tag:blogger.com,1999:blog-22283976784530651342024-03-14T06:15:38.123-07:00Dr PortnayNews and opinion on cardiovascular health, exercise and nutritionDr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.comBlogger603125tag:blogger.com,1999:blog-2228397678453065134.post-24873701301659282152018-07-27T17:18:00.001-07:002018-07-27T17:18:16.486-07:00Exercise To Renew A Middle-Aged Heart : Shots - Health News : NPR<div><base href="https://www.npr.org/sections/health-shots/2018/03/12/591513777/hearts-get-younger-even-at-middle-age-with-exercise"><style id="print"> @media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } } </style><title>Exercise To Renew A Middle-Aged Heart : Shots - Health News : NPR</title><div class="original-url"><br><a href="https://www.npr.org/sections/health-shots/2018/03/12/591513777/hearts-get-younger-even-at-middle-age-with-exercise">https://www.npr.org/sections/health-shots/2018/03/12/591513777/hearts-get-younger-even-at-middle-age-with-exercise</a><br><br></div><div id="article" role="article" style="text-rendering: optimizeLegibility; font-family: -apple-system-font; font-size: 1.2em; line-height: 1.5em; margin: 0px; padding: 0px;" class="system exported"> <!-- This node will contain a number of div.page. --> <div class="page" style="text-align: start; word-wrap: break-word; max-width: 100%;"><h1 class="title" style="font-weight: bold; font-size: 1.95552em; line-height: 1.2141em; margin-top: 0px; margin-bottom: 0.5em; text-align: start; -webkit-hyphens: manual; display: block; max-width: 100%;">Hearts Get 'Younger,' Even At Middle Age, With Exercise</h1><div class="metadata" style="text-align: start; -webkit-hyphens: manual; display: block; margin-bottom: 1.45em; margin-top: -0.75em; max-width: 100%;"><a href="https://www.npr.org/people/2100955/patti-neighmond" rel="author" data-metrics="{"action":"Click Byline","category":"Story Metadata"}" class="byline" style="margin: 0px; color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;">Patti Neighmond</a><span class="delimiter" style="margin: 0.07em 0.45em 0px; max-width: 100%; padding: 0px; content: ""; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: block !important;"></span><time datetime="2018-03-12T05:00:00-04:00" class="date" style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"><span style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;">March 12, 2018</span><span style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;">5:00 AM ET</span></time></div> <figure class="clear" style="max-width: 100%; font-size: 0.75em; line-height: 1.5em; clear: both; font-family: -apple-system-font; color: rgba(0, 0, 0, 0.65098); margin: 1.4em 0px;"> <div data-crop-type="" style="max-width: 100%;"> <img src="https://media.npr.org/assets/img/2018/03/09/npr_3918_wide-3127d2064fd19dd83b62dbd91b937cef0409f560-s700-c85.jpg" alt="As early as your mid-40s, especially if you're sedentary, your heart muscle can show signs of aging, losing its youthful elasticity and power. But moderately strenuous exercise can change that." class="" style="max-width: 100%; margin: 0.5em auto; display: block; height: auto;"> </div> <div style="max-width: 100%;"> <span aria-label="Image credit" style="font-style: italic; max-width: 100%;"> Maria Fabrizio for NPR </span> </div> </figure> <p style="max-width: 100%;">Eventually it happens to everyone. As we age, even if we're healthy, the heart becomes less flexible, more stiff and just isn't as efficient in processing oxygen as it used to be. In most people the first signs <a href="http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2011.218271/full" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">show up</a> in the 50s or early 60s. And among people who don't exercise, the underlying changes can start even sooner.</p> <p style="max-width: 100%;">"The heart gets smaller — stiffer," says <a href="http://profiles.utsouthwestern.edu/profile/14262/benjamin-levine.html" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">Dr. Ben Levine</a>, a sports cardiologist at University of Texas Southwestern Medical Center and director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital, in Dallas.</p> <p style="max-width: 100%;">Think of the heart muscle as a rubber band, Levine says. In the beginning, the rubber band is flexible and pliable. But put it in a drawer for 20 years and it will emerge dry and brittle.</p> <p style="max-width: 100%;">"That's what happens to the heart and blood vessels," he says. And down the road, that sort of stiffness can get worse, he notes, leading to the breathlessness and other symptoms of <a href="https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022300/" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">heart failure</a>, an inability of the heart to effectively pump blood to the lungs or throughout the body.</p> <!-- END ID="RES592149428" CLASS="BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL " --> <p style="max-width: 100%;">Fortunately for those in midlife, Levine is finding that even if you haven't been an avid exerciser, getting in shape now may head off that decline and help restore your aging heart. He and his colleagues <a href="http://circ.ahajournals.org/content/early/2018/01/03/CIRCULATIONAHA.117.030617" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">published</a> their recent findings in the American Heart Association's journal, <em style="max-width: 100%;">Circulation</em>.</p> <p style="max-width: 100%;">The research team recruited individuals between the ages of 45 and 64 who were mostly sedentary but otherwise healthy.</p> <p style="max-width: 100%;">Dallas resident Mae Onsry, an accounts payable manager, was 62 at the time. Raising two children and working full time, she says, she never had the flexibility to fit in exercise, although she knew it was important for her health.</p> <p style="max-width: 100%;">"I have my hobbies," says Onsry, including ballroom dancing and gardening. But it was nothing routine, nothing "disciplined," she says.</p> <p style="max-width: 100%;">So when she saw a flyer about Levine's study, she signed up — along with 52 other volunteers — for a two-year study.</p> <!-- END ID="RES592149573" CLASS="BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL " --> <p style="max-width: 100%;">Participants were randomly assigned to one of two groups. The first group engaged in a program of nonaerobic exercise — basic yoga, balance training and weight training — three times a week. The other group, which Onsry was in, was assigned a trainer and did moderate- to high-intensity aerobic exercise for four or more days a week.</p> <p style="max-width: 100%;">After two years, the group doing the higher-intensity exercise saw dramatic improvements in heart health.</p> <p style="max-width: 100%;">"We took these 50-year-old hearts and turned the clock back to 30- or 35-year-old hearts," says Levine. Their hearts processed oxygen more efficiently and were notably less stiff.</p> <p style="max-width: 100%;">"And the reason they got so much stronger and fitter," he says, "was because their hearts could now fill a lot better and pump a lot more blood during exercise."</p> <p style="max-width: 100%;">The hearts of those engaged in less intense routines didn't change, he says.</p> <p style="max-width: 100%;">A key part of the effective exercise regimen was interval training, Levine says — short bursts of high-intensity exercise followed by a few minutes of rest. The study incorporated what are often referred to as <a href="https://www.ntnu.edu/cerg/advice" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">4x4 intervals</a>.</p> <p style="max-width: 100%;">"It's an old Norwegian ski team workout," Levine explains. "It means four minutes at 95 percent of your maximal ability, followed by three minutes of active recovery, repeated four times."</p> <p style="max-width: 100%;">Pushing as hard as you can for four minutes stresses the heart, he explains, and forces it to function more efficiently. Repeating the intervals helps strengthen both the heart and the circulatory system.</p> <p style="max-width: 100%;">"The sweet spot in life to get off the couch and start exercising [if you haven't already] is in late middle age when the heart still has plasticity," Levine says. You may not be able to reverse the aging of the vessels if you wait.</p> <!-- END ID="RES592149458" CLASS="BUCKETWRAP INTERNALLINK INSETTWOCOLUMN INSET2COL " --> <p style="max-width: 100%;">"We put healthy 70-year-olds through a yearlong exercise training program, and nothing happened to them at all," Levine says. "We could not change the structure of their heart and blood vessels."</p> <p style="max-width: 100%;">Anyone considering beginning this, or a similarly strenuous exercise program, Levine says, should check with a doctor first and ask about individual health issues that might warrant a less intense program initially.</p> <p style="max-width: 100%;">For Onsry, who is now 65, the study was life changing. Today she exercises every day of the week, walking and jogging at least 5 miles around the lake near her home.</p> <p style="max-width: 100%;">If she misses a day, she says, she just doesn't feel as good physically. And the regimen has helped her mental health, too.</p> <p style="max-width: 100%;">"I'm not moody," she says. "I mean — I'm happy."</p> <p style="max-width: 100%;"><a href="https://nyulangone.org/doctors/1912084062/nieca-goldberg" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">Dr. Nieca Goldberg</a>, a cardiologist and medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center, and a spokeswoman for the American Heart Association, says Levine's research is important.</p> <p style="max-width: 100%;">"Many studies that are done that look at [cardiovascular] health look at improvements in risk factors like high blood pressure, cholesterol and diabetes," Goldberg says. "But this study specifically looked at heart function — and how heart function can improve with exercise."</p> <p style="max-width: 100%;">Goldberg says the findings are a great start. But the study was small and needs to be repeated with far larger groups of people to determine exactly which aspects of an exercise routine make the biggest difference.</p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-5350034140809710472018-07-27T09:14:00.001-07:002018-07-27T09:14:59.572-07:00Drinking Enough Water Changes Your Body In These 5 Ways<div><base href="https://www.medicaldaily.com/drinking-enough-water-changes-your-body-these-5-ways-425912"><style id="print"> @media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } } </style><title>Drinking Enough Water Changes Your Body In These 5 Ways</title><div class="original-url"><br><a href="https://www.medicaldaily.com/drinking-enough-water-changes-your-body-these-5-ways-425912">https://www.medicaldaily.com/drinking-enough-water-changes-your-body-these-5-ways-425912</a><br><br></div><div id="article" role="article" style="text-rendering: optimizeLegibility; font-family: -apple-system-font; font-size: 1.2em; line-height: 1.5em; margin: 0px; padding: 0px;" class="system exported"> <!-- This node will contain a number of div.page. --> <div class="page" style="text-align: start; word-wrap: break-word; max-width: 100%;"><h1 class="title" style="font-weight: bold; font-size: 1.95552em; line-height: 1.2141em; margin-top: 0px; margin-bottom: 0.5em; text-align: start; -webkit-hyphens: manual; display: block; max-width: 100%;">Drinking Enough Water Changes Your Body In These 5 Ways</h1><div class="metadata singleline" style="text-align: start; -webkit-hyphens: manual; display: block; margin-bottom: 1.45em; margin-top: -0.75em; max-width: 100%;"><div class="byline" style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"><time itemprop="datePublished" datetime="2018-07-23T06:19:11-04:00" style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;">Jul 23, 2018 06:19 AM </time> By <span style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"> <span itemtype="http://schema.org/Person" itemprop="author" itemscope="" style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"><a href="/reporters/sadhana-bharanidharan" rel="author" itemprop="url" style="margin: 0px; color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"><span itemprop="name" style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;">Sadhana Bharanidharan</span></a></span> <span style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"> </span> </span> <span class="delimiter" style="margin: 0.07em 0.45em 0px; max-width: 100%; padding: 0px; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"></span><time itemprop="dateModified" datetime="2018-07-23T06:19:11-04:00" style="margin: 0px; max-width: 100%; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;"></time></div></div><figure itemscope="" itemtype="http://schema.org/ImageObject" itemprop="image" style="max-width: 100%; font-size: 0.75em; line-height: 1.5em; font-family: -apple-system-font; color: rgba(0, 0, 0, 0.65098); margin: 1.4em 0px;"> <picture itemprop="contentUrl" width="840" height="560" style="max-width: 100%;"><!--[if IE 9]><video style="display: none;"><![endif]--><source data-srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_desktop_1x/public/2018/07/23/thirst.jpg 1x" media="(min-width: 992px)" srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_desktop_1x/public/2018/07/23/thirst.jpg 1x" src="" style="max-width: 100%;"><source data-srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_tablet_1x/public/2018/07/23/thirst.jpg 1x" media="(min-width: 768px)" srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_tablet_1x/public/2018/07/23/thirst.jpg 1x" src="" style="max-width: 100%;"><source data-srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_narrow_1x/public/2018/07/23/thirst.jpg 1x" media="(min-width: 481px)" srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_narrow_1x/public/2018/07/23/thirst.jpg 1x" src="" style="max-width: 100%;"><source data-srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_mobile_1x/public/2018/07/23/thirst.jpg 1x" media="(min-width: 0px)" srcset="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_mobile_1x/public/2018/07/23/thirst.jpg 1x" src="" style="max-width: 100%;"><img itemprop="contentUrl" width="840" height="560" src="https://images.medicaldaily.com/sites/medicaldaily.com/files/styles/headline/public/2018/07/23/thirst.jpg" alt="Thirst" title="" class="" style="max-width: 100%; margin: 0.5em auto; display: block; height: auto;"><!--[if IE 9]></video><![endif]--></picture> <figcaption style="max-width: 100%; margin-top: 0.8em; width: 100%; font-size: 0.75rem; color: rgba(0, 0, 0, 0.8);"> <span itemprop="caption" style="max-width: 100%; margin-top: 0.25em; margin-bottom: 0.25em;"> Despite the "8 glasses a day" rule, ideal water intake actually varies from person to person. </span> <span itemprop="copyrightHolder" style="font-style: italic; max-width: 100%; margin-top: 0.25em; margin-bottom: 0.25em;"> Olichel/Pixabay </span> </figcaption> </figure><p style="max-width: 100%;">Drinking enough water is important for the proper functioning of your body. Dehydration, caused by insufficient fluid intake, often results in noticeable changes to let you know that you should be reaching for a glass.</p><p style="max-width: 100%;">While the "<a href="https://theconversation.com/mondays-medical-myth-drink-eight-glasses-of-water-a-day-905" rel="nofollow" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">8 glasses a day</a>" rule is popular, the ideal intake level actually varies based on the individual. Here are five changes you can expect to see once you start the daily habit of drinking enough water:</p><p style="max-width: 100%;"><strong style="max-width: 100%;">1. The color of your urine changes </strong></p><p style="max-width: 100%;">Urine color is a <a href="https://health.clevelandclinic.org/what-the-color-of-your-urine-says-about-you-infographic/" rel="nofollow" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">good indicator</a> of whether you are drinking enough water on a daily basis. A very pale shade of yellow is good news, suggesting that your intake of water is at a healthy level.</p><p style="max-width: 100%;">Regular yellow or a dark shade of yellow are signs that your body is feeling dehydrated. If your urine is transparent and has no color at all, you may be drinking too much water and should try to reduce your intake.</p><p style="max-width: 100%;"><strong style="max-width: 100%;">2. Your body stops craving empty calories </strong></p><p style="max-width: 100%;">Sometimes, our body misinterprets thirst as a sign of hunger, <a href="https://www.everydayhealth.com/news/unusual-signs-of-dehydration/" rel="nofollow" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">said</a> Dr. John Higgins, a professor at the University of Texas. "When you're dehydrated, it can be difficult for organs like the liver, which uses water, to release [stored glucose] and other components of your energy stores, so you can actually get cravings for food."</p><p style="max-width: 100%;">Typically, craving for sweets is a sign that the body is having a hard time trying to break down glycogen. Drinking enough water and consuming fruits through the day can help ease the process and regulate your appetite.</p><p style="max-width: 100%;"><strong style="max-width: 100%;">3. Your energy levels will increase </strong></p><p style="max-width: 100%;">Experts have stated even mild dehydration can make you tired and reduce your energy levels. Due to an inadequate water supply, your body compensates by decreasing blood circulation. This, in turn, can slow down the process of getting oxygen to your muscles.</p><p style="max-width: 100%;">And this is why it is all the more important to stay hydrated through an intense workout or on a particularly hot day when you are likely to lose water via sweat. If you are prone to involuntary muscle contractions or cramps, try to increase your water intake. </p><p style="max-width: 100%;"><strong style="max-width: 100%;">4. Your brain power will get a boost </strong></p><p style="max-width: 100%;">Also, the benefit may not be exclusive to physical energy. Studies have suggested mild dehydration could also impair mental performance, potentially affecting your daily productivity.</p><p style="max-width: 100%;">"[Even] a minor degree of dehydration can disrupt brain functioning," <a href="https://theconversation.com/memory-and-attention-are-affected-by-much-lower-levels-of-dehydration-than-previously-thought-63950" rel="nofollow" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">said</a> Professor David Benton from Swansea University, England. </p><p style="max-width: 100%;">His research highlighted how the habit of drinking enough water should be taught to children who spend most of their days in the classroom.</p><p style="max-width: 100%;"><strong style="max-width: 100%;">5. Your bowel movements will be regulated </strong></p><p style="max-width: 100%;">If you have been experiencing constipation, chances are your H2O intake is too low. Apart from ensuring that you consume enough sources of dietary fiber, the most effective way to improve your bowel movement is to drink enough water. </p><p style="max-width: 100%;">"People who drink enough water usually have regular bowel movements. Hard bowel movements or constipation can be a sign that you aren't getting enough water," <a href="https://www.rd.com/health/diet-weight-loss/drinking-enough-water/" rel="nofollow" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">said</a> Dr. Ronald Navarro, orthopedic and sport medicine surgeon at Kaiser Permanente South Bay Medical Center.</p></div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-58624993380970565132018-07-25T17:40:00.001-07:002018-07-25T17:40:50.845-07:00Treating Depression May StopRepeat Heart Attack<div><base href="https://www.webmd.com/heart-disease/news/20180724/treating-depression-may-stop-repeat-heart-attack?src=RSS_PUBLIC"><style id="print"> @media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } } </style><title>Treating Depression May StopRepeat Heart Attack</title><div class="original-url"><br><a href="https://www.webmd.com/heart-disease/news/20180724/treating-depression-may-stop-repeat-heart-attack?src=RSS_PUBLIC">https://www.webmd.com/heart-disease/news/20180724/treating-depression-may-stop-repeat-heart-attack?src=RSS_PUBLIC</a><br><br></div><div id="article" role="article" style="text-rendering: optimizeLegibility; font-family: -apple-system-font; font-size: 1.2em; line-height: 1.5em; margin: 0px; padding: 0px;" class="system exported"> <!-- This node will contain a number of div.page. --> <div class="page" style="text-align: start; word-wrap: break-word; max-width: 100%;"><h1 class="title" style="font-weight: bold; font-size: 1.95552em; line-height: 1.2141em; margin-top: 0px; margin-bottom: 0.5em; text-align: start; -webkit-hyphens: manual; display: block; max-width: 100%;">Treating Depression May StopRepeat Heart Attack</h1> <div data-page="1" style="max-width: 100%;"> <section style="max-width: 100%;"> <p style="max-width: 100%;">By Amy Norton</p> <p style="max-width: 100%;"> <i style="max-width: 100%;">HealthDay Reporter</i> </p> </section> <section style="max-width: 100%;"> <p style="max-width: 100%;">TUESDAY, July 24, 2018 (HealthDay News) -- It's common for <a href="https://www.webmd.com/heart-disease/guide/heart-disease-heart-attacks" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">heart attack</a> survivors to develop <a href="https://www.webmd.com/depression/depression-assessment/default.htm" data-metrics-link="" data-crosslink-type="tools" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">depression</a>. Now a new trial has found that <a href="https://www.webmd.com/depression/video/anti-depressants-and-weight-gain" data-metrics-link="" data-crosslink-type="video" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">antidepressant</a> treatment may help those patients avoid a second <a href="https://www.webmd.com/women/video/heart-attack-women-different" data-metrics-link="" data-crosslink-type="video" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">heart attack</a>.