THURSDAY, May 24, 2018 (American Heart Association) — South Asians living in the United States are more likely to die from heart disease than the general population. But this risk has been largely hidden by a lack of data, researchers say.
Immigrants coming from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka are one of the fastest growing populations in the U.S.
“We’ve realized that South Asians are dying of heart disease a lot earlier than other ethnic groups, and that it’s devastating to their community,” said cardiologist Dr. Annabelle Volgman, who led an expert group that on May 24 published a report on the issue for the American Heart Association in the journal Circulation.
There were around 3.4 million people of South Asian descent living in the United States as of 2010, according to the U.S. Census Bureau. But despite their numbers, the threats to South Asians’ cardiovascular health have been obscured because researchers have been looking at Asian-Americans as a monolithic group. But when examined individually, South Asians have a higher risk of heart disease than other Asian groups, especially East Asians from China, Japan and Korea.
“We need to look at the different Asian groups within the Asian community so that we’re not all lumped together,” said Volgman, whose family is originally from the Philippines. “We’re not alike in terms of cardiovascular risk factors.”
It is not clear why South Asians are more prone to heart disease than other groups. While it is clear that cardiovascular disease can be passed down in families, researchers have yet to find a specific genetic cause that would make South Asians more at risk than other groups.
“We’ve observed the increased risk, but we are still looking for the smoking gun,” said Dr. Latha Palaniappan, an internist and clinical researcher who focuses on the gap in medical knowledge about Asian subgroups. She co-chaired the new report with Volgman.
Although the genetics are not yet clear, there are some conditions that increase the risk of cardiovascular disease among South Asians. One key connection is an increased risk of diabetes at a young age, and another is cholesterol abnormalities. Because studies indicate that South Asians develop heart disease earlier in life than other groups, doctors are working to increase awareness among the South Asian community to get tested for signs of cardiovascular problems as early as possible.
“I think that accessing preventative health care has been less than optimal in South Asian populations because they aren’t aware that they’re at increased risk,” Palaniappan said.
Although cardiovascular disease can be inherited, researchers say much of the risk can be mitigated by lifestyle changes, such as diet, exercise and avoiding tobacco. Exercise is especially important, as studies show that South Asians exercise less than other groups, and are also less aware of the connection between lack of exercise and heart disease.
Diet is also a key part of heart health, and although many South Asians are vegetarian, their diets include too much fat, sugar and refined carbohydrates, and these tendencies increase the longer they have lived in the United States.
In the past, researchers saw a significant difference between South Asians living in their countries of origin, who were more active and ate healthier diets than migrant groups. But now poor lifestyle habits from the U.S. are making their way back to Asia.
“The same increased risk that we were observing in worldwide diaspora (scattered) populations we’re now seeing in India because India is becoming more Westernized in terms of a more sedentary lifestyle and less healthy food choices,” Palaniappan said.
But researchers believe that these trends can be reversed with increased awareness. Now that they’re focused on the increased risk of heart disease in South Asians, researchers can target studies specifically to this group and physicians can work with their patients to address heart health at an earlier age.
“Because South Asians tend to have cardiovascular events at a younger age we really want to emphasize the need for more studies so that we don’t lose young mothers and fathers,” Volgman said.
THURSDAY, May 17, 2018 (American Heart Association) — The percentage of Americans with ideal heart health — measured by scoring seven lifestyle and biological markers — declined over two decades, according to a study that found people who maintain higher health scores over time have less risk of cardiovascular disease and death.
The research, published May 17 in the Journal of the American Heart Association, included detailed medical visits and measurements for 3,460 adults from 1991 to 2008. It showed the number of participants with an ideal cardiovascular health score dropped over that time — from 8.5 percent to 5.9 percent. The decline, the study said, was mostly because of poorer results in body mass index, blood pressure, blood sugar and cholesterol.
Meanwhile, the research also showed that people who maintained their ideal health throughout the study period had lower risk of heart disease and lower risk of dying, while those who had lower scores for a long time, even if they improved, had a greater risk of death and heart disease.
