Showing posts with label Heart. Show all posts
Showing posts with label Heart. Show all posts

Saturday, October 12, 2013

Can age-related heart failure be reversed?

Posted July 04, 2013, 2:00 am Stethoscpe

My husband has congestive heart failure. The doctor says it is caused by his age, and that there is no treatment. I read about a new discovery that age-related heart failure can be reversed in mice. Could that help my husband?

There are different kinds of congestive heart failure, and there are effective treatments for many. Your husband may have a common kind called age-related diastolic dysfunction. There is no specific treatment that prevents or reverses this condition. But you are right that a remarkable treatment was recently reported for a similar condition in mice.

Congestive heart failure occurs when the heart cannot pump efficiently enough to meet the body’s need for blood. In a young, healthy heart, when blood enters the main pumping chambers (the ventricles), their walls stretch and the chambers expand to receive all the blood.

In age-related diastolic dysfunction, the heart muscle becomes thicker and stiffer. As a result, when blood enters the heart, the heart muscle can’t stretch enough to accept all the blood. The blood backs up into the lungs, causing breathing difficulty. Blood also backs up into the rest of the body, causing fatigue and swelling — particularly of the legs and feet.

We don’t know what causes age-related heart failure in humans, and because of that, we don’t know how to prevent or reverse it. A similar condition occurs in mice, and we may now have figured out how to treat it.

A group of my colleagues at Harvard Medical School conducted the research in mice that you read about. They were led by Dr. Richard Lee, co-editor-in-chief of the Harvard Heart Letter, and professor Amy Wagers.

Dr. Lee and Dr. Wager’s team joined the blood circulation of an old mouse to that of a young mouse. Suddenly, the arteries and veins of the two animals shared the same blood. After four weeks of a shared circulation, the thickened, stiff heart muscle of the old mouse became dramatically less thick and stiff. The experiment was repeated on many pairs of old and young mice, with the same results.

This indicated that some substance was present in the blood of the young mice that rejuvenated the heart muscle of the old mice. Most likely, that substance had been in the blood of the old mice when they were younger, but the substance had decreased as the mice aged.

The team then identified a substance, called GDF11, which was present at high levels in the blood of young mice but not old mice. They treated old mice with enough GDF11 to raise their blood levels of GDF11 to the same levels as it was present in young mice. Again, the thickened, stiff heart muscle of the old mice became thinner and more flexible.

This discovery in mice may one day lead to effective treatments to prevent or reverse this common type of heart failure in humans. Although it will take many more years of research to determine if this discovery will help us, recent advances in aging research gives me hope that it will.

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Wednesday, October 2, 2013

Heart Rate Monitors?

I am looking to buy one of those heart rate monitor watches but I'm a little torn as to which would be good for me. I want to be able to use it on my treadmill, during bosu workouts, workout DVDs, working out in a park, runs outside, hiking, lifting weights, etc. so it won't be used just for running. I'd like to know how many calories I am burning during these various exercises. That is my main goal in which watch I choose.

Anyone have a HRM watch? Love it? Hate it? Any recommendations? Thanks guys!!!


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Monday, September 30, 2013

Do Heart Patients Get Too Many Cholesterol Tests?

Unnecessary screenings contribute to rising U.S. health costs, study suggestsWithout treatment, virus can lead to liver cancer.

By Steven Reinberg

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- Many U.S. heart patients may be getting their cholesterol levels checked unnecessarily, a new study suggests.

Statistics on more than 35,000 patients with coronary heart disease treated in a Houston-based Veterans Affairs network suggest this is an area of over-testing that's contributing to the nation's soaring medical costs, the study authors said.

At this one network of seven hospitals, the cost of redundant cholesterol blood tests amounted to more than $200,000 in one year, the study found.

"These results represent health care resource overuse and possibly their waste," said lead researcher Dr. Salim Virani, a cardiologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The study, published online July 1 in JAMA Internal Medicine, zeroed in on almost 28,000 patients taking statin drugs that were keeping their cholesterol levels in check -- less than 100 milligrams of cholesterol per deciliter of blood.

Over 11 months, repeat tests were ordered for one-third of those patients even though their medication had not been increased, the researchers found.

In all, nearly 13,000 additional tests were performed at about $16 each, bringing the total cost for this one group of hospitals to almost $204,000.

"Apart from the costs associated with these lipid panels, this also carries with it the cost for the patient's time to undergo a repeat blood test and cost for the health care provider's time to follow up on these results after redundant testing and to inform the patient about these results," said Virani.

