifth leading cause of death.

Cholesterol is a fatty substance that the liver and foods we eat, such as eggs, cheese, and certain meat products produce.

Cholesterol is necessary for the body to function. However, too much "bad" cholesterol, which is also called low-density lipoprotein (LDL), can clog the arteries with a fatty buildup, increasing the risk of heart attack, stroke, or peripheral artery disease.

Scientists have also linked high total cholesterol to overweight, lack of exercise, smoking, and alcohol consumption.

More than 12% of adults in the U.S. aged 20 years and over have total cholesterol levels above 240 milligrams per deciliter (mg/dl), which doctors consider high. Of children and adolescents aged 6–19 years, some 7% have high total cholesterol.

High-density lipoprotein (HDL) is "good" cholesterol and helps to sweep LDL from the arteries back to the liver, which removes it from the body.

A long look at lipidsA new, comprehensive study, appearing in The Lancet, follows almost 400,000 people in 19 countries for up to 43.5 years (1970–2013). The findings shine a spotlight on the link between bad cholesterol (non-HDL) levels in people under 45 years of age and the long-term risk of heart disease and stroke.Set apart from previous studies, this observational and modeling study, which looked at individual level data, suggests that elevated non-HDL cholesterol levels at a younger age can predict cardiovascular risk at 75 years of age.The study used data from 38 studies carried out in the U.S., Europe, and Australia.Of the nearly 400,000 individuals that the study followed, none had cardiovascular disease at the start. The scientists tracked the participants over decades and took details of any heart disease event, fatal or otherwise, or stroke.In total, there were 54,542 incidents of heart disease, fatal or non-fatal, and stroke.When researchers analyzed the data for all age groups and both sexes, they saw that the risk of heart disease or stroke dropped continuously as non-HDL levels dropped. In fact, those with the lowest non-HDL levels, — which the scientists defined as 2.6 millimoles (mmol) non-HDL cholesterol per liter — had the least risk.The highest long-term risks of heart and artery disease were in those younger than 45 years old. "This increased risk in younger people could be due to the longer exposure to harmful lipids in the blood," says Prof. Barbara Thorand, of the German Research Center for Environmental Health in Neuherberg.Study suggests early intervention vitalThe study confirmed that the level of non-HDL and HDL cholesterol in the blood played a significant part in predicting the risk of cardiovascular disease over time.Researchers used data to create a model for people aged 35–70 years that could estimate the chances of a heart event by age 75 years. It factored in sex, age, non-HDL levels, and cardiovascular risk factors, such as blood pressure, BMI, diabetes, and smoking status.It also examined how much one could lower risk if non-HDL cholesterol levels were a hypothetical 50% lower. Using this approach, the researchers saw the most significant reduction in risk in the youngest age group.As an example, a male under 45 years of age has starting levels of non-HDL cholesterol of between 3.7–4.8 mmol per liter and at least two risk factors for cardiovascular disease; if the individual was to halve their levels of non-HDL cholesterol, they could reduce the risk from 16% to 4%.A female with the same factors could reduce their risk from around 29% to 6%.Using the same levels of non-HDL cholesterol in individuals of 60 years or more, males could reduce risk from 21% to 10%, and females from 12% to 6%.The researchers suggest that intensive efforts to lower non-HDL cholesterol levels could reverse early signs of blocked arteries, which is known as atherosclerosis.However, there was no clarity on how much slightly increased or seemingly normal cholesterol levels affected cardiovascular risk over a person's lifetime or at what level treatment recommendations should occur, especially in younger adults."Our estimates suggest that halving non-HDL cholesterol levels may be associated with reduced risk of cardiovascular events by the age of 75 years and that this reduction in risk is larger the sooner cholesterol levels are reduced."Co-author Prof. Stefan Blankenberg"The risk scores currently used in the clinic to decide whether a person should have lipid-lowering treatment only assess the risk of cardiovascular disease over 10 years, and so may underestimate lifetime risk, particularly in young people," notes the study's co-author, Prof. Stefan Blankenberg.The authors say future research is needed to understand whether early intervention in younger people with low 10-year risk but high lifetime risk would have more benefits than later intervention.A limitation of the study is that it may not apply to all regions or ethnic groups because its focus was on high income countries.High cholesterol has no symptoms, and many people are unaware that they have high levels; however, doctors can check levels with a simple blood test.
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High blood pressure research: 2019 overview

In this special feature, we collate some of the most intriguing hypertension studies from 2019. We particularly focus on nutrition, risk factors, and hypertension's relationship with dementia.

Blood pressure checkShare on Pinterest2019 has been a fascinating year for hypertension research.

Today, in the United States, around 1 in 3 adults has high blood pressure, which doctors also call hypertension.

Hypertension increases the risk of cardiovascular events, such as stroke and coronary disease, and, if doctors don't treat it, it can reduce lifespan.

Because it is worryingly prevalent, and because the physical ramifications can be significant, scientists are plowing a great deal of effort into understanding hypertension.

Although people first identified hypertension as a medical condition thousands of years ago, scientists are still picking away at the details.

Research that scientists completed in 2019 has thrown out some exciting and, in some cases, unexpected findings. For instance, a paper appearing in February concluded that, for women over 80 years of age, having "normal" blood pressure had an increased risk of mortality when compared with individuals with high blood pressure.

