Wood Street Clinic Blog

According to a new study, intensive treatment for high blood pressure may reduce the risk of death from any cause, including cardiovascular disease, in people with type 2 diabetes.

Diabetes is one of the most common and costly chronic conditions in the United States. Over 100 million people in the U.S. have diabetes or prediabetes, according to the 2017 report compiled by the Centers for Disease Control and Prevention (CDC).

Diabetes is a disease that affects how the body processes glucose. Type 2 diabetes, which is the most common form of the disease, reduces the production of insulin, a hormone that regulates blood sugar levels. When this occurs, blood sugar levels rise, increasing the risk of heart disease.

Hypertension, or high blood pressure, also increases the risk of cardiovascular disease. According to the National Institutes of Health (NIH), blood pressure is "the force of blood pushing against the walls of [the] arteries as the heart pumps blood." Hypertension happens when "this force against the artery walls is too high."

Doctors measure blood pressure in millimeters of mercury (mmHg). The first number, or the systolic pressure, refers to the pressure in the blood vessels when the heart beats. The second number measures the diastolic blood pressure, which is the pressure in the blood vessels when the heart rests between beats.

Doctors define "prehypertension" as 120–139 mm Hg for systolic pressure and between 80–89 mmHg for diastolic pressure. They consider a pressure of 140/90 mmHg as high.

According to the CDC, about 75 million people in the U.S. have high blood pressure, but only about half of them have the condition under control.

Link between diabetes and hypertension

Many people with diabetes also have high blood pressure. Studies found that at least 1 in 3 people with diabetes also have hypertension.

Diabetes and high blood pressure make for a deadly combination because one condition makes the other worse. Diabetes may increase blood pressure by reducing the blood vessels' ability to stretch, increasing the fluid in the body, and affecting how the body manages insulin.

According to the American Heart Association (AHA), nearly 70% of people age 65 or older with diabetes die from cardiovascular disease, and 16% die of stroke. In addition, people with diabetes are up to four times more likely to die from heart disease than those without diabetes.

Looking for the best blood-pressure targets

Now, a new study, which appears in the AHA's journal Hypertension, found that people with type 2 diabetes who received intensive treatment to keep blood pressure levels at or below 130/80 mmHg experienced fewer heart attacks, strokes, and had a lower risk of death from any cause.

"Our findings demonstrate a benefit of more intensive therapy aiming for blood pressure thresholds at 130/80 [mmHg] or below and should help resolve some ongoing confusion over the best blood pressure targets for people with diabetes," says the study's senior investigator J. Bill McEvoy, a professor of preventive cardiology at the National University of Ireland in Galway.

The 2017 AHA blood pressure guidelines recommended intensive treatment for people with diabetes and hypertension to help reduce their blood pressure. The new study revealed that blood pressure levels of 130/80 mm/Hg may benefit people regardless of cardiovascular risk.

"Patients, including those with diabetes, with blood pressure levels above 130/80 on two consecutive checks should discuss with their physicians whether they need [a] change in treatment to get to a lower number."

Prof. McEvoy

Benefits of intensive hypertension therapy

The researchers analyzed the outcomes of about 11,000 people with type 2 diabetes. The researchers clinically followed the study participants over 4 years across multiple clinical centers and locations.

The scientists examined people with type 2 diabetes and high blood pressure, who had different levels of cardiovascular risk, and who received intensive treatment. They then compared them with people with the same conditions who received a placebo.

Previous findings had suggested that hypertension treatment was effective, but researchers did not know whether this benefit also applied to people with diabetes and blood pressure below 140/90 mmHg.

The new study looked at rates of overall death from any cause and found that all people benefited from intensive treatment, regardless of cardiovascular risk.

More than 800 deaths and over 950 major vascular events — including heart attacks, strokes, diabetic kidney disease, and diabetic eye disease — occurred during the study period.

The people who received intensive blood pressure treatment experienced 9% fewer events and 14% fewer deaths than the people who took a placebo.

A stressful work environment coupled with a lack of sleep can result in a threefold-higher risk of cardiovascular death in people with hypertension.

Recent research looked at how stress and insomnia affected the health of employees who have hypertension, and the news was sobering.

The researchers found that in comparison with their peers who slept well and did not experience work-related stress, hypertensive employees with stress and insomnia were three times more likely to die from cardiovascular disease.

Researchers analyzed data from nearly 2,000 employees whose ages ranged from 25 to 65 years. These workers had high blood pressure, but, at the time of the study, they did not have cardiovascular disease or diabetes.

Although those with either job-related stress or insomnia did have an increased risk of cardiovascular death, the risk was higher when people had both of these factors present in their everyday lives.

The authors published their findings in the European Journal of Preventive Cardiology.

"These are insidious problems," notes Prof. Karl-Heinz Ladwig of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich.

"The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave."

Prof. Karl-Heinz Ladwig

Hypertension is a major risk factor for many

Researchers define hypertension as high blood pressure in the arteries.

According to the American Heart Association (AHA), normal blood pressure readings for adults sit below 120/80 millimeters of mercury (mm Hg), while people with hypertension have either a systolic pressure (upper number) of 130 mm Hg or higher or a diastolic pressure (lower number) of 80 mm Hg or above.

High blood pressure is a widespread problem in the United States, with the AHA estimating that close to 103 million adults have hypertension.

This number equates to almost half of all adults in the U.S., and experts note that the death rate stemming from hypertension is increasing. In fact, it rose by nearly 11% from 2005 to 2015.

Many factors can increase a person's risk of heart disease, some of which are uncontrollable, such as increasing age, biological sex, and heredity.

However, other factors — such as smoking habits, high blood cholesterol, high blood pressure, physical inactivity, and being overweight — are modifiable.

High blood pressure is a significant risk factor for heart disease because when blood pressure becomes elevated, the heart has to work harder to pump blood around the body.

This extra work thickens the muscles of the heart, and it can also harden or damage artery walls. As a result, less oxygen makes its way to the body's organs, and the heart becomes damaged over time due to its increased workload.

How stress relates to sleep, heart health

Stress is another factor that can contribute to heart disease.

In the current study, the researchers defined a stressful job as one that places high demands on the employee without giving them much control over what they have to do and achieve each day.

They also noted that most of the people with sleep issues had problems staying asleep, while others had trouble falling asleep.

"Maintaining sleep is the most common problem in people with stressful jobs," says Prof. Ladwig. "They wake up at 4 o'clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues."

Hypertension on its own is a major risk factor for heart disease, but pairing it with both insomnia and work-related stress compounds the potential problems.

