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Moderate drinking tied to lower risk of hospitalization

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

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

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

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

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

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

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

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

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

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

Simona Costanzo

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

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

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

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

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

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

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Taquicardia: Causas, síntomas y tratamientos

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

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

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

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

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

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

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

Aurículas, ventrículos y circuitos eléctricos del corazón

El corazón humano se compone de cuatro cavidades:

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

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

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

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

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

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

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

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

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

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

People should not use this medication while pregnant.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Obesity and heart failure

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

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

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

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

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

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

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A practical way to obtain weight history

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

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

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

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

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

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

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

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

Weight history tied to heart failure risk

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

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

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

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

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

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Doctors should ask about weight history

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

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

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

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

Dr. Erin D. Michos

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How can you tell when you have high blood pressure?

High blood pressure is called a "silent killer" because it rarely causes symptoms until it severely damages a person's health.

High blood pressure, or hypertension, affects around 1 in 3 American adults. The current guidelines and definition mean that close to half of all adults in the United States will be diagnosed with the condition.

When a person has high blood pressure, their blood is putting too much pressure on the walls of the arteries as it flows through.

If a person does not receive treatment, hypertension can cause serious health complications, such as heart disease and stroke. Nearly everyone can treat hypertension with lifestyle changes, and some people may also benefit from medication.

In this article, we discuss the myths and facts of high blood pressure symptoms. We also describe high and normal blood pressure readings and complications of high blood pressure.

Fact and fiction Senior man checking his blood pressure
A person can check their blood pressure to find out what it is.

Some people may believe that if they do not experience symptoms, they have no reason to worry about their blood pressure. Unfortunately, this is not the case.

High blood pressure usually has no symptoms until it causes serious complications. The only way to know a person's blood pressure is to check it.

Many believe that high blood pressure causes symptoms such as headaches, nervousness, sweating, and facial redness. However, according to the American Heart Association (AHA), hypertension often causes none of these issues.

Symptoms that people often mistakenly attribute to high blood pressure include:

Headaches and nosebleeds: Hypertension only causes headaches or nosebleeds when blood pressure is dangerously high, which is known as a hypertensive crisis. This is considered a medical emergency. Dizziness: High blood pressure does not cause dizziness, though some blood pressure lowering medications can make a person feel dizzy. Facial redness: Hypertension does not cause facial flushing, but a person may temporarily experience both high blood pressure and facial flushing from factors such as stress, alcohol, or spicy foods.

People may experience symptoms of high blood pressure when the reading suddenly rises above 180/120 millimeters of mercury (mmHg). This is considered a hypertensive crisis with hypertensive urgency or a hypertensive emergency depending on a person's other symptoms.

Symptoms of a hypertensive crisis include the following:

severe headaches nosebleeds chest pain back pain severe anxiety shortness of breath Thank you for supporting Medical News Today Interpreting blood pressure readings Blood pressure readings contain two numbers expressed as a fraction, such as 120/80 mmHg. Systolic pressure is the first number, and diastolic pressure is the second. The readings show pressure in different stages: Systolic pressure: This indicates pressure in the arteries when the lower part of the heart beats and the blood pushes harder against the artery wall. Diastolic pressure: This indicates the pressure in the blood vessels between beats. The current definitions of normal and high blood pressure are: Blood pressure Systolic mmHg Diastolic mmHg Normal Less than 120 and Less than 80 Elevated 120–129 and Less than 80 Hypertension stage 1 130–139 or 80–89 Hypertension stage 2 140 or higher or 90 or higher Hypertensive crisis Higher than 180 and/or Higher than 120 Doctors group blood pressure readings into the following categories: Hypotension Doctors define hypotension, or low blood pressure, as pressure below 90/60 mmHg. Extremely low blood pressure can result in less oxygen flowing to organs, which can lead to health complications. Normal Normal blood pressure for adults refers to readings between 90/60 mmHg and 120/80 mmHg. Elevated Having a systolic pressure reading of 120–130 mmHg and a diastolic pressure reading below 80 mmHg is considered a red flag. Although these readings are beneath the range for hypertension, they indicate blood pressure that is higher than normal. Elevated blood pressure can rise and become dangerous. Hypertension stage 1 Hypertension stage 1 includes systolic pressures between 130–139 mmHg and diastolic pressures between 80–89 mmHg. Hypertension stage 2 This is a more severe form of high blood pressure. Hypertension stage 2 refers to systolic pressures of 140 mmHg or higher, or diastolic pressures of 90 mmHg or higher. Hypertensive crisis Hypertensive crisis refers to extremely high blood pressure, of above 180/120 mmHg. Doctors consider this an emergency. It requires immediate medical intervention to prevent damage to blood vessels and major organs. Symptoms of high blood pressure in pregnancy Pregnant woman with a headache
Symptoms of high blood pressure during pregnancy can include nausea and headaches. Hypertension is relatively common during pregnancy, affecting an estimated 6–8 percent of pregnant women ages 20–44 in the U.S. Hypertension during pregnancy is treatable. Women who have chronic high blood pressure can still have healthy babies, as long as they closely monitor and address their blood pressure throughout their pregnancy. If a pregnant woman does not receive treatment, however, the uncontrolled high blood pressure can cause serious complications for herself and the baby. Symptoms and signs of high blood pressure during pregnancy include: headaches nausea vomiting abdominal pain weight gain edema, or swelling signs of kidney problems, such as protein in the urine (proteinuria) shortness of breath dizziness vision problems Thank you for supporting Medical News Today Complications of high blood pressure High blood pressure can cause unnoticeable but progressive damage to the body over the course of several years before a person develops complications. Some complications of high blood pressure include: sexual dysfunction damage to the arteries and other blood vessels a heart attack heart failure ischemic heart disease microvascular disease an abnormally thickened wall of the left ventricle, which is called left ventricular hypertrophy an ischemic or hemorrhagic stroke an artery aneurysm and rupture vision loss kidney disease, including kidney failure Summary High blood pressure is a common health condition that can cause serious complications if a person does not receive treatment. Some people mistakenly believe that hypertension will cause noticeable symptoms, like headaches, nosebleeds, and dizziness. However, these usually do not occur until high blood pressure becomes a medical emergency. Usually, there are no symptoms, so many people are unaware that they have high blood pressure until serious health complications occur. The only way to assess blood pressure is to get it checked. It is important to do so regularly, especially for people who have had readings above the normal range. Women can develop high blood pressure during pregnancy. It may be a good idea for pregnant women to speak to their healthcare providers about ways to prevent or reduce high blood pressure.
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Mediterranean diet reduces cardiovascular risk by a quarter

A recent study has put the Mediterranean diet to the test once more, attempting to unpick the molecular mechanisms that produce its benefits.
Mediterranean diet couple dinner
More good news for advocates of the Mediterranean diet.

Inspired by the traditional eating patterns of people from Greece, Italy, and Spain, the Mediterranean diet can seemingly do no wrong.

In a nutshell, the diet is rich in plants and olive oil but low in meat and sugary products.

Over the years, studies have concluded that this eating pattern lowers the risk of various health issues, including coronary heart disease and stroke.

Studies have even concluded that the Mediterranean diet might extend lifespan in older adults as well as reduce the risk of Parkinson's and Alzheimer's.

Evidence is mounting for its health benefits, but scientists still do not know exactly how these benefits come about.

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The Mediterranean black box

A new study published in JAMA Network Open asks the following question: "Is the Mediterranean diet [...] associated with lower risk of cardiovascular disease (CVD) events in a [United States] population, and, if so, what are the underlying mechanisms?"

As corresponding study author Dr. Samia Mora explains, "While prior studies have shown benefit for the Mediterranean diet on reducing cardiovascular events and improving cardiovascular risk factors, it has been a black box regarding the extent to which improvements in known and novel risk factors contribute to these effects."

To investigate, the scientists took data from the Women's Health Study. Lead study author Shafqat Ahmad, Ph.D., led researchers from Brigham and Women's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health — all in Boston, MA.

In all, they had access to the health records and dietary habits of 25,994 women, all of whom were healthy at the start of the study. The researchers followed them for a maximum of 12 years.

The researchers measured the levels of 40 biomarkers, including lipids, inflammation, glucose metabolism, and lipoproteins. They split the participants into three groups — low, middle, and upper intake — depending on how strictly they adhered to the Mediterranean diet.

They were particularly interested in cardiovascular events, such as stroke and heart attack. They found that:

In the low intake group, 4.2 percent of women had a cardiovascular event. In the middle intake group, 3.8 percent of women had a cardiovascular event. In the upper intake group, 3.8 percent of women had a cardiovascular event.
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This marks the first long-term study in a U.S. population to explore the impact of the Mediterranean diet on CVD. The authors conclude:

"[H]igher [Mediterranean diet] intake was associated with approximately one-quarter lower risk of CVD events over a 12-year follow-up period."

The authors also note that this effect size is equivalent to that present in people who take statins, which are common drugs that doctors prescribe to lower cardiovascular risk.

Mediterranean metabolites

Next, they dived into the metabolic data to see if they could find any patterns. They discovered that variation in metabolites related to inflammation accounted for 29 percent of the reduction in CVD risk.

Glucose metabolism and insulin resistance accounted for 27.9 percent, body mass index (BMI) for 27.3 percent, and blood pressure for 26.6 percent.

The team also noted relationships between a number of other metabolites, including lipids, but these were less pronounced.

Dr. Mora says, "In this large study, we found that modest differences in biomarkers contributed in a multifactorial way to this cardiovascular benefit that was seen over the long-term."

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Once again, the Mediterranean eating pattern seems to have come up trumps; and now we know that its benefits are most likely due to the way it interacts with inflammation pathways, glucose metabolism, and insulin resistance.

Of course, there are some limitations to the study. For instance, as the authors explain, CVD risk could have been influenced by as-yet-unknown metabolic factors that the scientists did not measure in this study.

Also, the dietary information that they analyzed relied on the participants keeping a food diary, which comes with a potential for human error. However, the size of this study and the detailed information about biomarkers make this a relatively reliable research endeavor.

As evidence in favor of the Mediterranean diet mounts, its popularity is sure to continue climbing.