</p> <p style="max-width: 100%;">The study, of 300 <a href="https://www.webmd.com/heart/picture-of-the-heart" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">heart</a> patients with <a href="https://www.webmd.com/depression/default.htm" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">depression</a>, found that treatment with the <a href="https://www.webmd.com/depression/guide/depression-medications-antidepressants" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">antidepressant</a> <a href="https://www.webmd.com/drugs/drug-63989-escitalopram+oral.aspx" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">escitalopram</a> (Lexapro) almost halved the risk of suffering another <a href="https://www.webmd.com/heart-disease/ss/slideshow-heart-attack" data-metrics-link="" data-crosslink-type="slideshow" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">heart attack</a> in the next eight years.</p> <p style="max-width: 100%;">Patients on the <a href="https://www.webmd.com/drugs/index-drugs.aspx" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">medication</a> also had a lower death rate and less need for <a href="https://www.webmd.com/heart-disease/guide/treatment-angioplasty-stents" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">angioplasty</a> -- a procedure that opens blocked heart <a href="https://www.webmd.com/heart/picture-of-the-arteries" data-metrics-link="" data-crosslink-type="article" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">arteries</a>.</p> <p style="max-width: 100%;">Experts said they were encouraged by the findings.</p> <p style="max-width: 100%;">"This is a very important <a href="https://www.webmd.com/drug-medication/video/changes-in-how-new-drugs-are-tested" data-metrics-link="" data-crosslink-type="video" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">clinical trial</a>," said James Blumenthal, a professor of psychiatry at Duke University Medical Center, in Durham, N.C.</p> <p style="max-width: 100%;">Blumenthal, who was not involved in the trial, studies the role of psychological factors in heart disease.</p> <p style="max-width: 100%;">He said it's known that heart attack patients with depression typically fare worse than those without the condition. That includes a higher risk of a repeat heart attack.</p> </section> </div> <div data-page="2" style="max-width: 100%;"> <section style="max-width: 100%;"> <p style="max-width: 100%;">But proof has been lacking that depression treatment can translate into a better outlook.</p> <p style="max-width: 100%;">The new findings, Blumenthal said, show that it can.</p> <p style="max-width: 100%;">"Treating depression results not only in improved quality of life, but also improved clinical outcomes," he said. "This is good news for heart patients with depression."</p> <p style="max-width: 100%;">For the trial, Korean researchers led by Dr. Jae-Min Kim, from Chonnam National University Medical School in Gwangju, screened over 1,100 heart patients for depression. All of the patients had experienced an "acute coronary syndrome" within the past two weeks. The term refers to heart attacks, as well as unstable angina -- severe chest pain caused by obstructed blood flow to the heart.</p> <p style="max-width: 100%;">Over 400 of those patients met the definition of either mild or major depression. Ultimately, 300 entered the trial and were randomly assigned to take either escitalopram or placebo pills for six months.</p> <p style="max-width: 100%;">Over the next eight years, nearly half of all patients either died, had a repeat heart attack or needed angioplasty. However, the rate was lower among patients taking antidepressants: just under 41 percent, versus almost 54 percent among placebo patients.</p> </section> </div> <div data-page="3" style="max-width: 100%;"> <section style="max-width: 100%;"> <p style="max-width: 100%;">The benefit was most clear when it came to the risk of suffering another heart attack: less than 9 percent of antidepressant patients did, compared with over 15 percent of placebo patients, the findings showed.</p> <p style="max-width: 100%;">The death rate was also lower for those taking antidepressants -- about 21 percent, versus 24.5 percent for those taking a placebo. That difference was not significant in statistical terms, however.</p> <p style="max-width: 100%;">The trial was funded by Korean government grants. The report was published in the July 24/31 issue of the <i style="max-width: 100%;">Journal of the American Medical Association</i>.</p> <p style="max-width: 100%;">If antidepressant treatment does thwart future heart trouble, it's not clear why from this study, Blumenthal said.</p> <p style="max-width: 100%;">One possibility, he suggested, is that when patients see their depression lift, they become more physically active or better able to stick with lifestyle changes.</p> <p style="max-width: 100%;">But, improvement in depression might also have direct effects -- including less inflammation in the arteries and a healthier heart rate, Blumenthal suggested.</p> <p style="max-width: 100%;">Donald Edmondson is director of the Center for Behavioral Cardiovascular Health at Columbia University, in New York City.</p> </section> </div> <div data-page="4" style="max-width: 100%;"> <section style="max-width: 100%;"> <p style="max-width: 100%;">He called the findings "exciting and important."</p> <p style="max-width: 100%;">Why did this trial show benefits when past studies turned up empty? A likely reason, Edmondson said, is the long-term follow-up. It may take years for the benefits of depression treatment to show up.</p> <p style="max-width: 100%;">The bottom line for patients and families is that they should never dismiss lingering psychological symptoms, he explained.</p> <p style="max-width: 100%;">After a heart attack, Edmondson said, people sometimes want to "move on and forget it happened."</p> <p style="max-width: 100%;">But close to 40 percent of the initial group in this study screened positive for depression. "It's common," he said.</p> <p style="max-width: 100%;"> Edmondson suggested that family members be aware of that, and remember to check in: "Ask questions. Ask them how they're feeling."</p> <p style="max-width: 100%;">There are non-drug treatments for depression, including "talk therapy." This trial did not test them -- but Edmondson said he suspects any therapy that sends depression into remission might improve patients' heart outlook.</p> <p style="max-width: 100%;">In this study, he pointed out, patients whose depression went into remission within six months fared better -- even if they were in the placebo group.</p> </section> </div> <div data-page="5" style="max-width: 100%;"> <section style="max-width: 100%;"> <p style="max-width: 100%;">Those on medication were, however, more likely to see a remission: Over half did, versus 35 percent of placebo patients.</p> <p style="max-width: 100%;">Blumenthal said that some research has found that regular exercise can help ease depression -- and may be as effective as antidepressants.</p> <p style="max-width: 100%;">He is currently leading a trial that's testing exercise against escitalopram for treating anxiety in heart disease patients.</p> </section> <footer class="clear" style="max-width: 100%; clear: both;"> <p style="max-width: 100%;"> <span itemprop="publisher" style="max-width: 100%;">WebMD News from HealthDay</span> </p> <span style="max-width: 100%;"> <h4 data-toggle-selector=".sources" data-toggle-relation="parent" style="font-weight: bold; font-size: 1em; margin: 1em 0px; max-width: 100%;">Sources</h4> </span> <span class="clear" style="max-width: 100%; clear: both;"> <img src="https://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/logos/vendor/healthday_logo_81x25.jpg" alt="" title="" style="max-width: 100%; margin: 0.5em auto; display: block; height: auto;">Copyright © 2013-2018 HealthDay. All rights reserved.</span> </footer> </div> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-83053252005948376652018-07-25T11:54:00.000-07:002018-07-25T11:55:03.173-07:00No Scientific Proof That Multivitamins Promote Heart Health<div class="Apple-Mail-URLShareUserContentTopClass"><br class=""></div><div class="Apple-Mail-URLShareWrapperClass"><blockquote type="cite" style="border-left-style: none; color: inherit; padding: inherit; margin: inherit;" class=""><div class=""><div class="original-url"><br class=""><a href="https://www.medscape.com/viewarticle/899130" class="">https://www.medscape.com/viewarticle/899130</a><br class=""><br class=""></div><div id="article" role="article" style="text-rendering: optimizeLegibility; font-family: Georgia; font-size: 1.2em; line-height: 1.5em; margin: 0px; padding: 0px;" class="georgia exported"> <!-- This node will contain a number of div.page. --> <div class="page" style="word-wrap: break-word; max-width: 100%;"><h1 class="title" style="font-size: 1.95552em; line-height: 1.2141em; margin-top: 0px; margin-bottom: 0.5em; -webkit-hyphens: manual; max-width: 100%;">No Scientific Proof That Multivitamins Promote Heart Health</h1><p style="max-width: 100%;" class="">Taking multivitamin/mineral (MVM) supplements does not prevent myocardial infarction, stroke, or death from a cardiovascular cause, according to a comprehensive meta-analytic review of relevant research.</p><p style="max-width: 100%;" class="">"The take-home message is simple: there is no scientific evidence that MVM supplements promote cardiovascular health. We hope that our paper helps to settle the controversy on MVM use for CVD prevention," lead author Joonseok Kim, MD, University of Alabama at Birmingham, told <em style="max-width: 100%;" class=""><a href="http://theheart.org" class="">theheart.org</a> | Medscape Cardiology</em>.</p><p style="max-width: 100%;" class="">The study was <a href="http://circoutcomes.ahajournals.org/content/11/7/e004224" style="color: rgb(65, 110, 210); max-width: 100%;" class="">published online</a> today in <em style="max-width: 100%;" class="">Circulation: Cardiovascular Quality and Outcomes</em>.</p><p style="max-width: 100%;" class="">"Vitamin and mineral supplements are taken by nearly half of US adults, yet few benefits have been documented," said JoAnn Manson, MD, who was not involved in the study and is chief of preventive medicine, Brigham and Women's Hospital and professor of medicine, Harvard Medical School, both in Boston, Massachusetts.</p><p class="clear" style="max-width: 100%; clear: both;"> <b style="max-width: 100%;" class="">Multivitamin supplements will never be a substitute for a healthful and balanced diet. </b> <span style="max-width: 100%;" class="">Dr JoAnn Manson</span> </p><p style="max-width: 100%;" class="">"Regarding multivitamins and cardiovascular disease, specifically, neither observational studies nor randomized clinical trials have demonstrated clear benefits for primary or secondary prevention," Manson told <em style="max-width: 100%;" class=""><a href="http://theheart.org" class="">theheart.org</a> | Medscape Cardiology.</em> </p><p style="max-width: 100%;" class="">"Importantly, clinicians should emphasize with their patients that multivitamin supplements will never be a substitute for a healthful and balanced diet, which have many beneficial components for vascular health. Additionally, micronutrients in food are typically better absorbed by the body than those from supplements," she advised.</p><p style="max-width: 100%;" class="">Kim and colleagues did a systematic review and meta-analysis of 18 studies with more than 2 million adults (mean age, 57.8 years) with mean follow-up of 11.6 years. Eleven studies were from the United States, 4 from Europe, and 3 from Japan. Only 5 studies specified the dose and type of MVM supplement.</p><p style="max-width: 100%;" class="">Overall, there was no association between MVM supplement use and cardiovascular disease (CVD) mortality, the investigators report.</p><p style="max-width: 100%;" class=""> <b style="max-width: 100%;" class="">Table. MVM Supplementation and Outcome Risks</b> </p><div style="max-width: 100%;" class=""><div class="scrollable" style="max-width: 100%; overflow-x: scroll; word-wrap: normal;"><table style="max-width: none; font-size: 0.9em; word-wrap: break-word; border-collapse: collapse;" class=""> <tbody style="max-width: 100%;" class=""> </tbody> <tbody xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:dctm="http://www.documentum.com" xmlns:fmt="http://java.sun.com/jstl/fmt" xmlns:jsp="jsp" style="max-width: 100%;" class=""> <tr style="max-width: 100%;" class=""> <th style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216); background-color: rgba(0, 0, 0, 0.0235294);" class="">Outcome</th> <th style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216); background-color: rgba(0, 0, 0, 0.0235294);" class="">Relative Risk (95% Confidence Interval)</th> </tr> <tr style="max-width: 100%;" class=""> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">CVD mortality</td> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">1.00 (0.97 - 1.04)</td> </tr> <tr style="max-width: 100%;" class=""> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">Coronary heart disease mortality</td> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">1.02 (0.92 - 1.13)</td> </tr> <tr style="max-width: 100%;" class=""> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">Stroke mortality</td> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">0.95 (0.82 - 1.09)</td> </tr> <tr style="max-width: 100%;" class=""> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">Stroke incidence</td> <td style="max-width: 100%; padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216);" class="">0.98 (0.91 - 1.05)</td> </tr> </tbody> </table></div></div></div><div class="page" style="word-wrap: break-word; max-width: 100%;"><p style="max-width: 100%;" class="">There was also no link between MVM supplements and CVD or coronary heart disease (CHD) mortality in prespecified subgroups categorized by mean follow-up; mean age; period of MVM use; sex; type of population; exclusion of patients with history of CHD; and adjustment for diet, adjustment for smoking, adjustment for physical activity, and study site.</p><p style="max-width: 100%;" class="">MVM supplement use did appear to be associated with a lower risk for CHD incidence (relative risk [RR], 0.88; 95% confidence interval [CI], 0.79 - 0.97). However, this association did not remain significant in the pooled subgroup analysis of randomized controlled trials (RR, 0.97; 95% CI, 0.80 - 1.19).</p><p style="max-width: 100%;" class="">"It has been exceptionally difficult to convince people, including nutritional researchers, to acknowledge that multivitamin and mineral supplements don't prevent cardiovascular diseases," Kim said in a news release. "I hope our study findings help decrease the hype around multivitamin and mineral supplements and encourage people to use proven methods to reduce their risk of cardiovascular diseases — such as eating more fruits and vegetables, exercising and avoiding tobacco."</p><p style="max-width: 100%;" class="">The American Heart Association does not recommend use of MVM supplements for CVD prevention.</p><h3 style="font-size: 1.05em; max-width: 100%;" class=""> <b style="max-width: 100%;" class="">"Plausible but Failed Practice" </b> </h3><p style="max-width: 100%;" class="">In a <a href="http://circoutcomes.ahajournals.org/content/11/7/e004886" style="color: rgb(65, 110, 210); max-width: 100%;" class="">linked editorial</a>, Alyson Haslam, MD, and Vinay Prasad, MD, both from Oregon Health & Science University in Portland, note that practices in biomedicine are often adopted because they "appeal to our hopes and there is biologic plausibility.</p><p style="max-width: 100%;" class="">In the case of multivitamins, it is logical that some vitamins may reduce cardiovascular events because they are anti-inflammatory or more broadly improve health and well-being. Yet, in this case, it appears they do not, and as such, multivitamins for cardiovascular disease joins the list of plausible but failed practices in cardiology," they conclude.</p><p style="max-width: 100%;" class="">Although multivitamins tend to be moderately dosed and are likely to be safer than mega-doses of individual dietary supplements, "they are not completely free of risk in all patients," Manson told <em style="max-width: 100%;" class=""><a href="http://theheart.org" class="">theheart.org</a> | Medscape Cardiology.</em> </p><p style="max-width: 100%;" class="">For example, dietary supplements may interact with some medications, such as vitamin K and warfarin; interfere with the measurement of some clinical laboratory tests, such as biotin and troponin levels; they also have side effects, such as gastrointestinal symptoms, for some patients, she explained. </p><p style="max-width: 100%;" class="">"Thus, routine multivitamin supplementation is not recommended for the general population, but a targeted approach is appropriate for certain life stages and high-risk groups," said Manson.</p><p style="max-width: 100%;" class="">Some examples of relevant life stages include pregnancy, where supplementation with folic acid/prenatal vitamins is of benefit, and in midlife or older adults, some of whom may benefit from supplemental vitamin B12, vitamin D, and/or calcium. High-risk groups, such as those with malabsorption syndromes, restricted eating patterns, osteoporosis, pernicious anemia, and age-related macular degeneration, and those with long-term use of metformin or proton-pump inhibitors also may benefit from dietary supplements, she said.</p><p style="max-width: 100%;" class="">Manson also noted that the <a href="http://phs.bwh.harvard.edu/phs2.htm" style="color: rgb(65, 110, 210); max-width: 100%;" class="">Physicians' Health Study II</a>, a large-scale randomized clinical trial of multivitamins in men, demonstrated that these supplements may modestly reduce the incidence of cancer. This finding is being explored further in the ongoing <a href="https://www.cosmostrial.org/" style="color: rgb(65, 110, 210); max-width: 100%;" class="">COSMOS trial</a>, which is testing whether multivitamins, with or without cocoa flavonols, can reduce the risk for cancer and CVD in older men and women.</p><p style="max-width: 100%;" class=""> "Results from the COSMOS trial are expected in 2 years, so stay tuned," said Manson.</p><p style="max-width: 100%;" class=""> <em style="max-width: 100%;" class="">The authors report no outside funding or relevant disclosures. Prasad has received royalties from his book </em>Ending Medical Reversal <em style="max-width: 100%;" class="">and payments for contributions to Medscape</em>.</p><p style="max-width: 100%;" class=""> <em style="max-width: 100%;" class="">Circ Cardiovasc Qual Outcomes</em>. Published online July 10, 2018. <a href="http://circoutcomes.ahajournals.org/content/11/7/e004224" style="color: rgb(65, 110, 210); max-width: 100%;" class="">Full text</a>, <a href="http://circoutcomes.ahajournals.org/content/11/7/e004886" style="color: rgb(65, 110, 210); max-width: 100%;" class="">Editorial</a> </p><p style="max-width: 100%;" class=""> <em style="max-width: 100%;" class="">For more from <a href="http://theheart.org" class="">theheart.org</a>, join us on </em> <a href="https://twitter.com/theheartorg" style="color: rgb(65, 110, 210); max-width: 100%;" class=""> <em style="max-width: 100%;" class="">Twitter</em> </a> <em style="max-width: 100%;" class=""> and </em> <a href="http://www.facebook.com/medscapecardiology" style="color: rgb(65, 110, 210); max-width: 100%;" class=""> <em style="max-width: 100%;" class="">Facebook</em> </a></p></div></div></div></blockquote></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-21951629700814573072018-07-25T07:20:00.001-07:002018-07-25T07:20:47.098-07:00CHAMP-HF: Heart Failure Treatment in US Remains Subpar<div><base href="https://www.medscape.com/viewarticle/899433?src=rss"><style id="print"> @media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } } </style><title>CHAMP-HF: Heart Failure Treatment in US Remains Subpar</title><div class="original-url"><br><a href="https://www.medscape.com/viewarticle/899433?src=rss">https://www.medscape.com/viewarticle/899433?src=rss</a><br><br></div><div id="article" role="article" style="text-rendering: optimizeLegibility; font-family: -apple-system-font; font-size: 1.2em; line-height: 1.5em; margin: 0px; padding: 0px;" class="system exported"> <!-- This node will contain a number of div.page. --> <div class="page" style="text-align: start; word-wrap: break-word; max-width: 100%;"><h1 class="title" style="font-weight: bold; font-size: 1.95552em; line-height: 1.2141em; margin-top: 0px; margin-bottom: 0.5em; text-align: start; -webkit-hyphens: manual; display: block; max-width: 100%;">CHAMP-HF: Heart Failure Treatment in US Remains Subpar</h1> <p style="max-width: 100%;">Major gaps remain in use and dosing of evidence-based, guideline-recommended medications for heart failure with reduced ejection fraction (HFrEF), according to a new analysis of data from the Change the Management of Patients with Heart Failure (CHAMP-HF) registry.</p> <p style="max-width: 100%;">"Even in the absence of any new heart failure therapies being discovered, if the existing guideline-recommended medical therapies were optimally implemented and dosed, tens of thousands of additional deaths in patients with heart failure could be avoided each year," senior author Gregg Fonarow, MD, University of California, Los Angeles, told <em style="max-width: 100%;"><a href="http://theheart.org">theheart.org</a> | Medscape Cardiology.