Prof. Ladwig says that it would be a good idea for employers to offer stress management and sleep treatment in the workplace, while doctors should discuss sleep and job stress with people who have hypertension and may have a higher risk of issues with their cardiovascular health.

Differences in the cells that store fat in the body could explain why some people are more prone to obesity-related conditions, such as type 2 diabetes.

Scientists at the University of Melbourne, in Australia, led an investigation that examined human white fat cells from samples that volunteers had donated.

The samples came from white fat tissues in different parts of the body.

White fat cells are the cells that store energy in fat molecules called triglycerides.

The human body has reservoirs of regenerative cells, called adipose progenitor cells (APCs), which mature into white fat cells.

Using tools that assessed genes, proteins, and metabolism, the study is the first to identify three distinct subtypes of APCs.

In a recent Cell Reports paper, the authors explain how the APC subtypes differ in the ways that they deal with energy and hormones.

The findings suggest that the makeup and distribution of white fat in the body, in terms of the APC subtypes, could predict a person's risk of developing type 2 diabetes and other metabolic diseases.

The first APC subtype matures into fat cells that discharge lots of fat molecules into the bloodstream, while the second type leads to cells that burn energy fast. The third subtype has a more "neutral" profile and behaves more like scientists might expect a fat cell to behave, if rather more slowly.

Senior study author Prof. Matthew J. Watt, who heads the physiology department in the School of Biomedical Sciences at the University of Melbourne, suggests that the first subtype could be one that promotes fat deposits on organs and in other parts of the body. This could happen in people of healthy weight as well as in those who are overweight.

He suggests that the second APC subtype could be one that stops people from gaining weight.

Need for better understanding of fat cells

The World Health Organization (WHO) declare that the worldwide prevalence of obesity "has nearly tripled since 1975."

In the United States, figures from the Centers for Disease Control and Prevention (CDC) reveal that 40% of adults, amounting to some 93.3 million people, had obesity in 2015–2016.

Obesity-related health conditions such as heart disease and type 2 diabetes account for a large number of preventable early deaths.

In their study paper, Prof. Watt and his colleagues note that obesity and dysfunction of fat tissues are "inextricably linked to the development of metabolic diseases, such as dyslipidemia and type 2 diabetes."

Given the rising tide of worldwide obesity, "There remains intense interest," they write, in furthering knowledge of how fat cells develop and how their energy and hormone mechanisms work, especially in relation to overeating.

When they examined the fat tissue samples, the researchers found all three APC subtypes in all the samples. There was no part of the body in which white fat tissue did not have all three.

However, they did find that the distribution of the subtypes differed among individuals: Some subtypes were more abundant, while others were less so.

Prof. Watt remarks that this could mean that the makeup of people's APC subtypes in their white fat tissues could be a factor in their metabolic health.

Switching on the fast-burners to lose weight?

He imagines, for example, that future weight loss treatments could involve switching off the fat-releasing APCs and switching on the fast-burners.

Drugs that do this could potentially help to prevent obesity-related conditions and offer less invasive alternatives to surgery.

However, Prof. Watt cautions that there is still a lot of work to do, and it could be 10 years or more before such treatments become available.

Further studies should, for example, confirm whether having more or less of certain APC subtypes actually raises or lowers risk of specific metabolic diseases.

They then need to find out whether increasing or decreasing certain cell types can affect disease outcomes.

Even if treatments that alter APCs become available, Prof. Watt predicts that people will likely still need to adopt healthful lifestyles, reduce food consumption, and increase physical activity.

"The discovery is important because it tells us that not all fat cells are the same and that by understanding the fat subtypes in a human, we might be able to predict their future metabolic health."

Prof. Matthew J. Watt

New research offers fresh insights into how a type of immune cell can destabilize the fatty deposits, or plaques, that form in arteries during atherosclerosis.

Atherosclerosis is a persistent, inflammatory condition in which plaques build up inside arteries, causing them to narrow and restrict blood flow.

When an atherosclerotic plaque bursts or breaks, it can trigger a heart attack or stroke.

Neutrophils are an abundant type of leukocyte (white blood cell) that defend against infection by attacking microbes. They also serve "many roles in inflammation."

The new international study reveals that neutrophils can aggravate atherosclerosis by triggering a previously unknown type of cell death that destabilizes arterial plaques.

A recent Nature paper describes how neutrophils can induce a series of molecular events that also kills the smooth muscle cells that help to retain the plaques in the artery wall.

"Every inflammatory reaction," says co-corresponding study author Prof. Oliver Söhnlein, who is the director of the Institute for Cardiovascular Prevention at the Ludwig Maximilian University (LMU) of Munich in Germany, "results in some collateral damage, because neutrophils also attack healthy cells."

He and his colleagues have also designed and made a "tailored peptide" that could potentially target and block the cell-death process.

Atherosclerosis and its consequences

Arteries are vessels that supply the heart and other parts of the body with oxygen- and nutrient-rich blood, which cells need to function and live.

Atherosclerosis develops when various materials, such as cholesterol, fat, and cellular waste, deposit in the tissue lining the arteries. The deposits, or plaques, build up slowly over time causing the arteries to narrow and harden.

When arteries narrow, they impede blood flow and restrict the supply of oxygen and nutrients to cells. Depending on where it occurs, the restricted blood flow can result in heart disease, angina, carotid artery disease, peripheral artery disease, and chronic kidney disease.

The plaques themselves are also a risk. They can rupture, or pieces can break off, causing blockages. In addition, blockages can arise from blood clots that stick to the inner walls of narrowed arteries.

If the blockage is in an artery that supplies blood to the brain or the heart, it can result in a stroke or heart attack. Blockages in arteries that supply the legs can lead to tissue death, or gangrene.

According to statistics that the American Heart Association publish online, cardiovascular conditions, such as heart attack and stroke, were the primary cause of 840,678 deaths in 2016 in the United States.

Neutrophils help plaques become unstable

Another feature of atherosclerosis is that it triggers signals that prompt the immune system to send neutrophils and other immune cells through the bloodstream to the plaques.

When they reach a plaque site, the immune cells slip between the endothelial tissue cells of the artery lining. At the same time, they release chemicals that signal to the immune system to send even more immune cells.

This can set up a cycle that turns the initial inflammation response into persistent, or chronic, inflammation. Once the inflammation becomes chronic, it raises the risk that the plaque will grow, rupture, and cause a blockage.

Using mouse models of atherosclerosis to investigate what goes on at cell level, the researchers discovered that neutrophils can play a particularly destructive role in destabilizing plaques.

"They bind to the smooth muscle cells that underlie the vessel wall, and are activated," Prof. Söhnlein explains.