“We all know what we need to do to maintain a healthy heart,” said the study’s lead author, Vanessa Xanthakis, assistant professor at Boston University School of Medicine. “But we are still not doing it. More and more studies are coming out linking poor cardiovascular health with poor outcomes, including stroke, dementia, cancer and other types of diseases.”
People who started with a low score and kept a low score through the study were almost twice as likely as those who kept their score high to develop cardiovascular disease. Yet, those who started low and were able to improve by the end of 20 years still had a 70 percent higher risk.
“This reinforces the notion that you have to start early,” Xanthakis said. “You have to improve your cardiovascular health as early in your life as possible.”
The American Heart Association created what it calls Life’s Simple 7 in 2010 to help track improvements in the health of Americans. The measures are: tobacco use, diet, physical activity, body mass index, blood pressure, total cholesterol and blood sugar. Some of Life’s Simple 7 are tracked through medical exams. Others can be checked on your own.
Using the seven-item heart health scoring, the study categorized participants as being in “poor,” “intermediate” or “ideal” cardiovascular health. The categories also have been used in several recent studies. In 2014, researchers concluded that even medium scores helped prevent loss of memory and other brain functions. Last summer, research looking into heart failure and Life’s Simple 7 showed the better the score, the lower the risk. And a study in February concluded that recovery after a heart attack in midlife was better for those with higher scores.
“This is a robust finding, that one’s cardiovascular health status as measured by Life’s Simple 7 has a profound impact on future events,” said Wayne Rosamond, an epidemiology professor at the University of North Carolina’s Gillings School of Global Public Health. He wasn’t involved in the current study but took part in the research on heart attacks published in February.
“Life’s Simple 7 can be an empowering concept. It’s powerful to say, ‘I can do some things to optimize my own cardiovascular health,’ which is a different notion than simply trying to avoid having a heart attack or stroke,” Rosamond said. “It’s a more positive focus to take in improving one’s health. The earlier you establish ideal levels of these behaviors and factors, and the longer you hold onto them, the better you will be.”
Xanthakis agrees, and said the research shows the need for more comprehensive public health policy, starting with local communities and extending to national efforts.
“This is an important public health concern,” she said. “Cardiovascular disease is linked to high costs from hospitalizations and medications. More people are living with cardiovascular disease today than in previous years. We need to boost efforts to target smoking cessation, weight control, introduce healthy diets, emphasize regular physical activity, and screen and control for high levels of blood pressure, blood sugar and cholesterol.”
THURSDAY, May 17, 2018 (HealthDay News) — There is more reason than ever for people to make fish a bigger part of their diets, according to the American Heart Association.
The heart group has long recommended that people eat fish — preferably fatty varieties — once or twice a week. Now it is reaffirming that advice based on additional evidence that fish helps ward off heart disease.
Specifically, adults should strive for two 3.5-ounce servings of fish each week, the American Heart Association (AHA) said. The best choices are oily fish with large doses of omega-3 fatty acids. The options include salmon, albacore tuna, mackerel, lake trout, herring and sardines.
Whatever you choose, just don’t fry it, the group warned.
That’s because studies have found that fried-fish lovers have increased rates of heart failure.
The main omega-3 fatty acids in fish are EPA and DHA, said Sonya Angelone, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics.
EPA has anti-inflammatory effects that might help counter the hardening and narrowing of arteries that can lead to a heart attack, Angelone said.
Beyond that, she said, omega-3 fats may also make the blood less prone to clotting, while high doses can help lower triglycerides — a type of blood fat.
Oily fish is not the only source of omega-3, said Angelone, who was not involved in the AHA recommendations.
“Chia seeds, flaxseeds and walnuts are good sources of alpha linolenic acid (ALA), which is a precursor to EPA — which is then converted to DHA,” Angelone said.
The problem, she added, is that only a small amount of that ALA is converted. And a persons’ gene variants help determine that conversion.
In contrast, the heart association noted, 4 ounces of salmon each week would provide adults with the recommended daily intake of omega-3 — which is around 250 milligrams.
