Wood Street Clinic Blog

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Cardiovascular disease: Dietary cholesterol may not raise risk

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

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

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

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

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

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

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

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

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

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

Dysarthria is a collective term for a group of speech disorders that occur as a result of muscle weakness. People with dysarthria have neurological damage that weakens the muscles necessary for speech.The neurological damage underlying dysarthria may occur as a result of a stroke, brain injury, or neurodegenerative disease.Dysarthria shares many of its symptoms with other types of neurological disorders, such as aphasia, dysphasia, and apraxia.Aphasia and dysphasia affect a person's ability to understand or produce language. These disorders result from damage to the language centers within the brain. Apraxia affects a person's ability to produce speech and results from damage to the part of the brain that plays a role in planning speech.Dysarthria is a distinct speech disorder that specifically involves muscle weakness.Read on to learn more about the causes, types, and symptoms of dysarthria, as well as the treatment options available.
a person with dysarthria trying to talk to another personShare on PinterestA person with dysarthria may find it easier to communicate in a quiet place.Dysarthria occurs when damage to the nervous system weakens the muscles that produce speech sounds. It may affect the muscles in one or more of the following areas:facelipstonguethroatupper respiratory tractThe neurological damage that causes dysarthria can occur due to:neurological conditions, such as epilepsy, amyotrophic lateral sclerosis (ALS), and Parkinson's diseasebrain tumorstrauma from injuries to the head or neck, as well as repeated blunt force impacts to the skullinflammatory conditions, such as autoimmune diseases, encephalitis, and meningitisvascular conditions, such as stroke or Moyamoya diseaseexposure to toxic substances, such as alcohol, heavy metals, or carbon monoxide
People can develop different types of dysarthria depending on the location of neurological damage. We outline the different types of dysarthria below.Spastic dysarthriaPeople with spastic dysarthria may have speech problems alongside generalized muscle weakness and abnormal reflexes.Spastic dysarthria occurs as a result of damage to the motor neurons in the central nervous system (CNS). The CNS includes the brain and spinal cord.Flaccid dysarthriaThe hallmark of flaccid dysarthria is difficulty pronouncing consonants. Damage to the peripheral nervous system (PNS) is responsible for this type of dysarthria. The PNS connects the brain and spinal cord to the rest of the body.Flaccid dysarthria can result from any of the following:Ataxic dysarthriaAtaxic dysarthria causes symptoms of slurred speech and poor coordination.This type of dysarthria can occur if a person sustains damage to the cerebellum. The cerebellum is the part of the brain responsible for receiving sensory information and regulating movement.Hypokinetic dysarthriaA malfunction in the brain's extrapyramidal system causes hypokinetic dysarthria. This system includes areas of the brain that coordinate subconscious muscle movements.People with this condition may experience the following symptoms:a quiet, breathy, or monotone voicedifficulty starting sentencesa stutter or slurred speechdifficulty pronouncing consonantsrigidity or reduced movement in the face and neckdifficulty swallowing, which can cause droolingtremors or muscle spasmsHyperkinetic dysarthriaHyperkinetic dysarthria occurs as a result of damage to parts of the brain that doctors refer to collectively as the basal ganglia. The basal ganglia play a role in various functions, including involuntary muscle movement.Symptoms of hyperkinetic dysarthria include:slurred or slow speechshaky voiceshortness of breath or fatigue while speakingmuscle spasms and tremorsinvoluntary jerking or flailing movementsabnormal muscle toneDamage to the basal ganglia can develop as a result of neurodegenerative diseases, such as Parkinson's and Huntington's.
According to the American Speech-Language-Hearing Association, dysarthria can affect one or more of the following five systems that speech involves:Respiration: Respiration moves air across the vocal cords, creating sounds that the mouth and nose shape into words.Phonation: This system uses airflow from the lungs plus vocal cord vibrations to produce speech sounds.Resonance: Resonance refers to the quality of speech sounds that the vocal tract produces.Articulation: This term means shaping sounds into recognizable words, which involves forming precise and accurate vowels and consonants.Prosody: The rhythm and intonation of speech that give words and phrases their meaning.The five speech systems work together, meaning that impairment in one system can affect the others.People who have dysarthria may experience one or more of the following symptoms:abnormally quiet or loud speaking voicemonotonous tonerough, scratchy, or hoarse voicestuffy or nasal-sounding voicevocal tremorsspeech that is too fast or too slowdistorted consonant and vowel soundsAs conditions that cause dysarthria also affect the nerves that control muscles, people with dysarthria may experience physical symptoms, such as:tremors or involuntary movements of the jaw, tongue, or lipoverly sensitive or undersensitive gag reflexmuscle wastingweaknessPeople who have difficulty speaking can make an appointment to see a speech-language pathologist (SLP). SLPs are healthcare professionals who specialize in diagnosing and treating speech and language conditions.As part of the diagnostic procedure, the SLP will review a person's medical history and ask about their current symptoms. They will also test a person's speech and language. They may ask a person to:stick out their tongueinhale and exhalemake different consonant and vowel soundsread a few sentences out loudcount out loudAn SLP or other healthcare professional may recommend one or more of the following tests to rule out other medical conditions:blood or urine testsimaging tests, including MRI or CT scansbrain function testselectromyography, which tests muscle functionbrain biopsyspinal tapThe treatment for dysarthria varies depending on its type, underlying cause, and symptoms.Some people develop dysarthria due to an underlying medical condition, such as an infection or exposure to a toxic substance. These individuals may notice improvements in their speech after they receive antibiotics or identify and eliminate the toxic compound.An SLP may recommend exercises and techniques to help a person overcome speech difficulties. These may include:exercises to strengthen the muscles in the mouth, jaw, and throatbreathing techniques to increase or decrease the volume of a person's voicetechniques to address specific speech problems, such as teaching people to pause when talking to slow down their speechPeople who have dysarthria may also improve their communication skills by practicing these techniques:maintaining eye contact with the listenerhaving conversations in a quiet environmentusing gestures and facial expressions to convey meaningusing different words to reiterate a messagecarrying a pen and notepad to communicate via written word, if necessaryThe following tips can be helpful for people who want to communicate with someone who has dysarthria:reducing external distractions and finding a quiet, calm place to have a conversationwatching the person as they speakasking for clarification when having trouble understanding somethingavoiding finishing the person's sentences or correcting errorsspeaking normally and clearlyDysarthria is a speech disorder that occurs due to weakness in the muscles necessary for speech production.People can develop dysarthria after a stroke, brain infection, or brain injury. Certain neurodegenerative diseases can also damage parts of the brain that control the muscles that speech involves.Although dysarthria can make communication more complicated, an SLP can teach people how to improve their speaking ability. An SLP can also recommend strategies to aid conversation between a person with dysarthria and their communication partners.
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What causes acid reflux and shortness of breath?

Acid reflux occurs when acid leaks from the stomach back up into the esophagus. An occasional bout of acid reflux is generally not a cause for concern. However, a frequent pattern of acid reflux may be a sign of gastroesophageal reflux disease, which is a chronic digestive issue that can cause medical complications.Sometimes, acid reflux occurs together with shortness of breath. In some cases, acid reflux causes shortness of breath.People who have gastroesophageal reflux disease (GERD) may be at increased risk of have asthma or other respiratory conditions.This article describes the link between acid reflux and shortness of breath, outlines some of the symptoms of acid reflux, and looks at the treatment options available.
Acid reflux occurs when acid leaks up from the stomach back up into the esophagus. When this happens, the acid can irritate the airways, causing them to swell. This can result in breathing difficulties.The link between GERD and asthmaa woman experience acid reflux and shortness of breathShare on PinterestAcid reflux and shortness of breath can often occur together.Researchers have also identified a link between GERD and asthma. A 2019 study suggested a bidirectional relationship between GERD and asthma. This means that people with GERD may be more likely to have asthma, and people with asthma may be more likely to experience GERD.In fact, a 2015 study estimates that up to 89% of people with asthma also experience GERD symptoms. The reason for this may be due to how acid interacts with the airways. Acid in the esophagus sends a warning signal to the brain, which triggers the airways to contract. This, in turn, triggers asthma symptoms.In cases of GERD-related asthma, treating the symptoms of GERD may help alleviate the symptoms of asthma.As a 2016 review notes, asthma may also trigger GERD. During an asthma attack, the airways tighten, causing pressure in the esophagus. This increased pressure could encourage acid to leak into the esophagus.Sometimes, it may be difficult to tell whether a person's symptoms are the result of asthma or GERD. For instance, a 2015 case study notes that typical GERD symptoms, such as burping and shortness of breath, may sometimes be signs of asthma. The authors of this study emphasize the importance of a thorough diagnosis in each case.
A person experiencing acid reflux or GERD will likely experience additional symptoms, such as:People with GERD-related asthma symptoms may also notice that their breathing difficulties flare up at certain times. Often, this occurs during sleep or after eating a large meal.
Untreated or unmanaged GERD can lead to numerous health complications. Some examples include:Tooth decayGERD symptoms may cause partially digested food and acid to leak back up into the mouth. The acid can come into contact with the teeth, increasing the risk of tooth decay.Esophageal ulcersSometimes, acid can wear through the lining of the esophagus, causing ulcers.Esophageal ulcers may cause the person to spit up blood or pass blood in their stool.Respiratory complicationsAccidental inhalation of stomach acid into the airways (called aspiration) can worsen respiratory conditions such as asthma or lead to pneumonia.Throat and voice problemsLong-term exposure to stomach acid may lead to a sore throat or changes in a person's voice.Esophageal inflammationAcid that backs up into the esophagus may cause inflammation of the esophagus. Doctors refer to this as "esophagitis."Esophagitis can be painful and may lead to scarring of the esophagus.StrictureOver time, chronic inflammation of the esophagus can lead to a build-up of scar tissue and narrowing of the esophagus called a "stricture."A person who has a stricture may experience pain or difficulty when swallowing.Barrett's esophagusPeople who experience persistent GERD are at increased risk of developing Barrett's esophagus. This is where the tissue in the esophagus begins to resemble tissue in the small intestine.Some people with Barrett's esophagus will go on to develop esophageal cancer.Esophageal cancerPeople who experience severe and persistent GERD are at increased risk of developing esophageal cancer.Treatment for esophageal cancer is much more effective If a person begins treatment in the earlier stages of the disease.Symptoms of esophageal cancer include:chest painchronic coughdifficulty swallowing (which may progress from difficulty swallowing solids to liquids)weight lossbleeding into the esophagusbone pain (if the cancer has spread to bones)hoarsenessLifestyle and dietary changes are typically the first line treatment for GERD symptoms, such as acid reflux and shortness of breath. If these treatment options are not effective, a doctor may prescribe medication to manage GERD symptoms.Lifestyle changesSome lifestyle changes that may alleviate GERD symptoms include:achieving and maintaining a healthy weightquitting smokingavoiding laying down within 3 or 4 hours of eating a full mealelevating the head slightly while sleeping, which may help to reduce night-time acid refluxsleeping in a comfortable position that keeps the body alignedavoiding tight clothing, belts, or accessories that put pressure on the abdomenDietary changesThe following dietary changes may also help to alleviate GERD symptoms:identifying and avoiding personal food triggers for GERD, such as citrus, or other acidic foodsreducing alcohol consumption or avoiding alcohol completelyeating smaller, more frequent meals, instead of large mealsavoiding eating near bedtimeMedical treatmentThe following drugs may help to suppress acid reflux and prevent complications from GERD:over-the-counter (OTC) or prescription-strength antacidsproton pump inhibitorsH2 receptor blockersA one-off or occasional bout of acid reflux and shortness of breath may not be cause for concern. If a person can keep the symptoms at bay using OTC medications, there is generally no need to see a doctor.However, anyone experiencing persistent acid reflux or GERD symptoms should see a doctor for a full diagnosis. A doctor may carry out diagnostic tests to determine the cause of GERD and to identify any possible complications. A doctor may also prescribe medication to help manage GERD symptoms.A one-off or occasional bout of acid reflux and shortness of breath is rarely cause for concern. However, anyone who frequently experiences this combination of symptoms may have gastroesophageal reflux disease (GERD) or asthma. They should see a doctor for a full diagnosis.People who experience GERD symptoms may benefit from certain lifestyle and dietary changes. Some people may require medication. Early treatment may help to prevent complications from GERD.
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Widowmaker heart attack: Everything you need to know

