Wood Street Clinic Blog

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What role does the immune system play in hypertension?

Millions of people in the United States and across the world have hypertension, a condition that, without proper management, can contribute to the risk of heart disease and stroke.
woman getting her blood pressure checked
Specialist white blood cells play an important role in the regulation of blood pressure, a new study finds.

Data from the Centers for Disease Control and Prevention (CDC) indicate that approximately 75 million adults in the U.S. live with hypertension.

American Heart Association (AHA) guidelines from 2017 define "hypertension" as systolic blood pressure (during a heartbeat) of 130 millimeters of mercury (mm Hg) or higher and diastolic blood pressure (when the heart is resting) of 80 mm Hg or higher.

The AHA also name lack of physical activity, an unhealthful diet, high cholesterol, and stress as some of the primary modifiable factors that increase the risk of hypertension.

New research by scientists at the University of Edinburgh in the United Kingdom has now uncovered another factor that seems to play a role in the development of this condition.

The study, which the British Heart Foundation funded, found that a type of specialized immune cell could make a real difference to the risk of hypertension.

"Hypertension affects millions of people across the globe, including 70 percent of people over 70," says lead researcher Prof. Matthew Bailey.

"Our discovery sheds light on risk factors and, crucially, opens routes to investigate new drugs that could help patients," he adds.

Prof. Bailey and team's findings appear in the European Heart Journal, and they are available online.

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Cellular debris-eaters and blood pressure

In the new study, the researchers worked with mouse models and zeroed in on macrophages, a type of white blood cell that forms part of the immune system.

The role of macrophages is to identify and "eat up" foreign bodies that are present due to injury and infection. The immune cells also "eat" cellular debris, which consists of the remains of cells that are no longer functional.

The current research has now uncovered a new role that macrophages play. It seems that they also consume molecules of endothelin, which is a hormone that acts as a vasoconstrictor, meaning that it can stimulate blood vessels to narrow.

Prof. Bailey and colleagues explain that, by controlling blood levels of endothelin, macrophages can ensure that blood vessels properly relax, which helps lower blood pressure.

The researchers verified this mechanism by feeding mice with lowered blood macrophage levels a high-salt diet (which increases the risk of high blood pressure) and monitoring their physiological reactions.

These rodents, the researchers soon found, experienced high blood pressure. However, when the team allowed macrophage levels to return to normal, the mice's blood pressure became healthy again, which suggests that the specialist white blood cells had an important role to play.

When they repeated the experiment in mice that they had genetically modified to have poor endothelin system functioning, the findings remained consistent.

The researchers further verified the link between macrophages and blood pressure in rodents with drug-induced hypertension.

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A potential therapeutical target

To see whether these findings were also valid in humans, the research team analyzed macrophage activity in individuals who took drugs for the management of antineutrophil cytoplasmic antibody vasculitis, a condition that affects the immune system and damages blood vessels.

The scientists found that the drugs that lowered macrophage levels, such as cyclophosphamide, led to higher blood pressure readings in the people who took them.

These findings, note Prof. Bailey and team, could help doctors better identify people who are most at risk of hypertension, and they could also lead to new and improved therapies for high blood pressure.

Still, the researchers caution that further studies are necessary before the interaction between macrophages and endothelin can get the go-ahead as a therapeutic target.

"Our next steps will be to investigate the role of macrophages in people living with hypertension," says Prof. Bailey.

"[Undiagnosed high blood pressure] causes damage to the heart and blood vessels, putting you at risk of a potentially fatal heart attack or stroke. But, we still don't fully understand all the mechanisms that lead to high blood pressure," adds Jeremy Pearson, the associate medical director of the British Heart Foundation, who was not involved in the study.

"This study shows for the first time that macrophages — a type of cell that helps regulate our immune responses — can be involved in the control of blood pressure. More research is needed but these cells could be a new target for drugs to treat the condition."

Jeremy Pearson

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What is a stent? Everything you need to know

A stent is a tiny tube that a doctor places in an artery or duct to help keep it open and restore the flow of bodily fluids in the area.

Stents help relieve blockages and treat narrow or weakened arteries. Doctors may also insert stents in other areas of the body to support blood vessels in the brain or ducts that carry urine and bile.

A stent is usually a mesh-like metal tube, although fabric stents are also available. Sometimes, doctors will use dissolvable stents coated in medication as a temporary solution.

In this article, learn about why doctors use stents, as well as the benefits and possible risks.

Uses Doctor holding up heart stent
A stent can open up blood vessels with plaque blockages.

One of the most common uses for a stent is to open up a blood vessel that has a plaque blockage.

Plaque is a buildup of cholesterol, fat, and other substances found in the blood. When this plaque collects in the bloodstream, it sticks to the walls of the arteries.

Over time, this buildup narrows the arteries, limiting the amount of fresh blood that can reach the body.

A buildup of plaque in the arteries is a cause of coronary heart disease. Over time, people with narrowed arteries may begin to notice warning symptoms, such as chest pain. If people with the condition do not receive treatment, they may be at a higher risk of complications, such as a heart attack or stroke.

If the artery is at risk of collapsing or becoming blocked again, doctors may recommend inserting a stent to keep it open.

Doctors put a stent into an artery in a procedure known as a percutaneous coronary intervention (PCI), or angioplasty with stent.

During PCI, doctors will insert a catheter into the artery. The catheter has a small balloon with a stent around it on one end.

When the catheter reaches the point of the blockage, the doctor will inflate the balloon. When the balloon inflates, the stent expands and locks into place. The doctor will then remove the catheter, leaving the stent in place to hold the artery open.

A doctor will decide whether or not to insert a stent based on a few factors, such as the size of the artery and where the blockage occurs.

Doctors may also use stents for:

blood vessels in the brain or aorta that are at risk of an aneurysm bronchi in the lungs that are at risk of collapse ureters, which carry urine from the kidneys into the bladder bile ducts, which carry bile between the organs and small intestine Thank you for supporting Medical News Today Risks Surgeon looking at screen in operating theatre
A surgeon can explain the risks and benefits of PCI. PCI carries a small risk of complications, which include: bleeding from the catheter insertion site an infection an allergic reaction damage to the artery from inserting the catheter damage to the kidneys irregular heartbeat In some cases, restenosis may occur. Restenosis is when too much tissue grows around the stent. This could narrow or block the artery again. Doctors may recommend forms of radiation therapy or opt to insert a medication-coated stent to slow the growth of the tissue. People at risk of complications include: A stent can cause blood clotting, which may increase the risk of heart attack or stroke. The National Heart, Lung, and Blood Institute state that about 1 to 2 percent of people who have stented arteries develop a blood clot at the site of the stent. Doctors will usually prescribe one or more drugs to prevent clotting. Anti-clotting medications may carry their own risks and can cause irritating side effects, such as rashes. In rare cases, a person's body may reject the stent, or they may have an allergic reaction to the material in the stent. Anyone who has a known reaction to metals should talk to their doctor about alternatives. What to expect The surgeon will discuss the procedure with a person in advance, but it can help to know what to expect. Before the surgery A doctor will advise individuals on how they should prepare for a stent procedure. They will give them information on when to stop eating and drinking, as well as when to start or stop taking medications before the procedure. Anyone who has any other health conditions, such as diabetes or kidney disease, must tell their doctor. The doctor may then have to consider some additional steps. Doctors may also give the person prescriptions to fill before having the stent inserted, as they will need to start taking the medications as soon as the procedure is complete. During the surgery According to the National Heart, Lung, and Blood Institute, a stent procedure only takes about an hour and does not require general anesthesia. The person remains awake during the entire process so can hear any instructions the doctors may have. Doctors will administer medication to help the person relax. They will also numb the area where they insert the catheter. Most people do not feel the catheter threading through the artery. They may, however, feel a bit of pain as the balloon expands and pushes the stent into place. After placing the stent, doctors deflate the balloon and remove the catheter. They bandage the area where the catheter entered the skin and put pressure on the bandage to help prevent bleeding. After the surgery Most people will need to stay in the hospital for at least one night after having the procedure. This allows hospital staff to monitor the person. During the hospital stay, a nurse will regularly check the person's heart rate and blood pressure. They may also change the dressings or clean the wound. The person may leave the hospital the following day if there are no complications. As the insertion site heals, it will bruise and may develop into a small knot of tissue, which is normal. The area may remain tender for at least a week. Thank you for supporting Medical News Today Recovery Patient in hospital bed.
A person may have to rest for about a week after surgery. A successful stent surgery should reduce symptoms, such as chest pain and shortness of breath. Many people may be able to return to work and most normal activities within a week of a successful stent surgery. During recovery, doctors will prescribe antiplatelet drugs to help prevent blood clots from forming near the stent. Aspirin is an antiplatelet drug that a person will need to take daily for an indefinite period after having a stent inserted. Doctors may also recommend a drug called a P2Y inhibitor. P2Y inhibitors include clopidogrel, ticagrelor, and prasugrel. They will also provide the person with special recovery instructions, such as avoiding strenuous work or exercise while the body heals. Long-term use Most stents remain in the artery permanently to keep it open and prevent collapse and potentially life-threatening complications. Some stents are temporary. Doctors may use stents coated in particular medications that help break down plaque or prevent it from building up in the area. These stents will dissolve over time. While a stent may relieve symptoms, such as chest pain, it is not a cure for other underlying issues, such as atherosclerosis and coronary heart disease. Even with a stent, a person with these conditions may need to take steps to prevent further complications. Doctors will recommend healthy lifestyle changes after inserting a stent to help prevent plaque building up in the body. These recommendations often include: eating a healthful diet exercising regularly maintaining a healthy weight quitting smoking and tobacco use reducing stress Stents are often just one part of treatment. Doctors may also prescribe medications for any underlying conditions. If anyone experiences any bothersome side effects, it is best to talk to a doctor. They may recommend alternative medications or change the dose to help relieve side effects. Do not stop taking any medications without consulting a doctor first, however. Thank you for supporting Medical News Today Outlook Doctors commonly insert stents to widen arteries and prevent complications from coronary heart disease and other conditions. While a stent may provide relief, it is only one part of a treatment program. Even with a stent, it is possible for severe complications to occur. Always follow a doctor's advice about medications and recovery.
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Our guide to the Mediterranean diet

Many doctors and dietitians recommend a Mediterranean diet to prevent disease and keep people healthy for longer.

The Mediterranean diet emphasizes fruits, vegetables, and whole grains, and it includes less dairy and meat than a typical Western diet.

In this article, we explain what the Mediterranean diet is and provide a 7-day meal plan for people to follow.

What is a Mediterranean diet? Foods from a Mediterranean diet
A Mediterranean diet includes fresh produce and some healthful fats and oils.

Essentially, following a Mediterranean diet means eating in the way that the people in the Mediterranean region traditionally ate.

A traditional diet from the Mediterranean region includes a generous portion of fresh produce, whole grains, and legumes, as well as some healthful fats and fish.

The general guidelines of the diet recommend that people eat:

a wide variety of vegetables, fruits, and whole grains healthful fats, such as nuts, seeds, and olive oil moderate amounts of dairy and fish very little white meat and red meat few eggs red wine in moderation

The American Heart Association note that the average Mediterranean diet contains a high percentage of calories from fat.

Although more than half of the calories from fat come from monounsaturated fats, such as olive oil, the diet may not be right for people who need to limit their fat intake.