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Chronic venous insufficiency: What to know

Venous insufficiency occurs when the valves in a person's veins do not work properly. This means that the veins are less able to transport blood back to the heart.

Venous insufficiency is fairly common. According to the Society for Vascular Surgery, it affects up to 40 percent of people in the United States.

It is also usually chronic. This condition causes leg and foot swelling, varicose veins, and aching legs.

In this article, we cover the causes and risk factors for venous insufficiency, as well as how to diagnose and treat it.

What is venous insufficiency? Woman holding her leg due to venous insufficiency
Symptoms of venous insufficiency can include dull aching and swelling in the legs and blood clots.

The heart pumps oxygen-rich blood through the arteries to the rest of the body, while the veins bring deoxygenated blood back to the heart.

When a person has venous insufficiency, their veins have trouble moving deoxygenated blood from the arms and legs back to the heart. Faulty valves inside the veins usually cause venous insufficiency.

Veins have valves made up of two flaps, which prevent the backward flow of blood. These are called bicuspid valves. If the veins are damaged or become dilated, the valves may fail to close properly.

When the valves do not work properly, blood will flow back into the veins instead of forward to the heart. This causes blood to pool in the veins, often in the legs and feet.

This results in many of the symptoms associated with venous insufficiency, such as skin discoloration, swelling, and pain.

Symptoms Some of the symptoms of venous insufficiency include: heaviness, throbbing, or dull aching in the legs swelling of the legs and ankles cramping or itching in the legs patches of darker, brownish skin thicker or harder skin on the legs or ankles open sores blood clots varicose veins Thank you for supporting Medical News Today Causes and risk factors varicose veins on the leg
Varicose veins can cause venous insufficiency. The following factors are more likely to cause venous insufficiency: having a family history of the condition having blood clots having varicose veins being pregnant having obesity smoking having phlebitis, or swelling of superficial veins sitting or standing for long periods of time Treatments The best treatment for chronic venous insufficiency will vary from person to person. Doctors must consider several factors before deciding on the best treatment course. Some of these factors include the cause and symptoms of venous insufficiency and the age and health status of the person. Treatments for chronic venous insufficiency include the following: Medications Healthcare provides may prescribe medications that improve blood flow through the vessels. Some medications that can help treat venous insufficiency include: diuretics, which are medications that remove excess fluid from the body pentoxifylline, which reduces inflammation and improves blood flow blood thinners, or anticoagulants, which prevent blood clots Home remedies People can reduce the symptoms of venous insufficiency at home using the following methods: Wearing compression stockings. These are special elastic stockings that apply pressure to the lower leg and foot. Compression stockings help reduce swelling and improve blood flow. Elevating the legs above the heart. This helps pull blood from the legs toward the heart Practicing good skin hygiene. People with venous insufficiency can develop skin problem, such as dermatitis, cellulitis, or atrophie blanche (white atrophy). People with venous insufficiency can take care of their skin using the following methods: keeping it moisturized so that it does not become dry or flaky exfoliating regularly to remove dead skin cells applying topical ointments as their healthcare provider instructs Nonsurgical procedures The following nonsurgical methods can help treat venous insufficiency: Ablation In some cases, doctors will recommend destroying damaged veins in a process called ablation. They destroy the veins by applying either heat or chemicals. Sclerotherapy In sclerotherapy, a doctor will inject a liquid or foam solution into the damaged vein. The vein reacts to the solution and swells shut. Then, the body absorbs the vein and redirects blood to other healthy veins. Phlebectomy A phlebectomy is a minimally invasive procedure in which a medical professional removes varicose veins through small punctures in the skin. Laser therapy Laser therapy is a relatively new procedure in which a doctor uses lasers to close damaged veins. Surgical procedures People with serious cases of venous insufficiency may require surgery. Some surgical procedures that treat venous insufficiency include: repairing damaged veins or valves stripping or removing damaged veins implanting a small mesh tube, called a stent, to widen the vein ligation, in which a doctor ties off veins through a small incision in the skin Types of venous insufficiency Chronic venous insufficiency falls into three different categories depending on the severity of the symptoms. Stage 1. Swelling and changes in skin pigmentation characterize this stage. Stage 2. Swelling, changes in skin pigmentation, and dermatitis characterize this stage. Stage 3. Swelling, changes in skin pigmentation, varicose veins, and ulcers characterize this stage. Venous insufficiency can cause chronic venous hypertension, a condition characterized by high blood pressure in the veins of the legs. Blood clots or other blockages in the veins can also lead to this condition. If left untreated, chronic venous hypertension can cause abnormalities in the capillaries within the leg tissues, resulting in ulceration, swelling, and hyperpigmentation. This is a condition in which patches of skin become darker than usual. Thank you for supporting Medical News Today Diagnosis mri scanning procedure
A doctor may request an MRI scan to diagnose venous insufficiency. A physical examination is the first step toward diagnosing venous insufficiency. A doctor will also review a person's medical history and current health status before making a diagnosis. Diagnostic procedures that help determine whether or not a person has venous insufficiency include: Venogram. This examination uses X-ray technology to examine how blood flows through the veins. It requires injecting contrast material into a vein. Healthcare providers uses venograms to locate blood clots and evaluate varicose veins. Duplex ultrasound. This noninvasive test examines the speed and direction of blood flow through the veins and arteries. Additional medical tests for venous insufficiency can include: Prevention Many of the risk factors associated with venous insufficiency are related to a person's lifestyle. People can reduce their risk of developing venous insufficiency by making small lifestyle adjustments, such as: getting regular exercise avoiding wearing high heels avoiding standing or sitting for long periods of time maintaining a healthy body weight Summary Venous insufficiency is common condition in which the blood does not flow smoothly through the veins and back to the heart. This is due to faulty valves in the veins. Venous insufficiency is a common condition. It is not life-threatening, but it is usually chronic. Symptoms of venous insufficiency include varicose veins, swelling, and heavy, aching legs. Left untreated, venous insufficiency can lead to other health conditions, such as dermatitis, venous ulceration, and chronic venous hypertension. Treatment of venous insufficiency varies depending on the severity of the symptoms, the individual's medical history and current health status, and the cause of the condition. Treatments for venous insufficiency focus on managing symptoms and preventing further complications. Those who have had venous insufficiency require ongoing care even after successful treatment, as the condition often reappears.
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What to know about high blood pressure during pregnancy

A woman can develop high blood pressure, or hypertension, at any point during pregnancy.

High blood pressure is affecting more and more pregnant women. According to the Centers for Disease Control and Prevention (CDC), the number of pregnant women who developed high blood pressure in the United States almost doubled between 1993 and 2014.

High blood pressure affects an estimated 6–8 percent of pregnancies in women aged 20–44 in the U.S.

If left untreated, high blood pressure can lead to serious health complications for the mother, her infant, or both. In most cases, however, hypertension is preventable and treatable.

In this article, we will discuss the different types of high blood pressure that a woman can develop during pregnancy, the risk factors and complications of high blood pressure, and how to prevent and treat high blood pressure during pregnancy.

Types of hypertension in pregnancy Pregnant woman having her blood pressure taken
A woman may experience chronic hypertension, gestational hypertension, or preeclampsia during pregnancy.

According to the CDC, blood pressure measurements that are greater than or equal to 140/90 millimeters of mercury indicate high blood pressure.

Women can experience one of three types of high blood pressure during pregnancy: chronic hypertension, gestational hypertension, or preeclampsia.

A person may have chronic hypertension before pregnancy, whereas gestational hypertension only occurs during pregnancy.

However, gestational hypertension may sometimes persist after the pregnancy to become chronic hypertension.

Chronic hypertension

Women who have chronic hypertension either had high blood pressure before becoming pregnant or developed it within the first half, or 20 weeks, of their pregnancy.

It is possible for a woman to develop a subtype called chronic hypertension with superimposed preeclampsia.

Women with this condition have high blood pressure and can possibly develop an abnormal amount of protein in their urine, or proteinuria. The presence of protein in the urine can indicate problems with the kidneys. Women may also have changes in liver function.

Gestational hypertension

Gestational hypertension only occurs during pregnancy and without the presence of protein in the urine or changes in liver function. Women usually develop this condition in the second half, or after the first 20 weeks, of their pregnancy.

This form of high blood pressure is typically temporary and tends to go away after childbirth. However, it can increase a woman's risk of developing high blood pressure later in life.

In some cases, the blood pressure will remain elevated after the pregnancy, resulting in chronic hypertension.

Preeclampsia

Preeclampsia is a high blood pressure condition that women can develop during pregnancy or after giving birth. It is a serious condition that can have severe consequences. It usually occurs in the third trimester. It rarely occurs after delivery, but it is possible.

Doctors often diagnose preeclampsia after taking blood pressure measurements and testing blood and urine samples. Women who develop a mild form of preeclampsia may not experience any symptoms.

If symptoms of preeclampsia do develop, they can include:

high blood pressure proteinuria excessive swelling of the face and hands weight gain due to fluid retention headaches dizziness irritability shortness of breath abdominal pain nausea vomiting blurred vision sensitivity to light

Preeclampsia with seizures, or eclampsia, is a different condition. It can be fatal.

