Posts Tagged "healthy heart"

Cardiovascular screenings are a cost-effective way to identify middle-aged athletes who may risk heart attacks or strokes by participating in high-intensity sports, a new study suggests.

“I would suggest that all middle-aged athletes should be screened at least once, particularly men over 40 and women over 50,” said the study’s lead author, Dr. Andrea Menafoglio, a cardiologist at Ospedale San Giovanni in Bellinzona, Switzerland.

While the benefits of regular exercise are well known, vigorous physical exertion can be life-threatening for older athletes who may not realize that they have an underlying heart condition. Guidelines in Europe and the U.S. urge cardiovascular risk evaluations for middle-aged athletes, but researchers say the recommendations aren’t universally followed because widespread implementation hasn’t proved effective or affordable.

To see if widespread screening could detect hidden symptoms and risks for heart disease at a reasonable price, Menafoglio and colleagues at three hospitals in Switzerland evaluated 785 athletes between the ages of 35 and 65.

Each of the athletes reported spending at least two hours a week participating in high-intensity sports such as running, cycling, triathlon, football, swimming, tennis, climbing, or cross-country skiing.

The initial evaluation included a personal and family history, a physical exam, and a resting electrocardiogram, or ECG. For each participant, the researchers also estimated the risk of death from cardiovascular disease within the next 10 years based on gender, age, cholesterol level, blood pressure, and smoking habits.

Overall, the cost of screening averaged $199 per athlete (about 160 euros), because most athletes didn’t need any testing beyond the initial evaluation.

About one in seven athletes needed additional screening. Extra tests found some cases of previously unimagined diabetes, hypertension, high cholesterol, and mild heart valve disease.

Overall, the screenings caught previously undetected cardiovascular abnormalities in about 3 percent of participants and a high cardiovascular risk profile in about 4 percent.

Just three athletes had abnormalities that made it too dangerous for them to continue their exercise routines.

Source: Reuters Health

“The Presidential Healthcare Center can design a personalized exercise prescription for you.”

The winter season is chock full of delicious dishes and treats, but no one likes the extra calories and added pounds that can come with the seasonal food. Use these smart tips on substitutions and choices to enjoy your favorite winter beverages and foods.

Eggnog

• Mix it up. Fill your glass with half- to three-quarter-parts of low-fat or skim milk and one part eggnog. You’ll still get the flavor without all the calories.
• Act like a kid. Take out the alcohol. This simple step will reduce the caloric content.
• Cut the fluff. Pass on that big dollop of whipped cream to avoid the extra sugar and saturated fat.

Hot Chocolate

• Skip the heavy stuff. If you order hot chocolate at a restaurant or coffee shop, ask that it be made with low-fat or skim milk, and without the whipped cream.
• Do some research. To make instant hot chocolate at home, look for product packets marked “low-fat/fat-free” or “low-sugar/sugar-free.” Be sure to add the mix to low-fat milk, skim milk or hot water.
• Go easy on the toppings. Use five to eight mini-marshmallows instead of large ones. If using whipped cream, look for low-fat versions and stick to less than one tablespoon. If you have hot chocolate regularly, try to limit the toppings to “once in a while treats” since they can pack a lot of calories and added sugars.

Apple Cider

• Read the labels. When buying cider at the store, check its added sugar content. Many products contain added sugars, which can increase your calorie intake and cause weight gain. Choose low-sugar and sugar-free options.
• Do it yourself. When making cider at home, use low-sugar apple juice and a variety of spices (like cinnamon sticks, cloves, nutmeg and whole cranberries). You’ll keep the flavor while cutting calories.

Cocktails and Other Alcoholic Beverages

• Enjoy cocktails. Serve non-alcoholic versions of your favorite cocktails to lower the calories. Be sure to check the nutrition label, because sometimes products that are alcohol-free have more added sugar.
• Break it up. To reduce the amount of calorie-laden drinks you consume during a holiday gathering, drink a glass of water or sparkling water between each beverage. This will help fill your stomach, leaving less room to overindulge.