Thank you for supporting Medical News Today Building a meal plan The Mediterranean diet puts a higher focus on plant foods than many other diets. It is not uncommon for vegetables, whole grains, and legumes to make up all or most of a meal. People following the diet typically cook these foods using healthful fats, such as olive oil, and add plenty of flavorful spices. Meals may include small portions of fish, meat, or eggs. Water and sparkling water are common drink choices, as well as moderate amounts of red wine. People on a Mediterranean diet avoid the following foods: refined grains, such as white bread, white pasta, and pizza dough containing white flour refined oils, which include canola oil and soybean oil foods with added sugars, such as pastries, sodas, and candies deli meats, hot dogs, and other processed meats processed or packaged foods 7-day meal plan Here is an example of a 7-day Mediterranean diet meal plan: Day 1 Greek yoghurt with blueberries and walnuts
One breakfast option is greek yogurt with blueberries and walnuts. Breakfast one pan-fried egg whole-wheat toast grilled tomatoes For additional calories, add another egg or some sliced avocado to the toast. Lunch 2 cups of mixed salad greens with cherry tomatoes and olives on top and a dressing of olive oil and vinegar whole-grain pita bread 2 ounces (oz) of hummus Dinner whole-grain pizza with tomato sauce, grilled vegetables, and low-fat cheese as toppings For added calories, add some shredded chicken, ham, tuna, or pine nuts to the pizza. Day 2 Breakfast 1 cup of Greek yogurt One-half of a cup of fruits, such as blueberries, raspberries, or chopped nectarines For additional calories, add 1–2 oz of almonds or walnuts. Lunch Whole-grain sandwich with grilled vegetables, such as eggplant, zucchini, bell pepper, and onion To increase the calorie content, spread hummus or avocado on the bread before adding the fillings. Dinner one portion of baked cod or salmon with garlic and black pepper to add flavor one roasted potato with olive oil and chives Day 3 Breakfast 1 cup of whole-grain oats with cinnamon, dates, and honey top with low-sugar fruits, such as raspberries 1 oz of shredded almonds (optional) Lunch boiled white beans with spices, such as laurel, garlic, and cumin 1 cup of arugula with an olive oil dressing and toppings of tomato, cucumber, and feta cheese Dinner one-half of a cup of whole-grain pasta with tomato sauce, olive oil, and grilled vegetables 1 tablespoon of Parmesan cheese Day 4 Breakfast two-egg scramble with bell peppers, onions, and tomatoes top with 1 oz of queso fresco or one-quarter of an avocado Lunch roasted anchovies in olive oil on whole-grain toast with a sprinkling of lemon juice a warm salad comprising 2 cups of steamed kale and tomatoes Dinner 2 cups of steamed spinach with a sprinkling of lemon juice and herbs one boiled artichoke with olive oil, garlic powder, and salt Add another artichoke for a hearty, filling meal. Day 5 Breakfast 1 cup of Greek yogurt with cinnamon and honey on top mix in a chopped apple and shredded almonds Lunch 1 cup of quinoa with bell peppers, sun-dried tomatoes, and olives roasted garbanzo beans with oregano and thyme top with feta cheese crumbles or avocado (optional) Dinner 2 cups of steamed kale with tomato, cucumber, olives, lemon juice, and Parmesan cheese a portion of grilled sardines with a slice of lemon Day 6 Breakfast two slices of whole-grain toast with soft cheese, such as ricotta, queso fresco, or goat cheese add chopped blueberries or figs for sweetness Lunch 2 cups of mixed greens with tomato and cucumber a small portion of roasted chicken with a sprinkling of olive oil and lemon juice Dinner oven-roasted vegetables, such as: artichoke carrot zucchini eggplant sweet potato tomato toss in olive oil and heavy herbs before roasting 1 cup of whole-grain couscous Day 7 Breakfast whole-grain oats with cinnamon, dates, and maple syrup top with low-sugar fruits, such as raspberries or blackberries Lunch stewed zucchini, yellow squash, onion, and potato in a tomato and herb sauce Dinner 2 cups of greens, such as arugula or spinach, with tomato, olives, and olive oil a small portion of white fish leftover vegetable stew from lunch Thank you for supporting Medical News Today Snacks Avocado on toast
Avocado on toast is a healthful snack for people on a Mediterranean diet. There are many snack options available as part of the Mediterranean diet. Suitable snacks include: a small serving of nuts whole fruits, such as oranges, plums, and grapes dried fruits, including apricots and figs a small serving of yogurt hummus with celery, carrots, or other vegetables avocado on whole-grain toast Health benefits The Mediterranean diet receives a lot of attention from the medical community because many studies verify its benefits. The benefits of a Mediterranean diet include: Lowering the risk of cardiovascular disease Evidence suggests that a Mediterranean diet may reduce the risk of cardiovascular disease. A study that featured in The New England Journal of Medicine compared two Mediterranean diets with a control diet for almost 5 years. The research suggested that the diet reduced the risk of cardiovascular issues, including stroke, heart attack, and death, by about 30 percent compared with the control group. More studies are necessary to determine whether lifestyle factors, such as more physical activity and extended social support systems, are partly responsible for the lower incidence of heart disease in Mediterranean countries than in the United States. Improving sleep quality In a 2018 study, researchers explored how the Mediterranean diet affects sleep. Their research suggested that adhering to a Mediterranean diet may improve sleep quality in older adults. The diet did not seem to affect sleep quality in younger people. Weight loss The Mediterranean diet may also be helpful for people who are trying to lose weight. The authors of a 2016 review noted that people who were overweight or had obesity lost more weight on the Mediterranean diet than on a low-fat diet. The Mediterranean diet group achieved results that were similar to those of the participants on other standard weight loss diets. Thank you for supporting Medical News Today Summary Following a Mediterranean diet involves making long-term, sustainable dietary changes. Generally speaking, a person should aim for a diet that is rich in natural foods, including plenty of vegetables, whole grains, and healthful fats. Anyone who finds that the diet does not feel satisfying should talk to a dietitian. They can recommend additional or alternative foods to help increase satiety.
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Could bone broth boost heart health?

Recently, bone broth has enjoyed a boost in popularity. To add to its new-found fame, a recent study concludes that it could have benefits for heart health, too.
Woman eating bone broth
Bone broth may be fashionable, but is it good for your heart?

Bone broth is a soup containing brewed bones and connective tissue.

Slowly cooking the bones in vinegar releases some of the nutrients that a person might otherwise discard with the rest of the carcass.

According to some quarters, drinking bone broth carries a multitude of benefits.

From reducing inflammation to improving sleep, bone broth can seemingly do no wrong.

Although some are hailing bone broths as "the new coffee," there is little evidence to support its benefits.

It is true that bone broth delivers nutrients, including amino acids and minerals, but not in any higher quantities than might be found in many other foods.

Bone broth contains collagen, leading some supporters to claim that bone broth improves skin health and joint function. However, collagen that we consume never reaches the skin or joints because it is broken down into amino acids by the digestive system.

The authors of the most recent study into bone broth published their findings in the Journal of Agricultural and Food Chemistry. They focused on the amino acids and peptides that the bone and connective tissue produce as they break down.

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Bone broth and cardiovascular health

In particular, the researchers were interested in how cooked bones might release proteins which, during digestion, are broken down further into smaller chains of amino acids, referred to as peptides.

Once broken down in this way, peptides can have very different properties from the original proteins.

The scientists, led by Leticia Mora, wanted to understand whether Spanish dry-cured ham bones could be a source of heart-beneficial peptides. To investigate, they simulated both cooking and human digestion.

Once they had the final product, they tested the resulting peptides to see if they might block particular enzymes known to be involved in heart disease.

The enzymes of interest included angiotensin 1-converting enzyme (ACE-1), endothelin-converting enzyme, dipeptidyl peptidase-4, and platelet-activating factor acetylhydrolase.

All of the enzymes above regulate aspects of the cardiovascular system. ACE-1 inhibitors, for instance, are used to treat high blood pressure and inflammation-based heart disease. If scientists could source these peptides from foods, this might be beneficial for people who have an elevated risk of developing these conditions.

According to the authors, "their inhibition can result in the reduction of high blood pressure and alleviation of disorders, including type 2 diabetes, obesity, atherosclerosis, and inflammatory diseases."

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Potential heart benefits

The scientists found that peptides — predominantly derived from hemoglobin and collagen — could block the enzymes related to heart disease, even after cooking and digestion.

Additionally, they measured the presence of other peptides; many of these were chains of just two or three amino acids, making them more likely to be able to travel through the intestinal wall and be active in the body. The authors conclude:

"These results suggest that dry-cured ham bones [used in] stews and broths could have a positive impact on cardiovascular health and a possible reduction of high blood pressure for consumers."

However, as the authors note, measuring these peptides under artificial conditions is not the same as assessing their impact on living organisms. Scientists will need to do much more work before they can confirm the heart benefits of bone broth.

Understanding the chemistry of foods is only one small step toward realizing their impact on health. These findings might further boost bone broth's popularity, but the trend will probably be over before conclusive evidence rolls in.

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7 simple steps for heart health also prevent diabetes

New research suggests that following the American Heart Association's guidelines for maintaining heart health can also drastically reduce the risk of developing type 2 diabetes.
woman drinking smoothie after exercising
Exercising and healthful eating are among the "simple 7" guidelines that the AHA recommend.

According to the American Heart Association (AHA), there are seven cardiovascular risk factors that people can change to improve their heart health.

Dubbed "Life's Simple 7," these risk factors are: "smoking status, physical activity, weight, diet, blood glucose, cholesterol, and blood pressure."

The AHA note that research has shown that maintaining a minimum of five of the seven factors at an ideal level can lower the risk of cardiovascular death by almost 80 percent.

New research, which features in Diabetologia, the journal of the European Association for the Study of Diabetes, finds that these seven modifiable risk factors can also stave off diabetes.

Coming up with new strategies for preventing diabetes is crucial as over 100 million people in the United States are currently living with the condition or with prediabetes.

According to the Centers for Disease Control and Prevention (CDC), untreated prediabetes can progress into full-blown type 2 diabetes within 5 years.

Dr. Joshua J. Joseph, an endocrinologist and assistant professor at The Ohio State University Wexner Medical Center in Columbus, led the new research.

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In the new study, Dr. Joseph and colleagues evaluated diabetes status in 7,758 individuals who participated in the REasons for Geographic and Racial Differences in Stroke Study.

The team used the AHA's seven factors to assess the cardiovascular health of the participants.

The analysis revealed that participants who had at least four out of the seven factors within the ideal range were 70 percent less likely to develop diabetes over the next 10 years.

"What's interesting," reports the study's lead researcher, "is [that] when we compared people who had normal blood glucose and those who already had impaired blood glucose, [...] [t]hose in normal levels who attained four or more guideline factors had an 80 percent lower risk of developing diabetes."

However, he notes that those who already had prediabetes and met four of the seven factors did not seem to benefit from the lifestyle changes. Instead, their risk of diabetes remained the same.

This is further proof, continues the researcher, that people should use the "simple 7" to prevent the onset of diabetes.

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"Healthy people need to work to stay healthy," says Dr. Joseph. "Follow the guidelines," he advises.

"Don't proceed to high blood sugar and then worry about stopping diabetes. By that point, people need high-intensity interventions that focus on physical activity and diet to promote weight loss and, possibly, medications to lower the risk of diabetes."

Dr. Joshua J. Joseph

The physician also stresses the importance of educating the public about preventing diabetes. He and his team are actively engaged in community outreach programs that inform people about healthful practices.

"We don't wait for people to come to us as patients," Dr. Joseph says. "We're very engaged in taking our work from the lab and applying it to our populations so we can help keep our communities healthy."

The video below further details the findings and zooms in on the case of Tim Anderson, a man who has recently received a diabetes diagnosis:

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Exercise can halve heart attack risk in healthy people

New research, appearing in the European Heart Journal, suggests that lack of physical activity can drastically increase the risk of a heart attack in the long-term, even if there are no symptoms at present.
woman stretching before running
Exercise that raises the heart rate, such as running, may cut heart attack risk by half, suggests a new study.

Cardiorespiratory fitness describes the body's ability to deliver oxygen to the muscles when we are engaged in physical activity. Specifically, the term refers to "the efficiency of the heart, lungs and vascular system."

A significant body of research has linked cardiorespiratory fitness with a variety of positive health outcomes, ranging from preventing cardiovascular disease and all-cause mortality to staving off diabetes and improving insulin resistance.

However, most of these previous studies have relied on the participants' self-reported levels of fitness.

New research uses more precise methods of measuring cardiorespiratory fitness and highlights another one of its benefits.

Higher fitness levels can halve the risk of heart attack, the new study finds. Conversely, suggest the researchers, poor fitness levels can raise future risk even in the absence of warning symptoms in the present.

Bjarne Nes, from the Norwegian University of Science and Technology's Cardiac Exercise Research Group in Trondheim, is the corresponding and last author of the study.

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Studying fitness levels and heart attack risk

Nes and his colleagues analyzed the cardiorespiratory fitness of more than 4,500 people who took part in an extensive health survey called HUNT3.

None of the participants had a history of cardiovascular disease, lung disease, cancer, or high blood pressure at the start of the study.

Just over 50 percent of the participants were women, and more than 80 percent of all of them were at "low risk" of developing cardiovascular disease over a 10-year period.

The scientists used a "gold-standard method" — or maximum oxygen uptake — to directly measure the participants' fitness levels.

Maximum oxygen uptake refers to the maximum amount of oxygen the body can absorb during exercise. According to Nes, it is "the most precise measure of fitness."

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High fitness halves the risk of heart attack

By the end of the study, 147 of the participants had heart attacks or had developed angina pectoris — two conditions caused by blocked or narrowed coronary arteries.

The analysis by the researchers revealed a correlation between declining cardiovascular risk and increased fitness levels.

"Even among people who seem to be healthy, the top 25 percent of the most fit individuals actually have only half as high a risk as the least fit 25 percent," reports Nes.

Furthermore, even a small improvement in cardiorespiratory fitness saw significant benefits for heart health. Namely, each fitness increase of 3.5 points correlated with a 15 percent lower risk of heart attack or angina.