Once active, the neutrophils release "chromosomal DNA and its associated histones, which are highly charged and [toxic to cells]," he continues, adding: "Free histones kill nearby cells – in the case of atherosclerosis, smooth muscle cells."

Histones are proteins that help to package DNA tightly inside chromosomes.

Peptide could block toxic histones

The histones kill the smooth muscle cells by causing pores to form in their walls. This allows extracellular fluids to seep through the pores into the cells, causing them to burst.

Because smooth muscle cells help to retain the plaques in the artery wall, their destruction causes the fatty deposits to become unstable and more likely to rupture and break.

In another part of the study, the team used molecular modeling to design a small protein molecule, or peptide, that could block the toxic effect of the free histones.

The authors suggest that the "histone-inhibitory peptide" could disrupt the histones by binding to them so that they cannot create pores in the cell membranes.

Prof. Söhnlein says that the synthetic peptide could have a similar effect on other conditions that involve chronic inflammation, such as chronic bowel inflammation and arthritis.

He and his co-authors conclude:

New research in sheep shows that a drug that doctors usually prescribe for the treatment of erectile dysfunction can also treat heart failure.

In people with heart failure, the heart muscle becomes unable to pump out blood efficiently, meaning that some organs may not receive the amount of oxygen that they need to function properly.

The Centers for Disease Control and Prevention (CDC) note that 5.7 million adults in the United States have heart failure and that approximately half of the people with this condition die within about 5 years of receiving their diagnosis.

Moreover, research that Cardiac Failure Review published in 2017 argued that there is a "global pandemic" of heart failure, with this condition affecting an estimated 26 million people worldwide.

Such numbers suggest that finding new ways to treat heart failure is a priority for specialists who study this condition.

Recently, Prof. Andrew Trafford led a team of researchers from the University of Manchester in the United Kingdom who found that a drug that doctors typically use to treat erectile dysfunction could also treat systolic heart failure, in which the heart's left ventricle loses the ability to contract as normal.

The findings of the new study, which the researchers conducted in sheep, appeared today in the journal Scientific Reports.

Tadalafil brings significant improvements

Prof. Trafford and team decided to focus on tadalafil, which is available under the brand name Cialis among others. This drug falls under the same category as sildenafil, which people commonly refer to by the brand name Viagra.

"We do have limited evidence from human trials and epidemiological studies that show tadalafil can be effective in treating heart failure," Prof. Trafford says.

The researchers studied the effects of the drug in sheep, whose hearts are very similar to those of humans. The team treated the sheep with tadalafil once they had developed heart failure symptoms that were serious enough to require intervention.

Prof. Trafford and colleagues induced heart failure in the animals through the use of a pacemaker, and when they treated them with tadalafil, they gave them doses consistent with what a human patient would usually receive for erectile dysfunction.

After just 3 weeks of tadalafil treatment, the researchers began to notice improvements in the animals that received this drug.

The drug improved the heart's contraction and almost completely restored its ability to respond to epinephrine. It is a lack of response to this hormone that causes breathlessness in heart failure.

Although so far, the researchers have only tested the effects of this drug in sheep, Prof. Trafford maintains that humans are likely to experience the same benefits.

"This study provides further confirmation, adds mechanistic details, and demonstrates that tadalafil could now be a possible therapy for heart failure," the researcher notes, adding, "It's entirely possible that some patients taking it for erectile dysfunction have also unwittingly enjoyed a protective effect on their heart."

'We need safe and effective new treatments'

So, why does this drug have a therapeutic effect on heart failure? The scientists explain that tadalafil helps treat erectile dysfunction by acting on a particular enzyme called phosphodiesterase 5. This enzyme plays a key role in determining how different types of tissue interact with hormones, including epinephrine.

In the case of heart failure, the research team notes, tadalafil allows the heart to start responding to epinephrine once more, which means that the heart muscle regains its ability to pump out blood effectively.

These findings are promising because, as Prof. Trafford says, tadalafil "is a widely used and very safe drug with minimal side effects," but the researcher nevertheless cautions against self-prescription.

"[W]e would not advise the public to treat themselves with the drug, and [they] should always [speak] to their doctor if they have any concerns or questions," Prof. Trafford emphasizes.

"Tadalafil is only suitable as a treatment for systolic heart failure — when the heart is not able to pump properly — and there may be interactions with other drugs patients are taking," he warns.

Prof. Metin Avkiran, who is Associate Medical Director at the British Heart Foundation, which funded the current study, expresses hope that these findings might lead to a better treatment that could not only reduce the symptoms of heart failure but also potentially reverse the condition entirely.

"We need safe and effective new treatments for heart failure [...]. The evidence from this study — that a Viagra-like drug could reverse heart failure — should encourage further research in humans to determine if such drugs may help to save and improve lives."

Prof. Metin Avkiran

"Viagra-type drugs were initially developed as potential treatments for heart disease before they were found to have unexpected benefits in the treatment of erectile dysfunction," Prof. Avkiran notes.

"We seem to have gone full circle," he continues, "with findings from recent studies suggesting that they may be effective in the treatment of some forms of heart disease — in this case, heart failure."

New research suggests that a simple blood test, which doctors currently use to diagnose heart attacks, may be useful in predicting the risk of cardiovascular disease.

According to the latest statistics from the American Heart Association (AHA), almost half of the people living in the United States have some form of cardiovascular disease.

In fact, according to 2016 figures, 121.5 million U.S. adults, or 48 percent of the entire population, have cardiovascular disease (CVD), which is a cluster of conditions that includes hypertension. Doctors often call hypertension the "silent killer" because it does not show any visible symptoms until it is too late.

The same AHA report predicts that by 2035, over 130 million adults will have a form of CVD that could bring costs in the U.S. to 1.1 trillion dollars.

Currently, heart disease is the top leading cause of death in the U.S., while stroke is the fifth.

But what if there was a blood test that could accurately predict whether a person will have heart disease or a stroke?

New research suggests that such a test may already exist. By detecting the blood levels of specific proteins that heart muscles release when they are injured, scientists may be able to predict a person's risk of eventually developing CVD.

Dr. Christie Ballantyne, who is the cardiology chief at Baylor College of Medicine in Houston, TX, and his team, detail this idea in a new study that appears in the AHA journal Circulation.

Troponins are proteins that signal heart muscle damage, and in the new research, Dr. Ballantyne and his colleagues wanted to see if detecting troponin in the blood of healthy middle-aged adults or seniors could predict CVD risk.

Dr. Ballantyne and colleagues analyzed a group of 8,121 people aged 54–74 who participated in the "Atherosclerosis Risk in Communities" study. None of the participants had a history of cardiovascular disease.