Most of those who underwent repeat testing had a history of diabetes, high blood pressure and more frequent doctor visits, the research team found. The extra tests likely gave some of these patients a measure of comfort, the study authors noted.

The study drew mixed reactions from other experts.

Current national guidelines recommend that patients with coronary heart disease have their cholesterol checked every four to six months, said Dr. Gregg Fonarow, professor of cardiology at the University of California, Los Angeles and a spokesman for the American Heart Association.

"This new study shows a pattern of lipid testing that is entirely consistent with current guidelines," he said. "Whether less frequent testing and monitoring would result in similar outcomes at lower cost requires more study."

Using statin therapy to achieve and maintain appropriate LDL cholesterol levels remains one of the most cost-effective therapies for preventing recurrent cardiovascular events in men and women with coronary heart disease, he said.

Dr. Joseph Drozda Jr., author of an accompanying journal editorial, said that "seemingly inexpensive tests" really add up when done in large numbers.

"These cholesterol tests were being ordered with no benefit to the patient but cost the VA more than $200,000, and this was only in seven hospitals," said Drozda, from the Center for Innovative Care at Mercy Health in Chesterfield, Mo.

Drozda thinks this is just one example of the overuse of tests. "Most physicians will tell you this is not uncommon. A lot of tests are ordered without direct benefit to the patient and result in this kind of waste," he said.

"We need to be looking for all of these sources of waste and addressing them," he added.

About one of every six adult Americans has high blood cholesterol, putting them at risk of heart disease, according to the U.S. Centers for Disease Control and Prevention.


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Saturday, September 21, 2013

PTSD May Raise Heart Risks for Vietnam Vets

Study found those who suffered disorder were more likely to run into heart trouble, even after accounting for lifestyle factorsIdentifying pertinent experiences could lead to

By Robert Preidt

HealthDay Reporter

FRIDAY, June 28 (HealthDay News) -- Vietnam veterans with post-traumatic stress disorder (PTSD) are much more likely to develop heart disease, a new study finds.

Researchers looked at 562 middle-aged male twins (340 identical and 222 fraternal) who were veterans of the Vietnam War, and found that nearly 23 percent of the vets with PTSD had heart disease, compared with about 9 percent of the vets without PTSD.

When the researchers compared the 234 twins where one brother had PTSD and the other did not, 22 percent of those with PTSD had heart disease, compared with nearly 13 percent of those without PTSD.

The link between PTSD and heart disease remained strong even after the researchers accounted for lifestyle factors such as smoking, drinking and physical-activity levels, as well as for mental health problems such as depression.

The study was published online June 25 in the Journal of the American College of Cardiology and appears in the Sept. 10 print issue of the journal. The study was partially funded by the U.S. National Heart, Lung, and Blood Institute.

"This study suggests a link between PTSD and cardiovascular health," lead researcher Dr. Viola Vaccarino, a professor in the department of medicine at Emory University and chairwoman of the department of epidemiology at the Rollins School of Public Health, said in an institute news release.

"For example, repeated emotional triggers during everyday life in persons with PTSD could affect the heart by causing frequent increases in blood pressure, heart rate and heartbeat rhythm abnormalities that in susceptible individuals could lead to a heart attack," Vaccarino said.

"This study provides further evidence that PTSD may affect physical health," said Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute. "Future research to clarify the mechanisms underlying the link between PTSD and heart disease in Vietnam veterans and other groups will help to guide the development of effective prevention and treatment strategies for people with these serious conditions."

PTSD affects nearly 7.7 million U.S. adults.


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Tuesday, September 17, 2013

Think You're Stressed? Maybe You Should Have Your Heart Checked

Those who thought pressure was affecting their health twice as likely to suffer heart attack, study saysThose who thought pressure was affecting their

By Steven Reinberg

HealthDay Reporter

THURSDAY, June 27 (HealthDay News) -- People who think stress is affecting their health may be setting themselves up for a heart attack, a new study contends.

The researchers found that these people had double the risk of a heart attack compared with people who didn't think stress was harming their health.

"People's perceptions about the impact of stress on their health are likely to be correct," said study author Hermann Nabi, a senior research associate at the Centre for Research in Epidemiology and Population Health at INSERM in Villejuif, France.

"They may need to take actions when they feel that it is the case," he added.

These findings have both clinical and theoretical implications, Nabi said.

"From a clinical perspective, they suggest that complaints of adverse impact of stress on health should not be ignored in clinical settings as they may indicate increased risk of developing coronary heart disease," he said.

From a theoretical perspective, the findings imply that the perceived impact of stress on health is a valid concept that should be considered in future studies aimed at examining the association between stress and health outcomes, Nabi added.