Complications of hypertension for the mother If hypertension is severe or uncontrolled, it can cause complications for the mother and baby. High blood pressure during pregnancy puts women at an increased risk of more serious health conditions later in life. One 2013 study revealed that gestational hypertension was associated with a higher risk of ischemic heart disease, myocardial infarction (heart attack), heart failure, and ischemic stroke. Poorly controlled high blood pressure puts a woman at risk of developing preeclampsia and gestational diabetes. One complication of hypertension is HELLP syndrome. This is a rare life-threatening liver and blood disorder. Doctors consider it to be a severe variant of preeclampsia. HELLP stands for: Hemolysis, or the breaking down of red blood cells Elevated Liver enzymes, which is a sign of liver damage Low Platelet count; platelets are a material that forms blood clots Other complications associated with high blood pressure during pregnancy include: stroke placental abruption, a serious medical condition in which the placenta separates from the wall of the uterus too early preterm delivery, or giving birth before the due date, which healthcare providers may advise if the placenta is not providing a enough nutrients and oxygen to the baby or if the mother's life is in danger Thank you for supporting Medical News Today Risks of hypertension for the baby High blood pressure can increase the risk of poor birth outcomes, such as preterm delivery, smaller-than-average size, and infant death. High blood pressure affects the mother's blood vessels. This can decrease the flow of nutrients through the placenta to the baby, resulting in a low birth weight. Hypertension-related preterm delivery can result in health complications for the baby. These may include difficulty breathing if the lungs are not fully developed, for example. Signs and symptoms Pregnant woman at the doctors
A pregnant woman should attend regular prenatal checkups. The American Heart Association (AHA) call high blood pressure the "silent killer" because most people who have it do not develop symptoms. This means that a person may have high blood pressure without knowing it. Monitoring blood pressure is an essential part of prenatal care. It is important to remember that women can develop high blood pressure before, during, and after their pregnancy. It is important that women attend regular prenatal checkups to ensure that their blood pressure and other vital signs are within normal ranges and receive treatment if not. Also, blood pressure fluctuates in response to small changes in a person's life, such as stress, diet, exercise, and the quality of their sleep. This is why it is so important that people check their blood pressure regularly. Risk factors for hypertension Risk factors for gestational hypertension and preeclampsia include: a history of preeclampsia preexisting hypertension pregestational diabetes having twins or triplets preexisting kidney disease some autoimmune diseases The following are risk factors for a person to develop hypertension: having a family history of high blood pressure being overweight race age having high cholesterol stress smoking cigarettes drinking alcohol not exercising often becoming pregnant at an older age having had high blood pressure during a previous pregnancy Thank you for supporting Medical News Today Treatment Women with chronic hypertension should continue taking antihypertensive medication during their pregnancy. However, some common antihypertensive medications are not suitable for pregnant women to take, so healthcare providers may recommend a different medication. If gestational hypertension is severe or a woman develops preeclampsia or eclampsia, a doctor may prescribe medications to lower her blood pressure and help the baby mature if the pregnancy is not full-term. Women may be hospitalized for monitoring. Healthcare providers may recommend anticonvulsive medications, such as magnesium sulfate, to prevent seizures in people with eclampsia or preeclampsia. In some cases, a doctor may advise delivery of the baby for treatment. The timing of delivery depends on how severe the mother's condition has become, as well as how far along the pregnancy is. Women who are pregnant should speak with their healthcare provider about ways to control their blood pressure. Prevention Pregnant woman performing yoga
Doctors recommend regular exercise to prevent high blood pressure. Making simple lifestyle changes, such as getting more exercise and eating a more balanced diet, can help prevent high blood pressure. It is important to note that some risk factors, such as family history, race, and past pregnancy history, are not within a person's control. For this reason, not all cases of hypertension in pregnancy are preventable. Some ways to lower the risk of high blood pressure during pregnancy include: limiting salt intake staying hydrated eating a balanced diet that is rich in plant-based foods and low in processed foods getting regular exercise getting regular prenatal checkups avoiding smoking cigarettes and drinking alcohol Medical professionals tend to recommend that people have regular blood pressure screening, especially when they have risk factors, so that they can begin to treat it early. Summary High blood pressure, or hypertension, during pregnancy can be life-threatening to a woman in some cases. If left untreated, high blood pressure can cause harm to both the mother and her infant. It does not always lead to serious health complication, and sometimes, it will go away following childbirth. Hypertension during pregnancy is typically preventable and treatable. A doctor must closely monitor hypertension in pregnancy to prevent potentially life-threatening health complications. It is important that women attend regular prenatal evaluations and report any abnormal symptoms to ensure their own health and that of their infant.
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Statins: Risk of side effects is low, say experts

For most people who take statins to lower cholesterol, the risk of side effects is low compared to the benefits, according to a recent scientific statement.
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New research suggests that the benefits of statins outweigh the risks.

The American Heart Association (AHA) statement applies to those who — according to current guidelines — are at risk of heart attack and ischemic strokes, which are strokes arising from blood clots.

Statins are drugs that reduce low-density lipoprotein (LDL) cholesterol by blocking an enzyme in the liver.

Around a quarter of adults over the age of 40 years old in the United States use statins to reduce their risk of heart attack, ischemic stroke, and other conditions that can develop when plaque builds up in arteries.

However, up to 1 in 10 of individuals taking statins stop using them because they assume that the drug is responsible for symptoms that they experience, although that may not be the case.

"Stopping a statin," says Dr. Mark Creager, who is director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, and former president of the AHA, "can significantly increase the risk of a heart attack or stroke caused by a blocked artery."

The journal Arteriosclerosis, Thrombosis, and Vascular Biology carries a full report on the research that went into the statement.

Within guidelines, 'benefits outweigh risks'

The statement's authors say that trials have proved that statins have had a major effect on reducing heart attacks, strokes, other cardiovascular diseases, and associated deaths.

Further to this, they reviewed a large number of studies and clinical trials that have evaluated the safety and potential adverse effects of statins.

"Over 30 years of clinical investigation," the authors write, "have shown that statins exhibit few serious adverse effects."

They point out that, apart from a few exceptions, it is possible to reverse the adverse effects of statin use. This should be compared, they argue, with the fact that heart attacks and stroke damage the heart or brain permanently, and they can kill.

They list the exceptions as "hemorrhagic stroke and the possible exception of newly diagnosed diabetes mellitus and some cases of autoimmune necrotizing myositis."

"Thus," they conclude, "in the patient population in whom statins are recommended by current guidelines, the benefit of reducing cardiovascular risk with statin therapy far outweighs any safety concerns."

According to the AHA, the current guidelines recommend the use of statins for the following groups:

Those who have experienced heart attack, stroke, transient ischemic attacks, or who have a history of cardiovascular conditions such as angina and peripheral artery disease. Adults aged 40–75 years old whose LDL cholesterol is in the 70–189 milligrams per deciliter (mg/dl) range and whose risk of having a heart attack or stroke in the next 10 years is 7.5 percent or above. Adults aged 40–75 years of age who have diabetes and whose LDL cholesterol is in the range 70–89 mg/dl. Anyone aged 21 years and older with a very high LDL cholesterol level of 190 mg/dl and above.
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'Muscle aches and pains'

People using statins who report side effects most often mention "muscle aches and pains."

However, the research that the statement's authors reviewed reveals that fewer than 1 percent of people who use statins "develop muscle symptoms that are likely caused by statin drugs."

Uncertainty about the causes of any aches and pains, coupled with the fact that they are taking statins, may prompt people to make a link where none exists.

The AHA say that if individuals stop taking their statins for this reason, they may be doing more harm than good by raising their risk of a cardiovascular event.

They urge healthcare providers to "pay close attention to their patients' concerns and help them assess likely causes." They could, for instance, check for blood markers of muscle damage. If they are normal, this could reassure their patients.

Another option is to check vitamin D levels, as insufficiency amounts can also cause muscle aches and pains.

Risk of diabetes and hemorrhagic stroke

There is a slight chance that statins might raise the risk of diabetes, especially in those at higher risk. These include individuals with obesity or whose lifestyle is largely sedentary.

The statement suggests that the absolute risk of being diagnosed with diabetes as a result of using statins is around 0.2 percent per year.

For those who already have diabetes, there could be a slight increase in the amount of glucose in the blood, as their HbA1c measure may reflect.

However, the increase is very small and should not prevent the use of statins, note the AHA.

The research that the statement reviewed did not find that statins increase the risk of a first hemorrhagic stroke, which is a type of stroke that occurs when a blood vessel ruptures.

People with a history of hemorrhagic stroke, on the other hand, may have a slightly higher risk of a further one if they use statins. However, this risk is very small and the overall benefits of statin use in reducing strokes and "other vascular events" outweighs it.

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Risk of other side effects

The statement's authors also looked at evidence that statin use might increase the risk of other conditions. These included damage to peripheral nerves, other neurological effects, damage to the liver, cataracts, and ruptures to a tendon.

They found, however, "little evidence" to support the idea that using statins raised the risk of these conditions.

In rare instances, there could be a side effect called rhabdomyolysis, which is a type of muscle injury that can lead to acute kidney failure. A sign of this can be passing dark urine, so if this happens people should stop taking their statins and see their doctor, say the AHA.

From the reviewed evidence, the statement suggests that rhabdomyolysis is a side effect in less than 0.1 percent of people taking statins.

"In most cases, you should not stop taking your statin medication if you think you are having side effects from the drug — instead, talk to your healthcare provider about your concerns."

Dr. Mark Creager

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What are the best foods to eat for energy?

All food provides the body with energy, but this energy can vary greatly. Some foods, such as sugars and refined carbs, give the body a quick jolt of energy. However, more often, the body needs more sustainable energy from ingredients such as fruits, grains, and legumes.

The list we give here focuses on foods and drinks that provide more stable energy throughout the day.

Drinks The following drinks can help boost energy: 1. Water Energy boosting foods water
Drinking water throughout the day boosts energy levels.

Water is the most crucial energizing ingredient on this list. Water is vital for every cell in the body to work correctly.

While most people think of dehydration as an extreme scenario, the body may become partially dehydrated if a person goes all morning without water.

Maintaining energy can be as simple as carrying a water bottle around and sipping it throughout the day to stay properly hydrated.

2. Coffee

Coffee is a recognizable energy booster. The caffeine in coffee makes the body and mind feel alert and may make people more productive.

Coffee also contains antioxidants called polyphenols, which may reduce oxidative stress in the cells and help the body function better.

Coffee is a stimulant, however, so people should consume it in moderation. Too much coffee may lead to energy loss as the body withdraws from the caffeine.

3. Green tea

Green tea still contains small amounts of caffeine, but it also has compounds that may help reduce oxidative stress and inflammation in the body. The result may be a smoother transition than coffee to a more awake and energetic state.

4. Yerba maté

Yerba maté is a drink native to South America. Drinking the herb as a tea provides the body with similar stimulating effects as tea or coffee.

Yerba maté contains many active nutrients, antioxidants, and amino acids. People who drink yerba maté say it provides a much smoother form of energy by comparison to the jolt of energy from coffee.

As a study in the journal Nutrients notes, yerba maté may also improve mood and help people feel full, even after exercise, which may be helpful for those looking to lose weight while maintaining their energy levels.