The scientists identified troponin levels in 85% of the participants and applied Cox proportional hazards models to examine the links between these levels and cardiovascular disease.

Namely, they studied correlations with coronary heart disease, myocardial infarction, ischemic stroke, atherosclerotic cardiovascular disease, heart failure hospitalization, global cardiovascular disease, and all-cause mortality.

The research found that high levels of troponin correlated strongly with "increased global CVD incidence in the general population independent of traditional risk factors."

High-sensitivity troponin tests, therefore, proved to be an accurate way of predicting CVD risk, especially when combined with a standard method of calculating a person's 10-year cardiovascular risk.

"What we're finding out is that these tests can be used in the general population to give us information as to who is most likely to have a future problem, whether it be a heart attack, stroke, or heart failure," says Dr. Ballantyne.

"If you can treat someone much earlier, before {they] have symptoms, you will be far more effective in preventing events," continues the researcher, who adds, "Our major problem is that we do too little too late."

"If the first time you find out that you're at risk for heart failure is when you actually start getting short of breath and you end up in the hospital, you probably have advanced heart disease already, and it is going to be harder to treat than if that person took steps years earlier."

Dr. C. Ballantyne

Instead, knowing the risk in advance can prompt people to take preventive measures, such as exercising more and watching their blood pressure.

However, the scientists explain that although doctors currently use troponin tests to diagnose a heart attack, they do not yet accept them as a tool for predicting risk. Scientists need to do more research before using these tests to evaluate risk.

"Research in this area is leading us toward individualized care more and more, so we can better predict who's at risk for developing adverse cardiovascular outcomes," comments Dr. Rebecca Vigen, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, who did not participate in the research.

"This study is a step in the direction of personalizing care," Dr. Vigen says.

Vitamin K is an essential vitamin that supports blood clotting and healthy bones. It occurs in two forms, K-1 and K-2.

Vitamin K-1 is the primary form, and it mainly comes from leafy green vegetables. Vitamin K-2 occurs in animal proteins and fermented foods. The bacteria in the human gut also produce small quantities of K-2.

In this article, we discuss vitamin K-2, its functions, and how it differs from K-1. We also describe dietary sources, health benefits, the recommended daily intake, deficiency symptoms, and supplements.

What is it?
Sauerkraut is a good dietary source of vitamin K-2.

Statins are cholesterol-lowering drugs. Some statins work best in the evening while others work just as well in the morning. The best time to take statins depends on the specific drug.

Statins are a type of prescription medication that can lower a person's risk of heart disease. They do this primarily by reducing a person's low-density lipoprotein (LDL) cholesterol.

There are several different types of statin on the market, which the body may process differently. People may need to take some statins at specific times of the day to get the most benefit from them.

In this article, we look at the effects of statins at different times of the day and discuss the best times to take certain types. We also cover side effects and how a person can choose the right statin to suit their needs.

What do statins do?
Statins can help manage cholesterol levels.

A new study that analyzed the health information of thousands of women found that prolonged antibiotic use is correlated with a higher risk of experiencing a cardiovascular event.

Scientists at Tulane University in New Orleans, LA, Harvard Medical School and Harvard T. H. Chan School of Public Health in Boston, MA, and Fudan University in Shanghai, China investigated how antibiotic use is linked to women's risk of experiencing cardiovascular problems.

They were interested in the link between antibiotics and cardiovascular health because, they explain, antibiotics can have an important impact on gut microbiota, which, in turn, can affect various other aspects of health.

"Antibiotic use is the most critical factor in altering the balance of microorganisms in the gut," says study co-author Prof. Lu Qi.

"Previous studies have shown a link between alterations in the microbiotic environment of the gut and inflammation and narrowing of the blood vessels, stroke, and heart disease," he adds.

The study — the findings of which appear in the European Heart Journal — analyzes information the scientists collected from a cohort of 36,429 women enrolled in the Nurses' Health Study.

Specifically, the researchers examined data from 2004–2012; at the beginning of this period, all the women in the cohort were 60 or older.

All the participants reported how often they used antibiotics and other relevant information during three periods of their lives: ages 20–39, ages 40–59, and ages 60 and over.

Based on the antibiotic use patterns that the women reported, the scientists split them into four groups:

those who had never used antibiotics those who took antibiotics for fewer than 15 consecutive days at a time those who used antibiotics for between 15 days and 2 months those who took antibiotics for over 2 months

'A cumulative effect' of antibiotic use?

Over a follow-up period of almost 8 years, on average, 1,056 participants developed cardiovascular problems.

Throughout this period, the women continued to offer information about their antibiotic use every couple of years.

The scientists analyzed the data they took throughout this time, adjusting the results for potentially confounding factors. These included age, race, dietary choices, lifestyle habits, medical conditions, and overall drug use.

Women who took antibiotics for very long periods of time (for 2 months or longer) at age 60 or over had a 32% higher risk of experiencing cardiovascular disease compared with those who had never taken antibiotics.

Those who took antibiotics for 2 months or longer at ages 40–59 were 28% more likely to develop cardiovascular problems than women who did not take antibiotics at that age. However, the team found no correlation between prolonged antibiotic use at ages 20–39 and cardiovascular risk.

"By investigating the duration of antibiotic use in various stages of adulthood," points out first study author Yoriko Heianza, Ph.D., "we have found an association between long-term use in middle age and later life and an increased risk of stroke and heart disease during the following 8 years."

"As these women grew older they were more likely to need more antibiotics, and sometimes for longer periods of time, which suggests a cumulative effect may be the reason for the stronger link in older age between antibiotic use and cardiovascular disease."

Yoriko Heianza, Ph.D.

'The shorter time of use, the better'

The researchers also note that some of the most common reasons women cited for their antibiotic use included infections — respiratory and pertaining to the urinary tract — and oral health conditions.

Though this is the largest prospective study to date that has looked at the correlation between the use of antibiotics for long periods of time and cardiovascular risk, the research was not without its limitations.

For example, the researchers admit that the main problem they faced in this study was the fact that the participants self-reported their use of antibiotics, which tends to leave room for inaccuracies.

However, they also argue that the participants were likely to report fairly precise information, being healthcare professionals themselves.

The scientists are quite confident in their findings, but they explain that the study was observational and cannot, as yet, speak to cause and effect.

"This is an observational study," notes Prof. Qi, "and so it cannot show that antibiotics cause heart disease and stroke, only that there is a link between them."

"It's possible that women who reported more antibiotic use might be sicker in other ways that we were unable to measure, or there may be other factors that could affect the results that we have not been able [to] take account of," he goes on.