The latest heart association advice does not differ from its previous recommendations, issued in 2002. But there is now much more evidence to back it up.
Eric Rimm, a professor at the Harvard School of Public Health, is the lead author of the AHA report, published May 17 in Circulation.
“Scientific studies have further established the beneficial effects of eating seafood rich in omega-3 fatty acids, especially when it replaces less healthy foods, such as meats that are high in artery-clogging saturated fat,” Rimm said in an AHA news release.
A number of large studies have found that people who eat fish at least once a week have moderately lower risks of heart attack, stroke, heart failure and sudden cardiac death, according to the new report.
Across two large U.S. studies, replacing just 3 percent of protein calories from processed meat with protein from seafood was tied to a 31 percent reduction in the risk of dying from heart complications or stroke.
So it seems key to replace red or processed meat — or other less-than-healthy fare — with fish, the heart association advised.
Except, maybe, if that fish is fried. Two studies involving more than 90,000 Americans found that people who ate fried fish at least once a week were up to 48 percent more likely to develop heart failure than those who rarely fried their seafood.
Fish may even benefit people who’ve already suffered heart trouble, the heart association said. A study of heart attack survivors found that those who were told to eat fish twice a week were 27 percent less likely to die over the next two years, versus those given standard care only.
Seafood does contain mercury, the AHA pointed out. And pregnant women and young children should avoid certain large fish that are high in mercury — such as shark, swordfish and king mackerel.
But for most adults, the benefits of eating fish outweigh any potential harms associated with mercury, Rimm’s team said.
If you don’t like fish, are fish oil supplements a good substitute? No, according to the AHA. In a previous report, the group said supplements are not recommended for preventing heart disease, due to a lack of evidence that they work.
The U.S. National Institutes of Health has more on omega-3 fatty acids.
TUESDAY, May 15, 2018 (American Heart Association) — Kendra Plumley didn’t spend her childhood running around with other kids on her street, having friends over for sleepovers, or spending lazy summer days by the pool. Instead, she spent most of her time indoors. It wasn’t a choice. She had to protect her new heart.
Today, the 29-year-old from Midlothian, Texas, is making up for lost time by embracing all that life has to offer.
“I know that I’m a miracle,” Plumley said. “My heart was killing me.”
Plumley was born in 1988 with dilated cardiomyopathy. People with this condition have an enlarged left ventricle in their heart that is too weak to pump blood correctly. Early on, she said, her mother suspected something was wrong. Initially, though, her doctors attributed her problems eating to acid reflux. But before long, her doctors realized the situation was more dire. Tests showed she had dilated cardiomyopathy — the same condition her father had.
When she was 21 months old, she had a heart transplant.
Initially, life didn’t get much easier. Her mother had to keep her on a strict drug regimen and there was what seemed like an endless schedule of follow-up visits to her cardiologist. Plumley has needed multiple surgeries since her transplant to correct an intestinal problem, remove multiple cysts and manage gum overgrowth due to medications. She had pneumonia several times, and almost died from the infection.
Plumley said her mother constantly worried about her and, to try to keep her healthy, didn’t let her interact much with other kids. “All I ever wanted [was] just to be a kid,” said Plumley.
At school, some of her classmates picked on her relentlessly, in part because one of the medications she had to take caused her to have excess hair growth on her arms and legs.
Even now as an adult, she said, some social situations are still hard for her to navigate. But she’s got better tools to handle it. “I’ve grown a lot,” she said.
Susan Daneman was the assistant director of nursing in the transplant unit at Children’s Medical Center Dallas when Plumley received her new heart. The longtime nurse said her patient was quiet and intense, but also a “very sweet, precious child” who assumed a great deal of responsibility at a young age, following instructions to the letter.
Daneman is aware that many children who receive new hearts don’t live as long as Plumley, and said her former patient has done an excellent job taking care of her health. A recent study showed that children between ages 1 and 5 who got a new heart lived about an additional 21 years if they survived the first year after the procedure.
“I just loved watching her grow into a beautiful young woman who is independent and out there in the workforce and doing wonderful things with her life,” said Daneman. “I wish all my patients could be like her.”