Fruits The following fruits may help boost energy: 5. Bananas Bananas may be the best quick snack for sustained energy. While bananas are a good natural source of sugar, they are also rich in fibers that help slow the digestion of that sugar. Bananas contain helpful nutrients that make the body feel full of energy. A study in the journal PLoS One notes that eating a banana before a long bicycle ride helps performance and endurance just as much as a carbohydrate drink. While most people are not cycling each day, bananas may still provide energy. 6. Avocados Avocados are a well-rounded fruit in terms of health values and nutrients. As a study in Critical Reviews in Food Science and Nutrition notes, they contain nutrients, protein, and fiber that may help sustain energy levels throughout the day. They also contain good fats that may increase energy levels, and make fat-soluble nutrients more available in the body. 7. Goji Berries Goji berries are small, reddish berries containing many nutrients and important anti-aging and antioxidant properties, as a review in Drug Design, Development and Therapy notes. The specific antioxidants have many possible benefits, including giving the body more energy. Dried goji berries make a great addition to a trail mix, and many people add a few to a water bottle to drink throughout the day. 8. Apples Apples may be another simple snack to give the body lasting energy. Along with fiber and nutrients, a study in the journal Horticulture Research notes that apples are high in antioxidants called flavonoids, which may help fight against oxidative stress and inflammation in the body. 9. Strawberries As a study in the Journal of Agricultural and Food Chemistry notes, strawberries are a good source of minerals, vitamin C, and folates. They also contain phenols, which are essential antioxidants that may help the body create energy at the cellular level. People can add strawberries to many dishes, and a handful may also be an easy snack to add to a diet. 10. Oranges Most people enjoy oranges for their taste, which comes from the antioxidant vitamin C. Vitamin C may help reduce oxidative stress in the body and prevent fatigue. A study in the journal Antioxidants notes that young adult male students who have higher levels of vitamin C may also have better mood and may be less likely to experience confusion, anger, or depression. 11. Dark berries Berries, including blueberries, raspberries, and blackberries, may be a good energy boosting food when the body is craving something sweet. Dark berries tend to be higher in natural antioxidants than lighter-colored ones, which may reduce inflammation and fatigue in the body. They also tend to have less sugar than sweeter fruits, while still satisfying a craving for a sweet taste. Thank you for supporting Medical News Today Animal products The following animal products may help boost energy: 12. Fatty fish Energy boosting foods salmon
Salmon contains omega-3 fatty acids, which may improve brain function and reduce fatigue. Fish, in general, is an excellent and light source of protein and B vitamins that may give the body sustained energy throughout the day. Fatty cold-water fish, such as salmon, sardines, and tuna, tend to be higher in omega-3 fatty acids. As a study in the journal Nutrients notes, omega-3 fatty acids may improve brain function and reduce inflammation in the body, which may be a cause of fatigue in some people. 13. Beef liver Beef liver may be one of the best meat sources for vitamin B-12, which keeps the body feeling full of energy. While many cuts of meat contain vitamin B-12, the difference is that beef liver has a large amount. According to the United States Department of Agriculture (USDA), a 3-ounce cut of beef flank steak contains about 1.5 micrograms (mcg) of vitamin B-12. The same cut of beef liver contains 60 mcg of vitamin B-12, according to the USDA. 14. Yogurt Yogurt may also be a source of energy. As the USDA show, natural yogurt is rich in protein, fats, and simple carbohydrates, which provide energy to the body. Yogurt is also very easy to eat on the go, which makes it a great alternative to vending machine food. 15. Eggs Eggs provide the body with plenty of protein and nutrients for sustainable energy. As the USDA note, one large hard-boiled egg contains about 6 grams (g) of protein and 5 g of fat, as well as vitamins and minerals to help keep the body energized and feeling full for longer than other snacks. Vegetables The following vegetables are good options for energy: 16. Yams and sweet potatoes Yams and sweet potatoes are beneficial sources of carbohydrates, which provide energy. Yet sweet potatoes are also high in fiber, which may help slow the body's absorption of these carbohydrates. This may make them a good option for sustained energy throughout the day. 17. Beets As a study in the journal Food Science and Biotechnology notes, beets may provide the body with a great source of antioxidants and nutrients that help improve blood flow and energy. People can consume beets as dried beetroot chips, cooked beets or as a bottle of beetroot juice. 18. Dark leafy greens Dark, leafy greens such as kale, spinach, and collard greens are nutrient dense and contain filling proteins, as well as nutrients and antioxidants. Greens may be difficult to digest raw for some people, so breaking them down by cooking them with a bit of vinegar or lemon juice may help. 19. Dark chocolate Dark chocolate may be an easy way to increase energy. Rich, dark chocolate usually has much less sugar than milk chocolate. Less sugar means less immediate energy, but more cocoa content means more of the benefits of cocoa, including helpful antioxidants such as flavonoids. A study in the journal Archives of the Turkish Society of Cardiology notes that dark chocolate may benefit the cardiovascular system by helping more blood pump around the body. This blood carries fresh oxygen, which may also make a person feel more awake and alert. Grains The following grains may help with energy: 20. Oatmeal A bowl of whole-grain oatmeal may be a great way to provide the body with energy. Oats are rich in fiber, and they may enable the body to feel fuller for longer than other breakfast choices. As a study in The Journal of Nutrition notes, whole-grain oats are also a source of essential minerals, vitamins, and phenolic compounds, all of which may help energize the body. 21. Popcorn Popcorn is rich in carbohydrates. However, it also contains fiber to help slow the digestion. Popcorn may make a person feel full for longer than other carbohydrates. As a study in Nutrition Journal notes, people who ate popcorn rather than potato chips felt fuller from the snack. This may be helpful for dieters, as popcorn usually contains fewer calories than potato chips. 22. Quinoa Quinoa is a seed, but most people treat it as a grain. Quinoa is high in protein, carbohydrates, and fiber. The combination of amino acids and slow-release carbohydrates may make for sustainable energy rather than a short burst of glucose from other grains. 23. Brown rice One of the benefits of brown rice may be that it retains much of the fiber from the husk. The husk is not there in white rice, which may cause the body to absorb the carbohydrate content quickly. This may lead to a spike and then a crash in energy levels. By having the husk, brown rice may help slow the digestion of these carbohydrates, therefore, releasing energy more slowly. Thank you for supporting Medical News Today Beans and legumes The following beans and legumes may help with energy: 24. Soybeans Whether roasted soybeans or young edamame beans in the pod, soybeans contain protein with a wide variety of amino acids, as well as magnesium and potassium, according to the USDA. 25. Lentils Energy boosting foods lentils
Lentils are an excellent source of protein and fiber. Lentils are a relatively cheap form of protein and fiber, which may make them a great option for people on a budget. The USDA note that 1 cup of lentils contains about 18 g of protein, 40 g of carbs, 15 g of fiber, and less than 4 g of sugar. The fiber may help to manage the digestion of the carbs, keeping the body full and providing a source of sustained energy. 26. Nuts Many nuts contain a blend of protein, fats, and some carbohydrates to provide energy throughout the day. Nuts are typically also rich sources of vitamins and minerals such as magnesium, calcium, or phosphorous. Nuts are usually high in essential fatty acids. As a study in the Journal of Parenteral and Enteral Nutrition notes, these fatty acids may help reduce inflammation, which may also reduce fatigue. Nuts are high in calories, as well, so people should be careful not to eat too many 27. Peanut butter Peanut butter is typically rich in protein, fats, and fiber, and may help a person feel full for longer after eating it. This may cut the need for constant snacking, which may also leave a person feeling drained as their body has to digest continuously. 28. Seeds Many seeds, such as pumpkin seeds, chia seeds, and flax seeds, are rich sources of fatty acids and fiber, which may translate to more energy. Seeds are also easy to carry and make a great addition to a quick trail mix. Foods to avoid While most foods provide energy, the ones above focus on sustained energy. Foods to try to avoid may include: fast foods or fried foods added sugars packaged snacks and candy bars baked sweets such as cakes and cupcakes Takeaway While this list is not exhaustive, the idea behind finding energy boosting foods is to consume a varied, balanced diet. Vitamins, fiber, fats, and proteins are all essential for energy, but it is crucial to find a balance between them. People should try to choose a varied diet containing many different, nutritious foods that give the body sustained energy.
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Excess belly fat common in those with high heart risk

Excess waist fat is common in many people with a high risk of heart disease and stroke, according to a recent European study.
middle aged man doing squats
New research finds that two-thirds of people at high risk of developing cardiovascular disease have excess belly fat.

The study, called EUROASPIRE V, is a survey of cardiovascular disease prevention and diabetes. It forms part of a European Society of Cardiology research program.

The findings featured recently at the World Congress of Cardiology & Cardiovascular Health in Dubai in the United Arab Emirates.

They revealed that nearly two-thirds of individuals at high risk of cardiovascular disease had excess abdominal fat.

The results also showed that:

Only 47 percent of those taking drugs to reduce high blood pressure were achieving a target of under 140/90 millimeters of mercury, or under 140/85 for those who reported having diabetes. Among individuals using lipid-lowering medication, only 43 percent had reached the low-density lipoprotein (LDL) cholesterol target of under 2.5 millimoles per liter. Many who were not in receipt of treatment for high blood pressure and high LDL cholesterol had those conditions. Only 65 percent of individuals receiving treatment for type 2 diabetes had attained the target blood sugar of under 7.0 percent glycated hemoglobin (HbA1c).

"The survey," says Kornelia Kotseva, chair of the EUROASPIRE Steering Committee and a professor at Imperial College London in the United Kingdom, "shows that large proportions of individuals at high risk of cardiovascular disease have unhealthy lifestyle habits and uncontrolled blood pressure, lipids, and diabetes."

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Individuals with high heart risk

The recent study focuses on "apparently healthy individuals in primary care at high risk of developing cardiovascular disease, including those with diabetes."

Altogether, 78 primary care practices from 16, mainly European, countries took part in the research, which took place during 2017–2018.

They recruited individuals who were under 80 years of age and had no history of coronary artery disease or other conditions arising from atherosclerosis.

However, assessments had shown that they were at high risk of developing cardiovascular disease due to one or more of the following: high blood pressure, high cholesterol, or diabetes.

