Wood Street Clinic Blog

Here you will find a selection of RSS feeds and blog entries

Common heartburn drug linked with fatal conditions

New research suggests that drugs commonly used for heartburn, acid reflux, and ulcers may raise the risk of numerous fatal conditions, including heart disease and stomach cancer.
woman's palm holding white and blue pills against yellow background
A new study warns about the dangers of a class of drugs called proton pump inhibitors.

Physicians often prescribe proton pump inhibitors (PPIs) to treat gastrointestinal conditions that involve an excess of acid production.

Nexium, Aciphex, Zegerid, Dexilant, Prevacid, Prilosec, and Protonix are only some of the brand names that PPIs have taken over the years.

More than 15 million people in the United States take prescription PPIs, according to the most recent statistics available, and even more may be taking over-the-counter PPIs.

A new study, appearing in the journal The BMJ, suggests that these drugs may increase the risk of death from various chronic health conditions.

Dr. Ziyad Al-Aly, an assistant professor of medicine at the Washington University School of Medicine in St. Louis, MO, is the senior investigator of the study.

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For the new study, Dr. Al-Aly and colleagues examined data from the medical records of the U.S. Department of Veterans Affairs.

The researchers looked at data available from mid-2002 to mid-2004, a period during which 157,625 people in the cohort received PPI prescriptions from their physicians and 56,842 people received H2 blockers, another kind of acid suppressant.

The scientists clinically followed the participants — who were predominantly male, Caucasian, and 65 years old or older — for up to a decade.

They used the data to build a statistical model of a clinical trial, which would see the participants randomly assigned to take either PPI or H2 blockers.

This allowed them to estimate that during the follow-up period, there would be 45.2 excess deaths per every 1,000 individuals taking PPIs.

Honing in on the causes of death, the findings revealed associations with cardiovascular disease, stomach cancer, and chronic kidney disease.

The model estimates the death rates for cardiovascular disease to be 88.7 per 1,000 people in the PPI group and 73.3 per 1,000 people in the H2 blocker group.

This scientists saw 4.3 deaths in every 1,000 people from stomach cancer in the PPI group, with 4.6 deaths from the disease in the H2 blocker group in their model. The rates for chronic kidney disease deaths were 8.6 per 1,000 people in the PPI group and 4.4 in the H2 blocker group.

Also, the risk of death increased with the duration of the treatment, even when the study participants had taken low doses of the drug.

Finally, the research revealed that over half of those taking PPIs had no medical need for them. "Most alarming to me is that serious harm may be experienced by people who are on PPIs but may not need them," comments Dr. Al-Aly. "Overuse is not devoid of harm."

"PPIs sold over the counter should have a clearer warning about [the] potential for significant health risks, as well as a clearer warning about the need to limit the length of use, generally not to exceed 14 days," continues the lead researcher. "People who feel the need to take over-the-counter PPIs longer than this need to see their doctors."

"Taking PPIs over many months or years is not safe, and now we have a clearer picture of the health conditions associated with long-term PPI use," adds Dr. Al-Aly.

"Our study suggests the need to avoid PPIs when not medically necessary. For those who have a medical need, PPI use should be limited to the lowest effective dose and shortest duration possible."

Dr. Ziyad Al-Aly

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Is coffee bad for the heart or not?

Studies on coffee consumption variously claim that coffee harms the arteries, that it protects the heart, or that it has no effect on cardiovascular health. New research on thousands of participants weighs in again on the link between this favorite beverage and heart health.
coffee cup in a heart made from coffee beans
New findings suggest that even heavy coffee drinkers may have nothing to worry about when it comes to cardiovascular health.

Does coffee harm, protect, or have no effect on heart health and the vascular system?

For years, scientists have been trying to answer these questions, since coffee is such a favorite beverage around the world.

While some studies warn that drinking coffee can increase a person's risk of cardiovascular events, others suggest that it can help maintain heart health and blood vessel function.

Some research has suggested that regularly drinking a lot of coffee contributes to aortic stiffness — this is when the aorta, which is the largest blood vessel in the human body, becomes less and less flexible. Aortic stiffness can contribute to the risk of cardiovascular disease.

At the same time, other evidence has indicated that drinking more than three cups of coffee a day can protect against atherosclerosis, a condition in which plaque builds up inside the arteries, preventing blood from flowing normally.

Now, a new study conducted by researchers from the Queen Mary University of London in the United Kingdom has found that even people who drink a significant amount of coffee each day do not experience arterial stiffness, meaning that coffee does not increase their risk of cardiovascular problems in this way.

Lead author Prof. Steffen Petersen and colleagues presented the study's findings yesterday at the annual British Cardiovascular Society (BCS) Conference in Manchester, U.K.

The British Heart Foundation, a registered charity based in the U.K. that supports research about heart and circulatory conditions, funded the study.

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Same results across all groups

In the new study, the research team analyzed the data of 8,412 participants recruited via the U.K. Biobank Imaging Study. At the BCS Conference, the team explained that the participants agreed to undergo cardiovascular magnetic resonance imaging and other specialist assessments to allow the investigators to determine the state of their cardiovascular function.

The participants also self-reported how much coffee they typically drank on a day-to-day basis. Following these reports, the investigators then categorized the participants into three groups, according to their coffee consumption habits:

people who drank one or fewer cups of coffee a day those who drank between one and three cups of coffee per day those who drank more than three cups of coffee per day

In their final analysis, Prof. Petersen and team excluded individuals who drank more than 25 cups of coffee per day, as well as those who had cardiovascular disease at baseline.

When comparing measurements of arterial stiffness between the three groups, the researchers found no differences between moderate and heavy coffee drinkers (those who drank between one and three or more than three cups of coffee per day, respectively) and those who had one cup off coffee or less per day.

These results, the investigators say, suggest that even drinking significant amounts of coffee is unlikely to have an ill effect on arterial health, so it may not negatively influence heart health and vascular function.

"Despite the huge popularity of coffee worldwide, different reports could put people off from enjoying it. Whilst we can't prove a causal link in this study, our research indicates coffee isn't as bad for the arteries as previous studies would suggest," explains study coauthor Kenneth Fung.

These findings remained in place after the investigators adjusted for possible factors contributing to arterial stiffness, including age, biological sex, ethnicity, smoking status, alcohol consumption, height, weight, eating habits, hypertension (high blood pressure), high cholesterol, and diabetes.

What should and what shouldn't we believe?

The researchers also noted that moderate and heavy coffee drinkers were more likely to be male, habitual smokers, and frequent drinkers of alcohol.

"Although our study included individuals who drink up to 25 cups a day, the average intake amongst the highest coffee consumption group was five cups a day. We would like to study these people more closely in our future work so that we can help to advise safe limits," Fung also specifies.

Prof. Metin Avkiran, who is Associate Medical Director at the British Heart Foundation, and who was not involved in the current research, explains that such studies about the relationship between coffee consumption habits and heart health can help individuals make better-informed decisions.

"Understanding the impact that coffee has on our heart and circulatory system is something that researchers and the media have had brewing for some time. There are several conflicting studies saying different things about coffee, and it can be difficult to filter what we should believe and what we shouldn't."

Prof. Metin Avkiran

"This research will hopefully put some of the media reports in perspective, as it rules out one of the potential detrimental effects of coffee on our arteries," Prof. Avkiran says.

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Type 2 diabetes: High-intensity exercise may restore heart function

Type 2 diabetes can sometimes result in a loss of heart function. However, the results of a new study suggest this function may be recovered through high-intensity exercise.
close up of the hands of a woman who has been exercising
High-intensity exercise can protect the hearts of those living with type 2 diabetes, new research suggests.

Around 90–95% of the 30 million people in the United States who have diabetes have type 2 diabetes. In type 2 diabetes, the body's cells become resistant to the effects of insulin, the hormone that helps to convert blood sugar into energy.

With insulin unable to activate this energy conversion within cells, a rise in the body's blood sugar level occurs and creates the conditions for prediabetes and type 2 diabetes.

Elevated blood sugar levels can be very harmful, potentially causing vision loss and creating serious health problems within various organs, including the heart and kidneys.

Researchers behind the new study are from the University of Otago in Dunedin, New Zealand, and they have published their work in the American College of Sports Medicine's journal, Medicine & Science in Sports & Exercise.

They say that exercise is probably the best way to prevent heart disease among people with type 2 diabetes. They acknowledge, however, that one issue may be that many people with the condition have impaired heart function and so might be unable to train hard enough to receive the benefits of this exercise.

The Otago team put this to the test in their study, which focused on the benefits of high-intensity interval training (HIIT). HIIT involves short bursts of intense sprinting or stair climbing with alternate periods of moderate intensity exercise, such as jogging or fast walking.

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HIIT for 3 months improves heart function

In the study, over the course of 3 months, 11 middle-aged adults with type 2 diabetes engaged in 25-minute exercise sessions that included 10 minutes of very high-intensity activity.

The team took measures of heart function from the participants at the start of the study and the end of the 3-month training period. They then compared these measures to a control group of five participants who did not undertake the training.

The study found that the participants who undertook HIIT demonstrated improved heart function after 3 months and that this result was without any changes to their medication or diet.

More importantly, the study demonstrated that the high-intensity program was a safe and viable exercise regimen for middle-aged adults with type 2 diabetes, with an impressive 80% adherence rate over the course of the study.

Scientists will need to reproduce the results in larger studies to be sure of the benefits of HIIT among people with type 2 diabetes.

Lead author Genevieve Wilson, who did the study as part of her Ph.D., says the team's findings demonstrate that high-intensity exercise may provide "an inexpensive, practical way to reverse, or reduce the loss in heart function caused by type 2 diabetes."

Wilson adds that this is important as the leading cause of death in type 2 diabetes patients is heart disease.

Dunedin School of Medicine senior research fellow Dr. Chris Baldi supervised Wilson's work with coadviser, cardiologist and Associate Professor in the Department of Medicine, Gerry Wilkins.

Together, the researchers note that the study shows the HIIT program for middle-aged adults with type 2 diabetes was safe, and the participants were able to stick to it for the majority of the time.

"There are two important clinical implications of this work," Dr. Baldi maintains. "The first, that adults with type 2 diabetes will adhere to high-intensity interval training and are capable of comparable increases in aerobic capacity and left ventricular exercise response as those reported in non-diabetic adults."

"Secondly, high-intensity exercise is capable of reversing some of the changes in heart function that seem to precede diabetic heart disease," he continues.

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Reducing the risk of heart complications

For those with type 2 diabetes, the National Institute of Diabetes and Digestive and Kidney Diseases recommend some useful steps to lower the risk of developing heart disease.

These are the Manage your diabetes ABCs:

A is for the A1C test, which shows the average blood glucose level over the previous 3 months. For most people, the ideal A1C is below 7%, but a healthcare team can help set the right goal. B is for blood pressure. High blood pressure can cause a heart attack. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. C is for cholesterol. Too much "bad" cholesterol (LDL cholesterol) in the body can clog up blood vessels, increasing the risk of a heart attack or stroke. Statins can help reduce this cholesterol. S is for stop smoking. Diabetes and smoking both narrow blood vessels, forcing the heart to work harder. Quitting smoking lowers the risk of heart attack and other illnesses.
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Menopause and heart health: Why timing hormone therapy is key

Researchers already know that menopause affects the heart, but a new study suggests that changes start to take place in the years leading up to this phase. The study findings could change how doctors administer hormone replacement therapy.
close up of woman's hands and doctor, talking
New research suggests that changes in heart health may occur sooner than scientists previously believed.

