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Cardio Metabolic Health Congress – Official Blog

The Co-Occurrence of Diabetes & Heart Disease

The number of people living with diabetes has tripled since 2000, leading to enormous financial ramifications: the global cost of the disease is $850 billion each year. The latest estimates from the International Diabetes Federation indicate that one in 11 adults worldwide have diabetes; most have type 2 diabetes, which is strongly linked to obesity and lack of exercise. There is a strong link between type 2 diabetes and cardiovascular disease, as people with diabetes are more than twice as likely to develop cardiovascular disease and lower life expectancy.

According to a study presented at the American Heart Association’s Scientific Sessions last week, data indicates that children and young adults with diabetes mellitus have a fivefold increased risk of all-cause mortality, and a sevenfold increased risk of sudden cardiac death, compared with age-matched individuals without diabetes. The findings highlight the critical need for continuous cardiovascular risk monitoring and management in young people with DM.

Less than half of those diagnosed with diabetes are aware that the diseases places them at a much higher risk for cardiovascular disease complications; the lack of awareness prevents addressing risks and improving health–often leading to preventable deaths. Ken Thorpe, Chairman of the Partnership to Fight Chronic Disease, urges education and the power of prevention. “We must do better to diagnose, treat, and prevent chronic conditions like diabetes and cardiovascular diseases, and one of the first and most important actions we can take is to raise awareness among patients, providers, and policymakers of the alarming co-existence of these two debilitating conditions, and what can be done to avoid them in the first place.”

The total number of diabetes worldwide is now 451 million, and is expected to reach 693 million by 2045 if current trends continue.

New Guidelines for High Blood Pressure

According to a joint statement issued Monday by the American Heart Association and the American College of Cardiology, nearly half of all adult Americans will be considered to have high blood pressure under new guidelines. “The numbers are scary,” said Dr. Robert M. Carey, professor of medicine at the University of Virginia and co-chair of the committee that formulated the new guidelines.

The nation’s leading heart experts state that tens of millions more Americans will now meet criteria for the condition of high blood pressure, as the redefinition is now a reading of 130 over 80, down from 140 over 90. The number of adults with high blood pressure, or hypertension, will rise to 103 million from 72 million under the previous standards—meaning that 46% of U.S. adults will be considered hypertensive.

Carey states that the reformulation stems from the recognition that blood pressure considered ‘normal’ in the past—or ‘pre-hypertensive’—actually placed patients at significant risk for heart disease and death and disability, as medical evidence confirms that people with high blood pressure in the 130-139 range carry a doubled risk of heart attack, stroke, and heart and kidney failure. “The risk hasn’t changed. What’s changed is our recognition of the risk.”

Nevertheless, the report’s authors predict that few of those who fall into the new hypertensive category will require medication. Rather, the hope is that many with early stages of the condition will address it through lifestyle changes, including weight loss, diet improvements, increased physical activity, less alcohol and sodium consumption, and lowered stress. “An important cornerstone of these new guidelines is a strong emphasis on lifestyle changes as the first line of therapy. There is an opportunity to reduce risk without necessarily imposing medications,” said Richard Chazal, the immediate past president of the American College of Cardiology.

High blood pressure is the leading cause of death worldwide, and the second-leading cause of preventable death in the United States, after cigarette smoking. Hypertension is often a precursor for cardiovascular disease, strokes, severe kidney disease, and other disorders that kill millions annually. Thomas R. Frieden, the former director of the U.S. Centers for Disease Control and Prevention who now runs a global health initiative that focuses on heart disease and stroke, has called hypertension “the world’s most under-addressed preventable health problem.”

Big Data for Better Hearts

The genomics revolution has brought personalized medicine to cancer and rare diseases; an EU-funded initiative aims to bring cardiovascular care into the genomics era. The €19 million project, funded by the EU’s Innovative Medicines Initiative, was launched in order to apply the power of genomics and big data to cardiovascular health.

The project is a recognition that in the face of the enormous burden of heart failure, atrial fibrillation and acute coronary syndrome, the field lags behind other major disease areas in using genomic and big data to improve patient outcomes.