"We found a strong link between higher fitness levels and a lower risk of heart attack and angina pectoris over the 9 years following the measurements that were taken," says Nes.

"We know that patients with low oxygen uptake are at increased risk of premature death and cardiovascular disease," he continues.

"Our study shows that poorer fitness is an independent risk factor for coronary artery disease, even among healthy women and men who are relatively fit."

Bjarne Nes

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'Use training as preventive medicine'

Dr. Jon Magne Letnes, the study's first author, also further comments on the findings. "Our results should encourage people to use training as preventive medicine," Dr. Letnes says.

"A few months of regular exercise that gets you out of breath can be an effective strategy for reducing the risk of cardiovascular disease."

Dr. Letnes explains that cardiorespiratory fitness offers insights into so much more than just endurance to exercise.

"Fitness isn't just a measure of how much you've trained in your life, but it also tells you what kind of genes you have," he says.

"Other factors like obesity may also affect fitness. So we measure a lot of the body's functions, and from other studies, we know that both genes and physical activity play a role in how your heart and blood vessels function," Dr. Letnes explains.

The study's first author thinks doctors should consider fitness measurements when evaluating heart disease risk.

"Although it may be inconvenient and difficult to measure oxygen uptake at the doctor's office, some simple and relatively accurate calculators exist that can provide a good estimate of fitness and disease risk," he advises.

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A good night's sleep could lower cardiovascular risk

Can the duration and quality of your sleep affect your cardiovascular health? A new study suggests there is a connection between how much sleep you get each night — and how well you sleep — and the risk of cardiovascular problems.
person asleep in bed
Are you getting enough sleep, and could this be affecting your cardiovascular health?

Many studies have emphasized the importance of sleep in maintaining our health and well-being in general. Increasingly, however, researchers are finding out how sleep quality affects specific aspects of a person's health.

For instance, one recent study that was covered by Medical News Today found that poor sleep could well be a telltale sign of the development of Alzheimer's disease. Another study tied sleep problems with high blood pressure, at least in women.

Now, research from the Centro Nacional de Investigaciones Cardiovasculares Carlos III in Madrid, Spain, and Tufts University — with campuses in Medford and Somerville, MA — indicates that there is a link between sleep quality and the risk of atherosclerosis, a condition that doctors characterize by plaque buildup in the arteries.

"Cardiovascular disease is a major global problem, and we are preventing and treating it using several approaches, including pharmaceuticals, physical activity, and diet," says the new study's senior author, Dr. José Ordovás.

"But this study emphasizes we have to include sleep as one of the weapons we use to fight heart disease — a factor we are compromising every day," Dr. Ordovás explains.

The research team's findings now appear in the Journal of the American College of Cardiology.

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All about sleep duration and quality

The researchers analyzed the medical data of 3,974 individuals who averaged 46 years of age, were based in Spain, and who took part in the Progression of Early Subclinical Atherosclerosis (PESA) study.

Essentially, PESA recorded the prevalence and rate of progression of vascular problems that were not yet clinically relevant in the participants. None of the PESA-sourced volunteers had a diagnosis of heart disease at baseline, and two-thirds of them were male.

Besides allowing doctors to assess their vascular lesions, the participants also agreed to wear a sleep actigraph — a device that helps record a person's sleep patterns — for a period of 7 days.

Using the actigraph results, the researchers split the participants into four distinct groups:

people who slept under 6 hours per night people who slept 6–7 hours per night people who slept 7–8 hours each night people who slept longer than 8 hours.

All the participants also had 3-D heart ultrasounds, as well as cardiac CT scans, to check for the presence of heart disease. Moreover, the 3-D heart ultrasounds also measured atherosclerosis throughout the body.

The study found that — after the exclusion of other risk factors for heart disease — participants who slept under 6 hours every night had a 27 percent increase in the risk for atherosclerosis when the researchers compared them with people who slept between 7 and 8 hours each night.

Poor sleep quality — for instance, waking up often during the night — was associated with similar outcomes, increasing atherosclerosis risk by 34 percent.

Some researchers have emphasized that, even if you do end up sleeping less time, the quality of that sleep will have a noticeable impact on your health.

"It is important to realize that shorter sleep duration that is of good quality can overcome the detrimental effects of the shorter length," notes Dr. Valentin Fuster who is editor-in-chief of the Journal of the American College of Cardiology, in which the current study appears.

Intriguingly, the study also found some evidence that people who slept more than 8 hours per night — especially women — also had a heightened risk of atherosclerosis, though few people reported overly long slumber times.

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The first study of its kind

The study researchers also noted that participants who reported getting less sleep each night were more likely to drink more caffeinated and alcoholic drinks.

"Many people think alcohol is a good inducer of sleep, but there's a rebound effect," explains Dr. Ordovás. "If you drink alcohol," he adds, "you may wake up after a short period of sleep and have a hard time getting back to sleep. And if you do get back to sleep, it's often a poor-quality sleep."

As for the effects of coffee, the study's senior author notes that these are, most likely, down to an individual's genetic makeup, and how their body breaks down caffeine.

"Depending on your genetics, if you metabolize coffee faster, it won't affect your sleep, but if you metabolize it slowly, caffeine can affect your sleep and increase the odds of cardiovascular disease," he notes.

Dr. Ordovás believes that the current study is more accurate than previous efforts to map out the relationship between sleep and cardiovascular risk.

For one, the current study was larger than previous research. Most importantly, it reported on actigraph data to determine sleep patterns, rather than on self-reports from participants, which are subjective and can be unreliable.

"What people report and what they do are often different," Dr. Ordovás points out.

"This is the first study to show that objectively measured sleep is independently associated with atherosclerosis throughout the body, not just in the heart."

Dr. José Ordovás

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Metoprolol tartrate vs. metoprolol succinate

Metoprolol tartrate and metoprolol succinate are different salt forms of the same active ingredient, metoprolol. Although these medications are similar, they have slightly different uses and effects.

Metoprolol belongs to a class of drugs called beta-blockers. These drugs work by slowing down a person's heart rate and lowering their blood pressure.

Doctors often prescribe beta-blockers for people with cardiovascular conditions or those who have had a heart attack. Both metoprolol tartrate and metoprolol succinate are prescription-only drugs.

In this article, we explore the differences and similarities between these two drugs.

Uses Woman taking a pill
Metoprolol tartrate and metoprolol succinate can both treat high blood pressure and angina.

Doctors prescribe metoprolol tartrate to treat people with the following health conditions:

They use metoprolol succinate to treat the following health conditions:

Both drugs are effective in treating people with high blood pressure and angina. However, doctors prescribe only metoprolol tartrate to prevent further heart attacks in people who have already experienced a heart attack. For heart failure, they prescribe only metoprolol succinate.

Forms and dosage The appropriate dosage of both metoprolol tartrate and metoprolol succinate depends on a person's condition and how well that condition responds to the medication. Metoprolol tartrate Metoprolol tartrate is available either as an immediate-release tablet, as an intravenous injection, or in liquid form. People using the immediate-release tablet may need to take it several times a day, and doctors advise that they do so either with or directly after a meal. The recommended dosage of metoprolol tartrate ranges between 100–450 milligrams (mg) daily. One full dose of the intravenous injection provides 15 mg of the drug. If an individual tolerates this dose, the doctor may recommend that they switch to using metoprolol tartrate tablets instead. Metoprolol succinate Metoprolol succinate is available as an extended-release tablet, which means that people only have to take one tablet a day. The initial dosage of metoprolol succinate ranges from 25–100 mg per day. If the person experiences no problems on the initial dosage, a doctor may increase the dosage to a maximum of 200 mg per day. Thank you for supporting Medical News Today Who might benefit from these medications? A person may benefit from taking metoprolol tartrate if they have: experienced a heart attack high blood pressure angina Metoprolol succinate may benefit people who have: high blood pressure angina class II or III heart failure Side effects Woman with a headache and fatigue at her desk
Side effects of metoprolol tartrate can include fatigue and dizziness. Although beta-blockers are generally safe and effective drugs, they may cause unwanted side effects in some people. However, the side effects of metoprolol tartrate and metoprolol succinate are usually mild and temporary. Side effects of metoprolol tartrate can include: Side effects of metoprolol succinate can include: very low blood pressure dizziness difficulty sleeping fatigue difficulty breathing depression sexual dysfunction rash constipation nausea vomiting dry mouth rash Risks While metoprolol tartrate and metoprolol succinate are both generally very safe, people may experience problems if they abruptly stop taking them. Suddenly stopping beta-blockers can lead to worsening chest pain, increased blood pressure, and heart attack. If someone wishes to end their treatment, they should speak to a healthcare professional first. A doctor will usually advise people to lower the dosage gradually over 2 weeks. People who have diabetes may need to take care when taking any form of metoprolol medication because it can conceal symptoms that indicate low blood sugar, such as a rapid heartbeat. However, research has shown that beta-blockers can help control high blood pressure in people with diabetes. Beta-blockers can also affect how the heart responds to general anesthesia. A doctor may recommend temporarily withdrawing from beta-blocker treatment before undergoing major surgery. People should always consult their doctor before stopping or starting any new medications or supplements. Thank you for supporting Medical News Today Drug interactions Metoprolol tartrate and metoprolol succinate contain the same active ingredient, so these medications have similar drug interactions. People should inform a healthcare professional if they are taking any other prescription or over-the-counter drugs or supplements. Metoprolol tartrate and succinate can interact with a range of medications, including: Blood pressure drugs: amlodipine (Norvasc) hydralazine (Apresoline) ephedrine guanethidine betanidine clonidine Heart condition medications: digoxin (Lanoxin) furosemide (Lasix) quinidine gluconate Antipsychotics: haloperidol (Haldol) chlorpromazine (Thorazine, Largactil) fluphenazine (Prolixin) Antidepressants: phenelzine (Nardil) selegiline (Eldepryl) escitalopram (Lexapro) fluoxetine (Prozac) paroxetine (Paxil) Other medications: atorvastatin calcium (Lipitor) aspirin abiraterone acetate (Zytiga) acetaminophen (Tylenol) ergot alkaloid fingolimod (Gilenya) guaifenesin (Theocon Elixir, Brondelate) insulin glargine (Lantus) sildenafil (Viagra) Summary Metoprolol tartrate and metoprolol succinate belong to a class of drugs known as beta-blockers. Both drugs are different salts of the same active ingredient, metoprolol. However, despite being similar, they do have different uses. Both drugs are effective in treating people with high blood pressure and angina. However, doctors prescribe metoprolol tartrate for people who have had a heart attack and metoprolol succinate to treat individuals with type II and III heart failure. The two medications share similar drug interactions, so it is essential that people make their doctor aware of any medications or supplements that they are currently taking. Both forms of medication also share similar warnings. People should not stop taking these medications abruptly as this can lead to worsening symptoms and even heart attacks in some people. People with diabetes should take care when using beta-blockers because these medications can mask some symptoms of low blood sugar.
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Personal income may increase risk of heart disease

Income levels, if they are unstable, can easily turn into a stressor. However, the volatility of personal income could be having a more serious effect on people's heart health.
Money heart
Does how much money we earn affect cardiovascular health?

It is often expected that a person's income will constantly rise until they reach retirement age.

However, this isn't always the case. In fact, incomes have become so unpredictable that their volatility has reached an all-time high since 1980.

When a person's income fluctuates, it can alter many other factors in their life.

It can affect everything from mental health to diet, which could result in potentially serious health problems.

A new study suggests that personal income may even be associated with an increased risk of heart disease and death.

What is most surprising is that this link is present in relatively young people. We know this because an ongoing study has been tracking the health of young people living in four cities around the United States for nearly 3 decades.

The Coronary Artery Risk Development in Young Adults (CARDIA) study started in 1990. The four cities are Minneapolis, MN, Chicago, IL, Oakland, CA, and Birmingham, AL. Each participant was aged 23–35 years when the researchers first examined them.

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The risk of low income

The researchers behind the new study analyzed data from the CARDIA study to see whether there was a link between income fluctuations and risk of cardiovascular events as well as death. They first studied income levels taken from five assessments in 1990–2005.

They defined income volatility as a percentage change from one income figure to the next. They also looked at income drop, or an income decrease of 25 percent or more from the previous assessment figure.

They then tracked the number of people who experienced cardiovascular events — both fatal and non-fatal — or died of any cause in 2005–2015.

There were 106 cardiovascular events and 164 deaths. The team took into account factors such as pre-existing heart risk and sociodemographic background.

The results, now published in the journal Circulation, found that substantial fluctuations in personal income were associated with a higher risk of death and cardiovascular diseases in the decade following this income change.

The highest levels of income volatility were linked with almost double the risk of death and over double the risk of conditions such as strokes, heart failure, or heart attacks.

