0

Month: October 2017

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.

Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn

“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
Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn

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.
Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn

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.
Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn

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. 
Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn

How Healthy is YOUR Town?

Health
Exercise has received a lot more stage time in the recent years, especially due to the enormous focus on nutrition and the current obesity epidemic in our country.

We may personally feel like more gyms are packed and the lines are longer at grocery stores selling organic foods. It is no lie that people are more conscious of diet and staying active.

But is this just where YOU live?

An interesting article surfaced in the New York Daily News which covered exercise based on region; specifically cities in the US. A 2015-2016 Gallup and Sharecare poll showed that across 189 cities in the U.S., a person’s exercise frequency had nothing to do with where they lived.

While we would most likely agree that out of the 350,000 people polled, the ones living in metropolitan areas would be more likely to exercise a lot more, this poll proved us all wrong!

At least we were right about our earlier points:

  1. The poll showed that regions with higher rates of regular exercise also had less chronic health issues like heart attack, diabetes, obesity, and depression. Exercise = less disease, less obesity, better health.
  2. 53% of Americans were classified as “regular exercisers” in 2016. This was the highest rate on record since the same company ran the first U.S. poll in 2008. So we are on the right track!

The cities with the higher volume of exercisers are argued to have made routine exercise MORE possible for their citizens than other cities. Wouldn’t you be more likely to exercise if your city had more safe, livable, bike-able, run-able and walkable spaces accessible to you?

Now we know you are curious…who won? Who lost?

Boulder, Colorado (population of 108,000 approximately) had the highest percentage of regular exercising citizens. These people exercise three or more days a week, for at least 30 minutes a day.

NYC was almost at the end of the list (167 out of 189) and as far as who lost: Hickory, N.C. with 42%!

Are you wondering about your city? U.S. Cities ranked by Exercise Rate

New York Daily News. The surprising cities with the highest and lowest rates of exercise.
http://www.nydailynews.com/life-style/surprising-cities-highest-lowest-rates-exercise-article-1.3509233.
September 20, 2017. Accessed October 5, 2017.
Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn

Linking Cancer & Heart Disease: The Root of 2 Killers May Be The Same?

Inflammation, which we have all heard is a root cause of many diseases and dysfunctions in our bodies, has just linked two regularly UNLINKED killers: Cancer and Heart Disease.

In an exceptionally written article in The New York Times Magazine last week, readers were introduced to a patient who suffered from two deadly forms of cancer: lung and melanoma. When asked what he almost died from, this patient shared it was actually not these cancers, but a heart attack.

Throughout the rest of this thought-provoking article, the author, a Pulitzer Prize-winning cancer physician and scientist at Columbia University, Dr. Siddhartha Mukherjee, shared that the two top killers in our country, heart disease and cancer may now be linked. He carefully explains how.

Before today (and for the most part still) the subspecialists dealing with these killers—Cardiologists and oncologists have lived in two very different medical jurisdictions. They attend different medical conferences, read very different medical journals and essentially do not speak the same medical language.

The author brings up a distinguished faculty member of ours at Cardiometabolic Health Congress, Dr. Peter Libby in his article. He explains that Dr. Libby, a cardiologist, along with Dr. Paul Ridker, brought to light an important variable in the early 2000’s that was never discussed in relation to heart disease and plaque formation – inflammation.

For several years therafter, Drs. Libby and Ridker focused on a specific molecule involved in inflammation. A new drug that inhibited this one specific molecule, was actually being used to treat very rare inflammatory diseases; and in 2011, Dr. Ridker’s team enrolled thousands of patients with signs of inflammation (and at very high risk for coronary disease) into a study to determine the effects of this new drug on heart disease.

The basis of this article lies in the results of this study which were published only 2 months ago.

With higher doses of the drug, there was a noticeable reduction in heart attacks, stroke and cardiovascular death.

However, what caught the author’s attention was a separate investigation that inquired: Would this drug also reduce cancer risks?

A medical journal titled The Lancet published a paper where Dr. Ridker and his team found that there was a drop in all cancer death in drug-treated patients; specifically, a decrease in the deaths from and occurrence of lung cancer.

Bottom line, this article seems to point out that a component of inflammation is driving plaque formation in coronary disease that is ALSO driving cancer progression.

The author explains that this study will need careful reproduction and that the analysis coming out of this investigation was not meant to prove a hypothesis, but only to suggest one.

Many questions remain understandably, but if the findings hold true in future studies, any form of inhibiting the specific molecule, interleukin-1 beta, could eventually be ranked as one of the most effective prevention methods in cancer’s most recent history.

We are excited about anything that could potentially mean the prevention of cancer or heart disease here at CMHC, and we do know from a personal perspective how oncologists and cardiologists can benefit from networking and attending meetings together. We recognize this is only the beginning, but we encourage all specialists to check out our most recent meeting agenda, and help us congratulate our own distinguished faculty member, Dr. Peter Libby in his early discoveries of inflammation in the potential future prevention of cancer!

Dr. Peter Libby has graced our stage at CMHC in 2014 and most recently at our last meeting as our keynote in Oct. 2016. To read our blog based on Dr. Libby’s lecture last October, click here.

Share onShare on FacebookShare on Google+Tweet about this on TwitterShare on LinkedIn