Elsewhere, Greek scientists concluded that napping might help reduce blood pressure. "Midday sleep appears to lower blood pressure levels at the same magnitude as other lifestyle changes," explains one of the researchers, Dr. Manolis Kallistratos.

Another surprising study, which scientists presented at the 83rd Annual Scientific Meeting of the Japanese Circulation Society, concluded that needing to urinate multiple times at night might be a sign of hypertension.

The role of nutrition

The food that we eat has a huge impact on our overall health; that goes without saying. The America Heart Association, for instance, suggest that eating a diet rich in fruits and vegetables and avoiding products with high levels of salt and fat can help keep blood pressure in check.

Over the past few years, interest in nutrition, in general, has skyrocketed. More and more, scientists are focusing on individual foods or food compounds that can directly benefit health. So, although poor diet is a well-known risk factor for hypertension, researchers in 2019 drilled down deeper.

Specific foods and supplements

One study appearing in 2019 investigated the impact of consuming walnuts on blood pressure. It concluded that the individuals who ate an experimental walnut-heavy diet experienced a significant reduction in blood pressure.

In these types of studies, it is worth digging a little deeper; often, industry or organizations who might stand to benefit from positive results are funding them. The walnut study above, for instance, was partly funded by the California Walnut Commission.

This observation does not mean that we should dismiss the results out of hand, but it provides pause for thought.Another recent study concentrated on spirulina, which is the dried biomass of a bacterium called Spirulina platensis. Manufacturers can add it to foods, and some people take it as a supplement.Earlier experiments hinted at spirulina's potential to reduce hypertension, and in the most recent study, they attempted to find out why this might be.The scientists concluded that a protein that the digestion of spirulina produces causes blood vessels to relax. The authors hope that this protein, known as SP6, might one day be useful in the treatment of hypertension.Preservatives, additives, and waterRather than focus on specific foods, a further study looked at the impact of buying food from local retailers rather than supermarkets.The authors theorized that by eating local produce, individuals would avoid consuming the various preservatives and additives that keep food "fresh" over long distances.Although the study was relatively small, the authors found that after 6 months, those who consumed local produce had lower levels of visceral fat, improved depression scores, and reduced systolic blood pressure.Approaching from a different angle, a team of scientists recently asked whether drinking water that is high in minerals might reduce blood pressure.To investigate, they focused on people living in a coastal region of Bangladesh. Drinking water there varies in salinity. In areas of high salinity, the water contains greater quantities of sodium, which we know increases blood pressure. However, the same water also includes more magnesium and calcium, both of which reduce blood pressure.The authors concluded that higher salinity levels decreased blood pressure overall; they write that "the [blood pressure]-lowering effects of [calcium] and [magnesium] counteracted the harmful effects of [sodium].Causes and risk factorsSome risk factors for hypertension are fairly well established; they include drinking excessive amounts of alcohol, smoking tobacco, stress, and obesity. However, because high blood pressure is so common, there are likely to be many more factors at play.Similarly, although scientists know which lifestyle and dietary factors influence blood pressure, they are not entirely sure how they cause the changes.Understanding why and how blood pressure arises in some people and not others is essential and could, potentially, lead to innovative ways of treating or preventing hypertension.Some scientists are exploring possible risk factors which, at face value, seem unlikely. For instance, one paper, appearing in the Journal of Public Health in June, examined the role of where people live.Earlier studies found an association between exposure to air pollution and hypertension risk, and this latest work confirms those earlier suspicions and takes it a step further.As expected, the researchers found a relationship between air pollution and hypertension; however, the increase in risk was only significant for those who were living in multi-family homes, such as blocks of flats.The authors believe that this might be due to several factors, for instance, living in close quarters with other people may be more stressful or more noisy. This study provides a glimpse of the complex realm of potential elements that might influence blood pressure.Oral hygieneBizarrely, one group of scientists recently investigated how mouthwash might influence hypertension risk.Publishing their findings in the journal Frontiers in Cellular and Infection Microbiology, the authors conclude that mouthwash kills "good bacteria" in the mouth. These good bacteria produce nitric oxide (NO), which is important for blood vessel health.NO acts as a vasodilator, which means it causes the muscles that line blood vessels to relax, thereby widening the vessels and reducing blood pressure.In particular, the scientists concentrated on the chemical chlorhexidine, which they found in some mouthwashes.According to the authors, they demonstrated that "twice-daily chlorhexidine usage was associated with a significant increase in systolic blood pressure after 1 week of use, and recovery from use resulted in an enrichment in nitrate-reducing bacteria on the tongue."Still focusing on the oral region, a 2019 review looked for links between gum disease and hypertension. They showed that individuals with severe periodontitis — a form of gum disease — had a 49% increased risk of hypertension.Senior author Prof. Francesco D'Aiuto explains their results in a nutshell: "We observed a linear association — the more severe periodontitis is, the higher the probability of hypertension."The role of zincAnother project investigated the role of zinc in maintaining blood pressure at healthy levels. Over the years, researchers have noted links between low zinc levels and an increased risk of high blood pressure, but the precise mechanism has been tough to pin down.The latest research identified the key player in this interaction between zinc and blood pressure; according to the authors, the sodium chloride cotransporter (NCC) in the kidney is the lynchpin. The NCC is responsible for pumping sodium back into the body, thereby preventing it from being excreted in the urine.Zinc interacts with the NCC: when zinc is present, the NCC is less active, meaning that the body retains less sodium. This is important because high sodium levels — from consuming too much salt, for instance — are factors in increasing the risk of hypertension.The authors hope that this new knowledge will help improve treatment and write:"Understanding the specific mechanisms by which [zinc deficiency] contributes to [blood pressure] dysregulation may have an important effect on the treatment of hypertension in chronic disease settings."Hypertension and dementiaScientists have identified a relationship between hypertension and vascular dementia. The association makes sense because vascular dementia can occur following stroke, and hypertension is a risk factor for stroke.However, it also appears that hypertension might increase the risk of other types of dementia, including Alzheimer's disease.A study appearing in June this year found that a common blood pressure drug — nilvadipine — slowed the progress of Alzheimer's disease by improving blood flow in the brain.Specifically, the research team showed that people who took the medication had a 20% increase in blood flow in the hippocampus, a brain region vital for memory and learning, in comparison to those who did not take nilvadipine.Patterns throughout lifeOther scientists have looked at fluctuations in blood pressure and their possible role in dementia. For instance, one investigation that recruited participants who were living with Alzheimer's disease found that the condition progressed quicker in those whose blood pressure fluctuated most."More fluctuations [in blood pressure] might affect whether cognitive function declines more slowly or rapidly."Senior author Dr. Jurgen ClaassenWith a similar theme, another group of scientists observed the pattern of blood pressure across decades. The authors summarize their findings:"[A] pattern of sustained hypertension from middle to late life and a pattern of midlife hypertension followed by late-life hypotension were associated with an increased risk for subsequent dementia, compared with participants who maintained normal blood pressure." Another project that charted hypertension over a lifespan found that individuals with high or rising blood pressure between 36 and 53 years of age were more likely to have white matter lesions and a smaller brain volume in later life.The authors hope that these findings will inspire both doctors and the public to check and take charge of their blood pressure sooner rather than later.As 2020 rolls into view, hypertension is sure to stay high on the medical research agenda. As science gradually untangles hypertension's causes and mechanisms, managing and minimizing this highly prevalent condition must draw ever closer.
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2019 in medical research: What were the top findings?