The older a person gets, the more likely they are to develop heart disease. However, the risk of the condition — which is the biggest killer of women in the United States — increases even more during menopause.

Experts believe that this is due to a drop in the levels of estrogen, as this hormone helps the arteries function properly.

Hormone replacement therapy (HRT) is one way to treat the symptoms that this decline causes, but the fears surrounding this treatment have not subsided since decades-old research suggested a link to heart issues and cancer.

The American Heart Association (AHA), for example, caution against using the therapy to reduce the risk of coronary heart disease.

A 2017 JAMA study found that women who took HRT tablets were no more likely to die of cardiovascular disease, cancer, or another cause within 18 years than women who did not take them. Despite this, people are still reluctant to try the treatment.

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Mimicking the perimenopausal period

New findings suggest that HRT may be effective in protecting the heart, but not when people take it after the menopause, as is currently the norm.

The new study, which appears in Acta Physiologica, focused on what happens to the heart during the years leading up to menopause. This period is called perimenopause.

Previously, researchers only studied menopausal or postmenopausal hearts because scientists were unable to replicate the perimenopausal stage in mice.

That changed when a team from the University of Guelph in Ontario, Canada found a way to achieve this.

"We could induce instant menopause in lab mice by removing their ovaries, but that doesn't recapture the gradual change of menopause," says senior author Prof. Glen Pyle. "We now have a lab animal model in which we can make a mouse's ovaries fail slowly over time to mimic the gradual transition to menopause seen in women."

Testing 'the timing hypothesis'

As a result, a group of mice entered menopause slowly over 4 months. Their hearts appeared to look normal and function in the same way, but "markers of stress" appeared.

"So, it's like a house that looks fine, but there's a leak in the foundation. The changes are hidden, but they are there," notes Prof. Pyle.

The team administered drugs mimicking estrogen to the mice during perimenopause.

Prof. Pyle states, "We wanted to test the timing hypothesis: the idea that there's a window of opportunity for taking estrogen so that we could see if we could identify that window and determine how menopause impacted the response to estrogens."

When they examined how the mice's hearts responded to the estrogen, the researchers noted small but significant variations that indicated molecular changes in this vital organ.

According to Prof. Pyle, this showed that the heart had "fundamentally changed [...] during the perimenopausal period."

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When to try HRT

"That tells us that we can't simply place estrogens into a heart years after menopause," Prof. Pyle adds.

"It also tells us that timing is important and that we likely need to move the window for offering estrogen therapy back up, offering it much earlier and not waiting for after menopause."

Prof. Glen Pyle

Most importantly, the study authors want people to consider HRT as a protective treatment once again, instead of fearing it.

As the senior researcher concludes, "We've gone back to the drawing board with this study, back to the lab to get these answers on how menopause changes the heart."

"That's a fundamental question we needed answered. And now we know there are small but significant changes," continues the researcher.

"We want to continue this research to fine-tune estrogen replacement therapy to find out how it can be used beneficially because there's so much evidence that it does work."

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New study links air pollution with atherosclerosis

New research suggests that chronic exposure to ambient ozone may raise the risk of atherosclerosis and harm arterial health.
smog in a city
New findings indicate that smog, which largely consists of ambient ozone, may lead to atherosclerosis, a cardiovascular condition.

Atherosclerosis is the result of fatty deposits — such as cholesterol, fat, or cellular waste — accumulating inside a person's arteries.

Over time, the buildup of plaque inside the blood vessels' walls thickens the arteries, which restricts the blood, nutrients, and oxygen that would normally reach the rest of the body.

Atherosclerosis can lead to more dangerous cardiovascular events, such as coronary heart disease or peripheral artery disease, as well as a heart attack or stroke.

While researchers do not yet know what triggers atherosclerosis, factors such as high blood pressure, high cholesterol, and cigarette smoking are believed to cause much of the damage.

New research points the finger at another possible culprit: air pollution. Meng Wang, Ph.D., an assistant professor of epidemiology and environmental health at the University at Buffalo School of Public Health and Health Professions in New York, is the lead author of the study.

Wang and the team published their findings in the journal Environmental Health Perspectives.

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Wang and colleagues clinically followed 6,619 adults, who were 45–84 years old and who did not have cardiovascular disease or any other conditions at the start of the study.

They followed the participants for a mean period of 6.5 years, as part of the Multi-Ethnic Study of Atherosclerosis in which the participants had enrolled. They came from six cities across the United States: Winston-Salem, NC; New York City, NY; Baltimore, MD; St. Paul, MN; Chicago, IL; and Los Angeles, CA.

"We used statistical models to capture whether there are significant associations between ozone exposure and [atherosclerosis]," explains Wang.

"[The model] suggests that there is an association between long-term exposure to ozone and progression of atherosclerosis," he goes on to report.

Specifically, the study found an association between chronic ozone exposure and an "increased rate of carotid wall thickness progression and risk of new plaque formation." These results suggested arterial injury in the carotid arteries — the two large vessels that supply blood to the head and neck.

"This may indicate that the association between long-term exposure to ozone and cardiovascular mortality that has been observed in some studies is due to arterial injury and acceleration of atherosclerosis," comments Wang.

However, the researchers admit that they're in the dark regarding what may cause this link. "We can show that there is an association between ozone exposure and this outcome, but the biological mechanism for this association is not well understood," Wang notes.

To the authors' knowledge, this is the first epidemiological study to examine the link between ozone exposure and "subclinical vascular disease" — that is, injuries that damage the artery walls before a heart attack or a stroke occurs.

According to the American Lung Association, ground-level ozone also damages lung tissue when we breathe it in. Frequently referred to as smog, ozone is a gas molecule that harms lung tissue by chemically reacting to it.

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Can blueberries protect heart health?

According to a new study, consuming 1 cup of blueberries each day might improve the metabolic markers associated with cardiovascular risk.
Hands holding blueberries
Blueberries are tasty, but are they good for our hearts?

Blueberries are delicious and nutritious; if they could also lower the risk of heart disease, that would be a bonus.

For that reason, the United States Highbush Blueberry Council helped fund a study to investigate blueberries' potential benefit to heart health.

Researchers from the University of East Anglia in the United Kingdom teamed up with scientists from Harvard University in Cambridge, MA.

In particular, they wanted to understand whether regularly consuming blueberries could alter the metabolic profile of people with metabolic syndrome.

Metabolic syndrome describes a cluster of conditions that include high blood pressure, excess body fat around the waist, high blood sugar levels, and abnormal cholesterol and triglyceride levels. Together, these factors increase the risk of cardiovascular disease and type 2 diabetes.

Currently, metabolic syndrome affects more than one-third of adults in the U.S., with some experts referring to it as a global epidemic.

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Blueberries and anthocyanins

"Previous studies have indicated that people who regularly eat blueberries have a reduced risk of developing conditions including type 2 diabetes and cardiovascular disease," says lead researcher Prof. Aedin Cassidy.

"This," she says, "may be because blueberries are high in naturally occurring compounds called anthocyanins."

Anthocyanins are water soluble pigments that can appear red, black, blue, or purple. These flavonoids are present in the tissues — including the stems, leaves, flowers, roots, and fruits — of many higher plants.

Previous studies have revealed a relationship between increased anthocyanin consumption and reduced mortality risk; others have linked these chemicals to a reduced risk of cardiovascular disease.

However, to date, much of the research has taken place over a relatively short period; in fact, some studies looked at the consumption of just a single portion of blueberries.

There have also been no randomized controlled trials investigating blueberries' potential to protect against disease in a population with a higher risk of developing type 2 diabetes and cardiovascular disease.

Prof. Cassidy says, "We wanted to find out whether eating blueberries could help people who have already been identified as being at risk of developing these sort of conditions."

Testing blueberry powder

To investigate, the team recruited 115 participants, ages 50–75, all of whom were either overweight or obese and had metabolic syndrome. The study ran for 6 months, making it the longest of its kind.

Importantly, the scientists used "dietarily achievable levels" of blueberries rather than expecting the participants to consume an unsustainable and unrealistic amount of blueberries each day.

They split the participants into three groups:

One group consumed 1 cup (150 grams) of freeze-dried powdered blueberries per day. Another group consumed half a cup (75 grams) of freeze-dried powdered blueberries per day. The final group acted as a control group; they received a powder that looked similar to blueberry powder but which primarily contained dextrose, maltodextrin, and fructose.

At the start and end of the trial, the researchers assessed biomarkers for insulin resistance, lipid status, and vascular function. They recently published their findings in the American Journal of Clinical Nutrition.

"We found that eating 1 cup of blueberries per day resulted in sustained improvements in vascular function and arterial stiffness — making enough of a difference to reduce the risk of cardiovascular disease by between 12 and 15%."

Co-lead study author Dr. Peter Curtis

Interestingly, the scientists only saw the benefits in the group consuming 1 cup of blueberries per day — not in those consuming half a cup.

Dr. Curtis believes that this is because "higher daily intakes may be needed for heart health benefits in obese, at-risk populations, compared with the general population."

It is also worth noting that the blueberry intervention did not alter the other parameters the scientists measured. The authors write:

"No favorable effects of the intervention were shown for the primary endpoint [insulin sensitivity] or indices of glucose control. [...] The intervention had no effect on [blood pressure] or other biomarkers of vascular function."

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Explaining the benefits of blueberries

The scientists believe that the cardiovascular benefits they saw are primarily due to the presence of anthocyanins in blueberries.

In the lower intestine, the body metabolizes anthocyanins to produce a range of chemicals; some of these chemicals provide sustenance to the resident gut bacteria and are "likely play a key beneficial metabolic role," say the study authors.

They offer some examples. For instance, some researchers have shown that syringic acid, which is a chemical that the metabolism of anthocyanin produces, benefits vascular endothelial cells in the laboratory.

Similarly, scientists have found that vanillic acid, another breakdown product, reduces hypertension in rats.

Dr. Curtis concludes, "The simple and attainable message is to consume 1 cup of blueberries daily to improve cardiovascular health."

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At this point, it is worth mentioning that other foods contain anthocyanin, including blackcurrants, black and red raspberries, blackberries, red cabbage, plums, red radish, black carrot, and purple potato.

Although this project was the first long-term, placebo-controlled study to look at blueberries and cardiovascular and metabolic health, it is important to remember that only 115 participants completed this trial.

By the end, only 37 participants remained in the group consuming 1 cup of blueberries per day.

Blueberries are likely to be a healthful addition to any diet, as are most other fruits and vegetables. However, scientists will need to carry out larger studies to confirm the clinical benefits of blueberries.

Because the U.S. Highbush Blueberry Council are dedicated to "driving consumer demand," more research is likely to follow.

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Clinical trial shows why energy drinks are bad for the heart

Energy drinks are popular, especially among teenagers and young adults. But a clinical trial reports that energy drinks caused disturbances to the volunteers' heart rhythms and blood pressure.
Student with energy drink
How do energy drinks affect the heart?

Energy drinks are the second most popular dietary supplement of choice for teenagers and young adults in the United States, according to the National Center for Complementary and Integrative Health (NCCIH).

Packed with caffeine and other ingredients, such as guarana, taurine, ginseng, and B vitamins, these drinks promise to boost concentration, improve physical performance, and reduce fatigue.

A recent article in the American Journal of Preventive Medicine puts the rise in popularity of energy drinks into numbers.

The percentage of 12–19-year-olds consuming energy drinks in the U.S. has risen from 0.2% in 2003 to 1.4% in 2016. The highest increase was among young adults, aged 20–39, from 0.5% to 5.5% in this time period, while the figure rose from 0% to 1.2% in adults aged 40–59, according to the study's authors.