These findings were all compared with those of people who fell into a similar category but who had less of an alteration in their personal income.

Some people were more likely to experience high income volatility. Such people included women, African-American people, those who are unemployed, people who are not married, people who smoke, those with less than a high school education, and people with signs of depression.

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Why money matters

Lead study author Tali Elfassy, Ph.D., at the University of Miami Miller School of Medicine in Florida, says that income volatility "presents a growing public health threat, especially when federal programs, which are meant to absorb unpredictable income changes, are undergoing continuous changes, and mostly cuts."

"While this study is observational in nature and certainly not an evaluation of such programs, our results do highlight that large negative changes in income may be detrimental to heart health and may contribute to premature death."

Tali Elfassy, Ph.D.

It is not clear what exactly prompts income volatility to result in an elevated risk of cardiovascular problems, death, or both. It could be that fluctuations in a person's income result in unhealthful behaviors, such as excessive alcohol consumption, a lack of exercise, stress, and high blood pressure.

All of these things are linked to lifespan and cardiovascular health.

The researchers hope that other scientists will carry out further research to understand the cause of this newly found association. They list biologic and psychosocial pathways as being two potential reasons to explore.

They also see these findings as a way to more effectively screen people, especially those who are younger, for cardiovascular disease risk.

However, these results cannot currently be applied to all identities. Other ethnic groups and people living outside of cities will also need to be studied to see whether the same association is present.

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Study reveals how much fiber we should eat to prevent disease

A new meta-analysis examines 40 years' worth of research in an attempt to find out the ideal amount of fiber that we should consume to prevent chronic disease and premature mortality.
person eating cereals and fruit
Whole grain cereals and fruit are excellent sources of fiber.

Researchers and public health organizations have long hailed the benefits of eating fiber, but how much fiber should we consume, exactly?

This question has prompted the World Health Organization (WHO) to commission a new study. The results appear in the journal The Lancet.

The new research aimed to help develop new guidelines for dietary fiber consumption, as well as reveal which carbs protect the most against noncommunicable diseases and can stave off weight gain.

Noncommunicable diseases are also called chronic diseases. They typically last for a long time and progress slowly. According to WHO, there are "four main types of noncommunicable diseases:" cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes.

Professor Jim Mann, of the University of Otago, in New Zealand, is the corresponding author of the study, and Andrew Reynolds, a postdoctoral research fellow at Otago's Dunedin School of Medicine, is the first author of the paper.

Prof. Mann explains the motivation for the study, saying, "Previous reviews and meta-analyses have usually examined a single indicator of carbohydrate quality and a limited number of diseases, so it has not been possible to establish which foods to recommend for protecting against a range of conditions."

To find out, the researchers performed a meta-analysis of observational studies and clinical trials.

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Daily intake of 25–29 grams of fiber is ideal

Reynolds and colleagues examined the data included in 185 observational studies — amounting to 135 million person-years — and 58 clinical trials which recruited over 4,600 people in total. The studies analyzed took place over almost 40 years.

The scientists investigated the incidence of certain chronic diseases, as well as the rate of premature deaths resulting from them.

These conditions were: coronary heart disease, cardiovascular disease, stroke, type 2 diabetes, colon cancer, and a range of obesity-related cancers, such as breast cancer, endometrial cancer, esophageal cancer, and prostate cancer.

Overall, the research found that people who consume the most fiber in their diet are 15–30 percent less likely to die prematurely from any cause or a cardiovascular condition, compared with those who eat the least fiber.

Consuming foods rich in fiber correlated with a 16–24 percent lower incidence of coronary heart disease, stroke, type 2 diabetes, and colon cancer.

Fiber-rich foods include whole grains, vegetables, fruit, and pulses, such as peas, beans, lentils, and chickpeas.

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The analysis also revealed that the amount of fiber that people should consume daily to gain these health benefits is 25–29 grams (g). By comparison, adults in the United States consume 15 g of fiber daily, on average.

The authors also suggest that consuming more than 29 g of fiber per day may yield even more health benefits.

However, they do caution that, while the study in itself did not find any adverse health effects of consuming fiber, eating too much of it may be damaging for people with insufficient iron or minerals.

Eating large amounts of whole grains can further deplete the body of iron, explain the researchers.

Finally, the clinical trials included in the study also revealed that consuming more fiber correlates strongly with lower weight and lower cholesterol levels.

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Why fiber is so good for you

Prof. Mann comments on the significance of the findings, saying, "The health benefits of fiber are supported by over 100 years of research into its chemistry, physical properties, physiology, and effects on metabolism."

"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," he adds.

"The breakdown of fiber in the large bowel by the resident bacteria has additional wide-ranging effects including protection from colorectal cancer."

"Our findings provide convincing evidence for nutrition guidelines to focus on increasing dietary fiber and on replacing refined grains with whole grains. This reduces incidence risk and mortality from a broad range of important diseases."

Prof. Jim Mann

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What are the benefits of CoQ10?

Coenzyme Q10 is an essential chemical that the body produces naturally. A deficiency of this chemical can have adverse effects, and coenzyme Q10 supplements may offer health benefits.

In this article, we discuss the health benefits and risks of taking coenzyme Q10 (CoQ10) supplements.

What to know about CoQ10 young woman looking at complementary medicine
CoQ10 is a naturally produced chemical that is available as a supplement.

CoQ10 is an antioxidant that the body produces naturally and stores in components of the cell called mitochondria. It has associations with energy, protecting cells, and providing heart benefits.

CoQ10 plays a few critical roles in the body. For example, the body's cells need this compound to produce the energy that allows them to function.

As an antioxidant, CoQ10 also protects the cells in the body by neutralizing free radicals, which reduces oxidative stress in the body. Oxidative stress can cause tissue damage, inflammation, and cellular apoptosis, or cell death. There are links between oxidative stress and a range of disorders, including Alzheimer's disease and Parkinson's disease.

Naturally occurring levels of CoQ10 decrease with age. Scientists have identified associations between CoQ10 deficiency and heart disease and cancer.

There is currently not enough evidence to support using CoQ10 to either prevent or treat cancer or Parkinson's disease. However, it might help treat certain heart conditions and prevent migraines.

Researchers have also looked at the effects of CoQ10 on a variety of other conditions, but the results are inconclusive. These conditions include ALS, Down syndrome, Huntington's disease, and male infertility.

Thank you for supporting Medical News Today Health benefits of CoQ10 CoQ10 has many varied uses. We discuss its possible benefits below. Improving heart health CoQ10 might help treat specific heart conditions, such as congestive heart failure and high blood pressure, particularly among older individuals. Research on the effectiveness of CoQ10 for heart problems has provided mixed results. However, one study reported that CoQ10 was an important factor in the survival of older adults with chronic heart failure. Other research showed that CoQ10 might help people recover from some types of heart surgery. Reducing migraines According to both the American Academy of Neurology and the American Headache Society, CoQ10 may be effective in preventing migraines, although the research to support this is still limited. It is possible that CoQ10 has this effect because it keeps the mitochondria in the cells healthy. Easing statin side effects Some research suggests that CoQ10 might help ease muscle weakness that is due to taking cholesterol-lowering medications, known as statins. However, the results of another trial showed that treatment with CoQ10 did not reduce muscle pain in people who were also using statins to control their cholesterol levels. Sources and dosages People can obtain CoQ10 by eating certain meats and grain proteins, but the quantity present in these foods is too small to increase CoQ10 levels in the body significantly. Foods that contain CoQ10 include: organ meats, such as kidney and liver chicken beef pork fatty fish, such as sardine and trout spinach broccoli soybeans whole grains CoQ10 supplements are available to take either by intravenous (IV) injection or as capsules or tablets. Studies have used daily doses of CoQ10 ranging from 50 milligrams (mg) to 1,200 mg in adults. A typical daily dose for someone who has a CoQ10 deficiency is 100–200 mg, while the observed safe level is 1,200 mg per day. People should talk to their doctor before starting any new supplements or medications. Thank you for supporting Medical News Today Side effects and risks man suffering from insomnia
Although generally well-tolerated, CoQ10 supplements may cause insomnia. CoQ10 supplements appear to be safe and well-tolerated. Some mild side effects may include: Drug interactions Taking statins may reduce the amount of CoQ10 in a person's blood. Studies have shown a significant reduction in plasma CoQ10 concentrations following treatment with statins. Additionally, CoQ10 may reduce the effectiveness of blood-thinning drugs, such as warfarin, and this may increase the risk of blood clots. CoQ10 may also interfere with insulin and some chemotherapy medications. Thank you for supporting Medical News Today Summary Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that is present in almost every cell in the human body. Scientists have linked low levels of CoQ10 with various medical conditions, including heart disease and cancer. People usually tolerate CoQ10 supplementation well, and the supplements produce few, if any, side effects. However, there is limited research to support the health benefits that CoQ10 might offer. People can buy CoQ10 supplements in drug stores or online. It is essential to speak with a healthcare professional before taking any new dietary supplements, including CoQ10. 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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6 incredible cases of autosurgery

In this Spotlight, we will discuss six examples of self-surgery. The stories that follow are gruesome and unusual. Although they are not for the fainthearted, they are fascinating.
Surgical implements
Self-surgery is uncommon, thankfully.

Surgery is normally a skillful, delicate procedure that involves a surgeon and a patient.

However, over the years, for many reasons, one of the players in this classic duet has been absent.

In some cases, a surgeon's dedication to understanding the human body goes far beyond the walls of the library, inspiring them to cut themselves open.

In other cases, extreme situations have made extreme actions the only viable option.

Self-surgery, or autosurgery, is certainly not a frequent occurrence — especially in modern times. However, it does happen, and below are six extreme examples.

1. Cardiac catheterization

Werner Theodor Otto Forssman was studying medicine in Germany in the 1920s when a professor of his planted a question in his mind. That question was: Is it possible to reach the heart through the veins or arteries without the need for traumatic surgery?

Back then, the only way to access the heart was by conducting a fairly risky surgical procedure.

Forssman came across an article describing how a veterinarian had reached a horse's heart with a catheter via the internal jugular vein. This transports blood from the brain, face, and neck to the heart.

He came to the conclusion that in humans, he could use a ureteric catheter to reach the heart via the cubital vein, which lies close to the surface of the arm and travels to the heart.

Werner Theodor Otto Forssmann
Werner Theodor Otto Forssmann.

Excited, Forssman told the chief of surgery that he planned to attempt the procedure on a patient.

The chief was rightly concerned for the patient's safety and blocked his plans. So, Forssman asked if he could carry out the procedure on himself. Once again, the chief responded in the negative.

Undeterred, the young surgeon spoke with the operating room nurse; as the keeper of the equipment, he would need to have her permission.

She was impressed with the idea and offered herself as a test subject. Despite her courage, Forssman was still determined to carry out the procedure on himself.

He strapped the nurse down and pretended to make an incision on her, but he anesthetized his own cubital vein. He managed to advance the catheter 30 centimeters up his arm before the nurse realized that she had been duped.

Forssman asked her to call in an X-ray nurse so that he could chart the catheter's internal voyage from his arm to his heart.

While they were taking pictures of the catheter, a colleague saw what Forssman had done and attempted to pull the catheter out of his arm. However, Forssman won the ensuing tussle and continued his procedure.

The first images from the X-ray showed that the catheter had reached the level of his shoulder, so he continued feeding it through. Eventually, he achieved his goal: he could see the tip of his right ventricle cavity.

The procedure was a success, but Forssman had gone against the grain and was dismissed from his residency. Unable to find any surgical position, he turned to urology.

Then, 17 years later, alongside two others, he won the Nobel Prize for Physiology or Medicine for his part in the invention of cardiac catheterization.

Forssman's self-surgery was all in the name of medical advancement, but the next was a fight for survival.

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2. A most troublesome appendix

In 1960, Leonid Rogozov was a member of the 6th Soviet Antarctic expedition. He was the team's only medical professional.

Several weeks into the expedition, the 27-year-old surgeon noticed some of the telltale signs of appendicitis: fever, weakness, nausea, and significant pain in his right lower abdomen.

Drugs were not improving his situation; surgical intervention was needed. In his diary, he wrote:

"I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like a hundred jackals."

Antarctica view
Although beautiful, Antarctica is not the ideal setting for auto-surgery.

As winter deepened and the sea froze, Rogozov had no hope of returning to civilization for treatment. His only option was to carry out an appendectomy on himself.

This was an operation that he had completed many times, but certainly not under these circumstances.

"Still no obvious symptoms that perforation is imminent," he wrote, "but an oppressive feeling of foreboding hangs over me...This is it...I have to think through the only possible way out: to operate on myself...It's almost impossible...but I can't just fold my arms and give up."

He recruited three of his colleagues to assist him: one held the mirror and adjusted the lamp, one handed him the surgical implements as he requested them, and one acted as a reserve in case either of the others should faint or become nauseous.