Another busy year for clinical research has come and gone. What are the most important findings from 2019? Here is our overview of some of the most noteworthy studies of the year.

gloved hand picking samples for analysisShare on PinterestWhat happened in medical research in 2019? In this special feature, we summarize this year's top findings.

"Medicine is of all the Arts the most noble," wrote the Ancient Greek physician Hippocrates — whom historians call the "father of medicine" — over 2,000 years ago.

Advances in therapeutic practices have been helping people cure and manage illness since before the time of Hippocrates, and, today, researchers continue to look for ways of eradicating diseases and improving our well-being and quality of life.

Each year, specialists in all areas of medical research conduct new studies and clinical trials that bring us a better understanding of what keeps us happy and in good health, and what factors have the opposite effect.

And, while each year, experts manage to overcome many obstacles, challenges old and new keep the medical research field buzzing with initiatives.

Reflecting on how research has evolved over the past decade, the editors of the reputable journal PLOS Medicine — in a recent editorial — emphasize "ongoing struggles" with infectious diseases, as well as growing tensions between two approaches in medical research. These approaches are the effort of finding treatments that are consistently effective in large populations versus the notion of "precision medicine," which favors therapy that we closely tailor to an individual's very personal needs.

But how has clinical research fared in 2019? In this special feature, we look at some of the most prominent areas of study from this year and give you an overview of the most noteworthy findings.

Friends or foes?

The medication we take — as long as we follow our doctors' advice — is meant to help us fight off disease and improve our physical or mental well-being. But can these usually trusty allies sometimes turn into foes?

Most drugs can sometimes cause side effects, but more and more studies are now suggesting a link between common medication and a higher risk of developing different conditions.

In March this year, for instance, experts affiliated with the European Resuscitation Council — whose goal is to find the best ways to prevent and respond to cardiac arrest — found that a conventional drug doctors use to treat hypertension and angina may actually increase a person's risk of cardiac arrest.

By analyzing the data of more than 60,000 people, the researchers saw that a drug called nifedipine, which doctors often prescribe for cardiovascular problems, appeared to increase the risk of "sudden cardiac arrest."

Project leader Dr. Hanno Tan notes that, so far, healthcare practitioners have considered nifedipine to be perfectly safe. The current findings, however, suggest that doctors may want to consider offering people an alternative.

Another study, appearing in JAMA Internal Medicine in June, found that anticholinergic drugs — which work by regulating muscle contraction and relaxation — may increase a person's risk of developing dementia.

People may have to take anticholinergics if some of their muscles are not working correctly, usually as part of health issues, such as bladder or gastrointestinal conditions, and Parkinson's disease.