Despite these points, Prof. Qi concludes: "Our study suggests that antibiotics should be used only when they are absolutely needed. Considering the potentially cumulative adverse effects, the shorter time of antibiotic use the better."

A recent study in rats shows that an innovative patch prevented the stretching of the heart muscle common after a heart attack.

A heart attack occurs when the blood flow that provides the heart muscle with oxygen is significantly reduced or blocked.

The heart muscle is injured in the process, and the amount of damage usually depends on the size of the area supplied by the blocked artery.

It can take about 8 weeks for the heart muscle to heal. Despite the damage, the rest of the heart has to keep on pumping blood.

Scar tissue may form in the injured area and have an impact on the amount of blood that the heart is able to pump.

Most people who survive a heart attack have some degree of coronary artery disease. This occurs when arteries become hardened and narrowed. Usually, survivors have to make crucial lifestyle changes and may have to take medication to prevent a future heart attack.

According to the Centers for Disease Control and Prevention (CDC), more than 700,000 people in the United States have a heart attack every year. Of these, more than 500,000 experience their first heart attack and about 200,000 have already had one.

Signs of a heart attack include chest pain and shortness of breath. Half of U.S. individuals have at least one of the following risk factors: high blood pressure, high cholesterol, or smoking.

Diabetes, obesity, physical inactivity, and excessive alcohol use also increase the risk of a heart attack.

Testing a new type of adhesive heart patch

Scientists at Brown University in Providence, RI, Fudan University in Shanghai, China, and Soochow University in Suzhou, China have collaborated to create and test a new type of adhesive heart patch on rats.

The study was an interdisciplinary effort among researchers in computer modeling and mechanics, material scientists, and cardiology. The scientists published their findings in the journal Nature Biomedical Engineering.

The scientists created this adhesive patch using a water-based hydrogel material and developed it using computer simulations. The patch can sit directly on the heart, and the results of the study show that it may help limit the muscle damage that often occurs after a heart attack.

"The idea here," explains study co-author Prof. Huajian Gao, from Brown University, "is to provide mechanical support for damaged tissue, which hopefully gives it a chance to heal."

Prof. Gao goes on to say that past studies had shown that mechanical patches could be effective, but no research had attempted to identify the "optimum mechanical properties." Getting those properties right is crucial to ensuring that the patch can work properly.

"If the material is too hard or stiff," he adds, "then you could confine the movement of the heart so that it can't expand to the volume it needs to. But, if the material is too soft, then it won't provide enough support. So, we needed some mechanical principles to guide us."

Creating right mechanical properties is key

The researchers developed a computer model focused on two key components, one of which was the expanding and contracting of the heart and the impact the patch had on these functions.

The other was to model the injuries that occur after a heart attack. In this way, the team could look at how much mechanical support would be necessary to limit the damage.

Following the results of the computer model, the researchers — led by Prof. Lei Yang, of Soochow University — created a hydrogel material using food-sourced starch. This material is inexpensive, easy to make, and viscoelastic, which means that "it combines fluid and solid properties."

The study in rats showed that this new type of adhesive patch was effective in reducing muscle damage after a heart attack.

"[It] maintained a better cardiac output and thus greatly reduced the overload of those remaining cardiomyocytes and adverse cardiac remodeling," says study co-author Ning Sun, a cardiology researcher at Fudan University.

Their research found that the patch can reduce cell death, the accumulation of scar tissue, and oxidative stress. The researchers believe that more testing is required, but the results are promising.

"It remains to be seen if it will work in humans, but it's very promising."

Prof. Huajian Gao

Chest pain can be a sign that a person is having a heart attack. However, chest pain is also a common symptom of other, less serious conditions, such as gastroesophageal reflux disease.

Doctors refer to pain from heart attacks and other conditions that affect the cardiovascular system as cardiac chest pain. Pain that does not come from the cardiovascular system is called noncardiac chest pain.

Gastroesophageal reflux disease (GERD) can cause heartburn, which is a common type of noncardiac chest pain.

While heart attacks are a life-threatening medical emergency, heartburn is not. Therefore, being able to recognize the difference between cardiac and noncardiac chest pain is essential.

In this article, we discuss the symptoms of GERD and heart attacks along with the differences between cardiac and noncardiac chest pain. We also cover other causes of both types of chest pain.

Is it GERD?
Many conditions can cause chest pain, including acid reflux.

New research finds that sticking to a diet rich in fruits, vegetables, and fish can slash heart failure risk by 41 percent. By contrast, a diet rich in fats, fried foods, processed meat, and sugary drinks can raise the risk of this condition.

Heart failure occurs when the heart cannot supply enough blood and oxygen to the main organs in the body.

The condition affects about 5.7 million people in the United States and approximately 26 million people worldwide.

Some experts predict that heart failure will become more and more prevalent worldwide, which has led them to refer to it as a "global pandemic."

However, emerging evidence suggests that a diet consisting mainly of fruits and vegetables can prevent cardiovascular disease. Now, a new study strengthens this idea.

Dr. Kyla Lara, a cardiology fellow at the Mayo Clinic in Rochester, MN, and her colleagues, have examined the associations between five major dietary patterns and the risk of heart failure among people without any known history of heart disease.

Dr. Lara and her team published the results of their study in the Journal of the American College of Cardiology.

The effect of diets on heart failure

The researchers examined data available from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Namely, they looked at the dietary patterns among 16,068 black and white people who were 45 years old, on average.

The participants answered a 150-item survey, which included 107 food items. The researchers grouped the foods into five dietary patterns:

"convenience" diets, which consisted of meat-heavy dishes, pasta, pizza, and fast food "plant-based" diets, consisting mainly of vegetables, fruit, beans, and fish "Southern" diets, which comprised a significant amount of fried foods, processed meat, eggs, added fats, and sugary drinks "alcohol/salads" diets, which included lots of wine, liquor, beer, leafy greens, and salad dressing.

Dr. Lara and team followed the participants for 8.7 years on average, during which time, 363 people spent time in the hospital for heart failure for the first time.

Of these, 133 people had heart failure with preserved ejection fraction, and 157 had heart failure with reduced ejection fraction. The former refers to a form of heart failure in which the ejection fraction — a measure of how well the heart is pumping blood — is "normal," or "preserved."

Plant-based diets slash heart failure risk

Overall, the researchers found that adhering to the Southern diet increased the risk of hospitalization due to heart failure by 72 percent.

But when the researchers adjusted for body mass index (BMI), "waist circumference, hypertension, dyslipidemia, diabetes mellitus, atrial fibrillation, and chronic kidney disease," this association became no longer statistically significant.