Rogozov also explained how to revive him with epinephrine in case he lost consciousness.

At 2 a.m. on May 1, 1961 — after medicating himself with local anesthetic — he made the first 10–12-centimeter long incision in his abdomen. After around 30 minutes, Rogozov became weak and needed to take regular breaks, but he persevered.

His self-surgery was successful, and after 2 weeks, he was back to full health.

3. Self-cesarian

Most of these examples involve medically trained men, but this one bucks that trend. The woman in question had no medical training.

This example of autosurgery took place in March 2000 in a remote Mexican village, where access to healthcare is virtually nonexistent. A 40-year-old mother of eight was carrying her ninth child.

Around 2 years before this case of autosurgery, the woman had lost a child during labor due to an obstruction.

After hours of unproductive labor, she was concerned that she might lose the baby again. So, in a desperate attempt to prevent this from happening again, she decided to perform a cesarian on herself.

First, she drank three strong alcoholic drinks. Then, using a kitchen knife, she opened her abdomen with three strokes. According to a paper that describes the procedure, "[S]he used her skills at slaughtering animals." In all, the procedure took 1 hour.

Once free, the newborn boy breathed immediately. The woman then asked one of her children to fetch a local nurse to patch her up. The nurse repositioned the woman's intestines and sewed up the wound using a standard sewing needle and cotton.

Then, finally, she arrived at the nearest hospital — some 8 hours away by road. She did require extensive treatment, but she recovered enough to be released after 10 days.

In the paper mentioned above, the authors write:

"The natural, innate maternal instinct for preservation of offspring may result in the mother's disregard for self-safety, and even for her own life."

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4. Another troublesome appendix

Dr. Evan O'Neill Kane was the owner of Kane Summit Hospital in Pennsylvania. While awaiting the removal of his own appendix, he decided to do it himself.

Although the medical staff were less than comfortable with his decision, he was their boss, and they reluctantly allowed him to indulge in autosurgery.

Appendicitis illustration
An inflamed appendix (depicted here) can be incredibly painful.

In 30 minutes, Dr. Kane injected adrenalin and cocaine into his abdominal wall, cut himself open, found his appendix, and removed it.

In fact, he claimed he could have completed the surgery quicker had his staff not been so nervous.

During the surgery, Dr. Kane leaned a little too far forward and his intestines slipped through the wound in his abdomen.

Though his colleagues were shocked, he remained calm and simply pushed them back to where they belonged.

Just 2 weeks later, Dr. Kane had fully recovered and was operating again. When someone asked him why he had decided to embark on self-surgery, he told them that he wanted to know what it felt like.

Also, and perhaps more importantly, he wanted to demonstrate that it was possible to undergo minor procedures without the use of relatively dangerous general anesthetics.

This wasn't Dr. Kane's only foray into self-surgery; at age 70, he decided to repair his inguinal hernia under local anesthetic, and this time, he invited members of the press to attend.

The operation was successful, but Dr. Kane never recovered his full strength. He died of pneumonia within just 3 months.

5. The sixth stone

M. Clever Maldigny, a military surgeon, was plagued by kidney stones. By age 27, he had endured no less than five operations to remove them.

Some of these procedures had caused long-lasting complications, so, in 1824, Maldigny decided that he would remove the sixth stone himself.

Using a mirror and guided by the scars of previous procedures, he opened himself up. He located the neck of the bladder and found the offending article lodged among the scars formed by previous surgeries.

The self-surgery was successful and, according to Maldigny, 3 weeks later "he was tranquil and cheerful as if he had never been a sufferer."

When a seventh kidney stone appeared some years later, he opted for a new and minimally invasive surgery wherein a surgeon crushes the stone via a small hole.

He did not carry out the procedure himself.

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6. An egg-sized hernia

Our final example of self-surgery comes from Romanian surgeon called M. Alexandre Fzaicou. He had developed an inguinal hernia, in which some of the contents of the abdominal cavity push through a weak spot in the wall of the abdomen and form a painful swelling in the groin area.

According to Fzaicou, his hernia was the size of a hen's egg.

After many attempts at anesthetizing the region with strychnine-stovain, he finally found the right injection point in the groin and got to work.

The surgery took around 1 hour and was a success. Following the procedure, Fzaicou reported headache, insomnia, and pain in the upper abdomen, which lasted 1 week. He had returned to work in just 12 days.

If nothing else, these stories remind us of the amazing things that humans are capable of.

Although it probably goes without saying, Medical News Today do not suggest or imply that autosurgery is the best course of action for anyone.

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Heart failure: Flu vaccine could save lives

People with heart failure are more susceptible to flu complications than other people. However, a new study has revealed that flu vaccinations may have a significant impact on lifespan.
Vaccine flu older adult
The importance of the flu vaccine receives a further boost in a new study.

Most doctors, scientists, and other medical professionals consider flu vaccinations to be a safe and effective way of protecting people against influenza, or the flu.

The vaccine, usually given in the form of an injection, contains small amounts of deactivated flu viruses.

These viruses are not harmful in this state but do trigger the human body to produce antibodies to fight against them. This means that the next time the virus enters the body, it can produce the same response quickly.

The Centers for Disease Control and Prevention (CDC) advise that everyone over the age of 6 months has a flu vaccination. However, certain individuals are more at risk of experiencing flu-related complications or even death.

This includes people over 65 years old and over, those who are pregnant, and those who have medical conditions, such as heart disease.

A new study has examined just how much of an impact a flu shot can have on the survival rate of people diagnosed with heart failure. This group of individuals are often older and are also likely to have a range of other health issues. For these people, getting the flu can be a severe problem.

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The analysis

A team of researchers from the University of Copenhagen in Denmark analyzed data from a total of 134,048 Danish people who had recently received a diagnosis of heart failure. The researchers gathered the data from several national registries that store information on hospital diagnoses, prescriptions, and causes of death.

Each person born in Denmark receives a unique personal identification number, and this number allowed researchers to follow particular people for 12 years, from 2003 to 2015.

Many findings from the study came to light. The data analysis, now published in the American Heart Association's journal Circulation, firstly showed that the number of people getting flu vaccinations had increased.

In 2003, 16 percent of people with heart failure had the flu vaccine. In 2015, this had risen to 52 percent of people.

The researchers also found a link between flu vaccinations and "an 18 percent reduced risk of premature death." This reduction existed even after taking other factors, such as medications, other health issues, and financial situations, into account.

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The importance of vaccines

The research also identified the importance of having regular flu shots. For example, having an annual flu vaccination after a diagnosis of heart failure showed a 19 percent reduction in cardiovascular death and all-cause death compared to those who did not get vaccinated.

Having the flu shot less than once a year resulted in an 8 percent reduction in the risk of cardiovascular death and "a 13 percent reduced risk of all-cause death" when compared to people who had never had the vaccination.

The final factor that the researchers identified was the timing of the flu vaccination. The team found a reduction in the number of cardiovascular and all-cause deaths when people received the vaccine at the beginning of the flu season, which is usually around September or October, rather than in November and December, for example.

Heart failure's future

Scientists expect heart failure to become an increasing problem in future years, making these results potentially useful for a human population that is now living longer. One limitation of this research, however, is that the scientists only studied people newly diagnosed with heart failure. Lead author of the study Daniel Modin says:

"While this research only looked at patients with newly diagnosed heart failure, the protection from a flu shot likely benefits any patient with heart failure."

Daniel Modin

He continues, "I hope that our study can assist in making physicians and cardiologists who care for patients with heart failure aware of how important influenza vaccination is for their patients. Influenza vaccination may be regarded as a standard treatment in heart failure similar to medications."

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How does yo-yo dieting affect our heart health?

Sticking to a strict diet can be challenging, so our eating patterns can fluctuate wildly. A new study looks at how these changes might impact cardiovascular health.
Avocado heart
How does eating well intermittently affect our heart?

As we roll into 2019, many people will be trying out new diet regimes.

For many of us, sticking to a nut-filled, burger-free, fish-heavy Mediterranean-style diet will only last a matter of days before we return to the realms of cheesecake and cheese boards.

Though eating right over the long-term reduces the risk of cardiovascular problems, we know much less about how a fluctuating dietary regime impacts our heart health.

Because so many people choose a diet and then gradually stray from it, researchers are interested in how yo-yo dieting might influence markers of cardiovascular disease.

A team led by Prof. Wayne Campbell, of Purdue University in West Lafayette, IN, set out to investigate. The scientists recently published their findings in the journal Nutrients.

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Altering eating patterns periodically

To investigate, the scientists inspected data from two previous studies into dietary interventions carried out by the same group of researchers at Purdue University.

The participants of these studies followed one of two eating patterns: a Mediterranean diet or a Dietary Approaches to Stop Hypertension (DASH) diet.

Lead study author Lauren O'Connor explains these two eating patterns, saying, "Our DASH-style eating pattern focused on controlling sodium intake, while our Mediterranean-style focused on increasing healthy fats. Both eating patterns were rich in fruits, vegetables, and whole grains."

Participants followed their eating pattern for 5 or 6 weeks. After this period, the scientists assessed their cardiovascular risk by measuring a range of parameters.

These included blood pressure and levels of fats, glucose, and insulin in the blood.

Following the 5–6 weeks of dieting, participants went back to their standard eating patterns for a further 4 weeks. Then, after another cardiovascular assessment, they were restarted on DASH or Mediterranean diet plans for an additional 5–6 weeks. Finally, they had one more checkup at the end of this period.

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A cardiometabolic 'rollercoaster'

The analysis showed that, as expected, the cardiovascular markers improved when the individual stuck to the diet. Then, once they had returned to a less healthful eating regime, the biomarkers became less favorable again.

Then, once the healthful diets were restarted, the metabolic markers once again improved.

The key message is that only a few weeks of healthful eating can make measurable improvements to markers of cardiovascular health, but at the same time, it does not take long before they return to their unhealthy state once a person terminates their healthful diet.

"These findings should encourage people to try again if they fail at their first attempt to adopt a healthy eating pattern," Prof. Campbell says. "It seems that your body isn't going to become resistant to the health-promoting effects of this diet pattern just because you tried it and weren't successful the first time."

More research will be needed to explore whether yo-yo dieting has an impact on long-term health.

Some studies have shown that losing and gaining weight again in a cycle, or weight cycling, could cause stress to the cardiovascular system. However, the evidence is certainly not overwhelming, and some scientists question whether weight cycling has any adverse effects at all.

Overall, the results are bittersweet; they show that just a few weeks of dietary change can produce measurable improvements in health markers. On the flip side, after just a few weeks following the abandonment of a new diet, those benefits are lost.

However, if a person restarts their healthful eating plan, the benefits can be won back in the same short amount of time. As such, Prof. Campbell's message is one of stubborn persistence:

"The best option is to keep the healthy pattern going, but if you slip up, try again."

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Can exercise lower blood pressure as effectively as drugs?

Millions of people live with high blood pressure, which can place them at risk of developing cardiovascular diseases. For this condition, doctors typically prescribe blood-lowering drugs, but could exercise help just as well?
people jogging
A new study suggests that exercise can be just as effective as drugs when it comes to keeping blood pressure under control.

According to the Centers for Disease Control and Prevention (CDC), approximately 75 million adults in the United States have to manage high blood pressure, where it exceeds the threshold of 140 millimeters of mercury (mm Hg).

The condition can increase their risk of developing heart disease or experiencing a stroke, both of which are leading causes of death in the U.S.

Moreover, high blood pressure drives an expense of around $48.6 billion per year nationally, including the cost of medication, accessed health care, and absence from work.

People with high blood pressure typically follow an antihypertensive or blood pressure-lowering treatment, which includes special medication. At the same time, specialists sometimes advise that people make lifestyle changes to help them manage their blood pressure.

One such change is to take regular, structured exercise that can be of several types:

endurance exercises, such as walking, jogging, or swimming high-intensity interval training, involving short bursts of intensive exercise dynamic resistance, including strength training isometric resistance, such as the plank exercise a combination of endurance and resistance exercises

However, no studies have yet compared the effectiveness of physical activity in lowering blood pressure with that of antihypertensive medication.

A new study in the British Journal of Sports Medicine — a BMJ publication — aims to address this gap in the literature.

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Findings indicate similar effects

Since there are no studies that directly compare the effects of blood pressure medication with those of structured exercise, the study analyzed the data of various research projects that focused on one or other of these approaches.

The researchers — from institutions across Europe and the U.S., including the London School of Economics and Political Science in the United Kingdom, and the Stanford University School of Medicine in California — explain that structured exercise helps lower systolic blood pressure, which measures the blood pressure in the blood vessels as the heart beats.