Yet mounting evidence portrays energy drinks in a different light. "Consuming energy drinks raises important safety concerns," according to the NCCIH, with twice as many emergency department visits related to energy drinks recorded in 2011 than in 2007.

In the largest randomized, controlled clinical trial on the subject to date, researchers from the University of the Pacific in Stockton, CA, along with collaborators from other institutions, identify how energy drink consumption affects the heart.

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Hearth rhythm altered

For the study, published in the Journal of the American Heart Association, lead study author Sachin A. Shah, a professor of pharmacy practice at the University of the Pacific, enrolled 34 adults aged 18 to 40.

After an overnight fast, the volunteers consumed two 16-ounce bottles of either one of two energy drinks or a placebo, which contained carbonated water, lime juice, and cherry flavoring. The study was double-blinded, meaning that neither the participants nor the researchers knew who drank which product.

The researchers then measured the volunteers' heart rhythms with standard electrocardiogram and blood pressure readings every 30 minutes for a total of 4 hours.

Here they found a significant change in the time that the chambers of the heart needed to contract and relax. This measure is called the QT interval. The length of the QT interval is linked to a person's heart rate, so scientists often use a corrected version, called QTc, that takes heart rate into account.

A QTc interval of 450 milliseconds (ms) in men and 460 ms in women is considered the maximum for a healthy heart rhythm.

When this number rises — a phenomenon termed QT interval propagation — a person's risk of experiencing life-threatening arrhythmia, or disturbance of the heart's normal beat, and sudden cardiac death increases.

While consumption of the placebo drink caused a maximum change in QTc interval of an average of 11.9 ms, the two energy drinks resulted in average maximum changes of 17.9 ms and 19.6 ms.

Importantly, the researchers saw significant changes in the QTc interval length up to 4 hours after the volunteers had consumed the energy drinks.

In the paper, the authors comment that "According to the [Food and Drug Administration (FDA)], QTc prolongation is a well-established risk factor for arrhythmias, with a prolongation over 10 ms prompting further investigation."

"Energy drinks are readily accessible and commonly consumed by a large number of teens and young adults, including college students," comments study co-author Kate O'Dell, a professor of pharmacy at the University of the Pacific, on the findings. "Understanding how these drinks affect the heart is extremely important."

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Urgent 'need to investigate' ingredients

In addition to the effect on the QT interval, the researchers found an average maximum change of 3.5 millimeters of mercury (mmHg) in diastolic blood pressure and 4.6 to 6.1 mmHg in systolic blood pressure when the study participants had consumed the energy drinks.

In the study, the authors explain that the caffeine in the energy drinks may have contributed to the change in blood pressure, but only to some extent. Other ingredients, particularly taurine, could also play a role.

"We found an association between consuming energy drinks and changes in QT intervals and blood pressure that cannot be attributed to caffeine. We urgently need to investigate the particular ingredient or combination of ingredients in different types of energy drinks that might explain the findings seen in our clinical trial."

Prof. Sachin A. Shah

The authors point to the study's limitations. They asked the participants to drink a total of 32 ounces of energy drink or placebo, which limits how well the results translate to how people consume these products in their normal daily life.

The researchers also studied the volunteer's heart rhythm and blood pressure for only 4 hours, which does not provide insights into the long-term effects or chronic exposure to energy drinks, and they only enrolled healthy volunteers in the study.

Finally, people frequently consume energy drinks in combination with alcohol, which the team did not study in this clinical trial.

It is also important to mention that none of the participants experienced QTc intervals over 500 ms. In the paper, the authors explain that "Clinically, a QT/QTc interval over 500 ms or a change over 30 ms warrants careful monitoring."

Nevertheless, Prof. Shah urges caution: "The public should be aware of the impact of energy drinks on their body, especially if they have other underlying health conditions. Healthcare professionals should advise certain patient populations — for example, people with underlying congenital or acquired long QT syndrome or high blood pressure — to limit or monitor their consumption."

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Olives: Nutrition and health benefits

Olives are popular as both a snack and an ingredient in salads, sandwiches, and stews. They have a chewy texture and a rich, salty taste.

People have cultivated olive trees for more than 7,000 years, and they have long associated its fruit with health benefits.

There are hundreds of olive species, and these fruits and their oil form an integral part of the Mediterranean diet, which may help people prevent disease and live longer.

In this article, learn about the possible health benefits of olives as well as their nutritional content and how to use them.

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Are olives good for you? Different types of olives in oil in wooden bowl
Eating olives can help improve cardiovascular health. Olives and olive oil have a long history of reported health benefits, and there is a growing body of scientific evidence to back up these claims. Olive oil, which manufacturers make by crushing olive fruits and then separating the oil from the pulp, plays a key role in the Mediterranean diet. Olives are low in cholesterol and a good source of dietary fiber, which the body needs for good gut health. They are also rich in iron and copper. Research shows that following the diet can help people live longer. One study of almost 26,000 women found that the Mediterranean diet could cut the risk of developing cardiovascular disease by up to 28% compared with a control diet. The Mediterranean diet involves a daily intake of whole grains, fruits, vegetables, legumes, and nuts. People who follow the diet eat fish and lean meat in moderation but limit red and processed meats to 2–3 portions per month. The diet also emphasizes swapping unhealthful fats, such as the trans fats and saturated fats that are present in butter and margarine, with healthful fats, such as the polyunsaturated and monounsaturated fats that are in olives and olive oil. Olives are a good source of oleate, which is a monounsaturated fatty acid. A 2016 study found that eating more monosaturated fat reduced the risk of premature death due to disease compared with eating more carbohydrates. The American Heart Foundation also state that monounsaturated fats can have a beneficial effect on heart health when a person consumes them in moderation. Virgin olive oil is also high in a type of antioxidant called polyphenols, which can help prevent diseases relating to the heart and blood vessels. Some people believe that these antioxidants can slow the progression of neurodegenerative diseases and even cancer. However, more studies are necessary to confirm these claims. It is worth noting that food producers usually preserve olives in brine, which has a high salt content. Over time, excess levels of salt in the body can lead to high blood pressure, heart attacks, and stroke, so people should eat olives in moderation. Nutritional content of different types of olive Olives and Mediterranean food in buffet
Olives have a high fat content. The nutritional content of 100 grams (g) of ripe, canned black olives is as follows: Macronutrients: energy: 116 calories protein: 0.84 g total fat: 10.90 g carbohydrate: 6.04 g fiber: 1.60 g Minerals: calcium: 88 milligrams (mg) iron: 6.28 mg magnesium: 4 mg potassium: 8 mg sodium: 735 mg zinc: 0.22 mg copper: 0.25 mg Vitamins: vitamin C: 0.90 mg niacin: 0.04 mg vitamin B-6: 0.01 mg vitamin A: 17 micrograms (µg) vitamin E: 1.65 mg vitamin K: 1.4 µg The nutritional content of 100 g of canned or bottled green olives is as follows: Macronutrients: energy: 145 calories protein: 1.03 g total fat: 15.32 g carbohydrate: 3.84 g fiber: 3.30 g Minerals: calcium: 52 mg iron: 0.49 mg magnesium: 11 mg potassium: 42 mg sodium: 1,556 mg zinc: 0.04 mg copper: 0.12 mg Vitamins: niacin: 0.24 mg vitamin B-6: 0.03 mg folate: 3 µg vitamin A: 20 µg vitamin E: 3.81 mg vitamin K: 1.4 µg A tablespoon of standard olive oil contains the following nutrients, among others: energy: 119 calories total fat: 13.5 g (including 9.85 g monounsaturated fatty acids, 1.42 g polyunsaturated fatty acids, and 1.86 g saturated fatty acids) iron: 0.08 mg vitamin E: 1.94 mg vitamin K: 8.13 µg How to use Woman pouring olive oil onto salad
A person can benefit from olive oil by adding it to salads and vegetables. People can add olives and extra virgin olive oil to all manner of foods, including salad, raw or roasted vegetables, and whole-grain pasta. Mild-flavored variants of extra virgin olive oil can replace butter or other oils in baking. People can also cook with olive oil. While olives and olive oil contain plenty of useful nutrients, people should consume them in moderation as part of a balanced diet. Olive oil is high in fat, and the preservation process means that olives are often high in salt. Thank you for supporting Medical News Today Summary Generations of people have enjoyed olives and olive oil for their health-promoting qualities. Olives are low in cholesterol and a good source of dietary fiber, which the body needs for good gut health. They are also high in minerals that the body requires to function, such as iron and copper. However, it is best to consume olives in moderation, as producers usually preserve them in brine that is high in salt. Olive oil is an integral part of the Mediterranean diet, which can help people maintain a healthy weight, prevent heart disease, and live longer. The diet includes foods that contain high levels of monounsaturated fats, which are healthful fats that can benefit heart health. Olives are available for purchase in grocery stores, at food markets, and online. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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What is the link between asthma and pneumonia?

Asthma and pneumonia are two respiratory conditions. They share some symptoms, but they have different causes and treatments. Pneumonia may be more difficult to detect in people with asthma.

Asthma does not directly cause pneumonia, but people with a history of chronic respiratory problems, such as asthma, could have a higher risk of developing pneumonia.

In this article, we look at the link between asthma and pneumonia, explore symptoms and diagnoses, and discuss the differences between these conditions in children and adults.

What are asthma and pneumonia? asthma and pneumonia inhaler
Symptoms of asthma include difficulty breathing and tightening of the chest.

Asthma and pneumonia are conditions that affect the lungs.

Asthma is a chronic respiratory condition that results in narrowing and inflammation of the bronchiole airways.

Symptoms come and go over time and in response to triggers. They vary from person to person, but they often include:

difficulty breathing tightening of the chest coughing

Wheezing and coughing tend to occur during an asthma attack, making breathing more difficult.

Triggers of an asthma attack include but are not limited to:

typical allergens, such as pet dander, pollen, mold, and dust chemical fumes smoke air pollution cold, dry weather exercise

Pneumonia is an infection of the lungs caused by bacteria, fungi, parasites, or viruses. It can affect one or both lungs.

Bacterial pneumonia is by far the most common type of pneumonia in adults.

Like asthma, pneumonia causes lung inflammation, though it affects the air sacs — called alveoli — at the end of the bronchiole airways. An accumulation of pus or fluid in the air sacs makes breathing difficult.