This could mean that the Southern diet raises heart failure risk by increasing obesity and abdominal fat, explain the researchers.

Importantly, the researchers found that the risk of heart failure hospitalizations was 41 percent lower among people who adhered to the plant-based diet.

Finally, the researchers found no statistically significant associations among heart failure risk and the other three dietary patterns.

"Adherence to a plant-based dietary pattern was inversely associated with incident [heart failure] risk, whereas the Southern dietary pattern was positively associated with incident [heart failure] risk," conclude the researchers, who also outline some strengths and limitations to their study.

The researchers say that the socio-economically and demographically diverse study sample made the associations stronger. However, the study participants may have wrongly estimated their dietary intakes, which may have biased the results.

Also, the researchers examined the participants' diets only at the beginning of the study, and these dietary habits may have changed throughout the study period.

In a linked editorial, Dr. Dong Wang, a research fellow at the Harvard T.H. Chan School of Public Health in Boston, MA, comments on the significance of the findings, "This study represents an important step forward in establishing a robust evidence base for the dietary prevention of heart failure."

"The need for population-based preventive strategies for heart failure is critical [...] These findings support a population-based dietary strategy for lowering the risk of incident heart failure."

Dr. Kyla Lara

A meta-analysis of trials comparing the health effects of red meat consumption with those of other diets found that substituting healthful plant protein for red meat helps lower the risk of cardiovascular disease.

Many studies throughout the years have linked the consumption of red meat to cardiovascular disease and cancer, but the results have been inconsistent.

A 2015 study comparing the effects of plant protein and animal protein on the risk of cardiovascular disease found that the evidence was inconclusive.

Recent studies further investigated the link between red meat consumption and heart disease and found that red meat does not significantly increase the risk of cardiovascular disease when a person sticks to the recommended intake. Most of these studies focused on the potential harms of red meat, but they did not include an analysis of other specific diets.

Researchers from Harvard T.H. Chan School of Public Health in Boston, MA, and Purdue University in West Lafayette, IN, conducted the first meta-analysis of randomized controlled trials analyzing the effects of red meat by replacing it with other types of food. The results feature in the journal Circulation.

Red meat consumption in the United States

This new approach allowed researchers to examine a different side of the issue. Red meat consumption remains a very controversial topic, especially in the U.S., where the consumption of red meat per capita was more than 200 pounds in 2018, according to the U.S. Department of Agriculture.

Although red meat consumption in the U.S. is still high, chicken production and consumption have been increasing. The U.S. per capita beef consumption is down from its peak, but it is still remarkable — it is four times as high as the global average, according to the Organisation for Economic Co-operation and Development.

A recent survey showed that many people in the U.S. might be open to reducing their meat consumption in the future because they are becoming more aware of the associations that red meat has with nutritional and environmental health harms. The researchers suggested that education campaigns are necessary to accelerate the shift to a more sustainable diet.

Asking 'Is red meat good or bad?' is useless

In this latest study, the researchers analyzed data from 36 randomized controlled trials, which included a total of 1,803 participants. The team looked at blood pressure and blood concentrations of cholesterol, triglycerides, and lipoproteins in people who ate diets with red meat. They then compared these values with those of people who ate more of other foods, such as chicken, fish, carbohydrates, legumes, soy, or nuts.

"Previous findings from randomized controlled trials evaluating the effects of red meat on cardiovascular disease risk factors have been inconsistent," says Marta Guasch-Ferré, lead author of the study and research scientist in the Department of Nutrition at the Harvard T.H. Chan School of Public Health.

"But, our new study, which makes specific comparisons between diets high in red meat versus diets high in other types of foods, shows that substituting red meat with high-quality protein sources lead to more favorable changes in cardiovascular risk factors."

The findings showed that there were no significant differences in total cholesterol, lipoproteins, or blood pressure between those who ate red meat and those who ate more of other types of food. However, diets high in red meat did cause an increase in triglyceride concentrations. Conversely, diets rich in high-quality plant protein lowered the levels of bad cholesterol.

"Asking 'Is red meat good or bad?' is useless," says Meir Stampfer, senior author of the study and professor of epidemiology and nutrition at Harvard T.H. Chan. "It has to be 'Compared to what?'"

"If you replace burgers with cookies or fries, you don't get healthier. But, if you replace red meat with healthy plant protein sources, like nuts and beans, you get a health benefit."

Prof. Meir Stampfer

The authors recommend that people follow healthful vegetarian and Mediterranean-style diets that provide plenty of high-quality plant protein because they offer excellent health benefits and promote environmental sustainability.

Peanuts have a strong nutritional profile. They are an excellent source of plant-based protein, fiber, and many key vitamins and minerals.

Peanuts come in many forms, including roasted, salted, chocolate-coated, and as peanut butter. Different types have different nutritional profiles and various health benefits.

Along with their healthful nutritional profile, peanuts are a calorie-rich food, so they are most healthful when enjoyed in moderation.

In this article, we provide the nutritional profile of peanuts, their health benefits, and how different types compare.

Nutritional breakdown
Peanuts are most healthful when they are in their raw form.

Brazil nuts come from the South American Bertholletia excelsa, or Brazil nut, tree. They are a good source of healthful fats, protein, fiber, and selenium.

Despite its name, the Brazil nut is technically a seed rather than a nut. By definition, nuts are hard-shelled fruits that contain a single, large seed. Walnuts and pistachios are good examples.

Brazil nuts may offer surprising and powerful nutritional benefits, including boosting heart health, providing antioxidants, and improving brain function.

In this article, we discuss the health benefits of Brazil nuts, their risks, and how to add them to the diet.

1. Nutrition
Brazil nuts are a healthful source of essential nutrients.

Although 3D printing has advanced in leaps and bounds over the past few years, using it to print functioning human organs is still a far-flung dream. Recently, however, scientists have brought this dream one step closer.

Cardiovascular disease is the leading cause of death in the United States.

According to the Centers for Disease Control and Prevention (CDC), 610,000 people in the U.S. die from heart disease each year.

Once it has progressed to its final stages, the only treatment option is a heart transplant.

Because there are too few heart donors, the wait for a life-saving transplant is long.

Scientists are keen to find ways of patching up existing heart tissue to remove or postpone the need for a transplant.

For instance, if surgeons could impant a material into the heart, it could form a temporary scaffold to support cells and boost cellular reorganization.

This so-called cardiac tissue engineering has a number of problems; primarily, scientists need to find a type of material that the body would not reject. Researchers have already tried a range of materials and methods, but the perfect candidates are cells from the body of the patient.

Bioink and stem cells

During recent years, researchers have made some progress toward artificially replicating human tissue.