A widowmaker heart attack is a type of heart attack that occurs when a blood clot or plaque deposit completely blocks the left anterior descending (LAD) artery, which is one of the arteries around the heart.The medical term for a widowmaker heart attack is an anterior ST-segment elevation myocardial infarction (STEMI).Each year, about 805,000 people in the United States have a heart attack, which happens when a portion of the heart does not receive enough oxygen-rich blood.The severity of a heart attack varies depending on the underlying cause, the person's overall health status, and how quickly they receive treatment.In this article, learn more about a widowmaker heart attack, including what happens, the symptoms, and more.
a man experiencing a Widowmaker heart attackShare on PinterestChest pain or discomfort is a common symptom of a widowmaker heart attack.A widowmaker heart attack occurs when a blockage forms at the beginning of the LAD artery, completely restricting blood flow to a large portion of the heart, including the front part, which is the "workhorse" for the heart. A blockage in the LAD artery can substantially impair the heart's function.Within just a few seconds or minutes after the blockage forms, the heart muscle may become extremely weak, stop working, or have electrical instability that causes it to stop pumping. If the restoration of blood flow does not take place quickly, the heart muscle may die irreversibly.Most heart attacks occur as a result of coronary artery disease (CAD). People develop CAD when cholesterol-rich deposits called plaque accumulate in the coronary arteries, which supply the heart with oxygen-rich blood. The buildup of plaque inside the artery walls is called atherosclerosis.Widowmaker heart attacks have severe consequences. Even if a person receives treatment, the heart attack can cause irreversible tissue damage and scarring that can permanently affect the functioning of the heart muscle.
Anyone who thinks that they or another person may be having a heart attack should call 911 or head to the nearest emergency room immediately.Doctors can minimize damage to the heart and even stop a heart attack entirely if they administer treatment early on.At the emergency room, people may receive one or more of the following treatments:aspirin and blood thinner therapy to prevent further blood clottingoxygen therapynitroglycerin to improve blood flowthrombolytic medicines to dissolve blood clots in the coronary arteriesA doctor can treat a total LAD artery blockage with a procedure called a primary percutaneous coronary intervention (PCI). Doctors previously referred to this as an angioplasty with a stent.This procedure involves the following steps:A doctor inserts a catheter into the artery in the groin or wrist.The doctor guides the catheter through the artery until it reaches the LAD artery.They may suction the clot or inflate the balloon on the tip of the catheter, which helps open the artery. Sometimes, they may do both.Then, they insert a mesh tube called a stent into the artery. Once in place, the stent expands to hold the artery open so that oxygenated blood can flow to the heart.A doctor will closely monitor a person's recovery after a heart attack. Usually, the person will need to spend 2–3 days in the hospital, with the first 24 hours in the intensive care unit. Even after the PCI has opened up the artery, the heart is at risk of electrical complications for the first few days afterward.A doctor may recommend surgery if they find blockages in other arteries. Surgical procedures that can treat and prevent heart attacks include:A coronary artery bypass graft, which restores blood flow to the heart by rerouting the blood through a graft (a vein or artery vessel) so that it goes around the blockage.PCI or stent placement in the other blood vessels that supply blood to the heart, if doctors find a leaky or blocked valve.A valve replacement, which involves replacing a damaged or diseased heart valve with a healthy one. The replacement valve usually comprises cow or pig heart tissue or is a mechanical metal heart valve.
The authors of one 2018 study found that widowmaker heart attacks led to the highest increased risk of death, heart failure, and stroke in comparison with other types of heart attack.However, the likelihood that someone will survive a widowmaker heart attack depends on numerous factors, such as:how quickly they receive treatmentthe type of treatment that they receivethe extent of the damage to the heart musclethe person's overall health statusthe presence of other medical conditionsThe following risk factors can lower a person's chances of surviving a heart attack:
Medical advances have significantly increased heart attack survival rates. However, people who survive their first heart attack have a higher risk of having a second heart attack or a stroke compared with people who have never had a heart attack.In a 2015 retrospective study of 97,254 Swedish adults who survived a heart attack between 2006 and 2011, the researchers concluded that people who survive a heart attack have an 18.3% chance of experiencing another cardiovascular event within the first year.According to the Centers for Disease Control and Prevention (CDC), about 50% of people living in the U.S. have at least one of three major cardiovascular risk factors. These major risk factors are:high blood pressurehigh cholesterola history of smokingPeople can reduce their risk of having a heart attack by making healthful lifestyle choices and managing any underlying medical conditions that may contribute to a heart attack.People of all ages and those currently living with heart disease can help prevent heart attacks by:eating a diet rich in vegetables, fruits, whole grains, and lean proteinsavoiding artificial trans fats and added sugarslimiting alcohol consumptionavoiding or quitting smokingdoing at least 2.5 hours (150 minutes) of moderately intense physical activity per weekreducing stressmaintaining a moderate body weightPeople can also take medications that lower their blood pressure and cholesterol levels.However, it is important to speak with a doctor before starting any new medication, even over-the-counter drugs, such as aspirin. Newer studies have shown that low dose aspirin may not be beneficial except in people who have already had a prior heart attack or stroke or those who have specific risk factors, such as diabetes.A widowmaker heart attack occurs when a blood clot or cholesterol plaque completely blocks the LAD artery, which supplies oxygen-rich blood to the front of the heart.The total blockage of the LAD artery is a serious problem that requires immediate treatment. Delayed treatment for a heart attack can lead to significant tissue damage and scarring. It can be life threatening or lead to permanent disability.Not all heart attacks start with crushing chest pain or arm numbness. Some heart attacks come on slowly, causing only mild discomfort or no symptoms of chest discomfort at all. Some people may not even realize that they have had a heart attack.As the symptoms of a heart attack vary from person to person, it is vital to learn as much information about them as possible.People can start by asking their doctor about their heart health and how to reduce their risk of cardiovascular disease.
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FDA approve fish oil drug for cardiovascular disease

The Food and Drug Administration (FDA) have recently approved a drug derived from fish oil as an adjuvant therapy for people at risk of experiencing cardiovascular events.

blister pack of fish oil capsulesShare on PinterestThe FDA approve a new fish oil drug to help reduce cardiovascular risk.

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death among adults in the United States.

In fact, every 37 seconds, one person dies due to a cardiovascular event in the U.S.

For this reason, it is important to try to prevent poor cardiovascular outcomes in people at risk. Elevated triglyceride levels, which are a marker of blood lipids (fats), are one key risk factor to look out for.

Last week, the FDA issued a statement explaining that they had approved the use of a new drug as an adjuvant therapy to help prevent cradiovascular disease in adults with triglyceride levels of 150 milligrams per deciliter or higher, which count as elevated levels.The drug, Vascepa, comes in capsule form. Its main active ingredient is eicosapentaenoic acid. This is an omega-3 fatty acid extracted from fish oil.As per the FDA recommendations, doctors should only prescribe Vascepa to those with abnormally high triglyceride levels and as an additional therapy to the maximum tolerated dosage of statins. These are the drugs that people usually take to keep their cholesterol levels in check and minimize cardiovascular risk."The FDA [recognize that] there is a need for additional medical treatments for cardiovascular disease," says Dr. John Sharretts, the acting deputy director of the Division of Metabolism and Endocrinology Products in the FDA's Center for Drug Evaluation and Research."[This] approval will give [people] with elevated triglycerides and other important risk factors, including heart disease, stroke and diabetes, an adjunctive treatment option that can help decrease their risk of cardiovascular events."Dr. John SharrettsWhen triglyceride levels in the blood become too high, it can contribute to the thickening and stiffening of the artery walls. This increases a person's risk of experiencing a cardiovascular event, such as a stroke or heart attack.Vascepa can safely lower triglyceride levels, thus also helping reduce cardiovascular risk. However, the mechanisms through which the drug achieves this remain unclear.Nevertheless, a clinical trial involving 8,179 participants has demonstrated the drug's effectiveness and safety, ultimately leading to its approval by the FDA.The participants were all aged 45 or older with a history of various heart, vascular, or metabolic conditions. These included coronary artery disease, cerebrovascular disease, carotid artery disease, peripheral artery disease, or diabetes. They also had additional risk factors for cardiovascular disease.The trial showed that people who took Vascepa had a lower risk of experiencing a cardiovascular event than those who did not take the drug.According to its manufacturers, Vascepa can lower blood triglyceride levels by around 33%.The researchers who conducted the clinical trial did, however, note that the drug was sometimes associated with an increased risk of heart problems — specifically atrial fibrillation or atrial flutter — that called for hospitalization. However, this risk was more pronounced in people who already had a history of these two conditions.Another potential side effect is a higher risk of bleeding — though, again, this is more likely to occur in people already taking other drugs associated with a higher risk of bleeding events, such as aspirin, clopidogrel, or warfarin.The makers of Vascepa advise that people who receive a prescription for the drug take two 1-gram capsules or four 0.5-gram capsules twice per day with food.However, they warn that people with known allergies to fish or shellfish may experience allergic reactions to this drug, and that they should only take it as advised by their doctor and discontinue the treatment if they do experience any symptoms of an allergic reaction.
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Could hot chili peppers reduce mortality risk?

According to a recent study, people who regularly consume chili peppers have a reduced mortality risk compared with those who never eat chilis.

Selection of chili peppersShare on PinterestA new study concludes that chilis might reduce mortality risk.

Chili peppers are now a global phenomenon. From Cambodia to California, and from Birmingham, Alabama to Birmingham, United Kingdom, spicy food is ubiquitous.

Throughout history, cultures have associated various health benefits with eating chili peppers. However, as one of the authors of the recent study, Prof. Licia Iacoviello, explains, many of these beneficial properties have been ascribed "mostly on the basis of anecdotes or traditions, if not magic."

In more recent times, scientists have focused on capsaicin, the compound that gives chili their unmistakable punch. According to the authors of the latest study, capsaicin "has been observed to favorably improve cardiovascular function and metabolic regulation in experimental and population studies."

Other researchers have concluded that capsaicin might be useful in the fight against neuropathic pain, arthritis, gastrointestinal disorders, and even cancer.