Thank you for supporting Medical News Today What is the link? Asthma does not directly cause pneumonia, but people with chronic lung problems are more likely to develop pneumonia, due to previous lung damage or weakness in lung tissue. For the same reason, a person with asthma may have more severe symptoms and complications from colds and the flu. The flu can lead to pneumonia and, according to the Centers for Disease Control and Prevention (CDC), "Adults and children with asthma are more likely to develop pneumonia after getting sick with flu than people who do not have asthma." Some researchers believe that asthma medications may play a role. One study suggests that inhaled corticosteroids — a main treatment option for asthma — might increase the risk of developing pneumonia or other respiratory infections. Furthermore, some research indicates that young adults with asthma might experience "excess exacerbations" of the condition following pneumonia. The authors reported that the study group had made more frequent asthma-related hospital visits after having pneumonia. Symptoms of pneumonia in people with asthma asthma and pneumonia fever and chills
A person with asthma and pneumonia may develop a fever and chills. The symptoms of asthma and pneumonia can be similar, which can make pneumonia difficult for doctors to spot. Both asthma and pneumonia can cause: chest pain shortness of breath an increased respiratory rate an increased pulse coughing wheezing However, the conditions can also cause different symptoms. A person with asthma who suspects that they have pneumonia should look for: mucus in their cough a fever chest pain while coughing a crackling sound when they try to breathe in If any of these symptoms are present, see a doctor. A typical asthma flare-up involves coughing, wheezing, and a feeling of tightness in the chest. A decrease in lung function results in difficulty breathing and an increased pulse. The wheezing may be high-pitched and whistling. Uncomfortable asthma symptoms can last from a few minutes to several hours. Symptoms may flare up suddenly, and some people call these episodes asthma attacks. When a person has pneumonia, the initial symptoms may be similar to those of a typical cold or flu. As the lung infection evolves, green, yellow, or bloody mucus may accompany coughing. Common symptoms of pneumonia include, but are not limited to: headaches tiredness a loss of appetite shortness of breath clammy skin fever and chills chest pain that worsens with coughing or breathing Pneumonia can also cause a crackling sound while breathing. When pneumonia results from a virus, symptoms tend to include muscle pain and a dry cough from the very beginning. As the infection continues, the cough tends to worsen, and a person may produce mucus. When pneumonia is caused by bacteria, a person may have a high fever. Fevers of this degree come with their own side effects, including delirium and confusion. In severe cases of pneumonia, the lips or nail beds might turn blue as a result of a lack of oxygen. Complications of pneumonia in people with asthma asthma and pneumonia doctor
People with asthma and pneumonia should seek treatment as early as possible. If a person does not receive treatment, asthma and pneumonia can be life-threatening respiratory diseases. While asthma has no cure, symptoms tend to respond well to monitoring and appropriate treatments. In some cases, a person can recover from pneumonia within a week, while in others it may take at least a month. Because inflammation in the lungs can lead to an asthma attack, the airway dysfunction related to pneumonia can bring on a serious attack and cause severe complications. As bacteria or viruses replicate inside lung tissue, the body's natural immune defenses begin to flood the lungs with mucus. This makes breathing more difficult, and it causes a person to cough. The mucus blocks the airways, which constrict in response to inflammation, causing a lack of oxygen exchange in the body. As a result, the lungs must exert more effort, which can worsen chest pain. It is best to treat asthma and pneumonia as early as possible to prevent the conditions from worsening. Difference between asthma and pneumonia The main difference is that asthma is a chronic, noninfectious condition, whereas pneumonia is a lung infection. Asthma causes inflammation and narrowing of the airways. It mainly affects the bronchioles, which are the tiny branches of the airways in the lungs. Asthma is not a curable disease, though a person can manage its symptoms with the right medications. Asthma triggers can lessen over time and as a person learns to manage their illness. Pneumonia is an infection that can occur in one or both of the lungs. It causes inflammation in the air sacs, not the bronchioles. Pneumonia can cause the lungs to fill with fluid, making breathing painful and difficult. It is treatable. While asthma and pneumonia can cause many similar symptoms, they are different diseases with different treatment and care approaches. Thank you for supporting Medical News Today Summary It is important for people with asthma to understand the link with pneumonia. While one condition does not cause the other, people with asthma are more likely to develop pneumonia. If this happens, they have a greater risk of complications. Early treatment and preventive techniques are key to reducing the risk of these complications.
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What to do in the event of a heart attack

Learning to recognize warning signs and risk factors can help people avoid a heart attack. When a person has a heart attack, knowing what to do and acting quickly can help them have a better outcome.

According to the Centers for Disease Control and Prevention (CDC), a person has a heart attack every 40 seconds in the United States.

A heart attack occurs when there is a blockage of blood flow to the heart. When a blockage to blood flow occurs, it can damage or even kill parts of the heart tissue.

While the movies may depict heart attacks as happening suddenly, many heart attacks begin slowly and have many warning signs.

Signs and symptoms MAn experiencing heart attack sitting in chair holding shoulder and arm in pain.
A heart attack may cause pain in both shoulders and arms.

The main heart attack symptoms include the following:

Chest pain or discomfort: The chest pain or discomfort may feel like pressure, tightness, or a squeezing sensation. Shortness of breath: This may occur with or without chest pain. Discomfort in other parts of the body: The back, both arms and shoulders, neck, or jaw may also be uncomfortable during a heart attack.

While both males and females may experience the primary heart attack signs and symptoms, the symptoms we have listed above are more common in males.

Females are more likely to experience additional signs and symptoms. These include:

Thank you for supporting Medical News Today What to do A heart attack is a life-threatening medical emergency. If someone may be having a heart attack, a person should immediately call 911 for emergency help before doing anything else. Acting quickly can help save someone's life. If a person is having a heart attack, calling 911 is often a better course of action than taking the individual to the emergency room. Paramedics typically reach a person faster than they can get to the emergency room themselves. Additionally, when paramedics arrive, they can begin lifesaving treatment immediately. If the individual having the heart attack is unconscious, someone with cardiopulmonary resuscitation (CPR) training should begin CPR. If a defibrillator is available and someone knows how to use it, they should use the defibrillator after performing CPR if necessary. If you are alone If a person is alone and experiencing any symptoms of a heart attack, they should immediately call 911. Next, they should take aspirin if available, and unlock their door, so that paramedics have access. Then they should lay down near the door but not blocking it, to make it easy for paramedics to find them. Causes and risk factors Having high blood pressure can increase the risk of heart attacks.
Having high blood pressure can increase the risk of a heart attack. A person should be aware of their risk factors so they can take steps to prevent a heart attack. There are some heart attack risk factors that people can influence and others that they cannot. Heart attack risk factors that people cannot influence include: Age: While heart disease affects people of all ages, according to the American Heart Association (AHA) the most of those who die from coronary heart disease are adults over 65 years of age. Sex: Males are more likely than females to have and die of a heart attack. Family history: People with a significant family history of heart disease are more likely to experience a heart attack. Race and ethnicity: Some ethnic groups, including African Americans, some Asians, and Mexican Americans, are more likely to have a heart attack than others. While people cannot influence the above risk factors, there are many risk factors that they can modify or treat to prevent a heart attack. Modifiable risk factors for heart disease and heart attack include: Prevention Limiting alcohol intake can help reduce the risk of heart attacks.
Limiting alcohol intake can help reduce the risk of a heart attack. The best way to prevent a heart attack is to reduce any risk factors. People can reduce their chances of a heart attack by: losing weight if they are obese or overweight treating high blood pressure and high cholesterol by consulting a doctor controlling diabetes through diet, medication, and managing blood sugar eating a diet rich in fresh vegetables and fruits and low in saturated fats and processed foods stopping smoking or using tobacco products limiting alcohol consumption to no more than two drinks a day for men or one per day for women getting at least 150 minutes of moderate physical activity per week Additionally, a person should have regular checkups with their doctor. Regular checkups can help identify new risk factors for heart disease that a person may develop and monitor any existing ones they have. Summary Heart attacks are life-threatening medical emergencies that require immediate medical help. Knowing the signs and symptoms of a heart attack can help a person get the help they need as early as possible. Reducing risk factors for heart disease can help a person prevent a heart attack.
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How a fruit compound may lower blood pressure

Blueberries, red grapes, red wine, and peanuts are some of the natural sources of resveratrol — a plant compound that has received much attention in the medical community recently. New research in mice and human cells breaks down the mechanism through which resveratrol may lower blood pressure.
close up of woman's hands washing fruit
Red grapes and some blueberries contain resveratrol.

From protecting our neurons against aging to potentially preventing cancer, a significant number of studies have recently hailed the health benefits of resveratrol.

Also, a lot of previous research has focused on the benefits of resveratrol for heart health.

Clinical studies in rats and mice have demonstrated protective effects against stroke, heart failure, and hypertension, among other heart conditions.

Although some researchers believe that the benefits of resveratrol come from its antioxidant properties, the mechanisms behind its cardioprotective effects remain unclear.

New research gets closer to understanding these mechanisms, and the findings are an intriguing paradox.

A team of scientists from King's College London (KCL), in the United Kingdom, added resveratrol to the diet of mice with high blood pressure. Joseph Burgoyne, Ph.D., a senior lecturer in cardiovascular sciences at KCL, is the lead author of the study, which appears in the journal Circulation.

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The effects of resveratrol in mice

Burgoyne and the team induced high blood pressure in a group of wild-type mice. The researchers measured the rodent's blood pressure with implanted telemetry probes and monitored this for 15 days.

During this time, they fed the mice either a diet to which they had added resveratrol or a normal diet.

By the end of the study period, the researchers noted a drop of about 20 millimeters of mercury in the blood pressure of mice that had consumed resveratrol. The scientists also discovered that resveratrol relaxed the rodents' blood vessels by oxidizing the protein PKG1a.

"Resveratrol mediates lowering of blood pressure by paradoxically inducing protein oxidation, especially during times of oxidative stress, a mechanism that may be a common feature of 'antioxidant' molecules," conclude the authors.

The findings are counterintuitive, in the sense that the compound is believed to be an antioxidant, but this study shows that it behaves like an oxidant in order to lower blood pressure.

"We're slowly realizing that oxidants aren't always the villain. Our research shows that a molecule once deemed an antioxidant exerts its beneficial effects through oxidation. We think that many other so-called 'antioxidants' might also work in this way."

Joseph Burgoyne, Ph.D.

What do the findings mean for humans?

Importantly, the researchers were able to replicate the findings in human cell lines. Specifically, they applied resveratrol to smooth muscle cells taken from human blood vessels and noticed the same oxidization process.

However, the scientists caution against the interpretation that people should consume a lot of resveratrol-containing products in order to reap the same benefits that this study showcased in mice.

People should avoid red wine, in particular, the researchers warn. To recreate the benefits of the study in humans, say Burgoyne and colleagues, a person would have to consume 1,000 bottles of red wine every day. The compound is not very soluble, which is why high amounts of it are necessary.

"Our work could lay the foundations for chemically altering resveratrol to improve its delivery to the body," the study's lead author explains, "or designing new, more potent drugs which use the same pathway. In the future, we could have a whole new class of blood pressure drugs."

Metin Avkiran, Ph.D., a professor of molecular cardiology at KCL — who was not involved in the study — also comments on the significance of the findings.

"Unfortunately, this isn't the all-clear to open a bottle of merlot. To get the human equivalent dose of resveratrol used here, you'd need to drink an impossible amount of red wine every day."

Prof. Metin Avkiran, Ph.D.

"This study reveals the surprising way in which resveratrol works and opens up the possibility of new blood pressure drugs which work in a similar way," Prof. Avkiran adds. "The findings bring us a step closer to tackling this 'silent killer' which puts people at risk of having a devastating stroke or heart attack."

In the United States, over 100 million people are currently living with hypertension.

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What is the most healthful oil for frying?

How healthful an oil is to cook with mostly depends on how it reacts when heated. Generally, olive oil, avocado oil, and canola oil are healthful for cooking with.

Oil reaches its smoking point once it starts to smoke and break down. Once it passes the smoking point, it releases free radicals that can cause damage to cells in the body.

Oils with high smoke points may be more stable and more healthful to cook with than those with low smoke points. The stability of an oil depends on how tightly packed the fatty acids in them are. The more tightly packed, the harder they are to break apart when heated.

Saturated and monounsaturated fats are the most stable oils to cook with. Higher levels of saturation in oil mean that it is more resistant to oxidization, the process wherein the acids break apart.

Polyunsaturated oils contain short-chain fatty acids and break apart more easily when heated, releasing more free radicals. Polyunsaturated oils are best to use unheated, such as by drizzling them over food or using them in dressings.

