Posts Tagged "Heart disease"

Researchers found that women who had given birth might have a reduced risk of death from several common conditions than those who had not, according to a study released Friday by the Imperial College London (ICL).

The study, led by ICL researchers, was published in the journal BMC Medicine. It investigates the association between the so-called reproductive factors – such as having children and breastfeeding – and a woman’s risk of death.

Researchers analyzed data from 322,972 women across 10 countries, including the UK, France, Germany and Sweden, with an average age of 50.

Each woman was followed for an average of 12.9 years. During this period, there were 14,383 deaths overall, which included 5,938 deaths from cancer and 2,404 deaths from circulatory system diseases, according to the study.

The team compared a host of reproductive factors with risk of death from several common conditions, such as breast cancer, stroke and heart disease.

The researchers found that women who had given birth had a 20 per cent reduced risk of death than those who had not. It was also found that there was a reduced risk of death (eight per cent) in women who had breastfed compared to those who did not.

The risk of death from cancer was lower in those that had given birth compared to those that had not. Within this group, the risk was reduced even further in women that gave birth to two or three children in comparison to those who had one child.

Source: English News

Adults who get too much or too little sleep may have the beginnings of “hardening” of the arteries, which can be an early sign of heart disease, according to a new study.

“Many people, up to one third or one fourth of the general population, suffer from inadequate sleep – either insufficient duration of sleep or poor quality of sleep,” said co-lead author Dr. Chan-Won Kim of Kangbuk Samsung Hospital of Sungkyunkwan University School of Medicine in Seoul, South Korea.

Several studies have linked inadequate sleep with an increased risk of heart attack and stroke, but other conditions like depression or obesity could influence this association, Kim told Reuters Health by email.  

“In contrast, we studied if sleep of inadequate duration or quality would be linked to early markers of heart disease in asymptomatic healthy adults free of heart disease,” Kim said.

For the study, more than 47,000 men and women, age 42 on average, completed a sleep questionnaire and had tests to detect lesions of calcium and plaque in the artery leading to the heart, an early sign of disease, and arterial stiffness in the leg, a sign of vascular aging.

According to their questionnaires, the participants’ average sleep duration was 6.4 hours per night, and about 84 percent said their sleep quality was “good.” The researchers considered those who got five hours or less per night to be “short” sleepers, and those who got nine or more hours to be “long” sleepers.

Short sleepers had 50 percent more calcium in their coronary arteries than those who slept for seven hours per night, according to the results in Arteriosclerosis, Thrombosis and Vascular Biology. Long sleepers had 70 percent more calcium than those who slept seven hours.

“The associations of too short or too long sleep duration and of poor sleep quality with early indicators of heart disease, such as coronary calcium and arterial stiffness, provides strong support to the increasing body of evidence that links inadequate sleep with an increased risk of heart attacks,” Kim said.

Source: Reuters

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People infected with the hepatitis C virus are at risk for liver damage, but the results of a new Johns Hopkins study now show the infection may also spell heart trouble.

The findings, described online July 27 in The Journal of Infectious Diseases, emerged from a larger ongoing study of men who have sex with men, many but not all of whom were infected with HIV and followed over time to track risk of infection and disease progression. A subset of the participants had both HIV and hepatitis C, two infections that often occur together.

Even though people infected with HIV are already known to have an elevated risk for heart disease, researchers emphasize their results offer strong evidence that hepatitis C can spark cardiovascular damage independent of HIV.

Specifically, the research found that study participants chronically infected with hepatitis C were more likely to harbor abnormal fat-and-calcium plaques inside their arteries, a condition known as atherosclerosis and a common forerunner of heart attacks and strokes.

“We have strong reason to believe that infection with hepatitis C fuels cardiovascular disease, independent of HIV and sets the stage for subsequent cardiovascular trouble,” says study principal investigator Eric Seaberg, Ph.D., assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “We believe our findings are relevant to anyone infected with hepatitis C regardless of HIV status.”