In the current study, they looked at the data from 194 clinical trials that focused on antihypertensive drugs and their impact on systolic blood pressure, and another 197 clinical trials, looking at the effect of structured exercise on blood pressure measurements. In total, these trials collected information from 39,742 participants.

Dr. Huseyin Naci — from the Department of Health Policy at the London School of Economics and Political Science — and colleagues conducted several sets of analyses on the data from the trials.

First, they compared the effects of all types of antihypertensive drugs with those of all kinds of exercise. Then, they looked at specific drug types versus specific types of exercise. Finally, they compared the impact of different exercise intensities with those of different drug dosages.

In the first instance, the investigators conducted these analyses by using data from healthy participants with normal blood pressure. Then, they repeated them with data from individuals with high blood pressure only.

They found that antihypertensive drugs were more effective in lowering blood pressure than structured exercise in the case of the general population. However, when they looked specifically at people with high blood pressure, they saw that exercise was as effective as most blood-lowering medication.

Moreover, the study authors concluded that there is "compelling evidence that combining endurance and dynamic resistance training was effective in reducing [systolic blood pressure]."

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More exercise is beneficial

Still, the research team cautions that they based their analyses on many small-scale trials, and others should replicate their results with more extensive studies.

Dr. Naci and colleagues also strongly advise against giving up on antihypertensive medication and replacing it with exercise.

"We don't think, on the basis of our study, that patients should stop taking their antihypertensive medications," the researcher says in a podcast in which he speaks about the current research.

"But," Dr. Naci adds, "we hope that our findings will inform evidence-based discussions between clinicians and their patients."

The lead researcher notes that many people in the U.S. and throughout Europe lead sedentary lives and that they would benefit from taking more exercise.

At the same time, however, he emphasizes that doctors should make sure their patients can adhere to prescribed exercise regimens.

"It's one thing to recommend that physicians start prescribing exercise to their patients, but we also need to be cognizant of the resource implications and ensure that the patients that have been referred to exercise interventions can adhere to them and so really derive benefit."

Dr. Huseyin Naci

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Moderate drinking tied to lower risk of hospitalization

New research suggests that moderate drinking may lower the risk of being hospitalized for any cause, including cardiovascular conditions.
people toasting around a table
Drinking in moderation may reduce the risk of hospitalization.

The effects of alcohol consumption on health are the subject of much controversy. Some studies have suggested that moderate drinking may reduce the risk of stroke, depression, and benefit one's overall cardiovascular health.

Other studies, however, have warned that the risks of alcohol consumption outweigh the benefits. A recent comprehensive review of existing research, for instance, concluded that there is no such thing as a safe level of drinking.

A new study now helps to paint a more nuanced picture of alcohol's effects on health. An international team of researchers led by Simona Costanzo, from the Department of Epidemiology and Prevention at the Institute for Research, Hospitalization, and Health Care (IRCCS) Neuromed in Pozzilli, Italy, set out to examine the link between alcohol consumption and the risk of being hospitalized.

Costanzo and colleagues examined the drinking habits and medical records of almost 21,000 study participants for at least 6 years. The researchers published their findings in the journal Addiction.

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Specifically, the researchers looked at the link between all-cause hospitalizations and cause-specific hospitalizations among 20,682 people. These people had enrolled in the so-called Moli‐sani study and did not have cardiovascular disease or cancer at the beginning of the study.

The researchers divided the participants into "lifetime abstainers, former drinkers, occasional drinkers, and current drinkers," and clinically followed them between 2005 and 2010.

The Moli–sani study comprises almost 24,500 residents of the Molise region in Italy and aims to uncover the environmental and genetic causes of cardiovascular disease, cancer, and other chronic conditions.

The study's first author reports on the findings, saying, "We observed [...] that a heavy consumption of alcohol is associated with a higher probability of hospitalization, especially for cancer and alcohol-related diseases. This confirms the harmful effect of excessive alcohol drinking on the health," the researcher says.

"On the other hand, those who drink in moderation present a lower risk of hospitalization for all causes and for cardiovascular diseases compared to lifetime abstainers and former drinkers."

Simona Costanzo

The National Institutes of Health (NIH) define moderate drinking as "up to 1 drink per day for women and up to 2 drinks per day for men."

Study co-author Licia Iacoviello, who is the head of the Laboratory of Molecular and Nutritional Epidemiology of IRCCS Neuromed, also comments. "The data on hospitalizations is very important in relation to the impact of alcohol on public health," she says.

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"Hospital admissions, in fact, represent not only a serious problem for people, but they have also a strong impact on national health systems," continues the author.

"Our study confirms how much excess alcohol can weigh on healthcare facilities, underlining the urgent need of managing the problem, but it also confirms and extends our previous observations according to which moderate alcohol consumption is associated with a reduction in mortality risk, regardless of the type of disease."

The researchers warn, however, that they do not encourage people to start drinking. Study co-author Ken Mukamal, an associate professor of medicine at the Harvard Medical School in Boston, MA, cautions, "We are absolutely not saying [...] that any teetotaler should start drinking to improve his/her health."

"However, this research reaffirms that the effects of alcohol consumption cannot be reduced to a single catchphrase or punchline. This very comprehensive study clearly shows that we need to consider its health effects based upon both dose and disease."

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Taquicardia: Causas, síntomas y tratamientos

La taquicardia se define como la frecuencia cardíaca más rápida de lo normal cuando estamos en reposo, normalmente superior a las 100 pulsaciones por minuto. Puede ser peligrosa dependiendo de la causa subyacente y del nivel de esfuerzo que necesite el corazón para trabajar.

Es posible que algunas personas con taquicardia no presenten síntomas o complicaciones. Sin embargo, esta enfermedad incrementa de forma significativa el riesgo de sufrir un accidente cerebrovascular, un paro cardíaco repentino e incluso la muerte.

¿Qué es la taquicardia? Diagram of the heart
El corazón se compone de dos ventrículos y dos arterias. La taquicardia aparece cuando los latidos son demasiado rápidos.

La taquicardia alude a la frecuencia cardíaca más rápida de lo normal cuando estamos en reposo.

En general, un corazón adulto en reposo late entre 60 y 100 veces por minuto. Cuando un individuo padece taquicardia, las cavidades superiores o inferiores del corazón laten mucho más rápido.

Cuando el corazón late muy rápido, bombea de forma menos eficiente y se reduce el flujo sanguíneo del resto del cuerpo, incluyendo el corazón.

Como consecuencia, los músculos del corazón o el miocardio necesitan más oxígeno. Si esto persiste, las células miocárdicas privadas de oxígeno pueden morir, ya que necesitan oxígeno, y esto deriva en un ataque cardíaco.

Aurículas, ventrículos y circuitos eléctricos del corazón

El corazón humano se compone de cuatro cavidades:

Aurículas: Son las dos cavidades superiores. Ventrículos: Son las dos cavidades inferiores.

Podemos distinguir entre aurícula derecha e izquierda, así como ventrículo derecho e izquierdo.

El corazón tiene un marcapasos natural llamado nodo sinoauricular, se localiza en la aurícula derecha y produce impulsos eléctricos. Cada una de ellas desencadena un latido del corazón individual.

Los impulsos eléctricos continúan hacia el nodo sinoauricular (SA), un grupo de células. El nodo SA disminuye las señales eléctricas y luego los envía hacia los ventrículos.

Al retrasar las señales eléctricas, el NSA puede dejar tiempo a los ventrículos para que se llenen de sangre. Cuando los músculos de los ventrículos reciben las señales eléctricas, se contraen y bombean sangre a los pulmones o a resto del cuerpo.

Cuando hay un problema con las señales eléctricas, se produce una latido más rápido de lo normal, por lo que el individuo sufrirá taquicardia.