In this article, we take a look at the oils most healthful for deep frying, shallow frying, and roasting, along with other things to consider when choosing a cooking oil.

Most healthful oils for deep frying temperature gauge and oil in a pan
Extra virgin olive oil and coconut oil may be the most suitable oils for deep frying.

One study found that extra virgin olive oil and coconut oil were two of the most stable oils. The researchers heated 3 liters of oil in a deep fryer at 356°F (180°C) for 6 hours. This suggests that they may be the most suitable oils for deep frying.

Olive oil has anti-inflammatory properties and is high in antioxidants and fatty acids. This makes it a more stable oil when heated at high temperatures.

Coconut oil comprises 92% saturated fat, and its resistance to oxidization makes it a stable cooking oil. One study showed that coconut oil was still stable after 8 hours of deep frying.

Due to its high saturated fat content, it is best to use coconut oil in moderation. Research has suggested that coconut oil raises both high-density lipoprotein (HDL), or "good," and low-density lipoprotein (LDL), or "bad," cholesterol levels more than unsaturated oils but less than butter.

The same review suggested that coconut oil may not be suitable for deep frying, however, due to its low smoke point. As a result, it may be better for shallow frying.

There are also studies that suggest that smoke point may not be the most important factor in the safety of oils when heated.

The authors of a 2018 study suggest that oxidative stability is more important than smoke point when looking at how healthful cooking oils are. In this study, coconut oil had high stability after heating.

Thank you for supporting Medical News Today Most healthful oils for shallow frying Shallow frying<!--mce:protected %0A-->
Avocado oil is good for shallow frying. Along with coconut oil and olive oil, avocado oil is a good oil to use for shallow frying. Avocado oil contains high levels of monounsaturated fat, which means that it stays fairly stable when heated. Avocado oil raises the levels of good cholesterol in the body and lowers the bad. It also contains vitamin E, which is an antioxidant that may help reduce free radicals in the body. People can use sunflower oil for shallow frying. It has a high smoke point and is also a good source of vitamin E. Sunflower oil contains high levels of omega-6, however. Consuming too many omega-6 fatty acids can cause inflammation in the body. As a result, it may be best to use sunflower oil in moderation. Canola oil is another oil with a high smoke point, making it suitable for shallow frying. Most healthful oils for roasting When choosing an oil to use for roasting, it may be best to choose one that has a high smoke point. Oils with relatively high smoke points include coconut oil, peanut oil, and sunflower oil. Olive oil is one of the more healthful oils, but its smoke point is slightly lower than that of the above oils. As a result, it may be best to use when roasting at a temperature lower than 374°F (190°C). Avocado oil has a similar stability to olive oil at that heat. Other healthful oils The following oils have fairly healthful nutrition profiles. Some are more suitable for use in cooking than others, however. Peanut oil Also called groundnut oil, peanut oil is high in monounsaturated fat, which makes it suitable for cooking. However, it does contain polyunsaturated fats as well. It also has antioxidant and anti-inflammatory properties. Canola oil Canola oil is suitable for frying. Some research suggests that it can improve insulin sensitivity and help reduce cholesterol levels compared with other sources of fat. Flaxseed oil Flaxseed oil is full of omega-3 fatty acids, which are essential fats for the body, and which may help prevent health conditions such as heart disease. Flaxseed oil oxidizes easily, so it is best for drizzling over salads or food after cooking. It is best to keep it in a dark, airtight container in the fridge to prevent it from turning rancid. Considerations when choosing a cooking oil Oils that contain lower levels of linoleic acid, such as olive and canola oil, are better for frying. Polyunsaturated oils, such as corn, sunflower, and safflower, are best for using in dressings rather than cooking with. The American Heart Association (AHA) recommend that people choose oils containing less than 4 grams of saturated fat per tablespoon. They also advise people to avoid partially hydrogenated oils and trans fats. Thank you for supporting Medical News Today Oils and fats to avoid Trans fats increase LDL, or "bad," cholesterol in the body and increase inflammation. This can increase the risk of heart disease, diabetes, and stroke. Trans fats are present in processed foods, such as some store-bought cakes, donuts, cookies, and fast foods. Commercial deep-fried foods may contain trans fats if the manufacturers have cooked them in partially hydrogenated oils. Trans fats also occur naturally in small amounts in animal fats, such as milk and meat. People should also avoid heating oils at or above 375°F (190.5°C), as this can increase the chances of a toxic compound called 4-hydroxy-2-trans-nonenal (HNE) building up. HNE can increase the risk of health conditions such as liver disease, Parkinson's disease, and stroke. HNE can start to build up after just one use, and reheating the same oil to a high temperature can cause HNE to accumulate even further. Healthful alternatives to using fats and oils man using spray oil
Spray oil is a healthful alternative. People can also cook many foods without using fats or oils. Some alternative options include using the following: a small amount of stock or water to fry or roast foods in nonstick pans a spray oil, which helps a person use less oil when cooking Using other liquids in cooking can add flavor and create an easy sauce for the dish, such as: cooking sherry wine tomato juice lemon juice milk vinegar Thank you for supporting Medical News Today Summary Oils high in monounsaturated fats are best for cooking with due to their stability when heated, as well as their potential health benefits. Examples include olive, avocado, and canola oil. Coconut oil is also a stable fat to cook with. It may be best to use it in moderation due to its high saturated fat content, however. Polyunsaturated oils are not suitable for cooking with due to their high rate of oxidization, but they could provide health benefits when a person uses them raw. It is best to avoid trans fats and high quantities of saturated fats, as these can increase the risk of health conditions such as heart disease and diabetes. The cooking oils in this article are available to purchase online. Shop for extra virgin olive oil. Shop for coconut oil. Shop for avocado oil. Shop for canola oil. Q: What is the most healthful method of frying? A: People can enjoy fried foods occasionally, but they should be mindful about a few things when they decide to indulge. Firstly, they should fry the foods in their own kitchen so they can control how much oil they use. Choose a fresh, clean, heart-healthy oil with a high smoke point, and stick to appropriate temperatures using a thermometer. Use little to no batter, and always drain excess oil. Finally, try to pair the fried food with a healthful side dish. Katherine Marengo LDN, RD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice. 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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How lack of sleep harms circulation

Scientists have long been aware of the relationship between insufficient sleep and poor cardiovascular health. However, exactly how the lack of adequate sleep can harm circulation has remained unclear. A new study now uncovers some of the potential mechanisms.
person unable to sleep
Sleeplessness impairs crucial mechanisms that keep cardiovascular problems at bay, shows a new study.

Having a good night's sleep, which amounts to an uninterrupted 7 hours of sleep or so per night, is crucial to maintaining good overall health. Poor sleep hygiene disrupts both short- and long-term health, according to evidence from numerous studies.

One aspect of health that a person's quality of sleep can influence is cardiovascular health. For example, research findings from the start of this year showed that sleeping for less than 6 hours per night rather than for 7–8 hours could increase a person's risk of atherosclerosis — a condition in which plaque builds up inside the arteries — by as much as 27%.

Another study from this year explains how good sleep can help keep the arteries supple, thus maintaining good circulation.

Now, research from the University of Colorado Boulder has pinpointed a potential biological mechanism explaining the reverse of the medal — how lack of sleep affects circulation by promoting the buildup of fatty deposits in the arteries (atherogenesis), which can increase a person's risk of experiencing a stroke or heart attack.

The findings, which appear in the journal Experimental Physiology, tie sleeplessness to changes in the blood levels of micro RNA (miRNA), noncoding molecules that help regulate protein expression.

"This study proposes a new potential mechanism through which sleep influences heart health and overall physiology."

Senior author Prof. Christopher DeSouza

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How poor sleep promotes vascular problems

In the current study, the researchers collected blood samples from 24 healthy participants aged 44–62 years, who also provided information about their sleeping habits. Of the participants, 12 reported sleeping 7–8.5 hours per night, while the other 12 said that they only slept for 5–6.8 hours per night.

The team found that the participants who slept for less than 7 hours per night had blood levels of three key circulating miRNAs — miR-125A, miR-126, and miR-146a — that were 40–60% lower than those of their peers who slept for 7 or 8 hours. These three miRNAs, the researchers note, suppress the expression of proinflammatory proteins.

Having low levels of these molecules is problematic, because, as Prof. DeSouza explains, "[t]hey are like cellular brakes, so if beneficial microRNAs are lacking, that can have a big impact on the health of the cell."

In this case, insufficient circulating miR-125A, miR-126, and miR-146a could lead to vascular problems, including inflammation, as well as a higher risk of experiencing cardiovascular disease-related events, such as stroke or a heart attack.

Prof. DeSouza and his team had already found another worrying pattern in a previous study, for which they recruited adult men who slept for less than 6 hours each night. The study showed that the participants' endothelial cells — which make up the lining of blood vessels — did not function properly.

As a result, their blood vessels were unable to dilate and contract properly to allow blood to flow efficiently to different organs and parts of the body. This situation, Prof. DeSouza and colleagues have explained, poses another set of risks to cardiovascular health.

7 hours of sleep for cardiovascular health

"Why 7 or 8 hours [of sleep per night] seems to be the magic number [in maintaining health] is unclear," Prof. DeSouza admits.

"However," he continues, "it is plausible that people need at least 7 hours of sleep per night to maintain levels of important physiological regulators, such as microRNAs."

Commenting on the current findings, Prof. DeSouza argues that it may be possible to diagnose cardiovascular disease by performing blood tests. Laboratory technicians could assess a person's levels of circulating miRNAs and look for the presence of the atherogenic signature that the study has identified.

At present, the senior researcher and his team are working to find out whether improving a person's sleep habits can help reestablish healthy levels of important miRNAs in the blood.

In any case, Prof. DeSouza emphasizes that the findings of the recent study corroborate what sleep studies have been suggesting all along — that sleep quality influences unexpected aspects of health.

"Don't underestimate the importance of a good night's sleep," he stresses.

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What causes dizziness?

Dizziness refers to a range of sensations, such as feeling as though the room is spinning, lightheadedness, and feeling physically unsteady. Dizziness has many possible causes, which may relate to a person's external environment, the medications they take, or an underlying condition.

Recurring dizziness or severe dizzy spells can significantly interfere with a person's life. It rarely indicates a medical emergency, however. People can experience dizziness after:

spinning around quickly standing or sitting up too fast engaging in high-intensity exercise

Usually, people will be able to identify the cause of their dizziness. However, this symptom may occur unexpectedly or without any clear reason.

The causes of dizziness can range from temporary physical changes to more serious underlying medical conditions, some of which we will detail below.

1. Vertigo Woman holding her head and wondering why am I dizzy
Vertigo or a migraine can cause dizziness.

Many people use the terms "vertigo" and "dizziness" interchangeably.

Although these conditions create similar sensations, they are slightly different.

When someone feels dizzy, they can feel woozy or disoriented. Vertigo, on the other hand, refers to the artificial sensation of movement. Vertigo can cause people to feel as though the environment around them is spinning or tilting.

Vertigo occurs due to the development of problems in the inner ear. Causes of vertigo can include:

Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo develops when calcium carbonate particles collect in the inner ear canals.

These canals send information about the body's position and movements to the brain, but the presence of the calcium particles causes the brain to misread the information.

Ménière's disease

This inner ear condition has no known cause, but some scientists believe that it can occur when fluid builds up in the ear canals.