Plumley’s sister, Ashley, said she admired her younger sister’s strength and resilience in the face of the constant poking and prodding she had to endure as a child.
“I really look up to her for everything she’s been through — and how far she has come,” she said. Ashley said she often shares her family’s story in hopes of encouraging others to become organ donors.
These days, Plumley works as a construction trade show coordinator and is engaged. And she’s pursuing her passion for photography. Her favorite assignments, she said, are taking pictures of newborns.
As the 28th anniversary of her transplant approaches, Plumley finds herself thinking about what she went through, and how far she has come. Moving out on her own at 18 was a significant turning point, she said, pushing her to find her voice, get out of her comfort zone and take risks.
She’s still afraid of picking up germs, but that doesn’t stop her from traveling. Now and then, she’ll take her 1970 Ford Mustang out for a spin. She has numerous tattoos, including one in memory of her father, who died of heart failure in 2000.
After living so many years with restrictions, she said, “Nobody was ever going to tell me I wasn’t going to do something again.”
FRIDAY, May 4, 2018 (American Heart Association) — State-by-state disparities in heart disease and stroke are rooted in the economic health of communities and the people who live in them, according to an analysis of a report tracking the impact of cardiovascular disease across the country.
Despite a 38 percent overall drop in cardiovascular disease in the U.S. from 1990-2016, some states improved more slowly than others and a dozen states fell behind.
“Socioeconomic factors play a role. People with very low income who may struggle to put food on the table or keep a roof over their head can find it difficult to prioritize exercise, eating healthy, or even get to the doctor,” said Dr. Gregory Roth, a cardiologist and the report’s lead author.
“It’s not just a health problem,” Roth said, “but an economic problem and an economic policy problem in terms of giving people the resources they need so that when they get sick they’re not going to die from their illness.”
Lower-income communities are less likely to attract health care workers or investment in a health care facility, he said. Health care access can be limited by addictions, mental health problems, or a lack of transportation resulting from unemployment.
Published last month in JAMA Cardiology, the report tracked deaths from cardiovascular diseases including heart attack, stroke, irregular heart rhythms and coronary artery disease. It also looked at a dozen risk factors; the number of people living with cardiovascular disease; and income and education levels. Researchers analyzed the overall burden of these diseases for each state and ranked them.
The effort is part of the University of Washington School of Medicine’s broader “Global Burden of Disease Study” that was created by the Institute for Health Metrics and Evaluation in Seattle, where Roth leads cardiovascular disease modeling. The larger study investigated 332 causes of diseases and injuries, and 84 risk factors in 195 countries and territories.
Poor diet was the leading risk factor impacting cardiovascular health in the report, making it a “critical target” for improvement, according to an editor’s note by Mark Huffman, associate editor of JAMA Cardiology and associate professor of prevention at Northwestern University Feinberg School of Medicine in Chicago.
Other top risk factors included high blood pressure; high body mass index; high cholesterol; and high blood glucose levels, an indicator of diabetes.
Researchers and doctors have spent years studying the causes of heart disease and what factors promote cardiovascular health, and an important part of that is the social and economic environment in which people work and live, said Wayne Rosamond, professor of epidemiology at the University of North Carolina’s Gillings School of Global Public Health.
To successfully fight heart disease, Rosamond said, states need to work to evaluate their communities, then support and promote environmental, social and economic conditions that favor cardiovascular health.
Roth said health departments and hospitals should know and benchmark their progress. “If you can’t measure it, you’ll never know if health is getting better or worse.”
One of the solutions is to start early, with children, Roth said.
“We need to improve children’s skills and capacity to live healthy lives,” he said. This involves avoiding tobacco and alcohol, building coping mechanisms for depression, or solving education challenges so children don’t end up having a lifelong health problem.
For example, the rise of vaping in schools is troubling and could threaten national gains in smoking reduction, Roth said. “When we see a new technology that’s addicting children to nicotine, we need to be very, very worried.”
High-quality, affordable health care also should be part of the solution, according to researchers.