The research — that specialists from the University of Nottingham in the United Kingdom led — looked at the data of 58,769 people with and 225,574 people without dementia.It revealed that older individuals — at least 55 years old — who were frequent users of anticholinergics were almost 50% more likely to develop dementia than peers who had never used anticholinergics.But, while common drugs that doctors have prescribed for years may come with hidden dangers, they are, at least, subject to trials and drug review initiatives. The same is not true for many other so-called health products that are readily available to consumers.Such findings says the study's lead researcher, Prof. Carol Coupland, "highlight the importance of carrying out regular medication reviews."In 2019, we have celebrated 50 years since someone first successfully sent a message using a system that would eventually become the internet. We have come a long way, and now, we have almost everything within reach of a "click and collect" order.This, unfortunately, includes "therapeutics" that specialists may never have assessed, and which can end up putting people's health — and lives — in danger.In August, the Food and Drug Administration (FDA) issued a warning against an allegedly therapeutic product that was available online, and which appeared to be very popular.The product — variously sold under the names Master Mineral Solution, Miracle Mineral Supplement, Chlorine Dioxide Protocol, or Water Purification Solution — was supposed to be a kind of panacea, treating almost anything and everything, from cancer and HIV to the flu.Yet the FDA had never given the product an official assessment, and when the federal agency looked into it, they saw that the "therapeutic" — a liquid solution — contained no less than 28% sodium chlorite, an industrial bleach."[I]ngesting these products is the same as drinking bleach," which can easily be life threatening, warned the FDA's Acting Commissioner Dr. Ned Sharpless, who urged people to avoid them at all costs.The heart and its tributariesMany studies this year have also been concerned with cardiovascular health, revisiting long held notions and holding them up to further scrutiny.For instance, a study in the New England Journal of Medicine in July — which involved around 1.3 million people — suggested that, when it comes to predicting the state of a person's heart health, both blood pressure numbers are equally important.When a doctor measures blood pressure, they assess two different values. One is systolic blood pressure, which refers to the pressure the contracting heart puts on the arteries when it pumps blood to the rest of the body. The other is diastolic blood pressure, which refers to the pressure between heartbeats.So far, doctors have primarily taken only elevated systolic blood pressure into account as a risk factor for cardiovascular disease.However, the new study concluded that elevated systolic and diastolic blood pressure are both indicators of cardiovascular problems.Its authors emphasize that the large amount of data they had access to painted a "convincing" picture in this respect."This research brings a large amount of data to bear on a basic question, and it gives such a clear answer."Lead researcher Dr. Alexander Flint At the same time, a slightly earlier study, appearing in the European Heart Journal in March, emphasizes that having high blood pressure may not mean the same thing for everyone, and while doctors may associate it with adverse outcomes in some, this does not hold for all populations.The study's first author, Dr. Antonio Douros, argues that "[w]e should move away from the blanket approach of applying the recommendations of professional associations to all groups of patients."Dr. Douros and team analyzed the data of 1,628 participants with a mean age of 81 years. The researchers found that older individuals with lower systolic blood pressures actually faced a 40% higher risk of death than peers with elevated blood pressure values."[A]ntihypertensive [blood pressure lowering] treatment should be adjusted based on the needs of the individual," the study's first author advises.When it comes to protecting heart health, 2019 studies have shown that diet likely plays an important role. Thus, research in the Journal of the American Heart Association in August showed that people who adhered to plant-based diets had a 32% lower risk of death that researchers associate with cardiovascular disease than those who did not.People who ate plant-based foods also had a 25% lower risk of all-cause mortality, according to this study.And another study — from April in the journal Nutrients — warned that people who follow a ketogenic diet, which is high in fats and low in carbohydrates, and who decide to take a "day off" from this commitment every now and again, may experience blood vessel damage.Ketogenic — or keto — diets work by triggering ketosis, a process in which the body starts burning fat instead of sugar (glucose) for energy. But "cheat days" mean that, for a brief interval, the body switches back to relying on glucose."[W]e found [...] biomarkers in the blood, suggesting that vessel walls were being damaged by the sudden spike in glucose," notes first author Cody Durrer.Our diets, ourselvesIn 2019, the topic of how our food choices influence our health has remained popular among researchers and readers alike.According to Google Trends, some of the top searches in the United States this year included intermittent fasting diets, the Noom diet, and the 1,200 calorie diet.And this year's studies have certainly reflected the widespread interest in the link between dietary choices and well-being.One intriguing study — in Nature Metabolism in May — pointed out that protein shakes, which are popular among individuals who want to build muscle mass, may be a threat to health.Fitness protein powders, the study authors explain, contain mostly whey proteins, which have high levels of the essential amino acids leucine, valine, and isoleucine.The research — in mice — suggested that a high intake of these amino acids led to overly low levels of serotonin in the brain. This is a key hormone that plays a central role in mood regulation, but which science also implicates in various metabolic processes.In mice, the heightened levels of leucine, valine, and isoleucine, which caused excessively low serotonin, led to obesity and a shorter life span.So, if too much of certain types of protein can have such detrimental effects on health, what about fiber? Dietary fiber — present in fruit, vegetables, and legumes — is important in helping the body take up sugars little by little.But how much fiber should we consume? This is the question that a study commissioned by the World Health Organization (WHO) — and appearing in The Lancet in January — sought to lay to rest.The research took into account the findings of 185 observational studies and 58 clinical trials, covering almost 40 years.It concluded that to lower their death risk, as well as the incidence of coronary heart disease, stroke, type 2 diabetes, and colon cancer, a person should ideally consume 25–29 grams of fiber per day."Fiber-rich whole foods that require chewing and retain much of their structure in the gut increase satiety and help weight control and can favorably influence lipid and glucose levels," explains one of the authors, Prof. Jim Mann.On the other hand, several studies from this year draw attention to just how detrimental foods that are not 100% natural can be. A small trial, whose results came out in Cell Metabolism in May, showed that processed food leads to abrupt weight gain — but not for the reasons we may think.The study authors said they were surprised that when they asked participants to eat either an ultraprocessed food diet or a nonprocessed food diet — whose caloric contents the researchers matched perfectly — the people who ate processed foods rapidly gained more weight than the ones who ate the nonprocessed foods.The researchers blame this on the speed with which individuals end up eating processed foods, in particular. "There may be something about the textural or sensory properties of the food that made [participants] eat more quickly," says study author Kevin Hall, Ph.D."If you're eating very quickly, perhaps you're not giving your gastrointestinal tract enough time to signal to your brain that you're full. When this happens, you might easily overeat," he hypothesizes.And more research in mice — from Scientific Reports in January — found that emulsifiers, which are a common additive present in many products from mayonnaise to butter, could affect gut bacteria, leading to systemic inflammation.What is more, the impact on the gut could even influence processes that occur in the brain, increasing anxiety levels. "[W]e [now] know that inflammation triggers local immune cells to produce signaling molecules that can affect tissues in other places, including the brain," explains co-lead researcher Prof. Geert de Vries.While some of the studies that made the headlines in 2019 were conclusive, many encourage further research to confirm their findings or further investigate the underlying mechanisms.Stepping into the next decade, this much is clear: The wheels of medical research will keep on turning for better health across the globe.
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What causes arm numbness?