Causas Generalmente, la taquicardia se causa por la alteración en los impulsos eléctricos y normales que controlan el bombeo del corazón (la velocidad a la que bombea nuestro corazón). Las situaciones o enfermedades que aparecen a continuación son posibles causas: Una reacción a ciertos medicamentos Anormalidades congénitas del corazón El consumo excesivo del alcohol El consumo de cocaína y otras drogas recreativas El desequilibrio de los electrolitos Una enfermedad cardíaca, lo que provoca un mal suministro sanguíneo y daña los tejidos cardíacos, como por ejemplo, la cardiopatía isquémica, la valvulopatía cardíaca, la insuficiencia cardíaca, la miocardiopatía, los tumores o las infecciones La hipertensión Una glándula tiroidea hiperactiva El consumo del tabaco Algunas enfermedades pulmonares Algunas veces, el médico no puede identificar la causa exacta de la taquicardia. Tratamiento [Heart on an ECG]
Existen diferentes maneras para tratar la taquicardia. Las opciones de tratamientos varían dependiendo de la causa que ha provocado la enfermedad, la edad y la salud general de la persona que sufre taquicardia, además de otros factores. El objetivo del tratamiento es identificar la causa de la taquicardia. Cuando se pueda diagnosticar un tratamiento, el médico puede intentar reducir la velocidad, prevenir episodios posteriores de taquicardia y reducir el riesgo de complicaciones. En algunos casos, todo lo que se necesita es tratar la causa. En otras ocasiones, no se encuentran causan subyacentes, por lo que el médico tiene que buscar terapias diferentes. Maneras de ralentizar el latido del corazón acelerado Maniobras vagales El nervio vagal ayuda a regular el latido de nuestro corazón. Las maniobras que afectan a este nervio incluyen la tos, la hinchazón (como si defecara) y la aplicación de una compresa fría en la cara del paciente. Medicación Los fármacos antiarrítmicos pueden administrarse de forma oral o por inyección. Restablecen el latido normal del corazón y se llevan a cabo en el hospital. Los fármacos disponibles restablecen el ritmo normal del corazón o controlan la velocidad del mismo. A veces, el individuo necesitará tomar más de un medicamento de este tipo. Cardioversión Los electrodos se utilizan para administrar una descarga eléctrica en el corazón. Esto afecta a los impulsos eléctricos del corazón y restablece el ritmo normal. Este procedimiento se lleva a cabo en un hospital. Thank you for supporting Medical News Today Prevención Existen ciertas medidas para evitar que el latido del corazón se vuelva demasiado rápido o que se convierta en un problema de salud. Ablación con catéter por radiofrecuencia Los catéteres se introducen en el corazón por los vasos sanguíneos. Los electrodos en los extremos del catéter se calientan para poder extirpar o dañar las pequeñas zonas del corazón responsables del latido anómalo. Medicamentos Cuando se toman con regularidad, los medicamentos antiarrítmicos pueden evitar la taquicardia. El doctor puede recetar otros fármacos en combinación con estos, por ejemplo, bloqueadores de los canales, como diltiazem (Cardizem) y verapamilo (Calan), o bloqueadores beta, como propranolol (Inderal) y esmolol (Brevibloc). Desfibrilador cardioversor implantable (DCI) Es un dispositivo que monitoriza de forma continua el latido del corazón y se implanta a través de una operación en el pecho. El DCI detecta cualquier anomalía en los latidos y envía impulsos eléctricos para restablecer el ritmo normal del corazón. Cirugía Algunas veces, se necesita la cirugía para eliminar una parte del tejido. El cirujano puede crear un patrón de tejido cicatrizante, ya que es un mal conductor de la electricidad. Generalmente, este procedimiento solo se utiliza cuando se han recetado otras terapias y no han sido efectivas, o si la persona sufre otro tipo de enfermedad cardíaca. Warfarina La warfarina dificulta que la sangre se coagule. Se le administra a las personas que tienen un riesgo alto o moderado de desarrollar un accidente cerebrovascular o un infarto cardíaco. Aunque este procedimiento incrementa el riesgo de sangrado, se receta para los pacientes cuyo riesgo de sufrir un accidente cerebrovascular o un infarto es bastante superior al riesgo de padecer una hemorragia. Síntomas Entre los distintos signos y síntomas de la taquicardia, podemos encontrar: dolor de pecho; confusión; mareos/vértigos; baja presión arterial; aturdimiento; palpitaciones; dificultad para respirar; debilidad repentina, o desmayos. En algunos casos con taquicardia, no es nada frecuente que el individuo presente síntomas. En dichas circunstancias, sólo se puede descubrir la enfermedad cuando el paciente se somete a un análisis físico. Posibles complicaciones El riesgo de sufrir complicaciones depende de muchos factores, como: la gravedad; el tipo; la frecuencia cardíaca; la duración, o depende de si existen o no otras enfermedades cardíacas. Las complicaciones más comunes incluyen: Coágulos sanguíneos: Incrementan de forma significativa el riesgo de sufrir un infarto cardíaco o un accidente cerebrovascular. Insuficiencia cardíaca: Si no se controla la enfermedad, el corazón se debilitará, lo que podría derivar en una insuficiencia cardíaca. Esto ocurre cuando el corazón no bombea sangre por todo el cuerpo de forma adecuada. En estos casos, pueden verse afectados el lado izquierdo, el derecho o ambos. Desmayos: La persona con latidos cardíacos rápidos podría perder la conciencia. Muerte súbita: Generalmente, se relaciona con la taquicardia o la fibrilación ventricular. Tipos Los tipos más frecuentes de taquicardia incluyen: Fibrilación auricular Algunas veces, la actividad eléctrica puede aumentar desde la aurícula izquierda en lugar del nódulo sinoauricular. Esto provoca que las cavidades adquieran una frecuencia alta e irregular, lo que se llama fibrilación auricular. Un episodio de fibrilación auricular puede durar entre unas horas y muchos días y, algunas veces, no desaparece sin tratamiento. La mayoría de los individuos con fibrilación auricular presentan anomalías en el corazón relacionadas con la enfermedad. Aleteo auricular La aurícula late rápido, pero de forma regular. Suele ocasionarse debido a un problema en la aurícula derecha. Las contracciones de la aurícula se debilitan por la alta frecuencia cardíaca. Un episodio de aleteo auricular puede durar unas horas o algunos días. A veces, no desaparece sin tratamiento. En algunas ocasiones, suele aparecer debido a una complicación en la operación, pero también puede causarse por algunas alteraciones de la enfermedad cardíaca. Normalmente, las personas que padecen aleteo auricular también experimentan fibrilaciones. Taquicardias supraventriculares (TSV) Se refieren a cualquier ritmo cardíaco acelerado y originado por el tejido ventricular. Los ciclos cardíacos anómalos suelen estar presentes al nacer y crean un bucle de señales superpuestas. Un episodio de TSV puede durar desde unos segundos hasta varias horas. Taquicardia ventricular Las señales eléctricas y anómalas en los ventrículos provocan una rápida frecuencia cardíaca. La elevada velocidad no permite que los ventrículos se dilaten y se contraigan de forma adecuada, lo que provoca un mal suministro sanguíneo en el cuerpo. Este tipo de taquicardia suele ser una enfermedad que pone en peligro la vida del paciente y necesita tratarse como una urgencia médica. Fibrilación ventricular Los ventrículos no consiguen dilatarse de forma normal, lo que provoca un mal suministro sanguíneo por el cuerpo. Si el ritmo cardíaco normal no se restablece de forma rápida, la circulación sanguínea se detendrá y causará la muerte. Las personas con enfermedades cardíacas subyacentes o aquellos que han padecido traumas serios causados por la luz podrían experimentar fibrilación ventricular. Thank you for supporting Medical News Today Factores de riesgo ECG print out
Un electrocardiograma muestra la actividad eléctrica del corazón. El riesgo de taquicardia aumenta si el individuo presenta una enfermedad que daña los tejidos cardíacos o tensiona el corazón. Los factores que aparecen a continuación se relacionan con el riesgo alto de sufrir taquicardia: Edad: Las personas con más de 60 años presentan un riesgo superior de experimentar taquicardia, en comparación a los jóvenes. Genética: Los individuos que tengan familiares con taquicardia u otros problemas relacionados con el ritmo cardíaco tienen mayor riesgo de desarrollar la enfermedad. Otros factores potenciales incluyen: una enfermedad cardíaca; ansiedad; el consumo regular de grandes cantidades de cafeína y alcohol; presión arterial elevada; estrés mental; el consumo del tabaco, o el uso recreativo de medicamentos. Diagnóstico Normalmente, el médico puede diagnosticar taquicardia por medio de algunas preguntas relacionadas con los síntomas, con la realización de un análisis físico o con algunas pruebas. Entre ellas, encontramos: Electrocardiograma (ECG) Se utilizan electrodos en la piel para medir los impulsos eléctricos del corazón. Esta prueba también mostrará cualquier enfermedad cardíaca previa que pueda contribuir a la taquicardia. Ecocardiograma Un ecocardiograma es un tipo de investigación ultrasónica. Al rebotar los sonidos en las estructuras corporales y registrar los ecos, se produce una imagen en movimiento del corazón. Esto puede ayudar a buscar anomalías congénitas o estructurales que jueguen un papel fundamental en la taquicardia. Análisis de sangre Ayudan a determinar si existen problemas de tiroides u otras sustancias que contribuyan a la taquicardia. Monitor de Holter La persona con taquicardia lleva un dispositivo portable que registra todos los latidos cardíacos. Se coloca por debajo de la ropa y registra la información sobre la actividad eléctrica del corazón mientras el individuo realiza actividades normales durante 1 o 2 días. Registrador de eventos Este dispositivo es similar al monitor de Holter, pero no registra todos los latidos cardíacos. Encontramos dos tipos: Un tipo usa un teléfono para transmitir señales desde el registrador mientras que la persona está experimentando los síntomas. El otro se usa todo el tiempo durante una gran temporada. A veces, se puede llevar durante un mes. Este registrador de eventos es bueno para diagnosticar las alteraciones del ritmo que aparecen en momentos aleatorios. Estudio electrofisiológico o EF Se trata de una prueba invasiva, no dolorosa y no quirúrgica que puede determinar el tipo de arritmia, su origen y la respuesta potencial al tratamiento. La prueba se lleva a cabo en un laboratorio EF y la realiza un electrofisiólogo. Gracias a este estudio es posible reproducir las arritmias problemáticas en un entorno controlado. Prueba de la mesa inclinada Si el individuo experimenta desmayos, mareos o aturdimientos y ni el ECG ni el monitor de Holter revelaron arritmias, se puede realizar una prueba de este tipo. Consiste en monitorizar la presión sanguínea, el ritmo cardíaco y la frecuencia cardíaca mientras que el paciente se incorpora. En cuanto los reflejos funcionen de forma correcta, la frecuencia cardíaca y la presión sanguínea se modificarán cuando el paciente se coloque en posición vertical. El objetivo es asegurarse de que el cerebro consigue un suministro adecuado de sangre. Si los reflejos no son los adecuados, los desmayos y los síntomas asociados tendrían explicación. Radiografía de tórax Las imágenes de la radiografía ayudan al médico a comprobar el estado del corazón y los pulmones. También se podrían detectar otras enfermedades que explican la taquicardia. Complicaciones Las complicaciones de la taquicardia incluyen: desmayos y mareos; cansancio y fatiga, o dificultad para respirar. También pueden derivar en: coágulos de sangre y un mayor riesgo de ataque cardíaco o accidente cerebrovascular, o insuficiencia cardíaca, cuando el corazón ya no puede bombear la sangre con eficacia. En algunos casos, podría provocar la muerte súbita. Traducido por Carmen María González Morales Revisado por Brenda Carreras Leer el artículo en Inglés
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Losartan potassium: Uses and warnings

Losartan potassium is a medication that doctors prescribe to treat high blood pressure or hypertension.

Losartan potassium works by relaxing the blood vessels to allow the blood to flow more efficiently, which reduces a person's blood pressure. The United States Food and Drug Administration (FDA) approved the drug in 1995 to treat hypertension.

The World Health Organization (WHO) include losartan potassium on their list of essential medicines, which catalogs the most effective and safe medications that experts consider necessary in a healthcare system.

People should not use this medication while pregnant.

This article provides an overview of losartan potassium, including its uses, side effects, potential drug interactions, and other warnings.

What is losartan potassium used for? man taking medication while working at desk
A doctor may prescribe losartan potassium to treat high blood pressure.

Losartan potassium is a type of angiotensin receptor blocker (ARB) known by the brand name Cozaar. Doctors prescribe it to treat hypertension and nephropathy, which is damage to the kidneys, in people with type 2 diabetes.

Doctors most commonly prescribe losartan potassium to treat hypertension in adults and children over 6 years of age.

For many people, lifestyle changes, such as diet, exercise, and avoiding smoking and alcohol, are sufficient to reduce blood pressure to healthy levels. Others may need medication to control their blood pressure.

Untreated high blood pressure can have serious health consequences. Reducing high blood pressure protects against some related health conditions, including:

Medications such as losartan potassium are just one aspect of hypertension treatment. Others include lifestyle and dietary changes. Sometimes, individuals will take losartan alongside other medicines, including diuretics, to control their high blood pressure.

People with diabetes may take losartan to protect their kidneys from damage that occurs as the result of the disease, such as diabetic nephropathy.

Thank you for supporting Medical News Today How effective is losartan potassium? The WHO consider losartan as safe, effective, and necessary in a health system. Many research studies also report that the medication is both safe and effective for a variety of uses. A 2010 research paper, which reviewed the previous 15 years of losartan use, reports that the drug is beneficial for: controlling hypertension decreasing stroke risk reducing proteinuria, which is an abnormal amount of protein in the urine that suggests kidney damage slowing diabetic nephropathy The research also states that losartan potassium has other positive effects, including: decreased uric acid levels: uric acid contributes to the development of gout reduced platelet aggregation: platelet aggregation increases blood clot risk regression of left ventricular hypertrophy: enlargement of the heart's left ventricle, which raises the risk of heart problems Losartan potassium can cause dizziness, but it produces few other side effects. A 2015 study suggests that losartan has a lower incidence of side effects yet is just as effective as other drugs for hypertension. This medication is also effective in young people. A meta-analysis from 2018 looked at the effects of losartan potassium in children and adolescents, with a median age of 12, whose hypertension had not improved through lifestyle changes. They found that the treatment reduced blood pressure more than a placebo. Side effects woman driving
A person should not drive if taking losartan potassium causes dizziness. Dizziness is a common side effect of losartan. This usually affects people who are just beginning treatment, as their bodies are adjusting to the drug. Other side effects include: upper respiratory infection nasal congestion back pain To prevent dizziness or associated injuries, doctors advise people to change positions slowly. For example, carefully move from a lying position to a sitting one, and from a seated position to an upright one. Avoid driving or using heavy machinery while dizzy. See a doctor if dizziness or lightheadedness persists or gets worse. Most people do not experience serious adverse reactions to losartan potassium. If serious side effects do occur, seek urgent medical attention. These include: chest pain fainting irregular heartbeat or palpitations muscle weakness unusual changes in the amount of urine output vomiting Call 911 or go to the nearest emergency department if symptoms of an allergic reaction to the drug occur. Allergy symptoms include: breathing difficulties itching loss of consciousness rash severe dizziness swelling of the face, tongue, or throat Allergic reactions to losartan are rare. Thank you for supporting Medical News Today Losartan potassium warnings Losartan potassium is not suitable for everyone. People with hypertension should consider and talk to a doctor about the following factors before taking losartan potassium: Drug allergies People who are allergic to losartan potassium or other inactive ingredients in the drug should avoid it. Inactive ingredients in Cozaar are: hydroxypropyl cellulose hypromellose anhydrous lactose magnesium stearate microcrystalline cellulose cornstarch titanium dioxide Inform a doctor or pharmacist of all drug allergies before taking losartan. Pregnancy, trying to conceive, or breast-feeding Losartan and similar medicines can affect a fetus. They may affect the kidney function of the fetus and increase their risk of illness or death. People taking losartan should speak to their doctor immediately after confirming the pregnancy, as they will likely need to stop taking the medication until the baby is born. The FDA advise that people who breast-feed should not take losartan, as they do not know whether or not the medication passes into the breast milk. Medical conditions or symptoms People who have any of the following conditions should speak to their doctor before taking losartan: Drug interactions Losartan potassium can interact with some drugs and supplements. People should give their doctor a complete list of the prescription medications, non-prescription medications, vitamins, and supplements they take. Among others, losartan may interact with: How to take losartan potassium and dosage packets of medication in pharmacy
The dosage for losartan potassium can vary, and people should take it as prescribed. Losartan potassium, sold as Cozaar, is available in tablet form in three doses: 25 milligrams (mg) 50 mg 100 mg The dosage of losartan a person will take will depend on several factors. Their doctor will prescribe the necessary dose for their age, weight, condition, and overall health. General guidelines for losartan potassium dosage are as follows: Hypertension. Typically, people will take 50 mg once a day, although some individuals may require 100 mg daily. A doctor may prescribe other hypertension drugs or diuretics in addition to losartan. Nephropathy in people with type 2 diabetes. People with diabetes typically begin on 50 mg daily, which may increase to 100 mg daily depending on their reaction to the drug. Hypertension in people with left ventricular hypertrophy. The starting dose is usually 50 mg, and this may increase to 100 mg daily. Hypertension in children. Children aged 6 and over may begin on a very low dose. Rarely, they may require up to 50 mg of losartan per day, depending on their blood pressure response. Always take losartan exactly as a doctor prescribes. Swallow the tablet with a glass of water, with or without food. Take missed doses as soon as possible, but do not take 2 doses close together. Only take one dose at a time. A losartan overdose that causes severe symptoms requires emergency medical attention. Call 911 right away. For less severe symptoms, call the American Association of Poison Control Centers at 1-800-222-1222. Thank you for supporting Medical News Today Summary Losartan potassium is a hypertension treatment. Research suggests that the medication is safe and effective for most people. People may experience mild side effects, such as dizziness, in the early stages of treatment. People who experience severe or persistent side effects should contact their doctor right away. Seek emergency medical attention for symptoms that affect breathing or cause swelling of the mouth or throat. To reduce blood pressure and avoid complications, always take losartan according to a doctor's instructions. Be sure to discuss any concerns about losartan or its effects with a medical professional.
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All you need to know about metoprolol

Metoprolol is a prescription drug that doctors may use to treat heart issues, such as high blood pressure, heart attack, and heart failure. The most common form is metoprolol succinate, which people can buy under the brand name Toprol-XL. Metoprolol may also refer to metoprolol tartrate, which has the brand name Lopressor.

