Archive for the 'Cardiovascular Disease' Category
June 8th, 2009 by Nina Thompson, ARNP
Actos (pioglitazone), an oral drug used in Diabetes, appears to slow the rate of atherosclerosis in the carotid arteries, according to researchers at the Phoenix VA HealthCare System.
In their recent study, prediabetic patients taking pioglitazone preventively had a 38% lower rate of change in atherosclerotic progression in the carotid artery over three years compared to patients taking placebo.
Cholesterol is a waxy, fat-like substance made in the liver, but also is found in certain foods. Throughout life, beginning in childhood, there is a gradual build up of cholesterol and other substances on the inner lining of an artery referred to as atherosclerotic plaques. In Diabetes, the rate of atherosclerosis progression is even more accelerated.
Over time, these plaques can harden and narrow an artery enough to slow or even block blood flow. The illustration above shows the build up of an atherosclerotic plaque on an artery wall.
Atherosclerotic plaques are often unstable and can rupture into the vessel lumen causing a blood clot to form. This can result in a sudden blockage of an artery. This is often the process by which people experience heart attacks or strokes. In some people, the first sign of atherosclerosis might be a heart attack or even sudden death.
Diagram courtesy of the National Heart Lung and Blood Institute (NHLBI).
Reaven PD, et al “Pioglitazone reduces long-term progression of carotid atherosclerosis in IGT” ADA 2009; Abstract 15-LB.
May 27th, 2009 by Nina Thompson, ARNP
A genetic link between a severe form of gum disease (periodontitis) and heart disease has been found by German researchers. The association between the two diseases has been known for years, but a genetic connection hadn’t been confirmed until this most recent discovery.
Periodontal (gum) disease is an infection of the tissues surrounding and supporting the teeth and is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it.
Periodontal disease is caused by plaque which is a sticky film of bacteria that constantly forms on the teeth. The bacteria create toxins that can damage the gums.
Gingivitis is the early stage of periodontal disease. In this stage, the gums can become red, swollen and bleed easily. At this point, the disease is still reversible and can usually be treated by daily brushing and flossing.
Periodontitis is the more advanced stage of periodontal (gum) disease when the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out or have to be removed by a dentist.
Early preventive measures are very important when it comes to taking care of your teeth and gums. Brushing at least twice daily and flossing once daily, are important steps to protect your teeth and gums. Regular visits to the dentist are essential to monitor for tooth decay as well as to detect any other serious conditions such as periodontitis. Eating a well-balanced diet is also important. Choose a variety of foods from the basic food groups, such as whole-grain breads, cereals and other grain products; fruits; vegetables; meat, poultry and fish; and dairy products, such as milk, cheese and yogurt.
Healthy gums are firm and pale pink. If you chronically have bad breath or your gums are puffy, dusky red and bleed easily, or show other signs or symptoms of periodontitis, see your dentist right away. The sooner you see receive dental care, the better your chances of reversing damage from periodontitis and preventing other serious health problems.
Source: European Society of Human Genetics, news release, May 25, 2009
Source: American Dental Association, ADA.org: Gum Disease (Periodontal Disease)
May 20th, 2009 by Nina Thompson, ARNP
Almonds appear to enhance immune health and reduce inflammation, according to researchers from the Institute of Food Research, Norwich, UK. The results of their research were presented Tuesday at the annual meeting of the American Society for Microbiology in Philadelphia.
Almonds have also been found to be a high-fiber food and are quite heart healthy. They’re a good snack with a lot of nutrition packed into a convenient package. About a handful of almonds provides an excellent source of vitamin E, magnesium, fiber, monounsaturated fat, protein, potassium, calcium, phosphorous, and iron.
Source: Institute of Food Research, Norwich, UK, May 2009
April 9th, 2009 by Nina Thompson, ARNP
Being overweight or obese raises a person’s risk of developing heart failure, according to a recent analysis of two large Swedish studies, from the Cardiovascular Epidemiology Research Unit of Beth Israel Deaconess Medical Center in Boston.
In these two studies, waist size was also a factor for women, but not for men. In women, body mass index was a risk factor for heart failure, but only among those with the largest waists. Whereas for men, waist size was not a factor, but for each one-point increase in BMI, the risk of heart failure increased by 4%.
Read more:
Source: “Heart Failure” Circulation, April 7, 2009
March 24th, 2009 by Nina Thompson, ARNP
The combination of normal systolic blood pressure and very low LDL cholesterol levels, provide the most benefit in slowing the progression of atherosclerotic plaque build up in the wall of the coronary arteries, according to Cleveland Clinic researchers.
Normal systolic blood pressure is defined as 120 mm Hg or less (the top number on the BP reading), and very low LDL cholesterol level is defined as 70 mg/dL or less.