Investigators emphasize they don’t know exactly how infection with the hepatitis C virus precipitates the growth of artery-clogging plaque but that their evidence is strong enough to warrant vigilant monitoring for cardiac symptoms among people infected with the virus.

“People infected with hepatitis C are already followed regularly for signs of liver disease, but our findings suggest clinicians who care for them should also assess their overall cardiac risk profile regularly,” says study author Wendy Post, M.D., M.S., professor of medicine at the Johns Hopkins University School of Medicine and a cardiologist at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

Source: Johns Hopkins Bloomberg School of Public Health

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Irregular sleeping patterns have been “unequivocally” shown to lead to cancer in tests on mice, a study suggests.

The report, in Current Biology, lends weight to concerns about the damaging impact of shift work on health.

The researchers said women with a family risk of breast cancer should never work shifts, but cautioned that further tests in people were needed.

The data also indicated the animals were 20% heavier despite eating the same amount of food.

Studies in people have often suggested a higher risk of diseases such as breast cancer in shift workers and flight attendants.

One argument is disrupting the body’s internal rhythm – or body clock – increases the risk of disease.

However, the link is uncertain because the type of person who works shifts may also be more likely to develop cancer due to factors such as social class, activity levels or the amount of vitamin D they get.

Mice prone to developing breast cancer had their body clock delayed by 12 hours every week for a year.

Normally they had tumors after 50 weeks – but with regular disruption to their sleeping patterns, the tumors appeared eight weeks earlier.

The report said: “This is the first study that unequivocally shows a link between chronic light-dark inversions and breast cancer development.”

Interpreting the consequences for humans is fraught with difficulty, but the researchers guesstimated the equivalent effect could be an extra 10kg (1st 8lb) of body weight or for at-risk women getting cancer about five years earlier.

“If you had a situation where a family is at risk for breast cancer, I would certainly advise those people not to work as a flight attendant or to do shift work,” one of the researchers, Gijsbetus van der Horst, from the Erasmus University Medical Centre, in the Netherlands, said.

Dr Michael Hastings, from the UK’s Medical Research Council, told the BBC: “I consider this study to give the definitive experimental proof, in mouse models, that circadian [body clock] disruption can accelerate the development of breast cancer.

“The general public health message coming out of my area of work is shift work, particularly rotational shift work is a stress and therefore it has consequences.

“There are things people should be looking out for – pay more attention to your body weight, pay more attention to inspecting breasts, and employers should offer more in-work health checks.

“If we’re going to do it, then let’s keep an eye on people and inform them.”

Source: BBC

Living decades with high cholesterol greatly increases the risk for heart disease, according to a recent study that bolsters a push by some doctors for regular cholesterol testing and perhaps early drug treatment of people in their 30s and 40s.

About 37% of young adults have never had their cholesterol checked, according to the Centers for Disease Control and Prevention. And when elevated cholesterol levels are found, doctors typically won’t prescribe a drug until patients are in their 50s or 60s. By then, significant damage from years of cholesterol buildup has been done, the new research indicates.

“If we wait until people are in their 50s and 60s to be thinking about high cholesterol, it is probably too late,” said Ann Marie Navar-Boggan, a cardiology fellow at Duke Clinical Research Institute in Durham, N.C., and lead author of the study, which was published in the journal Circulation in January. The risk of developing heart disease increases by 39% for every 10 years a person lives with high cholesterol, the research found.

Heart disease can be prevented through healthier eating, more exercise and weight loss, though many patients find it difficult to make the necessary lifestyle changes. Although statins have been proved to lower cholesterol and reduce the risk of heart attack, the safety and effectiveness of taking the drugs for several decades hasn’t been closely studied. In short-term studies, some people experience side effects to statins including muscle pains.

Source: WSJ

The Presidential Healthcare Center Provides Advanced Cardiovascular Screening.

Cardiovascular disease (CVD) is the top killer in women and is largely preventable. The call for women to reduce their risk comes from the European Society of Cardiology (ESC) today on International Women’s Day.