Metoprolol often causes side effects so some people may wish to consider using alternative medications.

Importantly, no one taking metoprolol should stop taking the drug unless they are following direct orders from a doctor. Even if the drug causes side effects, the person will need to come off the drug gradually or transfer to a new drug.

Uses Senior woman holding bottle of pills in front of tablet.
Metoprolol can help treat a range of conditions, including angina and high blood pressure.

Metoprolol often features in treatment plans for high blood pressure and angina, a type of chest pain. The type of metoprolol will determine its other uses.

For example, metoprolol tartrate may help prevent a heart attack in people with heart disease or those who have already had a heart attack. However, metoprolol succinate will not help prevent heart attacks from occurring.

In some cases, doctors may also prescribe the drug as a way to prevent migraines.

How it works Metoprolol is a cardioselective beta-blocker. Beta-blockers prevent the heart from getting too excited or overworked. They do this by blocking off the beta receptors in the blood and heart. When the receptors are inaccessible, compounds that would usually excite the heart, such as epinephrine, cannot act on them and cause these effects. As a result, this may help keep the blood vessels relaxed. When the blood vessels are relaxed, the heart does not have to work as hard to pump blood, which can help lower a person's heart rate. Beta-blockers may also reduce how much oxygen the heart requires and lessen the need for it to pump faster. This combination of effects is what helps reduce the symptoms of heart problems, including high blood pressure and angina. Thank you for supporting Medical News Today How to take it The required dosage of each drug will differ from person to person as it will depend on a few different factors, including the condition that requires treatment. It is important to follow the dosing instructions that the doctor provides. In some cases, doctors may prescribe a low dose of the drug initially and then increase it incrementally to find the smallest effective dose that still relieves symptoms. As the Toprol-XL label states, the individual should take the extended-release metoprolol succinate tablet regularly and continuously, once each day, and preferably with or just after a meal. If the person misses a dose, they should not take a double dose but should take the next tablet as usual the following day. Side effects Side effects of metoprolol can include shortness of breath, dizziness, and fatigue.
Side effects of metoprolol can include shortness of breath, dizziness, and fatigue. Metoprolol may cause side effects, the severity of which can vary between people. Common side effects include: dizziness fatigue constipation diarrhea shortness of breath coughing or wheezing skin rashes temporary mental confusion blurry vision short-term memory loss reduced sex drive or loss of interest in sex Many of these side effects will be temporary and may be relatively mild. More severe side effects are also possible when using metoprolol, although they are generally less common. They include: an allergic reaction, which may cause itching of the throat and swelling of the face, throat, or hands cold hands or feet that may feel numb extremely low or slow heart rate or weak pulse extreme fatigue that may get worse over time trouble concentrating symptoms of depression, such as continuous or recurring feelings of sadness Anyone experiencing serious side effects from metoprolol should contact their doctor immediately. If the symptoms feel life-threatening or the person loses consciousness, they need emergency medical attention. Interactions Metoprolol interacts with several drugs. People who are taking the drug or may need to should review their other medications with a doctor first to check for any interactions. The same goes for vitamins, supplements, and over-the-counter medications that the person may also be taking. A few different types of drug interact with metoprolol. Monoamine oxidase inhibitors Doctors often prescribe monoamine oxidase inhibitor (MAOI) drugs for mental health issues. These drugs may add to the effects of metoprolol, which may put the person at risk of complications, such as those that result from an extremely low heart rate. Some common MAOI drugs include: tranylcypromine (Parnate) isocarboxazid (Marplan) selegiline (Emsam) phenelzine (Nardil) Selective serotonin reuptake inhibitors Some selective serotonin reuptake inhibitor (SSRI) antidepressant drugs may also affect how metoprolol works. The body may process these drugs in a similar way to metoprolol, which could increase the amount of the drug in the body or its effectiveness. These drugs include: paroxetine (Paxil) sertraline (Zoloft) fluoxetine (Prozac) Alpha-blockers In some cases, the person may already be taking a medication that could interfere with metoprolol. For instance, doctors often prescribe alpha-blockers for high blood pressure. If the individual takes the drugs together, the effect may be too significant, putting the person at risk of issues resulting from low blood pressure. Alpha-blockers include the following drugs: clonidine (Catapres) terazosin (Hytrin) prazosin (Minipress) Other drugs Other drugs that may interact with metoprolol include: antihistamine drugs, such as diphenhydramine (Benadryl) some antifungal and antimalarial drugs hydralazine, a drug for blood pressure ritonavir, a drug that people use to treat HIV some herbs, such as St. John's wort Alcohol could also lower a person's blood pressure and increase some of the effects of the drug. Doctors are likely to advise the individual about alcohol consumption, and they may recommend that a person stops drinking while taking the medication. It is essential to note that this is not a complete list of interactions. Anyone with a metoprolol prescription should have a thorough discussion with their doctor about any other drugs or supplements that they are taking to avoid potentially serious complications. Thank you for supporting Medical News Today Warnings A doctor can explain the risks of metoprolol.
A doctor can explain the risks of metoprolol. There are a few important warnings to consider when taking metoprolol. The drug has a United States Food and Drug Administration (FDA) black box warning, which is the most serious warning that a drug can receive. The FDA note that people who take beta-blockers and then abruptly stop might have a higher risk of issues relating to the heart. Unless a doctor gives a direct order, do not suddenly stop using metoprolol. Doing so may cause a sharp increase in blood pressure, and it could significantly increase the risk of symptoms returning or the person having a heart attack. There are additional factors to consider when using the drug. It is crucial to take the drug exactly as the doctor advises. Taking too much of the drug or taking it too often may lead to a drug overdose, which could reduce the heart rate to dangerous levels and lead to hospitalization. Anyone who thinks that they have taken too much of the drug should seek emergency medical attention. In some cases, the drug may cause a severe allergic reaction. Signs of an allergic reaction include: swelling of the face, tongue, or throat itching in the throat difficulty breathing Anyone experiencing these symptoms should also seek emergency medical attention. Metoprolol can cross the placenta and enter the breast milk. Therefore, anyone who is pregnant or breastfeeding should discuss all options and possibilities with their doctor before using metoprolol. There may also be a link between metoprolol and drug-induced liver injury, although reported cases are rare. People who have issues with their liver may need to be cautious when using the drug. Considerations for certain health conditions People with certain health conditions should be aware of the risks when taking the drug, while others should not take it at all. Poor circulation. People with circulation issues, such as difficulty getting fresh blood into the legs and hands, may need to consider other options. Metoprolol could make circulation issues worse. Major surgery. People who are about to have major surgery should not start taking the drug as it may lead to severe complications. Diabetes. People with diabetes may need to take extra care to monitor their blood sugar levels when using the drug. Metoprolol may hide some of the signs of low blood sugar, such as increased heart rate. COPD or asthma. People with conditions that cause muscle walls deep in the lungs to spasm, such as COPD or asthma, should usually avoid taking beta-blockers. However, the FDA note that in some cases of COPD and asthma, it is necessary to use metoprolol if the person does not respond well to other treatments. Doctors will monitor these individuals closely to check for any complications. Alternative drugs There are a few alternatives to metoprolol. The alternatives available to someone will depend on many factors, such as other medications that they are taking, any medical conditions that they have, and their reason for needing the drug in the first place. Anyone who thinks that metoprolol is not right for them should talk to their doctor about possible alternatives. It is vital never to stop taking the drug suddenly. Takeaway Metoprolol is a drug that may help many people control potentially dangerous symptoms of the heart and circulatory system. A person should consider many factors before starting the drug, including potential side effects and any other medications that they are taking. As always, it is best to discuss possible complications and alternative treatment options with a doctor.
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Recalled 'weight history' can predict heart failure risk

Asking older adults how much they weighed in the past can help to predict their risk of heart failure, according to recent research.
senior woman receiving heart from women's hands
New research found that asking seniors how much they weighed in their 20s and 40s accurately predicted heart failure risk.

Ideally, doctors treating older people would have ready access to accurate weight histories from lifelong medical records.

In reality, however, medical records tend not to accompany people as they change their primary care doctors.

After studying more than 6,000 older adults, researchers from the Johns Hopkins School of Medicine in Baltimore, MD, concluded that just asking older individuals how much they weighed when they were 20 and 40 years old could help predict their risk of heart failure.

"Self-reported lifetime weight," they write in a report of the study that features in the Journal of the American Heart Association, "is a low-tech tool easily utilized in any clinical encounter."

While unlikely to be as accurate as clinically recorded weight, they found that self-reported weight, over and above current body mass index (BMI), could be a good predictor of heart failure risk.

Obesity and heart failure

Previous studies have shown that the more years that individuals spend with obesity, the more likely they are to have a higher risk of heart failure.

"That is why," explains senior study author Dr. Erin D. Michos, who is an associate professor of medicine, "measuring a person's weight at older ages may not tell the whole story about their risk."

There is mounting evidence that individuals who have only recently developed obesity are overall in less danger compared with counterparts who have a history of obesity, she adds.

Heart failure, also known as congestive heart failure, is a severe condition. It develops when heart muscle gradually weakens and stiffens until it cannot pump enough oxygen- and nutrient-rich blood to the body's organs and tissues.

The Centers for Disease Control and Prevention (CDC) estimate that around 5.7 million people have heart failure in the United States, where the condition contributed to 1 in 9 deaths in 2009.

Around half of those diagnosed with heart failure do not live more than 5 years following diagnosis.

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A practical way to obtain weight history

In the routine assessment of heart disease and heart failure risk, doctors bring together measures of cholesterol, blood pressure, diet, BMI, and family history of cardiovascular disease.

Dr. Michos notes that while it is useful to have the current BMI measure when making such an assessment in older adults, having a weight history would be even more helpful.

So, she and her team set out to investigate if there might a practical way of obtaining a weight history that is good enough to inform routine clinical assessment.

They used data from the Multi-Ethnic Study of Atherosclerosis (MESA) on 6,437 people living in six different states in the U.S. The individuals, of which 53 percent were female, had joined the study during 2000-2002 when their average age was 62 years.

Regarding ethnic composition, the cohort was around 39 percent white, more than 26 percent African-American, 22 percent Hispanic, and just over 12 percent Chinese-American.

At the start of the study, the participants had filled in questionnaires that asked them about their weight when they were 20 and 40 years old.

During an average follow-up of 13 years, there was a total of five in-person visits that included weight measurement.

The investigators converted the weight measurements into BMI by dividing the weight in kilograms by the square of the height in meters. They classed BMIs under 25 as normal, between 25 and under 30 as overweight, and 30 and above as being in the obesity range.

Weight history tied to heart failure risk

During the follow-up, 290 individuals had developed heart failure. Another 828 had experienced heart attacks, strokes, or other conditions due to arterial plaque buildup, or had died because of one of these conditions.

Dr. Michos says that, as they expected, there was a link between the weight measures that came from the follow-up visits and the risk of developing heart failure.

For every 5 kilograms per square meter of extra BMI, the risk of developing heart failure went up by 34 percent. This was after accounting for other possible risk factors, such as smoking, age, exercise, diabetes, and blood pressure.

However, further analysis also revealed that reporting having had obesity at age 20 was linked to an above threefold risk of heart failure. Reporting having had obesity at age 40 was tied to a twofold risk.

These risks were in comparison to those who reported having BMIs in the normal range at those two ages.

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Doctors should ask about weight history

The team notes that self-reporting can be subject to bias from imperfect memory, but they suggest that most older adults have a reasonable ability to recall how much they weighed when they were younger.

They propose that just asking about weight history can be a help. And yet, while it is an easy thing to incorporate into routine clinical assessments, most doctors don't ask the question.

Dr. Michos calls for further research on how best to include self-reported weight history in clinical practice and electronic health records.

"Our findings emphasize the importance of lifelong maintenance of a healthy weight, as greater cumulative weight from young adulthood is more risky to heart health."

Dr. Erin D. Michos

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