It is hoped that the outputs will lead to a major revamp of clinical guidelines in cardiology. The researchers involved in BigData@Heart have been instrumental in shaping current treatment and management of heart conditions and there is an emerging consensus that these should be updated to reflect advances in big data.

“Today’s treatment guidelines reflect the scientific constraints of an earlier era where clinical markers to guide therapy were limited to conventional risk factors and end-organ damage, and where the main endpoint in clinical trials is patient death and hospitalization,” said project member Stefan Anker of Charité University Medicine, Berlin. “Our goal is to build a much more personalized, data-driven system that brings cardiology into the ‘omics era.”

While the treatment of cardiovascular diseases has improved vastly in recent decades, the human and economic cost of lost productivity, hospitalization and death remains substantial, said Maureen Cronin of the pharmaceutical company Vifor Pharma, a co-lead of the project. “Advances in ‘omics have changed how we think about disease but have not been fully embraced in cardiovascular disease. If you look to oncology and rare diseases, there has been much greater progress.”

A simple blood test can help predict the risk of developing breast cancer, or guide doctors in selecting cancer drugs. This more personalized approach to cancer care is the result of decades of genetics research and advances in diagnostic testing. Similarly, genomics is making a major contribution to the diagnosis and treatment of rare diseases.

So for example, the National Health Service in England now makes DNA sequencing of tumors to identify mutations against which there are targeted drugs, an integrated part of clinical care. In inherited rare diseases, the genomes of patients are being sequenced in order to try and reach a diagnosis and to inform treatment. Cancers and rare diseases are amenable to this approach because in most cases they are driven by mutations. Cardiovascular diseases, in contrast, tend to have more heterogeneous etiologies, and patients often have comorbidities.

“In cardiovascular conditions, there is most likely a genetic component but the relative roles of genetics, comorbidities, such as hypertension, diabetes or kidney disease and risk factors, such as exercise and diet are not yet fully elucidated,” said Folkert Asselbergs of UMC Utrecht and University College London. “This complicates our understanding of a patient’s prognosis.”

However, advances in computing power and the availability of large patient data sets could allow researchers to build algorithms that take account of a patient’s genes, lifestyles and other chronic illnesses. Ultimately, said Asselbergs, this would pave the way for a more individualized and efficient approach to therapy.

BigData@Heart is one of four disease-specific projects exploring how to use patient information to improve outcomes being funded by IMI. The €5.3 billion collaboration between the pharmaceutical industry and the European Commission is designed to speed up drug discovery and development, through investments in research infrastructure, streamlining clinical trials processes and promoting data sharing.

“Thanks to this public-private partnership approach, BigData@Heart has access to most of the relevant large-scale European cardiovascular disease databases, ranging from electronic health records and disease registries to clinical trials and large epidemiological cohorts,” said Rick Grobee, UMC Utrecht and academic leader of the project. “This brings together data from more than five million cases of atrial fibrillation, heart failure and acute coronary syndrome, as well as [that of] over 16 million healthy individuals.”

Building on the experience gained in other IMI projects, the researchers will use machine learning and data mining to design prognosis algorithms that can predict patient outcomes. The system will use an individual’s medical history, along with hospitalization rates and country-specific statistics for similar patients, to advise on the best course of treatment and the likely results.

Along with more tailored use of existing treatments, the consortium hopes to identify new drug targets. The development pipeline for cardiovascular drugs is slow, expensive and high-risk, Cronin noted. “The chance of eventual approval for a cardiovascular disease drug candidate in Phase I trials is 7 per cent, the lowest of any disease category – along with oncology,” she said. “We need better definitions of these diseases, their markers and endpoints, as well as better segmentation of patient populations. In defining disease outcomes, we must listen to patients and take account of what matters to them, including functional capacity and quality of life.”