Numbness in the arm has many possible causes that range from mild to severe. Simply sitting or sleeping in the wrong position can restrict the blood flow or put excess pressure on a nerve, making the arm go numb.However, unexplained arm numbness may indicate an underlying health condition, such as nerve damage, a herniated disc, or cardiovascular disease. Severe causes of arm numbness include heart attacks and strokes.In this article, we discuss eight possible causes of arm numbness and their treatments.
a woman experiencing arm numbnessShare on PinterestA person may experience arm numbness because of poor circulation.Blocked or compressed blood vessels can interfere with blood circulation to and from the heart. Poor circulation can cause numbness and tingling in the arms, hands, legs, and feet.Reduced blood flow can cause other symptoms, such as:cold hands and feetextremely pale or blue-tinted skinswelling in the legs, ankles, and feetfatiguejoint or muscle painPoor circulation is not a medical condition in itself, but it can happen if a person does not move enough during the day. It can also be a symptom of other conditions, including those below:Atherosclerosis occurs when cholesterol deposits, called plaque, accumulate in the blood vessels. Plaque buildups can cause the arteries to harden and narrow, restricting blood flow.Blood clots form when coagulated blood clumps together inside a blood vessel. Blood clots can create partial or complete blockages inside a blood vessel.Peripheral artery disease is a type of atherosclerosis in which plaque accumulates in the arteries in the arms and legs.Diabetes can affect the circulatory system because high levels of blood sugar lead to plaque formation and blood vessel damage.Treatment for poor circulation depends on the underlying cause. Wearing compression wraps can help reduce swelling in the limbs. Exercising can also help improve circulation.People who have large blood clots or several blocked arteries may require surgery. Doctors can prescribe medications to treat underlying health conditions that may contribute to poor circulation.
Peripheral neuropathy includes multiple conditions that damage the peripheral nervous system (PNS). The PNS carries information between the central nervous system — the brain and spinal cord — and the rest of the body.Peripheral neuropathy causes a range of symptoms, depending on which nerves it affects. In general, people who have peripheral neuropathy may experience:numbness or tingling in the arms, hands, legs, or feetheightened sensitivity to touch and temperature changesmuscle weaknessuncontrollable muscle twitchingmuscle wasting, or loss of muscleexcessive sweatingfeeling hot or coldSeveral conditions can contribute to peripheral neuropathy, including:diabetesautoimmune diseasesinjuries that cause broken or dislocated bonesatherosclerosis, vasculitis, and other types of cardiovascular diseasehormonal imbalanceskidney or liver diseasea vitamin B-12 deficiencycertain types of cancer and cancer treatments
Thoracic outlet syndrome (TOS) refers to a group of conditions that compress the nerves and blood vessels that pass between the collarbone and the first rib.People who have TOS may experience numbness or tingling in a hand, as well as weakness in the neck or arm.Physical therapy exercises that strengthen the chest and back muscles can help improve a person's posture and reduce pressure on the nerves and blood vessels that pass through the thoracic outlet.Doctors can prescribe medication to prevent blood clots and reduce pain. They may also recommend surgery if a person's symptoms do not improve with physical therapy or medication.
Cervical spinal stenosis occurs when the hollow space of the spinal canal narrows, compressing the spinal cord. This compression can cause numbness or weakness in the arms or feet. It can also cause neck and back pain.People can develop this condition if they have cervical spondylosis, which is arthritis that affects the part of the spine in the neck. Neck or back injuries and tumors in the spine can also contribute to cervical spinal stenosis.Doctors treat this condition with medication, back braces, physical therapy, and surgery.
A herniated disk occurs when the soft nucleus of the disk slips through a crack in its outer portion.A herniated disk can press against surrounding nerves, which may cause numbness or pain in the arm.Treatment options for herniated disks include pain medication, physical therapy, and surgery.People who have hemiplegic migraine experience temporary weakness or paralysis on one side of the body. This symptom can appear before or alongside a headache. People may feel numbness or tingling in the leg, arm, or side of the face.Migraine also causes intense, throbbing headaches that can affect one or both sides of the head.The symptoms of hemiplegic migraine vary from mild to severe. A severe hemiplegic migraine episode can cause additional symptoms, such as:confusionmemory losspersonality changesseizuresDoctors may prescribe pain relievers and nonsteroidal anti-inflammatory drugs to treat migraine.According to the National Organization for Rare Disorders, doctors have not established standard treatment protocols for hemiplegic migraine because the condition is rare.A heart attack occurs when the heart does not receive enough oxygen-rich blood. A blood clot or plaque buildup can create a partial or complete blockage in one or more of the blood vessels that supply the heart, causing a heart attack.In rare cases, a heart attack can also happen when the coronary artery spasms, which tightens the vessel and restricts blood flow to the heart. The heart muscle may become damaged or stop functioning altogether if it does not receive enough oxygen.The most common symptoms of a heart attack, according to the National Heart, Lung, and Blood Institute, include:pain or discomfort in one or both armsintense pressure in the chestpain in the upper stomach, which may feel like indigestion or heartburnshortness of breathOther symptoms to look for include:pain or numbness in the back, shoulders, neck, or jawfeeling lightheaded or faintnausea and vomitingsweatingA heart attack is a serious medical emergency. People should call 911 immediately if they think that they or someone else is having a heart attack.Doctors will attempt to open the blocked artery and restore blood flow to the heart. The exact type of treatment will depend on the location of the blockage, the person's overall health status, and the amount of time that has elapsed since the heart attack began.A stroke occurs when something restricts or completely blocks blood flow to part of the brain.Strokes often cause numbness in one arm, leg, or side of the face. Other symptoms of a stroke include:a sudden, severe headachevision changesconfusiondifficulty speakingdizzinessloss of coordinationThere are two main types of stroke:Ischemic strokes occur when blood clots or fatty deposits develop inside a blood vessel and restrict blood flow to the brain.Hemorrhagic strokes occur when a blood vessel in the brain ruptures and bleeds into the surrounding tissue.A stroke is a serious condition that requires emergency medical treatment.A doctor can treat an ischemic stroke with thrombolytic medications that dissolve blood clots. If a person has a hemorrhagic stroke, a doctor will need to repair the damaged blood vessel, which may require surgery.Arm numbness is a common symptom of many minor issues, such as temporarily cutting off the circulation, but it is also a sign of a heart attack or stroke.People who have a high risk or history of cardiovascular disease should seek immediate medical attention if they experience unexplained numbness or tingling in their arm.Persistent numbness in the arm without an apparent cause suggests an underlying medical problem that may require physical therapy or surgery.Many people experience occasional numbness in an arm. Arm numbness can occur for several reasons that range from mild causes, such as sleeping in the wrong position, to a severe medical condition, such as a heart attack.Sudden numbness in one or both arms may be a sign of a heart attack, stroke, or nerve damage, especially if a person has other symptoms.People who experience arm numbness and weakness on one side of the body that precedes a severe headache may have a rare type of migraine called hemiplegic migraine.Anyone who has arm numbness without an obvious cause should contact their doctor, especially if they have a history or increased risk of cardiovascular disease or diabetes.
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What causes chest pain on the left side?