Sodium

• Limit your sodium. Did you know that many of your favorite holiday dishes may be packed with sodium? Breads and rolls, poultry, and canned soups are three common foods that can add sodium to your diet. When shopping for ingredients to prepare your holiday meal, compare the labels to find lower sodium varieties.
• Savor the flavor. Use herbs and spices, like rosemary and cloves, to flavor dishes instead of salt or butter.
• Go fresh. Choose fresh fruits and vegetables to use in your dishes. If using canned products, rinse with water in a colander before cooking and serving.

Turkey

• Outsmart the bird. Reach for the lighter pieces of meat; they have fewer calories and less fat than the darker ones. Another way to cut calories is to take off the skin.
• Keep portions in check. A serving size of meat is 3 oz., about the size of a deck of cards. So, be conscious of how much you put on your plate, and pass on that second helping. If you’re also having another meat, like ham or lamb, take smaller portions of each.
• Watch out for the gravy train. Turkey usually comes with gravy, which can add excess fat, calories and sodium. Limit gravy to a tablespoon, and keep it off other items, like the dressing.

Dressing

• Call it what it is. Dressing is intended to be a complement to your meal, not an entrée. To keep calories and excess fat in check, aim for ¼ cup (or about half a scoop with a serving spoon).
• Judge it by its cover. If the dressing is filled with fatty meats like sausage and pork, looks greasy or buttery, and is made with white bread or sweet rolls, it may be best to pass. Better options would be dressings that have whole grain or cornbread, lean meat (or no meat), nuts (like almonds or walnuts), and lots of veggies and fruits.

Desserts

• Treat yourself right. The best way to enjoy an occasional sweet without losing control is by sampling a selection or two, rather than having full servings. For example, have one bite of pie, half a cookie or one small square of fudge. Find a friend or family member who will stick to the sampling rule with you.

Source: American Heart Association

A progressively rising blood pressure trajectory is not an inevitable part of aging in men who remain active and maintain high levels of cardiorespiratory fitness, a prospective, population-based study found.

The study included almost 14,000 men without high blood pressure, cardiovascular disease, or cancer at baseline followed for three and a half decades.

Men in the study who were categorized as having the lowest level of fitness, based on baseline treadmill tests, reached a systolic blood pressure (SBP) of >120 mmHg at approximately 46 years of age, compared with 54 years of age among those whose fitness levels were highest. Age-related diastolic blood pressure differences (DBP) were far more pronounced, with low-fitness men reaching >80 mmHg at approximately 42 years old compared with beyond age 90 in the highest fitness group.

“This suggests that highly fit men are likely to reach abnormal SBP values about a decade later than men in the low fitness category, implying that improving fitness levels may reduce the duration of elevated SBP,” researcher Junxiu Liu, MD, of the University of South Carolina Columbia, and colleagues wrote in the Journal of the American College of Cardiology, published online Sept. 15.

Exercise Keeps Heart Young

The study is one of two published in the issue suggesting that staying physically fit throughout life can keep aging hearts healthy.

In a separate investigation, researchers in Texas examined the impact of long-term exercise on left ventricular (LV) compliance and distensibility in around a hundred older men and women.

The study showed that while low levels of casual, lifelong exercise did not prevent decreased compliance and distensibility, four to five ≥30 minute exercise sessions a week throughout adulthood did prevent most age-related LV stiffness.

“This finding holds important implications for global health, as ventricular stiffening has been implicated in the pathophysiology of many common cardiovascular conditions affecting the elderly,” researcher Paul S. Bhella, MD, of the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, and colleagues, wrote.

Fit Men Had ‘Younger’ BP

The study by Liu and colleagues included an all male cohort from the Aerobics Center Longitudinal Study, which was a large study that included mostly white, college-educated people with middle to high socioeconomic status.

The men were between the ages of 20 and 90 at study entry, and they completed between three and 28 (mean 3.8) follow-up medical examinations between 1970 and 2006. Fitness was measured by a maximal treadmill exercise test, and longitudinal data were analysed using linear mixed models.

Cardiovascular fitness was assessed using the Balke maximal treadmill exercise test, with total treadmill time (highly correlated with oxygen uptake) used as an index of aerobic power. Participants were classified into low (<33rd percentile), moderate (33rd to 66th percentile), or high fitness categories (>66th percentile), according to the distribution of age-specific treadmill time.