The project will run to 2022, focusing on six pilot studies and will also address ethical and regulatory issues. Central to this will be finding ways to access patient data while safeguarding personal privacy, and agreeing on the essential elements of electronic patient records. Cronin says getting that right will make or break Europe’s efforts to catch up with the US in the race to unlock the potential of big data in healthcare.

“The US precision medicine initiative is taking these issues seriously,” she says. “In the EU, the complexities of managing data in several countries, each with its own health system, mean there is a lot of catching up to do. We need to be sure that Europe is not left behind.”

Adolescent & Childhood Obesity Reaches All-Time High

The number of obese children and adolescents rose to 124 million in 2016: more than 10 times higher than the 11 million classified as obese 40 years ago, in 1975. A further 213 million children and adolescents were overweight in 2016, finds a new study published Tuesday in the Lancet.

Looking at the broader picture, this equated to roughly 5.6% of girls and 7.8% of boys being obese last year. Most countries within the Pacific Islands, including the Cook Islands and Nauru, had the highest rates globally, with more than 30% of their youth ages 5 to 19 estimated to be obese.

The United States and some countries in the Caribbean, such as Puerto Rico, as well as the Middle East, including Kuwait and Qatar, came next with levels of obesity above 20% for the same age group, according to the new data, visualized by the NCD Risk Factor Collaboration.

“Over the past four decades, obesity rates in children and adolescents have soared globally, and continue to do so in low- and middle-income countries,” said Majid Ezzati, professor of global environmental health at Imperial College London in the UK, who led the research. “More recently, they have plateaued in higher-income countries, although obesity levels remain unacceptably high,” he said.

Over the same time period, the rise in obesity has particularly accelerated in East and South Asia. “We now have children who are gaining weight when they are 5 years old,” unlike children at the same age two generations ago, Ezzati told CNN.

In the largest study of its kind, more than 1,000 researchers collaborated to analyze weight and height data for almost 130 million people, including more than 31 million people 5 to 19 years old, to identify obesity trends from 1975 to 2016.

“Rates of child and adolescent obesity are accelerating in East, South and Southeast Asia, and continue to increase in other low and middle-income regions,” said James Bentham, a statistician at the University of Kent, who co-authored the paper.

Obesity in adults is defined using a person’s body mass index, the ratio between weight and height. A BMI of 18.5 to 24.9 is classified as a healthy weight, 25 to 29.9 considered overweight and 30 and over obese. Cut-offs are lower among children and adolescents and vary based on age.

“While average BMI among children and adolescents has recently plateaued in Europe and North America, this is not an excuse for complacency as more than one in five young people in the U,S. and one in 10 in the UK are obese,” he said.

Being obese as a child comes with a high likelihood of being obese as an adult and the many health consequences that come with it, including the increased risk of diabetes, cardiovascular disease and some cancers. The potential for these chronic conditions into adulthood also puts an increased burden on health systems — and financial constraints on individuals.

“We are seeing very worrying trends with pediatricians who have children come in as young as 7 with type 2 diabetes,” said Temo Waqanivalu, programme officer for population-based prevention of non-communicable diseases at the World Health Organization. WHO co-led the research with Imperial College London.

African-Americans More Likely to Die from Cardiovascular Disease

According to the American Heart Association, African Americans experience significantly worsened cardiovascular health, and thus face greater mortality rates from heart disease. African Americans die an average of 3.4 years before white Americans, a gap largely attributable to prevalent cardiovascular disease and risk factors. Recent publication of a scientific statement from the organization reads: “The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites.”

Dr. Mercedes R. Carnethon from Northwestern University Preventive Medicine in Chicago states that traditional cardiovascular risk factors—including high blood pressure, diabetes, obesity, and atherosclerosis—are not only more common among African Americans, but also manifest at relatively young ages. Data indicates that high blood pressure is diagnosed in 13.8 percent of black children, compared to 8.5 percent in white children. The risk of persisting hypertension in black adults, throughout adulthood, is 1.5 times higher than in whites. “Interrupting this process by preventing the early onset of cardiovascular diseases is one strategy to reduce disparities in cardiovascular disease mortality,” Dr. Carnethon writes.