The researchers used medical records to identify those eligible for the study and invited them for an interview and clinical exam.

The interviewers asked questions about diet, exercise, smoking, and other lifestyle factors.

The analysis included a total of 2,759 people. Of these:

64 percent had central obesity, which is a measure of excess abdominal fat. 37 percent were in the overweight category for body mass index (25.0–29.9 kilograms per square meter). 18 percent were current smokers. 36 percent were achieving the typical guideline physical activity level of at least 30 minutes on 5 days of the week.

The researchers defined central obesity as having a waist size of at least 88 centimeters (34.7 inches) for women and at least 102 centimeters (40.2 inches) for men.

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'GPs need to be more proactive'

Prof. Kotseva urges primary care practitioners to be proactive about looking for cardiovascular risk factors.

They need to probe beyond the risk factors that they are already aware of and "always investigate smoking, obesity, unhealthy diet, physical inactivity, blood pressure, cholesterol, and diabetes," she argues.

Individuals often don't realize that they should be receiving treatment. They may visit their doctor for diabetes care and not know that they also have high blood pressure.

"In our study, many participants with high blood pressure and cholesterol were not being treated," notes Prof. Kotseva.

She suggests that the findings highlight a need for more investment and policy that focuses on prevention.

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The recent news follows that of earlier research that featured at the European Society of Cardiology Congress in April 2018 in Ljubljana, Slovenia.

In that study, researchers from the Mayo Clinic in Rochester, MN concluded that excess belly fat is "bad for the heart," even in individuals whose BMI is in the normal range.

They advised doctors not to assume that having normal BMI means that there is no heart-related issue in an otherwise healthy individual.

A BMI in the normal range does not necessarily indicate normal fat distribution. It is important to measure central obesity as well, to get a better picture of heart risk.

"These data make it clear that more efforts must be made to improve cardiovascular prevention in people at high risk of cardiovascular disease."

Prof: Kornelia Kotseva

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What too much sleep can do to your health

New research finds that both insufficient and excessive sleep may raise the risk of cardiovascular problems and premature death.
person in bed waking up with their hand on their face
New research finds that sleeping too much can raise the risk of early death and cardiovascular problems.

The Centers for Disease Control and Prevention (CDC) report that a third of the United States population does not get enough sleep.

The CDC also warn that sleep deprivation raises the risk of various chronic conditions such as diabetes, cardiovascular disease, obesity, and depression.

But, according to new research appearing in the European Heart Journal, sleeping too much may affect health just as negatively as sleeping too little.

Chuangshi Wang, a doctoral candidate at McMaster University in Ontario in Canada, and Peking Union Medical College at the Chinese Academy of Medical Sciences in China, is the lead author of the new paper.

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Wang and colleagues examined the sleeping habits of more than 116,000 people aged between 35 and 70 years who had enrolled in the Prospective Urban Rural Epidemiology (PURE) study.

In their analysis, the researchers also included information about the participants' socioeconomic status, lifestyle habits, physical activity, diet, use of various medications, and family history of chronic conditions.

Overall, 4,381 people died and 4,365 people had a heart attack or stroke during the 8-year follow-up period of the PURE study.

The analysis by Wang and her team revealed that people who regularly slept more than the recommended 6–8 hours a night were more likely to die prematurely or develop cardiovascular disease.

More specifically, the risk of premature death or cardiovascular conditions was 5 percent higher for people who slept 8–9 hours than for people who slept the recommended amount.

Those who slept 9–10 hours were 17 percent more likely to die or develop heart and blood vessel conditions. Similarly, people who regularly slept more than 10 hours were 41 percent more likely to die prematurely or develop cardiovascular problems.

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Also, the study found a 9 percent higher risk of the outcomes mentioned above among those who slept 6 hours or less. However, the authors caution that this increase was not statistically significant.

Wang comments on the findings, saying, "Our study shows that the optimal duration of estimated sleep is six to eight hours per day for adults."

"Given that this is an observational study that can only show an association rather than proving a causal relationship, we cannot say that too much sleep per se causes cardiovascular diseases," she cautions.

"However, too little sleep could be an underlying contributor to death and cases of cardiovascular disease, and too much sleep may indicate underlying conditions that increase risk."

Corresponding author Dr. Salim Yusuf, who is the principal investigator of the PURE study, and a professor of medicine at McMaster, also comments on the findings.

"The general public should ensure that they get about six to eight hours of sleep a day. On the other hand, if you sleep too much regularly, say more than nine hours a day, then you may want to visit a doctor to check your overall health."

Dr. Salim Yusuf

"For doctors," continues Dr. Yusuf, "including questions about the duration of sleep and daytime naps in the clinical histories of your patients may be helpful in identifying people at high risk of heart and blood vessel problems or death."

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What foods protect the liver?

The liver is responsible for breaking down carbohydrates, making glucose, and detoxing the body. It also stores nutrients and creates bile, which is necessary to digest and absorb the nutrients in food properly. There are many foods and drinks that a person can consume to help protect the liver.

Liver health is vital for overall health. Liver dysfunction can lead to liver disease, metabolic disorder, and even type 2 diabetes.

While it may be impossible to manage all risk factors, consuming certain foods and drinks may help promote liver health.

In this article, we will cover the best foods for liver health, their beneficial effects for the organ, and some foods to avoid.

Top foods and drinks for liver health Some of the best foods and drinks that are good for the liver include: 1. Coffee Foods good for liver coffee
Drinking coffee offers protection against fatty liver disease.

A 2013 review that appears in the journal Liver International suggests that over 50 percent of people in the United States consume coffee daily.

Coffee appears to be good for the liver, especially because it protects against issues such as fatty liver disease.

The review also notes that daily coffee intake may help reduce the risk of chronic liver disease. It may also protect the liver from damaging conditions, such as liver cancer.

A 2014 study that appears in the Journal of Clinical Gastroenterology suggests that the protective effects of coffee are due to how it influences liver enzymes.

Coffee, it reports, seems to reduce fat buildup in the liver. It also increases protective antioxidants in the liver. Compounds in coffee also help liver enzymes rid the body of cancer-causing substances.

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2. Oatmeal

Consuming oatmeal is an easy way to add fiber to the diet. Fiber is an important tool for digestion, and the specific fibers in oats may be especially helpful for the liver. Oats and oatmeal are high in compounds called beta-glucans.

As a 2017 study in the International Journal of Molecular Sciences reports, beta-glucans are very biologically active in the body. They help modulate the immune system and fight against inflammation, and they may be especially helpful in the fight against diabetes and obesity.

The review also notes that beta-glucans from oats appear to help reduce the amount of fat stored in the liver in mice, which could also help protect the liver. More clinical studies are necessary to confirm this, however.

People looking to add oats or oatmeal to their diet should look for whole oats or steel-cut oats, rather than prepackaged oatmeal. Prepackaged oatmeal may contain fillers such as flour or sugars, which will not be as beneficial for the body.

3. Green tea

Foods good for liver green tea
Consuming green tea may help reduce overall fat content.

A 2015 study in the World Journal of Gastroenterology notes that green tea may help reduce overall fat content, fight against oxidative stress, and reduce other signs of nonalcoholic fatty liver disease (NAFLD).

It is important to note that tea may be better than extracts, as some extracts may damage the liver rather than heal it.

The study notes that there are still no specific recommendations for people with this condition to consume tea or tea extracts, but the link to liver health is promising.

4. Garlic

Adding garlic to the diet may also help stimulate the liver. A 2016 study that appears in the journal Advanced Biomedical Research notes that garlic consumption reduces body weight and fat content in people with NAFLD, with no changes to lean body mass. This is beneficial, as being overweight or obese is a contributing factor to NAFLD.

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5. Berries

Many dark berries, such as blueberries, raspberries, and cranberries, contain antioxidants called polyphenols, which may help protect the liver from damage.

As a study in the World Journal of Gastroenterology suggests, regularly eating berries may also help stimulate the immune system.

6. Grapes

The study that features in the World Journal of Gastroenterology reports that grapes, grape juice, and grape seeds are rich in antioxidants that may help the liver by reducing inflammation and preventing liver damage.

Eating whole, seeded grapes is a simple way to add these compounds to the diet. A grape seed extract supplement may also provide antioxidants.

7. Grapefruit

The World Journal of Gastroenterology study also mentions grapefruit as a helpful food. Grapefruit contains two primary antioxidants: naringin and naringenin. These may help protect the liver from injury by reducing inflammation and protecting the liver cells.

The compounds may also reduce fat buildup in the liver and increase the enzymes that burn fat. This may make grapefruit a helpful tool in the fight against NAFLD.

8. Prickly pear

The fruit and juice of the prickly pear may also be beneficial to liver health. The World Journal of Gastroenterology study suggests that compounds in the fruit may help protect the organ.

Most research focuses on extracts from the fruit, however, so studies that focus on the fruit or juice itself are necessary.

9. Plant foods in general

Foods good for liver avacado
Avocados and other plant foods contain compounds linked closely to liver health.

A 2015 study that appears in the journal Evidence-based Complementary and Alternative Medicine reports that a large number of plant foods may be helpful for the liver.

These include:

avocado banana barley beets and beet juice broccoli brown rice carrots fig greens such as kale and collards lemon papaya watermelon

People should eat these foods as part of a whole and balanced diet.

10. Fatty fish

As a study in the World Journal of Gastroenterology points out, consuming fatty fish and fish oil supplements may help reduce the impact of conditions such as NAFLD.

Fatty fish is rich in omega-3 fatty acids, which are the good fats that help reduce inflammation. These fats may be especially helpful in the liver, as they appear to prevent the buildup of excess fats and maintain enzyme levels in the liver.

The study recommends eating oily fish two or more times each week. If it is not easy to incorporate fatty fish such as herring or salmon into the diet, try taking a daily fish oil supplement.

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11. Nuts

The same study says that eating nuts may be another simple way to keep the liver healthy and protect against NAFLD. Nuts generally contain unsaturated fatty acids, vitamin E, and antioxidants. These compounds may help prevent NAFLD, as well as reduce inflammation and oxidative stress.

