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Middle-Aged? Reverse Heart Risk with Exercise

For those who fear it may be too late in life to improve their fitness and wellness, a recent study published in the journal Circulation has found that people into late middle age can reverse or reduce the risk of heart failure caused by decades of sedentary living by exercising.

There, is, however, a catch: research indicates that it takes two years of aerobic exercise, four to five days a week, to mitigate the risk of heart failure. Research has shown that sedentary behaviors – such as sitting or reclining for long periods of time – increase the risk of heart disease.

The study’s participants, all of whom did not exercise regularly, were divided into two groups, with one following an aerobic exercise routine that progressed in intensity over the two years and another doing yoga, balance training and weight training three times a week, also for two years.

The aerobic exercise group showed an 18% improvement in their maximum oxygen intake during exercise and a more than 25% improvement in “plasticity” in the left ventricular muscle of the heart – both markers of a healthier heart. However, the benefits were not seen in the second group.

Dr Benjamin Levine, lead author of the study and the founder and director of the Institute for Exercise and Environmental Medicine, a joint program between Texas Health Resources and UT Southwestern Medical Center Dallas, Texas, states: “The key to a healthier heart in middle age is the right dose of exercise, at the right time in life. We found what we believe to be the optimal dose of the right kind of exercise, which is four to five times a week, and the ‘sweet spot’ in time, when the heart risk from a lifetime of sedentary behavior can be improved – which is late-middle age. The result was a reversal of decades of a sedentary lifestyle on the heart for most of the study participants.”

Dr Richard Siow, vice-dean for the faculty of life sciences and medicine at King’s College London and director of aging research at King’s, told the BBC the study was valuable in that shows we can delay cardiovascular aging. Dr. Siow said that it provided further evidence that “we can, in a way, rejuvenate or make the cells in the heart, and also in the blood vessels for that matter, resemble younger cells through an exercise program”.

“I think that’s a very important take-home message for those of us who may have a doom and gloom view there’s nothing we can do about it. Yes there is, we can start by getting off the couch to have a more active lifestyle.”

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Live Longer By Saying “I Do”

In a new study published last week in the Journal of the American Heart Association, researchers at Emory University in Atlanta found that people with cardiovascular disease who were not married –- including those who were divorced, separated, widowed or never married –- had 24 percent higher rates of death from any cause during the study period, compared to those who were married. 

Specifically, not being married was associated with a higher risk of death from cardiovascular causes, like heart attacks and strokes, for the more than 6,000 Emory Healthcare patients in this study. Divorced and separated people had a 41 percent increased risk of death; widowed people had nearly double that risk.

“I was somewhat surprised at the impact,” Dr. Arshed Quyyumi, the study’s lead researcher and co-director of Emory Clinical Cardiovascular Research Institute, told ABC News. “But we suspected there might be something, since there have been studies that signal that marital status affects how well people do.”

This was a large study conducted between 2003 and 2015 that included 50 to 70 year old participants, from diverse racial groups, who had cardiovascular disease — including coronary artery disease, heart failure and previous heart attacks. Each participant was followed for an average of 3.7 years.

Even after accounting for known cardiac risk factors — such as diabetes and smoking, different types of heart disease, socioeconomic background, age, sex and appropriate treatment –- being unmarried still showed higher risk of death for these patients.
One expert not involved with the research agreed that the findings offer additional clues to the importance of relationships when it comes to health.

“This study adds to this line of research,” Dr. Matthew Dupre, an associate professor at Duke University who has done extensive research on social factors and heart outcomes, told ABC News. “There is now a growing body of work showing how our social relationships, particularly the disruption of these relationships through divorce or widowhood, can get under our skin and have immediate and lasting consequences for our cardiovascular health.”

For this study, the researchers did not specifically look for why these differences exist. But the research team, as well as Dupre, note that previous research suggests less social support, stress from divorce or a spouse passing and less motivation to have a healthy lifestyle, or to stick to medical treatment, may play a role.

“All these things can be put under the basket of social support,” study author Quyyumi said. “Cardiovascular disease, even though we consider diabetes and high cholesterol to be high risk factors, it is sizably impacted by psychosocial status –- how stressed you are, how depressed you are. Being alone, lonely, etc. may well do the same.”

For people who are widowed or getting divorced, there may be other stressors that can lead to worse heart health. “After the depression and grieving, be alerted to the fact that your life is altered and don’t fall into high risk behaviors. Perhaps, create a social network,” Quyyumi said. “All those things become important.”