The research team at the American Heart Association notes that circumstances have remained fairly stagnant since 2005; relatively little has changed since 2005, when the same journal pointed to disparities in the rates of cardiovascular disease, disease management, and outcomes for African Americans. While genetic differences between African Americans and other groups do not account for the disparities in cardiovascular disease rates and outcomes, many of the variances arise from “unhealthy behaviors, lower implementation of guidelines shown to improve cardiovascular health, ingrained cultural preferences and attitudes, and lack of persistence in following lifestyle changes that need to be lifelong.”

While Dr. Carnethon’s team notes that cardiovascular disease is often preventable through the implementation and continued practice of a healthy, nutritious lifestyle, she discusses the difficulties faced by many African Americans—particularly those in lower income groups—in accessing the necessary resources to lead healthy lifestyles: specifically, access to healthful foods, safe spaces for physical activity and exercise, and homes that allow for restorative sleep. Moreover, she argues that despite the strides our country has made in broadening access to healthcare, many African-Americans are still unable to afford and prioritize preventive care visits.

Dr. LaPrincess Brewer from the Mayo Clinic in Rochester, Minnesota has continuously worked to promote cardiovascular health in African-American communities, promotes “culturally relevant, community-based cardiovascular health interventions that focus more on positive motivation towards promoting cardiovascular health rather than the negative impact of cardiovascular disease.” Through increased awareness, and a collective, collaborative effort on the part of clinicians, public health workers, researchers, social services, and community stakeholders, the high burden of traditional risk factors among African Americans can be addressed—in tandem with the inherent social and environmental contextual barriers faced by this specific population.

Trick-Or-Jump

A recent article[1] revealed what happens if you frequently visit your office’s Halloween candy stash, or you eat your kid’s leftover Trick-Or-Treat candies…

Jumping Jacks. 

Lots and lots of them, if you want to burn off what you ate! Although Halloween candies often come in smaller, “mini” versions of the regular candy sizes, they are all still packed with calories and sugar.

The article provided this handy but SCARY chart* (how appropriate for Halloween), which shows us just how many minutes of jumping jacks you need to do in order to fight off the evil Halloween candy you consume…

*Calculations based on a 150-pound woman

[1] Popsugar. Sugar, Jenny. “This Is How May Jumping Jacks You Need to Do to Work Off Halloween Candy.” https://www.popsugar.com/fitness/How-Burn-Off-Halloween-Candy-42393489?utm_source=facebook.com&utm_medium=social&utm_campaign=popsugar.com. October 29, 2017. Accessed October 30, 2017.

“Eat your breakfast! It’s the most important meal of the day!” -Your Mom (and Science).

First your mom told you, and now, science is nodding—your mom is always right.

A link between skipping breakfast and poor cardiovascular health has now been researched and proven.

A recent study1 consisted of 4,052 middle-aged female and male participants with no previous history of cardiovascular disease. The study researchers also collected information on the cholesterol levels, physical activity, body mass index, and smoking status of all study participants. All participants were told to take note of what they had eaten along with the specific times they had eaten these items.

Imaging techniques were used to study the buildup of fatty material in the arteries around the heart and neck. Compared to those participants who consumed more than 20% of their daily calories at breakfast time, the participants who had tiny breakfasts or who skipped breakfast altogether, were found to have a greater extent of artery buildup which means their risk of heart attacks and strokes is increased.

Sub-clinical atherosclerosis (the buildup of fat) was found in 75% of those who skip breakfast Even when high blood pressure, smoking or other factors were taken into account, the link between skipping breakfast and poor cardiovascular health was evident throughout the study results.

What was interesting aside from JUST skipping breakfast, the participants who were breakfast skippers were also more likely to lead a lifestyle that was unhealthy overall. These breakfast skippers also maintained a poor diet, were usually smokers, and found to drink alcohol frequently. “Perhaps skipping breakfast is not what is to blame for heart disease. It seems to be a poor lifestyle that is causing the heart disease; and simultaneously also making people MORE likely to skip out on breakfast.”