</em> </p> <p style="max-width: 100%;">"Despite a robust database and well-articulated clinical practice guidelines, the findings from the CHAMP-HF registry demonstrate the care deficit that still needs to be addressed," said Clyde Yancy, MD, Northwestern University Feinberg School of Medicine in Chicago, Illinois, who wasn't involved in the study.</p> <p style="max-width: 100%;">The study was <a href="http://www.onlinejacc.org/content/72/4/351" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">published online</a> July 16 in the <em style="max-width: 100%;">Journal of the American College of Cardiology</em>.</p> <p class="clear" style="max-width: 100%; clear: both;"> <b style="max-width: 100%;">There is substantial opportunity to improve care and outcomes for patients with heart failure with reduced ejection fraction.</b> <span style="max-width: 100%;">Dr Gregg Fonarow</span> </p> <p style="max-width: 100%;">The investigators, led by Stephen J. Greene, MD, Duke Clinical Research Institute, Durham, North Carolina, examined data from 3518 outpatients with HFrEF (mean EF, 29%) receiving at least one oral medication for management of HF from 150 primary care and cardiology practices across the United States. Their mean age was 66 years, and 29% were women.</p> <p style="max-width: 100%;">Among patients eligible to receive medication, 27% were not prescribed an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker/angiotensin receptor<a name="_GoBack" style="text-decoration: none; max-width: 100%;"></a>–neprilysin inhibitor, 33% didn't get a β-blocker, and 67% were not prescribed a mineralocorticoid receptor antagonist, the researchers found.</p> <p style="max-width: 100%;">Even when patients did receive recommended medications, they generally received the medications at a dose lower than the recommended target dose. Fewer than one in four eligible patients were receiving all three guideline-recommended drug types, and only 1% were receiving the target dose of all three medications, the researchers found.</p> <p style="max-width: 100%;">Factors associated with lower medication use or dose were older age, lower blood pressure, more severe functional heart class, renal insufficiency, and recent HF hospitalization. Social and economic characteristics were not independently associated with medication use or dose.</p> <p style="max-width: 100%;">"As these medications have been demonstrated to improve health status, quality of life, reduce the need for hospitalization, and mortality when provided at recommended doses, these findings suggest that there is substantial opportunity to improve care and outcomes for patients with heart failure with reduced ejection fraction," Fonarow told <em style="max-width: 100%;"><a href="http://theheart.org">theheart.org</a> | Medscape Cardiology</em>.</p> <p style="max-width: 100%;">"There is a compelling need for multifaceted quality improvement systems to be implemented in every setting in which patients with heart failure receive care. These systems have been shown to help improve the use and dosing of guideline-directed medical therapies and, in turn, improve outcomes," he said.</p> <p style="max-width: 100%;">Fonarow also noted that traditional measures to assess quality of care have focused on whether eligible patients were treated with a class of medication (yes vs no). "These findings suggest that new quality measures that also focus on whether there was adequate dosing of the medication, in the absence of contraindications or intolerance of higher doses, may also be useful," he said.</p> <h3 style="font-weight: bold; font-size: 1.25em; max-width: 100%;"> <b style="max-width: 100%;">Sobering but Not Surprising </b> </h3> <p style="max-width: 100%;">The finding that only 1% of patients with HFrEF with clear eligibility for all classes of guideline-directed medical therapy (GDMT) were receiving indicated therapies at the appropriate doses is "sobering but not unexpected because the translation of evidence into practice, ie, implementation science, remains a still nascent and poorly informed process," Yancy told <em style="max-width: 100%;"><a href="http://theheart.org">theheart.org</a> | Medscape Cardiology.</em> </p> <p style="max-width: 100%;">"As well, the exigencies of clinical practice — access to medical care, appropriate insurance for drug benefits, absolute and relative contraindications, and importantly patient preferences — all serve as rate-limiting steps," Yancy explained. While tools to support the guidelines and the construct of optimal medical regimens for HFrEF have been developed and are readily available, "there is much more that needs to be explored and developed to effectuate ideal implementation" of guideline-directed care for HF, he said.</p> <p style="max-width: 100%;">"We and others have demonstrated clearly that doing the right thing for the right patient at the right time and in the right manner yields lives saved and hospitalizations prevented. That should be sufficient for us to be ever diligent in our quest to improve the quality of care for heart failure," said Yancy.</p> <p style="max-width: 100%;">John L. Jefferies, MD, MPH, The Heart Institute, Cincinnati Children's Hospital Medical Center, Ohio, and Nasrien E. Ibrahim, MD, Massachusetts General Hospital, Boston, are also not particularly surprised by the findings of Fonarow and colleagues.</p> <p style="max-width: 100%;">Despite published clinical practice guidelines, adoption of such therapies with established survival benefit "continue[s] to be dismally low and show[s] no significant improvement over the last 8 years," they note in a <a href="http://www.onlinejacc.org/content/72/4/367" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">related editorial</a> titled, "Are Guidelines Merely Suggestions?"</p> <p style="max-width: 100%;">Jefferies and Ibrahim say efforts to improve uptake of GDMT among patients with HFrEF should be aimed at the clinician, the patient, and the system factors that contribute to "clinical or therapeutic inertia. If we can address the clinician, patient, and system factors that are modifiable…we can improve the implementation of GDMT and, in turn, reduce the morbidity and mortality associated with HF," they predict.</p> <p style="max-width: 100%;">"[J]ust as stop signs are not merely suggestions for drivers at intersections, neither are published guidelines for clinicians managing patients with HF," they conclude.</p> <p style="max-width: 100%;"> <em style="max-width: 100%;">CHAMP-HF was supported by Novartis Pharmaceuticals. Fonarow has consulted for Amgen, Bayer, Medtronic, and Novartis. Greene has received support from a National Institutes of Health grant, the Heart Failure Society of America/Emergency Medicine Foundation Acute Heart Failure Young Investigator award funded by Novartis, and Novartis. Jefferies has consulted for Bayer, Novartis, and Sanofi Genzyme and has received grants from Medtronic. Ibrahim is supported in part by the Dennis and Marilyn Barry Fellowship in Cardiology. Yancy has no relevant disclosures. </em> </p> <p style="max-width: 100%;"> <em style="max-width: 100%;">J Am Coll Cardiol</em>. Published online July 16, 2018. <a href="http://www.onlinejacc.org/content/72/4/351" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">Abstract</a>, <a href="http://www.onlinejacc.org/content/72/4/367" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">Editorial</a> </p> <p style="max-width: 100%;"><br></p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-59665300857911906192018-07-18T15:55:00.000-07:002018-07-18T15:56:01.222-07:00Omega-3 supplements don't help prevent disease - Business Insider<div><base href="http://www.businessinsider.com/omega-3-supplements-dont-help-prevent-disease-2018-7"><style id="print"> @media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } } </style><title>Omega-3 supplements don't help prevent disease - Business Insider</title><div class="original-url"><br><a href="http://www.businessinsider.com/omega-3-supplements-dont-help-prevent-disease-2018-7">http://www.businessinsider.com/omega-3-supplements-dont-help-prevent-disease-2018-7</a><br><br></div><div id="article" role="article" style="text-rendering: optimizeLegibility; font-family: -apple-system-font; font-size: 1.2em; line-height: 1.5em; margin: 0px; padding: 0px;" class="system exported"> <!-- This node will contain a number of div.page. --> <div class="page" style="text-align: start; word-wrap: break-word; max-width: 100%;"><h1 class="title" style="font-weight: bold; font-size: 1.95552em; line-height: 1.2141em; margin-top: 0px; margin-bottom: 0.5em; text-align: start; -webkit-hyphens: manual; display: block; max-width: 100%;">Omega-3 supplements are essentially useless for preventing diseases, according to a new study</h1><div class="metadata singleline" style="text-align: start; -webkit-hyphens: manual; display: block; margin-bottom: 1.45em; margin-top: -0.75em; max-width: 100%;"><a data-e2e-name="byline-author-name" href="/author/lindsay-dodgson" class="byline" style="margin: 0px; color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline; font-size: 1em !important; font-weight: normal !important; font-style: normal !important; display: inline !important;">Lindsay Dodgson</a></div> <section data-track-content="" data-post-type="post" style="max-width: 100%;"> <div style="max-width: 100%;"><figure data-type="img" data-e2e-name="image-figure-image" data-media-container="image" style="max-width: 100%; font-size: 0.75em; line-height: 1.5em; font-family: -apple-system-font; color: rgba(0, 0, 0, 0.65098); margin: 1.4em 0px;"><img alt="fish oil omega 3 pills" src="https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-750-563.jpg" sizes="(min-width: 768px) and (max-width: 959px) 960px, (min-width: 960px) and (max-width: 1239px) 1136px, (min-width: 1240px) 1260px, (-webkit-min-device-pixel-ratio: 2) 50vw, 100vw" srcset="https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-160-120.jpg 160w, https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-320-240.jpg 320w, https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-480-360.jpg 480w, https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-640-480.jpg 640w, https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-750-563.jpg 750w, https://amp.businessinsider.com/images/5b4f4d24260a2918008b464b-960-720.jpg 960w" (min-width:="" 768px)="" and="" (max-width:="" 959px)="" 960px,="" 960px)="" 1239px)="" 1136px,="" 1240px)="" 1260px,="" (-webkit-min-device-pixel-ratio:="" 2)="" 50vw,="" 100vw="" class="" style="max-width: 100%; margin: 0.5em auto; display: block; height: auto;"><span style="max-width: 100%;"><span data-e2e-name="image-source" style="max-width: 100%;"><a href="https://www.shutterstock.com/image-photo/fish-oil-pills-hand-1109317925?src=XAlDlkU2TQ_ilnzKZv_1Sg-4-31" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">Baoyan zeng / Shutterstock</a></span></span></figure><ul style="max-width: 100%;"><li style="max-width: 100%;"><strong style="max-width: 100%;">A new Cochrane review has found omega-3 supplement pills probably don't do that much for our health.</strong></li><li style="max-width: 100%;"><strong style="max-width: 100%;">Out of over 112,000 people, 8.8% died while taking fish oil pills, compared to 9% of those who didn't take any.</strong></li><li style="max-width: 100%;"><strong style="max-width: 100%;">This is not a significant difference.</strong></li><li style="max-width: 100%;"><strong style="max-width: 100%;">For some reason, we have been looking at omega-3 as a magical pill for health and intelligence for a long time.</strong></li><li style="max-width: 100%;"><strong style="max-width: 100%;">But it's becoming increasingly clear this is not the case.</strong></li></ul><div data-piano-inline-content-wrapper="" style="max-width: 100%;"><hr style="max-width: 100%; background-color: rgba(0, 0, 0, 0.2); height: 1px; border: 0px;"><p style="max-width: 100%;"> There's a growing body of evidence to suggest <a href="http://www.businessinsider.com/what-vitamins-should-i-take-2015-10" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">most vitamin supplements don't do all that much</a>. In fact, <a href="http://www.businessinsider.com/most-vitamin-supplements-are-useless-according-to-new-study-2018-5" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">a study earlier this year</a> found how some of the most popular vitamin supplements, including vitamin C and calcium, don't really have major health benefits. </p><p style="max-width: 100%;"> The next pill in the firing line is fish oil. Also known as omega-3, fish oil has been widely publicised as being protective against heart disease, but according to a new Cochrane review, <a href="https://www.uea.ac.uk/about/-/omega-3-supplements-have-little-or-no-heart-or-vascular-health-benefit" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">led by the University of East Anglia</a>, the supplements offer little benefit to those taking them. </p><p style="max-width: 100%;"> Omega-3 fats like alphalinolenic acid (ALA), eicosapentaenoic acid, and docosahexaenoic acid, are certainly good for you, because they are essential for our health. </p><p style="max-width: 100%;"> But the review, which combined the results from 79 different trials, involving over 112,000 people, found that omega-3 supplements like fish oils didn't seem to protect the heart. </p><p style="max-width: 100%;"> Participants were randomly assigned to either increase their omega-3 fat intake, or maintain their usual amount of fat in their diet for a year, then they were assessed for diseases of the heart and circulation. </p><p style="max-width: 100%;"> Results showed no significant difference in death rates, with 8.8% of people taking omega-3 dying compared to 9% of those in control groups. There was also no significant difference in the rates of heart attacks or strokes. </p><p style="max-width: 100%;"> Lee Hooper, a researcher at UEA's Norwich Medical School, who led the study, said the results show there is little evidence that omega-3 pills benefit the heart, or reduce the risk of death from any cause. </p><p style="max-width: 100%;"><a href="https://www.thetimes.co.uk/edition/news/omega-3-pills-and-fish-oil-useless-for-preventing-disease-vh6zjtwdf?CMP=Sprkr-_-Editorial-_-TheTimesandTheSundayTimes-_-Unspecified-_-FBPAGE" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">She told The Times</a> it's much better to include oily fish in your diet rather than take supplements, because it's not just the omega-3 you're ingesting. </p><p style="max-width: 100%;"> "You're also getting a protein source that replaces something else in your diet like saturated fat, and seafood has selenium, iron and vitamin D. All of these are useful nutrients," she said. </p><p style="max-width: 100%;"> She added that the review did find some evidence that one omega-3 fat alphalinolenic acid (ALA), found in rapeseed or canola oil and walnuts, may be slightly protective against heart and circulation diseases. </p><p style="max-width: 100%;"> "However, the effect is very small," she said. "143 people would need to increase their ALA intake to prevent one person developing arrhythmia. One thousand people would need to increase their ALA intake to prevent one person dying of coronary heart disease or experiencing a cardiovascular event." </p><p style="max-width: 100%;"> Fish oil seems to have been blown up in our health estimations for a long time. Over a decade ago, 3,000 children in Durham were given fish oil to see if it improved GCSE performance. Academics, <a href="https://www.theguardian.com/commentisfree/2008/sep/27/medicalresearch" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">including journalist and doctor Ben Goldacre</a>, pointed out this wasn't how a scientific study should be conducted — there was no control group, and it would likely produce false positive results. </p><p style="max-width: 100%;"> The results were further skewed by the fact over 2,000 children dropped out of the trial. But this didn't stop journalists picking up on the line that "832 pupils had 80% or greater compliance." </p><p style="max-width: 100%;"> Journalists also jumped on a story that suggested omega-3 improved school performance and behaviour in children, <a href="https://www.theguardian.com/commentisfree/2010/jun/05/bad-science-omega3-fish-oil" target="_blank" style="color: rgb(65, 110, 210); max-width: 100%; text-decoration: underline;">despite no paper saying anything of the sort</a>. </p><p style="max-width: 100%;"> This isn't to say omega-3 is useless for everything. It's a staple of our diet, just as many vitamins and minerals are. But what's becoming increasingly clear is that if you're looking for a magical supplement pill to work wonders on your health or mental agility, you probably won't find one. </p></div></div> </section> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-81098133614938101742018-07-16T08:54:00.001-07:002018-07-16T08:54:26.797-07:00Hands Only CPR Saves Lives<a href="https://www.cbsnews.com/video/how-administering-hands-only-cpr-could-save-a-life/">https://www.cbsnews.com/video/how-administering-hands-only-cpr-could-save-a-life/</a>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-52188854458452456422017-11-15T11:24:00.000-08:002017-11-15T11:24:32.108-08:00How Do I Lower My Blood Pressure?As I wrote in <a href="https://drportnay.blogspot.com/2017/11/breaking-news-definition-of-high-blood.html" target="_blank">my last blog post</a>, the AHA/ACC earlier this week released new guidelines for the management of hypertension (HTN or blood pressure). The biggest change to these guidelines is the new definition of high blood pressure...<br />
<br />
<ul>
<li>Now anyone with a blood pressure > 130/80 is classified as having Stage 1 HTN</li>
<li>Anyone with a blood pressure > 140/90 is classified as having Stage 2 HTN</li>
</ul>
<div>
The treatment recommendations have also been changed...</div>
<div>
<ul>
<li>Stage 1 HTN with increased cardiac risk should be treated medically to BP < 130/80 + adopt aggressive life style modifications known to lower BP</li>
<li>Stage 1 HTN with no increased cardiac risk should adopt aggressive life style modifications known to lower BP</li>
<li>Stage 2 HTN should be treated medically + adopt aggressive life style modifications known to lower BP</li>
</ul>
<div>
<b><i>So, what are some of the known life sytle modifications we can adopt that are known to lower BP</i></b></div>
</div>
<div>
<ul>
<li>Eat a low salt diet or specifically follow the <a href="https://www.nhlbi.nih.gov/health/resources/heart/hbp-dash-week-dash-html" target="_blank">DASH Diet </a></li>
<li>Lose weight </li>
<li>Exercise (30-45min at least 3-5x week)</li>
<li>Decrease alcohol intake (no more than 2 glasses/day for men and 1 glass/day for women)</li>
<li>Avoid supplements known to raise BP (ephedra, St John's wort)</li>
<li>Avoid medications known to raise BP (amphetamines, decongestants, non-steroidal anti-inflammatory drugs/NSAIDs (ibuprofen/Advil and Celebrex), and prednisone</li>
</ul>
<div>
As with any of my recommendations, I suggest you discuss you BP/diet/medications with your physician</div>
</div>
Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-16951272909360803372017-11-14T08:03:00.000-08:002017-11-14T08:03:59.583-08:00BREAKING NEWS: Definition of High Blood Pressure Drops<b style="font-weight: normal;"><br id="docs-internal-guid-a25c9cf2-bb43-721e-c11a-63801a881324" /><i>Just yesterday, the American Heart Association and the American College of Cardiology announced new guideline for hypertension. Below is an excellent summary of this new report. Please discuss the following with your doctor. </i></b><br />