Information on age, smoking status, and alcohol consumption were obtained by self-administered questionnaire. Body fat percentage was assessed using hydrostatic weigh in, skin fold thickness measurements, or both.

Among the key findings from the study:

-DBP tended to increase until nearly 60 years of age, when a decrease was observed, while SBP tended to increase over all age periods.

-Multivariate analysis revealed that average SBP increased by 0.30 mmHg (95% CI 0.29-0.31) with 1-year age increment after adjusting for body fat percent, fitness, resting heart rate, glucose level, triglyceride level, cholesterol level, current smoking, heavy alcohol consumption, and parental history of hypertension.

– had a yearly increase of 0.14 mm Hg (95% CI 0.13-0.15) before age 60 years.

-Overall, abnormal SBP (>120 mm Hg) began to occur at approximately 50 years of age and abnormal DBP (>80 mm Hg) began to occur at 60 years of age.

-Higher fitness levels significantly modified the risk in SBP trajectory across the lifespan, and the age-fitness interaction remained significant after adjusting for known hypertension risk factors.

Study strengths included the large number of participants, the longitudinal measure of SBP, DBP, and other time varying covariates, and the assessment of body fat percentage to measure obesity.

Limitations included the exclusion of women from the study, as well as the inclusion of only a small percentage (5%) of nonwhite and low income men, which limited its generalizability to these populations.

Findings May Not Apply to Women, Nonwhite Men

In an editorial accompanying the study, Stanley S .Franklin, MD, of the University of California Irvine, and Gary L. Pierce, PhD, of the University of Iowa, Iowa City, wrote that the exclusion of women was a major study limitation.

“There is some evidence that men have a steeper rate of increase in aortic stiffening beyond 50 years of age compared with women; therefore, fitness may have a different modifying effect on SBP and DBP trajectory with aging in women than men,” they wrote.

Even with the limitations, Franklin and Pierce wrote that the study suggests “habitual aerobic exercise may counteract the burden of cardiometabolic abnormalities that accelerate artery stiffening- characterized as ‘early vascular aging’ — and therefore slow the onset and severity of isolated systolic hypertension.”

Regular Exercise Preserves LV Function

In the study by Bhella and colleagues, 102 healthy older people (>64 years of age) were recruited and screened for lifelong patterns of exercise. The participants were stratified into four groups: sedentary (<2 ≥30 minute sessions/week), casual (2 to 3 sessions/week) committed (4 to 5 sessions/week) and competitive (6 to 7 sessions/week).

Right heart catheterization and echocardiography were performed while pre-load was manipulated using lower body negative pressure and rapid saline infusion to define LV pressure-volume relationships.

Peak oxygen uptake and LV mass increased with escalating doses of lifelong exercise, with little change in systolic function. At baseline, LV distensibility was greater in committed (21%) and competitive (36%) exercisers than in sedentary participants.

Group LV stiffness constants (sedentary: 0.062±0.039; casual: 0.079±0.052; committed: 0.055±0.033; and competitive: 0.035 ±0.033) revealed increased stiffness in sedentary subjects compared with competitive athletes, whereas lifelong casual exercise had no effect. They also showed greater compliance in committed exercisers than in sedentary or casual exercisers.

The researchers noted that sedentary aging, and the decreases in LV compliance and distensibility that accompany it, may set the stage for the cardiovascular conditions that affect the elderly, such as atrial fibrillation and heart failure with preserved ejection fraction.

In a commentary published with the study, Wilbur Y.W. Lew, MD, of the VA San Diego Healthcare System and the University of California San Diego, wrote that the effects of exercise on the heart are multifactorial and complex and that potential factors that prevent age-related changes in LV compliance include lowering blood pressure and arterial stiffness, decreasing cardiovascular comorbidities, improving endothelial function, and activating metabolic and signaling pathways to reduce chronic inflammation, fibrosis, and LV remodeling.

“A long-term commitment to exercise preserves LV compliance comparable to a young heart,” he wrote. “This may facilitate diastolic filling and preserve diastolic function. We face challenges to establishing causality, identifying mechanisms, and applying these results to an increasingly sedentary population.”

Source: medpagetoday.com