The researchers did not account for people who changed their marriage status during the study, but Quyyumi explained that would not likely affect the results because only a small amount of people in their sixties change marital status over the course of two to seven years. The study also did not specifically account for people who have partners, but are not married.

“I wouldn’t say that if you have heart disease, you have to get married. I’m not sure anyone has prescribed getting married to prevent getting sicker,” Quyyumi said. “But I think doctors and even family and friends can pay more attention when life events occur –- perhaps these people need extra care and attention to compensate for things they are now missing.”

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Cheese: A Heart Healthy Snack?

Cheese is typically considered more of an indulgence than a health food, but a new review of research suggests that it may not be as bad for you as once thought. In fact, people in the analysis who ate a little bit of cheese every day were less likely to develop heart disease or have a stroke, compared to those who rarely or never ate cheese.

Cheese, like other dairy products, contains high levels of saturated fat—which has been linked to high cholesterol, atherosclerosis and an increased risk of heart disease. (Recently, however, some nutrition experts believe that saturated fat is more benign.) But cheese also contains potentially beneficial ingredients like calcium, protein and probiotics, wrote the authors of the new paper, published in the European Journal of Nutrition.

To learn more about how long-term cheese consumption affects a person’s risk for cardiovascular disease, researchers from China and the Netherlands combined and analyzed data from 15 observational studies including more than 200,000 people. All but one of the studies excluded people with existing heart disease, and all but two tracked people for 10 years or more.

The researchers’ findings were “certainly different from what people might expect,” says Dr. Allan Stewart, director of aortic surgery at Ichan School of Medicine at Mount Sinai Medical Center, who was not involved in the new analysis. Overall, people who consumed high levels of cheese had a 14% lower risk of developing coronary heart disease and were 10% less likely to have a stroke than those who rarely or never ate cheese.

The relationship, however, was U-shaped rather than linear—meaning that higher quantities of cheese were not necessarily better. The people who had the lowest risks for heart disease and stroke were those who consumed, on average, about 40 grams a day—about the size of a matchbook. (According to the review, the average American eats about 42.5 grams a day.)

“This is not the same as eating a big slice of cheesy pizza every day,” says Stewart. He also cautions against reading too much into data that’s self-reported—as much of the data was—because people tend to over- or under-estimate their consumption of specific foods.

Stewart points out that the study was only able to find an association between cheese consumption and decreased risk of heart disease, rather than a cause-and-effect relationship. It could be that people who eat cheese on a daily basis are healthier overall, or have more disposable income and higher socioeconomic statuses.

But it’s also possible that cheese has beneficial qualities that offset the negative impact of its high saturated fat content, says Stewart. “Cheese can be high in probiotics, which tend to put you in less of an inflammatory state,” he says. Cheese also contains conjugated linoleic acid (CLA), an unsaturated fatty acid that may increase the amount of of HDL “good” cholesterol and decrease “bad” LDL levels.

“There is some evidence that cheese—as a substitute for milk, for example—may actually have a protective effect on the heart,” says Stewart. “No one’s saying you should definitely go out and eat 40 grams of cheese a day. But on the upside, a bit of cheese on a cracker doesn’t sound unreasonable.”

The study did not look at different types of cheeses, and Stewart says more research is needed to know whether certain varieties hold more health benefits (or risks) than others. Overall, though, the news is good for cheese lovers.

“We’re always are searching for ways to minimize heart disease and reduce atherosclerosis,” he says. “It’s promising to find that something that actually tastes good—and pairs well with a nice glass of red wine—may offer some protection, as well.”

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Coffee & Cardiovascular Health

You can feel less guilty reaching for your third espresso shot in the midst of the holiday craziness this season— a recent study has linked that extra cup of coffee (up to six cups daily!) to a decreased risk of of heart failure, stroke and coronary heart disease.

Researchers from the University of Colorado School of Medicine presented their findings last week at the American Heart Association’s Scientific Sessions 2017, reporting that every 8-ounce cup of coffee per day reduced heart failure risk by 7 percent, stroke risk by 8 percent and coronary heart disease by 5 percent in comparison to non-coffee drinkers. While this is not the first study of its kind to identify a link between drinking coffee and cardiovascular health, it is the first study to offer numerical data to back up previous research suggesting that coffee’s antioxidant-rich, anti-inflammatory makeup contributes to overall heart health.