A person should never ignore chest pain. If a person is experiencing chest pain on the left side of their body, this could indicate a heart attack or other medical conditions, such as a lung problem or inflammation of the lining around a person's heart.This article will cover the potential causes and symptoms of chest pain on the left side.
a woman experiencing chest pain on the left sideShare on PinterestA person with chest pain on the left side may be experiencing lung problems.It can be difficult to identify whether chest pain is a sign of a heart attack.However, there are three indications that chest pain may not be a heart attack:Specific location: If pain is coming from one particular place, it is not likely to be a heart attack.Worsening pain: Chest pain associated with a heart attack does not get worse when breathing.Varying locations: Chest pain associated with a heart attack may spread between the shoulder blades, and into the arms and jaw, but it does not move from one side to the other.If a person thinks they may be experiencing a heart attack, they should call 911 and seek immediate medical attention. They should not attempt to drive themselves to the hospital.Signs a person may be having a heart attack include:chest pain or tightness that typically starts in the center of the chest and radiates outwarddizzinessfeeling faintnauseapain that may extend from the chest to the arms, neck, jaw, or shouldersshortness of breathsweatingWomen are more likely than men to experience symptoms such as nausea, vomiting, fatigue, and pain in the back or jaw.Learn more about chest pain in women here.
Acid reflux and gastroesophageal reflux disease (GERD) are common causes of left-sided chest pain.These conditions occur when acid comes up from the stomach into the esophagus.The result is a burning sensation across the chest that may occur on one side or the other.Other symptoms may include:a burning feeling in the chestdifficulty swallowinga sour taste in the mouth
An esophageal tear or rupture is a medical emergency that may cause non-cardiac chest pain.The condition occurs when the tube that connects the mouth to the stomach tears. This enables food or fluids from the mouth to leak into the chest and around the lungs.Symptoms of an esophageal rupture include:faster breathingchest painfevernauseavomiting, including vomiting bloodSometimes a person may experience this type of injury after extreme vomiting or experiencing physical trauma around the esophagus.
There are many types of injury to soft tissue or bones in the chest that can cause left-sided chest pain. An example could be a broken rib or costochondritis, which is inflammation of the cartilage surrounding a rib.If a person has experienced some form of trauma, such as a fall or a car accident, these injuries may lead to chest pain.Some signs that a musculoskeletal injury has occurred include:hearing or feeling a cracking sensation related to the ribspain that usually worsens when breathingswelling or tenderness at a specific areavisible bruising
Pericarditis is a medical condition that results from inflammation in the pericardium, which is the tissue that holds the heart.The layers usually glide against each other effortlessly, allowing the heart to beat. However, if the layers become inflamed, a person may experience left-sided chest pain.Additional pericarditis symptoms include:coughingfatigueheart palpitations or occasional rapid heart rateleg swellinglow-grade feversharp chest pain that is usually worse when taking a breath inshortness of breathA person may often experience pericarditis after an illness, such as an upper respiratory infection.Pleurisy is a condition where the tissues around the lungs become inflamed. This can cause pain in the chest, especially when breathing.Other symptoms may include:a dry coughshortness of breathpain in the shoulderA variety of conditions may lead to pleurisy, such as flu or bacterial infections.A pneumothorax is a collapsed lung.This can occur spontaneously, collapsing a small portion of the lung or the lung in almost its entirety.Symptoms of a pneumothorax include:becoming easily fatiguedbreathing that becomes more painful when taking a deep breath or coughinga rapid heart rateshortness of breatha sudden, sharp chest paintightness in the chestIf the pneumothorax is very large, a person may require the insertion of a chest tube to re-inflate the lung and help keep it open while the lung heals.Left-sided chest pain has many potential causes.A doctor will consider a person's medical history and symptoms when making a diagnosis. A doctor may also perform a physical examination on the chest, heart, lungs, neck, and abdomen.After the physical exam, a doctor may order a variety of tests, including:an ECGan X-raya complete blood count (CBC)a computed tomography pulmonary angiography (CTPA)an ultrasoundTreatments for left-sided chest pain depend upon the underlying cause.For gastrointestinal pain such as GERD, the treatment typically includes medications, including proton pump inhibitors, H2 blockers, and promotility agents.Inflammation due to pericarditis or pleurisy may involve administering antibiotics and resting until the tissue lining has had time to heal.A person may require surgery to treat pneumothorax and esophageal ruptures.If a person can pinpoint chest pain on their left side, it is less likely that a heart attack is the underlying cause.However, several conditions may be medical emergencies, such as esophageal rupture and pneumothorax.If a person's symptoms are severe or they are having trouble breathing, they should seek immediate medical attention.
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Does your season of birth affect your mortality risk?