Eating a handful of nuts, such as walnuts or almonds, each day may help maintain liver health. People should be sure not to eat too many, however, as nuts are high in calories.

12. Olive oil

Eating too much fat is not good for the liver, but some fats may help it. According to the World Journal of Gastroenterology study, adding olive oil to the diet may help reduce oxidative stress and improve liver function. This is due to the high content of unsaturated fatty acids in the oil.

Foods to avoid In general, finding balance in the diet will keep the liver healthy. However, there are also some foods and food groups that the liver finds harder to process. These include: Fatty foods: These include fried foods, fast food, and takeout from many restaurants. Packaged snacks, chips, and nuts may also be surprisingly high in fats. Starchy foods: These include breads, pasta, and cakes or baked goods. Sugar: Cutting back on sugar and sugary foods such as cereals, baked goods, and candies may help reduce the stress on the liver. Salt: Simple ways to reduce salt intake include eating out less, avoiding canned meats or vegetables, and reducing or avoiding salted deli meats and bacon. Alcohol: Anyone looking to give their liver a break should consider reducing their intake of alcohol or eliminating it from the diet completely. Summary The liver plays an important role in the body. While it largely takes care of itself, a person can help maintain liver health by consuming some certain foods and drinks. There are also many types of food that may harm the liver. Choosing foods that are good for the liver can help a person avoid potential health issues in the future.
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What is a pescatarian diet?

In the pescatarian diet, a person's main source of animal protein comes from fish and other seafood, such as shrimp.

Eating a diet consisting mainly of plant-based foods has a variety of health benefits, which the addition of fish and fish products may enhance.

However, some types of fish may absorb mercury from their environment, so certain people may need to limit their intake.

In this article, we look at the potential health benefits of a pescatarian diet and what people can eat on this kind of diet.

Health benefits of the pescatarian diet The pescatarian diet has many health benefits. Below, we cover some of these benefits. Heart health Pescatarian diet salmon
Eating fish provides omega-3 fatty acids, some of which are integral for healthy living.

Eating fish, especially fatty fish, provides increased long-chain omega-3 fatty acid intake. An omega-3 fatty acid is an unsaturated fat that can be beneficial to people, and some omega-3s are integral for healthy living.

People who eat fish have lower blood pressure, a lower risk of abnormal heart rhythms, and fewer fatal heart attacks than those who do not include fish in their diet.

Apart from fish, the pescatarian diet consists mainly of plant foods. According to one 2017 analysis, people who have a diet high in vegetables and other plant foods have a reduced risk of coronary heart disease.

The study authors say that the heart health benefits of a plant-based diet include improved blood lipids and lower blood pressure.

The same research concludes that a vegetarian diet could reverse atherosclerotic plaques when combined with exercise and stress management.

Atherosclerosis occurs when plaque builds up in the arteries. This causes the arteries to harden, narrow, and restrict the blood flow.

Cancer

A pescatarian diet may also protect people against colorectal cancers, or cancers that affect the colon and rectum.

According to a 2015 study, colorectal cancers are the second leading cause of cancer deaths in the United States.

The study used data from a cohort of over 77,650 people and found that the pescatarian diet had a strong protective effect against colorectal cancers.

Diabetes and inflammation

Following a plant-based diet can reduce the risk of type 2 diabetes and metabolic syndrome.

Metabolic syndrome includes conditions such as insulin resistance, high blood pressure, and obesity.

There is also evidence that omega-3s present in fatty fish may reduce inflammation, though this evidence comes from trials of supplements.

Plant-based diets are high in anti-inflammatory and antioxidant agents, such as flavonoids. These are natural compounds present in plants. Flavonoids have a range of anti-inflammatory and antidiabetic properties.

A 2016 study, again looking at different dietary patterns among more than 77,000 people in the U.S., found that people following a pescatarian diet had the highest flavonoid intake of all those taking part.

Thank you for supporting Medical News Today Environmental and animal welfare benefits Some people choose vegetarian diets because they disagree with factory farming practices or killing animals for food. For people concerned about animal welfare, the pescatarian diet may be a little more suitable. This is because some scientists argue that fish cannot feel pain. A 2015 study concluded that although fish can experience psychological stress, they lack the neural network necessary to experience pain. The pescatarian diet may also appeal to those who want to eat foods from what they perceive to be sustainable farming practices. Is a pescatarian diet sustainable? Pescatarian diet fish farming
While some see farming fish as a solution to over-fishing, it can still damage water ecosystems. The pescatarian diet is more sustainable than factory farming of mammals or birds, but it does have some environmental issues. Some people believe that the farming of pigs and ruminants, such as cattle, sheep, and goats, can harm the environment. Both groups emit greenhouse gases, with ruminants producing methane gas and pigs producing ammonia. On a global scale, these gases contribute to global warming. Also, large-scale deforestation for grazing and agriculture makes the greenhouse gas issue worse. Although fish do not produce greenhouse gases, fishing and fisheries represent a challenge to water ecosystems. For example, eating wild line-caught fish is not necessarily better for the environment than eating farmed fish, and the trawlers used to catch trawler-caught fish can affect ocean ecosystems in many ways. Some people see farming fish as a solution to over-fishing and depleted fish stocks, and the practice has grown rapidly over the past few years. However, in certain circumstances, fish farming can: damage water ecosystems introduce invasive species use wild fish for feed cause overcrowding cause disease The pescatarian diet may also be expensive or difficult to maintain when people live some distance from coastlines or fresh waterways. Some people may also find it hard to access sustainably sourced tinned fish. What can someone following the pescatarian diet eat? Listed below are some suggestions for sources of fish that a person on a pescatarian diet can eat: canned sardines canned salmon canned tuna fish sticks frozen salmon, trout, and herring frozen shrimp fresh fish, such as salmon, pollock, catfish, and sardines fresh shellfish, such as shrimp, clams, and scallops Other foods to include are: fruit vegetables cereals and whole grains, including oats, bulgar wheat, amaranth, corn, and rice food containing grain products pseudo grains, such as quinoa and buckwheat, which are gluten-free legumes, including kidney beans, pinto beans, and peas legume products, including tofu and hummus nuts and nut butters seeds, such as flaxseeds, hemp seeds, and chia eggs and dairy, if lacto-ovo-vegetarian If a person follows a strict pescatarian diet and avoids consuming eggs and dairy, they might need to check their calcium intake and consider taking supplements. Thank you for supporting Medical News Today 1-day meal plan Here, we give examples of recipes for meals that a person might consider when choosing a pescatarian diet: Breakfast Pescatarian diet sardines on crosti
Sardines are an excellent source of protein and omega-3s. Sardines on crostini Sardines are an excellent source of omega-3s. Using spinach to make a pesto spread on the crostini provides a source of vitamin C and vitamin A. The vitamin C helps increase the amount of iron a person absorbs. This recipe uses canned sardines, but it is also possible to use fresh sardines or anchovies. Starting the day with protein increases the feeling of fullness, and the pesto adds healthful greens that are a source of iron. Lunch Classic baked falafel Tahini is good source of plant protein and omega-3s. Chickpeas are also a good source of plant protein and fiber. Add a healthful Mediterranean salad to this recipe to create a filling lunch. Dinner Roasted salmon with shallot grapefruit sauce Salmon provides omega-3s essential fatty acids. Strong-flavored fish go very well with citrus fruits such as grapefruit. The addition of grapefruit to this recipe also adds vitamin C and fiber, and it counts toward the 2 servings of fruit that a person should eat per day. Disadvantages of a pescatarian diet Heavy metal and pollutants in marine fish is a global issue. With 92 percent of fish consumed by humans being marine fish, mostly from coastal fisheries, there is a risk of contamination. Mercury is present in the atmosphere and bodies of water and, because of this, nearly all fish may be a source of mercury. For most people, the mercury present in fish is not a risk, explain the U.S. Food and Drug Administration (FDA). However, they advise women considering becoming pregnant, women who are pregnant, nursing mothers, and young children not to eat specific fish. Fish to avoid include: shark sword fish king mackerel tilefish Fish low in mercury include: canned light tuna salmon pollock shrimp catfish Thank you for supporting Medical News Today Summary A pescatarian diet may be healthful and carries health benefits, as long as people avoid fish with high levels of mercury. However, this diet may not be as sustainable as some people think. Plant-based diets can help a person maintain a healthy weight, and they also may help with weight loss when necessary. A pescatarian diet may also be more healthful than some diets that rely on calorie deficits to reduce weight. People may find that canned tuna and sardines, as well as smoked fish, are the easiest foods to obtain and eat. These are full-flavored options, but frozen white fish and fish sticks are more delicately flavored options. Where possible, people may wish to try to buy fresh fish from sustainable sources. A useful website that can help is Seafood Watch.
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Iron-rich foods for vegetarians and vegans

Iron is an essential mineral for health. Although red meat and seafood are good sources of iron, many plant-based foods also contain plenty of this mineral.

Numerous vegetables, legumes, and other foods contain a form of iron called nonheme iron, which accounts for the majority of people's iron intake in the United States. The type of iron in animal products is called heme iron.

Although the body can absorb it more easily, heme iron is not essential to the human diet.

By selecting the right foods, people eating a vegetarian or vegan diet can meet their daily iron requirements without needing to take supplements.

In this article, we list the best iron-rich vegetarian foods. We also provide some tips to help people maximize their iron absorption from nonheme sources.

The following are some of the best iron-rich foods for vegetarians and vegans:

Lentils Different lentils on spoons which are iron-rich foods for vegetarians
Lentils are rich in iron and protein.

Lentils are rich in iron, protein, and fiber, making them a great addition to a healthful diet. Each cup of cooked lentils contains 6.59 milligrams (mg) of iron and 17.86 grams (g) of protein.

Lentils also contain many other nutrients, including B vitamins, magnesium, potassium, and zinc.

Research suggests that eating lentils on a regular basis reduces the risk of diabetes, obesity, cancer, and heart disease.

People can include brown, red, or green lentils in soups, stews, curries, salads, and other meals.