Researchers applied machine learning, a process that uses artificial intelligence to track algorithms and patterns within data sets, to analyze the relationship between drinking coffee and cardiovascular health from across three well-known studies: the Framingham Heart Study, the Cardiovascular Heart Study and the Atherosclerosis Risk In Communities Study. All three previous studies are recognized by the American Heart Association and contained useful data, tracking which food and beverages participants were consuming and how their cardiovascular health improved or worsened over time.

“Our findings suggest that machine learning could help us identify additional factors to improve existing risk assessment models. The risk assessment tools we currently use for predicting whether someone might develop heart disease, particularly heart failure or stroke, are very good but they are not 100 percent accurate,” said study author Laura M. Stevens, B.S. While the researchers confirmed that machine learning cannot definitively prove cause and effect, the correlations between coffee consumption and heart health were promising, paving the way for more studies to utilize machine learning in order to more deeply examine relationships between certain foods or beverages and health.

It’s critical to point out that the researchers were examining the effects of coffee and coffee alone—the positive health effects surrounding your morning cup aren’t taking into consideration what you’re adding into it. Businesses have adapted to the overwhelming amount of ways people take their coffee in 2017; Starbucks is perhaps the most infamous in its availability of choice, where it’s customary to get held up in line while the barista prepares a “Grande iced, Half-Caff Ristretto 4-Pump Sugar-Free Cinnamon Dolce Soy Skinny Latte,” for the person in front of you. Regardless of which type of milk, milk substitute, or sweetener you reach for, the research shows that black coffee is the safest and simplest way to consume coffee and reap its health benefits.

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Heart Rate Variability

Thinking about your health means understanding your heart health, and paying attention to measures like cholesterol, blood pressure, and triglycerides. There is one more to add to the list: heart rate variability.

“Heart rate variability is the variation in the time between each heart beat,” explains John P. Higgins, MD, MBA, a sports cardiologist at McGovern Medical School at the University of Texas Health Science Center at Houston. This is different than your heart rate, which is measured by the number of times your heart beats per minute. And unlike your heart rate, which you can calculate by counting your pulse, heart rate variability is measured at the doctor’s office with an electrocardiogram (ECG or EKG) test that records the electrical activity of your heart.

When using the term variability, it refers to your heart beat’s ‘ability to shift throughout the day,’ as one’s heart rate is not meant to be the same, static speed; it changes depending on activities, emotions, and actions. A high HRV means that the body can efficiently change heart rate, depending on activity: intended to be a measure of the efficiency and performance of your cardiovascular system. Heart rate variability may also be a marker of the ways in which your body can handle stress, as a higher HRV communicates a better performance, whereas a lower HRV indicates that it would be difficult to ‘bounce back after a stressful situation.’

While age affects one’s HRV, being at an elevated risk for heart disease also affects it. Moreover, chronic stress, high blood pressure, and high cholesterol may impair functioning of this system, which leads to difficulties with heart rate and blood pressure–and ultimately HRV.

The best way to improve one’s HRV is exercise: even moderate workouts for 150 minutes per week. Biofeedback and meditation have also demonstrated usefulness in improving HRV, as deep & controlled breathing taps into the parasympathetic nervous system, causes one to destress and calm down.

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Apple Cider Vinegar: More Than A Diet Trick?

While heart disease can be triggered by a poor diet, experts say apple cider vinegar may have positive benefits for certain cardiovascular risk factors, in addition to helping with weight loss.

Researchers believe that apple cider vinegar could have a protective effect on your heart. Consuming a few teaspoons before breakfast has become a health trend, due to claims that it aids weight loss, yet apple cider vinegar may also help boost heart health.

Research has suggested that it assists with lowering cholesterol and triglyceride levels, which have been linked to increased risk of heart attacks.

What’s more, studies found it protects against LDL cholesterol oxidation – which could lead to heart disease – and can reduce blood pressure. “Several ‘risk factors’ for heart disease and strokes have been shown to be improved by apple cider vinegar consumption,” said Fleur Brown, a nutritionist and author of Beat Chronic Disease – The Nutrition Solution. “It contains the antioxidant chlorogenic acid, which has been shown to protect LDL cholesterol particles from becoming oxidised, a crucial step in the prevention of heart disease process.