Cardiovascular disease will continue to be a problem “as long as we believe that health is only something you should have if you can afford to pay for health care,” Roth said.
Mississippi had the highest impacts from cardiovascular disease in 1990 and again in 2016. But it improved significantly, lowering its burden by nearly a third, Roth said. Its rank didn’t change because other states also improved, largely because of improved treatments and healthier behaviors.
After Mississippi, the highest cardiovascular disease burden was in Arkansas, Oklahoma, Louisiana, Alabama, Tennessee, Kentucky, West Virginia, South Carolina and Georgia. Other states ranked nearly as high: Indiana, Missouri, Ohio, Michigan, North Carolina, Nevada and Texas.
The healthiest state was Minnesota, followed by Colorado, Massachusetts, New Hampshire, Washington, Connecticut, Vermont and Oregon.
Cardiovascular disease is the leading killer of men and women in the U.S., according to the American Heart Association. It can be prevented by treating risk factors such as high blood pressure, high cholesterol, tobacco use, unhealthy diet, obesity and low levels of physical activity, according to the researchers.
But not enough has been done, Roth said, “to address the root causes of disparity between states, even as we have done a lot to treat [cardiovascular] disease itself.”
THURSDAY, April 19, 2018 (HealthDay News) — Men under 50 who smoke cigarettes are increasing their risk for a stroke, researchers warn.
And the more they smoke, the greater their stroke risk, reported the University of Maryland investigators.
The bottom line: quit. But if you can’t, smoking fewer cigarettes may help reduce your risk, the researchers said.
“We found that men who smoked were 88 percent more likely to have a stroke than men who never smoked,” said lead researcher Janina Markidan, a university medical student.
At the lower end, men who currently smoked fewer than 11 cigarettes daily were 46 percent more likely to have a stroke than those who never smoked, she said.
But heavier smokers — those with a two-pack-a-day or greater habit — were nearly five times more likely to have a stroke than those who never smoked, Markidan said.
These findings are particularly important because ischemic strokes among younger adults are increasing. And tobacco use among young adults is also on the rise, she said.
Markidan’s team’s prior research identified a strong link between smoking and stroke in young women, but less was known about the relationship in younger men, the researchers said in background notes.
Ischemic strokes — the most common kind — occur when blood supply to the brain is blocked. Stroke is the leading preventable cause of disability, according to the American Stroke Association. Nearly 800,000 Americans suffer a stroke every year.
Markidan added that although cutting back on cigarettes can reduce your stroke risk, only quitting altogether can slash your odds dramatically.
“These findings can offer hope for quitters, as former smokers had a stroke risk that was closer to never smokers than to current smokers,” she said.
The relationship between cigarette smoking and cardiovascular disease has been known for a long time, said neurologist Dr. Richard Libman.
“Cigarette smoking may accelerate atherosclerosis, popularly known as hardening of the arteries, and also increase the chances of forming blood clots,” explained Libman. He’s vice chair of neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y.
“A specific relationship between smoking and risk of stroke in young men is what has been clarified in the study,” said Libman, who wasn’t involved with the research.
It’s clear smoking increases your risk for stroke, Libman said. He agreed the best means of prevention is to quit.
For the study, Markidan and her colleagues collected data on 615 males ages 15 to 49 who had had a stroke in the past three years.
The men were compared with 530 similarly aged healthy men. Participants were categorized as never smokers, former smokers or current smokers.
Current smokers were placed into groups based on how many cigarettes they smoked daily — 1 to 10, 11 to 20, 21 to 39, or 40 or more.
Some factors the researchers didn’t take into account might have affected the findings. These include whether the men used other tobacco products in addition to cigarettes, if they drank alcohol, were physically active, or if they reported their smoking habits correctly.
The report was published online April 19 in the journal Stroke.
For more on smoking and stroke, visit the American Stroke Association.
FRIDAY, April 13, 2018 (American Heart Association) — Hanging out with friends can make kids less sedentary, but having inviting outdoor spaces and nearby parks can help them be more physically active, according to new research.