Dr. Susanna Price, ESC spokesperson and consultant cardiologist at the Royal Brompton Hospital in London, UK, said:

“CVD is still largely considered a man’s problem with breast cancer commonly perceived as the greater issue for women. However, CVD is the top killer of women in Europe, resulting in 51% of deaths compared to 3% caused by breast cancer.” (1)

She added: “Women’s risk of heart disease tends to be underestimated by both the public and the medical profession because of the perception that estrogen protects them. In reality this just delays the onset of CVD by 10 years. (2) The result is that women’s risk factors are left untreated, leaving them more vulnerable to heart attack, heart failure and sudden cardiac death when the protection fades after menopause.”

Despite these misconceptions, the facts are that:

-CVD is the main cause of death in women in all countries of Europe (3)

-CVD causes 51% of deaths in women and 42% of deaths in men in Europe (1)

-CVD kills 51% of women in Europe and breast cancer causes 3% of deaths (1)

-The risks of smoking are higher in women because women metabolize nicotine faster, especially those taking oral contraceptives (2)

-Type 2 diabetes doubles CVD risk in men but more than triples the risk in women (4)

-Women are more likely to be severely disabled after a stroke than men (5).

Source: European Society of Cardiology

Mortality among current smokers is 2 to 3 times as high as that among persons who never smoked. Most of this excess mortality is believed to be explained by 21 common diseases that have been formally established as caused by cigarette smoking and are included in official estimates of smoking-attributable mortality in the United States. However, if smoking causes additional diseases, these official estimates may significantly underestimate the number of deaths attributable to smoking.

We pooled data from five contemporary U.S. cohort studies including 421,378 men and 532,651 women 55 years of age or older. Participants were followed from 2000 through 2011, and relative risks and 95% confidence intervals were estimated with the use of Cox proportional-hazards models adjusted for age, race, educational level, daily alcohol consumption, and cohort.

During the follow-up period, there were 181,377 deaths, including 16,475 among current smokers. Overall, approximately 17% of the excess mortality among current smokers was due to associations with causes that are not currently established as attributable to smoking. These included associations between current smoking and deaths from renal failure, intestinal ischemia, hypertensive heart disease, infections, various respiratory diseases, breast cancer, and prostate cancer. Among former smokers, the relative risk for each of these outcomes declined as the number of years since quitting increased.

A substantial portion of the excess mortality among current smokers between 2000 and 2011 was due to associations with diseases that have not been formally established as caused by smoking. These associations should be investigated further and, when appropriate, taken into account when the mortality burden of smoking is investigated.

Source: The New England Journal of Medicine

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

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With nearly four in five older Americans living with multiple chronic medical conditions, a new study by researchers at Johns Hopkins Bloomberg School of Public Health finds that the more ailments you have after retirement age, the shorter your life expectancy. The analysis, one of the first to examine the burden of multiple chronic conditions on life expectancy among the elderly, may help explain why increases in life expectancy among older Americans are slowing.

A report on the findings, based on an analysis of 1.4 million Medicare enrollees, appears in the August issue of the journal Medical Care.

“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” says Eva H. DuGoff, a recent PhD recipient at the Johns Hopkins Bloomberg School of Public Health and lead author of the report. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”

For their analysis, researchers used the Medicare 5% sample, a nationally representative sample of Medicare beneficiaries, enrolled as of January 1, 2008, which included 21 defined chronic conditions and the records of nearly 1.4 million people 67 and older.

Life expectancy in the U.S. is rising more slowly than in other parts of the developed world and many blame the obesity epidemic and its related health conditions for the worsening health of the American population.

The analysis found that, on average, a 75-year-old American woman with no chronic conditions will live 17.3 additional years (that’s to more than 92 years old). But a 75-year-old woman with five chronic conditions will only live, on average, to the age of 87, and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men, while white people live longer than black people.

It’s not just how many diseases you have, but also what disease that matters. At 67, an individual with heart disease is estimated to live an additional 21.2 years on average, while someone diagnosed with Alzheimer’s disease is only expected to live 12 additional years.