In conclusion, healthier people are more likely to actually eat breakfast.

What the researchers in this study found is that people who skipped breakfast were likely doing so in an unhealthy way in order to lose weight. This would explain why the rate of obesity was higher in those who skipped breakfast. Apparently, the breakfast skipping caused an odd consumption of calories at strange times during the day and disrupted a good “pattern of eating.”

The study participants will be followed for 10 more years in order to determine how arterial disease progresses, with the hope that we could glean a better idea of this link between poor cardiovascular health and skipping the first meal of the day.

The question is really not only about whether you are a breakfast eater or breakfast skipper. It is really about how that choice begins your path to other choices for healthy options during the rest of your 24 hours!

If you are trying to be healthy or to actually lose weight, you should keep an eye on your consumption but be diligent as to what food you are eating throughout your day; instead of trying to get rid of a meal (or calories) in the beginning of the day. It’s never a good idea for us to skip our meals, so do yourself a favor and eat at regular times. Listen to your mom!

Do you have patients that skip meals? Do YOU skip meals as a busy practitioner?
If you are interested in CME education on cardiovascular health and how to get YOUR patients some more help with their nutrition and lifestyles, visit us at CMHC West in May!

1Metro.co.uk. Scott, Ellen. http://metro.co.uk/2017/10/03/people-who-skip-breakfast-could-have-an-increased-risk-of-heart-disease-6972641/. October 3, 2017. Accessed October 26, 2017

I’m an athlete. I can’t have a heart attack.

If you’ve ever thought, “I exercise so I shouldn’t have any heart issues”—this is for you.

135 people have died from sudden heart attacks during triathlons in the US from 1985 until 2016 (just last year) according to a recent Internal Medicine study1.
To continue our blog theme about raising awareness of cardiac arrest and heart attack symptoms, we continue by sharing some scary statistics such as the one above. Even serious athletes are not immune to heart conditions and heart-related deaths.

The Facts

• 67 percent of these deaths occurred during the swimming portion of the triathlon (usually the first part of a triathlon)
• 85 % of the deaths were men
• In men, the risk increased substantially with age (risk was way higher for men 60 years old and older)

The Causes

Not warming up that well: The researchers commented that warming up properly could play into the cause of these heart-related deaths. By not adequately warming up, it puts an extra strain on your heart as a competitor in a serious race like a triathlon.

Denial: Denial is probably the most serious issue of them all. And in reality, most athletes lean towards denial of health issues since they have taken active steps (literally) towards being healthy.

The Coach of the Rocky Mountain Triathlon Club, Charles Perez was interviewed in a recent article about this study and he shared “once we get over 40, we start to get into denial very, very quickly. I know myself that was very true. When I first started noticing these heart arrhythmias I was in total denial this can’t be true – I’ve been running my whole life and there’s no way I can be having any sort of heart issues. It took a long time before I finally went into the doc and had it checked out and went to a heart specialist and they told me exactly what I had and gave me some options on what I could do for it.” Mr. Perez had been competing in endurance races for over 20 years when he developed Supraventricular Tachycardia which he had surgery for in 2001.

The great news is that he recovered and was able to continue doing triathlons. What we learned from all this is that we should never be in denial no matter what our regular level of exercise is.

What to look for?

They call heart disease the “silent killer” for a reason.

Heart issues often don’t have symptoms and can appear suddenly. You don’t know if you’ve got hardening of your arteries until you have what is referred to as an “event.”

By exerting your body to its highest level, a triathlon is truly like a stress test and can aggravate things to the point that an event can occur.

Signs/Symptoms may include:

• feeling dizzy
• feeling light-headed
• shortness of breath
• chest pains
• a rapid heartbeat

If it’s so SILENT, how do we try to prevent it?

According to editorialists at The New England Journal of Medicine, “Although pre-participation screening may not be popular in this older group of athletes, education (especially men over 40) about the signs and symptoms of cardiovascular disease (including the use of performance-enhancing drugs) and the need for proper medical attention is warranted.”

