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Exercise and Heart Damage

running 3Running marathons or completing other ultra-endurance events is not necessarily bad for the heart, although it could be. But first, a clarification: By standard definitions of exercise intensity, running or jogging is moderate or even vigorous exercise. During such exertion, the heart works hard to supply blood to working muscles and over time becomes stronger and somewhat larger.

Research has been unclear on whether these changes can become harmful. Multiple studies have shown that immediately after running a marathon, most racers show increased levels of a protein associated with cardiac damage. But those levels soon return to normal, with no lingering damage.

Years of prolonged and repeated endurance training and racing, however, might have more pronounced, lasting and running 2worrisome effects. A 2011 study of aging former Olympic runners and rowers from Britain, for instance, found that compared with healthy but unathletic men of the same age, the retired Olympians were disproportionately more likely to have scarring within their heart muscles. Similarly, in a 2013 study, people who had competed multiple times in a grueling, 56-mile cross-country ski race in Sweden had a much-higher-than-normal risk of developing heart arrhythmia within five years.

But these studies, although disquieting, “do not mean that it has suddenly become dangerous to exercise,” said Kasper Andersen, a professor at Uppsala University in Sweden who led the study of skiers. In fact, an earlier study from his lab found that, over all, runningparticipants in the ski race had a below-average risk of premature death.

Even the Olympians with heart scarring seemed largely unaffected. They were running and competing well into their 60s and 70s, that study found. Conceivably, the researchers wrote, the Olympians’ cardiac changes, which would be undesirable in most people, were normal in lifelong endurance athletes.

At this point, scientists just do not know precisely how years of endurance training might affect the heart.

So the best advice for those who enjoy endurance training is “carry on as usual,” Dr. Andersen said. “But remember to listen to your body and seek a doctor if you experience any symptoms from the heart.”

Source: New York Times

The Presidential Healthcare Center uses cardiac imaging to screen for “Athletic Heart Syndrome”


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Focus More Heart Care on the Young, Study Says

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

About 37% of young adults have never had their cholesterol checked, according to the Centers for Disease Control and Prevention. And when elevated cholesterol levels are found, doctors typically won’t prescribe a drug until patients are in their 50s or 60s. By then, significant damage from years of cholesterol buildup has been done, the new research indicates.cholesterol 2

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

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

Source: WSJ

The Presidential Healthcare Center Provides Advanced Cardiovascular Screening.


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Air Pollution Raises Stroke Risk

pollution 1Air pollution — even for just one day — significantly increases the risk of stroke, a large review of studies has found.

Researchers pooled data from 103 studies involving 6.2 million stroke hospitalizations and deaths in 28 countries.

The analysis, published online in BMJ, found that all types of pollution except ozone were associated with increased risk for stroke, and the higher the level of pollution, the more strokes there were.

Daily increases in pollution from nitrogen dioxide, sulfur dioxide, carbon monoxide and particulate matter were associated with corresponding increases in strokes and hospital admissions. The pollution 3strongest associations were apparent on the day of exposure, but increases in particulate matter had longer-lasting effects.

The exact reason for the effect is unclear, but studies have shown that air pollution can constrict blood vessels, increase blood pressure and increase the risk for blood clots. Other research has tied air pollution to a higher risk of heart attacks, stroke and other ills.

Source: New York Times


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Cardiovascular Disease Kills 51% Of Women In Europe And Breast Cancer Kills 3%

Cardiology 2Cardiovascular disease (CVD) is the top killer in women and is largely preventable. The call for women to reduce their risk comes from the European Society of Cardiology (ESC) today on International Women’s Day.

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

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

She added: “Women’s risk of heart disease tends to be underestimated by both the public and the medical Cardiology 1profession because of the perception that estrogen protects them. In reality this just delays the onset of CVD by 10 years. (2) The result is that women’s risk factors are left untreated, leaving them more vulnerable to heart attack, heart failure and sudden cardiac death when the protection fades after menopause.”

Despite these misconceptions, the facts are that:

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

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

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

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

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

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

Source: European Society of Cardiology


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Smoking and Mortality

smoking 4Mortality among current smokers is 2 to 3 times as high as that among persons who never smoked. Most of this excess mortality is believed to be explained by 21 common diseases that have been formally established as caused by cigarette smoking and are included in official estimates of smoking-attributable mortality in the United States. However, if smoking causes additional diseases, these official estimates may significantly underestimate the number of deaths attributable to smoking.