Both are important for kids’ health, said Tracie Barnett, lead author of a study based on data mined from a Quebec-based research group called QUALITY that investigates obesity in children. Barnett focused on neighborhood characteristics and linked them to individual characteristics, including which factors affected how often children were laying around or not getting enough of the recommended daily exercise.
“The more days kids spent doing things with their friends, the less sedentary they were,” said Barnett, a researcher at the Institut Armand-Frappier Research Centre and the Sainte-Justine University Children’s Hospital in Montreal. “It’s tough to get kids to be more active, so maybe we can focus on helping them be less sedentary.”
The study followed 431 children, ages 8-10, for at least 10 hours a day and for at least four days over one week. Two years later, researchers tracked a smaller group of the same children when they were 10-12 years old.
Using monitors to measure minute-by-minute activity, the researchers found that more than one-fifth of children ages 8-10 were excessively sedentary, which they defined as spending at least half their waking hours in low-energy situations such as sitting and watching TV. About 68 percent were deemed “physically inactive,” which meant they weren’t getting the recommended 60 minutes or more a day of moderate exercise.
By ages 10-12, the number of children who were excessively sedentary more than doubled to 56 percent, while 79 percent of them were physically inactive.
Kids can reach the minimum amount of physical activity, but still remain sedentary the remaining waking hours, Barnett said.
“We tend to think of sedentary behavior and physical activity as the opposite sides of a coin but in fact they’re not quite linked in that way,” said Dr. Stephen Daniels, chairman of the department of pediatrics at the University of Colorado School of Medicine.
“Kids really like being involved with their friends and being involved with their families,” said Daniels, a pediatrician-in-chief and chair of pediatrics at Children’s Hospital Colorado. He did not take part in the study. “If those engagements can focus on not being sedentary but being active, that’s a huge plus.”
The study, presented last month at the American Heart Association’s Epidemiology and Lifestyle conference in New Orleans, showed that having good walking paths and being close to parks and schools reduced inactivity levels, but didn’t necessarily reduce the time kids spent reclining and being still.
When parents considered the neighborhood unsafe, kids were most likely indoors, Barnett said. “What are kids doing when they’re indoors? They’re most likely on their screens.”
Encouraging device-free social interactions and outdoor playtime should be as important to parents as fruits and vegetables, she said. She suggests more board games or family walks.
But kids aren’t the only ones spending too much sedentary time in front of screens.
“Some parents are just as attached to their devices,” Barnett said, encouraging parents to not use devices during mealtimes or in the bedroom. “Instead of FaceTime, let’s have some face-to-face time.”
Daniels said more than one-third of U.S. children are overweight or obese, but there are many benefits to physical activity, including weight loss, fitness and even mental health. The most important thing is for children to do something they like.
“Activity has to be fun. If kids are going to keep doing it they have to enjoy it,” Daniels said. Some kids enjoy structured sports, but less athletic kids can walk, hike or do scouting, he said. There’s no one-size-fits-all approach.
Physical education classes and recess during school could help.
“I’d love to see PE every day,” Daniels said. “It’s a guarantee of activity, can help kids be more comfortable with physical skills, and it can actually improve their school performance.”
Recess gives kids an important opportunity for unstructured play, he said. It “represents an essential, planned respite from rigorous cognitive tasks,” according to an American Academy of Pediatrics’ 2013 policy statement touting the benefits of recess.
Barnett’s previous research suggested that having parks and other outdoor recreational spaces close to home made kids more likely to walk to school or walk during their free time.
She also recommends short activity breaks during the school day to prevent excessive sitting from becoming a lifelong habit.
“Kids should be outdoors as much as possible, moving as much as possible, sitting as little as possible, and be exposed to a variety of things from a young age,” Barnett said. “Fun and play should be emphasized. Things should not be overly scheduled and programmed: let creativity and imagination lead the way.”
WEDNESDAY, April 4, 2018 (American Heart Association) — Although past research has shown that thigh, hip and buttocks fat might actually protect against heart disease, a new study says losing fat in those areas is linked to better cardiovascular health.