Additionally, there are also some studies showing that the vinegar can help reduce blood pressure. It appears to have the ability break down fat deposits in the body, improve circulation and thus lower pressure in the arteries. High insulin and blood glucose levels are also thought to contribute to heart disease, and apple cider vinegar can reduce both.

This is particularly important since diabetics are at an increased risk of heart disease as they have raised insulin and blood glucose levels., Additionally the knock-on effect of lowered levels of insulin is weight loss: being overweight can increase the risk of cardiovascular disease, therefore losing weight with the aid of apple cider vinegar can lower the risk of heart attacks and strokes.”

Nevertheless, research done so far to support apple cider vinegar’s direct positive effects on the heart, such as a 2015 study published in the Journal of Diabetes Research, have been conducted on animals. As yet, there have been no human studies, meaning we cannot know for certain that it would yield the same results.

“There is a limited amount of research to show that apple cider vinegar may help to lower blood cholesterol levels and so be good for the heart but most of this research comes from studies in rats, so we need to be careful about extrapolating to humans,” explained Dr Sarah Schenker, a registered dietician and nutritionist. What has been shown in humans is that apple cider vinegar can help with weight loss – which can also help heart health. “Several human studies suggest that apple cider vinegar can increase satiety, making you feel fuller more quickly,” said Brown.

Human studies have demonstrated that drinking apple cider vinegar along with high-carb meals can increase feelings of fullness and make people eat 200 to 275 fewer calories for the rest of the day. Reducing calories on a daily basis can result in reduced weight over time, and reduced risk of developing cardiovascular disease.”

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Pick Up the Pace!

According to a new study, healthy adults who are slow walkers are twice as likely to die from heart disease as those of us who walk at a more brisk pace. “This suggests that habitual walking pace is an independent predictor of heart-related death,” lead author Professor Tom Yates said.

Researchers from the University of Leicester followed 420,727 people over a period of six years to assess death rates.  Those who were slow walkers were found to be between 1.8 and 2.4 times more likely to die of heart disease – which is the world’s biggest killer – during the timeframe.

The researchers took into account risk factors including smoking, BMI and diet, but found that the conclusion still applied to both men and women. However, it was actually adults with the lowest BMIs who were found to have the highest risk from walking slowly.

The study’s authors believe that walking pace is an indicator of overall health and fitness as it’s strongly linked to exercise tolerance.

“Self-reported walking pace could be used to identify individuals who have low physical fitness and high mortality risk,” said Professor Yates. The researchers also looked into whether walking pace could be linked to cancer, but no connection was found.

This is not the first study to link heart disease and walking pace though – research from 2009 concluded that walking slowly is “strongly associated” with an increased risk of dying from cardiovascular disease, including heart disease and stroke.

Heart disease is often a result of high blood pressure, obesity and high cholesterol, and is the leading cause of death in the US, second only to dementia in the UK.

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Salt Consumption: Enough to Damage Heart?

The amount of salt a typical American adult consumes each day may be enough to damage the heart muscle and make it harder to pump blood, a U.S. study suggests.

A high-salt diet has long been linked to higher odds of developing high blood pressure and heart disease as well as an increased risk of heart attack, stroke and heart failure. But determining the ideal amount of dietary salt is controversial because some research has also found an elevated risk of heart disease, high blood pressure and heart attacks in otherwise healthy people who consume too little salt.

In the current study, published in the Journal of the American College of Cardiology, half of the people consumed at least 3.73 grams a day of sodium, the equivalent of about two teaspoons of table salt.

Compared with adults who ate less sodium, people who consumed more than 3.7 grams of sodium a day were more likely to have enlargement in the left chambers of the heart that are responsible for pumping oxygen-rich blood into the body. They were also more likely to have signs of muscle strain in the heart that can precede structural damage.

“This study enhances our understanding of the adverse effects of salt intake on heart function,” said lead study author Dr. Senthil Selvaraj, a researcher at the Hospital of the University of Pennsylvania in Philadelphia.

While the results don’t settle the debate over the optimal amount of salt, the findings should still encourage people who eat a lot of salt to cut back, Selvaraj said by email. That’s because reducing sodium intake can help reverse high blood pressure, a major risk factor for heart failure, stroke and heart attacks.

“There is still a healthy debate ongoing,” Selvaraj added. “It is still worth the effort to reduce your sodium intake.”