A physical exam by your physician if you are over 40 is not a bad idea before you start training for an endurance race of any kind.

And don’t get lazy. As we have seen with the statistics above, someone who is in good physical condition and has been involved in endurance events/races for many years can STILL be at risk for heart issues. Therefore, follow up appointments throughout your training are also important.

In conclusion—get educated and get checked regularly!

And most importantly, next time you think that because you are an avid jogger or swimmer, or that because you go to the gym that you may be immune from any kind of heart-related issues, think again. If you are a physician or healthcare practitioner and want to further your cardiology knowledge to help your patients avoid cardiac events, visit us at The Wynn in Las Vegas for our CMHC West event May 4-5, 2018! If you would like to stay aware of signs or symptoms, check out our recent blog about risk factors or visit the The American Heart Association’s website.

1Annals of Internal Medicine. http://annals.org/aim/article/2654457/death-cardiac-arrest-u-s-triathlon-participants-1985-2016-cas. September 19, 2017. Accessed October 17, 2017.
2KUSA 9News. Erica Tinsley. Heart attacks killing triathletes during race. http://www.9news.com/news/local/study-heart-attacks-killing-triathletes-during-race-1/477472167. September 20, 2017. Accessed October 17, 2017.

Eating your way OUT of a heart attack

A couple days ago, we shared the difference between a cardiac arrest and a heart attack with you.
We also shared that even though they are different things, they do share the SAME risk factors.
What we want to share with you today, is the good news: many of these risk factors can be eliminated.

The Facts

According to the CDC, every year about 735,000 Americans have a heart attack.1

“Heart disease needs urgent intervention. And that intervention, it is increasingly getting clear, has to be a lifestyle and diet makeover” according to Kenneth Thorpe, chairman at Partnership to Fight Chronic Disease (PFCD).2

But I’m young…

Studies have noted a marked increase in the number of young patients suffering from heart attacks.

A recent article shared a story about a 29-year-old marketing and sales professional who had suffered a heart attack. He had no family history of a heart attack.

What they did report however was that this patient’s lifestyle included heavy smoking, not enough exercise, and that he was overweight. In 2011, this same patient had a second heart attack, followed by a third in 2013. He failed bypass surgery, and ended up undergoing a heart transplant in August last year at the young age (in our opinion) of 45 years old.

In the past year, he has lost approximately 70 pounds. Abhay Singh, was 205 lbs. at the time of his first heart attack. Before his heart transplant he shot up to 253lbs.

Mr. Singh, now 46 years old and 182 lbs., leads a normal life. However, it is a different life from before.

He has to exercise every day, drink and smoke minimally, not eat as much salt, and also must keep a close eye on his lipid profile.

Listen to your body

At 29 years old, Mr. Singh thought his first heart attack was just indigestion.

When he finally got to the doctor 12 hours later, his heart had sustained significant damage.

Manage your DIET
A study published in the Journal Of The American Medical Association (JAMA) in March 2017 shows that a large percentage of deaths due to cardiovascular disease and diabetes are linked to a poor diet.

According to the study, 10 foods/nutrients associated with cardiometabolic diseases are fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats (refined oils, hydrogenated fats, etc.), sugar-sweetened beverages (SSBs), polyunsaturated fats (PUFA), seafood omega-3 fats and sodium.

NO MORE SALT
Excess sodium intake (too much salt) was connected to the highest proportion of heart disease (it was associated in 9.5% of deaths). It has been proven that high-salt diets increase blood pressure and the risk of heart disease extensively. Research (3) has found that those of us who consumed more than 13.7g of salt daily had a two times higher risk of heart failure compared to those who consumed less than 6.8g. “The World Health Organization recommends a maximum of 5g per day.” says Dr. Sundeep Mishra, professor of cardiology, All India Institute of Medical Sciences (AIIMS). Scary but true, the majority of us ingest more than 10 times the amount of salt we need to meet our sodium requirements.

Other top-of-the-list dietary patterns affecting heart health were low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%) and low fruit and vegetable intake (7.6 and 7.5%, respectively).