The report was published June 27 in the online edition of the European Heart Journal.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "stress and reactions to stressful situations have been associated with increased risk of cardiovascular disease in many studies."

However, few studies have looked at whether an individual's perception of stress is associated with cardiovascular outcomes, he said.

And it's not clear if reducing stress would affect the risk for heart attack, Fonarow said.

"Further studies are needed to determine whether stress reduction or other risk reduction strategies can reduce cardiovascular events in men and women who perceive they are under stress that is adversely impacting their health," he said.

For the study, Nabi's team collected data on more than 7,000 men and women who took part in the Whitehall II study, which has followed London-based civil servants since 1985.

Participants were asked how much they felt that stress or pressure in their lives had affected their health. Based on their answers, they were placed into one of three groups: "not at all," "slightly or moderately," or "a lot or extremely."

Participants were also asked about their levels of stress and other lifestyle factors such as smoking, drinking, diet and physical activity.

The researchers also collected medical information, such as blood pressure, diabetes status and weight, and other data, including marital status, age, sex, ethnicity and socioeconomic status.

Over 18 years of follow-up, there were 352 heart attacks or deaths from heart attack.

After taking all of these factors into account, the investigators found those who said their health was a "lot or extremely" affected by stress had more than double the risk of a heart attack compared with those who said stress had no effect on their health.


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Friday, September 6, 2013

Should I worry because my resting heart rate is high?

Posted June 24, 2013, 2:00 am bigstock-Doctor-taking-patient-s-pulse--12826166

I’m a man in my 50s. I’m in good shape and I exercise regularly, but I have a high resting heart rate. Is this cause for concern?

Your heart rate changes from minute to minute. It depends on whether you are standing up or lying down, moving around or sitting still, stressed or relaxed. Your resting heart rate is how fast your heart beats when you are relaxed and sitting still.

To answer your question, there is cause for concern. Based on a recent study, even fit men with higher resting heart rates may have a higher risk of early death.

The study followed nearly 2,800 middle-aged men for 16 years. Men whose resting heart rates were 80 or more beats per minute died earlier, on average, than men with a resting heart rate of 65 beats per minute.

Experts have recognized the link between faster resting heart rates and heart disease and shorter lives for the past few years. Until recently, the leading explanation has been that resting heart rates in the 60 to 70 beats-per-minute range most often reflect better fitness. And with better fitness you are less likely to develop heart problems and more likely to live longer.

The new study found that higher resting heart rates meant shorter life expectancy — even in fit people. This was true even for men who exercised regularly when researchers factored in age and health habits.

Regular exercise does lower the resting heart rate. But even among regular exercisers, there are those with resting heart rates in the range of 55–75, and those with higher rates. In this study, those folks with higher rates were likely to die younger.

So what else causes a higher resting heart rate, besides not being fit? Genes and aging play a role. In my experience, there are some people who respond to the challenges of their daily lives by releasing a lot of the adrenaline hormone. Adrenaline raises heart rate, and constant high levels in the blood may make the heart more irritable.

People who smoke or drink too much alcohol generally have higher resting heart rates. Stress, medicines and medical conditions also influence heart rate.

Discuss your resting heart rate with your doctor at your next visit. In the meantime, you can start to lower your heart rate on your own:

Exercise more. When you take a brisk walk, swim or ride a bike, your heart beats faster during the activity and for a short time afterward. But exercising every day gradually slows your resting heart rate.Reduce stress. Meditation, tai chi and other stress-busting techniques can lower your heart rate over time.

There are medicines that can lower your heart rate. The most widely used are beta blockers. These medicines are effective in treating high blood pressure. In people with known heart disease, they reduce the risk of future heart problems.

To my knowledge, there are no studies of whether people who just have high resting heart rates would benefit from taking beta blockers.

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Tuesday, April 2, 2013

Long Waits in the ER May Raise PTSD Risk for Heart Patients

Title: Long Waits in the ER May Raise PTSD Risk for Heart Patients
Category: Health News
Created: 2/11/2013 4:36:00 PM
Last Editorial Review: 2/12/2013 12:00:00 AM

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Sunday, March 31, 2013

Calcium Supplements May Raise Odds of Heart Death in Women

Study also found combined risk from dietary

By Steven Reinberg

HealthDay Reporter

TUESDAY, Feb. 12 (HealthDay News) -- Women eating a high-calcium diet and taking calcium supplements adding up to more than 1,400 milligrams a day may be running nearly twice the risk of dying from heart disease, a large Swedish study suggests.

Both men and women take calcium supplements to prevent bone loss. The new findings come on the heels of another recent study that found a similar increased risk of death related to calcium intake among men.