Cannellini beans Cannellini beans, or white kidney beans, provide 5.2 mg of iron per cup. As with lentils, the protein and fiber content of beans makes them a healthful option. They also contain many other essential minerals and plant compounds. Several studies support the consumption of beans to reduce the risk of heart disease and related conditions. Other types of bean, including those below, also contain high amounts of iron per cup: Beans are a very versatile food, and they work well as an ingredient in many dishes, including tacos, chili, soups, salads, and bean dips. Tofu Tofu is a bean curd that manufacturers make by coagulating the milk from soybeans. It is popular among vegans and vegetarians as it contains significant amounts of protein, iron, and calcium. A half-cup serving of tofu contains 6.65 mg of iron and about 10 g of protein. Some research suggests that soy products reduce the risk of heart disease, breast cancer, and prostate cancer. Tempeh and natto are other soy products that contain iron and may provide additional health benefits. Tofu is available in several different forms, including firm, soft, and silken. People can grill or fry firm tofu to use as a meat substitute, add soft tofu to casseroles, and blend silken tofu with cocoa powder and a sweetener to make a delicious chocolate dessert. Amaranth This ancient grain is gluten-free and provides 5.17 mg of iron per cooked cup along with over 9 g of protein. It also contains many other nutrients that are essential for health, including fiber, manganese, and magnesium. A 2012 review of research on the amaranth grain suggests that it has antioxidant and antitumor effects, reduces cholesterol and blood sugar levels, boosts immune function, and improves high blood pressure and anemia. Other grains that provide plenty of iron include quinoa and steel-cut oats. Thank you for supporting Medical News Today Fortified cereals Oats in a bowl which are an iron-rich food
Fortified cereals are a good source of iron for vegetarians and vegans. Many types of breakfast cereal, including oats, contain iron that manufacturers add during processing. Fortified grains are a vital source of this mineral, providing approximately half of all dietary iron in the U.S. People should look for fortified breakfast cereals that contain 100 percent of the daily value of iron per serving. While these cereals are generally suitable for vegetarians, vegans should check if the product also has added vitamin D. Not all vitamin D sources are vegan-friendly. Dark chocolate Although chocolate is traditionally a dessert food, a 3-ounce serving of dark chocolate provides 7 mg of iron. Cocoa is also one of the best sources of flavonoid antioxidants, which may provide heart benefits, protect nerves, boost immunity, and improve cognitive function and mood. While dark chocolate is an iron-rich food, it is high in calories, so people should enjoy it as an occasional treat. Baked potatoes Potatoes, especially their skins, are a good source of iron. A medium potato in its skin provides 2 mg of iron. Potatoes are a staple food in many cultures and can benefit health in numerous ways. They are a source of carbohydrates, dietary fiber, resistant starch, vitamin C, and potassium. For a complete meal, people can top baked potatoes with cottage cheese, hummus, beans, or lentils and serve them with vegetables or salad. It is best to avoid adding a lot of butter, oil, or cheese to the potatoes as this increases the fat and calorie content of the meal. Spinach Spinach is low in calories but high in fiber, vitamins, minerals, and antioxidants. One cup of cooked spinach provides 6.43 mg of iron. Most people find it easy to incorporate more spinach into their diets by sautéing or steaming the vegetable and adding it to soups and stir-fries. Raw spinach can also be an ingredient in smoothies and salads. Dried apricots A cup of dried apricot halves contains 4.1 mg of iron. Dried fruits are also rich in fiber, vitamins, minerals, and antioxidants. They make ideal snacks as they are easy to eat on the go. However, dried fruit is also high in sugar and calories. To avoid weight gain or the effects of too much sugar, people should enjoy dried apricots in moderation. Thank you for supporting Medical News Today Hulled hemp seeds Hulled hemp seeds
Hulled hemp seeds are a plant-based source of omega-3 fats. A 3-tablespoon serving of hulled hemp seeds contains 2.38 mg of iron and over 9 grams of protein. These seeds are one of the few plant-based sources of omega-3 fats, which are essential for heart and brain health. A 2018 study reported that hemp seed extract demonstrated antioxidant effects in laboratory tests. These antioxidant benefits, coupled with the omega-3 content of the seeds, may help protect against heart problems and neurodegenerative diseases. People can sprinkle hemp seeds on oatmeal, yogurt, or desserts, or blend them into smoothies for a snack that is rich in iron and protein. Blackstrap molasses Blackstrap molasses is a byproduct of sugar production. Unlike sugar, the molasses retains the nutrients from sugar cane, which include calcium, magnesium, and vitamin B-6. This thick syrup is also a good source of iron, providing 3.6 mg per tablespoon. However, it is best to limit the intake of blackstrap molasses to avoid consuming too much sugar. People typically use blackstrap molasses in baked goods and raw desserts, as a glaze for vegetables, or to sweeten oatmeal. How much iron do you need? The National Institutes of Health recommend that women over the age of 50 years and all adult men get 8 mg of iron daily. Women aged between 19 and 50 years should aim for 18 mg per day, while pregnant women require 27 mg of iron for fetal health. However, some sources suggest that vegetarians and vegans may need up to 1.8 times these amounts because the body does not absorb nonheme iron as easily as it does heme iron. Low iron intake or absorption can lead to iron deficiency anemia. Symptoms may include: tiredness weakness pale skin heart palpitations headaches cold hands and feet a sore tongue brittle nails poor appetite Anyone who is experiencing these symptoms should see a doctor. A person can increase the amount of iron that their body absorbs from plant-based sources by eating iron-rich foods alongside a source of vitamin C. Good sources of vitamin C include: bell peppers broccoli cantaloupe melon cauliflower citrus fruits kiwi fruit leafy green vegetables mango papaya strawberries sweet potatoes tomatoes They should also avoid foods, beverages, and supplements that reduce iron absorption for up to 2 hours before and after iron-rich meals. These include: black tea calcium supplements coffee dairy eggs peppermint tea red wine Antacid medications also inhibit iron absorption. Summary Vegetarian foods can be excellent sources of iron, especially when people eat them in combination with a food that is rich in vitamin C. People who do not eat meat can ensure that they get enough iron by consuming a wide variety of iron-rich, plant-based foods. Anyone who is concerned that they may not be getting enough iron from their diet should speak to a doctor or dietician.
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Are statins overprescribed for cardiovascular disease prevention?

For millions of people who take statins to prevent the onset of cardiovascular disease, the potential harms of the cholesterol-lowering medication may outweigh the benefits.
bowl of pills with heart made of string
Statins may be 'significantly overprescribed' for the primary prevention of cardiovascular disease, suggests a new study.

So concludes a recent modeling study from the University of Zurich in Switzerland that questions whether statins are "significantly overprescribed."

The research, which features in the Annals of Internal Medicine, concerns the use of statins for the "primary prevention" of cardiovascular disease in people with no history of the disease.

A primary prevention measure is one that intervenes to prevent a condition before it can impact health. Vaccinations, for example, are primary prevention measures.

Statins are some of the most prescribed classes of drugs worldwide. They work by blocking an enzyme called HMG-CoA reductase that helps the liver to make cholesterol.

Most medical guidelines recommend the use of statins for people with no history of symptoms when their expected risk of developing cardiovascular disease over the next 10 years is 7.5–10 percent.

Such a 10-year risk threshold places around 3 out of every 10 adults worldwide as eligible for treatment.

However, the authors note that "whether and how guideline developers weighed harms against benefits is often unclear."

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Statins for primary prevention

In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) updated the recommendations that guide doctors in the treatment of cholesterol and use of statins.

One reason for the update was the argument that high blood cholesterol is one of the "most prevalent" of alterable cardiovascular risk factors.

Another argument was that there is evidence that treating cholesterol reduces numbers of people who develop cardiovascular diseases and who die of them.

The update caused controversy. This was mainly because it lowered the thresholds that doctors should use to help them decide whether to prescribe statins for primary cardiovascular disease prevention.

This recommended that doctors should consider adults with no history of heart problems as eligible for primary prevention if their risk of developing cardiovascular disease in the next 10 years is 7.5 percent or higher.

Also, the revision expanded the target of prevention to include not just coronary heart disease, but also atherosclerosis, stroke, and peripheral arterial disease.

Experts predicted at the time that full implementation of the guidelines would identify around 13 million people in the United States as "newly eligible for consideration" for treatment with statins.

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Thresholds are too high

The University of Zurich researchers used a computer model to assess the 10-year risk for cardiovascular disease "at which statins provide at least a 60 percent probability of net benefit."

They adjusted the results to take out any effects from "competing risk" of death that was not due to cardiovascular disease, as well as "baseline risk, frequencies of and preferences for statin benefits and harms."

The harms that they included in their calculations were "adverse events," such as myopathy (muscle weakness), liver dysfunction, and onset of diabetes.

The results showed that the 10-year cardiovascular risk thresholds at which benefits of statin use exceed the harms are consistently higher than those recommended in the guidelines.

For instance, in the case of men aged 70–75 years with no history of symptoms, the harms of taking statins were greater than the benefits until the risk of developing cardiovascular disease over 10 years was over 21 percent.

For women aged 70–75 years, the 10-year risk required for benefit to outweigh harms was 22 percent.

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For those aged 40–44, the benefits outweighed harms at 14 percent 10-year cardiovascular risk for men and 17 percent for women.

"Atorvastatin and rosuvastatin provided net benefit at lower 10-year risks than simvastatin and pravastatin," note the authors.

In an editorial linked to the findings, Drs. Ilana B. Richman and Joseph S. Ross of Yale University School of Medicine in New Haven, CT, note some concerns about the updated thresholds, particularly in relation to older adults.

They also comment that the guidelines have "largely dismissed" many of the side effects included in the study.

"The recommendation raised important questions about the 'right' risk threshold at which to start statin therapy for primary prevention, particularly because many older adults exceed this threshold on the basis of age alone."

Drs. Ilana B. Richman and Joseph S. Ross

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The health risks of being a night owl

The first international review to compare night owls with early risers outlines the health risks associated with preferring late nights. However, these risks may not be set in stone.
Woman drinking coffee at her laptop
A recent review takes a fresh look at the impact of being a night owl.

Most individuals fit one of two chronotypes: We are morning people or evening people.

Either we prefer to stay up late — and are referred to as night owls — or we rise earlier and go to bed earlier.

These patterns in circadian preferences are, to a certain extent, written in our genes.