What this proves is that diet matters when it comes to heart disease.

GOOD fat?
Apparently, not all fats are bad, and the kind of fat we eat is a big deal.

“Saturated and trans fats increase blood cholesterol and heart attack rates. PUFA (Polyunsaturated fatty acids) and monounsaturated (MUFA) fats lower the risk of heart attacks,” according to Dr. Simmi Manocha, head of department, non-invasive cardiology, Asian Institute of Medical Sciences, Faridabad.

Most of us have heard of Omega-3’s and apparently they are a type of PUFA that is really beneficial for cardiovascular health. Want proof?

Both plant-based and seafood-based omega-3 lower the risk of fatal heart attacks by about 10% according to a study by Tufts University, US. The researchers also found that Fish, walnuts and flaxseed oil are the best sources of omega-3.

Are you an apple or a pear?

So according to all of the above, we learned that a poor diet is bad for the heart.

A bad diet can lead to weight gain, and even if you are otherwise considered healthy, gaining weight raises the risk of heart attack by over a quarter!

Even if you have healthy blood pressure, blood sugar and cholesterol levels, being overweight or obese increases your risk of coronary heart disease (CHD) by up to 28% compared to those with a healthy bodyweight, according to a study published in the European Heart Journal.

A person who carries the bulk of their body fat around their stomach (an “apple” shaped body) is at greater risk of heart disease than someone whose body fat tends to settle around their bottom, hips and thighs (a “pear” shaped body) according to Dr. Manocha.

SUMMARIZE:

  • Avoid packaged foods
  • Avoid salt
  • Take Omega 3’s
  • Stick to natural, minimal processed foods like nuts or fruits – remember PUFA & MUFA (Polyunsaturated fatty acids and monounsaturated)
  • Keep an eye on your weight (avoid an apple shape)
  • Manage your lifestyle – don’t overdo drinking; try to stop smoking
  • Listen to your body (see a doctor immediately if you feel warning signs)
  • Get educated (that’s where we come in)…

At CMHC, we try to bring the latest science and research in the cardiometabolic space to physicians and allied health professionals like you. Every one of you treats heart health or deals with the risk factors listed in this article. Most of all, we try to get you the most robust education that ties all of this research into what can help YOUR patients, today. A few years ago, we launched CMHC West and are so excited to take it to Las Vegas next year from May 4-5, 2018.

Our 2018 agenda will capture the integrity and high-quality education of the annual CMHC event (that just wrapped up in Boston) as the top U.S. experts in cardiometabolic health will highlight the latest updates in heart failure, diabetes, hypertension, cardiovascular health and lifestyle management. Invest in your education and visit us in Las Vegas – register for only $99 until December 31 when the price increases!

Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131:e29-322.
LiveMint. Are you eating your way to a heart attack? http://www.livemint.com/Science/6UgERyTXiXXdSAgJomm6kL/Are-you-eating-your-way-to-a-heart-attack.html. September 26, 2017. Accessed October 13, 2017.

What the Loss of Tom Petty Taught Us: Cardiac Arrest vs. Heart Attack

We like to tie our blogs to current events and one very sad event was the loss of superstar Tom Petty last week. At the very young age of 66 a seemingly larger-than-life rockstar lost his life to one of the things we have dedicated our mission to here at CMHC.

Tom Petty’s death has aimed a spotlight on a heart condition that strikes suddenly and can kill in minutes. Cardiac arrests kill more than 300,000 Americans every year.

Have you ever used the term “heart attack” when describing a cardiac arrest? Or vice versa?

We are here to tell you that you are not alone. We know many of us have, and this is a blog article to try to help you learn and remember the difference.

Difference Between a CARDIAC Arrest and a Heart Attack. Wait…there is a difference?

A cardiac arrest is triggered by a heart malfunction which causes the heart to stop beating unexpectedly. When the heart stops its pumping action, blood flow to the rest of the body stops.

A heart attack occurs when there are blockages in blood vessels that nourish your heart so blood flow to the heart is blocked.

