Women and men share most of the same risk factors for cardiovascular disease (CVD), a large international study has found – the first such study to include people not only from high income countries, but also from low- and middle-income countries where the burden of CVD is the greatest.
The study was published in The Lancet.
The global study assessed risk factors, including metabolic (such as high blood pressure, obesity and diabetes), behavioral (smoking and diet), and psycho-social (economic status and depression) in about 156,000 people without a history of CVD between the ages of 35 and 70. Living in 21 low, middle and high-income countries on five continents, they were followed for an average of 10 years.
“Women and men have similar CVD risk factors, which emphasizes the importance of a similar strategy for the prevention of CVD in men and women,” said the paper’s first author Marjan Walli-Attaei, a research fellow at the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences (HHS).
Overall, women had a lower risk of developing CVD than men, especially at younger ages.
However, diet was more strongly associated with CVD risk in woman than men – “something that’s not been previous described, and which requires independent confirmation,” said Salim Yusuf, lead investigator of the study, senior author, executive director of PHRI, professor of medicine at McMaster University, and cardiologist at HHS.
High levels of bad (LDL) cholesterol and symptoms of depression were more strongly associated with CVD risk in men than in women.
The patterns of these findings were generally similar in high-income countries and upper-middle-income countries, and in low-income and lower-middle-income countries.
Lifestyle changes are known to reduce the risk for heart attacks and strokes. A new study that simulated the effect of lifestyle change on future cardiovascular risks for people with high blood pressure suggests one change – adopting a heart-healthy diet – may do more than others.
The findings predict adopting the DASH (Dietary Approaches to Stop Hypertension) diet would do more to cut cardiovascular events over a 10-year period than changes such as weight loss and physical activity for young and middle-aged adults with stage 1 hypertension that isn’t being treated.
The Journal of the American College of Cardiology (JACC) has issued a four-part focus seminar series on sports cardiology and of the impact of physical activity, cardio-respiratory fitness and exercise training on the general U.S. population and professional athletes’ cardiovascular health.
“The field of sports cardiology is a well-established but still rapidly evolving sub-specialty,” said Jason C. Kovacic, professor at the Icahn School of Medicine at Mount Sinai and author of the accompanying introduction article to the focus seminar series. “Given the mounting interest in sports cardiology, its key relevance to all cardiovascular practitioners, and the knowledge explosion in this field, we felt it was particularly timely to pay special attention to this broad topic with a JACC Focus Seminar series.”
Researchers tracked the incidence of heart failure over six years in more than 94,000 middle-aged adults in the U.K. Biobank who wore wrist accelerometers to record the amount and intensity of their physical activity over seven days between 2013-2015.
Participants who engaged in 150-300 minutes of moderate physical activity or 75-150 minutes of vigorous physical activity during the week of observation reduced their risk of being hospitalized for or death from heart failure by two-thirds compared to participants who did not engage in the same amounts of moderate or vigorous physical activity during the week.
A six-year analysis of more than 94,000 adults in the U.K. Biobank with no history of heart failure at enrollment has found that engaging in moderate or vigorous physical activity may lower the risk of developing heart failure, according to new research published today in the American Heart Association’s flagship journal Circulation.
The study is one of the first to use objectively measured activity levels to estimate heart failure risk. The results are consistent with previous studies finding that performing 150-300 minutes of moderate exercise or 75-150 minutes of vigorous exercise each week may reduce the incidence of heart attack and stroke.
“Genetic testing for potentially lethal variants is more accessible than ever before and this document focuses on which athletes should be tested and when,” said author Dr. Michael Papadakis of St George’s, University of London, UK. “Sportspeople should be counselled on the potential outcomes prior to genetic testing since it could mean exclusion or restricted play,” The European Society of Cardiology (ESC) reported.
In most cases, clinical evaluation will dictate the need for preventive therapy such as a defibrillator and the advice on exercise and participation in competitive sports. Dr. Papadakis explained: “Even if a genetic abnormality is found, recommendations on treatment and return to play usually depend on how severe the disease is clinically. Is it causing symptoms such as fainting? Is the heart excessively weak or thick? Can we see many irregularities of the heart rhythm (arrhythmias) and do they get worse during exercise? If the answer is ‘yes’ to any of these questions then play is likely to be curtailed in some way.”
Chemicals produced by microbes in the digestive tract may be partly responsible for the increased heart disease risk associated with higher consumption of red meats such as beef and pork, a new study suggests, according to the American Heart Association (AHA).
Cardiovascular disease – which includes heart attacks and strokes – is the leading cause of death in the U.S. and around the world. As people age, their cardiovascular disease risk increases.
But risks can be lowered by eating a diet emphasizing fruits and vegetables, legumes, nuts, whole grains, lean protein and fish, staying physically active, getting enough sleep, maintaining a healthy body weight, not smoking and properly managing blood pressure, cholesterol and blood sugar levels.
“Most of the focus on red meat intake and health has been around dietary saturated fat and blood cholesterol levels,” study co-author Meng Wang said in a news release. Wang is a postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts University in Boston.
“Based on our findings, novel interventions may be helpful to target the interactions between red meat and the gut microbiome to help us find ways to reduce cardiovascular risk,” she said.