"Many older adults increase dietary intake of calcium or take calcium supplements to prevent bone loss and there had been speculation that increased calcium intake with or without vitamin D could improve cardiovascular health," said Dr. Gregg Fonarow, an American Heart Association spokesman who wasn't involved in the study.

However, a number of recent studies have suggested that higher dietary intake or calcium supplementation may not only not improve cardiovascular health -- they may be associated with increased risk for cardiovascular events and mortality, said Fonarow, a professor of cardiology at University of California, Los Angeles.

The new report was published in the Feb. 12 online edition of the BMJ.

To see if calcium supplements raised the risk of dying from heart disease, a team led by Dr. Karl Michaelsson, a clinical professor in the department of orthopedic surgical sciences at Uppsala University in Sweden, analyzed data collected on more than 61,000 women enrolled in a study on mammograms.

Over 19 years of follow-up, nearly 12,000 women died -- almost 4,000 dying from cardiovascular disease, about 1,900 from heart disease and 1,100 from stroke, the researchers found.

The highest rates of death were seen among women whose calcium intake was higher than 1,400 milligrams a day, the researchers noted. On the other hand, women who took less than 600 milligrams of calcium a day were also at an increased risk of death.

Moreover, women taking 1,400 milligrams of calcium a day and also using a supplement had even a higher risk of dying than women not using supplements, Michaelsson's group found.

All in all, women getting more than 1,400 milligrams of calcium a day were more than twice as likely to die than women getting 600 to 999 milligrams a day, the researchers said.

The U.S. Office of Dietary Supplements recommends 1,000 to 1,200 milligrams of calcium a day for most adults.

According to the study authors, diets very low or very high in calcium can override normal control by the body, causing changes in blood levels of calcium.

Rather than worry about increasing calcium intake of those getting enough through their diet, emphasis should be placed on people with a low intake of calcium, the authors suggest.


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Monday, March 18, 2013

Which Fats Really Are Good for Your Heart?

butter melting in pan

Feb. 6, 2013 -- The standard advice about which fats are best for heart health is under debate again.

Triggering it is new research, just published in BMJ, finding that a form of omega-6 fatty acid found in vegetable oils may actually boost heart disease risk. Omega-6 fatty acids are a type of polyunsatured fat, which has generally been considered heart healthy.

The new findings could significantly alter the advice about which type of fats to eat, some experts say. The new research warrants another look at the current recommendations, says a spokesperson for the American Heart Association.

WebMD turned to the study author and other experts to sort out the findings -- and to figure out which fats to eat now.

First, a refresher course on fats:

Saturated fats, found in high-fat dairy, meats, and fried foods, as well as trans-fats, found in processed foods such as chips and cookies, should be limited. Experts agree they raise the risk of heart disease.Unsaturated fats, in moderation, are considered heart-healthy, overall. These include monounsaturated fats and polyunsaturated. Monounsaturated fats are found in olive oil, nuts, and other foods. Polyunsaturated fats can be broken down into two types: omega-6 fatty acids, found in soybean oil, corn oil, and safflower oil; and omega-3 fatty acids, also in soybean and canola oil and in nuts and some fish as well.

What's the ''back story'' on omega-6 fatty acids?

While polyunsaturated fatty acids -- which include omega-3 and omega-6 fatty acids -- are viewed as heart-healthier fats, the information about the benefits of omega-6 fatty acids is more limited, says Christopher Ramsden, MD, a clinical investigator at the National Institutes of Health. He led the research.

Because many oils often contain both, it has been difficult to know which is healthier than the other.

The benefits of foods with both omega-3 and omega-6 fatty acids (such as many vegetable oils)  may be due more to the omega-3 fatty acids, says Ramsden. "We suspect that omega-6 might not be as healthy as omega-3," he says.

Different fatty acids may have different effects on heart health, he says.

What exactly did the study look at?

Ramsden and his team recovered some unanalyzed data from the Sydney Diet Heart Study, conducted from 1966 to 1973. The study included 458 men, ages 30 to 59, with a history of heart attack or other heart problems.

One group was told to reduce their saturated fat intake to less than 10% of daily calories and increase their polyunsaturated fat intake to about 15% of calories. They were told to use safflower oil or safflower oil margarine, which has linoleic acid, a form of omega-6, but no omega-3 fats.

The other group received no specific instruction on diet.


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Wednesday, March 13, 2013

Calcium Supplements May Raise Men's Death Risk From Heart Disease

This should reassure those in U.S., other

By Steven Reinberg

HealthDay Reporter

MONDAY, Feb. 4 (HealthDay News) -- Men taking calcium supplements may be running a nearly 20 percent increased risk of dying from cardiovascular disease, a new study suggests.