<div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">By Dennis Thompson</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">HealthDay Reporter</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">MONDAY, Nov. 13, 2017 (HealthDay News) -- Nearly half of all adult Americans will be considered to have high blood pressure under new guidelines issued Monday by the nation's top heart health organizations.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The new guidelines lower the diagnostic threshold for stage 1 high blood pressure to 130/80, down from the previous level of 140/90, according to a joint statement from the American Heart Association and the American College of Cardiology.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Further, the guidelines also call for more aggressive treatment of high blood pressure, asking doctors and patients to set 130/80 as the new goal of therapy.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">High blood pressure can lead to heart attacks, strokes and heart failure.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">But the guidelines also press for more judicious treatment of high blood pressure -- sometimes called hypertension -- and an emphasis on lifestyle risk factors. Prescriptions for blood pressure drugs are not expected to leap under the guidelines, experts said.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The two heart organizations announced the new guidelines Monday at the American Heart Association's annual meeting, in Anaheim, Calif. The guidelines were last revised in 2003.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">This change means that 103 million Americans will be considered to have high blood pressure, or about 46 percent of the adult population, said Dr. Paul Whelton. He is chair of the 2017 Hypertension Practice Guidelines and a professor of Global Public Health at Tulane University School of Public Health and Tropical Medicine in New Orleans.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">That's a 14 percent increase from the previous guidelines, under which 72.2 million Americans (32 percent of adults) were considered to have high blood pressure.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The latest medical evidence has proven that people with blood pressure in the 130-139 range carry a doubled risk of heart attack, stroke, heart failure and kidney failure, compared to those with lower blood pressure, said Dr. Joaquin Cigarroa, a member of the clinical guidelines task force.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Previously, those people were considered to have prehypertension, but not actual high blood pressure.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">"By incorporating the latest science, we recognize the risk is doubled," said Cigarroa, chief of cardiology and clinical chief of the Knight Cardiovascular Institute at Oregon Health & Science University, in Portland. "This now allows 14 percent of our population to understand that's a call to action. We have to empower them with the tools to make a difference."</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The impact of the new guidelines is expected to be greatest among younger people. High blood pressure is expected to triple among men under age 45 and double among women under 45, according to the guidelines report.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">However, only about 30 percent of people with stage 1 high blood pressure under the guidelines will require drug therapy, Whelton said.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">That's because everyone with stage 1 high blood pressure will be evaluated for heart disease. Only those with heart disease or at high risk for developing it during the next decade will be prescribed drugs, the guidelines state.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">"We're more specific about who should get treatment," Whelton said. "It's a nice combination of understanding accurately average blood pressure and also understanding underlying risk. We didn't have that in previous guidelines."</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The rest of those at risk under the new guidelines will be urged to reduce their blood pressure through lifestyle changes -- losing weight, eating healthful foods, cutting down on salt, increasing potassium-rich foods, exercising regularly and moderating their drinking, said Dr. Bob Carey. He is vice chair of the 2017 Hypertension Practice Guidelines and dean emeritus of the University of Virginia School of Medicine.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The experts estimate "a projected increase in patients with stage 1 hypertension requiring drug therapy of 1.9 percent," Carey said. "This amounts to 4.2 million people, based on the U.S. population."</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The new guidelines also stress the importance of using proper technique to measure blood pressure, with a person's level based on an average of two to three readings on at least two different occasions.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Home blood pressure monitoring also will be emphasized to avoid "white-coat hypertension" -- the tendency for some people to have higher blood pressure in a medical setting than they do in everyday life, the report said.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The U.S. government in 2013 asked the AHA and ACC to draft new guidelines for blood pressure management, said ACC President Dr. Mary Walsh. She is medical director of Heart Failure and Cardiac Transplantation at St. Vincent Heart Center of Indiana.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The new guidelines are the product of a 21-member committee, following a three-year review of medical evidence that included more than 900 studies, Whelton said. The studies were reviewed by 52 experts who submitted close to 1,000 questions, and approved by 11 partnering medical organizations.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">The new guidelines "take advantage of evidence almost up to the minute, so they are very current," Whelton said.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Blood pressure categories in the new guidelines are:</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Normal: Less than 120 systolic pressure (the top number).</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Prehypertension: 120 to 129.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Stage 1: Systolic between 130 and139.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Stage 2: Systolic of 140 or higher.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Systolic pressure is the amount of pressure in your arteries during contraction of the heart muscle.</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">WebMD News from HealthDay</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline;">Sources</span><span style="background-color: transparent; color: black; font-family: Arial; font-size: 11pt; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; 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<br />Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-55103491678209586722017-11-13T07:33:00.000-08:002017-11-13T07:35:48.357-08:00Do Statins Raise Odds for Type 2 Diabetes? Maybe, but heart benefits likely outweigh any potential risk from the drugs, experts say<h1 class="title" style="-webkit-hyphens: manual; font-family: Georgia; font-size: 1.95552em; line-height: 1.2141em; margin-bottom: 0.5em; margin-top: 0px; max-width: 100%;">
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<span style="color: orange;">The following is an article recently published on WebMD. Many patients have mentioned to me the reports about statins increasing the risk of developing Type 2 Diabetes. I definitely agree with Drs Crandall and Donovan (see statements in orange below). The benefits of statins in terms of prevention of cardiovascular events outweigh the slight increase risk in HgbA1C/DM.</span></div>
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By Serena Gordon</div>
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<i style="max-width: 100%;">HealthDay Reporter</i></div>
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<span style="color: #1b1b1b;">TUESDAY, Oct. 24, 2017 (HealthDay News) --</span><span style="color: #1b1b1b;"> </span><span style="color: black;"><a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/cholesterol-management/default.htm" style="max-width: 100%; text-decoration: none;">Cholesterol</a>-lowering <a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/drugs/index-drugs.aspx" style="max-width: 100%; text-decoration: none;">medications</a> known as <a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/cholesterol-management/side-effects-of-statin-drugs" style="max-width: 100%; text-decoration: none;">statins</a> may lower your risk of <a data-crosslink-type="slideshow" data-metrics-link="" href="https://www.webmd.com/heart-disease/ss/slideshow-visual-guide-to-heart-disease" style="max-width: 100%; text-decoration: none;">heart disease</a>, but also might boost the odds you'll develop <a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/diabetes/type-2-diabetes-guide/type-2-diabetes" style="max-width: 100%; text-decoration: none;">type 2 diabetes</a>, new research suggests.</span></div>
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"In a group of people at high risk of <a data-crosslink-type="slideshow" data-metrics-link="" href="https://www.webmd.com/diabetes/ss/slideshow-type-2-diabetes-overview" style="max-width: 100%; text-decoration: none;">type 2 diabetes</a>, <a data-crosslink-type="video" data-metrics-link="" href="https://www.webmd.com/cholesterol-management/video/should-i-take-a-statin" style="max-width: 100%; text-decoration: none;">statins</a> do seem to increase the risk of developing <a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/diabetes/default.htm" style="max-width: 100%; text-decoration: none;">diabetes</a> by about 30 percent," said the study's lead author, Dr. Jill Crandall. She's a professor of medicine and director of the diabetes <a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/a-to-z-guides/clincial-trial-guide-patients" style="max-width: 100%; text-decoration: none;">clinical trials</a> unit at Albert Einstein College of Medicine in New York City.</div>
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But, she added, that doesn't mean anyone should give up on statins.</div>
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<span style="color: orange;">"The benefits of statins in terms of cardiovascular risk are so strong and so well established that our recommendation isn't that people should stop taking statins, but people should be monitored for the development of diabetes while on a statin," she explained.</span></div>
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At least one other diabetes expert agreed that statins are still beneficial for those at risk of heart trouble.</div>
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Dr. Daniel Donovan Jr. is professor of medicine and director of clinical research at the Icahn School of Medicine at Mount Sinai Diabetes, Obesity and Metabolism Institute in New York City.</div>
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<span style="color: orange;">"We still need to give statins when LDL (bad) cholesterol isn't under control. A statin intervention can lower the risk of a cardiovascular event by 40 percent, and it's possible the diabetes may have been destined to happen," he said.</span></div>
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The new study is an analysis of data collected from another ongoing study. More than 3,200 adults were recruited from 27 diabetes centers across the United States for the study.</div>
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The research goal was to prevent the progression of type 2 diabetes in people with a high risk of the disease, Crandall said. All of the study participants were overweight or obese. They also all showed signs that they weren't metabolizing sugar properly at the start of the study, but not poorly enough to be diagnosed with type 2 diabetes.</div>
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Study volunteers were randomly chosen to get treatment with lifestyle changes that would lead to modest weight loss, the drug metformin or a placebo pill.</div>
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At the end of the intervention, they were asked to participate in the 10-year follow-up program. They had their blood sugar levels measured twice a year, and their statin use was tracked, too.</div>
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At the start of the follow-up period, 4 percent of participants were taking statins. At the end, about one-third were.</div>
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Simvastatin (Zocor) and atorvastatin (Lipitor) were the most commonly used statins.</div>
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The study was an observational study, so it couldn't show a cause and effect relationship.</div>
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However, Crandall said the researchers measured levels of insulin secretion and insulin resistance. Insulin is a hormone that helps the body usher the sugar from foods into the body's cells to be used as fuel.</div>
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Crandall said insulin secretion goes down when people take statins. Less insulin would lead to higher blood sugar levels. She said there was no indication that statins affected insulin resistance.</div>
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Donovan added that the study provides important information. "But I don't think the message is stop statins," he said. "Most people are probably developing heart disease before diabetes, and it's important to treat the risk factors you can."</div>
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Though they weren't included in this study, people who already have type 2 diabetes should be closely monitored for increases in blood sugar when they start taking a statin, Crandall said. "The evidence so far is rather limited, but there have certainly been anecdotal reports of blood sugar being higher when someone starts statins," she said.</div>
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She also suggested that blood sugar levels likely aren't as much of a concern for those without diabetes or risk factors for diabetes when starting a statin. Besides excess weight, those risks include older age, high blood pressure and a family history of diabetes.</div>
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Crandall added that there are many people 50 and over with prediabetes who don't know it, so it could be an issue for them.</div>
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Findings from the study were published online Oct. 23 in <em style="max-width: 100%;">BMJ Open Diabetes Research & Care</em>.</div>
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Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-65860732298368527972017-11-13T07:19:00.000-08:002017-11-13T07:19:46.017-08:00WebMD: Does Sex Really Trigger Cardiac Arrest?<h1 class="title" style="-webkit-hyphens: manual; color: #1b1b1b; font-family: Georgia; font-size: 1.95552em; line-height: 1.2141em; margin-bottom: 0.5em; margin-top: 0px; max-width: 100%;">
Does Sex Really Trigger Cardiac Arrest?</h1>
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By Dennis Thompson</div>
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<i style="max-width: 100%;">HealthDay Reporter</i></div>
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SUNDAY, Nov. 12, 2017 (HealthDay News) -- It's a common Hollywood trope -- an older guy is having enthusiastic sex with a gal half his age when he suddenly flops over dead.</div>
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But in real life, sexual activity very rarely causes cardiac arrest, a new study reassuringly reports.</div>
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Sex was linked to only 34 out of more than 4,500 cardiac arrests that occurred in the Portland, Ore., metropolitan area between 2002 and 2015. That's a rate of just 0.7 percent, the researchers noted.</div>
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Of those cases, 18 occurred during sex and 15 immediately after sex. Time couldn't be determined for the last case.</div>
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"I'm a little surprised at the really tiny number," said study senior researcher Dr. Sumeet Chugh, medical director of the Heart Rhythm Center at Cedars-Sinai Medical Center in Los Angeles. "But mostly I feel it's reassuring data."</div>
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The news is most welcome for patients with <a data-crosslink-type="article" data-metrics-link="" href="https://www.webmd.com/heart/picture-of-the-heart" style="color: #416ed2; max-width: 100%; text-decoration: none;">heart</a> problems who aren't sure if sex could be dangerous, Chugh said.</div>
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"Previously we would say the risk is probably low, but we don't know how low," Chugh noted. "Now we have data and we can say to them the risk is very low."</div>
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The new findings are part of a 16-year study of <a data-crosslink-type="tools" data-metrics-link="" href="https://www.webmd.com/heart-disease/rm-quiz-know-heart" style="color: #416ed2; max-width: 100%; text-decoration: none;">heart</a> risk factors involving about a million people living in and around Portland.</div>
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"Sexual activity is just one variable in the whole big picture" of cardiac risks, but one that hasn't been studied in depth, Chugh added.</div>
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Men are more likely than women to have their heart stop as a result of sex. Just two of the 34 cardiac arrest patients were female, the findings showed.</div>
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But overall, sex was linked to only 1 percent of all cardiac arrests that occurred in men.</div>
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Other heart experts said they weren't surprised by the results.</div>
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Sex just isn't as strenuous as people believe. The aerobic activity associated with sex is equivalent to climbing two flights of stairs, explained Dr. Nieca Goldberg. She is director of the NYU Center for Women's Health and an AHA spokeswoman.</div>
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Dr. Martha Gulati, chief of cardiology for the University of Arizona College of Medicine, said, "Although a lot of us think sex requires an intense level of activity, even in the most extreme situations it's not as intense as people imagine it."</div>
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Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-59867515633127954742017-11-13T07:16:00.000-08:002017-11-13T07:16:52.597-08:00NYTimes: The Growing Toll of Our Ever-Expanding Waistlines<h1 class="title" style="-webkit-hyphens: manual; color: #1b1b1b; font-family: Georgia; font-size: 1.95552em; line-height: 1.2141em; margin-bottom: 0.5em; margin-top: 0px; max-width: 100%;">
The Growing Toll of Our Ever-Expanding Waistlines</h1>
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By <span itemid="https://www.nytimes.com/by/jane-e-brody" itemprop="author creator" itemscope="" itemtype="http://schema.org/Person" style="display: inline !important; font-size: 1em !important; font-weight: normal !important; margin: 0px; max-width: 100%;"><a href="https://www.nytimes.com/by/jane-e-brody" style="color: var(--body-font-color); display: inline !important; font-size: 1em !important; margin: 0px; max-width: 100%; text-decoration: none;" title="More Articles by JANE E. BRODY"><span data-byline-name="Jane E. Brody" itemprop="name" style="display: inline !important; font-size: 1em !important; margin: 0px; max-width: 100%;">JANE E. BRODY</span> </a></span><span class="delimiter" style="display: inline !important; font-size: 1em !important; font-weight: normal !important; margin: 0.07em 0.45em 0px; max-width: 100%; padding: 0px;"></span><time content="2017-11-13T06:00:12-05:00" datetime="2017-11-13T06:00:12-05:00" itemprop="dateModified" style="display: inline !important; font-size: 1em !important; font-weight: normal !important; margin: 0px; max-width: 100%;">NOV. 13, 2017</time></div>
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<img alt="" class="extendsBeyondTextColumn" data-mediaviewer-caption="" data-mediaviewer-credit="Paul Rogers" data-mediaviewer-src="https://static01.nyt.com/images/2017/11/14/science/14BRODY/14BRODY-superJumbo.jpg" itemid="https://static01.nyt.com/images/2017/11/14/science/14BRODY/14BRODY-master768.jpg" itemprop="url" src="https://static01.nyt.com/images/2017/11/14/science/14BRODY/14BRODY-superJumbo.jpg" style="-webkit-margin-start: -70px; display: block; height: auto; margin: 0.5em auto; max-width: none; width: 814.59375px;" /><div style="max-width: 100%;">
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I hope you’re not chomping on a bagel or, worse, a doughnut while you read about what is probably the most serious public health irony of the last half century in this country: As one major killer — smoking — declined, another rose precipitously to take its place: obesity.</div>
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Many cancer deaths were averted after millions quit lighting up, but they are now rising because even greater numbers are unable to keep their waistlines in check.</div>
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Today, obesity and smoking remain the two leading causes of preventable deaths in this country.</div>
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Reviewing more than 1,000 studies, the International Agency for Research on Cancer and the <a href="https://www.cdc.gov/mmwr/volumes/66/wr/mm6639e1.htm" style="color: #416ed2; max-width: 100%; text-decoration: none;">Centers for Disease Control</a> and Prevention <a href="https://well.blogs.nytimes.com/2016/08/24/obesity-linked-to-at-least-13-types-of-cancer/" style="color: #416ed2; max-width: 100%; text-decoration: none;">linked the risk of developing 13 kinds of cancer</a> to overweight and obesity, especially cancers that are now being diagnosed in increasing numbers among younger people.</div>
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Included are cancers of the esophagus, liver, gallbladder, colon and rectum, upper stomach, pancreas, uterus, ovary, kidney and thyroid; breast cancer in postmenopausal women; meningioma and multiple myeloma. Only for colorectal cancers has the overall incidence declined, primarily the result of increased screening and removal of precancerous polyps.</div>
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In most cases, the studies revealed, cancer risk rose in direct proportion to the degree of excess weight. In other words, the heavier you are, the more likely you will be to develop one of these often fatal cancers.</div>
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From 2005 to 2014, the C.D.C. reported in October, there was a 1.4 percent <em style="max-width: 100%;">annual</em>increase in cancers related to overweight and obesity among people aged 20 to 49, and a 0.4 percent rise in these cancers among people 50 to 64.</div>
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“Nearly half of all cancers in people younger than 65 were associated with overweight and obesity,” C.D.C. experts <a href="https://jamanetwork.com/journals/jama/fullarticle/2656710" style="color: #416ed2; max-width: 100%; text-decoration: none;">reported in JAMA</a>. And they predicted that given the current “high prevalence of overweight and obesity among adults, children and adolescents,” going forward there will be additional increases in weight-related cancers and cancer deaths among Americans.</div>