Chilis on a population level

Although interest is mounting, only a few studies have investigated the impact of regularly eating chilis on overall health and mortality.

The authors, from the Mediterranean Neurological Institute in Italy, mention two population studies designed to answer this question. One took place in China, and the other in the United States. Both reported lower mortality risk in the individuals who consumed the most chili peppers.

In this recent study, the authors set out to confirm or deny these earlier findings in a European population. Also, by analyzing cardiovascular disease biomarkers, such as lipid levels in the blood, they hoped to identify how chili peppers might reduce mortality risk.To investigate, they took data from the Molisani study; this data set includes 24,325 men and women living in Molise, Italy. After excluding individuals with missing data, 22,811 people took part.They published their findings in the Journal of the American College of Cardiology.All participants were over 35 years of age, and researchers followed them for an average of 8.2 years. During this time, the researchers captured information about the 1,236 participants who died during the study.The scientists also had access to information about other factors that can influence health outcomes, including medical history, leisure-time physical activity, smoking status, alcohol intake, and socioeconomic data.Each participant completed a questionnaire about their dietary habits during the year before enrollment in the study, including questions about chili peppers.In total, 24.3% of the participants consumed chili peppers four or more times each week, and 33.7% consumed chili peppers either rarely or never. The authors summarize their findings:"In a model adjusted only for age, sex, and energy intake, regular consumption [4 or more times each week] of chili pepper was associated with 23% lower risk of all-cause mortality, as opposed to none/rare intake, and results remained substantially unchanged in the fully adjusted model."Chilis and cardiovascular healthWhen considering heart disease, the authors found that regular consumers of chili peppers had a 34% lower risk of cardiovascular mortality than those who rarely consumed chili peppers.The beneficial effect was most pronounced in cerebrovascular-related deaths and ischemic heart disease.When they investigated cancer mortality, they found that although chili peppers were associated with a drop in risk, it did not reach statistical significance.The authors analyzed deaths caused by anything other than cancer and cardiovascular disease. Here, too, chili peppers seemed to provide a benefit. The authors write that "regular intakes were associated with [a] lower risk of other causes of mortality."Interestingly, when the scientists controlled for diet quality, it did not influence the findings."[P]rotection from mortality risk was independent of the type of diet people followed. In other words, someone can follow the healthy Mediterranean diet; someone else can eat less healthily, but, for all of them, chili pepper has a protective effect."First author Dr. Marialaura BonaccioMore surprisesCompared with those who ate the least chilis, those who ate the most were more likely to be male, more highly educated, and older.Surprisingly, given the conclusions of the study, those who ate the most chilis were also more likely to have diabetes and hypertension, higher levels of blood lipids, and a higher BMI, compared with those who rarely ate chilis.Because these are risk factors for cardiovascular disease, the authors believe that this suggests the mechanism by which chilis reduce mortality risk is independent of classic cardiovascular risk factors.How chili peppers might benefit health is still up for debate, though. Some scientists have theorized that, because capsaicin might aid weight loss, this could explain the benefits. However, in this study population, the group that consumed the most chilis had a higher average BMI.Limitations and the futureAlthough the study echoes the findings of two extensive studies carried out in the U.S. and China and involved a large pool of participants, the authors do recognize some limitations. First and foremost, this was an observational study, meaning that it is difficult to tease apart cause and effect. In these studies, it is always possible that other factors that researchers did not measure influenced the results.They also note that although the overall number of participants was high, the number of deaths in each category was relatively low. As an example, there were only 173 cancer-related deaths in the group that rarely ate chilis.Also, dietary information was only collected once at the beginning of the trial. People's diets change over time; this is an issue that plagues research into health and nutrition.In this study, the top category of chili consumption included those who ate hot chilis four or more times each week. In follow up work, it would be interesting to see if the effect differed in individuals who ate chilis once or twice each day.Overall, the authors conclude that "[r]egular consumption of chili peppers is associated with [a] lower risk of total and [cardiovascular disease] mortality." The evidence that chilis might benefit health is mounting; the next step will be to understand how.
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How fish oil might reduce inflammation

Recent research has revealed a mechanism through which fish oil, which contains omega-3 fatty acids, might reduce inflammation. A study that tested an enriched fish oil supplement found that it increased blood levels of certain anti-inflammatory molecules.

close up of hand holding fish oil supplementsShare on PinterestA new study sheds light on the inflammation-reducing properties of fish oil supplements.

The anti-inflammatory molecules are called specialized pro-resolving mediators (SPMs), and they have a powerful effect on white blood cells, as well as controlling blood vessel inflammation.

Scientists already knew that the body makes SPMs by breaking down essential fatty acids, including some omega-3 fatty acids. However, the relationship between supplement intake and circulating levels of SPMs remained unclear.

So, a team of researchers from the William Harvey Research Institute at Queen Mary University of London in the United Kingdom set out to clarify the relationship by testing the effect of an enriched fish oil supplement in 22 healthy volunteers whose ages ranged from 19 to 37 years.

The team conducted the Circulation Research study as a double-blind, placebo-controlled trial. Therefore, neither the participants nor those who gave them the doses and monitored them knew who received fish oil supplements and who received the placebo.

"We used the molecules as our biomarkers to show how omega-3 fatty acids are used by our body and to determine if the production of these molecules has a beneficial effect on white blood cells," says senior study author Jesmond Dalli, who is a professor of molecular pharmacology at the William Harvey Institute.

Enriched fish oil increased blood markersThe trial tested three doses of enriched fish oil supplement against the placebo. The researchers took samples of the participants' blood to test.Each participant gave five samples over 24 hours — at baseline and then 2, 4, 6, and 24 hours after taking their dose of supplement or placebo.The researchers found that taking the enriched fish oil supplement raised blood levels of SPMs. The results showed a "time and dose-dependent" increase in circulating blood levels of SPMs.The tests also revealed that supplementation led to a dose-dependent increase in immune cell attacks against bacteria and a decrease in cell activity that promotes blood clotting.Inflammation is a defense response by the immune system that is essential to health. Various factors can trigger the response, including damaged cells, toxins, and pathogens such as bacteria.Some of the immune cells that are active during inflammation can also damage tissue, so it is important, once the threat is over, for inflammation to subside to allow healing. Putting a stop to inflammation is where anti-inflammatory agents, such as SPMs, have a role.However, if inflammation persists and becomes chronic, then, instead of protecting health, it undermines it. Studies have linked inflammation to heart disease, rheumatoid arthritis, and other serious health conditions.Although it remains unclear whether those molecules reduce cardiovascular disease, a press release on the study notes that they do "supercharge macrophages, specialized cells that destroy bacteria and eliminate dead cells," as well as making "platelets less sticky, potentially reducing the formation of blood clots."Research has also shown the molecules to play a role in tissue regeneration. As Prof. Dalli notes, "These molecules have multiple targets."Beware of unregulated supplementsAn earlier 2019 study in NEJM showed that a prescription formula containing eicosapentaenoic acid (EPA) could reduce heart attacks and strokes — and deaths relating to these events — in people who are at high risk of cardiovascular disease or already have it. EPA is an omega-3 fatty acid that is present in fish oil.However, Dr. Deepak L. Bhatt, who is a cardiologist at Brigham and Women's Hospital and professor of medicine at Harvard Medical School, both in Boston, MA, and who led that study, says that there is no reliable evidence that over-the-counter supplements can have the same effect.In the United States, federal regulators have approved two formulations: one containing EPA and a second that combines EPA with another omega-3 fatty acid called docosahexaenoic acid (DHA).The American Heart Association (AHA) recently issued a scientific advisory that cautions consumers to avoid unregulated omega-3 supplements.An earlier AHA advisory had stated that while such supplements may slightly lessen the risk of death following a heart attack or heart failure, there is no evidence that they prevent heart disease in the first place.Prof. Dalli says that there is a need for further studies to establish whether people over the age of 45 years would experience the same results from enriched fish oil supplements that they saw in the younger volunteers.Compared with healthy people, those living with chronic inflammation have lower levels of SPMs, he remarks, noting that the enzymes that produce them do not work as well in these individuals.He suggests that this is the kind of information that developers will need to consider when formulating supplements for treating disease. It will also be important to check that the body is breaking down the supplements into protective molecules."We're still far away from having the magic formula. Each person will need a specific formulation or at least a specific dosing, and that's something we need to learn more about."Prof. Jesmond Dalli
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Stroke: Excessive sleep may raise risk by 85%

Stroke is one of the leading causes of death and disability worldwide and in the United States, specifically. New research finds that excessive sleep considerably raises the risk of this cardiovascular problem.

person sleepingShare on PinterestNew research suggests that people who take long naps in the day may be at a higher risk of stroke.

Globally, 15 million people experience a stroke each year. Almost 6 million of these people die as a result, and 5 million go on to live with a disability.

In the U.S., over 795,000 people have a stroke each year.

The list of traditional risk factors for stroke is long, ranging from elements of lifestyle, including smoking, to preexisting conditions, such as diabetes.

More recently, researchers have started exploring sleep duration as another potential risk factor. Some studies have found that either too much or too little sleep can increase the risk of cardiovascular events, including stroke.

According to these findings, regular sleep deprivation and sleep for more than 7 hours per night are each associated with a higher risk of stroke.

Now, a study appearing in the journal Neurology finds an association between daytime naps, excessive sleep, and stroke risk.Dr. Xiaomin Zhang, from Huazhong University of Science and Technology, in Wuhan, China, is the corresponding author of the paper that details this study.85% higher risk in long sleepers, nappersDr. Zhang and the team collected information from 31,750 people in China. None of the participants — who were 62 years old, on average — had a history of stroke or any other serious health condition at the start of the study.The participants answered questions about their sleeping patterns and napping habits, and the researchers clinically followed the group for an average of 6 years.The team found that 8% of the participants were in the habit of taking naps that lasted longer than 90 minutes, and 24% reported sleeping for at least 9 hours each night.Over the study period, there were 1,557 strokes among the participants. Those who slept for 9 or more hours per night were 23% more likely to experience a stroke than those who regularly slept only 7–8 hours each night.People who got less than 7 hours of shuteye or 8–9 hours had no higher risk of stroke than those who slept 7–8 hours.Importantly, people who both slept for longer than 9 hours and napped for more than 90 minutes per day had an 85% higher risk of stroke than those who slept and napped moderately.Finally, sleep quality seemed to play a role — people who reported poor sleep quality were 29% more likely to have a stroke than those whose sleep quality was reportedly good.These results continued to be significant after adjusting for potential confounders, such as hypertension, diabetes, and smoking."These results highlight the importance of moderate napping and sleeping duration and maintaining good sleep quality, especially in middle-age and older adults." Dr. Xiaomin ZhangStudy limitations and potential mechanismsThe researchers acknowledge some limitations to their work, as well as the fact that more research is necessary.First, because the study was observational, it cannot prove causality. Second, the research did not account for sleep apnea or other sleep disorders that may have influenced the results.Third, self-reported data is not as reliable as data recorded by researchers who observe participants' sleep.Finally, the results may only apply to older, healthy Chinese adults and not to other populations."More research is needed to understand how taking long naps and sleeping longer hours at night may be tied to an increased risk of stroke, but previous studies have shown that long nappers and sleepers have unfavorable changes in their cholesterol levels and increased waist circumferences, both of which are risk factors for stroke," explains Dr. Zhang."In addition, long napping and sleeping may suggest an overall inactive lifestyle, which is also related to increased risk of stroke."
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Excessive blood fat could cause organ damage

In a new study, researchers have found the mechanisms through which high levels of blood lipids could lead to inflammation and, over time, more serious consequences, such as organ damage.

blood samplesShare on PinterestNew research shows how high blood fat levels can induce inflammation.

