Category Archives: heart attack

Uncontrolled blood pressure, diabetes may be common among people with heart failure – AHA

Many people with heart failure also have diabetes or high blood pressure. But new research suggests those conditions, even when treated, aren’t well controlled, placing people at risk for worsening heart problems, according to the American Heart Association (AHA).

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“We know that controlling hypertension and diabetes is critical for people with heart failure,” said Dr. Madeline Sterling, a primary care physician at Weill Cornell Medicine in New York City. “But few studies have been able to ascertain how well those risk factors have been controlled. This study really takes a big step forward in doing that.”

Sterling wrote an editorial accompanying the study that appeared in the American Heart Association’s journal Circulation: Heart Failure.

Heart failure occurs when the heart can’t pump as well as it should and fails to deliver enough oxygen to the body, making it harder for people to perform everyday tasks. Hypertension, another name for high blood pressure, and diabetes are major risk factors for heart failure, which affects more than 6 million people in the U.S., especially those who have other heart problems or who have had heart attacks.

In the new study, researchers analyzed 18 years of data from the National Health and Nutrition Examination Survey, a series of federal studies assessing the prevalence of major diseases and their risk factors among U.S. adults.

While just 8% of 1,423 people diagnosed with heart failure had poor glycemic control, defined in the study as a hemoglobin A1C level of 8% or higher, 21% of those being treated for diabetes failed to meet blood glucose goals. This did not vary by race or ethnicity.

Researchers also found 48% of people with heart failure had uncontrolled hypertension, which the researchers defined as a systolic blood pressure, the top number in a reading, of at least 130. Among people prescribed blood pressure-lowering medication, poor control was even higher, at 51%. Black adults had higher uncontrolled rates than their white peers, at 53% compared to 47%.

That higher rate of poor blood pressure control among Black adults with heart failure was not surprising since it mirrors racial disparities in blood pressure control in the general population, said Dr. Sadiya Khan, senior author of the study, funded in part by the AHA.

“This speaks to a larger problem, which is a systemic failing to control the leading risk factors that account for the greatest number of non-communicable deaths worldwide,” said Khan, an assistant professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.

“The reasons for these disparities are manifold,” said Dr. Leah Rethy, a resident physician at the University of Pennsylvania Perelman School of Medicine and lead author of the study. They include the history of structural racism in the U.S., which is largely responsible for disparities in access to health care, proximity to green spaces where people can safely meet exercise goals and “all sorts of things that influence somebody’s life course up until the time they get heart failure,” she said.

While the vast majority of people in the study had insurance, they also reported incomes below the poverty line, which could affect their access to quality care or the ability to pay for medications, said Sterling, who was not involved in the research. The study also did not track whether people being treated for high blood pressure and diabetes were actually taking the medications prescribed to them.

The study documented only the prevalence of uncontrolled blood pressure and poor glycemic control, not why those risk factors were uncontrolled, Rethy said.

“We think there’s probably a number of reasons that include a lack of understanding or focus from providers about the importance of blood pressure control, but also perhaps a lack of accessibility to consistent and affordable primary and specialty care for adults with heart failure,” she said, “particularly those under age 65 who don’t qualify for Medicare.”

Sterling added that “it’s actually quite hard to control these risk factors. It’s not just a matter of giving people medications. This study is shedding light on this.”

Many people who have heart failure are older, frail and may have cognitive issues, so it may be difficult for them to perform the extensive self-monitoring needed to manage their health, she said. “A lot is put on patients to manage this at home, and it’s a challenge.”

But that doesn’t mean it’s an insurmountable one, Rethy said. The key is finding ways to help health care professionals and patients put into practice what researchers know about how to get blood pressure and blood glucose levels under control.

“There are many good medications and lifestyle interventions that we know work,” she said. “We shouldn’t think of it as too lofty to achieve. We have access to lots of tools to help fix it.”

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Filed under blood pressure, blood pressure monitor, diabetes, heart attack, heart failure, heart health

Air pollution exposure may cause heart attack within an hour – AHA

Exposure to air pollutants – even at levels below World Health Organization air quality guidelines – may trigger a heart attack within the hour, according to a new study from China that found the risks were highest among older people and when the weather was colder.

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The study found exposure to any level of four common air pollutants could quickly trigger the onset of acute coronary syndrome. ACS is an umbrella term describing any situation in which blood supplied to the heart muscle is blocked, such as in a heart attack or unstable angina, chest pain caused by blood clots that temporarily block an artery. The strongest risk occurred within the first hour of exposure and diminished over the course of the day.