Both men and women take calcium supplements to prevent bone loss. In this study of calcium intake, the risk of dying from heart disease was higher for men but not for women.

"Increasing evidence indicates that too much supplemental calcium might increase the risk of cardiovascular disease," said Susanna Larsson, an associate professor at the Institute of Environmental Medicine at the Karolinska Institute, in Stockholm.

Larsson, who was not part of the study but wrote an accompanying journal editorial, added that "the paradigm 'the more the better' seems invalid for calcium supplementation."

The report was published in the Feb. 4 online edition of the journal JAMA Internal Medicine.

To find out if calcium supplements were associated with an increased risk of dying from cardiovascular disease, a team of scientists led by Qian Xiao, of the U.S. National Cancer Institute, collected data on more than 388,000 men and women, aged 50 to 71 years old. They took part in a study on diet and health conducted by the U.S. National Institutes of Health and the AARP from 1995 to 1996.

Over an average 12 years of follow-up, about 7,900 men died from cardiovascular disease, as did nearly 4,000 women. Among those who died, 51 percent of men and 70 percent of women were taking calcium supplements, the researchers found.

Xiao's group calculated that men taking 1,000 milligrams a day of a calcium supplement had a 20 percent increased risk of dying from heart disease. Men also had a 14 percent increased risk of dying from a stroke, but this was not statistically significant, the researchers said.

Among women, however, calcium supplements were not linked to an increased risk of dying from cardiovascular disease. And, calcium from diet didn't increase the risk of dying from cardiovascular disease for either sex, the researchers found.

The study authors said more research is needed to determine whether there is difference between men and women in the cardiovascular effects of calcium supplements.

"Given the extensive use of calcium supplements in the population[often for osteoporosis], it is of great importance to assess the effect of supplemental calcium use beyond bone health," the investigators concluded in the study.

Taylor Wallace, a representative of the supplement industry, faulted this and other studies because, he said, they were not specifically meant to address calcium supplements and heart disease.

Wallace, who is senior director for Scientific & Regulatory Affairs at the Council for Responsible Nutrition, said most studies of calcium supplements show no effects on the heart.


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Saturday, March 2, 2013

Vegetarian Diet May Cut Heart Disease Risk

By Peter Russell
WebMD Health Newsfresh raw vegetables

Jan. 31, 2013 -- The risk of hospitalization or death from heart disease is almost a third lower in vegetarians than in people who eat meat and fish, according to a new study.

Researchers from the University of Oxford in England say the health benefits of not eating meat likely stem from having lower blood pressure and cholesterol levels.

But heart experts caution that following a vegetarian diet is unlikely to be enough to prevent heart disease.

Heart disease is the largest cause of death in developed countries.

The study looked at 44,561 men and women living in England and Scotland who were enrolled during the 1990s in a separate Oxford study looking at links between cancer and nutrition.

Researchers used this database because of the unusually high number of vegetarians enlisted: 34% of the people.

All the people were asked about their health and lifestyles when they joined. This included questions about diet and exercise, as well as other factors affecting health such as smoking and drinking alcohol. Almost 20,000 participants also had their blood pressures recorded and gave blood samples for cholesterol testing.

The volunteers were tracked until 2009. During that time, researchers recorded 1,066 people with heart disease and 169 deaths from heart disease.

The researchers found that vegetarians had a 32% lower risk of developing heart disease than those who ate fish and meat. They did not differentiate between red and white meat, nor did they track how much meat was eaten.

"We didn't look at the specific components of the vegetarian diet that might contribute to the lower risk of heart disease in this study, but because the vegetarians have lower blood cholesterol, it is probably because they have a lower intake of saturated fat and a higher intake of polyunsaturated fat,” says Francesca Crowe, who led the study.

Crowe says the vegetarians also ate more fruits, vegetables, and fiber, which might have contributed to their lower risk of heart disease.

The researchers say lower blood pressure among the vegetarians is likely to be an important factor.

Additionally, vegetarians typically had a lower body mass index (BMI) and fewer cases of diabetes (although these were not found to significantly affect the results). If the results are adjusted to exclude the effects of BMI, vegetarians are 28% less likely to develop heart disease, the researchers say.

The study appears in the American Journal of Clinical Nutrition.


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Friday, March 1, 2013

Marriage May Cut Heart Attack Risk for Both Spouses

THURSDAY, Jan. 31 (HealthDay News) -- Marriage appears to reduce the risk of heart attacks for both men and women, according to researchers in Finland.