On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up.

“We tend to think about diseases in isolation. You have diabetes or you have heart failure. But many people have both, and then some,” says senior author Gerard F. Anderson, PhD, a professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “The balancing act needed to care for all of those conditions is complicated, more organ systems become involved as do more physicians prescribing more medications. Our system is not set up to care for people with so many different illnesses. Each one adds up and makes the burden of disease greater than the sum of its parts.”

The researchers say their findings could be useful to Social Security and Medicare planners as they make population and cost predictions for the future. Policymakers are facing a different landscape as so many more people are living with multiple chronic conditions than before: 60 percent of those 67 and older in the U.S. have three or more of these diseases, the researchers found. Eventually, there may be a tipping point, when the medical advances that have boosted life expectancy for so long can no longer keep pace with the many illnesses people are collecting as they age.

“We already knew that living with multiple chronic conditions affects an individual’s quality of life, now we know the impact on quantity of life,” DuGoff says. “The growing burden of chronic disease could erase decades of progress. We don’t want to turn around and see that life expectancy gains have stopped or reversed.”

“Multiple Chronic Conditions and Life Expectancy, A Life Table Analysis” was written by Eva H. DuGoff, PhD; Vladimir Canudas-Romo, PhD; Christine Buttorff; Bruce Leff, MD; and Gerard F. Anderson, PhD. The study was supported by the American Insurance Group.

Source: Johns Hopkins

Stress has long been thought to trigger heart attacks, but the mechanism is unknown. Now, researchers think that bacteria could play a role. A study published today in suggests that stress hormones can break up mats of bacteria growing on the fatty plaques in arteries, releasing the plaques and causing strokes or heart attacks.

Researchers have suspected for years that bacteria infect the plaques of hardened arteries. The plaques form a surface on which bacteria can attach and grow in masses called biofilms, held together in a scaffold. To test this, a team led by bacteriologist David Davies of Binghamton University in New York analyzed arteries from 15 patients with cardiovascular disease. Using fluorescent tags that mark bacterial DNA, they discovered at least 10 species of bacteria clustered tightly around the plaques, including the biofilm-forming Pseudomonas aeruginosa.

If these biofilms are tightly attached to plaques, they may have an effect on cardiovascular disease, Davies says. Plaques in blood vessels are normally stable, but if they break up and enter the bloodstream, they can trigger blood clots that lead to heart attacks or strokes.

To test this idea, the researchers grew P. aeruginosa in artificial arteries made of silicone tubing and waited for the bacteria to form biofilms. They then flooded the tubes with the stress hormone noradrenaline, which caused the biofilms to break up.

The authors say that stress hormones in the blood trigger the body’s cells to release iron into the bloodstream. The iron causes bacteria such as P. aeruginosa to produce enzymes that sever the polymer bonds that hold the bacteria together in the biofilm matrix and attach the bacteria to the plaque. The plaque is broken up as collateral damage, Davies says. Although he says that much more research in animals and humans is needed, the work “introduces a completely unexpected potential culprit” in the mystery of how plaques trigger heart attacks, he adds.

“It’s quite an intriguing hypothesis,” says microbiologist Primrose Freestone of the University of Leicester, UK. But she adds that the amount of noradrenaline that the authors used in the experiment is much higher than would be present in a human body.

Still, Freestone says, it is possible that noradrenaline levels are somewhat higher at the site of the plaque. And she says that the project could serve as a “springboard” for researchers to think more about the role of bacteria in cardiovascular disease.

Emil Kozarov, a microbiologist at Columbia University in New York, agrees that the idea is interesting. But he says that he would like to see whether noradrenaline breaks up plaques in mice injected with the biofilm bacteria, and whether noradrenaline disperses biofilms formed by other bacterial species.

Davies says that he plans to model the process in mice. He and his team are also planning to determine whether the arteries of healthy people contain biofilm-forming bacteria.

Source: Scientific American