In the illustration to the right, the red blood vessels on the surface of the heart are the coronary arteries. Good blood flow through these arteries is critical to the normal functioning of the heart muscle. However, the coronary arteries are often the source of signficant disease. In fact, coronary heart disease is America’s No. 1 killer.
Throughout life, beginning in childhood, there is a gradual build up of cholesterol and other substances on the inner lining of an artery referred to as atherosclerotic plaques. Over time, these plaques can harden and narrow an artery enough to slow or even block blood flow. Atherosclerotic plaques are often unstable and can rupture into the vessel causing a blood clot to form. This can result in a sudden blockage of an artery and is often the process by which people experience heart attacks or strokes. In some people, the first sign of atherosclerosis might be a heart attack or even sudden death.
Read more:
Source: Chhatriwalla A, et al “Low levels of low-density lipoprotein cholesterol and blood pressure and progression of coronary atherosclerosis” J Am Coll Cardiol 2009; 53: 1110-1115.
Source: “Lowering BP and LDL Cholesterol in Tandem Slows Atherosclerosis” MedPage Today, March 23, 2009
March 24th, 2009 by Nina Thompson, ARNP
Too many burgers, steaks and hot dogs may shorten your life, according to researchers from the National Cancer Institute. In a recent large prospective study, investigators found that eating more red and processed meat is associated with an increased risk of mortality, particularly from cancer and cardiovascular causes. On the other hand, white meat had a small protective effect against total and cancer mortality.
Source: Sinha R, et al “Meat intake and mortality” Arch Intern Med 2009; 169(6): 562-71.
Source: “Red Meat Associated With Increased Mortality Risk” MedPage Today, March 23, 2009
March 4th, 2009 by Nina Thompson, ARNP
The health benefits of alcohol are frequently touted on the daily news, but the many hazards are often omitted. Americans truly enjoy their alcohol, but the facts remain that excessive alcohol use is the third leading cause of preventable death in the United States and is a risk factor for numerous serious health and societal problems.
What is excessive alcohol use? It can take the form of heavy drinking, binge drinking, or both. Heavy drinking is defined for women, as more than one drink per day on average, and for men, two drinks per day on average. Binge drinking may occur only once per week or once per month but is defined as 5 or more drinks during a single occasion (in about 2 hours) for men or 4 or more drinks during a single occasion for women. Approximately 5% of the total population drinks heavily and 15% of the population engages in binge drinking, according to the CDC.
Binge drinking alone is associated with a number of very serious and significant consequences. Not to mention the many accidents, injuries, sexually transmitted diseases, unintended pregnancies, and children born with fetal alcohol syndrome, alcohol intoxication from binge drinking is often responsible for significant brain damage, liver disease, high blood pressure, stroke and other cardiovascular diseases, sexual dysfunction, and deadly alcohol poisoning.
Have you ever heard on the news that alcohol can cause cancer or brain damage? Well it can, yet this seems to be a well-kept secret. Heavy alcohol consumption, and in some cases moderate alcohol consumption, has a huge downside such as increasing the risk of cancer of the breast, mouth, pharynx, larynx, esophagus, and liver; not to mention other toxic and harmful effects on the brain and liver.
Despite all the well-documented research that shows the hazards of drinking alcohol, most people when asked will say, drinking a glass or two of wine or an alcoholic drink is “good for you”. Sure, an occasional glass of wine probably won’t hurt most people, but any more than a glass per day for a woman is considered heavy drinking, and there are bad consequences of heavy drinking.
The daily news is not completely wrong, there does appear to be some health benefits of alcohol, but many leading authorities contend that the hazards outweigh the benefits.
Source: National Institute of Alcohol Abuse and Alcoholism of the National Institute of Health
March 3rd, 2009 by Nina Thompson, ARNP
Men who averaged three drinks a day over a lifetime had more than twice the risk of hypertension as those who drank little or no alcohol, according to a 2008 study from the University of Bristol in the United Kingdom.
Often referred to as the “Silent Killer”, high blood pressure can insidiously damage any organ in your body for years before symptoms develop. Over time, high blood pressure eventually leads to life-threatening or disabling conditions such as stroke, heart attack, heart failure, kidney failure, cognitive decline, aneurysm development, erectile dysfunction, nerve damage and vision problems.
One in three adult Americans has high blood pressure, and nearly one-third of them don’t know they have it. The only way to know if you have hypertension is to have your blood pressure checked. People whose blood pressure is above 120/80 should consult their doctor about methods for lowering it.