Other studies have shown that being single or living alone increases the risk for developing and dying from heart disease. Many of these studies, however, were only among men, the researchers said, while this new study includes both sexes.

"Our study suggests that marriage reduces the risk of acute coronary events and death due to acute coronary events in both men and women and at all ages," said lead researcher Dr. Aino Lammintausta, of Turku University Hospital.

"Furthermore, especially among middle-aged men and women, being married and cohabiting are associated with considerably better prognosis of incident acute coronary events both before hospitalization and after reaching the hospital alive," she said.

The report was published Jan. 31 in the European Journal of Preventive Cardiology.

For the study, Lammintausta's team collected data on more than 15,300 people who suffered heart attacks between 1993 and 2002. Among these people, about 7,700 died within 28 days of their attack.

Looking at the role marriage might play in the likelihood of having a heart attack, the researchers found that unmarried men were 58 percent to 66 percent more likely to have a heart attack, as were 60 percent to 65 percent of single women, compared to members of married couples.

The gap in risk of dying from a heart attack was even greater for single men and women, the researchers said. For single men, the risk of dying within 28 days of a heart attack was 60 percent to 168 percent higher than for married men; for single women, the risk of death due to heart attack was 71 percent to 175 percent higher than for married women.

The odds of dying from a heart attack were increased for unmarried men and women regardless of age, compared with similar-aged married couples, the researchers noted.

Why marriage might have this effect isn't clear. The researchers, however, suggest several possible reasons.

Single people may be more likely to be in poor health, they said. Married people may be better off financially, live healthier lives and have more friends and social support, all of which promotes health. Married people also may be more likely to call an ambulance sooner than single people, the researchers said.

In addition, married couples get better treatment in the hospital and after discharge, the researchers noted.

On the other hand, the researchers suggested, single people may be less likely to follow measures that might help prevent heart attacks -- such as taking daily aspirin, cholesterol-lowering statins and medications to control high blood pressure.

"For better or worse, marriage is associated with better cardiovascular health and a lower risk of death due to an acute coronary event," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles.

The reasons marriage or cohabitation may protect people from heart attacks requires further study, he added. Further research is also needed to establish a cause-and-effect relationship between marital status and heart attack incidence and survival.

More information

To learn more about heart attacks, visit the American Heart Association.


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Thursday, February 28, 2013

Women's Heart Attack Symptoms: 6 Possible Signs

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WebMD Feature Reviewed byBrunilda Nazario, MD

When a heart attack strikes, it doesn’t always feel the same in women as it does in men.

Women don't always get the same classic heart attack symptoms as men, such as crushing chest pain that radiates down one arm. Those heart attack symptoms can certainly happen to women, but  many experience vague or even “silent” symptoms that they may miss.

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Read the Heart Palpitations article > >

These six heart attack symptoms are common in women:

Chest pain or discomfort. Chest pain is the most common heart attack symptom, but some women may experience it differently than men. It may feel like a squeezing or fullness, and the pain can be anywhere in the chest, not just on the left side. It's usually "truly uncomfortable" during a heart attack, says cardiologist Rita Redberg, MD, director of Women’s Cardiovascular Services at the University of California, San Francisco. "It feels like a vise being tightened." Pain in your arm(s), back, neck, or jaw. This type of pain is more common in women than in men. It may confuse women who expect their pain to be focused on their chest and left arm, not their back or jaw. The pain can be gradual or sudden, and it may wax and wane before becoming intense. If you're asleep, it may wake you up. You should report any "not typical or unexplained" symptoms in any part of your body above your waist to your doctor or other health care provider, says cardiologist C. Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles. Stomach pain. Sometimes people mistake stomach pain that signals a heart attack with heartburn, the flu, or a stomach ulcer. Other times, women experience severe abdominal pressure that feels like an elephant sitting on your stomach, says cardiologist Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center in New York. Shortness of breath, nausea, or lightheadedness. If you're having trouble breathing for no apparent reason, you could be having a heart attack, especially if you're also having one or more other symptoms. "It can feel like you have run a marathon, but you didn't make a move," Goldberg says. Sweating. Breaking out in a nervous, cold sweat is common among women who are having a heart attack. It will feel more like stress-related sweating than perspiration from exercising or spending time outside in the heat. "Get it checked out" if you don't typically sweat like that and there is no other reason for it, such as heat or hot flashes, Bairey Merz says. Fatigue. Some women who have heart attacks feel extremely tired, even if they've been sitting still for a while or haven't moved much. "Patients often complain of a tiredness in the chest," Goldberg says. "They say that they can't do simple activities, like walk to the bathroom."