The study, published in the April 4 issue of the Journal of the American Heart Association, comes eight years after a well-publicized study in the International Journal of Obesity that showed fat in the thighs, hips and backside can help reduce the risk of heart disease and diabetes.
In the new study, an Australian researcher wanted to find out what happens if you lose that so-called “protective” layer of gluteofemoral fat and the nearby muscle.
“If you are a person who keeps most of your fat in these protective regions and you decide to lose weight, are you gaining any benefit from this weight loss? Or are you doing yourself harm in terms of cardiovascular disease?” said the study’s author, Dr. Peter Clifton, a professor of nutrition at the University of South Australia and a researcher at the National Health and Medical Research Council of Australia.
Conflicting results from past studies have left unanswered the question of how specific changes in the distribution of body fat affects cardiovascular risk. So, Clifton analyzed data from 399 participants in seven previously published diet-induced weight loss studies to see how losing thigh and backside fat and muscle would impact the risk of heart disease.
After looking at levels of glucose, insulin, total cholesterol, triglycerides, LDL cholesterol and blood pressure, he found that losing fat and muscle in the thighs, hips and buttocks was “directly associated” with beneficial changes in heart disease risk markers.
“The bottom line is that any weight loss — regardless of whether it is fat or lean, backside or abdomen — reduces cardiovascular risk factors,” Clifton said. “For lowering cholesterol, losing leg fat is just as important as losing abdominal fat.”
The study also found there’s no harm in losing lean tissue or muscle in the thighs, hips and backside. “I found that quite interesting,” Clifton said.
Doctors should not “worry about getting patients to exercise to minimize their muscle loss. You can just focus on losing weight first. Then when [patients] are lighter, get them to increase exercise,” he said.
Dr. Robert Eckel, an endocrinologist and physician-scientist at the University of Colorado Anschutz Medical Campus, said he found the study’s overall results somewhat surprising.
“In general, weight loss that is more abdominal is felt to be more favorable for cardiovascular disease risk, compared to peripheral weight loss, meaning in the legs and arms,” said Eckel, who was not involved in the study.
Today, about four in 10 American adults are obese, according to data released in March from researchers at the Centers for Disease Control and Prevention. The condition puts them at higher risk for high blood pressure, diabetes, stroke and heart disease.
Eckel said that while additional studies are needed to learn more about fat distribution, “the message we really want to give the public is weight loss is good for you, and losing a few pounds isn’t enough,” he said.
Guidelines recommend that overweight and obese patients should lose at least 5 percent to 10 percent of their body weight to have a positive impact on blood pressure, glucose tolerance, diabetes control and cholesterol.
“The cardiovascular benefit of the 5 to 10 percent weight loss is proven,” Eckel said.
And based on these latest findings, Clifton adds, patients who lose weight “should not worry about where your fat is coming off — all fat loss is good, at least for the heart,” he said.
WEDNESDAY, April 4, 2018 (American Heart Association) — Jerry McCann, Ray Rivera and Taunya Stewart are living proof that there’s no good excuse to avoid physical activity, especially during Move More Month in April.
For each of them, becoming more active was a matter of life or death. McCann had a heart transplant. Rivera was diagnosed with a series of heart problems. Stewart went to the hospital with hypertension.
The trio has since taken all the right steps to improve their conditions and live happier, healthier lives.
Jerry McCann of Madison, Wisc., was put on a waiting list for a new heart nearly 20 years after quadruple bypass surgery at age 39. A heart attack nine years later, along with high blood pressure, ultimately led to heart failure. A surgically implanted left ventricular assist device, or LVAD, helped his heart pump blood through the body while he waited for a new heart.
Finally, McCann received a call in 2014 that would change his life: A donor heart was available. He successfully underwent a 10-hour heart transplant procedure at the University of Wisconsin Hospital.
McCann’s wife, Margaret, said his cardiac rehabilitation was key to helping her husband get back on his feet. McCann, now 65, walks 30 minutes most days of the week and is eating healthier.
The couple participated in American Heart Association Heart Walks with their grown daughters in Orlando, Fla., and Seattle just a year after the transplant. That inspired a new goal: participating in Heart Walks in all 50 states.