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The experts called upon clinicians who treat children and adults to do their due diligence and spend more time assessing body mass index (B.M.I.) and counseling patients about how to avoid or reduce excess weight. The payoff in terms of health, life and dollar savings would likely far outweigh the costs of society-wide professional and public health measures to curb America’s expanding waistlines.</div>
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Of course, it is not just cases and deaths from cancer that such an effort could prevent. Overweight, and especially obesity, are major risk factors for Type 2 diabetes, heart disease and stroke, high blood pressure, osteoarthritis, gout, gallbladder disease, and respiratory disorders like sleep apnea and asthma.</div>
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However, even when the costs of weight assessments and counseling are fully covered by insurance, it seems they are rarely done. In November 2011, the Obama administration offered free weight-loss counseling to obese seniors on Medicare, with no co-payment or deductible for those with Medicare Part B insurance. The benefit, which is still available, applied to the approximately 30 percent of Medicare beneficiaries with a B.M.I. of 30 or more.</div>
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Yet in the first three years, only about 120,000 seniors, representing less than 1 percent of those on Medicare, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003721/" style="color: #416ed2; max-width: 100%; text-decoration: none;">took advantage of this benefit</a>, a result weight-loss specialists have called “very disappointing” and “a huge lost opportunity.”</div>
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The free coverage includes weekly counseling for the first month, a session every other week for months two through six, then monthly sessions for another six months for those who lose at least 6.6 pounds by the sixth month. Participants who fail to hit the six-month target can get a second chance six months later, with no limit to how many times they can take advantage of this benefit if their B.M.I. is still 30 or higher.</div>
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To be sure, many of those with serious weight problems have probably tried and failed to lose weight and keep it off, leading them to think there’s little hope that yet another effort will bring success. But it is worth noting that for most <a href="https://www.healthline.com/health-news/quitting-smoking-expect-failure-before-you-succeed" style="color: #416ed2; max-width: 100%; text-decoration: none;">people who managed to quit smoking</a>, it typically took anywhere from eight to 30 attempts.</div>
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The fault with weight-loss failures may lie almost as much with health care practitioners as with their patients. Many primary care doctors have little to no training in how to counsel patients who need to lose weight. Some have told me that they are afraid patients won’t come back if they focus on a need to lose weight. And patients are often turned off by what they perceive to be their health care providers’ negative attitudes toward people with weight problems.</div>
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An online survey by researchers at Yale University’s Rudd Center for Food Policy and Obesity revealed that people considered terms like “obese,” “fat” and “morbidly obese” to be <a href="https://www.ncbi.nlm.nih.gov/pubmed/22777543" style="color: #416ed2; max-width: 100%; text-decoration: none;">stigmatizing and blaming language</a> used by doctors. Nearly one participant in five said they would avoid future medical appointments, and 21 percent said they would seek a new doctor, if they felt stigmatized about their weight.</div>
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The Medicare opportunity notwithstanding, there is a growing need to tackle weight issues much earlier in life. Researchers at the Harvard School of Public Health <a href="http://jamanetwork.com/journals/jama/fullarticle/2643761" style="color: #416ed2; max-width: 100%; text-decoration: none;">reported in JAMA</a> in July that 23 percent of women and 13 percent of men gained 44 pounds or more between the ages of 18 and 55. And Dr. William H. Dietz of the C.D.C., who noted in an <a href="http://jamanetwork.com/journals/jama/fullarticle/2643743" style="color: #416ed2; max-width: 100%; text-decoration: none;">accompanying editorial</a> that “obesity-related cancers in both men and women were associated with moderate weight gain during adulthood,” added that “efforts to prevent and control obesity in young adults should be accorded a high priority.”</div>
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Dr. Dietz also pointed to a doubling in the prevalence of obesity between the childhood ages of 6 to 11, now at 17 percent, and young adulthood ages of 20 to 29, now at 34 percent.</div>
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Why are so many young Americans seriously overweight? The prevalence of high-calorie snacks and fast foods and cutbacks in physical activity both within and outside of school are not the only reasons. The problem can start as soon as babies are weaned and able to eat solid foods. Too often parents and caretakers, in the interest of keeping youngsters subdued, ply them with snacks all day long, creating in some a lifelong oral drive linking comfort and food.</div>
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And, for too many, I’m afraid, an increased risk of developing and dying from cancer.</div>
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Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-49035964872219625442016-08-24T12:23:00.001-07:002016-08-24T12:23:25.619-07:00Cancer on Course to Become Americans' Top Killer<base class=""><div class="Apple-Mail-URLShareUserContentTopClass"><br class=""></div><div class="Apple-Mail-URLShareWrapperClass" style="position: relative !important;"><blockquote type="cite" style="border-left-style: none; color: inherit; padding: inherit; margin: inherit;" class=""><div class=""><div class="original-url"><a href="http://www.webmd.com/cancer/news/20160824/cancer-on-course-to-become-top-killer-of-americans" class="">http://www.webmd.com/cancer/news/20160824/cancer-on-course-to-become-top-killer-of-americans</a><br class=""><br class=""></div><div id="article" role="article" style="-webkit-locale: en; border-bottom-width: 0px;" class=""> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Cancer on Course to Become Americans' Top Killer</h1><p class="">Report shows it will probably eclipse heart disease as leading cause of death in coming years</p> <div class=""> <br class="">WebMD News from HealthDay</div><p class="">By Dennis Thompson</p><p xmlns:xalan="http://xml.apache.org/xalan" class=""> <i class="">HealthDay Reporter</i> </p><p class="">WEDNESDAY, Aug. 24, 2016 (HealthDay News) -- <a href="http://www.webmd.com/cancer/" class="">Cancer</a> is on track to become the leading cause of death in the United States, closing in on <a href="http://www.webmd.com/heart-disease/default.htm" class="">heart disease</a> as America's number one killer, a new government study shows.</p><p class=""> <a href="http://www.webmd.com/heart-disease/ss/slideshow-visual-guide-to-heart-disease" class="">Heart disease</a> has consistently been the leading cause of death for decades, and remained so in 2014, according to a report from the National Center for Health Statistics (NCHS) at the U.S. Centers for Disease Control and Prevention.</p><p class="">But the gap between <a href="http://www.webmd.com/heart-disease/video/bernstein-heart-disease-kill" class="">heart disease</a> and the second-leading cause of death, <a href="http://www.webmd.com/cancer/ss/does-this-cause-cancer" class="">cancer</a>, has been narrowing since 1968, the researchers said.</p><p class=""> <a href="http://www.webmd.com/cancer/cancer-prevention-detection-16/rm-quiz-cancer-myths-facts" class="">Cancer</a> actually surpassed heart disease as the leading cause of death for 22 states in 2014, the study found. Back in 2000, Alaska and Minnesota were the only two states where cancer killed more people than heart disease.</p><p class="">In addition, cancer is now the leading cause of death for a number of minority groups, including Hispanics, Asians and Pacific Islanders, the report showed.</p><p class="">"It's been edging this way for a while," said co-author Robert Anderson, chief of the Mortality Statistics Branch at the NCHS. "We've taken for granted that <a href="http://www.webmd.com/heart-disease/rm-quiz-know-heart" class="">heart</a> disease is the leading cause of death, but now because of prevention efforts and advances in treatment, we're making substantial progress with heart disease, to the point where now it's roughly on par with cancer."</p><p class="">Annual heart disease deaths have decreased nationwide from a peak of just over 771,000 in 1985 to nearly 597,000 in 2011. In the meantime, cancer deaths have nearly tripled from just under 211,000 in 1950 to almost 577,000 in 2011, the report stated.</p><p class=""> Dr. Mariell Jessup is a spokeswoman for the American Heart Association. She pointed out that new medicines have made it easier for people to control their <a href="http://www.webmd.com/hypertension-high-blood-pressure/guide/diastolic-and-systolic-blood-pressure-know-your-numbers" class="">blood pressure</a> and <a href="http://www.webmd.com/cholesterol-management/default.htm" class="">cholesterol</a>, treatment advances like <a href="http://www.webmd.com/heart-disease/guide/treatment-angioplasty-stents" class="">angioplasty</a> and heart bypass surgery saves the lives of many heart patients, and more people have <a href="http://www.webmd.com/smoking-cessation/default.htm" class="">quit smoking</a> and started eating healthier diets. </p><p class="">"One could argue that we're doing a better job of keeping people with heart disease alive," said Jessup, who is a professor at the Hospital of the University of Pennsylvania in Philadelphia. "It's not that people aren't experiencing heart disease, but they're not dying from it."</p> </div><div class="page"><p class="">Report shows it will probably eclipse heart disease as leading cause of death in coming years</p> <a name="1" class=""> </a> <h3 class=""> continued...</h3><p class="">Another expert agreed, with a twist on the thinking.</p><p xmlns:xalan="http://xml.apache.org/xalan" class="">Essentially, modern medicine has gotten so good at <a href="http://www.webmd.com/heart-disease/guide/living-with-heart-disease" class="">dealing with heart disease</a> that people are living much longer, making them more apt to eventually develop cancer, said Dr. Richard Schilsky. He is chief medical officer for the American Society of Clinical Oncology.</p><p class="">"We have to keep in mind that everyone's going to die eventually from something. Any time we reduce the risk of death for any particular cause, we increase the risk you're going to die from another cause," Schilsky explained.</p><p class=""> "Cancer is a disease that is fundamentally associated with aging. If you outlive all the competing causes of mortality, there's a greater and greater likelihood that you're going to get cancer," Schilsky added.</p><p class="">That view is reflected in the states where cancer has overtaken heart disease, said Rebecca Siegel, strategic director of Surveillance Information Services for the American Cancer Society.</p><p class="">In those states, people seem to be healthier overall than in states where heart disease reigns supreme. Death rates for both heart disease and cancer were lower in the states where cancer was the leading cause of death, Siegel said.</p><p class="">"It's not that cancer rates are high in those states at all," Siegel said. "We all have to die from something, right?"</p><p class="">She added that <a href="http://www.webmd.com/heart-disease/guide/understanding-heart-disease-treatment" class="">heart disease treatment</a> and prevention has benefited from rapid progress because it's a more narrow field of medicine.</p><p class="">"Heart disease is basically one disease, whereas with cancer we're looking at more than 100 different diseases," she said. "You have very effective ways to prevent and treat heart disease, and we've had them for quite some time, whereas knowledge about the biology of cancer and how to prevent it and treat it is still in its infancy."</p><p class="">In recent years -- between 2011 and 2014 -- heart disease and cancer deaths have both increased in roughly parallel fashion, the report noted.</p><p class="">Heart disease deaths increased by 3 percent between 2011 and 2014, from 596,577 to 614,348, while cancer deaths increased by 2.6 percent during the same period, from 576,691 to 591,699, the findings showed.</p> </div><div class="page"><p class="">Report shows it will probably eclipse heart disease as leading cause of death in coming years</p> <a name="1" class=""> </a> <h3 class=""> continued...</h3><p class="">These increases could be related to the <a href="http://www.webmd.com/diet/obesity/features/am-i-obese" class="">obesity</a> epidemic, Siegel suggested.</p><p xmlns:xalan="http://xml.apache.org/xalan" class="">"The <a href="http://www.webmd.com/diet/obesity/video/obesity-risks" class="">obesity</a> epidemic is catching up with us," she said. "It's overcoming our ability to prevent and treat heart disease, and there are a lot of cancers that are also associated with obesity."</p><p class="">The report was published online Aug. 24 in the CDC's <i class="">NCHS Data Brief</i>.</p></div></div></div></blockquote></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-31682532788060587472016-08-24T09:44:00.001-07:002016-08-24T09:44:31.146-07:00AHA Says Cap Added Sugars for Kids at 6 Teaspoons a Day<div><base href="http://www.medscape.com/viewarticle/867841?src=rss"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>AHA Says Cap Added Sugars for Kids at 6 Teaspoons a Day</title><div class="original-url"><br><a href="http://www.medscape.com/viewarticle/867841?src=rss">http://www.medscape.com/viewarticle/867841?src=rss</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">AHA Says Cap Added Sugars for Kids at 6 Teaspoons a Day</h1> <p>Children should consume less than 25 g, or the equivalent of 6 tsp, of added sugars a day — far below current intake in the United States, according to the <a href="http://circ.ahajournals.org/content/early/2016/08/22/CIR.0000000000000439">first scientific statement</a> on the subject by the American Heart Association (AHA).</p> <p>Currently, US children ages 2 to 19 years old consume more than three times that amount — about 80 g of added sugar daily — half from food and half from drinks, say the diet and nutrition experts who analyzed National Health and Nutrition Examination Survey data from 2009–2012. And because intake amounts in the surveys were self-reported, the numbers likely even underestimate the problem, the authors of the statement say.</p> <p>Added sugars include table sugar, fructose, and honey used in processing and preparing foods or drinks and sugars added to foods at the table or eaten separately.</p> <p> <b>Only 8 Oz of Sugary Drinks a Week, Guidelines Say</b> </p> <p>Miriam B Vos, MD, MsPH, associate professor of pediatrics at Emory University School of Medicine, Atlanta, Georgia, and fellow committee members write in the statement published August 22 in <em>Circulation</em>: "Current evidence supports the associations of added sugars with increased energy intake, increased adiposity, increased central adiposity, and increased dyslipidemia."</p> <p>They add that overweight children who continue to ingest more added sugars are also more likely to become insulin-resistant, a precursor for type 2 diabetes.</p> <p>Beginning July 2018, the Food and Drug Administration (FDA) will require that food labels show not just all sugars but also those that were added.</p> <p>"Until then, the best way to avoid added sugars in your child's diet is to serve mostly foods that are high in nutrition, such as fruits, vegetables, whole grains, low-fat dairy products, lean meat, poultry, and fish and to limit foods with little nutritional value," Dr Vos said in a press statement.</p> <p>In addition to limiting intake of table sugar, fructose, and honey, people should watch for labels for brown sugar, corn sweetener, corn syrup, dextrose, glucose, invert sugar, lactose, malt syrup, maltose, molasses, sucrose, trehalose, and turbinado sugar, the AHA suggests.</p> <p>One of the biggest sources of added sugars is sugar-sweetened beverages, particularly soft drinks, sweet tea, and sports and energy drinks.</p> <p>The AHA cautions that children and teens should have no more than 8 oz weekly of sugar-sweetened drinks. Parents should avoid all added sugar for children under the age of 2 years. Calorie requirements are only about 1000 a day for infants, so there is less room for added low-value sugars. Also, taste preferences start early in life, so limiting added sugars may help develop healthy eating habits.</p> <p>"Children should not drink more than one 8-oz sugar-sweetened drink a week, yet they are currently drinking their age in sugary drink servings each and every week," Dr Vos commented.</p> <p>As to whether using artificial sweeteners such as aspartame, saccharine, and sucralose may be a good solution, the authors point to a dearth of research in that area for both child and adult populations and therefore could not offer a recommendation.</p> <p>Further research is also needed into the genetic component of bodies' response to sugar and how the interaction between the microbiome and added sugars and consequently CVD risk varies among individuals, the authors suggest.</p> <p>The AHA guidelines align with the World Health Organization and the Food and Drug Administration recommendations that added sugars should make up less than 10% of calories.</p> <p> <em>Dr Vos has no relevant financial relationships. Disclosures for the coauthors are listed in the article.</em> </p> <p> <em> For more diabetes and endocrinology news, follow us on <a href="https://twitter.com/medscapeEndo" target="_blank">Twitter</a> and on <a href="https://www.facebook.com/MedscapeDiabetesAndEndocrinology" target="_blank">Facebook</a>. </em> </p> <p> <em>Circulation</em>. Published online August 22, 2016. <a href="http://circ.ahajournals.org/content/early/2016/08/22/CIR.0000000000000439">Abstract</a> </p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-16065343384773588712016-08-21T07:28:00.001-07:002016-08-21T07:28:24.978-07:00Why You Should Never Tell Someone to Relax - WSJ<div><base href="http://www.wsj.com/articles/why-you-should-never-tell-someone-to-relax-1471370408"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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margin-right: 6px; padding-left: 16px; } blockquote:not(.simple) { border-left: 3px solid rgba(0, 0, 0, 0.1); } /* Collapse excess whitespace. */ .page p > p:empty, .page div > p:empty, .page p > div:empty, .page div > div:empty, .page p + br, .page p > br:only-child, .page div > br:only-child, .page img + br { display: none; } .page table { font-size: 0.9em; text-align: start; word-wrap: break-word; border-collapse: collapse; } .page table td, .page table th { padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216); } .page table th { background-color: rgba(0, 0, 0, 0.025); } .page sup, .page sub { line-height: 1; font-size: 0.75em; } .hidden { display: none; } /* Fonts */ body.system { font-family: -apple-system-font; } body.athelas { font-family: Athelas; } body.charter { font-family: Charter; } body.georgia { font-family: Georgia; } body.iowan { font-family: 'Iowan Old Style'; } body.palatino { font-family: Palatino; } body.seravek { font-family: Seravek; } body.times { font-family: 'Times New Roman'; } body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Why You Should Never Tell Someone to Relax - WSJ</title><div class="original-url"><br><a href="http://www.wsj.com/articles/why-you-should-never-tell-someone-to-relax-1471370408">http://www.wsj.com/articles/why-you-should-never-tell-someone-to-relax-1471370408</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Why You Should Never Tell Someone to Relax</h1> <p>It's a paradoxical fact: When someone is getting stressed out, one of the least effective (and perhaps most annoying) things to say is "Relax."</p> <p>The directive has exactly the opposite effect on most people. People who instruct a colleague, subordinate or loved one to relax may have good intentions. But it is usually better to resist ordering people to change their emotional state and try a different strategy. If you are on the receiving end of an order to relax, there are countermoves that can keep your blood pressure from soaring higher.</p> <p> Anna Runyan was working hard on a previous job as a consultant several years ago when her boss approached her desk and told her to relax, adding, "you don't have to be perfect," says Ms. Runyan of San Diego. </p> <div> <div> <div> <amp-img src="https://si.wsj.net/public/resources/images/BN-PK305_WORKFA_H_20160815132012.jpg" layout="responsive" placeholder="" height="439" width="659" alt="Anna Runyan of San Diego felt angry when a former boss told her to stop working so hard, suggesting that he didn't understand what she faced."><i-amp-sizer></i-amp-sizer> <img amp-img-id="AMP_6" alt="Anna Runyan of San Diego felt angry when a former boss told her to stop working so hard, suggesting that he didn't understand what she faced." width="659" height="439" src="https://si.wsj.net/public/resources/images/BN-PK305_WORKFA_H_20160815132012.jpg" class="" style=""></amp-img> <p>Anna Runyan of San Diego felt angry when a former boss told her to stop working so hard, suggesting that he didn't understand what she faced.