Not everyone gets all of those symptoms. If you have chest discomfort, especially if you also have one or more of the other signs, call 911 immediately.

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Monday, February 25, 2013

Erectile Dysfunction May Signal Hidden Heart Disease

Large study found even mild impotence was tied to

TUESDAY, Jan. 29 (HealthDay News) -- Doctors should look more closely at the overall health of impotent men, a large new study suggests.

Men with even mild erectile dysfunction -- but no known heart problems -- face a major extra risk of developing cardiovascular conditions in the future. And as erectile dysfunction becomes more pronounced, signs of hidden heart disease and earlier death risk grow.

Not surprisingly, men already known to have a heart condition along with severe erectile dysfunction fare worst of all, the Australian researchers found.

Among men aged 45 and up without diagnosed heart disease, those with moderate or severe erectile dysfunction were up to 50 percent more likely to be hospitalized for heart problems, according to an adjusted analysis. Erectile dysfunction boosted the risk for hospitalization even more when men had a history of cardiovascular disease.

Erectile problems, which become more likely as men grow older, aren't a guarantee of heart problems. Still, men with erectile dysfunction should "take action by seeing a health professional and asking for a heart check," said study lead author Dr. Emily Banks. "Men with erectile dysfunction need to be assessed for their future risk of cardiovascular disease, and any identified risk must be managed appropriately."

Banks is a professor of epidemiology at the Australian National University's National Center for Epidemiology and Population Health.

Banks said an estimated 60 percent of men aged 70 and up suffer from moderate to severe erectile dysfunction. The condition can place major limits on sexual activity and require the use of drugs like Viagra that can come with side effects and awkward challenges when it comes to the timing of doses.

A variety of causes can contribute to impotence, but "it is widely acknowledged that erectile dysfunction is predominantly the result of underlying cardiovascular disease," Banks said.

Doctors already believe that erectile dysfunction is an early warning sign of heart problems, but it's not clear why. It's possible, Banks said, that the arteries of the penis are smaller than those of other parts of the body and may be more likely to reveal problems when their lining deteriorates.

The new study aims to gain more insight into how the severity of erectile dysfunction translates into a higher risk of cardiovascular disease. The researchers tracked more than 95,000 men aged 45 and up, and compared data collected between 2006 and 2009 to data collected in 2010.

The researchers adjusted their statistics so they wouldn't be thrown off by factors like high or low numbers of men who smoked or drank alcohol, or were wealthy or poor. They found that the men with severe erectile dysfunction, compared to those with no problem, were eight times more likely to have heart failure, 60 percent more likely to have heart disease and almost twice as likely to die of any cause.


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Sunday, February 24, 2013

For Diabetes: BP, Cholesterol Key v. Heart Disease

person taking own blood pressure

Jan. 28, 2013 -- People with diabetes who want to lower their risk of heart attack and stroke should focus on controlling their blood pressure and ''bad'' cholesterol, according to a new study of more than 26,000 patients.

Controlling both these risk factors, the researchers found, made patients less likely to be hospitalized for heart attacks or strokes than those who only controlled blood sugar during the six-year follow-up.

"It's not that blood glucose is not important. It's that low-density cholesterol and blood pressure control are more important if cardiovascular disease is what you are trying to prevent," says Gregory A. Nichols, PhD, a senior investigator at Kaiser Permanente Center for Health Research.

The study is published in the Journal of General Internal Medicine.

More than 18 million people in the U.S. have diabetes, according to the American Diabetes Association. 

Those with type 2 diabetes (in which the body doesn't make enough insulin or use it properly) have a higher risk of heart disease and stroke.

To minimize the risk, research suggests, those with diabetes should control not only blood sugar levels but also their LDL or ''bad" cholesterol and their blood pressure.

However, Nichols says, he is not aware of any study that looked at the contribution of these risk factors to heart attack or stroke risk among people with diabetes.

For the new study, the researchers calculated all patients' average values on systolic blood pressure (the upper number of the reading), cholesterol, and blood sugar levels.

"There were actually eight different possible categories," Nichols says. These ranged from having none of the risk factors under control to having all of them under control.

Guidelines suggest that systolic blood pressure in those with type 2 diabetes should be less than 130.

"LDL ideally is less than 100 [mg/dL] and A1c [a blood sugar measure] is less than 7%," Nichols says.

Next, they looked at whether the patients had a hospital admission with a diagnosis of heart disease or stroke. During the study, 1,943 patients were hospitalized for those reasons.

Those who were in the hospital were on average 65 years old. Those who were not were on average 58.

Nichols looked at the risk factor status of all patients.