Inflammation is both caused by and a risk factor for many conditions. These include obesity, diabetes, and cardiovascular problems.

One of the greatest reasons for inflammation is infection. When the body senses that dangerous foreign microorganisms, such as bacteria, have entered it, it unleashes an immune response. Inflammation is a key part of that response.

This turn of events is natural and usually helps maintain a state of health. Sometimes, however, inflammation occurs for reasons other than infection, and it may persist abnormally, leading to different types of damage.

In a new study, the results of which feature in the journal Nature Immunology, Dr. Timo Speer and colleagues — from Saarland University in Saarbrücken, Germany — closed in on a factor that they say causes unhealthful inflammation: high triglyceride levels, which are a measure of blood fat.The study uncovered the mechanisms through which high blood fat can lead to inflammation — which, in turn, can affect other biological processes, potentially leading to organ and blood vessel damage.The researchers conducted their study first in vitro, and then in mouse models, before studying the relevant mechanisms in human participants. They focused their research on a key inflammasome complex: nod-like receptor family pyrin domain-containing 3 (NLRP3).This is a protein complex that plays a crucial role in activating the body's immune response. Dr. Speer and team wanted to find out what could mistakenly set NLRP3 into motion.Their preliminary efforts revealed that abnormally high lipid levels — and, specifically, high levels of triglycerides — were responsible for harmful inflammation.How? The researchers found that apolipoprotein C3 — a protein the liver secretes that is also present on triglyceride-rich lipoproteins — activates NLRP3, thereby triggering inflammation.In mouse models, high apolipoprotein C3 concentrations led to organ damage, the researchers saw.Working with human participants — some with chronic kidney disease and some with a history of heart attack — the researchers found that higher apolipoprotein C3 may contribute to kidney damage as well as vascular problems.High apolipoprotein C3 levels were also associated with an increased risk of mortality from all causes."Our work has involved studying a special group of lipids, the triglycerides. We've been able to show that when these naturally occurring fats are present at elevated concentrations they can alter our defence cells in such a way that the body reacts as if responding to a bacterial infection," explains Dr. Speer."This leads to inflammation, which, if it becomes chronic, can damage the kidneys or cause atherosclerosis — the narrowing of arteries due to a buildup of deposits on the inner arterial wall. And atherosclerosis is one of the main causes of heart attacks and strokes."Dr. Timo SpeerThese findings, the researchers argue, suggest that by targeting excessive apolipoprotein C3, specialists may eventually be able to fight unhealthful inflammation.It will also be important, they say, to focus on the ways in which diet can affect levels of blood fats. "Put another way, we can now say that adopting a low fat diet can significantly extend the life expectancy of high risk patients, such as those with diabetes or those whose blood pressure is too high," notes Dr. Speer.This is because blood triglyceride levels tend to increase in people with high fat diets."As a result of biochemical changes, the triglycerides develop toxic properties that activate the body's innate immune system. This initiates a series of self-destructive processes, including those in which the walls of the arteries are attacked and the blood vessels become occluded, reducing blood flow," Dr. Speer adds.Nevertheless, he concludes that he and his colleagues "hope that [their] results will help in developing new strategies for treating and preventing these life threatening diseases."
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Can mammograms show who is at risk of heart failure?

Mammograms have, so far, had the single role of identifying potentially cancerous tumors in the breast. However, could they also help doctors identify women at risk of heart disease and heart failure?

woman undergoing a mammogramShare on PinterestSome researchers believe that mammograms could also help doctors identify women with a high risk of heart failure.

Mammograms work by using low energy X-rays to "scan" breast tissue for irregularities and abnormalities that may be signs of cancer. They are the first port of call when it comes to diagnosing breast cancer in its early stages.

In 2016, the United States Preventive Services Task Force recommended that women aged 50–74 years — the age range in which women's risk of breast cancer increases — should undergo breast cancer screening once every 2 years.

Mammograms do not only detect potential cancerous tumors, though. As it turns out, they also show the formation of breast arterial calcifications, which are calcium buildups inside the arteries in the breast.

This, at least, is the finding of recent research by Dr. Quan Minh Bui and colleagues from the University of California, San Diego. Dr. Bui and team presented their findings at this year's American Heart Association's Scientific Sessions, which took place in Philadelphia, PA, last month.

Killing two birds with one stone?Breast arterial calcification is often associated with coronary artery calcium — a dangerous buildup of calcium sediment in the arteries that transport oxygenated blood to the heart — particularly in women.Coronary artery calcium is, in itself, a strong predictor of cardiovascular disease, and doctors will use computed tomography (CT) scans to screen for these buildups in people whom they believe to be at risk.Dr. Bui and colleagues argue that breast arterial calcification can help identify women who may be at risk of cardiovascular problems, including heart attack, stroke, and heart failure, in which the heart is unable to pump blood effectively.In particular, the investigators argue that mammograms — which women over a certain age will often undertake as a regular screening procedure anyway — could help doctors detect not just cancer but also the risk of heart disease. They explain that these tests could do this by highlighting the presence of calcium buildups in breast arteries."Mammography has the potential to alter the course of two leading causes of death in women: breast cancer and heart disease."Dr. Quan Minh Bui"We believe that there is truth to the sentiment that 'a picture is worth a thousand words,' and that seeing calcifications in the breast arteries may empower patients to participate in their medical care," he adds.Looking at the evidenceIn their study, the investigators analyzed data from the medical records of 278 female participants with a mean age of about 61 years. These records covered the period of 2006–2016.All of these participants had undergone both a mammogram and a coronary CT scan within the same year.The researchers observed that as many as 90 participants (32%) had breast arterial calcification, while 19 of them (7%) had heart failure.After they adjusted their analysis for confounding factors — including age, diabetes, high blood pressure, and risk factors for heart failure — the investigators found that female participants with breast arterial calcification had 2.2 times the likelihood of either having or developing heart failure, compared with those without calcium buildups.Heart failure in women is challenging for doctors to diagnose and treat because it has slightly different causes than heart failure in men, and it develops in different ways.Women typically develop heart failure later in life than men, and they also tend to experience more clinical symptoms. Compared with men, women with heart failure have stiffer heart muscles but maintain a normal blood pumping ability."That's why preventing heart failure from developing in the first place is so important, by identifying at-risk individuals and applying appropriate lifestyle and pharmacology strategies," explains Dr. Erin Michos, director of women's cardiovascular health at Johns Hopkins School of Medicine in Baltimore, MD, who did not contribute to the current study.If mammograms could reveal the presence of markers of heart failure risks, this may help doctors address this issue earlier on. However, Dr. Michos cautions, it remains unclear what course of action doctors should take in this case.At present, Dr. Bui and colleagues are taking their recent research further by analyzing an additional set of mammograms from female participants who have also received a diagnosis of cardiovascular conditions relating to calcium buildup in the arteries.In the meantime, the researchers advise healthcare professionals to start including more information about heart health risks in reports for women whose mammograms reveal arterial calcium buildup."Incidental calcification is reported on other diagnostic studies, such as CT scans, and we envision [breast arterial calcification] not being any different. We suggest that reports include a statement in fine print noting an association of [breast arterial calcification] with cardiovascular disease," says Dr. Bui.
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Chest pain in women: What causes it, and how do doctors diagnose it?

Chest pain or discomfort is a common symptom of a heart attack in both men and women. Anyone who experiences chest pain or discomfort that lasts for several minutes or recurs should seek emergency medical help.In some cases, pain or discomfort may be due to other causes, such as heartburn, reflux, a lung-related issue, or another problem affecting the heart. Although some possible causes of chest pain are less serious, a woman should seek help immediately as this symptom may indicate a medical emergency.In this article, we provide more information on the typical female signs and symptoms of a heart attack and discuss other possible causes of chest pain.
one of many women who experience pain in the chestShare on PinterestA person should seek immediate medical attention if they experience symptoms of a heart attack.According to the Centers for Disease Control And Prevention (CDC), 1 in 4 male deaths and 1 in 5 female deaths are due to heart disease. Heart disease refers to several conditions that affect this organ, including heart attack.Men and women tend to show different signs of a heart attack.Women are less likely than males to feel an overwhelming amount of pressure in their chest. Instead, they are more likely to experience dizziness, fatigue, or nausea. They may also have pain in both arms, rather than just the left arm.Any woman who experiences any of these symptoms should call 911 or seek emergency medical care immediately.According to the American Heart Association (AHA), the typical symptoms of heart attacks in women include:chest pain or discomfortshortness of breathcold sweat, lightheadedness, or nauseadiscomfort, numbness, or pain in one or both arms, the neck, stomach, jaw, or backa squeezing sensation, pain, uncomfortable pressure, or fullness in the center of the chestThe sensations affecting the chest tend to last for more than a few minutes or stop before starting again.
There are several other possible causes of chest pain in women.Although many causes are not as severe as a heart attack, they may still require medical attention.Heart-related conditionsSome heart-related conditions that may cause chest pain include:myocarditis, which is inflammation of the heart muscleangina, which is pain resulting from the heart not getting enough bloodcardiomyopathy, which is a disease of the heart musclepericarditis, which is inflammation of the sac around the heartaortic dissection, which is a rare condition in which there is a tear in the aortaGastrointestinal complicationsIn some cases, chest pain may be due to gastrointestinal complications and conditions. These may include:heartburn or gastroesophageal reflux disease (GERD)inflamed gallbladder or pancreasgallstonesLung-related conditionsOther possible causes of chest pain have an association with the lungs and can include:Bone or muscle problemsIn other cases, a woman may experience chest pain due to issues with the bones or muscles.A broken or bruised rib can cause pain and swelling, while chronic pain syndrome and the overexertion of muscles can both cause pain in the chest.A compression fracture may put pressure on a nerve, causing pain.
Anyone with unexplained chest pain should see a doctor, who can run tests to determine the underlying cause and suggest appropriate treatments.Typically, a doctor will ask several questions about the person's individual and family medical history. They will also ask about other symptoms and the medications that a person is taking.Knowing this information can help the doctor rule out some possible causes.In addition, the doctor may run one or more tests to determine the cause of the pain. These tests might include:A chest X-ray: An X-ray allows the doctor to look at the heart, lungs, and blood vessels.Blood tests: These tests measure enzyme levels in the blood.An MRI: This scan can reveal any damage to the heart or aorta.An angiogram: Doctors use this exam to check for blockages in specific arteries.An electrocardiogram (EKG): This test records the heart's electrical activity.Stress tests: Doctors use these to measure heart function after exertion.An echocardiogram: An echocardiogram uses sound waves to record moving images of the heart.A doctor may prescribe one of several treatment options, depending on their diagnosis and the results of the tests. The underlying cause of the pain will often determine the urgency and extent of the treatment.If the chest pain is due to issues with the heart, the doctor may suggest one or more of the following treatments:cardiac catheterization, which is a procedure to open blocked arteriesmedications that open closed arteries, break down clots, or thin the bloodsurgery to repair arteriesIn cases where the cause of the chest pain does not relate to the heart, a doctor may recommend one or more of the following treatments:antacids or acid reducers to help prevent reflux and heartburnreinflation of a collapsed lunganxiety medicationWomen should take sudden or unexplained chest pain seriously, particularly if they experience any other symptoms of a heart attack.It is beneficial to talk to a doctor about any chest pain because treatment can usually help alleviate the pain and heal the underlying condition.
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Brushing your teeth may keep your heart healthy

New research finds that brushing the teeth three or more times a day significantly reduces the risk of atrial fibrillation and heart failure.

man putting toothpaste on a tooth brushShare on PinterestBrushing your teeth three times or more a day may significantly protect the heart.