Read more:
L Chen, G Smith, R Harbord, S Lewis, “Alcohol Intake and Blood Pressure: A Systematic Review Implementing a Mendelian Randomization Approach” PLOS Medicine, Mar 2008
February 21st, 2009 by Nina Thompson, ARNP
Most of us truly love our coffee and especially look forward to that first cup in the morning. It’s delicious, it helps you wake up, and quite honestly, most of us are addicted to this wonderful brew. But are we going to regret this delicious indulgence some day?
A number of researchers have recently investigated the health benefits of coffee and found that drinking regular coffee on a routine basis was associated with many important health benefits such as a decreased risk of stroke, diabetes and dementia. Also, several studies have found that people who drink coffee on a regular basis are up to 80% less likely to develop Parkinson’s. Other research shows that compared to not drinking coffee, at least two cups daily was linked to a 25% reduced risk of colon cancer, an 80% drop in liver cirrhosis risk, and nearly half the risk of gallstones.
Coffee has been found to be helpful in people who have asthma. It also has been known to stop a headache, improve mood, increase concentration and give you that extra energy needed to get through the day.
Some of the health benefits of coffee are merely from the caffeine. An eight ounce cup of drip-brewed coffee contains about 85 mg of caffeine, whereas eight ounces of black tea only has about 45 mg of caffeine and 12 ounces of Coke has 35 mg of caffeine. Many of the so called “Sports/Energy Drinks” on the market are loading up on caffeine for that extra jolt and may contain over 150 mg of caffeine.
Researchers believe that most of the health benefits from coffee probably originate from substances other than caffeine. Phenolic compounds in coffee have strong antioxidant properties, which may improve endothelial function. Caffeinated coffee appears to have beneficial effects on glucose metabolism, inflammation, and endothelial function which would account for protection against diabetes and stroke.
Of course adding cream which is loaded with fat may counteract some of the health benefits of coffee, and pouring several spoons full of sugar into the cup adds another carbohydrate load that is not beneficial.
While these studies are very good news for coffee drinkers, be aware that coffee can lead to a number of health problems. These can include fast heart rate, tremors, irritable bladder, excessive urination, stomach irritation, gastroesophageal reflux (GERD), nausea, vomiting, restlessness, anxiety, depression, and difficulty sleeping.
Caffeine is notorious for interfering with much-needed sleep. Many people get in a viscious cycle of using caffeine to mask their sleep deprivation, but then the excess caffeine keeps them from falling asleep the following night. The best way to break this cycle is to avoid all caffeine eight to ten hours before your desired bedtime. Drinking coffee later in the day is more likely to cause insomnia as well as stomach irritation and reflux for many people.
Another drawback of coffee is that certain drugs can interact with caffeine. Pregnant women and people with coronary heart disease or peptic ulcers are often advised to restrict or avoid using caffeine altogether.
Contrary to the popular belief that coffee will sober you up after drinking too much alcohol, it can actually worsen the problem. A recent study found that a high caffeine energy drink mixed with vodka actually reduced the participants’ perception of motor coordination compared with vodka alone. This could obviously lead to disasterous consequences in a person who is drinking heavily away from home and has several cups of coffee to sober up before driving home.
So, is coffee good for us? It depends on who you are, how much you drink, and when you drink it. It’s a good idea to talk to your doctor about the amount of coffee you drink.
Source: “High Coffee Consumption Linked to Lower Stroke Risk for Women”, MedPage Today, February 17, 2009
Source: Lopez-Garcia E, et al “Coffee consumption and risk of stroke in women” Circulation 2009; 119: 1116-1123.
February 19th, 2009 by Nina Thompson, ARNP
Drinking caffeinated coffee regularly may be linked with a lower stroke risk, according to Harvard and Madrid researchers. Women who drank two to three cups a day had a 19% reduction in the risk of all strokes but consumption of tea and caffeinated soft drinks was not significantly associated with a lowered stroke risk. The association was significant only in women who had never smoked or who had quit.
Other recent studies have also found that drinking coffee was associated with a decreased risk of diabetes as well as dementia.
Researchers believe the health benefits from coffee probably originate from substances other than caffeine. Phenolic compounds in coffee have strong antioxidant properties, which may improve endothelial function. Caffeinated coffee appears to have beneficial effects on glucose metabolism, inflammation, and endothelial function which would account for protection against diabetes and stroke.
While these studies are very good news for coffee drinkers, be aware that more research needs to be done. Also keep in mind that some people should not drink coffee at all, and for others, drinking too much coffee can be problematic and lead to a number of health problems.
Source: “High Coffee Consumption Linked to Lower Stroke Risk for Women”, MedPage Today, February 17, 2009
Source: Lopez-Garcia E, et al “Coffee consumption and risk of stroke in women” Circulation 2009; 119: 1116-1123.