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Obesity significantly increased heart failure risk among women with late menopause – AHA

Research Highlights:

  • While women who enter menopause before age 45 are known to be at higher risk of heart failure, obesity significantly increased heart failure risk among women who experienced late menopause – at age 55 or older, according to a new study.
  • The findings indicate that maintaining a healthy weight and avoiding abdominal obesity may protect against developing heart failure, especially among women who experience late menopause.
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While women who enter menopause before age 45 are known to be at higher risk for heart failure, obesity significantly increased heart failure risk among women who experienced late menopause – at age 55 or older, according to new research published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

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Soft Skin Patch Could Provide Early Warning for Strokes, Heart Attacks – UC San Diego

Engineers at the University of California San Diego developed a soft and stretchy ultrasound patch that can be worn on the skin to monitor blood flow through major arteries and veins deep inside a person’s body.

Knowing how fast and how much blood flows through a patient’s blood vessels is important because it can help clinicians diagnose various cardiovascular conditions, including blood clots; heart valve problems; poor circulation in the limbs; or blockages in the arteries that could lead to strokes or heart attacks.

This soft, stretchy skin patch uses ultrasound to monitor blood flow to organs like the heart and brain. This image was selected as the cover image for the July 2021 issue of Nature Biomedical Engineering.

The new ultrasound patch developed at UC San Diego can continuously monitor blood flow—as well as blood pressure and heart function—in real time. Wearing such a device could make it easier to identify cardiovascular problems early on.

A team led by Sheng Xu, a professor of nanoengineering at the UC San Diego Jacobs School of Engineering, reported the patch in a paper published July 16 in Nature Biomedical Engineering.

The patch can be worn on the neck or chest. What’s special about the patch is that it can sense and measure cardiovascular signals as deep as 14 centimeters inside the body in a non-invasive manner. And it can do so with high accuracy.

“This type of wearable device can give you a more comprehensive, more accurate picture of what’s going on in deep tissues and critical organs like the heart and the brain, all from the surface of the skin,” said Xu.

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Could this plaque identifying toothpaste prevent a heart attack or stroke?

Study shows Plaque HD® significantly reduces inflammation throughout the body

For decades, researchers have suggested a link between oral health and inflammatory diseases affecting the entire body — in particular, heart attacks and strokes. Inflammation is intimately involved in the pathogenesis of atherosclerosis and is accurately measured by high sensitivity C-reactive protein (hs-CRP), a sensitive marker for future risks of heart attacks and strokes.

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Researchers from Florida Atlantic University’s Schmidt College of Medicine, Marshfield Clinic Research Institute, and the University of Wisconsin School of Medicine and Public Health, collaborated on a randomized trial titled, “Correlation between Oral Health and Systemic Inflammation” (COHESION), to further explore whether Plaque HD®, a plaque identifying toothpaste, reduces hs-CRP. Continue reading

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Heart Attacks Striking Younger Women

Being a senior citizen I have to admit that I fall prey to accepting the cliche that you youngsters don’t have any physical problems. However, this item from Johns-Hopkins says otherwise.

two women in black tank tops and black leggings doing yoga

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Younger women are having more heart attacks, says a recent study. Researchers were surprised to find that while the heart attack rate has decreased among older adults, it’s risen among those ages 35-54, especially women. The Atherosclerosis Risk in Communities study reviewed more than 28,000 hospitalizations for heart attacks in four cities.

“This observational study found a trend in young women,” says Virginia Colliver, M.D., cardiologist with Johns Hopkins Community Physicians-Heart Care in Bethesda, Maryland. “But the research doesn’t provide insight into why the uptick in heart attacks is happening to younger people. I suspect it has to do with more people having risk factors for heart disease at an earlier age.”

Heart Attack Risk Factors for Women

There are several factors that increase your chance of developing heart disease. Almost 50% of all Americans have at least one of three major risk factors for the condition: Continue reading

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Filed under heart attack, heart health, high blood pressure, high cholesterol, smoking, Uncategorized

Signs of a heart attack or stroke – Do you know them?

Most people realize getting medical help quickly is crucial in response to a heart attack or stroke. But you need to know the signs so you can act, according to the American Heart Association.

“It is an emergency. People need to call 911,” said Dr. Erin Michos, associate director of preventive cardiology at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore.

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Emergency medical responders can begin evaluating a potential heart attack or stroke, and start treatment before arriving at a hospital, she said.