The bacteria in our mouths may hold the key to many facets of our health.

Researchers have found intriguing clues about pancreatic and esophageal cancer risk in mouth bacteria, and some studies have linked poor oral hygiene with respiratory problems.

Mounting evidence is also strengthening the link between oral health and cardiovascular health.

For instance, some studies have found oral bacteria in the blood clots of people receiving emergency treatment for stroke, and experts have linked severe gum disease with a significantly higher risk of hypertension.

Conversely, destroying "friendly" oral bacteria that help maintain a healthy and balanced oral microbiome could disrupt blood pressure levels and also lead to hypertension.

Maintaining good oral health, therefore, seems to be key to cardiovascular health.

Now, a new study that appears in the European Journal of Preventive Cardiology suggests that regular toothbrushing may keep heart failure and atrial fibrillation (A-fib) — a type of arrhythmia — at bay.Dr. Tae-Jin Song of Ewha Womans University in Seoul, Korea, is the senior author of the new study.In their paper, Dr. Song and team explain that the motivation for the study hinges on the mediating role of inflammation. They write, "Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure."Studying A-fib, heart failure, and oral hygieneIn their study, Dr. Song and team examined atrial fibrillation's associations with both heart failure and poor oral hygiene. They used data from 161,286 people who were part of the Korean National Health Insurance System-Health Screening Cohort.A-fib is a condition affecting at least 2.7 million people in the United States. In people with A-fib, the heart cannot efficiently pump blood to the rest of the body because it does not beat regularly.The heart also does not pump blood as it should in people with heart failure. This inefficiency results in fatigue and, sometimes, breathing difficulties, as insufficient oxygen reaches the other organs in the body.The participants of the current study were 40–79 years old and had no history of either A-fib or heart failure. During enrollment, which took place between 2003 and 2004, the team measured the height and weight of each of the participants and asked them questions about their lifestyle, oral health, and oral hygiene habits.The participants also underwent some laboratory tests, which included blood tests, urine tests, and blood pressure readings.Brushing lowers heart failure risk by 12%Over a median follow-up period of 10.5 years, 4,911 participants received a diagnosis of A-fib, and 7,971 developed heart failure.Brushing the teeth three times or more a day was linked with a 10% lower chance of developing A-fib and a 12% lower risk of heart failure. Confounding factors — including age, sex, socioeconomic status, physical activity, alcohol intake, body mass index, and other coexisting conditions, such as hypertension — did not influence these results, as the researchers accounted for them in their analysis.The authors conclude:"Improved oral hygiene care was associated with decreased risk of atrial fibrillation and heart failure. Healthier oral hygiene by frequent toothbrushing and professional dental cleanings may reduce risk of atrial fibrillation and heart failure."However, they also note that, as with any observational study, the research is limited and cannot explain causation. The study is also limited because it only looked at people living in one country, so the results may not be generalizable.Nonetheless, notes the study's senior author, "We studied a large group over a long period, which adds strength to our findings."Study strengths and limitationsIn an accompanying editorial, authors Pascal Meyre, from the Cardiovascular Research Institute at the Basel University Hospital in Switzerland, and David Conen, from the Population Health Research Institute, McMaster University, Canada, offer a critical look at the findings.They agree that the strengths of the study "are the large sample size, with over 160,000 individuals included in the study, the large number of outcome events, and the long follow-up duration.""This allowed the investigators to carry out meaningful analyses and adjust the multivariable models for many covariates, such that some of the confounding could be controlled," they add. However, the retrospective design of the study "may have introduced selection bias," say the authors of the editorial. Furthermore, the participants' "level of education, marital status, and information on inflammatory biomarkers, such as C-reactive protein, were not available."The information on toothbrushing and oral hygiene habits was self-reported, which might subject it to recall bias, write Meyre and Conen."The causality of these associations is unclear, and it is certainly too early to recommend toothbrushing for the prevention of [A-fib] and [congestive heart failure]," they conclude:"While the role of inflammation in the occurrence of cardiovascular disease is becoming more and more evident, intervention studies are needed to define strategies of public health importance."
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Understanding blood pressure readings

Blood pressure is the force of a person's blood pushing against their artery walls. A person's blood pressure can become too low or too high. When it becomes too high, it can lead to potential health complications.Often, people do not experience symptoms of high blood pressure, or hypertension. This means that it is important for people to get their blood pressure checked regularly, particularly if they are older or have a history of heart complications.High blood pressure can also lead to other complications, such as:This article explains everything that a person needs to know about blood pressure readings and what they mean.
a man using a blood pressure device at home that has a screen attached to explain the readings.Share on PinterestA person may experience health complications if their blood pressure is too high.A blood pressure measurement involves two numbers that indicate the amount of pressure the blood is exerting against the arteries' walls.Systolic: This is the first number. This indicates the amount of pressure that the blood exerts against the artery walls as the heart contracts.Diastolic: This is the second number. This shows the amount of pressure that the blood exerts against the artery walls as the heart relaxes.Both numbers are equally significant because they provide insight into a person's heart health. However, doctors and healthcare professionals often give systolic blood pressure more attention as they consider it a major risk factor for cardiovascular disease in some people.
Blood pressure refers to the force of blood against the artery walls, whereas a person's pulse indicates the number of times the heart beats per minute.A resting heart rate is when a person is sitting, lying down, or not engaged in an activity.An active heart rate is when a person is exercising or engaged in physical activity.Everyone has a slightly different resting heart rate, but the average rate is between 60 and 100 beats per minute. A physically active person may have a heart rate as low as 40 beats per minute.Similarly to blood pressure, a person's heart rate or pulse indicates how healthy the heart is.
According to the American Heart Association (AHA), a normal blood pressure range is lower than 120/80 millimeters of mercury (mm Hg). When a person's blood pressure is higher than the normal range, they may have elevated blood pressure or hypertension.A person's blood pressure can also drop too low. A lower than normal blood pressure can also lead to health issues.If it drops too low, a person may feel faint, lightheaded, or dizzy. If a person has consistently low readings, they should talk to their doctor.a blood pressure chart infographic
There are five categories of blood pressure:Normal rangeAccording to the AHA, a normal blood pressure reading is no more than 120/80 mm Hg. Consistently higher numbers may mean a person has elevated blood pressure or hypertension.Elevated rangeAn elevated blood pressure range occurs when a person has a systolic reading of between 120–129 and a diastolic reading below 80.A person with elevated blood pressure is more likely to develop hypertension unless they take steps to lower it.Hypertension: Stage 1A person who has stage 1 hypertension consistently has blood pressure readings of between 130–139 systolic and 80–89 diastolic.A doctor will likely advise a person to make lifestyle changes and may also prescribe blood pressure medication to reduce the risk of having a heart attack or stroke.Hypertension: Stage 2A person who has stage 2 hypertension consistently has blood pressure readings that are around 140/90 mm Hg or higher.A person will likely need to take blood pressure medication and make lifestyle changes to help lower their blood pressure.Hypertensive crisisA hypertensive crisis occurs if a person suddenly has a blood pressure reading of 180/120 mm Hg. If this occurs, a person should wait for 5 minutes and remeasure their blood pressure. If the readings are still high, seek medical help from the doctor.A person may be experiencing organ damage if the readings are high, and they develop these symptoms:shortness of breathnumbness or weaknesschange in visionchest painback paindifficulty speakingIf a person experiences these symptoms, they should call 911 immediately.If someone is experiencing a hypertensive crisis, along with signs of organ failure, they should seek emergency medical help.A person with a history of heart disease, heart attack, stroke, or other cardiac issues should regularly see their doctor for blood pressure checks. They may also want to check their pressure at home regularly.A person should see their doctor if their blood pressure is higher than the normal readings to understand what the cause is and how to treat it.People measure blood pressure using two numbers that represent the pressure the blood exerts on the arteries as the heart contracts and relaxes.Doctors consider a person's blood pressure to be in the normal range when they have readings consistently below 120/80.Higher readings can indicate a person has elevated or hypertension. If left untreated, this can lead to cardiac issues.A person can make changes in their diet and exercise regime to help keep their blood pressure under control.
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What to know about blood thinners for heart disease