Heart health and your health in general are clearly tied to your psychological health. It should come as no surprise to regular readers here that eat less; move more; live longer works.
The American Heart Association has released a scientific statement addressing how psychological health can contribute to cardiovascular disease (CVD). Their analysis of science to date concluded that negative psychological health (depression, chronic stress, anxiety, anger, pessimism, and dissatisfaction with one’s current life) is linked to CVD risk and may play a direct role in both biological processes and downstream lifestyle behaviors that cause CVD. Conversely, positive psychological health can contribute to better cardiovascular health and reduced cardiovascular risk.The majority of research suggests interventions to improve psychological health can have a beneficial impact on cardiovascular health.
Get regular health check-ups that include basic screening for psychological health and seek help from a mental health professional if you have concerns. The study also recommends exercise, meditation, and other self-care as potential ways to promote both mental and physical health.
“There are chemotherapies that can damage the heart, and radiation to the chest can also affect the heart,” said lead researcher Dr. Roberta Florido, director of cardio-oncology at Johns Hopkins Medicine in Baltimore. “So it’s possible that these therapies, in the long run, increase the risk of cardiovascular disease.”
Meditation, as a religious practice or mystic experience, may be as old as humanity. Evidence of its use dates back as far as 7,000 years, and some scholars speculate it might have begun among people sitting in caves, gazing into their fires.
Today, it’s also the focus of serious scientific attention. While much of the work is preliminary, what researchers have learned about potential health benefits has them eager to learn more.
“Interest in meditation is vast – and is deep,” said Dr. Prab Nijjar, a cardiologist and assistant professor at the University of Minnesota School of Medicine in Minneapolis.
Nijjar, who has led studies related to meditation and the heart, cautions that “there’s probably more that we don’t know than we know” about meditation’s benefits. But he’s far from alone in seeing potential.
Levels of alcohol consumption currently considered safe by some countries are linked with development of heart failure, according to research presented at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC).
“This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed,” said study author Dr. Bethany Wong of St. Vincent’s University Hospital, Dublin, Ireland. “To minimize the risk of alcohol causing harm to the heart, if you don’t drink, don’t start. If you do drink, limit your weekly consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5% beer.”
Young adults diagnosed with prediabetes may be more likely to be hospitalized for heart attacks than their peers with normal blood sugar levels, according to preliminary new research.
Prediabetes occurs when a person’s blood sugar levels are higher than normal but not high enough for a diagnosis of Type 2 diabetes. It is defined as having fasting blood sugar levels between 100 and 125 mg/dL. About 88 million U.S. adults have prediabetes, 29 million of whom are under 45 years old.
“Prediabetes, if left untreated, can significantly impact health and can progress to Type 2 diabetes, which is known to increase a person’s risk for cardiovascular disease,” researcher Dr. Akhil Jain said in a news release. He is a resident physician at Mercy Catholic Medical Center in Darby, Pennsylvania.
“With heart attacks happening increasingly in young adults, our study was focused on defining the risk factors pertinent to this young population, so that future scientific guidelines and health policies may be better able to address cardiovascular disease risks in relation to prediabetes,” he said.
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).
“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.”
It is estimated that about one in four adults worldwide has an abnormal build-up of fat in the liver, called non-alcoholic fatty liver disease (NAFLD).
NAFLD can lead to permanent liver damage, and heart disease is the leading cause of death in people with fatty liver disease.
Because NAFLD is often missed in routine medical screening, the new American Heart Association scientific statement raises awareness and understanding about its link to heart disease and to outline how to prevent and diagnose the condition.
It is estimated that about one in four adults worldwide has a liver condition that is a risk factor for heart disease, according to a new American Heart Association scientific statement published today in the Association’s peer-reviewed journal Arteriosclerosis, Thrombosis, and Vascular Biology. The condition, called nonalcoholic fatty liver disease (NAFLD), occurs when abnormally elevated amounts of fat are deposited in the liver, sometimes resulting in inflammation and scarring. The prevalence of NAFLD is an estimate, given the challenges in diagnosing the condition, which are detailed in the statement.
An American Heart Association scientific statement is an expert analysis of current research and may inform future guidelines. Professional organizations specializing in gastroenterology have previously published statements on the condition, however, they focus on liver toxicity (including scarring, cirrhosis and liver cancer) rather than heart disease risk. This is the Association’s first statement about NAFLD.
“Nonalcoholic fatty liver disease (NAFLD) is a common condition that is often hidden or missed in routine medical care. It is important to know about the condition and treat it early because it is a risk factor for chronic liver damage and cardiovascular disease,” said P. Barton Duell, M.D., FAHA, chair of the statement writing committee and professor of medicine in the Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition at Oregon Health & Science University in Portland, Oregon.
There are two types of NAFLD: one when only fat is present in the liver (called non-alcoholic fatty liver), and the other when inflammation and scarring are also present (called non-alcoholic steatohepatitis, or NASH). Excess alcohol intake can cause similar fat deposits and liver dysfunction, so the term NAFLD is used to differentiate between disease caused by excess alcohol intake vs. disease without alcohol as the underlying cause.
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.
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.
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.
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.