A group of scientists from Tel Aviv University in Israel has taken this work one step further and moved cardiac tissue engineering to the next stage.

"This is the first time anyone anywhere has successfully engineered and printed an entire heart replete with cells, blood vessels, ventricles, and chambers."

Lead researcher Prof. Tal Dvir

The scientists have designed a groundbreaking approach that allows them to create the closest thing to an artificial heart to date.

Their first step was to take a biopsy of fatty tissue from the patient; then, they separated cellular material from noncellular material.

The researchers reprogrammed the cells of the fatty tissue to become pluripotent stem cells, which can develop into the range of cell types necessary to grow a heart.

The noncellular material consists of structural components, such as glycoproteins and collagen; the scientists modified these to turn them into a "bioink."

Then, they mixed this bioink with the stem cells. The cells differentiated into cardiac or endothelial cells (which line blood vessels), which the scientists could use to create cardiac patches, including blood vessels.

They describe their methods in detail in a recent paper published in the journal Advanced Science.

'The size of a rabbit's heart'

"This heart is made from human cells and patient-specific biological materials. In our process these materials serve as the bioinks, substances made of sugars and proteins that can be used for 3D printing of complex tissue models," says Prof. Dvir.

He goes on to say: "People have managed to 3D-print the structure of a heart in the past, but not with cells or with blood vessels. Our results demonstrate the potential of our approach for engineering personalized tissue and organ replacement in the future."

To demonstrate the potential of their technique, the scientists created a small but anatomically precise heart, complete with blood vessels and cells.

"At this stage, our 3D heart is small, the size of a rabbit's heart," says Prof. Dvir. "But larger human hearts require the same technology."

It is worth noting that this technology is still very far from being able to replace heart transplants. This is just another step along the path — albeit a rather large step.

The crucial next task, as Prof. Dvir says, is to teach them to behave like hearts; he explains that they "need to develop the printed heart further. The cells need to form a pumping ability; they can currently contract, but we need them to work together."

"Our hope," he goes on, "is that we will succeed and prove our method's efficacy and usefulness."

There is still a long road ahead, but the researchers are excited about how far they have come.

"Maybe, in 10 years, there will be organ printers in the finest hospitals around the world, and these procedures will be conducted routinely."

Prof. Tal Dvir

A recent study warns that women with low levels of low-density lipoprotein cholesterol, sometimes called "bad cholesterol," may face an increased risk of bleeding stroke.

According to the latest guidelines from the American College of Cardiology and the American Heart Association, a person's levels of low-density lipoprotein (LDL) cholesterol should remain under 100 milligrams per deciliter (mg/dl) to maintain health.

That is because, generally, specialists have considered LDL to be "bad" cholesterol. LDL carries cholesterol to the cells that need to make use of it, but if its levels are too high, it can stick to the arteries, leading to all manner of cardiovascular problems.

However, new research from the Brigham and Women's Hospital and Harvard Medical School in Boston, MA, has found that women with LDL levels below 100 mg/dl may actually be more at risk of hemorrhagic (bleeding) stroke. This type of stroke, though less common than an ischemic stroke, is harder to treat and thus more dangerous to the person experiencing it.

"Strategies to lower cholesterol and triglyceride levels, like modifying diet or taking statins, are widely used to prevent cardiovascular disease," explains study author Pamela Rist, from Brigham and Women's Hospital.

"But, our large study shows that in women, very low levels may also carry some risks. Women already have a higher risk of stroke than men, in part because they live longer, so clearly defining ways to reduce their risk is important."

Pamela Rist

The new study's findings now appear online ahead of print in the journal Neurology.

In this study, the researchers looked at the data of 27,937 women aged 45 years and over who took part in the Women's Health Study. The data included measurements of each participant's LDL cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride levels at the beginning of the study.

Rist and team looked at both these data and the participants' medical records over an average 19-year follow-up period.

They found that during this time, 137 women had experienced a bleeding stroke. They noted that nine (or 0.8 percent) of the 1,069 women with LDL levels of 70 mg/dl or lower experienced this type of cardiovascular event, whereas it affected 40 (or 0.4 percent) of the 10,067 women with LDL cholesterol levels of 100–130 mg/dl.

After adjusting for possible confounding factors, the researchers concluded that women with the lowest levels of LDL cholesterol were more than twice (2.2 times) as likely to have a bleeding stroke as those with high LDL cholesterol levels.

They identified a similar association in relation to triglyceride levels: 34 (or 0.6 percent) of the 5,714 women with the lowest triglyceride levels had experienced a bleeding stroke, whereas this event had occurred in 29 (0.4 percent) of the 7,989 women with the highest triglyceride levels.

Once more, after adjusting for other potential risk factors, the team concluded that women with the lowest triglyceride levels had a risk of bleeding stroke that was twice as high as that of the women with the highest triglyceride levels.

At the same time, the researchers found no such discrepancies regarding total cholesterol and HDL cholesterol levels.

"Women with very low LDL cholesterol or low triglycerides should be monitored by their doctors for other stroke risk factors that can be modified, like high blood pressure and smoking, in order to reduce their risk of hemorrhagic stroke," Rist advises.

"Also, additional research is needed to determine how to lower the risk of hemorrhagic stroke in women with very low LDL and low triglycerides," she adds.

The researchers also admit that their study has faced some limitations, including the fact that they only had access to cholesterol and triglyceride level measurements at baseline and that they did not have a chance to investigate whether menopause-related factors played a role in some of the women's increased stroke risk.

A low-carb, high-fat diet involves a person reducing the number of carbohydrates they consume and replacing them with healthful fats. In recent years, this type of diet has become popular among people trying to lose weight.

A low-carb, high-fat diet (LCHF) involves using ketones from fat for energy instead of glucose, which comes directly from carbohydrates. When a person significantly reduces or limits the number of carbs they consume in a day, it forces the body to use fat stores as fuel, which may lead to weight loss.

However, science does not always agree on the safety of LCHF diets. Although some research supports its use to help a variety of health conditions, other studies report that LCHF diets can be dangerous.

Read on to learn more about LCHF diets, how to begin, and are they safe?

Is a low-carb, high-fat diet good for you?
An LCHF diet may have a positive effect on type 2 diabetes and certain cancers.

A large Swedish population study has found strong links between psychiatric conditions that can follow extremely stressful experiences and the risk of several types of cardiovascular disease.

In addition, the researchers found that the risk of a heart attack and other sudden and severe cardiovascular events is especially high in the 6 months that follow the diagnosis of the stress-related condition.

For other types of cardiovascular disease — such as heart failure, a disease that develops slowly — the risk appears to be highest during the 12 months that follow the psychiatric diagnosis.