Blood thinners help prevent and treat blood clots. Blood clots can partially or completely block blood flow through a blood vessel.Doctors refer to blood clots as thromboses. A blood clot can cause serious health effects, such as a heart attack, stroke, or pulmonary embolism.In this article, learn about blood thinners for different types of heart disease and how they prevent and treat blood clots. We also discuss the side effects and risks of taking blood thinners.
a hand holding two blood thinners pillsShare on PinterestThe most suitable type of blood thinner may depend on a person's medical history.People take blood thinners to prevent the formation of blood clots and reduce their risk of heart attack, stroke, and pulmonary embolism.Blood clots can cause different types of heart disease. People can also develop heart disease if they have atherosclerosis, which is a buildup of fatty deposits in the arteries.Blood clots can partially or completely block a blood vessel. They can form anywhere in the body but are more common in certain areas. The area where they develop will determine the severity of the risk that they pose.If a person has a blood clot in the blood vessels leading to the brain, they can have a stroke, while a blood clot in the blood vessels around the heart can result in a heart attack. People with atrial fibrillation are also at risk of stroke due to blood clots developing in the heart.Doctors use the term pulmonary embolism to refer to a blood clot in a major blood vessel in the lungs. They call a blood clot in the legs a deep vein thrombosis (DVT). A DVT can dislodge and move up to the lungs, causing a pulmonary embolism.Blood thinners act on different parts of the clotting pathway that can lead to blood clots. Doctors use specific blood thinners that block factors that cause blood clots.People with clots in their arteries due to a platelet plug — the stage before a thrombosis forms — may require a different type of blood thinner that acts on particular blood cells, such as platelets.Below, we cover the different types of blood thinners for heart disease.
Today, doctors can choose from many different blood thinners. They will select the most appropriate blood thinner depending on their evaluation of the person, which is likely to take into account:the person's family and personal medical historytheir risk factors for developing blood clotsthe location of the blood clotwhether it is the person's first blood clotthe severity of the blockageThere are two categories of blood thinners: antiplatelets and anticoagulants.AntiplateletsA person may receive injectable, intravenous, or oral antiplatelet medications. Antiplatelet medications that people take orally include:aspirinclopidogrel (Plavix)ticagrelor (Brilinta)prasugrel (Effient)pentoxifylline (Trental)cilostazol (Pletal)dipyridamole (Persantine)The injectable or intravenous antiplatelet drugs include:tirofiban (Aggrastat)eptifibatide (Integrilin)AnticoagulantsIn some situations, doctors will prescribe anticoagulants. There are three classes of anticoagulants:heparin and low molecular weight heparinvitamin K antagonists, such as warfarinnewer direct oral anticoagulantsThe following table lists the drugs in these categories.Vitamin K antagonistsNewer direct oral anticoagulantsHeparinswarfarin (Coumadin)dabigatran (Pradaxa)heparinedoxaban (Savaysa)enoxaparin (Lovenox)rivaroxaban (Xarelto)dalteparin (Fragmin)apixaban (Eliquis)Blood clotting is a complex process that depends on many factors. Warfarin works by preventing vitamin K-dependent clotting factors from forming.Newer direct oral anticoagulants inhibit other factors, such as factor Xa or an enzyme called thrombin, both in the blood and in existing clots.Heparins also inactivate thrombin, which helps treat clots and prevent new ones from forming.
People who take blood thinners are at an increased risk of excessive bleeding. If they cut themselves, it may take longer for the bleeding to stop. Sometimes, bleeding may require medical attention.The most common side effects of antiplatelet medications include:easy bruisingnosebleedsblood in the urinehemorrhage or large bleedsbleeding in the stomachbreathing difficulty due to ticagrelorlow blood platelet countaspirin-induced asthmanasal polypsWarfarin can also cause bleeding, which can occasionally be severe. Some people can experience major bleeds in the brain, eyes, and digestive tract.Other side effects of warfarin include:nauseavomitingstomach painbloatingflatulence (gas)change in the sense of tasteIf a person experiences dangerous bleeding from warfarin, doctors can reverse the drug's action by giving them intravenous vitamin K and fresh frozen plasma or prothrombin complex concentrate.Newer direct oral anticoagulants have an association with lower rates of major bleeds, including life threatening bleeding and bleeding into the brain.The newer direct oral anticoagulants also have commercially available medicines to reverse their actions.If people experience heavy bleeding or hemorrhage, doctors will stop giving them the drug and provide protamine sulfate, which inactivates heparin.Other side effects that may occur when using heparin are:low blood platelet countosteoporosisfractureslow levels of aldosterone, a hormone that regulates salt and water in the bodyallergic reactionsPeople taking blood thinners should let their doctors know about any other medications that they are taking. Some blood thinners also interact with certain foods.In general, combining blood thinners with other drugs that cause bleeding further increases a person's risk of bleeding.Antiplatelet medicationsOther substances that may interact with aspirin or antiplatelet medications include:diureticsnonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil)steroid drugsalcoholAs well as interacting with other drugs that thin the blood, Plavix and Effient may interact with opioids. Plavix also interacts with omeprazole (Prilosec), which reduces stomach acid.Brilinta can interact with digoxin (Lanoxin) and with high doses of simvastatin (Zocor) and lovastatin (Altoprev).A doctor will closely monitor people who take blood thinners.WarfarinDoctors who prescribe warfarin must warn the person about the many drug and food interactions that occur with this anticoagulant.Some substances that interact with warfarin include:antibioticsantifungalsbotanical or herbal productsother anticoagulants and antiplatelet agentsfoods containing vitamin KPeople need to do frequent blood tests when taking warfarin. Doctors will use the blood test to check a person's International Normalized Ratio (INR).The INR test provides important information to help doctors determine the appropriate dosage of warfarin. Drug and food interactions can cause changes in a person's INR.An INR reading that is too low puts people at risk of clotting, whereas a reading that is too high indicates an increased risk of bleeding. The correct reading for someone on anticoagulants is 2–3.Doctors may also tell people taking warfarin to pay attention to the vitamin K content in the foods that they eat. People taking warfarin should not avoid vitamin K altogether, but they may need to limit their intake of it.Learn more about vitamin K, diet, and warfarin in this article.HeparinAnyone who takes heparin or low molecular weight heparin should avoid any drugs that increase the risk of major bleeding.If someone requires other blood thinners while taking heparin, doctors will need to monitor the person closely for signs of bleeding.Newer direct oral anticoagulantsCompared with warfarin, newer direct oral anticoagulants have fewer drug interactions and may be safer options, although more, long-term clinical use is necessary to confirm this.These drugs also do not require people to make dietary changes or have INR monitoring. Researchers note, however, that newer direct oral anticoagulants may be more expensive than warfarin for many people.Some foods and supplements have blood-thinning effects. People who need to take prescription blood-thinning medications should limit or avoid these foods and supplements, which may increase their risk of bleeding.The following supplements and foods may thin the blood:Blood thinners include antiplatelet and anticoagulant medications. People who have a blood clot or a higher risk of developing one may need to take one or more blood thinners to prevent problems, which can include:a heart attacka strokepulmonary embolismDoctors and pharmacists must explain the risks of taking blood thinners, including the possible drug and food interactions, to prevent excessive bleeding.Many natural and over-the-counter products can thin the blood and increase a person's risk of bleeding.Newer oral direct anticoagulants may be safer alternatives to warfarin as they have fewer drug interactions. Some people find that they also cause fewer side effects.
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What to know about angioplasty

Angioplasty is a medical procedure that opens up a blocked or narrowed artery around the heart. It is a standard treatment for narrowed or blocked arteries in this area of the body.Doctors also refer to angioplasty as percutaneous coronary intervention, or PCI.During angioplasty, a surgeon inserts a tube into an artery in the groin or wrist. They then thread the tube towards the affected artery around the heart. Finally, they insert a balloon or stent (metal tube) to open the artery.Doctors perform more than 1.2 million angioplasties a year in the United States, according to the American College of Cardiology.Here, we give an overview of angioplasty or PCI, including its uses, types, risks, procedure, and recovery.
surgeon performing angioplastyShare on PinterestAn angioplasty may help reduce chest pain, or angina.In the term angioplasty, "angio" means blood vessel, and "plasty" is opening up.In PCI, the "P" stands for percutaneous or "through the skin" while coronary refers to the location of blood vessels around the heart.Angioplasty is a conventional treatment for coronary heart disease (CHD) and heart attacks (acute coronary syndrome).In these conditions, there is a buildup of plaque, or atherosclerosis, on the walls of the arteries. As plaque accumulates, the arteries narrow and can become blocked.In a heart attack, the plaque may rupture, spilling cholesterol into an artery, potentially leading to a clot that stops blood flow.During a standard angioplasty, the doctor makes an incision in the groin or wrist and inserts a tube, or catheter, into an artery.Next, they thread the catheter upwards and into the affected blood vessel around the heart.Usually, the catheter contains an inflatable balloon that displaces the plaque or clot, effectively opening up the artery.Doctors use live X-rays and a contrast dye to guide the catheter and assess the arteries they need to treat.Compared with heart surgery, angioplasty is a minimally invasive as it does not involve opening up the chest.Doctors may recommend angioplasty to:treat an abnormal stress testincrease blood flow to the heartreduce chest pain, or anginaimprove blood supply to the heart muscle during or after a heart attacksupport more activity for people with chest pain
There are two main types of angioplasty:Balloon angioplasty, which involves using the pressure of an inflating balloon to clear plaque that is blocking an artery. This is rarely done alone except in cases when doctors are unable to place a stent in the required position.Stent placement in the artery, which involves a tube, or stent, made out of wire mesh. Stents help to prevent an artery narrowing again after angioplasty.Stents may be made of bare metal or have a coating of medication. When they include medication, they are called drug eluting stents (DES) and are less likely to plug up again.DES are now used almost exclusively with very little use of bare metal stents.Research from 2018 estimates that doctors in the U.S. implant over 1.8 million stents each year.
Angioplasty is a minimally invasive procedure, but it is still surgery, and people must follow their doctor's instructions carefully beforehand.People need to inform their doctor about any medications and supplements they are taking. In some cases, they may need to stop taking these drugs, especially blood thinners, before the procedure.Also, an individual may need to avoid food or drinks for several hours before the angioplasty procedure as doctors will need to sedate them.Kidney tests may be needed beforehand, too, as the contrast dye that the surgeons use can affect kidney function.Before beginning angioplasty, a healthcare professional will clean and numb the area where the catheter enters the body, usually the groin but sometimes the wrist.Next, a doctor inserts the catheter into the artery and directs it towards the coronary artery, watching its progress on an X-ray feed.Once the catheter is in position, the doctor injects a contrast dye through the artery, which helps identify blockages around the heart. Once they locate the blockages, the doctor inserts a second catheter and a guidewire, usually with a balloon at the tip.When the second catheter is in position, the doctor inflates the balloon, which pushes the plaque buildup away and opens up the artery. The surgeon may insert a stent to keep the artery propped open.According to the American Heart Association, angioplasty can take anywhere from 30 minutes to a few hours. The person may need to stay in hospital overnight.On the whole, angioplasty is a safe procedure without complications.One estimate says the rate of complications is 5 in every 100 people, with fewer in large institutes that specialize in angioplasty.Although complications from angioplasty are rare, they can include:prolonged bleeding from the catheter insertion site in the groin or wristdamage to blood vessels, kidneys, or arteriesan allergic reaction to the dyechest painarrhythmia, or abnormal heart rhythma blockage that requires an emergency bypassblood clotstrokeheart attacka tear or damage to artery or major blood vesseldeathOlder individuals have a higher risk of complications from angioplasty, as do those with the following conditions:There is also a chance of the artery becoming blocked with plaque again through a process called restenosis, plaque shift, or stent thrombosis, which is a clot in the stent.When angioplasty is complete, the cardiologist removes the catheters and bandages. Soreness, bruising, and possibly bleeding are common around the area where catheters entered the body.Typically, a person will recover in the hospital for a few hours or overnight before going home. They must not drive as they may still have sedative medications in their system. They will also have restrictions on lifting for about a week afterward.People can often return to work within a week, but their doctor will advise on how active they can be and when.The follow-up visit after angioplasty is a key aspect of the treatment. The doctor will review the individual's recovery, adjust medications as they need, and develop an ongoing treatment plan for their cardiovascular health.Angioplasty is a standard, minimally invasive procedure that doctors use to unblock clogged arteries and improve blood flow in the heart. Doctors frequently recommend angioplasty to treat acute heart problems. It is generally a safe procedure, although arteries can become blocked again, and there is a small risk of significant complications in some cases.
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What does high blood pressure in the morning mean?