Over the years, many scientists have set out to answer the same question: Does the month or season of your birth influence mortality risk? A recent study takes a deeper look at this query.

Four seasons in one parkShare on PinterestHow does your season of birth affect your mortality risk?

Scientists from the United States, Sweden, Germany, Austria, Denmark, Lithuania, Japan, and elsewhere, have investigated this topic.

Some of these earlier studies concluded that, in the northern hemisphere, people born in November have the lowest risk of overall mortality and heart disease-related mortality.

Conversely, those born in the spring or summer have the highest risk; this increase peaks in May. In the southern hemisphere, these general patterns shift by 6 months.

Although scientists have spent a great deal of time and effort investigating this relationship, exactly how your month of birth might influence your future health is still unclear.

Some scientists believe that the birth-month mortality effect may have its roots in socioeconomic factors. However, to date, few studies on this topic have been able to control their analysis for socioeconomic factors.Recently, scientists from Brigham and Women's Hospital and Harvard Medical School, both in Boston, MA, looked into this question once more. They published their findings in the BMJ.Access to detailed dataTo investigate, the researchers took data from the Nurses' Health Study, which began in the 1970s; it involved 121,700 registered U.S. female nurses who were 30–55 years of age at enrollment. The dataset includes information about each participant, including medical history, weight, height, smoking status, demographics, and lifestyle factors.The Nurses' Health Study provides impressively granular detail; for instance, it contains information about the education level of the participants' husbands, and whether the participant's parents owned their home at the time they were born.In all, 116,911 participants were eligible for the current study; the authors collated information about the causes of any deaths. Over 38 years of follow-up, there were 43,248 deaths.Was there an effect?Once the scientists had adjusted their analysis for a range of variables, they found no significant association between overall mortality and either the month or season of their birth. However, they did identify an effect on cardiovascular mortality risk. The authors write:"[C]ompared with women born in November, those born from March to July had a higher mortality for cardiovascular disease [...] while women born in December [...] had the lowest cardiovascular disease-related mortality."When they looked at cardiovascular disease and the seasons, they identified a small but statistically significant relationship. They measured an increase in the risk of death from heart disease for those born in spring and summer when compared with those born in fall.After controlling for a number of factors, including familial and socioeconomic variables, the relationship remained significant.These results are in line with other large scale studies. For instance, the authors discuss two Swedishstudies, both of which involved millions of participants and 20 years of follow-up. As with the current research, they measured the lowest cardiovascular mortality rate in those born in November."Previous epidemiological studies have relatively consistently described individuals born in November to have the lowest risk of overall and cardiovascular mortality," explain the authors, "and those born in the spring or summer to have the highest mortality risk."Does vitamin D play a role?The findings from the most recent investigation suggest that socioeconomic factors may not be the primary reason for varying cardiovascular mortality rates with the season of birth. Scientists still do not know why this pattern emerges, but there are some theories.Some experts suspect that vitamin D might play a part. They argue that if a pregnant woman experiences less sunlight during pregnancy — in the winter months, for instance — she may be deficient in vitamin D.This deficiency, perhaps, could increase the future cardiac risk of the unborn child. At this stage, however, there is no evidence to back up this theory.In their paper, the authors also wonder whether this small but significant seasonal trend will stand the test of time. As people live for longer, as food is now readily available all year round, and as the climate changes, perhaps this effect will dwindle, or maybe it will gradually shift. Whatever the answer, only time will tell.It is worth noting that there are certain limitations to the latest study. For instance, the research only included females and, although the team controlled for a range of variables, there is always the possibility that a variable the scientists did not measure was driving the relationship.With that said, the large dataset, detailed analysis, and agreement with other large studies make the latest findings compelling.
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Cardiovascular disease: Dietary cholesterol may not raise risk