Cardiovascular diseases are the leading cause of death worldwide, killing almost one in every three people. Sodium is found not only in table salt, but also in a variety of foods such as bread, milk, eggs, meat, and shellfish as well as processed items like soup, pretzels, popcorn, soy sauce and bouillon or stock cubes.

To lower the risk of heart disease, adults should reduce sodium intake to less than 2 grams a day, or the equivalent of about one teaspoon of salt, according to the World Health Organization (WHO).

For the current study, researchers examined data from lab tests of sodium intake, heart structure and heart function for almost 3,000 adults. Participants were 49 years old on average, 54 percent had high blood pressure and half were African-American. They were typically overweight or obese. To assess how sodium intake influenced the heart, researchers accounted for age, sex, smoking status, alcohol use, activity levels, and certain medications.

The study wasn’t a controlled experiment designed to prove how or if salt damages the heart or impairs heart function.
One limitation of the study is that researchers tested sodium intake using overnight urine samples, which may not be as accurate as the gold standard, 24-hour urine collection, the authors note.

Researchers also didn’t have enough data on people who consumed very little sodium to assess how low salt intake influences the heart. “We know less than we should about salt,” said Thomas Marwick, author of an accompanying editorial and director of the Baker Heart and Diabetes Institute in Melbourne, Australia.

“In general, most of the population take far more salt than is good for them and this is a reminder to reduce intake,” Marwick said by email. “It’s ubiquitous and hard to reduce to very low levels,” Marwick added. “While some zealots want to reduce intake to zero, I’m not sure that drastic reduction is necessarily beneficial.”

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Link Between Childhood Cardiovascular Risk Factors & Future Lower Cognition

A recent study published by the Journal of the American College of Cardiology includes data that indicates an association between the presence of cardiovascular risk factors in adolescence, and a lower cognition later in life–“regardless of the exposure experienced during adulthood.”


The data investigated a sample of 3,596 individuals from childhood to adulthood, including follow-up cognitive testing, in addition to measurements of cardiovascular risk factors like cholesterol levels, blood pressure, body mass index, exposure to smoking, etc.

The study was able to specifically pinpoint the worsening of midlife cognitive performance among those individuals with high blood pressure and cholesterol in childhood, adolescence, and young adulthood. The data further demonstrated that smoking in adolescence and young adulthood is linked to a decrease in cognition: specifically, memory and learning.

Study participants between the ages of 6 and 24 who had all risk factors within the recommended levels performed better on cognitive testing than their counterparts who exceeded all risk factors guidelines at least twice; the difference corresponded to the effect of 6 years of aging. Researchers further found that those participants with the highest blood pressure had a difference in cognitive age of 8.4 years, compared to those with the lowest blood pressure.

Suvi Rovio, PhD, lead author of the study and a senior scientist at the Research Centre of Applied and Preventative Cardiovascular Medicine at the University of Turku in Finland, stated: “These findings support the need for active monitoring and treatment strategies against cardiovascular risk factors from childhood…this shouldn’t just be a matter of cognitive deficits prevention, but one of primordial prevention.”

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A “Vaccine” for Cholesterol Clearance?

AT04A, a peptide-based formulation that induces an immune response against a protein that interferes with cholesterol clearance, has been effective in lowering cholesterol in studies with mice. AT04A qualifies as an immunotherapy, as it targets one of the body’s own proteins–not a protein associated with a pathogen.

The study is the first to demonstrate that the AT04A vaccine induced high and persistent’ antibody levels against PCSK9 (an enzyme that prevents the clearance of low-density lipoprotein cholesterol–‘bad’ cholesterol–from the blood).

When the AT04A formulation was injected under the skin of mice that had been fed diets of fatty food, it reduced the total amount of cholesterol by 53%, shrank atherosclerotic damage to blood vessels by 64%, and reduced biological markers of blood vessel inflammation by 21% to 28%, in comparison to the unvaccinated mice. Moreover, the induced antibodies remained functional over the entire study period, and concentrations were still high at the study’s conclusion.

“The way that AT04A is administered is comparable to a vaccine,” explained Gunther Staffler, PhD, the chief technology officer at the company that initially developed AT04A. “However, the difference between a conventional vaccine and our approach is that a vaccine induces antibodies that are specific to bacterial or viral proteins that are foreign to the body—pathogens—whereas AT04A induces antibodies against a target protein that is produced by the body—endogenous proteins. This it is really an immunotherapeutic approach rather than a vaccine approach.”

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