<span>Photo: Evan Yamada Productions</span></p> </div> </div> </div> <div> <p> <span>Advertisement</span> </p> </div><p>She felt her face flush with anger. She wanted some acknowledgment of her hard work and tight deadlines, but "he really didn't understand all the things I was doing," says Ms. Runyan, founder of <a href="http://classycareergirl.com">ClassyCareerGirl.com</a>, a career and business site for women. "I wanted to shut down." Afterward, she tried updating her boss more frequently on her workload but left the company the following year.</p> <p>Relaxing on command is physiologically impossible if "the body is already too acutely stressed to turn it around," says Wendy Mendes, a professor of emotion at the University of California, San Francisco, and a researcher on stress. While the body responds rapidly to stress, returning to a relaxed state can take 20 to 60 minutes, she says.</p> <p>Other research shows that trying to hide or suppress an emotion, called "emotion suppression," typically backfires. When people are told to hide how they feel and try to clamp down on the emotion, "it actually leaks out more," Dr. Mendes says.</p> <p>Such misfires can open a deep divide between an employee and a boss. Brandon Smith was extremely stressed on a previous job as a retailing manager years ago, after his boss ordered him on his first day to start laying off several co-workers, says Mr. Smith, now an adjunct professor of business at Emory University in Atlanta. </p> <div> <div> <div> <amp-img src="https://si.wsj.net/public/resources/images/BN-PK306_WORKFA_H_20160815132012.jpg" layout="responsive" placeholder="" height="439" width="659" alt="Brandon Smith of Atlanta says a former boss's dismissive remark that laying off co-workers wasn't a 'big deal' motivated him to build a new career as an executive coach. "><i-amp-sizer></i-amp-sizer> </amp-img> <p>Brandon Smith of Atlanta says a former boss's dismissive remark that laying off co-workers wasn't a 'big deal' motivated him to build a new career as an executive coach. <span>Photo: Allison Shirreffs</span></p> </div> </div> </div> <p>When his boss passed his desk and remarked "just settle down, it's not a big deal," Mr. Smith says, "I wanted to explode with anger." He was so shaken that he emerged with a new career purpose. After leaving that job, he earned two master's degrees, in clinical therapy and business, and became an executive coach and team-building consultant, says Mr. Smith, founder of <a href="http://theworkplacetherapist.com">TheWorkplaceTherapist.com</a>.</p> <p>Advising someone to relax can mask a variety of motives. The underlying message may be, "I can't stand the way you're making me feel, so stop it," says Joseph Burgo, a clinical psychologist and writer best known for his work on narcissism. </p> <p>If it is a loved one giving the order to relax, it may reflect a genuine need—for instance, for calm time together. Nina Batson of Tinton Falls, N.J., sometimes rushes to get laundry and other housework done in the evening after work. If her 13-year-old daughter Tati tells her, "Oh, Mom, relax, slow down," Ms. Batson stops to watch TV with her for a while, talk, laugh and have a cup of tea, even though she knows it will take her longer to finish the chores. </p> <div> <div> <div> <amp-img src="https://si.wsj.net/public/resources/images/PJ-CH478_WORKFA_8U_20160816134536.jpg" layout="responsive" placeholder="" height="285" width="634" alt="Left: 'Calm down!' can be well meant, but when a boss makes this command, an employee can feel even more stressed as well as defensive or angry. Right: Open-ended questions like 'How's it going?' or 'Would you like to talk?' invite the employee to describe the pressures she is under, helping her to shake her stress and feel better. "><i-amp-sizer></i-amp-sizer> </amp-img> <p>Left: 'Calm down!' can be well meant, but when a boss makes this command, an employee can feel even more stressed as well as defensive or angry. Right: Open-ended questions like 'How's it going?' or 'Would you like to talk?' invite the employee to describe the pressures she is under, helping her to shake her stress and feel better. <span>Illustration: Tim Bower for The Wall Street Journal</span></p> </div> </div> </div> <p>If you're criticized for appearing stressed, pause and take a deep breath before responding, says Debra Burdick, an Enfield, Conn., speaker and author of books on mindfulness. Try not to take it personally, and regard it as a cue to address the underlying problems. </p> <p>Consider starting a conversation about reducing the causes of stress, says Jordan Friedman, a New York City stress coach. Acknowledge that you're feeling the strain, and then add, "It would be great if we could sit down at the beginning of next week and figure out how to make this process less stressful for me and everyone else."</p> <p>Also, take a moment to "hold up a mirror and take a look" at whether your style of working might be stressful to others, says Nancy Ancowitz, a New York City presentation and career coach. If so, say thanks for the feedback, and try reducing stress through exercise, more frequent breaks, deep breathing or other techniques. </p> <div> <div> <div> <amp-img src="https://si.wsj.net/public/resources/images/BN-PK304_WORKFA_H_20160815132011.jpg" layout="responsive" placeholder="" height="439" width="659" alt="New York City graduate student Adam Ma says a professor's order to 'calm down' before giving a major presentation unnerved him at first but helped him perform better in the end. "><i-amp-sizer></i-amp-sizer> </amp-img> <p>New York City graduate student Adam Ma says a professor's order to 'calm down' before giving a major presentation unnerved him at first but helped him perform better in the end. <span>Photo: Adam Ma</span></p> </div> </div> </div> <p>Embracing more realistic expectations of yourself can help in some situations. Adam Ma of New York City, a graduate student whose first language is Mandarin, was extremely nervous several years ago when he stepped up to give a presentation to 40 fellow students. He wanted his English to be perfect, and he had memorized rigid rules about maintaining good posture and constant eye contact with listeners. When his professor told him in front of the whole class to "calm down," Mr. Ma says, at first, "it just made me feel worse."</p> <p>But then, "I decided to adjust my expectations to be more comfortable," he says. He allowed himself to use his notes and to pause now and then to look away from the audience, have a sip of water and take a breath. "I felt such relief," he says. He felt he made an emotional connection with listeners, who applauded warmly, and he scored an A for the course. </p> <p>Mr. Ma, who also works full-time as a project and process manager, says telling colleagues before making a presentation that he is feeling stressed helps him relax and "helps prepare people for what they're going to get and how they can help me," he says. "And probably, people will make a couple of jokes, and we will have some laughs."</p> <p>To help calm someone who is stressed, acknowledge his or her feelings first by saying, "Looks like you're having a tough day," Ms. Ancowitz says. Show empathy and ask open-ended questions such as "Tell me what's going on," to give the person a chance to talk about his or her feelings. You could acknowledge that it's been a stressful time for everybody, saying, "Other people are feeling the pressure too. Let's try to figure this out as a group," Mr. Friedman says. If a discussion is getting heated, suggest taking a break for a walk, a cup of coffee or lunch. </p> <p>In New York City, Glenn Chiarello, who has been a dentist for 30 years, says he never tells his patients to relax, even though most new ones are nervous. "Instead, I become inquisitive. 'How do you feel about having this work done today?' " he says. Most patients start talking, and as he listens, "they do in fact do what we want them to do: They start to relax."</p> <p> <strong>Write to </strong>Sue Shellenbarger at <a href="mailto:sue.shellenbarger@wsj.com" target="_blank">sue.shellenbarger@wsj.com</a> </p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-50222024659883845182016-08-21T07:17:00.001-07:002016-08-21T07:17:40.726-07:00What should I do if I feel a fluttering feeling in my chest? Here's some advice from an expert<div><base href="http://www.thejournal.ie/readme/health-advice-heart-palpitations-2935662-Aug2016/"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>What should I do if I feel a fluttering feeling in my chest? Here's some advice from an expert</title><div class="original-url"><br><a href="http://www.thejournal.ie/readme/health-advice-heart-palpitations-2935662-Aug2016/">http://www.thejournal.ie/readme/health-advice-heart-palpitations-2935662-Aug2016/</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">What should I do if I feel a fluttering feeling in my chest? Here's some advice from an expert</h1><p>HEART PALPITATIONS CAN be alarming, a nuisance and can feel very unpleasant. But when should you start to worry?</p> <p>Palpitations are often described as a fluttering feeling in the chest or a sensation of the heart racing or pounding. Sometimes you may feel skips and jumps, like missed or extra beats. This can last for anything from seconds to hours or even days.</p> <p>Palpitations describe the feeling of your heartbeat or an awareness of a change in your heart rhythm. Most of the time we are completely unaware of our heart beating.</p> <p>Palpitations are very common, and most people can experience them from time to time. In most cases they are harmless and not a sign of heart problems.</p> <p>But accompanied by other symptoms, such as dizziness, fainting or tightness in your chest, they can sometimes be a sign of a heart problem and may need further investigation.</p> <p><strong>What causes palpitations?</strong></p> <p>Palpitations are a common occurrence and usually nothing to worry about, yet the cause is often unknown. Certain situations and lifestyle factors can trigger palpitations or cause them to occur more frequently.</p> <p>Common triggers include:</p> <ul> <li>Strenuous exercise</li> <li>Surges of adrenaline, a hormone released in response to strong emotions like anxiety, excitement and stress</li> <li>Cigarette smoking due to the stimulating effect of nicotine</li> <li>Excessive consumption of tea or coffee due to the stimulating effect of caffeine</li> <li>Drinking excessive amounts of alcohol or eating rich, spicy foods</li> <li>Using recreational drugs</li> <li>Illness such as colds or flu and fever</li> </ul> <p>Less common triggers:</p> <ul> <li>Hormone changes associated with menstruation, pregnancy or menopause</li> <li>Side effects from some types of medication e.g. some asthma inhaler medications that contain stimulants; some cold and cough remedies</li> <li>Palpitations can sometimes be associated with some medical conditions which can make the heart beat faster, stronger or irregularly. These include an overactive thyroid, a low blood sugar level, anaemia (a low blood count), and an abnormal heart rhythm (arrhythmia).</li> </ul> <p><strong>What do I need to do?</strong><br> Palpitations that occur just occasionally and last a few seconds usually don't need any investigation or treatment.</p> <p>If you are concerned about your palpitations, it is sensible to go and see your GP, particularly if they happen on a frequent basis.</p> <p>Unless your doctor finds that you have a heart condition, they rarely need treatment. Instead, your doctor may recommend ways for you to avoid the triggers that cause your palpitations.</p> <p>If you have a history of heart disease, your palpitations become more frequent or they worsen, or they are accompanied by other symptoms, see your doctor. You may have a heart rhythm problem (arrhythmia), such as atrial fibrillation (a fib) or supraventricular tachycardia (SVT). Further tests may be needed to assess your heart rate and rhythm.</p> <p>If your palpitations are caused by an arrhythmia, your treatment will focus on correcting the underlying condition.</p> <p>A fib is one of the most common heart rhythm problems causing a fast, irregular pulse. It is generally not life threatening, but is a major cause of stroke and will usually require treatment.</p> <p>SVT is an abnormally fast heart rate which is usually steady and regular. Episodes are usually harmless and often settle down on their own without treatment.</p> <p><strong>Tips to reduce common triggers</strong></p> <ul> <li>Stay well hydrated when exercising</li> <li>Reduce stress and anxiety. Try relaxation techniques such as meditation, yoga, mindfulness</li> <li>Avoid stimulants like excess alcohol, nicotine and some cold and flu remedies</li> <li>Reduce caffeine drinks like tea, coffee and energy drinks</li> <li>Avoid recreational drugs</li> </ul> <p><em>For more information on heart health, visit the Irish Heart Foundation's <a href="http://www.irishheart.ie/iopen24/heart-health-information-resources-t-7_21.html">website</a>.</em></p> <p><em>Patricia Hall is the Irish Heart Foundation's Helpline Nurse Manager.</em></p> <h3>Read: <a href="http://www.thejournal.ie/readme/bodywhys-eating-disorders-2920342-Aug2016/">Getting help: What to do if you or someone you know has an eating disorder</a></h3> <h3>Read: <a href="http://www.thejournal.ie/readme/check-skin-cancer-signs-2907577-Aug2016/">What do I do if I find something unusual on my skin? Here's some advice from an expert</a></h3> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-67923900257537806882016-08-16T19:21:00.001-07:002016-08-16T19:21:42.195-07:00New FDA-Approved Medication, ARNI Therapy, Could Prevent Nearly 30,000 Deaths From Heart Failure<div><base href="http://www.medicaldaily.com/fda-approved-angiotensin-receptor-neprilysin-inhibitor-heart-failure-deaths-390537"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} #article .auxiliary figcaption { font-size: 100%; } #article .auxiliary * { margin-top: 0.5em; margin-bottom: 0.5em; } #article .float.left { float: left; margin-right: 20px; } #article .float.right { float: right; margin-left: 20px; } #article .clear { clear: both; } #article ul.list-style-type-none, #article ol.list-style-type-none, #article .list-style-type-none > li { list-style-type: none; -webkit-padding-start: 0; } #article .page div.scrollable { overflow-x: scroll; word-wrap: normal; } #article .page div.scrollable table { max-width: none; } #article .large-element { max-width: 100%; height: auto; } #article .leading-image, #article figure, #article .auxiliary { font-family: -apple-system-font; } body #article .leading-image, body #article figure, body #article .auxiliary { color: rgba(0, 0, 0, 0.65); } figure { margin: 0; } hr { background: rgba(0, 0, 0, 0.2); height: 1px; border: 0; } pre { font-size: 0.93em; line-height: 1.5em; } blockquote { color: rgba(0, 0, 0, 0.65); margin-left: 2px; margin-right: 6px; padding-left: 16px; } blockquote:not(.simple) { border-left: 3px solid rgba(0, 0, 0, 0.1); } /* Collapse excess whitespace. */ .page p > p:empty, .page div > p:empty, .page p > div:empty, .page div > div:empty, .page p + br, .page p > br:only-child, .page div > br:only-child, .page img + br { display: none; } .page table { font-size: 0.9em; text-align: start; word-wrap: break-word; border-collapse: collapse; } .page table td, .page table th { padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216); } .page table th { background-color: rgba(0, 0, 0, 0.025); } .page sup, .page sub { line-height: 1; font-size: 0.75em; } .hidden { display: none; } /* Fonts */ body.system { font-family: -apple-system-font; } body.athelas { font-family: Athelas; } body.charter { font-family: Charter; } body.georgia { font-family: Georgia; } body.iowan { font-family: 'Iowan Old Style'; } body.palatino { font-family: Palatino; } body.seravek { font-family: Seravek; } body.times { font-family: 'Times New Roman'; } body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>New FDA-Approved Medication, ARNI Therapy, Could Prevent Nearly 30,000 Deaths From Heart Failure</title><div class="original-url"><br><a href="http://www.medicaldaily.com/fda-approved-angiotensin-receptor-neprilysin-inhibitor-heart-failure-deaths-390537">http://www.medicaldaily.com/fda-approved-angiotensin-receptor-neprilysin-inhibitor-heart-failure-deaths-390537</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">New FDA-Approved Medication, ARNI Therapy, Could Prevent Nearly 30,000 Deaths From Heart Failure</h1><p>A new FDA-approved class of cardiovascular medication could save thousands of<a href="http://www.medicaldaily.com/latinos-heart-failure-risk-factor-racial-disparity-381522"> heart failure</a> patients from dying each year in the United States, according to a recent <a href="http://cardiology.jamanetwork.com/article.aspx?articleid=2529720" rel="nofollow" target="_blank">study</a> published in <em>JAMA Cardiology</em>.</p><p>Heart failure occurs when the heart no longer pumps blood as well as it should. This illness, which usually develops after other conditions have damaged or weakened the heart, affects about 5.7 million adults in the U.S., according to the <a href="http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm" rel="nofollow" target="_blank"> Centers for Disease Control and Prevention</a>. However, 2.7 million people with <a href="http://www.medicaldaily.com/teen-weight-heart-failure-middle-age-389930">heart failure</a> have also been diagnosed with reduced ejection fraction — the heart muscle does not contract effectively and less oxygen-rich blood is pumped out to the body. Doctors use the heart's ejection to essentially diagnose and track heart failure. And with this new medication, ARNI therapy using a combination drug of valsartan/sacubitril called Entresto, doctors could also enhance the body's protective hormonal systems while simultaneously inhibiting the overactive hormones that harm the heart.</p><p> <span itemscope="" itemtype="http://schema.org/ImageObject" itemprop="image" itemid="http://images.medicaldaily.com/sites/medicaldaily.com/files/styles/embedded_full/public/2016/06/25/pulse-trace-163708640.jpg"> <span> <picture title="Heart failure" itemprop="contentUrl" width="640" height="360"><!--[if IE 9]><video style="display: none;"><![endif]--><source srcset="http://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_desktop_1x/public/2016/06/25/pulse-trace-163708640.jpg 1x" media="(min-width: 992px)" src=""><source srcset="http://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_tablet_1x/public/2016/06/25/pulse-trace-163708640.jpg 1x" media="(min-width: 768px)" src=""><source srcset="http://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_narrow_1x/public/2016/06/25/pulse-trace-163708640.jpg 1x" media="(min-width: 481px)" src=""><source srcset="http://images.medicaldaily.com/sites/medicaldaily.com/files/styles/full_breakpoints_theme_medicaldaily_mobile_1x/public/2016/06/25/pulse-trace-163708640.jpg 1x" media="(min-width: 0px)" src=""><!--[if IE 9]></video><![endif]--><img itemprop="contentUrl" width="640" height="360" src="http://images.medicaldaily.com/sites/medicaldaily.com/files/styles/embedded_full/public/2016/06/25/pulse-trace-163708640.jpg" alt="Heart failure" title="Heart failure" class="" style=""></picture></span> <span> <span itemprop="caption">New heart failure therapy could prevent thousands of deaths each year in the U.S., finds study.</span> <span itemprop="copyrightHolder" style="font-style: italic;">Pixabay</span> </span> </span></p><p>Although previous studies have shown that this heart failure therapy can reduce mortality in heart failure patients, researchers wanted to quantify the deaths that were prevented or postponed with ARNI therapy. To do this, they analyzed published data of patients who were eligible for the therapy. They also looked at population-based estimates of people with heart failure and reduced ejection fraction, as well as those who needed to be treated with medication in order to avert or delay death.</p><p>Researchers found that of the 2.7 million people diagnosed with heart failure with reduced ejection fraction, 84 percent were potential candidates for ARNI therapy. Their analysis also showed that if most, if not all, eligible patients received ARNI therapy, it could potentially prevent approximately 28,484 deaths each year in the U.S.</p><p>"We have demonstrated the potential gains that may be achieved with the application of ARNI therapy for patients with [heart failure and reduced ejection fraction] in the United States," researchers wrote. "Given the substantial [heart failure] burden and potential benefits of implementation for preventing deaths, efforts to ensure comprehensive implementation of ARNI therapy should be considered."</p><p>Heart failure can't be cured, but it can be treated and managed with exercise, a healthy diet and lifestyle. This may include eating less salt, weight loss and smoking cessation.</p><p>Source: Fonarrow G, Hernandez A, Solomon S, Yancy C. Potential Mortality Reduction With Optimal Implementation of Angiotensin Receptor Neprilysin Inhibitor Therapy in Heart Failure. <em>JAMA Cardiology</em>. 2016.