Ménière's disease can develop suddenly and without any apparent cause. It can give rise to vertigo, a ringing or roaring sound in the ears, and hearing loss.


Infections can cause inflammation in the inner ear, or labyrinth. Labyrinthitis tends to develop after a viral infection, such as a cold or flu.

Antiviral and antihistamine medications can effectively treat labyrinthitis. However, parts of the inner ear may sustain permanent damage as a result of this condition.

2. Motion sickness Repetitive motion from being in a vehicle, such as a car, airplane, or boat, can disrupt the structures of the inner ear, causing dizziness, nausea, and vomiting. People call this "motion sickness" or "seasickness." Being pregnant or taking certain medications can increase a person's sensitivity to motion and increase their risk of experiencing motion sickness. The symptoms of motion sickness usually subside away once the person sets foot on solid ground. Thank you for supporting Medical News Today 3. Migraine A migraine is a type of recurring headache that can cause a throbbing or pulsing pain on one side of the head. The American Migraine Foundation estimate that 30–50% of people will experience dizziness during a migraine episode. Sometimes, people experience dizziness before the onset of a migraine episode. Other neurologic symptoms, or auras, can precede the pain of a migraine headache. Auras can affect a person's vision, speech, and motor control. 4. Low blood pressure A sharp drop in blood pressure can cause a brief sensation of lightheadedness. Blood pressure changes can occur after sitting or standing up too quickly. Other conditions that can cause blood pressure changes include: Taking certain medications, such as diuretics, beta-blockers, or antidepressants, can also cause changes in blood pressure. 5. Cardiovascular disease Conditions that affect the cardiovascular system, such as the buildup of plaque in the arteries and congestive heart failure, can cause dizziness. People may experience dizziness or feel lightheaded before or after a heart attack or stroke. If a person has cardiovascular disease, they will likely experience other signs and symptoms, including: irregular heartbeat shortness of breath discomfort or tightness in the chest a persistent cough excess fluid in the arms, legs, or feet fatigue nausea, vomiting, or both 6. Low iron tofu high iron
Eating a diet rich in iron can reduce the symptoms of anemia. Iron deficiency can result in a condition called anemia, in which the body does not have enough oxygen-rich blood. Anemia can cause the following symptoms: dizziness shortness of breath chest pain fatigue Making appropriate dietary changes and taking iron supplements can help treat mild forms of iron-deficiency anemia. People who have a severe iron deficiency may require a blood transfusion. 7. Hypoglycemia (low blood sugar) Hypoglycemia occurs when blood glucose, or blood sugar, falls below the normal levels. Causes of hypoglycemia include: skipping meals consuming alcohol taking certain medications, such as insulin or aspirin having hormonal imbalances Symptoms of hypoglycemia can appear suddenly and vary in severity. A few of these symptoms include: dizziness or lightheadedness loss of balance fatigue headache hunger mood changes difficulty concentrating irregular heartbeat 8. Autoimmune inner ear disease Autoimmune inner ear disease (AIED) refers to any condition wherein the immune system mistakenly attacks the inner ear. AIED can cause hearing loss in one or both ears. Other symptoms of AIED include: dizziness tinnitus, or ringing in the ears loss of balance or coordination AIED causes nonspecific symptoms that are similar to those of an ear infection. For doctors to accurately diagnose AIED, they need to take a full medical history, perform a physical examination, and track any additional symptoms. People who have AIED may develop another autoimmune disease that affects the entire body. Thank you for supporting Medical News Today 9. Stress anxious woman closes her laptop
Stress and anxiety are common symptoms of dizziness. Long-term or chronic stress may contribute to the development of significant health problems, such as depression, anxiety, heart disease, diabetes, or immune dysfunction. During the stress response, the brain releases hormones that affect the respiratory and cardiovascular systems. These hormones narrow the blood vessels, raise the heart rate, and cause rapid, shallow breathing. These responses can lead to dizziness or lightheadedness. Other symptoms of stress include: sweating trembling or shaking headaches chest pain rapid heartbeat difficulty sleeping difficulty concentrating nausea 10. Anxiety Dizziness is a common symptom of anxiety. However, the exact relationship between the two varies among people. Some people may experience anxiety attacks that trigger dizziness, while others might have a sudden onset of dizziness that triggers an anxiety attack. Stressful events, such as an exam or a challenging emotional situation, can trigger anxiety attacks. People may feel dizzy, disoriented, and nauseous during an anxiety attack. Other symptoms of anxiety include: worry restlessness or fidgeting difficulty concentrating sleep problems mood changes irritability rapid heart rate headache sweating dry mouth When to see a doctor Dizziness may indicate a more serious underlying medical condition when it occurs alongside symptoms such as: double vision vomiting fever numbness difficulty moving or controlling the arms or legs headache chest pain loss of consciousness Thank you for supporting Medical News Today Takeaway Experiencing an episode of sudden or severe dizziness can be alarming. However, the dizziness usually resolves on its own and does not require emergency medical attention. Dizziness is a nonspecific symptom that can indicate an underlying medical condition, such as anxiety, stress, or low blood sugar. People should speak with their healthcare provider if they experience severe or recurring dizziness.
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Best 10 foods to boost metabolism

Certain foods contain specific nutrients that increase the body's metabolism. Metabolism is the rate at which the body burns calories and carries out other processes.

By boosting their metabolic rate, people may be able to shed excess weight and reduce their risk of obesity and related health issues.

Read on to discover 10 of the best metabolism boosting foods, along with some other ways to increase metabolic function.

1. Eggs Boiled eggs on a board which are a metabolism boosting food
Eggs are rich in protein and are a great option for boosting metabolism.

Protein-rich foods are amongst the best options for boosting metabolism.

Eggs are rich in protein, with each large, hard-boiled egg containing 6.29 grams (g), making them an ideal choice for people who want to speed up their metabolism.

Protein is one of the most effective nutrients for increasing metabolic rate because the body needs to use more energy to digest it than it does for fats or carbohydrates. Scientists call this energy expenditure the thermic effect of food (TEF), or diet-induced thermogenesis (DIT).

According to some research, people who consumed 29% of their total daily calories as protein had a higher metabolic rate than those who consumed 11% of total calories from protein.

2. Flaxseeds Flaxseeds are seeds that contain protein, vitamins, and other key nutrients. Some people consider flaxseeds a "functional food," which means that people eat them for their health benefits. Eating flaxseeds could help boost metabolism and improve metabolic syndrome, which is a group of conditions that contribute to diabetes, obesity, and cardiovascular disease. At present, the National Center for Complementary and Integrative Health (NCCIH) is funding research into the role of flaxseeds for metabolic syndrome. A 2019 study on mice indicates that flaxseeds may boost metabolism. This is probably because they contain good amounts of fiber and protein, along with essential omega-3 fats, antioxidants, and other essential nutrients. The fiber in flaxseeds ferments in the gut to improve the gut's bacterial profile. This process aids metabolic health, and it may protect against obesity. Studies suggest that flaxseeds and their nutrients may also help treat or protect against: Thank you for supporting Medical News Today 3. Lentils Lentils are another functional food that may reduce the effects of metabolic syndrome. A 2016 review of 41 animal studies reports that eating lentils and other legumes, such as beans and peas, can play a central role in preventing and treating metabolic syndrome. Lentils may also increase metabolism because they are rich in protein. They also contain good amounts of fiber to feed beneficial bacteria in the gut. 4. Chili peppers Chili peppers on a board which can help to boost metabolism
Studies suggest that capsaicin can boost metabolic rate. Spicy meals that contain fresh or dried chili peppers can increase metabolism and a feeling of fullness. A compound in peppers, called capsaicin, is responsible for these health benefits and more. A 2015 study reports that eating capsaicin boosts metabolic rate modestly. The research also suggests that the compound can contribute to weight management in other ways by increasing the speed at which the body burns fat and reducing appetite. This builds on existing research, published in 2012, which indicates that capsaicin helps the body to burn approximately 50 extra calories each day. Capsaicin may also reduce pain and inflammation, act as an anticancer agent, and provide antioxidant benefits. As a result, some researchers suggest that the compound may help treat conditions such as rheumatoid arthritis and Alzheimer's disease. 5. Ginger Adding ginger to meals could increase body temperature and metabolic rate, and help control appetite. A 2018 review of studies evaluated ginger's effects on weight loss and metabolic profiles in people who were overweight. It found that the spice may help to reduce body weight and fasting glucose levels while increasing high-density lipoprotein (HDL), or "good" cholesterol. Ginger also has anti-inflammatory properties, and it may help to reduce nausea during pregnancy and after chemotherapy treatment. 6. Green Tea Green tea has received plenty of attention in recent years as researchers have shed light on its potential health benefits. Several studies suggest that green tea extract (GTE) may increase fat metabolism both at rest and during exercise. However, other research reports no notable effects. Furthermore, scientists cannot guarantee that drinking green tea would have the same results as taking GTE. A small-scale 2013 study involving 63 people with type 2 diabetes suggests that drinking 4 cups of green tea daily can significantly reduce body weight, body mass index (BMI), waist size, and systolic blood pressure. Other proposed health benefits of green tea include: anti-inflammatory effects antioxidant properties antimicrobial activity anticancer effects benefits for heart and oral health 7. Coffee Coffee can stimulate metabolism thanks to its caffeine content. Research reports that caffeine intake has a stimulating effect on energy expenditure and can lead to increased metabolism. However, it is essential to be mindful of total consumption. Learn about how much caffeine is too much, here. Decaffeinated coffee does not have the same metabolism boosting benefits. Also, adding cream or sugar will increase its calorie content, which may work against the caffeine's beneficial effects on metabolism. 8. Brazil nuts Brazil nuts are one of the richest sources of selenium, a mineral that is essential for metabolism, reproduction, and immune function. They also contain protein and healthful fats to make people feel fuller. Selenium is especially important for the thyroid gland, a gland that regulates metabolic function and produces several vital hormones. According to the National Institutes of Health (NIH), each Brazil nut provides 68 to 91 micrograms (mcg) of selenium, which is more than the recommended dietary allowance (RDA) of 55 mcg per day. People should avoid eating too many nuts, however, as this can cause selenium toxicity. The NIH set upper limits of selenium intake at 400 mcg. Research also suggests that Brazil nuts can improve the cholesterol levels of healthy people. Abnormal cholesterol levels are a marker of metabolic syndrome. Thank you for supporting Medical News Today 9. Broccoli Broccoli may benefit metabolism because it contains a substance called glucoraphanin. Glucoraphanin helps to "retune" metabolism, lower blood fat levels, and reduce the risk of many age-related diseases. Broccoli and other cruciferous vegetables may also prevent or slow down several forms of cancer. For more significant metabolism enhancing effects, look for Beneforte broccoli, which contains high levels of glucoraphanin. 10. Dark, leafy green vegetables curly kale containing silicon dioxide on wooden hopping board
Kale is high in iron, which is essential for metabolism. Spinach, kale, and other leafy green vegetables may boost metabolism thanks to their iron content. Iron is an essential mineral for metabolism, growth, and development. Leafy greens are a source of non-heme, or non-animal, iron. Try pairing leafy greens with a source of vitamin C — such as lemon, tomatoes, or winter squash — to increase the body's absorption of this type of iron. Many leafy greens also provide good amounts of magnesium, another mineral that supports metabolic function and plays a role in over 300 processes in the body. Other tips to boost metabolism Eating a healthful diet is essential for regulating metabolism. Other ways to boost metabolic function include: Drinking water According to one small-scale study, drinking an extra 1,500 milliliters (ml) of water daily can decrease body weight and BMI in some people who are overweight. Participants drank 500 ml before each meal. The researchers suggest that this is due to water-induced thermogenesis, where water increases metabolism. Sleep Getting enough sleep is essential for metabolism and overall health. Research suggests that a lack of sleep may be contributing to the trend of increasing obesity and diabetes, which are consequences of metabolic syndrome. According to the National Sleep Foundation, adults should aim to sleep for 7 to 9 hours a night. To improve sleep patterns, try to go to bed and get up at the same time each day. Strength and resistance training Lifting weights regularly allows people to gain and retain muscle mass and to burn fat. The Physical Activity Guidelines for Americans recommend that adults should perform strengthening exercises 2 or more days each week. A 2018 study on sedentary women found that resistance training increased the overall basal metabolic rate (BMR) for up to 48 hours. BMR refers to the number of calories that the body burns while resting. Thank you for supporting Medical News Today Summary Many foods, including green vegetables, chili peppers, and protein sources, can boost metabolism and help people achieve or maintain a healthy weight. For optimum results, eat these foods as part of a balanced diet. Other lifestyle changes that improve metabolic health include drinking enough water, getting adequate sleep, and exercise activities.
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What to know about nitroglycerin

When something restricts blood flow to the heart muscle, a person can experience intense chest pain that doctors call angina. People often use the drug nitroglycerin to relieve chest pain that angina causes.