We pooled data from five contemporary U.S. cohort studies including 421,378 men and 532,651 women 55 years of age or older. Participants were followed from 2000 through 2011, and relative risks and 95% confidence intervals were estimated with the use of Cox proportional-hazards models adjusted for age, race, educational level, daily alcohol consumption, and cohort.Smoking 2

During the follow-up period, there were 181,377 deaths, including 16,475 among current smokers. Overall, approximately 17% of the excess mortality among current smokers was due to associations with causes that are not currently established as attributable to smoking. These included associations between current smoking and deaths from renal failure, intestinal ischemia, hypertensive heart disease, infections, various respiratory smoking 3diseases, breast cancer, and prostate cancer. Among former smokers, the relative risk for each of these outcomes declined as the number of years since quitting increased.

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

Source: The New England Journal of Medicine


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Mediterranean Diet Has Marked Impact On Aging

M Diet 2The Mediterranean diet consistently has been linked with an array of health benefits, including decreased risk of chronic disease and cancer. Until now, however, no studies had associated the diet with longer telomeres, one of the biomarkers of aging.

In a study published Tuesday online in The BMJ, researchers at Harvard-affiliated Brigham and Women’s Hospital (BWH) found that greater adherence to the Mediterranean diet correlated with longer telomeres.

Telomeres are repetitive DNA sequences at the ends of chromosomes that get shorter every time a cell divides. Shorter telomeres have been associated with decreased life expectancy and increased risk of aging-related disease, while longer telomeres have been linked to longevity. Telomere shortening is accelerated by stress and inflammation, and scientists have speculated that adherence to the Mediterranean diet may help protect against that effect.M diet 3

“To our knowledge this is the largest population-based study specifically addressing the association between Mediterranean diet adherence and telomere length in healthy, middle-aged women,” explained Immaculata De Vivo, an associate professor in the Channing Division of Network Medicine at BWH and the Harvard T.H. Chan School of Public Health, the senior author of this study. “Our results further support the benefits of adherence to this diet to promote health and longevity.”

The researchers analyzed 4,676 disease-free women from the Nurses’ Health Study who had completed the food-frequency questionnaire and whose telomere lengths had been measured. They found that a greater adherence to the Mediterranean diet was associated with longer telomeres, and that even small changes in diet made a difference.

“Our findings showed that healthy eating, overall, was associated with longer telomeres. However, the strongest association M Dietwas observed among women who adhered to the Mediterranean diet,” explained Marta Crous Bou, a postdoctoral fellow in the Channing Division of Network Medicine and the first author of the study.

De Vivo notes that future research should be aimed at determining which components of the Mediterranean diet drive this association. This would allow researchers to gain insight into the biological mechanism, as well as provide a basis for increased public education for informed lifestyle choices.

Source: Harvard Gazette

“The Presidential Healthcare Center Provides Nutritional Assessments.”  


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Cardiovascular Screening May Be Worthwhile For Middle-Aged Athletes

Heart 2Cardiovascular screenings are a cost-effective way to identify middle-aged athletes who may risk heart attacks or strokes by participating in high-intensity sports, a new study suggests.

“I would suggest that all middle-aged athletes should be screened at least once, particularly men over 40 and women over 50,” said the study’s lead author, Dr. Andrea Menafoglio, a cardiologist at Ospedale San Giovanni in Bellinzona, Switzerland.

While the benefits of regular exercise are well known, vigorous physical exertion can be life-threatening for older athletes who may not realize that they have an underlying heart condition. Guidelines in Europe and the U.S. urge cardiovascular risk evaluations for middle-aged athletes, but researchers say the recommendations aren’t universally followed because widespread implementation hasn’t proved effective or affordable.

To see if widespread screening could detect hidden symptoms and risks for heart disease at a reasonable price, MenafoglioHeart 3 and colleagues at three hospitals in Switzerland evaluated 785 athletes between the ages of 35 and 65.

Each of the athletes reported spending at least two hours a week participating in high-intensity sports such as running, cycling, triathlon, football, swimming, tennis, climbing, or cross-country skiing.

The initial evaluation included a personal and family history, a physical heart 5exam, and a resting electrocardiogram, or ECG. For each participant, the researchers also estimated the risk of death from cardiovascular disease within the next 10 years based on gender, age, cholesterol level, blood pressure, and smoking habits.

Overall, the cost of screening averaged $199 per athlete (about 160 euros), because most athletes didn’t need any testing beyond the initial evaluation.

About one in seven athletes needed additional screening. Extra tests found some cases of previously unimagined diabetes, hypertension, high cholesterol, and mild heart valve disease.

Overall, the screenings caught previously undetected cardiovascular abnormalities in about 3 percent of participants and aheart 4 high cardiovascular risk profile in about 4 percent.

Just three athletes had abnormalities that made it too dangerous for them to continue their exercise routines.

Source: Reuters Health

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