</p></div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-78286971053459017242016-08-15T10:36:00.001-07:002016-08-15T10:36:49.244-07:00Heart disease and cancer are responsible for nearly half of all deaths in the U.S., report says - LA Times<base class=""><div class="Apple-Mail-URLShareUserContentTopClass"><br class=""></div><div class="Apple-Mail-URLShareWrapperClass" style="position: relative !important;"><blockquote type="cite" style="border-left-style: none; color: inherit; padding: inherit; margin: inherit;" class=""><div class=""><div class="original-url"><a href="http://www.latimes.com/science/sciencenow/la-sci-sn-causes-of-death-20160629-snap-story.html" class="">http://www.latimes.com/science/sciencenow/la-sci-sn-causes-of-death-20160629-snap-story.html</a><br class=""><br class=""></div><div id="article" role="article" style="-webkit-locale: en; border-bottom-width: 0px;" class=""> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Heart disease and cancer are responsible for nearly half of all deaths in the U.S., report says</h1><div class="leading-image"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKdgNKDrs7E-2Bn-50uNG8xbWi-IS3bmSz-QWtWhM5tofD4RJKCkgjiUCVQMuRLqKgc4lWxnLWJicgd99Wti4iGII6nUlSk0fEnafYdUA7l2VZCEuyXB5mXJ3PuhgBD0rgC1Bi3pmgrCiS/s1600/750x422-709246"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKdgNKDrs7E-2Bn-50uNG8xbWi-IS3bmSz-QWtWhM5tofD4RJKCkgjiUCVQMuRLqKgc4lWxnLWJicgd99Wti4iGII6nUlSk0fEnafYdUA7l2VZCEuyXB5mXJ3PuhgBD0rgC1Bi3pmgrCiS/s320/750x422-709246" border="0" alt="" id="BLOGGER_PHOTO_ID_6319110689127409106" /></a></div><p class="">What are the most common ways to die in America? The answer depends on how old you are, whether you're a man or a woman, and your racial and ethnic background, a new report shows.</p><p class="">Alzheimer's disease accounted for 5% of deaths among U.S. women, for instance, but only 2.1% of deaths among men. Accidents and unintentional injuries caused 39.7% of deaths among people between the ages of 10 and 24, but only 7.4% of deaths for adults between the ages of 45 and 64. <a title="Diabetes" href="/topic/health/diseases-illnesses/diabetes-HEDAI0000022-topic.html" class="">Diabetes</a> was responsible for 4.3% of African American deaths and 2.7% of white deaths.</p><p class="">Overall, <a title="Heart Disease" href="/topic/health/diseases-illnesses/heart-disease-HEDAI0000026-topic.html" class="">heart disease</a> was the No. 1 cause of death for Americans, killing 614,348 people in 2014, according to a government analysis of all death certificates filed in the country that year. Cancer came in second, causing 591,699 deaths. Together, the two diseases accounted for 45.9% of all deaths in the U.S., the report says.</p><p class="">Heart disease and cancer have long topped the list of leading causes of death, and each killed a few thousand more people in 2014 than in 2013. However, while cancer held steady at 22.5% of all deaths in the U.S., the proportion of deaths due to heart disease fell slightly, from 23.5% in 2013 to 23.4% in 2014.</p><p class="clear">The next three leading causes of death — chronic lower respiratory diseases, accidents and unintentional injuries, and stroke — accounted for 15.8% of U.S. deaths in 2014. Alzheimer's, diabetes, <a title="Flu" href="/topic/health/diseases-illnesses/flu-HEDAI0000047-topic.html" class="">influenza</a> and <a title="Pneumonia" href="/topic/health/diseases-illnesses/pneumonia-HEDAI0000061-topic.html" class="">pneumonia</a>, kidney disease and suicide rounded out the top 10. Combined, they were responsible for 12% of fatalities that year.</p><p class="">Among the 10 leading causes of death, eight — Alzheimer's, accidents, suicides, strokes, kidney disease, cancer, diabetes and heart disease — killed more people in 2014 than in 2013. By far, the biggest jump was for Alzheimer's, which caused 10.5% more deaths in 2014 compared with the previous year.</p><p class="">Meanwhile, deadly cases of flu and pneumonia fell 3.1%, and deaths from chronic lower respiratory diseases fell by 1.4%.</p><p class="">Heart disease and cancer ranked No. 1 and No. 2 for both men and women, but both killed a slightly greater proportion of men than women. For women, respiratory diseases ranked third, followed by stroke and Alzheimer's. For men, accidents were the third-leading cause of death, followed by respiratory diseases and stroke.</p><p class="">Accidents and unintentional injuries were the leading cause of death for children, teens and younger adults. Cancer took over as the leading cause of death among those 45 and older. Cancer deaths were surpassed by deaths due to heart disease at 65.</p><p class="">Breaking down the death certificate statistics according to race revealed that seven of the leading causes of death were shared by whites, blacks, Asians and Native Americans. Cancer was the No. 1 killer of Asian Americans, accounting for 26.8% of deaths in 2014. For the other three groups, the top killer was heart disease, which was responsible for 23.7% of deaths among blacks, 23.4% of deaths among whites and 18.3% of deaths among Native Americans.</p><p class="">Alzheimer's disease was among the top 10 killers for blacks, whites and Asians, but not for Native Americans. Suicide and influenza and pneumonia were on the list for Asians, whites and Native Americans, but not for blacks. However, African Americans were alone in having homicide and the bloodstream infection <a href="https://www.nlm.nih.gov/medlineplus/ency/article/001355.htm" target="_blank" class="">septicemia</a> among the leading causes of death.</p><p class="">Latinos had a lower proportion of deaths due to heart disease and cancer than did non-Hispanic blacks and non-Hispanic whites, according to the report. They also had a greater burden of accident-related deaths, which ranked third, and of chronic liver disease and cirrhosis, which ranked sixth.</p><p class="">The No. 1 cause of infant deaths was congenital malformations, deformations and chromosomal abnormalities, which accounted for 20.4% of deaths among children under a year old. Close behind were deaths due to premature birth and low birth weight, at 18%. Maternal complications during pregnancy, sudden infant death syndrome and accidents completed the top five causes of infant deaths.</p><p class="">These were the top 10 causes of death for all Americans in 2014, along with their contribution to overall deaths:</p><ol class="list-style-type-none"> <li class="">Heart disease (23.4%)</li> <li class="">Cancer (22.5%)</li> <li class="">Chronic lower respiratory diseases (5.6%)</li> <li class="">Accidents/unintentional injuries (5.2%)</li> <li class="">Stroke/cerebrovascular disease (5.1%)</li> <li class="">Alzheimer's disease (3.6%)</li> <li class="">Diabetes (2.9%)</li> <li class="">Influenza and pneumonia (2.1%)</li> <li class="">Kidney disease (1.8%)</li> <li class="">Suicide/intentional self-harm (1.6)</li> </ol><p class="">The report was compiled by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.</p><p class=""><strong class=""><a href="mailto:karen.kaplan@latimes.com" target="_blank" class="">karen.kaplan@latimes.com</a></strong></p><p class=""><strong class="">Follow me on Twitter <a href="https://twitter.com/LATkarenkaplan" target="_blank" class="">@LATkarenkaplan</a> and "like" <a href="https://www.facebook.com/latimesscience/" target="_blank" class="">Los Angeles Times Science & Health</a> on Facebook.</strong></p><p class=""><strong class="">MORE IN SCIENCE</strong></p><p class=""><a href="http://www.latimes.com/la-sci-sn-church-attendance-suicide-20160629-snap-story.html" target="_blank" class=""><strong class="">Church attendance linked with reduced risk of suicide, especially for Catholics</strong></a></p><p class=""><a href="http://www.latimes.com/la-sci-sn-microbes-boston-20160628-snap-story.html" target="_blank" class=""><strong class="">What germs are riding the subway with you? You'll be surprised</strong></a></p><p class=""><a href="http://www.latimes.com/la-sci-sn-zika-vaccine-20160628-snap-story.html" target="_blank" class=""><strong class="">Two new vaccines can protect against Zika after a single shot</strong></a></p></div></div></div></blockquote></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-61642243132072840392016-08-15T10:30:00.001-07:002016-08-15T10:30:30.736-07:00Cardiac Rehab Saves Lives. So Why Don't More Heart Patients Sign Up? : Shots - Health News : NPR<div><base href="http://www.npr.org/sections/health-shots/2016/07/18/485871530/cardiac-rehab-works-great-so-why-don-t-people-do-it"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Cardiac Rehab Saves Lives. So Why Don't More Heart Patients Sign Up? : Shots - Health News : NPR</title><div class="original-url"><br><a href="http://www.npr.org/sections/health-shots/2016/07/18/485871530/cardiac-rehab-works-great-so-why-don-t-people-do-it">http://www.npr.org/sections/health-shots/2016/07/18/485871530/cardiac-rehab-works-great-so-why-don-t-people-do-it</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Cardiac Rehab Saves Lives. So Why Don't More Heart Patients Sign Up?</h1> <div> <div data-crop-type=""> <img src="http://media.npr.org/assets/img/2016/07/13/gt8a8114_custom-d5205a4577377721713c8dfd0ffba51e9fe0b5cd-s700-c85.jpg" title="Exercise physiologist Courtney Conners checks Mario Oikonomides' vital signs before his cardiac rehab workout at the University of Virginia Health System clinic." alt="Exercise physiologist Courtney Conners checks Mario Oikonomides' vital signs before his cardiac rehab workout at the University of Virginia Health System clinic." class="" style=""> </div> <div> <div> <p> Exercise physiologist Courtney Conners checks Mario Oikonomides' vital signs before his cardiac rehab workout at the University of Virginia Health System clinic. </p> </div> <span style="font-style: italic;"> Francis Ying/Kaiser Health News </span> </div> </div> <p>When Mario Oikonomides was 38 years old he had a massive heart attack. About a month later, after he'd recuperated from the emergency, his doctors sent him to a <a href="https://www.nhlbi.nih.gov/health/health-topics/topics/rehab">cardiac rehabilitation</a> program, where he learned about the role physical activity can play in reducing cardiac risk.</p> <p>"I never exercised before," Oikonomides says. "I became addicted to exercising." The program, overseen by a medical team, also checked up on his medications, provided nutrition counseling and offered other help and coaching in the fraught weeks and months after his hospitalization.</p> <p>Oikonomides is 69 now and lives in Charlottesville, Va. When he recently needed bypass surgery, long decades after that heart attack, he again signed up for a rehabilitation program as soon as he could.</p> <p>"I bought myself 30 years of healthy life as a result of cardiac rehab," he says.</p> <p>But, despite many years of <a href="http://circ.ahajournals.org/content/124/25/2951">research</a> showing that joining a cardiac rehabilitation program can help heart patients heal faster and even live longer, Oikonomides is among a minority of patients who take advantage of such programs; fewer than <a href="http://archinte.jamanetwork.com/article.aspx?articleid=2422065">a third</a> do.</p> <p>Why is rehab such a hard sell? Blame it on a number of factors, doctors say.</p> <p>Some patients have to travel a long way to the nearest program; work schedules keep others from joining. Uninsured patients often can't afford it. And even those with insurance can be stopped short by copayments that can be $20, $40 — or even $50 a class.</p> <p>"The number one barrier is the cost of the copay, which is frustrating," says <a href="https://uvahealth.com/findadoctor/profile/ellen-c-keeley">Dr. Ellen Keeley</a>, a cardiologist at the University of Virginia Health System.</p> <p>These days, Medicare and most private insurers cover cardiac rehab for patients who have had heart attacks, coronary bypass surgery, or who have had stents implanted or received a diagnosis of heart failure or any of several other conditions. Most plans cover two or three hour-long visits per week — up to 36 sessions. With most programs encouraging patients to participate two or three days a week, the cost of copayments can add up fast.</p> <p>Courtney Conners is an exercise physiologist at U.Va. who meets with patients after a heart attack. The U.Va. clinic, started by Keeley about a year ago, contacts patients before they are discharged and brings them back to the clinic a week or 10 days later to meet one-on-one with a nutritionist, pharmacist, cardiologist and exercise physiologist to develop a tailored rehab program.</p> <p>"There's a little hesitance, where they're like, 'I don't really want to come. I don't know if I want to go three days a week,'" Conners says of the exercise program. "And then their wife, or one of their family members will push them, and then they'll agree to sign up."</p> <div> <div data-crop-type=""> <img src="http://media.npr.org/assets/img/2016/07/13/gt8a7995_custom-fd30dee3189eed67e615420093205e8640a90a2b-s700-c85.jpg" title="Charles Greiner gets his heart rate up — with supervision — at the U.Va. cardiac rehabilitation gym in Charlottesville, Va." alt="Charles Greiner gets his heart rate up — with supervision — at the U.Va. cardiac rehabilitation gym in Charlottesville, Va." class="" style=""> </div> <div> <div> <p> Charles Greiner gets his heart rate up — with supervision — at the U.Va. cardiac rehabilitation gym in Charlottesville, Va. </p> </div> <span style="font-style: italic;"> Francis Ying/Kaiser Health News </span> </div> </div> <p>Right now, there actually aren't enough rehab programs in the U.S. to accommodate all the patients who are eligible, advocates say. A recent study in the <em>Journal of Cardiopulmonary Rehabilitation and Prevention</em> <a href="https://mayoclinic.pure.elsevier.com/en/publications/the-current-and-potential-capacity-for-cardiac-rehabilitation-uti">surveyed </a>812 existing cardiac rehab programs across the nation and found that even if they were expanded modestly and operated at capacity, the existing programs could serve only 47 percent of qualifying patients.</p> <p>Still, advocates are hopeful that cardiac rehab may start to gain more traction, now that hospitals have an extra incentive to encourage patients to sign up. Because of provisions in the Affordable Care Act, hospitals now face financial penalties if too many of their cardiac patients need to be readmitted soon after discharge — and enrolling patients in rehab helps keep those numbers down, the evidence shows.</p> <p>For example, getting patients into cardiac rehab programs cut hospital re-admissions by 31 percent in one Canadian study, according to <a href="https://www.heart.org/idc/groups/ahaecc-public/@wcm/@adv/documents/downloadable/ucm_473083.pdf">a review of the literature</a> by the American Hospital Association, saving $8.5 million a year; a study in Vermont pegged the savings at about $900 per patient.</p> <p>Kathryn Shiflett, a hospital phlebotomist and one of Keeley's patients, is just 33 and has two young kids. A week after her heart attack she was at the U.Va. clinic looking for information about a rehab program. She's eager to get well. But she's not used to exercise and she's a bit nervous about cardiac rehab.</p> <p>After being reassured that her vital signs would be monitored closely as she exercised, Shiflett hinted at the real barrier: She lives an hour away and is about to start a new job. Cardiac rehab classes happen Mondays, Wednesdays and Fridays, with sessions at 8 a.m., 10 a.m. and 3 p.m.</p> <div> <div data-crop-type=""> <img src="http://media.npr.org/assets/img/2016/07/13/gt8a8149_custom-df267c51ae1ba27395080099234bd5c561781cd9-s700-c85.jpg" title="Just a week after her heart attack, Kathyrn Shiflett meets with Dr. Ellen Keeley, a U.Va. cardiologist, to learn more about the next steps in healing." alt="Just a week after her heart attack, Kathyrn Shiflett meets with Dr. Ellen Keeley, a U.Va. cardiologist, to learn more about the next steps in healing." class="" style=""> </div> <div> <div> <p> Just a week after her heart attack, Kathyrn Shiflett meets with Dr. Ellen Keeley, a U.Va. cardiologist, to learn more about the next steps in healing. </p> </div> <span style="font-style: italic;"> Francis Ying/Kaiser Health News </span> </div> </div> <p>"I don't know if I can get there by then," Shiflett says. "My job goes from 4:30 in the morning until 3."</p> <p>Oikonomides says there was no question that he would do whatever it took to participate in rehab after his bypass surgery this winter. Cardiac rehab sparked his love of exercise, he says — and that has helped keep him out of the hospital for decades.</p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-69058452764935171422016-08-12T09:46:00.001-07:002016-08-12T09:46:14.846-07:00U.S. Kids Don't Make the Grade on Heart Health<base class=""><div class="Apple-Mail-URLShareUserContentTopClass"><br class=""></div><div class="Apple-Mail-URLShareWrapperClass" style="position: relative !important;"><blockquote type="cite" style="border-left-style: none; color: inherit; padding: inherit; margin: inherit;" class=""><div class=""><div class="original-url"><a href="http://www.webmd.com/children/news/20160811/us-kids-dont-make-the-grade-on-heart-health" class="">http://www.webmd.com/children/news/20160811/us-kids-dont-make-the-grade-on-heart-health</a><br class=""><br class=""></div><div id="article" role="article" style="-webkit-locale: en; border-bottom-width: 0px;" class=""> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">U.S. Kids Don't Make the Grade on Heart Health</h1><p class="">Most don't eat right or get enough exercise, and the American Heart Association warns of problems ahead</p> <div class=""> <br class="">WebMD News from HealthDay</div><p class="">By Robert Preidt</p><p xmlns:xalan="http://xml.apache.org/xalan" class=""> <i class="">HealthDay Reporter</i> </p><p class="">THURSDAY, Aug. 11, 2016 (HealthDay News) -- Most American children fall short of ideal <a href="http://www.webmd.com/heart/default.htm" class="">heart health</a>, a new American Heart Association scientific statement says.</p><p class="">An analysis of 2007-08 federal government survey results found that about 91 percent of youngsters did not have <a href="http://www.webmd.com/diet/default.htm" class="">healthy diets</a>. Those between the ages of 2 and 19 get most of their calories from simple carbohydrates such as sugary drinks and desserts.</p><p class="">"A primary reason for so few children having ideal cardiovascular health is poor nutrition," statement author Dr. Julia Steinberger said in an association news release. "Children are eating high-calorie, low-nutrition foods and not eating enough healthy foods, such as fruits, vegetables, whole-grains, <a href="http://www.webmd.com/food-recipes/ss/slideshow-foolproof-fish" class="">fish</a> and other foods strongly associated with good heart health and a <a href="http://www.webmd.com/diet/tc/healthy-weight-what-is-a-healthy-weight" class="">healthy body weight</a>." </p><p class="">Lack of <a href="http://www.webmd.com/fitness-exercise/default.htm" class="">physical activity</a> is another concern. Among 6- to 11-year-olds, half of boys and about a third of girls got the recommended 60 minutes or more a day of <a href="http://www.webmd.com/fitness-exercise/ss/slideshow-7-most-effective-exercises" class="">exercise</a>. Between 16 and 19 years of age, those percentages plummeted to 10 percent of boys and 5 percent of girls.</p><p class="">Not surprisingly, kids have packed on the pounds. About 10 percent of 2- to 5-year-olds were <a href="http://www.webmd.com/diet/obesity/features/am-i-obese" class="">obese</a>, compared to between 19 percent and 27 percent of 12- to 19-year olds. About a third of the older kids had tried a cigarette.</p><p class="">Nearly all the children had ideal <a href="http://www.webmd.com/hypertension-high-blood-pressure/guide/diastolic-and-systolic-blood-pressure-know-your-numbers" class="">blood pressure</a>. And most had ideal <a href="http://www.webmd.com/cholesterol-management/default.htm" class="">cholesterol</a> and <a href="http://www.webmd.com/diabetes/guide/blood-glucose" class="">blood sugar levels</a>, though not as good as blood pressure levels, according to the statement published Aug. 11 in the journal <i class="">Circulation</i>.</p><p class="">Overall, the findings show that instead "of taking a wait-and-see approach by treating disease later in adulthood, we should help children maintain the standards of ideal cardiovascular health that most children are born with," said Steinberger, director of pediatric cardiology at the University of Minnesota.</p><p class="">"It's much harder to turn back the clock," she added.</p></div></div></div></blockquote></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-90551350235299924162016-08-06T21:15:00.001-07:002016-08-11T09:01:15.282-07:00Most heart transplant patients don’t live more than 20 years. He just passed 30. | Miami Herald<div><base href="http://www.miamiherald.com/news/nation-world/national/article94201062.html"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Most heart transplant patients don't live more than 20 years. He just passed 30. | Miami Herald</title><div class="original-url"><br><a href="http://www.miamiherald.com/news/nation-world/national/article94201062.html">http://www.miamiherald.com/news/nation-world/national/article94201062.html</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Most heart transplant patients don't live more than 20 years. He just passed 30.</h1> <p>Without the death of a Wisconsin boy, Hank Mihelcic might not be alive today.</p><p>The 85-year-old Belleville resident received the boy's heart during a transplant surgery at <a href="http://www.barnesjewish.org/" target="_blank" title="">Barnes-Jewish Hospital in St. Louis</a> on May 13, 1986. </p><p>Now 30 years later, Hank wishes he knew more about the boy and his family.</p><p>"At that time, they would not tell the recipients anything about the donor. They do now. They didn't then. It was a big secret," Hank said. "All I know is it was from a 16-year-old male from Milwaukee, Wisconsin." </p><p>Living so long after a heart transplant is rare. Dr. Gregory Ewald, a cardiologist and medical director of the heart-transplant program at Barnes, said only 25 to 30 percent of heart-transplant patients live more than 20 years.</p><p>"It's not necessarily always a heart transplant issue that limits their survival," Ewald said. "A lot of patients end up developing medical problems that become life threatening or take their life that probably would have happened anyway." </p><p>Barnes-Jewish Hospital has done about 800 adult heart transplants since the fall of 1985. </p><p>Hank's was the 29th.