Over the years, the medical community has debated the health impacts associated with each chronotype, and the findings have not always been conclusive.

To develop a clearer picture, a group of scientists from a number of institutions have conducted the most extensive review of relevant research to date. Their findings were published recently in the journal Advances in Nutrition.

Sleeping, eating, and health

The scientists were especially interested in understanding the relationship between circadian rhythms and eating patterns — called chrono-nutrition — and overall cardiometabolic health.

Because modern life is often hectic, eating and sleeping patterns may frequently be disturbed. Exposure to artificial light sources can also misalign our circadian patterns.

These disruptions can alter cyclical metabolic processes, such as glucose control, lipid metabolism, and blood pressure.

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Scientists are working to determine the long-term health effects of these changes.

Because this area of study is in its infancy, the authors of the recent review delved into previous studies, hoping to identify patterns in results.

The team found that individuals who went to bed later tended to have less healthful eating patterns.

For instance, they generally ate later in the day, at less regular times, and they consumed more alcohol, sugar, and caffeinated products than earlier risers. Night owls were also more likely to skip breakfast.

In addition, night owls were likelier to consume fewer vegetables and grains. They also ate less often but had bigger meals.

This eating pattern may explain the finding that night owls had an increased risk of heart disease and metabolic conditions, such as type 2 diabetes.

In fact, one study showed that night owls were 2.5 times more likely to have type 2 diabetes than early risers.

The leader of the study, Suzana Almoosawi, Ph.D., a research fellow at Northumbria University in the United Kingdom, explains that "In adulthood, being an evening chronotype is associated with greater risk of heart disease and type 2 diabetes, and this may be potentially due to the poorer eating behavior and diet of people with evening chronotype."

According to the researchers, being a night owl can even affect the way a person manages their diabetes: "Our review also found that people who have a poorer control of their diabetes are more likely to be evening types," says Almoosawi.

The body's circadian fluctuations in glucose metabolism may mediate the link with type 2 diabetes. Throughout the day, glucose levels decline, and by the evening they are at their lowest point.

However, because night owls eat later in the day, glucose levels spike just before bedtime. This goes against the body's regular biological processes, and so it could impact metabolism.

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Growing knowledge but gaps remain

The review uncovered some other interesting findings. Perhaps unsurprisingly, children were much more likely to be early risers, including 90 percent of 2-year-olds and 58 percent of 6-year-olds.

As people enter old age, they are more likely to revert to their early-rising preferences of youth.

Although this type of study is still in the initial stages, and much more research is needed, the findings to date may have huge implications for public health.

"Scientific evidence is providing increasing insight into the relationship between your chronotype, diet, and cardiometabolic health."

Study co-author Leonidas G. Karagounis, Nestlé Health Science

Karagounis continues, "Further research on the best methods to assess an individual's chronotype and how this may affect their long-term cardiometabolic health can potentially guide the development of health promotion strategies aimed at preventing and treating chronic diseases based on an individual's chronotype."

The review also highlights gaps in our understanding. For instance, the existing body of literature does not provide much information about why our circadian rhythms and eating patterns shift throughout our lifespans.

Though scientists are still unsure why our preferences morph as we age, modern living may drive this pattern, at least in part.

As children, we are more likely to rise early, but as we become embedded in society, we are more likely to develop into night owls. In older age, as we pull back from society's cut and thrust, we tend to go back to rising early.

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It will take far more research to determine whether this pendulum swing in chronotype results from social pressures — such as school and work start times — or whether it is triggered by hormonal changes, for example.

However, it seems that the adverse health effects of being a night owl may predominantly revolve around dietary habits that are, for the most part, modifiable.

For instance, by eating more healthfully, not skipping breakfast, and drinking less alcohol, a person may be able to avoid some of the risks.

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Snoring can worsen heart function, especially in women

Both snoring and obstructive sleep apnea could lead to earlier impairment of cardiac function in women, according to a new study.
Woman snoring
A recent study unlocks the health issues linked to snoring.

"Snoring" refers to a sleeping pattern in which a person breathes while emitting a snorting or grunting sound.

The National Sleep Foundation suggest that 90 million people in the United States snore.

Snoring might become more dangerous as people age, and it can also lead to heart disease.

There are different types of sleep apnea, but the most common is called obstructive sleep apnea (OSA). At least 18 million U.S. adults have sleep apnea.

This condition affects breathing patterns while sleeping, causing a person to stop breathing and start again repeatedly. About half of people who snore loudly have OSA.

When OSA occurs, the muscles in the throat that are responsible for keeping the airway open actually prevent the flow of air.

According to a new study presented recently at the annual meeting of the Radiological Society of North America — held in Chicago, IL — snoring and OSA may lead to earlier impairment of cardiac function in women than in men.

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Sleep apnea and heart disease?

It is unclear whether or not sleep apnea directly causes heart disease, but some specialists believe that people with sleep apnea are at risk of developing hypertension, or high blood pressure.

Many people who have sleep apnea also have co-existing diseases. This is one of the reasons why it is harder to establish a direct link between sleep apnea and heart disease.

According to the American Heart Association (AHA), some people living with sleep apnea and high blood pressure who received treatment for sleep apnea also saw their blood pressure drop. Such findings show a possible link between hypertension and sleep apnea.

OSA is also associated with obesity, which is a risk factor for heart disease.

Obesity contributes to sleep apnea, and the sleep deprivation that sleep apnea causes can give rise to further obesity, in the long-term. As a person gains more weight, the throat muscles that keep the airway open relax, and sleep apnea becomes more serious.

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Women who snore may be at greater risk

The researchers analyzed data associated with cardiac parameters in relation to diagnosed OSA and self-reported snoring using data from the UK Biobank.

The UK Biobank is an international health resource, open to researchers, that aims to improve the prevention, diagnosis, and treatment of diseases.

The data were of 4,877 participants who had received a cardiac MRI scan. The scientists divided them into three groups: those with OSA, those with self-reported snoring, and those with neither.

When the researchers compared the snoring group with the group without sleep disorders, they found a striking difference in the left ventricular mass in women compared with men.

Increased left ventricular mass means that the heart needs to work harder to fulfil the body's needs.

These patterns in people who self-reportedly snore may be an indication of undiagnosed OSA.

"We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement."

Researcher Dr. Adrian Curta

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OSA may be vastly underdiagnosed

The researchers also found that the number of diagnosed OSA cases in the study was extremely low, suggesting that OSA may be underdiagnosed across the board.

Dr. Curta, a radiology resident at Munich University Hospital in Germany, urges people who snore to get screened for OSA and those with OSA to seek treatment.

"I would encourage people who snore to ask their partner to observe them and look for phases during sleep when they stop breathing for a short while and then gasp for air," says Dr. Curta.

He continues, "If unsure, they can spend the night at a sleep lab where breathing is constantly monitored during sleep and even slight alterations can be recorded."

The team now hopes to conduct more research to fully understand the sex differences linked to snoring and OSA.

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Infections could trigger cardiovascular disease

Researchers find a higher risk of coronary events during the 3 months after an infection. The body's immune response, they suggest, may explain why infections "trigger" heart attack and stroke.
woman sneezing
Scientists encourage everyone to have their flu shots this year, as simple influenza viruses may trigger cardiovascular events.

The term cardiovascular disease (CVD) covers a range of conditions: from heart attack and heart disease to stroke, hypertension, and heart failure.

As many as 84 million people in the United States are living with one of the conditions above, and 2,200 people die every day as a result.

Several factors may raise the risk of cardiovascular conditions. Some of these factors are modifiable, such as smoking, high cholesterol, and high blood pressure. Other factors, such as sex, race, age, and family history, cannot be modified.

However, there are also a number of "acute" risk factors, or triggers, that can lead to CVD. Some research has linked urinary infections and pneumonia, for instance, with the risk of having heart attacks and stroke.

A new study, published in the Journal of the American Heart Association, zooms in on the link between infections and adverse cardiovascular events.

Dr. Kamakshi Lakshminarayan, a neurologist and associate professor of epidemiology at the University of Minnesota in Minneapolis, is the senior author of the study.

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Studying infections and coronary events risk

Dr. Lakshminarayan and colleagues examined 1,312 people who had had a coronary event such as a heart attack, or myocardial infarction, and compared them with 727 people who had had an ischemic stroke.

The study included both outpatients and people who were hospitalized to receive treatment for their infection.

The researchers looked for infections that these people developed up to 1–2 years before the cardiovascular event. The most commonly reported infections were urinary tract infections, pneumonia, and respiratory infections.

Overall, the study found that approximately 37 percent of the participants with heart disease had developed an infection in the 3 months leading up to the coronary event. Among people with stroke, this number was almost 30 percent.

In the first 2 weeks after having an infection, the risk of a stroke or a heart attack was the highest.

Though the analysis found this link among both inpatients and outpatients, people who received care in the hospital were more likely to have a coronary event.

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Immune response may elicit coronary events

Although the study was observational, the scientists speculate on the mechanism that may explain the results.

During an infection, explains Dr. Lakshminarayan, the body's immune system produces more white blood cells to fight it off. However, this immune response also makes small blood cells, called platelets, stickier.

In a healthy body, the role of platelets is to bind to a damaged blood vessel and create a blood clot. This is very useful for accidental cuts, for example, but too many platelets, or platelets that are too sticky, can raise the risk of blood clots.

"The infection appears to be the trigger for changing the finely tuned balance in the blood and making us more prone to thrombosis, or clot formation," says Dr. Lakshminarayan. "It's a trigger for the blood vessels to get blocked up and puts us at higher risk of serious events like heart attack and stroke."

"One of the biggest takeaways is that we have to prevent these infections whenever possible [...] and that means flu shots and pneumonia vaccines, especially for older individuals."

Dr. Kamakshi Lakshminarayan

In an accompanying editorial, Juan Badimon — who was not involved in the research — explains why the risk of a coronary event may have been higher in the hospitalized group. He says that for these people, the infection might have been more severe.

"And if the infection is that severe, we can assume a stronger inflammatory response will result in a higher cardiovascular risk," he said in an interview.

Badimon is a professor of medicine and the director of the atherothrombosis research unit at Mount Sinai School of Medicine's Cardiovascular Institute in New York City, NY.

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