Dr. Steven Nissen, distinguished faculty member of ours at CMHC and chairman of cardiovascular medicine at Cleveland Clinic, explained in a CBS News interview that cardiac arrest “is really more of an electrical problem. A heart attack is more of a mechanical problem.”

Different Symptoms

You have probably heard about heart attack symptoms. They include:

• pain in the chest
• pain in any other areas of the upper body
• vomiting
• nausea
• cold sweats
• shortness of breath.
• Many people have even heard a pain in the left arm could be one of the “signs”.

Heart attack symptoms can happen suddenly, but it is very common for them to actually begin slowly and persist for hours and days, or sometimes, even weeks before an actual heart attack occurs!

Very differently than the above, cardiac arrest victims immediately become unresponsive and death occurs within minutes without treatment.  Basically, to put it simply, no long-lasting or persistent symptoms.

It has actually been found that about half the time, cardiac arrest victims had early warning signs including palpitations, shortness of breath, intermittent chest pain and pressure, or ongoing flu-like symptoms such as nausea and abdominal/back pain. However, most of them, in fact 80%, were found to ignore the symptoms and not seek treatment.

Unfortunately, cardiac arrest is fatal approximately 90 percent of the time.

Are they even related? What comes first?

Try not to let this confuse you. The most common cause of a cardiac arrest is a heart attack.

However, the majority of heart attacks do NOT lead to cardiac arrests.

Also, there are MANY victims that go into cardiac arrest without having suffered a heart attack.

So, let’s make this clear, HEART ATTACK ——-MAY LEAD TO—– CARDIAC ARREST.

But the majority of heart attacks don’t and most cardiac arrests (70%) are caused by coronary heart disease risk factors.

Because BOTH heart attacks and cardiac arrests are related, they share the same risk factors – diabetes, high cholesterol, smoking, high blood pressure and family history.

All the things we warn you about in our other blogs.

Cardiac Arrest Victims

Cardiac arrest victims are “often people who have had previous damage to the heart due to disease of the heart muscle or due to previous coronary heart disease where the weakened heart is more susceptible to a rhythm disturbance that leads to a cardiac arrest,” Dr. Nissen said.

There is a chance to survive a cardiac arrest, but it comes only if a victim is treated within a few minutes. In a scary statement reported by a senior author in the Annals of Internal Medicine, this is a very limited few.

Dr. Sumeet Chugh, the medical director of the Heart Rhythm Center in the Cedars-Sinai Heart Institute shared, that “no matter how fast we get there, at the most, we save 10 percent of people who have a cardiac arrest. There is no condition known to man where you have the chance of dying within 10 minutes. This is what people don’t understand. As each minute goes by, there’s a 10 percent less chance of survival. If the paramedics get there in 10 minutes, you’re gone.”

WHAT TO DO…in case…

If you think that someone around you may be going into cardiac arrest, call 9-1-1 immediately and begin to perform CPR (or find somebody that knows how to). CPR can buy minutes for emergency responders to arrive and help resuscitate the victim.

Luckily, most crowded buildings now have Automated External Defibrillators available, so look for one. They are in airplanes, airports, train stations and even concert venues and stadiums. They are very easy to use and accessible.

Now that we explained the difference between the two, shared some scary stuff and armed you with what to do in case someone you care about may be suffering from any of the symptoms, we want to honor Tom Petty and wish there was a way we could have saved him along with all the rest of the victims that heart disease has affected in 2017. Keep reading our blogs about ways to prevent cardiovascular disease and lessen your risk factors for this terrible disease and if you are a physician or healthcare practitioner, check out our next CME event to learn how to save your patients!

For more about Dr. Nissen, visit his CMHC bio or check out his keynote lecture topic on our 2016 Annual CMHC agenda.

 CBS News. Mary Brophy Marcus. Sudden cardiac arrest may have warning signs after all. https://www.cbsnews.com/news/sudden-cardiac-arrest-may-have-warning-signs-after-all/.  December 2015. Accessed October 10, 2017.