For embolism and thrombosis, which are major conditions that develop from blood clots, the risk is likely higher 1 year or more after a diagnosis of stress-induced illness.

In a paper in The BMJ about the study, the authors state that the findings apply "equally to men and women" and do not depend on medical history, family background, or having other psychiatric illnesses.

They also note that the results support those of previous studies on relations between stress-induced conditions and cardiovascular disease.

However, most previous findings have come from research that drew largely on male war veterans or men on active military service, and they also focused almost entirely on PTSD, with symptom data from self-reports.

PTSD and similar stress-induced conditions

Anyone who has witnessed or experienced a traumatic event, such as combat, rape, violent assault, or natural disaster can develop PTSD, which affects around 3.5 percent of adults in the United States.

However, witnessing or experiencing a traumatic event does not necessarily lead to PTSD.

When diagnosing PTSD, doctors look for symptoms such as startled reaction to loud noise, flashbacks, and nightmares, together with feelings of detachment, more-than-usual anger, sadness, and irritability that remain intense and do not wane with time.

In some people, the symptoms of PTSD can last for years.

Acute stress disorder is a similar condition to PTSD; it can occur in response to traumatic events and has some of the same symptoms, but it tends to arise within 3–30 days after the traumatic event.

In the U.S., estimates suggest that 13–21 percent of car accident survivors and up to half of those who survive rape, assault, or mass shootings will develop acute stress disorder. Around half of the people with acute stress disorder go on to develop PTSD.

The study and its key findings

The new investigation used 1987–2013 data from the Swedish National Patient Register on 136,637 patients "with stress-related disorders, including [PTSD], acute stress reaction, adjustment disorder, and other stress reactions."

The researchers ran comparisons between this "exposed" cohort and two other "unexposed" cohorts, one comprising 171,314 full siblings and the other comprising 1,366,370 matched individuals from the general population. By unexposed, the researchers mean free of stress-related conditions.

The team first calculated the average rate of cardiovascular disease among the three cohorts over the period of the study. This came to 10.5 per 1,000 person-years for the exposed group and 8.4 and 6.9 for the unexposed sibling and matched general population cohorts, respectively.

Further analysis revealed links between psychiatric conditions resulting from trauma or highly stressful life events and a raised risk of developing a number of cardiovascular diseases. These links were particularly marked during the 12 months following the psychiatric diagnosis.

Specifically, those with a stress-related illness were 64 percent more likely to develop a form of cardiovascular disease in the 12 months after a psychiatric diagnosis than their unexposed siblings. Comparisons with unexposed, matched members of the general population yielded a similar result.

The researchers also found a particularly strong link between stress-induced psychiatric conditions and cardiovascular diseases that tend to develop before the age of 50.

Need to investigate 'bidirectional nature'

The authors point out that, due to the nature of their study design, they cannot conclude that stress-related disorders actually cause cardiovascular diseases.

Simon Bacon, a professor at Concordia University, in Montreal, Canada, takes up this point in a linked editorial.

He raises the possibility of cause being in the other direction. For example, could it be the case that people who already have some degree of cardiovascular disease are more susceptible to developing stress-induced psychiatric conditions?

To counter this, "as evidence" of cause running in the other direction, he points out that the researchers "quite rightly cite" the raised risk that they found of heart attack, stroke, and other acute cardiovascular events 1 year following the psychiatric diagnosis.

However, he also highlights the large effect that the researchers found in the link to a raised risk of heart failure and how this occurred "less than 1 year after diagnosis." Because heart failure is a disease that progresses slowly, "reverse causation cannot be ruled out entirely."

Prof. Bacon argues that these questions call for further investigation into the "potential bidirectional nature" of these links.

The researchers suggest that there is a need for doctors to know that cardiovascular disease could be more likely to develop following highly stressful events that lead to diagnoses of stress-related conditions, especially during the first year.

The authors conclude:

Preliminary research reveals that a technique called Inspiratory Muscle Strength Training can boost cognitive and physical performance, as well as cardiovascular health.

Most of us know that exercising and eating right are good for us.

However, putting in the effort to do so can often require more willpower than we have.

What if there was a way to reap all the benefits of a workout without having to lift a finger?

New research introduces a 5-minute technique that might improve blood pressure, lower heart attack risk, boost cognitive ability, and enhance sports performance — all while barely having to move.

The technique is called Inspiratory Muscle Strength Training (IMST), and researchers led by Daniel Craighead — a postdoctoral researcher in the University of Colorado Boulder's Department of Integrative Physiology — have tested the technique in a clinical trial.

"IMST is basically strength-training for the muscles you breathe in with," explains Craighead. The researcher and his colleagues presented the preliminary results of their research at the annual Experimental Biology conference, which this year takes place in Orlando, FL.

Why study the benefits of IMST?

IMST involves inhaling through a resistive hand-held device called an inspiratory muscle trainer. Its creators initially developed it for people with respiratory problems such as chronic obstructive pulmonary disease, bronchitis, or cystic fibrosis, or to wean people off ventilators.

Craighead and team explain that in 2016, a 6-week trial on the effects of IMST on obstructive sleep apnea — during which participants performed 30 inhalations per day — revealed that using the device also lowered systolic blood pressure by 12 millimeters of mercury.

Exercising for the same amount of time usually only lowers blood pressure by half that amount, and the benefits seem to exceed those normally achieved with hypertension medication.

This trial piqued the researchers' interest, so they set out to study the possible benefits of IMST for the vascular, cognitive, and physical health of 50 middle-aged adults.

"Our goal is to develop time-efficient, evidence-based interventions that [...] busy midlife adults will actually perform," explains senior investigator Prof. Doug Seals, the director of the University of Colorado Boulder's Integrative Physiology of Aging Laboratory.

Lowers blood pressure and boosts cognition

The researchers compared participants who tried IMST with people who used a sham device that provided no resistance on inhalation. They found that the blood pressure was significantly lower among IMST participants and that the function of their large arteries had improved considerably.

IMST participants also performed better on cognitive tests and treadmill tests. In the treadmill tests, they were able to run for longer and keep their heart rate and oxygen consumption low.

"[IMST is] something you can do quickly in your home or office, without having to change your clothes, and so far it looks like it is very beneficial to lower blood pressure and possibly boost cognitive and physical performance."

Daniel Craighead

"High blood pressure," claims Craighead, "is a major risk factor for cardiovascular disease, which is the number one cause of death in America. Having another option in the toolbox to help prevent it would be a real victory."

However, the study authors caution that their results are preliminary, and that people interested in the technique should consult their physician first.