Most often, the reason for the decrease in blood flow is plaque formation and narrowing of the arteries supplying blood to the heart.

Nitroglycerin helps to open up the blood vessels and allow blood to flow. People also use nitroglycerin to treat chronic anal fissures.

In this article, we provide an overview of nitroglycerin, including its uses, how it works, and the possible side effects, interactions, and warnings.

What is nitroglycerin, and how does it work? senior man using nitroglycerin spray
A person can use nitroglycerin to relieve angina symptoms.

Nitroglycerin is a medication that treats angina and chronic anal fissures. It works by promoting blood flow.

The body breaks nitroglycerin down into nitric oxide. Nitric oxide causes the smooth muscle within the blood vessels to relax. This allows the arteries and veins to open up, allowing more blood to flow through. Healthcare professionals call this action vasodilation.

During an angina attack, a person will experience intense chest pain. Nitroglycerin will start working within 1 to 3 minutes, but its maximal effect occurs after 5 minutes.

When people use nitroglycerin for anal fissures, the ointment will relax the anal sphincter, which is the muscle tissue around the anus, and lower the pressure in the anus. This promotes blood flow to the area and helps heal the fissure.

Thank you for supporting Medical News Today Uses Doctors usually use nitroglycerin to treat the pain that angina causes. Narrowing of the arteries that supply the heart with blood is what causes unstable angina. Doctors call this condition coronary artery disease (CAD). CAD is the most common type of heart disease. More than 370,000 people in the United States die every year because of CAD. Nitroglycerin allows the blood vessels to open up, which lets oxygen and nutrient-rich blood feed the heart muscle. This action offers immediate relief from chest pain. People can also use nitroglycerin to treat anal fissures. Anal fissures are tears in the skin of the anus. People can get anal fissures from passing hard stools. Similarly to its effects for angina, nitroglycerin as a rectal ointment helps the healing process by stimulating blood flow to the affected area. How to take it The following table lists the different formulations of nitroglycerin. Form of nitroglycerin How to use aerosol solution
tablet dissolve under the tongue ointment
24-hour patch apply to the skin rectal ointment rectal use only Angina When someone is having intense chest pain, it is vitalto resolve this symptom as quickly as possible. People can also take fast-acting nitroglycerin formulations 5 to 10 minutes before doing an activity that may cause an angina attack. The aerosol spray, pumpspray, packet, and tablet are all fast-acting forms of nitroglycerin. Aerosol spray and pumpspray People can use these devices by giving one or two sprays on or under the tongue once a person feels angina pains. They should not inhale the spray. Packet A sublingual packet of nitroglycerin contains 400 micrograms (mcg) of nitroglycerin powder. A person places the contents of the packet under their tongue when angina pains begin. Tablet At the first signs of angina pains, a person should place the tablet under their tongue or between the gums and the cheek. The tablet will dissolve and absorb through the tissues of the mouth. People who use the aerosol spray, pumpspray, packet, or tablet should not swallow the drug. Nitroglycerin will absorb through the mouth tissues. This provides faster relief than swallowing the medicine. People should also avoid rinsing or spitting for 5 minutes after administering the dose. A person can take each of these forms of fast-acting nitroglycerin at 5-minute intervals. If they do not feel relief from the intense chest pain, they can take two more doses 5 minutes apart. If someone has taken three doses of either fast-acting formulations and does not experience any pain relief, they should seek medical attention immediately. There are also two other formulations of nitroglycerin that can prevent angina attacks. These are not fast-acting, and people should not use them to stop an attack when it is happening. Patch Nitroglycerin patches come in doses ranging from 0.1 milligrams per hour (mg/hr) to 0.8 mg/hr. A person places the patch on their skin anywhere except the areas below the knee and elbow. Most people place the patch on their chest. The area should be clean, dry, and hairless to allow the nitroglycerin to absorb across the skin. A person should leave the patch on the skin for 12 to 14 hours and remove it for 10 to 12 hours. People will usually have the patch on during the day and remove it during sleep. Ointment close up of hands with tube of ointment
A person can apply nitroglycerin ointment to the skin twice a day. People can apply nitroglycerin ointment to their skin using a dose-measuring applicator that comes with the tube. A person will measure the desired dose onto the measuring applicator and then place the applicator ointment side down on the skin. They then spread the ointment across the skin. The person should not rub the medicine in but allow the ointment to absorb across the skin. Finally, they tape the applicator to the skin. People take two doses of ointment each day. Doctors will tell people to use the ointment first thing in the morning and then reapply it 6 hours later. Anal fissures The rectal ointment for anal fissures contains 0.4% nitroglycerin. A person will insert the ointment into their anus every 12 hours for up to 3 weeks. To apply the rectal ointment, a person will cover their finger with plastic wrap and squeeze out 1 inch of ointment along the finger. They then insert the finger into the anal canal up to the first finger joint. The person will then smear the ointment around the area. If this is too painful, the person may apply the ointment to the outside of the anus instead. Side effects People may experience many side effects when using nitroglycerin, including: When people take nitroglycerin for relieving angina, they should be in a relaxed, seated position. An individual's blood pressure can drop significantly after using nitroglycerin. If they stand up too quickly after administering the dose, their blood pressure may drop even lower and put them at risk of fainting. The most common side effect of long-acting nitroglycerin is headaches, but this side effect decreases with use. Although the rectal ointment is only put in the anus, a person may still experience headache and dizziness. Precautions and risks Some people may be allergic to nitroglycerin, and doctors do not recommend that people use it if they have a history of allergic reactions to nitroglycerin. Doctors will not prescribe nitroglycerin to anyone with a history of severe anemia, heart attack occurring on the right side of the heart, or increased pressure in the brain. Thank you for supporting Medical News Today Interactions Nitroglycerin may interact with certain other medications. PDE-5 inhibitors are drugs that doctors give to treat erectile dysfunction in males. Viagra, Cialis, and Levitra are PDE-5 inhibitors. As with nitroglycerin, these drugs also cause increased blood flow and can lower blood pressure. Doctors do not recommend that people use nitroglycerin with PDE-5 inhibitors, as they can cause fainting if someone is taking them together. Males should avoid using nitroglycerin if they have taken Viagra or Levitra within the last 24 hours or Cialis within the previous 48 hours. Any person using long-acting nitroglycerin cannot take PDE-5 inhibitors. Overdose senior lady holding head in pain
Throbbing headaches can be a sign of a nitroglycerin overdose. An overdose of nitroglycerin may occur when people use PDE-5 inhibitors with nitroglycerin or if they use too much nitroglycerin during an attack. Severe side effects that healthcare professionals associate with a nitroglycerin overdose include: a sudden drop in blood pressure increased heart rate increased blood flow and pressure in the brain throbbing headaches confusion dizziness disturbances in vision Currently, no drug can reverse a nitroglycerin overdose. Doctors can provide care to people experiencing an overdose by giving intravenous fluids and elevating their legs. Thank you for supporting Medical News Today Summary Using nitroglycerin in the appropriate way can delay the serious complications of angina that can include heart attack, stroke, and even death. People may experience side effects with nitroglycerin and should remain seated while the drug is having its effect. Nitroglycerin can interact with medications for erectile dysfunction. Males with angina should report the use of Viagra, Cialis, and Levitra to their doctor because the use of both drugs together may be dangerous. People can also treat anal fissures with nitroglycerin rectal ointment. Side effects and interactions can also occur with topical use of nitroglycerin.
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More women risking heart health through lack of exercise

A new study finds that the number of women in the United States with cardiovascular disease who are not doing enough physical activity is on the rise.
woman lying on a sofa checking out her tablet
Women between 40 and 64 years of age are getting less and less exercise, new research shows.

Cardiovascular disease is the leading cause of death among women in the U.S.

The American Heart Association (AHA) estimate that every year the condition kills 400,000 women — approximately the same number of females who die from cancer, chronic lower respiratory disease, and diabetes put together.

When variables such as race are considered, the statistics become even more dramatic. The prevalence of heart disease among African American women is much greater than among white women.

Despite this, most cases of cardiovascular disease can be prevented with healthy lifestyle choices, such as exercising and following a balanced, healthful diet.

A new study that researchers from the Johns Hopkins University School of Medicine in Baltimore, MD, have conducted found that more than half of women with cardiovascular disease continue not to exercise enough, and the number has increased over the past decade.

The results of the study appear in the journal JAMA Network Open.

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Exercise is essential for heart health

The study suggests that more needs to be done to improve physical activity among women with cardiovascular disease who would benefit from increasing their exercise levels — to ensure they experience optimal heart health.

This intervention would also decrease their healthcare costs associated with cardiovascular disorders.

"Physical activity is a known, cost-effective prevention strategy for women with and without cardiovascular disease, and our study shows worsening health and financial trends over time among women with cardiovascular disease who don't get enough physical activity," says Victor Okunrintemi, internal medicine resident at East Carolina University, and author on the study.

The AHA and the Centers for Disease Control and Prevention (CDC) have similar physical activity guidelines. They recommend that adults do at least 150 minutes of moderate activity a week or 30 to 75 minutes of vigorous activity per week.

The new study found that more than half of women in the U.S. with cardiovascular conditions continue to not meet these guidelines.

Assessing changes in trends over the years

The researchers used data from a 2006–2015 questionnaire by the U.S. Agency for Health Care Research and Quality's Medical Expenditure Panel Survey, which included more than 18,000 women of different races (non-Hispanic white, Asian, African American, and Hispanic) with cardiovascular disease.

The research team looked at the answers collected in 2006–2007 and then compared them with those from 2014–2015.

They found that the number of women with cardiovascular disease not meeting the recommended physical activity guidelines increased from 2006 to 2015, rising from 58% to nearly 62%. They also found trends related to age, race, and socioeconomic factors.

Their findings showed that women between 40–64 years old were the age group that was increasing the fastest for not getting enough exercise.

African American, Hispanic, and women with low-income levels and low education were more likely to not exercise enough.

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Physical activity affects healthcare costs

The study also revealed that women with cardiovascular disease who did not exercise saw an increase in their healthcare costs between 2006–2007 and 2014–2015.