Heart disease is the nation’s leading killer, and every 40 seconds someone has a heart attack. Continue reading

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Omega-3 fish oil supplements linked with lower cardiovascular disease risk – Harvard

People who received omega-3 fish oil supplements in randomized clinical trials had lower risks of heart attack and other cardiovascular disease (CVD) events compared with those who were given placebo, according to a new meta-analysis from Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital. Researchers found an association between daily omega-3 supplementation and reduced risk of most CVD outcomes, including heart attack, death from coronary heart disease, and death from CVD, but did not see benefit for stroke. In addition, higher doses of omega-3 fish oil supplements appeared to provide even greater risk reduction.

shallow focus photo of a fish

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The study was published online September 30, 2019 in the Journal of the American Heart Association.

“This meta-analysis provides the most up-to-date evidence regarding the effects of omega-3 supplementation on risk of multiple CVD outcomes. We found significant protective effects of daily omega-3 supplementation against most CVD outcome risks and the associations appeared to be in a dose-response manner,” said first author Yang Hu, a postdoctoral fellow in the Department of Nutrition at Harvard Chan School. Continue reading

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Tips from Tufts on eating eggs …

I count myself as one of those confused about whether and to what extent eggs are a healthy addition to my diet. Love the protein, not so thrilled with the fats… Here is what the Tufts Health & Nutrition Letter has to say about it.

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Filed under American Heart Association, cholesterol, diabetes, eggs, HDL Cholesterol, heart attack, LDL Cholesterol

Heart Attack Patients with Mild Cognitive Impairment Get Fewer Treatments

I guess this would be an example of the old adage, “When it rains, it pours.”

A new study finds people who have mild cognitive impairment (MCI), which lies on the continuum of cognitive decline between normal cognition and dementia, are less likely to receive proven heart attack treatment in the hospital.

dementia

Researchers found no evidence that those with MCI would derive less benefit from evidence-based treatment that’s offered to their cognitively normal peers who have heart attacks, says lead author Deborah Levine, M.D., MPH.

“Patients should get the treatments they would want if they were properly informed,” says Levine, an associate professor of internal medicine and neurology at Michigan Medicine.

Some people with thinking, memory and language problems have MCI. Unlike dementia, which severely interferes with daily functioning and worsens over time, MCI does not severely interfere with daily functioning and might not worsen over time. Although people with MCI have an increased risk of developing dementia, it’s not an inevitable next step, Levine says.

“While some may progress to dementia, many will persist in having MCI, and a few will actually improve and revert to normal cognition,” says Levine, also a member of the University of Michigan Institute for Healthcare Policy and Innovation. “Many older adults with MCI live years with good quality of life, and so face common health risks of aging like heart attack and stroke.

“Clinicians, patients and families might be overestimating the risk of dementia after a mild cognitive impairment diagnosis even without realizing it. These older adults with MCI should still receive evidence-based treatments when indicated.” Continue reading

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Gain years keeping heart disease at bay – AHA

Heart disease is the nation’s No. 1 cause of death, killing about 650,000 people every year. Life expectancy is cut short by the disease and the health problems that stem from it. But by how much – and what can people do to take those years back?

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For heart attacks alone, more than 16 years of life are lost on average, according to American Heart Association statistics. Researchers estimate people with heart failure lose nearly 10 years of life compared to those without heart failure.

“In the past few years, there have been tremendous gains in reducing cardiovascular disease and increasing life expectancy, but we’ve hit a plateau,” said Paul Muntner, an epidemiologist at the University of Alabama at Birmingham.

Some people are at greater risk than others.

African Americans, for example, are more likely to have high blood pressure, obesity and diabetes, and they live 3.4 years less than their white counterparts. Among the six largest Asian American subgroups, research shows Asian Indian, Filipino and Vietnamese populations lose the most years of life to heart disease – up to 18 years for some – compared with white people.

The risk of early death also is high for people with a history of diabetes, stroke and heart attack. Reporting in the Journal of the American Medical Association in 2015, researchers found people with all three conditions had their life expectancy cut by 15 years compared to those without any of the health problems. Even having just two of the conditions reduced life expectancy by 12 years.

But there is hope. Continue reading

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A glass of water …

I just ran across this and thought you might enjoy it as much as I did. Sometimes simple things can be very beneficial to our health.

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Tony

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Excess belly fat – Sign of high risk for heart attack or stroke

I have written about central obesity – excess belly fat – previously. You can find further details on my Page – How dangerous is a big belly?

Nearly two-thirds of people at high risk of heart disease and stroke have excess belly fat, according to results of the European Society of Cardiology (ESC) EUROASPIRE V survey presented today at the World Congress of Cardiology & Cardiovascular Health in Dubai, United Arab Emirates.

woman girl jeans clothes

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Excess fat around the middle of the body (central obesity) is a marker of abnormal fat distribution. This belly fat is bad for the heart, even in people who are not otherwise overweight or obese.