</p><div class="clear"><p style="font-weight: 600;">The first heart transplant ever performed was done in 1967 by Christiaan Barnard in South Africa. </p></div><h3>Heart attack strikes <span data-value="252"> </span></h3><p>April 18, 1986, was supposed to be a special day — Hank's and his wife Darlene's 26th wedding anniversary.</p><p>They went out for a prime rib dinner at a Belleville restaurant to celebrate. Darlene couldn't finish all of hers so Hank ate the rest. "I was pretty well overloaded," he said.</p><p>The couple went home, and Hank, who was 54 at the time, took their dog for a walk. During the walk, he noticed something was wrong, that he may be having a heart attack. "I made it back home somehow," he said. </p><p>He collapsed inside, and Darlene called 911. It didn't look good, and neither Hank nor Darlene knew if he was going to survive. He believes 40 years of smoking had caught up with him and caused the attack.</p><p>Hank, an Air Force veteran, initially went to Scott Air Force Base Medical Center before being transferred to Barnes-Jewish. "They kept reviving me with the shock treatment — like three or four times," he said. "When it was all done, half my heart muscle was dead." </p><p>That's when doctors decided the only way to save him was with a heart transplant. "I figured I was a cooked goose," Hank said. </p><div class="clear" style="font-weight: 600;"><p>I never thought that we would face anything like that. Hank was very, very lucky, because he was critical. He didn't have much time left. He had very little functioning heart muscle left.</p><p><span>Darlene Mihelcic, wife of 30-year heart transplant survivor </span></p></div><p>Hank waited four days for a new heart after being placed on the waiting list. Doctors kept his weakened heart going with a pacemaker; first a temporary one and then a permanent one. </p><p>"The very morning they were placing a pacemaker in my shoulder the heart arrived. It came from Milwaukee," he said. </p><p>Darlene was scared. "I never thought that we would face anything like that," she said. "Hank was very, very lucky, because he was critical. He didn't have much time left. He had very little functioning heart muscle left." </p><p>On May 13, 1986, Hank had a successful heart transplant and went home nine days later. </p><h3>30 years later <span data-value="252"> </span></h3><p>Hank and Darlene have been married for 56 years. They are busy for two retirees. Hank spends his days surfing the Internet, walking and doing yard work. </p><p>He admits the yard work is getting harder. "Things are slowing down, but we still do all of our own stuff," Hank said.</p><p>He doesn't smoke anymore. In fact he quit the day of his heart attack. "I never smoked again,'' he said.</p><p>Hank takes pride in his military service and proudly shows off photos from his 25 years in the Air Force. One photo shows Hank with a flight crew in front of a B-52G Bomber. He was a navigator while serving as a second lieutenant.</p><p>He's also fond of his time as a coal miner, railroad telegrapher, insurance salesman and real estate agent. </p><p>Their home in a quaint neighborhood near Douglas School in Belleville is filled with photos of loved ones including their three sons, five grandchildren and one great grandchild. </p><div class="clear" style="font-weight: 600;"><p>I have kept up the regimen of medication faithfully to the best of my ability. I only missed a few times. ... That's probably the main reason I'm still alive.</p><p><span>Hank Mihelcic, Belleville resident who had a heart transplant </span></p></div><p>Hank takes a handful of pills in the morning and evening, including immunosuppressant medication to help prevent his body from rejecting his donor heart. </p><p>"I have kept up the regimen of medication faithfully to the best of my ability," he said. "I only missed a few times. ... That's probably the main reason I'm still alive." </p><p>Hank said Darlene — "the world's greatest nurse" — keeps him on track and takes good care of him. She's a retired registered nurse who worked at Memorial Hospital in Belleville. "I'm not afraid to use supplements either," Hank said.</p><p>Darlene, who is 85, had high praise for her husband. "This is an amazing man," she said. </p><p>"Oh listen to that," Hank chimed in. </p><p>"As a nurse I'm saying that, not as your wife," Darlene said. "He has had no rejection; he has had no problems." </p><p>Hank's strong genes also have helped, she said.</p><h3>Lifelong friends <span data-value="252"> </span></h3><p>Hank visits the heart transplant team at Barnes once a year for a check-up.</p><p>Hank and his heart transplant nurse coordinator Cindy Pasque look forward to seeing each other on those visits. Pasque has worked with Hank the last 29 years. </p><p>"We've become pretty good friends," Hank said. "Whenever I need anything I send her an e-mail or a phone call. We get along just fine." </p><p>Pasque said heart transplant team members are available to patients and try to answer their questions or concerns.</p><p>"We know them quite well. We follow them for life," Pasque said. "You get to see these patients over their course of their life. You get to help them and be a part of their family as well."</p><p>She says Hank and his family have had a lot to do with his successful recovery over the years.</p><p>"His great attitude has gotten him through the issues along with his supportive family," Pasque said. "People like him are what makes our job so worthwhile. Hank has done really well. He's done everything he's supposed to do to take care of himself for the last 30 years, and he's watched his children become successful and his grandchildren grow."</p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-48839516545065698162016-08-05T10:40:00.001-07:002016-08-05T10:41:22.203-07:00Weight Has Greater Impact on Diabetes Than Heart Disease - NYTimes.com<div><base href="http://mobile.nytimes.com/blogs/well/2016/08/04/weight-has-greater-impact-on-diabetes-than-heart-disease/?partner=rss&emc=rss&referer="><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Weight Has Greater Impact on Diabetes Than Heart Disease - NYTimes.com</title><div class="original-url"><br><a href="http://mobile.nytimes.com/blogs/well/2016/08/04/weight-has-greater-impact-on-diabetes-than-heart-disease/?partner=rss&emc=rss&referer=">http://mobile.nytimes.com/blogs/well/2016/08/04/weight-has-greater-impact-on-diabetes-than-heart-disease/?partner=rss&emc=rss&referer=</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Weight Has Greater Impact on Diabetes Than Heart Disease</h1><div class="leading-image"><img src="https://cdn1.nyt.com/images/2016/08/05/science/wellweight/wellweight-jumbo.jpg"></div><p>Carrying excess weight may have a greater impact on the risk for diabetes than it does on the risk for heart disease or early death, a new study has found.</p><p>To look at the effect of obesity independent of genetics, Swedish researchers followed 4,046 pairs of identical twins whose average age was 58. One of the twins was overweight, and the other was not. Since identical twins have the same genes, their weight difference could not be attributed to genetics. The <a href="http://archinte.jamanetwork.com/article.aspx?articleid=2540539">study is in JAMA Internal Medicine.</a></p><p>After accounting for physical activity, smoking and educational level, the researchers found that having a higher body mass index, or B.M.I. — even among those in the obese range of 30 or higher — was not associated with an increased risk for heart attack or death. But a high B.M.I. was associated with an increased risk for diabetes.</p><p>"Based on these results, the association between obesity and cardiovascular disease is explained by genetic, not environmental, factors," said the lead author, Peter Nordstrom, a professor of geriatric medicine at Umea University. "Unfortunately, this also means that environmental factors that reduce obesity do not reduce the risk of cardiovascular disease or death. But they most certainly decrease the risk for diabetes."</p></div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-33937112918591776942016-08-02T10:05:00.000-07:002016-08-05T10:41:11.420-07:00Order Lunch Early, Lose Weight Later?<div><base href="http://www.m.webmd.com/diet/news/20160801/order-lunch-early-lose-weight-later?src=RSS_PUBLIC"><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Order Lunch Early, Lose Weight Later?</title><div class="original-url"><br><a href="http://www.m.webmd.com/diet/news/20160801/order-lunch-early-lose-weight-later?src=RSS_PUBLIC">http://www.m.webmd.com/diet/news/20160801/order-lunch-early-lose-weight-later?src=RSS_PUBLIC</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Order Lunch Early, Lose Weight Later?</h1> <h3> </h3> <p>By Robert Preidt</p> <p xmlns:xalan="http://xml.apache.org/xalan"> <i>HealthDay Reporter</i> </p> <h3></h3> <p>MONDAY, Aug. 1, 2016 (HealthDay News) -- You might be able to cut your calorie intake by ordering meals before you're actually hungry, a new study suggests.</p> <p>Researchers examined the lunch orders of 690 employees using a corporate cafeteria and 195 university students choosing catered lunch options.</p> <p>The participants selected high-calorie meals when they ordered their lunches immediately before eating, but lower-calorie meals when they placed their orders an hour or more before lunch.</p><article class="clear"><a href=" http://www.m.webmd.com/food-recipes/news/20160404/berries-nutrition-perks "><span><img src="http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/article_thumbnails/other/generic_nutrition_and_healthy_eating_5_other/69x75_generic_nutrition_and_healthy_eating_5_other.jpg"></span><span><h3>Berries: Big Health Benefits in Small Packages </h3><p><span> </span><span> </span></p></span></a></article> <p>The findings suggest a new way to combat the <a href="http://www.m.webmd.com/diet/features/am-i-obese">obesity</a> epidemic in the United States, according to the researchers.</p> <p>"Our results show that ordering meals when you're already hungry and ready to eat leads to an overall increase in the number of calories ordered, and suggest that by ordering meals in advance the likelihood of making indulgent purchases is drastically reduced," said study author Eric VanEpps. He is a postdoctoral researcher in the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania.</p> </div><div class="page"> <h3> </h3> <p>"The implication is that restaurants and other food providers can generate health benefits for their customers by offering the opportunity to place advance orders," he said in a university news release.</p> <p xmlns:xalan="http://xml.apache.org/xalan">"These findings provide one more piece of evidence that decisions made in the heat of the moment are not as farsighted as those made in advance," said study senior author George Loewenstein, a professor of economics and <a href="http://www.m.webmd.com/a-to-z-guides/guide-to-psychiatry-and-counseling">psychology</a> at Carnegie Mellon University in Pittsburgh.</p> <p>"For example, people who plan to practice <a href="http://www.m.webmd.com/a-to-z-guides/safe-sex-preventing-hiv-aids-stds">safe sex</a> often fail to do so when caught up in the act, and people who, in dispassionate moments, recognize the stupidity of road rage nevertheless regularly succumb to it. Unfortunately, pre-commitment strategies are more feasible when it comes to diet than to many other 'hot' behaviors," Loewenstein noted.</p> <p>The findings were published recently in the <i>Journal of Marketing Research</i>.</p> </div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-43259725611066531392016-07-29T14:42:00.001-07:002016-07-29T14:43:00.318-07:00Do Compression Sleeves Help With Muscle Recovery? - NYTimes.com<div><base href="http://mobile.nytimes.com/blogs/well/2016/07/29/do-compression-sleeves-help-with-muscle-recovery/?partner=rss&emc=rss&referer="><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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margin-right: 6px; padding-left: 16px; } blockquote:not(.simple) { border-left: 3px solid rgba(0, 0, 0, 0.1); } /* Collapse excess whitespace. */ .page p > p:empty, .page div > p:empty, .page p > div:empty, .page div > div:empty, .page p + br, .page p > br:only-child, .page div > br:only-child, .page img + br { display: none; } .page table { font-size: 0.9em; text-align: start; word-wrap: break-word; border-collapse: collapse; } .page table td, .page table th { padding: 0.25em 0.5em; border: 1px solid rgb(216, 216, 216); } .page table th { background-color: rgba(0, 0, 0, 0.025); } .page sup, .page sub { line-height: 1; font-size: 0.75em; } .hidden { display: none; } /* Fonts */ body.system { font-family: -apple-system-font; } body.athelas { font-family: Athelas; } body.charter { font-family: Charter; } body.georgia { font-family: Georgia; } body.iowan { font-family: 'Iowan Old Style'; } body.palatino { font-family: Palatino; } body.seravek { font-family: Seravek; } body.times { font-family: 'Times New Roman'; } body.yugothic { font-family: 'YuGothic'; } body.yumincho { font-family: 'YuMincho'; } body.hiraginokaku { font-family: 'Hiragino Kaku Gothic ProN'; } body.hiraginomincho { font-family: 'Hiragino Mincho ProN'; } body.hiraginomaru { font-family: 'Hiragino Maru Gothic ProN'; } body.heitisc { font-family: 'Heiti SC'; } body.songtisc { font-family: 'Songti SC'; } body.kaitisc { font-family: 'Kaiti SC'; } body.yuantisc { font-family: 'Yuanti SC'; } body.heititc { font-family: 'Heiti TC'; } body.songtitc { font-family: 'Songti TC'; } body.kaititc { font-family: 'Kaiti TC'; } body.applesdgothicneo { font-family: 'Apple SD Gothic Neo'; } body.nanumgothic { font-family: 'NanumGothic'; } body.nanummyeongjo { font-family: 'NanumMyeongjo'; } body.khmer { font-family: 'Khmer MN'; } body.khmersangnam { font-family: 'Khmer Sangnam MN'; } body.lao { font-family: 'Lao MN'; } body.laosangnam { font-family: 'LaoSangnam MN'; } body.thonburi { font-family: 'Thonburi'; } body.kailasa { font-family: 'Kailasa'; } body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Do Compression Sleeves Help With Muscle Recovery? - NYTimes.com</title><div class="original-url"><br><a href="http://mobile.nytimes.com/blogs/well/2016/07/29/do-compression-sleeves-help-with-muscle-recovery/?partner=rss&emc=rss&referer=">http://mobile.nytimes.com/blogs/well/2016/07/29/do-compression-sleeves-help-with-muscle-recovery/?partner=rss&emc=rss&referer=</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Do Compression Sleeves Help With Muscle Recovery?</h1><div class="leading-image"><img src="https://cdn1.nyt.com/images/2016/07/28/science/wellmeb/wellmeb-articleLarge.jpg"></div><p><strong>Question:</strong></p><p>Do compression sleeves help with muscle recovery?</p><p><strong>Answer:</strong></p><p>Compression sleeves and garments probably do help muscles recover after exhausting exercise, new research suggests. But they also have certain downsides that may discourage some of us from wearing them.</p><p>When the Summer Olympics start this week, viewers will see many track-and-field and other athletes sporting stretchy tubes of fabric on their arms, thighs or calves. These garments fit like sausage casings and are said to increase the flow of blood through muscles, potentially improving athletic performance and speeding recovery after workouts.</p><p>The evidence to support some of the claims for compression sleeves is scant, however. Most recent studies indicate that compression sleeves do not boost blood flow through muscles during exercise, probably because the movement of blood when we are exercising is already at its peak.</p><p>Similarly, while many athletes report that exercise feels easier when they wear compression clothing, those athletes perform about the same whether they wear the garments or not, according to a new review of studies of compression clothing and running that was published in April in Sports Medicine.</p><p>On the other hand, compression garments do seem to significantly aid muscles' recovery once strenuous exercise is over, says Billy Sperlich, a professor of sport science at the University of Würzburg in Germany who was a co-author of the new review. The garments can augment the movement of blood through muscles after exercising, when blood flow would otherwise slow, he says. This increase in circulation may help flush away some of the biochemical byproducts of hard workouts, like lactate, he says, reducing inflammation and muscle aches.</p><p>But to provide these benefits, compression clothing must be quite tight, which some people find uncomfortable, Dr. Sperlich says. The garments must also be worn for several hours after a workout, even if they become clammy and malodorous.</p><p>The upside is that when finally freed from these casings, he says, your muscles should "have less pain" than if they had not been squeezed at all.</p></div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0tag:blogger.com,1999:blog-2228397678453065134.post-19558712075373281772016-07-28T10:02:00.001-07:002016-07-28T10:03:36.151-07:00Can Statins Cause Diabetes? - NYTimes.com<div><base href="http://mobile.nytimes.com/blogs/well/2016/07/22/can-statins-cause-diabetes/?partner=rss&emc=rss&referer="><style id="article-content"> h1, h2, h3, h4, h5, h6 { font-weight: bold; } h1 { font-size: 1.25em; line-height: 1.4em; } h2 { font-size: 1.125em; } h3 { font-size: 1.05em; } h4, h5, h6 { font-size: 1em; margin: 1em 0; } h1.title { text-align: start; -webkit-hyphens: manual; margin-bottom: 1em; } .title { display: none; } :nth-child(1 of .page) .title { display: block; } .page { text-align: start; word-wrap: break-word; } .page.rtl { direction: rtl; } a { color: rgb(65, 110, 210); text-decoration: none; } #article { text-rendering: optimizeLegibility; } #article * { /* Scale down anything larger than our view. 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} body.geezapro { font-family: 'Geeza Pro'; } body.kefa { font-family: 'Kefa' } body.arialhebrew { font-family: 'Arial Hebrew' } body.mshtakan { font-family: 'Mshtakan' } body.plantagenetcherokee { font-family: 'Plantagenet Cherokee' } body.euphemiaucas { font-family: 'Euphemia UCAS' } body.bangla { font-family: 'Bangla Sangam MN' } body.gujarati { font-family: 'Gujarati Sangam MN' } body.gurmukhi { font-family: 'Gurmukhi MN' } body.devanagari { font-family: 'Devanagari Sangam MN' } body.kannada { font-family: 'Kannada Sangam MN' } body.malayalam { font-family: 'Malayalam Sangam MN' } body.oriya { font-family: 'Oriya Sangam MN' } body.sinhala { font-family: 'Sinhala Sangam MN' } body.inaimathi { font-family: 'InaiMathi' } body.tamil { font-family: 'Tamil Sangam MN' } body.telugu { font-family: 'Telugu Sangam MN' } @media print { body { margin: 2mm 9mm; line-height: 1.5em; font-family: -apple-system-font; } .original-url { display: none; } a { text-decoration: underline; } } </style><title>Can Statins Cause Diabetes? - NYTimes.com</title><div class="original-url"><br><a href="http://mobile.nytimes.com/blogs/well/2016/07/22/can-statins-cause-diabetes/?partner=rss&emc=rss&referer=">http://mobile.nytimes.com/blogs/well/2016/07/22/can-statins-cause-diabetes/?partner=rss&emc=rss&referer=</a><br><br></div><div id="article" role="article" style="-webkit-locale: en;"> <!-- This node will contain a number of div.page. --> <div class="page"><h1 class="title">Can Statins Cause Diabetes?</h1><div class="leading-image"><img src="https://cdn1.nyt.com/images/2012/10/23/health/well_diabetes/well_diabetes-articleLarge.jpg"></div><p><strong>Question:</strong></p><p>Is it true that prolonged use of Lipitor-type drugs can cause diabetes?</p><p><strong>Answer:</strong></p><p>It's true. All medications have side effects, and numerous studies have shown that cholesterol-lowering statin drugs are linked to a small increase in the risk of Type 2 diabetes, even as they reduce the risk of heart attacks. </p><p>The higher the dose of a statin, the greater the diabetes risk, said Dr. Eric Topol, director of the Scripps Translational Science Institute and chief academic officer at Scripps Health. But many heart doctors, including Dr. Mary Norine Walsh, president-elect of the American College of Cardiology, say concern about diabetes should not deter patients from taking statins "if you fall into the higher risk category" for heart disease.</p><p>On the other hand, someone who has never had heart disease and who has high cholesterol but no other risk factors is less likely to derive benefit from a statin drug while still facing the risk of diabetes, Dr. Topol said, adding, "There you have a very tight benefit-to-risk ratio."</p><p>The Food and Drug Administration updated its advisory about statins in 2012 to include warnings about the slightly increased risk of higher blood sugars and Type 2 diabetes, based in part on two large analyses of earlier studies that controlled for diabetes risk factors like being overweight or being older. <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=sattar%2C+preiss%2Cstatins%2C+diabetes%2C+2010">One found a 9 percent increase</a> in the risk of diabetes among statin users, and the <a href="http://www.ncbi.nlm.nih.gov/pubmed/21693744">other a 12 percent increase</a>, with a greater risk for those on intensive rather than moderate doses of the drugs.</p><p>The <a href="http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm293330.htm#3">2012 F.D.A. advisory</a> also warns of other side effects of statins, such as muscle injury, rare cases of liver damage and reports of memory loss and confusion.</p><p>"<b>You and your physician need to be aware of risks," said Dr. Walsh, and you may want to be assessed for diabetes. But she said, "It is not a reason not to take a statin if you fall into the higher risk category. The overall benefit of statins for people who need them because of their cardiovascular risk far exceeds the risk of diabetes."</b></p><p><br></p></div></div></div><div></div>Dr Portnayhttp://www.blogger.com/profile/06403411164707417324noreply@blogger.com0