Expenditure was around $12,700 in 2006–2007 and $14,800 in 2014–2015. In comparison, women with cardiovascular disease who did exercise enough spent about $8,800 in 2006–2007 and $10,500 in 2014–2015.

The researchers explained that the study was not focused on cause/effect, but it aimed at identifying 10-year trends in the levels of physical activity among U.S. women, considering variables such as age, race/ethnicity, and socioeconomic factors.

"Many high-risk women need encouragement to get more physically active in hopes of living healthier lives while reducing their health care costs," says Erin Michos, lead author of the study and associate professor of medicine at the Johns Hopkins University School of Medicine.

The researchers concluded that healthcare providers need to encourage vulnerable groups, such as older women, women with lower socioeconomic status, and those from minority groups to follow physical activity guidelines.

Also, they say there is a need for additional support for doctors to enable them to support their heart patients to do more heart-heathly exercise, and to share tips to make their activity tasks easier and more enjoyable.

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How much coffee is too much for the heart?

For many people, coffee is the magical brew that kickstarts the day, a much-needed pick-me-up in the afternoon, and sometimes even a well-appreciated digestive after dinner. However, how much coffee is too much? A large new study claims to hold the answer.
three hands golding cups of coffee
How much coffee might increase habitual drinkers' cardiovascular risk?

"What on earth could be more luxurious than a sofa, a book, and a cup of coffee?" So wrote the Victorian writer Anthony Trollope in his 1855 novel The Warden.

Whatever it is that draws people to coffee — be it its taste and aroma or effects as a stimulant — it is undeniable that this is one of the world's most popular beverages.

In the United States, coffee drinking has even been on the rise. Statistic reports indicate that, in the 2018/2019 fiscal year alone, people in the U.S. have consumed almost 26.5 million 60-kilogram bags of coffee.

According to the same reports, this is significantly more than they consumed during the previous fiscal year.

Other statistics show that for 2018, almost half of young adults (aged 18–24) reported drinking coffee, and approximately three-quarters of older adults reported the same.

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Many recent studies have suggested that drinking coffee can bring a number of benefits in addition to enhancing focus and productivity. In fact, researchers have argued that coffee can help maintain brain health, help increase a person's lifespan, and even slow down prostate cancer.

However, as with any food or beverage — even the most nutritious and healthful ones — there is a limit to how much coffee we can consume.

Not only can drinking too much coffee create ill effects in the short-term — some of the symptoms of overcaffeination are headaches, dizziness, and nausea — but consistently having too much of this drink could increase a person's risk of developing cardiovascular disease.

How much is "too much" for the heart? This is the question that scientists at the University of South Australia in Adelaide aimed to answer in their new study, the findings of which now appear in The American Journal of Clinical Nutrition.

The researchers build on previous studies indicating that people with a specific variant of the gene CYP1A2, which plays a key role in caffeine metabolism, metabolize this substance less efficiently. This can put them at an increased risk of developing high blood pressure (hypertension) and cardiovascular disease.

In the new study, the investigators wanted to determine how much coffee would increase the cardiovascular risk of people with and without this genetic variant.

To find out, they analyzed the data of 347,077 people aged 37–73, of whom 8,368 had diagnosed cardiovascular disease. The scientists accessed these data through the UK Biobank.

"An estimated 3 billion cups of coffee are enjoyed every day around the world," explains study co-author Prof. Elina Hyppönen. For this reason, she explains, "[k]nowing the limits of what's good for you and what's not is imperative."

"As with many things," she cautions, "it's all about moderation; overindulge and your health will pay for it."

In their analysis, the scientists looked at how much coffee the participants drank per day, whether or not they had the genetic variant that resulted in slow caffeine metabolism, and how likely they were to develop cardiovascular disease.

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They found that despite the fact that people without the specific CYP1A2 genetic variant were able to process caffeine four times faster than those with it, this did not appear to significantly affect their cardiovascular risk. However, the amount of coffee they consumed per day did.

In fact, all the people who frequently drank six or more cups of coffee per day — the scientists defined one cup as containing around 75 milligrams of caffeine — had a modest increase in cardiovascular disease risk.

"Most people would agree that if you drink a lot of coffee, you might feel jittery, irritable, or perhaps even [nauseous] — that's because caffeine helps your body work faster and harder, but it is also likely to suggest that you may have reached your limit for the time being," says Prof. Hyppönen.

"We also know that risk of cardiovascular disease increases with high blood pressure, a known consequence of excess caffeine consumption," she notes.

"In order to maintain a healthy heart and a healthy blood pressure, people must limit their coffees to fewer than six cups a day — based on our data six was the tipping point where caffeine started to negatively affect cardiovascular risk."

Prof. Elina Hyppönen

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Supplement for joint pain linked to lower heart disease risk

Glucosamine, a dietary supplement that people commonly take to ease joint pain and reduce symptoms of osteoarthritis, may lower the risk of cardiovascular problems, according to a study analyzing health data from over 400,000 participants.
small jar of white capsules
Does glucosamine, a popular dietary supplement, have a preventive effect against heart disease?

Information from the National Center for Complementary and Integrative Health shows that about 2.6% of adults in the United States — which equates to 6.5 million people — take glucosamine, chondroitin, or both. These two dietary supplements treat joint pain and strengthen cartilage, respectively.

This statistic makes glucosamine one of the most popular supplements among the U.S. adult population.

Now, researchers from Tulane University in New Orleans, LA, have carried out a large observational study and found that people who take glucosamine may also have a lower risk of cardiovascular disease and adverse health events relating to the heart or the vascular system, such as stroke.

The research team, which Prof. Lu Qi from Tulane led, accessed the U.K. Biobank study database to use available data from 466,039 participants. None of these participants had cardiovascular disease at baseline, and they all submitted information on their use of dietary supplements.

Among these participants, 19.3% — or about one in five — said that they took glucosamine when they joined the study.

The study's findings, which appear in the BMJ, suggest that taking glucosamine on a regular basis may help prevent cardiovascular problems. However, the current study is observational, and the authors warn that further trials should test whether there is a causal relationship behind this association.

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Prof. Qi and team looked at the participants' hospital records and, when necessary, their death records over an average follow-up period of 7 years. They noted whether each participant developed cardiovascular disease, experienced any cardiovascular problems — including coronary heart disease and stroke — or died due to cardiovascular disease.

The researchers found that people who had reported using this supplement had a 15% lower risk of experiencing a cardiovascular disease-related event compared with participants who did not take glucosamine. They also had a 9–22% lower risk of developing coronary heart disease, experiencing a stroke, and dying from cardiovascular-related causes.

These associations were independent of modifying factors, such as a person's age, biological sex, body mass index (BMI), lifestyle and diet, and medication and supplement use, for which the researchers accounted.

At the same time, Prof. Qi and colleagues also noted that these associations were stronger in current smokers, who saw a 37% lower risk of heart disease with glucosamine supplementation, than in former smokers and never-smokers, whose risk was 18% and 12% lower respectively.

The researchers hypothesize that if there is a causal explanation, it may lie in certain biological mechanisms that relate to inflammation. For instance, they note that there is an association between glucosamine use and lower levels of C-reactive protein in the body.

Researchers have linked this protein to heightened inflammation. Therefore, glucosamine may actually help reduce that inflammation, which is present at higher levels in smokers than in never-smokers and former smokers.

Another hypothesis is that taking glucosamine may have similar effects to following a diet low in carbohydrates, which studies have also tied to a lower risk of cardiovascular disease.

The study authors conclude their paper by saying:

"Habitual use of glucosamine supplement to relieve osteoarthritis pain might also be related to lower risks of [cardiovascular disease] events."

However, they also caution that, due to the observational nature of this study, "[f]urther clinical trials are needed to test this hypothesis."

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What to know about omega-3 fatty acids

Omega-3 fatty acids are present in foods and dietary supplements. They help keep the membranes that surround all cells in the body working well.

There are three types of omega-3 fatty acid:

alpha-linolenic acid (ALA) eicosapentaenoic acid (EPA) docosahexaenoic acid (DHA)

ALA is mostly present in plant oils, such as chia seeds, flaxseeds, and walnuts. DHA and EPA are mostly present in cold-water fatty fish, such as mackerel, salmon, herring, and sardines.

A person's body can convert small amounts of ALA into DHA and EPA. According to the Office of Dietary Supplements (ODS), most people in the United States get enough ALA in their diet. Experts have not yet established how much DHA and EPA a person needs.

Possible benefits chia seeds and a spoon which contain omega 3 fatty acids
Chia seeds are a good source of omega-3 fatty acid.

Beyond the basic maintenance of cells in a person's body, initial research has linked omega-3 fatty acids with various other health benefits.

However, a lot of the research that demonstrates these links is in the early stages or relies on experiments on animals.

In general, until scientists conduct further research, it is not clear to what extent omega-3 fatty acids benefit a person beyond the basic maintenance of their body's cells.

The ODS note that studies have found that people who eat fish, which is a key source of omega-3 fatty acids, typically have a lower risk of various long-term illnesses compared with those who do not eat fish.

However, it is not clear whether this is because of the omega-3s that the fish contain or something else. Furthermore, if it is because of the omega-3s that fish contain, it is not clear if a person taking omega-3 supplements will have the same benefits.

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May reduce inflammation

According to an article in the British Journal of Clinical Pharmacology, research has shown DHA and EPA to reduce the process of inflammation, which has links to various cardiovascular illnesses.

However, while these effects were evident in animal studies, clinical trials on humans were less conclusive.

People with rheumatoid arthritis appeared to benefit from taking fish-oil supplements, but there was no clear benefit for people with inflammatory bowel disease or asthma.

May reduce the chance of heart attack

According to the ODS, there is some evidence that taking omega-3 supplements may reduce the risk of a person having a heart attack. However, the ODS note that other studies did not find a link between omega-3 supplements and less chance of a person having cardiovascular issues in general.

A review article in the Journal of Physiology and Biochemistry states that this is a controversial area of research that is still up for debate.

According to the National Centre for Complementary and Integrative Health (NCCIH), researchers have shown omega-3s to help lower a person's triglyceride levels. Triglycerides are fats, and if a person has an excess of these, they are more at risk of cardiovascular diseases.

However, the NCCIH point out that medications that contain omega-3s among other ingredients have approval by the U.S. Food and Drug Administration (FDA) to treat high triglyceride levels, although the same does not apply to omega-3 supplements.

May help combat obesity

An article in The Journal of Nutritional Biochemistry states that research in humans is yet to show omega-3 supplements to help a person lose weight. They may be able to help a person stop putting weight back on, however, although it is not clear precisely how they may do this.

May contribute to infant health

The NCCIH highlight a study that shows that the children of mothers who took a high-dose fish oil supplement were less likely to develop asthma than the children of mothers who took a placebo. However, the NCCIH also note that other studies contradict this finding.

Risks man with headache or migraine holds head leaning against the vehicle window
Side effects of taking omega-3 supplements include nausea and headaches. According to the NCCIH, the side effects from omega-3 supplements are usually mild and might include: The ODS note that if a person is taking anticoagulants, which are drugs that stop their blood from clotting, then taking high doses of omega-3 supplements may lead to bleeding problems. Thank you for supporting Medical News Today Summary Omega-3 fatty acids are an important part of a person's nutrition and contribute to the basic health of all cells in the body. Most people get enough omega-3 fatty acids in their diet to achieve this. A key source of omega-3 fatty acids is fish. There is clear evidence that eating more fish can help reduce the chances of a person developing cardiovascular illnesses. However, there has yet to be conclusive evidence that taking omega-3 supplements has similar health benefits.
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