According to the American Heart Association (AHA), consumers should continue to stick to heart-healthy diets for optimum cardiovascular health. However, there is no numerical recommendation of cholesterol intake from food, as the AHA finds no link between dietary cholesterol and cardiovascular risk.

close up of a person eating eggsShare on PinterestAHA's new Scientific Advisory finds no link between egg intake and the risk of cardiovascular disease.

This is according to a new Scientific Advisory from the AHA, which appears in the journal Circulation.

Jo Ann S. Carson, Ph.D., is its first author.

Carson is the immediate past chair and current member of the AHA's nutrition committee and a professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.

She and her colleagues explain in the paper that recent changes in dietary guidelines for reducing cardiovascular disease (CVD) prompted their new research.

Namely, recent recommendations from the AHA, the American College of Cardiology, and the "2015–2020 Dietary Guidelines for Americans" have no longer explicitly set a target for dietary cholesterol.

This goes against the "traditional" grain of numerically limiting dietary cholesterol to no more than 300 milligrams (mg) per day.

The Advisory includes a meta-analysis of existing research. It concludes that the studies and trials available have not managed to find a conclusive association between dietary cholesterol and higher blood levels of low-lipoprotein density (LDL) cholesterol — also known as the "bad" kind of cholesterol.

The problem with observational studies"Findings from observational studies have not generally supported an association between dietary cholesterol and CVD risk," write the researchers.Furthermore, the results of the studies that did find an association were attenuated after adjusting for other dietary factors, such as fiber, saturated fat, or energy intake.This suggests that methodological issues riddle such studies and that it is difficult to disentangle the effect of dietary cholesterol from other dietary compounds, such as saturated fatsbecause most foods that contain high levels of the latter are also high in the former.Carson and colleagues conclude:"In summary, the majority of published observational studies do not identify a significant positive association between dietary cholesterol and CVD risk."Egg intake, cholesterol, and CVD riskOn average, egg consumption makes up a quarter of the dietary cholesterol intake in the United States, with one large egg containing approximately 185 mg of cholesterol.However, different studies have come up with varying results in regards to the association between egg intake and CVD risk, depending on the subtype of CVD studied.For example, several studies in populations from the U.S., Sweden, Iran, and Finland did not find an association between egg intake and the risk of coronary heart disease.Another study even found that eating seven or more eggs per week was associated with a lower risk of stroke compared with eating less than one egg per week.For heart failure, however, a study in the U.S. and another one in Sweden found a 20–30% higher risk in those who ate more than one egg per day, but the results only applied to men.Overall, conclude the researchers, "For both dietary cholesterol and egg consumption, the published literature does not generally support statistically significant associations with CVD risk."Still, they go on to note some limitations to this existing body of knowledge, such as the fact that methods in nutritional epidemiology have changed considerably over time, or that different study populations have different dietary patterns that may have influenced the results.For instance, they write, in China, egg consumption represents a healthful addition to the diet that is already rich in fiber, vegetables, and fruit.Clinical trials on healthful dietsThe Advisory also looked at 17 randomized controlled trials that assessed the effect of high-cholesterol dietary interventions.These trials did find a dose-dependent relationship between dietary cholesterol and high blood levels of LDL cholesterol, but only when the intervention was much higher than the levels of cholesterol that people usually eat — for instance, the equivalent of 3–7 eggs per day.Furthermore, each of these trials had a small sample size.Considering the above, the researchers stress the importance of an overall heart-healthy diet, as opposed to numerically limiting dietary cholesterol."Consideration of the relationship between dietary cholesterol and CVD risk cannot ignore two aspects of diet. First, most foods contributing cholesterol to the U.S. diet are usually high in saturated fat, which is strongly linked to an increased risk of too much LDL cholesterol," says Carson."Second, we know from an enormous body of scientific studies that heart-healthy dietary patterns, such as Mediterranean-style and DASH style diet (Dietary Approaches to Stop Hypertension), are inherently low in cholesterol."The author goes on to recommend "Eating a nutrient-rich diet that emphasizes fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean cuts of meat, poultry, fish or plant-based protein, nuts, and seeds.""Saturated fats — mostly found in animal products, such as meat and full fat dairy, as well as tropical oils — should be replaced with polyunsaturated fats such as corn, canola, or soybean oils. Foods high in added sugars and sodium (salt) should be limited."Jo Ann S. Carson
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