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Friday, February 22, 2013

Heart Problems Tied to Early Signs of Dementia

senior woman with pensive expression

Jan. 29, 2013 -- Older women with heart problems may be at greater risk for mental changes that are thought to signal the beginnings of a type of dementia, a new study shows.

Called vascular dementia, it is a type of mental decline that’s thought to be caused by problems in blood flow to the brain. It is believed to be different from the loss of memory and function that happens in Alzheimer’s disease, which is linked to the buildup of proteins in the brain.

The study, which is published in the journal JAMA Neurology, followed 1,450 men and women in the Rochester, Minn., area. At the start of the study, all participants, who were in their 70s and 80s, were free of memory loss or thinking difficulties. Researchers gave them tests to measure brain function every 15 months.

After about four years, 348 people in the study had developed some form of mild cognitive impairment (MCI). This can include problems such as memory loss, having trouble making decisions, coming up with the right words, or navigating a familiar neighborhood.

Of those people, 94 had developed the type of mild cognitive impairment linked to vascular dementia. This type does not include memory loss, but does include the other problems such as with decision making, reasoning, and visual-spatial relations.

Heart health did seem to influence the risk of developing these types of mental changes. Even after researchers took into account other factors known to raise the risk of dementia (like family history, stroke, high blood pressure, diabetes, depression, and exercise) having heart problems -- including atrial fibrillation, coronary artery disease, and heart failure -- nearly doubled a person’s risk for developing mild cognitive impairment without memory loss.

The link was particularly strong in women. Women with heart problems were about three times more likely to develop it than women without heart concerns. The link was not significant in men.

Researchers say preventing heart disease, through regular exercise and a healthy diet, is the first step. For people who’ve already been diagnosed with heart disease, regular checkups to make sure diabetes, blood pressure, and cholesterol are under control may be important for brain and heart health.

“If we reduce the risk of the conditions that lead to cardiac disease, hopefully we can reduce the risk of developing MCI, and thereby reduce the risk of developing dementia,” says researcher Rosebud Roberts, MD, professor of epidemiology at the Mayo Clinic in Rochester, Minn.


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Friday, February 1, 2013

Some Migraines Linked to Heart Attack, Blood Clots

woman with a migraine

Jan. 15, 2013 -- Women who have migraine with aura may have a higher risk of heart attacks, and they may face a higher risk of dangerous blood clots if they use certain hormonal contraceptives.

Those are the findings from two newly published studies to be presented in March at the 65th annual meeting of the American Academy of Neurology in San Diego.

Migraine with aura refers to migraine headaches that are preceded by visual or other sensory symptoms such as flashing lights, blind spots, smell distortion, numbness, or tingling of the hands and face.

About 1 in 4 people with migraines have this type of migraine.

In the first study, having migraine with aura, but not regular migraines, was a risk factor for heart attacks among middle-aged and older women.

The analysis included data on close to 28,000 women enrolled in the ongoing Women’s Health Study.

During 15 years of follow-up, about 1,400 women who had migraine with aura were identified, and there were 1,030 heart attacks, strokes, or deaths from cardiovascular causes.

After having high blood pressure, having migraine with aura was found to be the second strongest contributor to heart attack and stroke risk, according to researcher Tobias Kurth, MD, of Brigham and Women’s Hospital in Boston and the French National Institute of Health.

Migraine with aura was found in the study to be a bigger risk factor for these cardiovascular conditions than having a family history of early heart disease or having diabetes or being obese or a smoker.

“We have known that migraine with aura is associated with cardiovascular risk,” neurologist and migraine specialist Noah Rosen, MD, says. “What is striking about this study is that it shows just how big this risk is.”

Rosen directs the Headache Center at the Cushing Neuroscience Institute, of the North Shore-LIJ Health System in Manhasset, N.Y.

In the second study, women with migraines who used combined hormonal contraceptives had a higher risk for dangerous deep vein blood clots, and the risk was highest in women with migraine with aura. Combined hormonal contraceptives contain both estrogen and progestin.

While there was a suggestion that newer-generation combined hormonal contraceptives might carry a greater risk for blood clots, researcher Shivang Joshi, MD, of Boston’s Brigham and Women’s Faulkner Hospital, says the difference among users of newer- and older-generation hormonal contraceptives was not that great.

Joshi and colleagues examined the impact of migraine type and combined hormonal contraception type on blood clot risk using data from a health insurance registry that included women enrolled between 2001 and 2012.

The researchers identified around 145,000 women who used combined hormonal contraceptives, including 2,691 who had migraines with aura and 3,437 who had migraines without aura.


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