Blood pressure fluctuates naturally throughout the day and tends to increase around the time a person wakes up. However, for many people, blood pressure may be abnormally high in the mornings. Doctors refer to this as morning hypertension.Morning hypertension can increase the risk of heart attack and stroke. These medical emergencies often occur in the early hours when blood pressure rises.In this article, we explore the causes and effects of morning hypertension. We also look at ways in which people can prevent and control this condition.
a woman lying in bed whos blood pressure Is always high in the morningShare on PinterestStress or anxiety may influence blood pressure in the morning.Blood pressure refers to the force with which the heart pumps blood around the circulatory system. Several factors can influence blood pressure, including:When a person measures their blood pressure, the reading will appear as two numbers. The top number denotes systolic blood pressure, which is the pressure when the heart contracts. The bottom number shows diastolic blood pressure, which is a measure of the pressure when the heart relaxes.A blood pressure monitor uses a unit of measurement called millimeters of mercury (mm Hg) to measure the pressure inside the blood vessels. Normal blood pressure is less than 120/80 mm Hg.Readings between 120/80 mm Hg and 139/89 mm Hg indicate that a person is at risk of developing hypertension, while readings of more than 140/90 mm Hg signify hypertension.Blood pressure rises and falls throughout the day and night. During sleep, blood pressure falls by 10–30%. It then increases around the time of wakening. In some people, this increase may be significant, resulting in morning hypertension.People who have an abnormal blood pressure pattern may be at risk of complications, such as heart attack and stroke. As a 2010 review notes, the onset of stroke and other serious cardiac events peaks in the first 4–6 hours after waking.
Some potential causes of morning hypertension include those below.MedicationSome people take antihypertensive medications to control their blood pressure. According to a 2018 review, uncontrolled morning hypertension may indicate a problem with the type or dosage of these medications.Specifically, morning hypertension may be due to one or more of the following factors:taking a medication dosage that is too lowtaking short-acting or intermediate-acting medications rather than long-acting medicationstaking a single antihypertensive medication rather than a combination of medicationsSome people may find that taking their medications before bed rather than in the morning provides better blood pressure control. Others may need to split their daily dose, taking half in the morning and half before bed. In some cases, a person may need to change to another type of blood pressure drug altogether.It is important to speak to a doctor before making any changes to medications.Medical conditionsCertain medical conditions may increase the risk of hypertension. These include:Lifestyle factorsCertain lifestyle factors can also increase the risk of hypertension. Examples include:smokingheavy alcohol consumptioneating a diet high in salt and saturated fatnot getting enough exercise
The following factors can increase a person's risk of developing morning hypertension:being over the age of 65 yearsbeing of African or Caribbean descenthaving a relative with high blood pressurehaving overweight or obesitydrinking alcoholsmokinganxiety or excessive stressinsufficient sleepdisturbed sleep, for example, working night shifts
Regular use of a home blood pressure monitor can help people better understand their blood pressure fluctuations. It can also allow people to identify episodes of morning hypertension.The American Heart Association (AHA) recommend using a cuff-style blood pressure monitor. These monitors are more reliable than monitors that attach to the finger or wrist.The AHA also provide the following guidelines for measuring blood pressure at home:Before measuring blood pressure:Empty the bladder.Rest comfortably and quietly for 5 minutes before measuring blood pressure.Avoid smoking, drinking alcohol, or exercising within 30 minutes of measuring blood pressure.When measuring blood pressure:Take readings at the same time each day.Sit with the back straight, legs uncrossed, and feet flat on the floor.Rest the arm on a flat surface so that the upper arm is at heart level.Place the cuff on the arm so that the bottom of the cuff is directly above the elbow crease.Take two or three readings approximately 1 minute apart and calculate the average value.Keep a record of all readings, as this can help a doctor determine the best course of treatment.
High blood pressure typically does not cause symptoms, even when levels are dangerously high.Certain symptoms are more common in people with hypertension. However, they do not necessarily occur as a direct result of hypertension. These symptoms include:The diagnosis of high blood pressure in the morning typically relies on a person's self-reported readings.Depending on what these readings show, a doctor may recommend a 24 hour blood pressure monitoring test. This test involves wearing a device that takes regular blood pressure readings throughout the day and night.The doctor will also review the person's medical history and carry out a physical examination. If necessary, they may order additional tests to confirm or rule out a diagnosis. Examples include:an echocardiogram, which is an ultrasound of the heartan electrocardiogram (EKG) to trace the heart's electrical activityblood testsurine testsPeople with morning hypertension are at higher risk of cardiovascular events than those with normal morning blood pressure readings.Getting morning hypertension under control can reduce the risk of heart attack and stroke, among other cardiovascular events.The treatment for morning hypertension involves addressing its underlying cause.If an underlying medical condition is responsible, treating the condition may help reduce morning hypertension.If morning hypertension is due to issues with blood pressure medications, a doctor will need to fix this problem. Doing this may involve changing the dosage or the time of the day that the person takes the medication. In some cases, a doctor may recommend taking additional medications.Some people experience morning hypertension as a result of certain lifestyle factors. People can ask their doctor for information and specific advice on diet, exercise, or quitting smoking.Anyone who is not already on antihypertensive medications may need to begin taking these drugs.Following a healthful lifestyle can help control hypertension in the morning and at other times of the day. Managing hypertension will help lower the risk of complications, such as heart attack and stroke.Healthful lifestyle behaviors include:eating a balanced diet that is low in sodium, refined sugar, and saturated fatlimiting alcohol intakeavoiding tobaccoexercising for 90–150 minutes each weekachieving and maintaining a body mass index (BMI) of between 18.5 and 24.9practicing stress management and relaxation techniques, such as yoga or meditationtaking blood pressure medications according to the prescriptiontreating any underlying medical conditions that may contribute to hypertensionBlood pressure fluctuates throughout the day and night. It naturally increases in the hours around waking.However, abnormally high blood pressure readings in the morning can indicate that a person is at increased risk of cardiovascular events.Careful monitoring of blood pressure can alert people to instances of morning hypertension. Healthful lifestyle behaviors and prompt medical treatment may help prevent heart attack, stroke, and other complications of hypertension.
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Peas and beans: Can they improve heart health?

A recent review and meta-analysis focus on the role of legumes in heart health. Taking data from multiple studies and earlier analyses, the authors conclude that legumes might benefit heart health but that the evidence is not overwhelming.

Selection of legumesShare on PinterestA new analysis looks at the links between legume intake and heart health.

It is a no-brainer that nutrition plays a pivotal role in health. At one end of the spectrum, it is common knowledge that eating a diet that is high in sugar, salt, and fat increases the risk of poorer health outcomes.

At the other end, eating a balanced diet that is rich in fresh fruits and vegetables is likely to reduce the risk of certain conditions.

However, drilling down to the effect of individual foods on specific conditions is notoriously difficult.

The authors of a recent review in Advances In Nutrition have taken up that gauntlet. They wanted to understand how legumes, which include beans, peas, and lentils, affect heart health.

In particular, they focused on cardiovascular disease (CVD) risk and CVD mortality. CVD includes coronary heart disease, myocardial infarction, and stroke. They also investigated legume consumption in relation to diabetes, hypertension, and obesity.Study co-author Dr. Hana Kahleova, from the Physicians Committee for Responsible Medicine in Washington, DC, explains why investigating heart health is such a pressing matter, stating that "[c]ardiovascular disease is the world's leading — and most expensive — cause of death, costing the United States nearly 1 billion dollars a day."Why legumes?Legumes are rich in fiber, protein, and micronutrients but contain very little fat and sugar. Due to this, as the authors of the current study explain:"The American Heart Association, Canadian Cardiovascular Society, and European Society for Cardiology encourage dietary patterns that emphasize intake of legumes" to reduce levels of low-density lipoprotein (LDL, or bad) cholesterol, lower blood pressure, and manage diabetes.Recently, the European Association for the Study of Diabetes commissioned a series of systematic reviews and meta-analyses. Using the results of these studies, they hope to update current recommendations on the role of legumes in preventing and treating cardiometabolic diseases.In the current review, the authors compared data on people with the lowest and highest intake of legumes. They found that "dietary pulses with or without other legumes were associated with an 8%, 10%, 9%, and 13% decrease in CVD, [coronary heart disease], hypertension, and obesity incidence, respectively."However, they found that there was no association between legume intake and the incidence of myocardial infarction, diabetes, or stroke. Similarly, they identified no relationship between legumes and mortality from CVD, coronary heart disease, or stroke.Although the team identified a positive relationship between consuming higher quantities of legumes and a reduced risk of certain cardiovascular parameters, the authors' conclusions are still relatively muted. They write:"The overall certainty of the evidence was graded as 'low' for CVD incidence and 'very low' for all other outcomes."They continue, "Current evidence shows that dietary pulses with or without other legumes are associated with reduced CVD incidence with low certainty and reduced [coronary heart disease], hypertension, and obesity incidence with very low certainty."Nutritional difficultiesOne of the primary issues that scientists face when investigating nutrition and health is residual confounding. For instance, if someone eats more legumes than average, they might also eat more vegetables in general. Conversely, someone who eats few legumes might eat less fruit and vegetables overall.If this is the case, it is difficult to pin any measured benefits on the legumes, specifically. They might simply be due to the increase in plant food overall.Similarly, someone who eats particularly healthfully might also be more likely to exercise. Understanding whether the legume, the overall dietary patterns, or the entire lifestyle influences any given health outcome is verging on impossible.Another problem centers around self-reporting food intake. Human memory, as impressive as it is, can make mistakes. One paper on this topic states that self-reports of food intake "are so poor that they are wholly unacceptable for scientific research."Studies attempt to minimize the influence of these factors as much as possible, but it can be challenging. As the authors explain, "Despite the inclusion of several large, high quality cohorts, the inability to rule out residual confounding is a limitation inherent in all observational studies."Despite the difficulties, overall, the authors believe that increasing legume intake could improve the heart health of the population of the United States."Americans eat less than one serving of legumes per day, on average. Simply adding more beans to our plates could be a powerful tool in fighting heart disease and bringing down blood pressure."Co-author Dr. Hana KahleovaAlthough those studying nutrition and disease face many challenges, it is important to continue this line of investigation. Currently, in the U.S., 1 in 4 deaths relate to cardiovascular disease. If a simple change in diet could reduce the risk even a small amount, it might make a significant difference at the population level.
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Sleep loss may contribute to heart disease in those with low incomes

People who are in a precarious financial position have an increased risk of cardiovascular disease. New research reveals that chronic sleep loss may contribute to this risk in the context of social inequality.

older man unable to sleepShare on PinterestShort sleep may help explain why people with low incomes are at higher risk of heart disease, especially in the case of men.

Last year, research featured in the journal Circulation of the American Heart Association explained that individuals with low socioeconomic status are more likely to develop cardiovascular disease than those who are in a less precarious financial condition.

And as recently as April of this year, a study published in The Lancet: Global Health found that people living in low income countries face a higher risk of cardiovascular disease.

Many biological and psychosocial factors can explain the link between low socioeconomic status and a higher risk of heart problems, such as anxiety and high blood pressure.