Cardiovascular diseases are the leading cause of death in Europe. Each year in Europe there are more than 11 million new cases of cardiovascular disease and 3.9 million deaths caused by cardiovascular disease. Elimination of risk behaviours would prevent at least 80% of cardiovascular diseases.

The study also found that less than half (47%) of those on antihypertensive medication reached the blood pressure target of less than 140/90 mmHg (less than 140/85 mmHg in patients with self-reported diabetes). Among those taking lipid-lowering drugs, only 43% attained the LDL cholesterol target of less than 2.5 mmol/L. In addition, many participants not taking any antihypertensive and/or lipid-lowering therapy had elevated blood pressure and elevated LDL cholesterol. Among patients being treated for type 2 diabetes, 65% achieved the blood sugar target of glycated haemoglobin (HbA1c) less than <7.0%.

Professor Kornelia Kotseva, chair of the EUROASPIRE Steering Committee from Imperial College London, UK, said: “The survey shows that large proportions of individuals at high risk of cardiovascular disease have unhealthy lifestyle habits and uncontrolled blood pressure, lipids and diabetes.” Continue reading

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Shoveling snow is dangerous

I wanted to post this early to remind you about the nature of snow shoveling. The sight of snow can be a beautiful thing, but the nitty gritty of it is otherwise. Driving a car over snow is treacherous, ditto trying to navigate a bicycle. But the worst can be removing it. Shoveling snow is dangerous work.

While I strongly support calorie burning exercises to build up your cardiovascular system and other benefits, it is important to know your limits. If you are not currently working out or don’t consider yourself to be “in condition,” please think twice before you grab that snow shovel and race out to clear the walk.

nature photography of river near trees

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The American Journal of Emergency Medicine reported that more than 195,000 people were treated in U.S. Emergency Rooms for snow-shovel-related incidents from 1990 to 2006. This is an average of 11,500 individuals per year. Keep in mind that this information only covers folks who actually went to the ER for treatment. Plenty more stayed home and nursed their wounds ….

About 2/3 of these incidents occurred among males. Children younger than 18 made up 15.3% of the cases. Older adults (above 55 years) accounted for more than 20%.
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Filed under Exercise, heart attack, heart health brain health, snow shoveling

Heart attacks often follow dramatic changes in outdoor temperature

As regular readers know I pretty much ride my bike every day here in Chicago. I say ‘pretty much’ because several  years ago, my doctor told me that I shouldn’t be doing my big rides in high temperatures. I said that I felt I was in great shape and my body could handle it. She answered that she said the same thing to her 40-year-old patients. Extreme heat puts the body under special stress and it is not wise to actively exercise in those conditions.

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Here I am riding with my dog in the annual Bike the Drive ride in Chicago down Lake Shore Drive. As a Memorial Day ride, the temps rarely hit high extremes.

Now, it seems that now only high temp extremes, but also large intra-day changes can be damaging, according to a study being presented at the American College of Cardiology’s 67th Annual Scientific Session. It states that large day-to-day swings in temperature were associated with significantly more heart attacks in a study being presented at the American College of Cardiology’s 67th Annual Scientific Session.

Regarding extreme weather events, Hedvig Andersson, MD, a cardiology researcher at the University of Michigan and the study’s lead author, said, “Our study suggests that such fluctuations in outdoor temperature could potentially lead to an increased number of heart attacks and affect global cardiac health in the future.”

There is a large body of evidence showing that outdoor temperature affects the rate of heart attacks, with cold weather bringing the highest risk, but most previous studies have focused on overall daily temperatures. This new study is among the first to examine associations with sudden temperature changes. Continue reading

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Filed under cold weather exercising, Exercise, heart, heart attack, high blood pressure, outdoor exercise, Risky exercise, smoking, Smoking dangers, summer exercise, temperature changes

Harvard says, ‘Nuts to you’ – for heart health

I am fortunate in that I like nuts in all manner and form. Always have. So, nuts are an integral part of my daily diet.

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Many people think of nuts as just another junk food snack. In reality, nuts are excellent sources of healthy fat, protein, and other healthful nutrients.

One surprising finding from nutrition research is that people who regularly eat nuts are less likely to have heart attacks or die from heart disease than those who rarely eat them. Several of the largest cohort studies, including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study have shown a consistent 30 percent to 50 percent lower risk of myocardial infarction, sudden cardiac death, or cardiovascular disease associated with eating nuts several times a week. In fact, the FDA now allows some nuts and foods made with them to carry this claim: “Eating a diet that includes one ounce of nuts daily can reduce your risk of heart disease.” Continue reading

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