But in a new study, researchers affiliated with the Lifepath Consortium — a research consortium aiming to understand better how socioeconomic differences impact health — have gathered evidence that poor sleep may significantly contribute to the risk of cardiovascular disease in people at a financial disadvantage.The team reports and explains the new findings in a study paper that features in the journal Cardiovascular Research. In the study paper, the researchers outline why they were interested in the potential link between socioeconomic status, sleep duration, and heart disease, explaining that:"First, individuals who experienced social adversity across the life-course report sleep-related problems more frequently [...] In particular, people working in shifts, living in deprived neighborhoods, or who have experienced adversity in childhood show an increased prevalence of sleep-related disorders. Second, inadequate sleep has been associated with an increased risk of cardiovascular disease."In the current study, the investigators analyzed data from a total of 111,205 participants across eight different cohorts from four countries: France, the United Kingdom, Switzerland, and Portugal.The team split the participants into different socioeconomic categories — low, middle, or high income — based on the participants' occupation, as well as the occupation of each participant's father.Thanks to medical exams and self-reported measures, the researchers also had access to the participants' history of coronary heart disease and cardiovascular events. The investigators also looked at measures of sleep duration, categorizing them as recommended sleep (6–8.5 hours per night), long sleep (over 8.5. hours per night), and short sleep (fewer than 6 hours per night).To understand how, and if sleep loss was likely to contribute to cardiovascular problems in people of different incomes, the researchers used mediation analysis, a specialized statistical method.The researchers' findings indicated that insufficient sleep might play a role in the heightened risk of cardiovascular disease in people of lower socioeconomic status. However, the impact seemed to vary by biological sex.The researchers note that short sleep likely explains 13.4% of the link between occupations associated with lower socioeconomic status and coronary heart disease in men.Although women in lower socioeconomic groups also get heart disease, it does not appear to be linked to sleep in the same way as in men. The researchers hypothesize that this may be because most women already face a much higher burden of responsibilities outside of their professional occupation that independently affects their sleep and their health.According to study co-author Dusan Petrovic from the University Centre of General Medicine and Public Health in Lausanne, Switzerland, "Women with low socioeconomic status often combine the physical and psychosocial strain of manual, poorly paid jobs with household responsibilities and stress, which negatively affects sleep and its health-restoring effects compared to men."Based on the study findings, the researchers argue that societies must address many issues that lie at their cores in order to help every single one of their members to achieve adequate sleep as much as possible."Structural reforms are needed at every level of society to enable people to get more sleep," advises Petrovic."For example, attempting to reduce noise, which is an important source of sleep disturbances, with double glazed windows, limiting traffic, and not building houses next to airports or highways."Dusan Petrovic
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Everything you need to know about choline

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Choline is a nutrient that supports various bodily functions, including cellular growth and metabolism. The body makes some choline, but the majority comes from dietary sources.

In 1998, the Institute of Medicine officially recognized choline as an essential nutrient. However, some research suggests that most people do not get enough of it.

Continue reading this article to learn more about choline, including the recommended daily intake, its sources, and how it can benefit people's overall health.

a woman eating nuts as a source of cholineShare on PinterestNuts and seeds are good sources of choline.Choline is an essential nutrient that supports vital bodily functions and people's overall health. Although the body makes some choline, people need to incorporate choline-rich foods into their diet to get enough of it.Choline supports numerous vital bodily functions, including:Cell maintenance: The body uses choline to produce fats that make up cellular membranes.DNA synthesis: Choline, along with other nutrients such as folate and vitamin B-12, can affect gene expression.Metabolism: Choline helps metabolize fats.Nervous system functioning: The body converts choline into a neurotransmitter that affects the nerves and plays a role in regulating automatic bodily functions, such as breathing and heart rate.Choline exists as both water-soluble and fat-soluble molecules. The body transports and absorbs choline differently depending on its form.Water-soluble choline molecules go to the liver, where the body converts them into a type of fat called lecithin.Fat-soluble choline usually comes from dietary sources, so the body absorbs it in the gastrointestinal tract.Choline supports several vital bodily functions and may offer a wide range of other health benefits, such as:Improving memory and cognitionCholine is an essential nutrient for brain development.In one observational study of 2,195 participants aged 70–74 years, those with higher choline levels had better cognitive functioning than participants with low choline levels.Another observational study from 2019 found that inadequate levels of choline, vitamin C, and zinc were associated with poorer working memory in older men.Protecting heart healthThe authors of a 2018 study found an association between higher dietary intakes of choline and a lower risk of ischemic stroke.The study looked at nearly 4,000 African American participants, with an average 9 year follow-up period.Boosting metabolismSome research has shown that choline plays a role in metabolizing fats.The authors of a small 2014 study found that female athletes who took choline supplements had lower body mass indexes (BMIs) and leptin levels than the control group. Leptin is a hormone that controls body fat.Reducing the risk of pregnancy complicationsCholine can affect fetal development and may influence pregnancy outcomes. In one 2013 study, for example, women in their third trimester of pregnancy received either 480 milligrams (mg) or 930 mg of choline per day.Those who took higher doses had reduced markers of preeclampsia. Symptoms of preeclampsia include high blood pressure, swelling, and severe headaches.Improving cystic fibrosis symptomsOne 2018 study found that choline supplementation improved lung function and reduced symptoms of fatty liver disease in 10 adult males with cystic fibrosis.The precise amount of choline a person needs depends on the following factors:pregnancy or lactationbiological sexgeneticsageThe following table lists the estimated adequate intakes (AI) for choline based on age, biological sex, and pregnancy and lactation status:Daily AI for cholineAgeMaleFemalePregnancyLactation0–1 year125–150 mg/day125–150 mg/day——1–3 years200 mg/day200 mg/day——4–8 years250 mg/day250 mg/day——9–13 years375 mg/day375 mg/day——14–19+ years550 mg/day400–425 mg/day450 mg/day550 mg/dayHowever, most people do not meet the recommended AIs for choline.According to the United States Department of Agriculture, males aged 20–59 consume an average of 406–421 mg of choline per day, while females in the same age group consume around 290–303 mg per day.Pregnant women, those who are lactating, and people who have genetic alterations that increase the body's demand for choline may also have a higher risk of choline deficiency.Although some people believe that vegetarians and vegans may be at risk of choline deficiencies, there is only mixed evidence to support this.In fact, some of the foods with the highest choline content include soybeans, potatoes, and mushrooms. Eating a nutritious diet that focuses on whole foods should be enough to prevent deficiency.Choline deficiency can contribute to the following health conditions:Although choline deficiencies can lead to adverse health effects, too much choline can also cause problems, including:The National Institutes of Health (NIH) provide the following upper intake levels for choline based on age:children aged 1–8: 1 gram (g) per daychildren aged 9–13: 2 g per dayteenagers aged 14–18: 3 g per dayadults aged 19 or older: 3.5 g per dayPeople can get choline from various dietary sources. Infants require lots of choline during the first few months of life, most of which they get from breast milk or fortified formula.After infanthood, most people get choline from their diet.Dietary sources of choline include:proteins, such as beef, soybeans, fish, poultry, and eggsvegetables, including broccoli, potatoes, and mushroomswhole grains, such as quinoa, rice, and whole wheat breadnuts and seedsSome multivitamins and dietary supplements, as well as prepackaged and fortified foods, may contain choline in the form of lecithin.People can also find supplements that contain only choline. The exact amount of available choline varies, so it is vital that people read labels before taking any dietary supplements.Choline supplements are available in pharmacies, health food stores, and online.Healthcare professionals can test a person's choline levels by taking a blood sample and looking at how much choline is present.However, the authors of one 2018 article state that different testing procedures can affect the choline concentration in blood samples.For this reason, blood tests may not be a good indicator of whether or not a person is getting enough choline.Choline is an essential nutrient that regulates vital bodily functions, such as forming cell membranes and aiding communication between neurons.The body does not produce enough choline on its own, so people need to get it from food sources, such as meat, eggs, and vegetables.Current scientific studies suggest that choline may improve memory and cognition and reduce the risk of ischemic stroke.Choline supports brain development and growth in newborn babies. Research also suggests that choline may reduce the risk of preeclampsia and congenital irregularities.Though the recommended intake for choline is relatively low (125–550 mg per day), most people do not get enough.Choline deficiency can cause muscle and liver disease and contribute to cardiovascular disease, dementia, and neural tube irregularities in infants. 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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Microvascular ischemic disease: What to know

Microvascular ischemic disease describes conditions that affect the small blood vessels in the brain. These conditions include stroke, cerebral hemorrhage, and dementia.Age and high blood pressure are among the main risk factors for microvascular ischemic disease.In this article, we provide more information on microvascular ischemic disease, including its symptoms, causes, and treatment.
a woman experiencing a headache because of Microvascular ischemic diseaseShare on PinterestA person with microvascular ischemic disease may experience difficulty thinking and focusing.Doctors use the term microvascular ischemic disease to refer to changes that occur in the walls of the blood vessels of the brain.Conditions that affect these blood vessels can damage white matter in the brain. White matter contains nerve fibers that send signals between different parts of the brain.Microvascular ischemic disease is a "silent" disease, which means that most people who have it do not experience noticeable symptoms.However, doctors can look for signs of microvascular ischemic disease using MRI brain scans.Microvascular ischemic disease commonly affects older adults. Without treatment, it can significantly contribute to cognitive decline, dementia, stroke, and walking problems.
The symptoms of microvascular ischemic disease can range from mild to severe, depending on the extent of the damage.People who have mild forms of microvascular ischemic disease may have no symptoms. However, those with more advanced white matter damage may experience:difficulty thinkingproblems focusingmemory losschanges in mooddepressiondifficulty sleepingchanges in bladder habitsSmall vessel disease accounts for up to 25% of all ischemic strokes. The symptoms of a stroke include:a sudden and severe headacheweaknessdizzinessnumbness in the face, arms, or legsvision problemsdifficulty breathingconfusionAnyone experiencing symptoms of a stroke requires immediate medical attention.
Age is a significant risk factor for microvascular ischemic disease. According to a 2019 review, the disease affects just 5% of people who are at least 50 years of age but nearly 100% of people over the age of 90 years.Other risk factors for microvascular ischemic disease include:high blood pressurehigh cholesterola history of stroke and other cardiovascular diseasesinflammation of the blood vessels due to infection or an overactive immune systemexposure to radiationsmokingdiabetesThe exact cause of microvascular ischemic disease remains poorly understood, however, as many factors can affect the blood vessels in the brain.The accumulation of plaque, fatty tissue, or scar tissue inside arteries can partially or entirely restrict blood flow to the brain.Without enough blood flow, certain areas of brain tissue may not receive enough oxygen, which can result in tissue damage or an ischemic stroke.The blood vessels can also become hard and brittle. These hardened arteries can develop bulges called aneurysms, which can leak or burst, causing bleeding in the brain. This condition is called a hemorrhagic stroke.Microvascular ischemic disease affects tiny blood vessels that are less than 0.5 millimeters (mm) in diameter, which makes the condition challenging to identify and treat with surgical procedures.According to a 2015 article, treatment options include lifestyle changes and medications to help reduce the risk of stroke, cognitive decline, and physical disabilities.A doctor may recommend one or more of the following treatment strategies, depending on a person's risk factors:dietary changes and regular exercise for weight lossquitting smokingblood pressure medications, such as warfarinanti-inflammatory drugs, such as steroids, ibuprofen, and aspirinantiplatelet drugs, such as aspirin and cilostazol, to help prevent strokeThere are currently no specific recommendations on how to prevent microvascular ischemic disease.However, people can lower their risk of developing microvascular ischemic disease by improving their cardiovascular health.Steps to improve cardiovascular health include:Microvascular ischemic disease does not always cause symptoms, but it can contribute to other medical conditions, such as stroke and dementia.The risk of developing microvascular ischemic disease increases with age. People can speak with their doctor about reducing their risk by exercising regularly, making dietary changes, and taking medications that help control cholesterol levels and blood pressure.
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