They’ve made it to 16 states so far, and McCann walks in tribute to his anonymous donor. His message to others is to “enjoy every day. I’m just extremely grateful to have a second chance on life,” he said.
Ray Rivera, 63, was already an avid walker when he was diagnosed with atrial fibrillation, an irregular heartbeat. A few months after the diagnosis, doctors discovered a leaky heart valve. Rivera had surgery in 2016 to replace his heart valve, ablation to correct the AFib, and bypass surgery to relieve two clogged arteries.
Six months after his heart procedure, the Pasadena, Calif., resident embarked on a 200-mile walk along a trail in France, followed by a second 200-mile walk six months later. His last 200-mile walk was in Spain in 2017, and this April he will return to the country for a 300-mile walk. At home, Rivera stays in shape between walks by walking or going to the gym five to six times a week.
“My doctors think I did well through surgery and in recovery because I was in good shape physically,” said Rivera, who added that he cut back on alcohol and now eats more fruits and vegetables. “While I never want to think I am totally out of the woods, I do anything I want physically without any problems.”
Taunya Stewart’s journey to better health began when she awoke one day in 2015 wondering if she was having a heart attack. Emergency room doctors measured her blood pressure at 226 over 154 — a “hypertensive crisis” that could lead to a stroke or heart attack.
Stewart was prescribed blood pressure medicine that she was told she would need to take for the rest of her life.
Today, the 43-year-old New Orleans resident walks 3 to 5 miles five days a week and checks her blood pressure daily. Her blood pressure is significantly lower, she’s taking less medication, and her doctor has been pleased with her progress, Stewart said. Her goal is to be off blood pressure medicine by next year.
“Being cognizant of what the risk factors are help to keep me motivated,” Stewart said. “When you are unfit, that is when you need to exercise. When you are tired, you need to exercise. When you don’t know what to do, you need to exercise.”
Stewart also is eating better, drinking more water and has lost weight. She has become more active as an organizer and fitness nutrition specialist at GirlTrek, a national movement to encourage black women to walk together as a first step to increase physical activity that helped her get more fit.
These success stories underscore the many benefits of regular physical activity, including lower risk of heart failure, lower blood pressure and better brain health.
Walking can help reduce or even reverse the risk of heart failure, even for people who have been sedentary but otherwise healthy, according to a recent study published in the journal Circulation. Men and women in their 50s who stuck to a regular aerobic workout for two years saw positive changes, according to researchers.
Moving more doesn’t require hours-long gym workouts to get to the recommended 150 minutes a week. Another study published last month in the Journal of the American Heart Association suggested that the risk of death can drop even when moderate or vigorous activity comes in short, five-minute bursts (like walking up several flights of stairs or walking briskly from a remote parking spot).
Stewart said her newfound focus on taking care of herself has been life-changing.
“We spend time doing everything for everybody else, and we have to make time for ourselves,” she said. “It’s not being selfish, it’s being smart enough to know that an empty vessel cannot continue to pour out.”
MONDAY, April 2, 2018 (HealthDay News) — Older Americans dramatically reduced their risks for heart attack and stroke over a recent 20-year period, a new analysis finds.
The likely reason: greater use of drugs to control cholesterol and blood pressure, as well as a decline in smoking, according to researchers from the University of Southern California.
The benefits were seen in both sexes, which suggests women are now getting medical care equal to men, the study authors noted.
“We used to think men had a higher cardiovascular risk than women,” said senior researcher Eileen Crimmins, a professor of gerontology. “But now we see everybody has gotten better. Cardiovascular risk has improved and that’s a big plus.”
In general, “both men and women are equally treated, and treatment has gotten more effective,” Crimmins said.
The findings may help explain why the life expectancy gap between the sexes has narrowed, she added.
For the study, the research team analyzed national data on adults aged 40 and over from 1990 to 2010. The heart risk factors studied included blood pressure, body mass index (BMI), cholesterol, triglycerides and blood sugar.
Heart specialists welcomed the report.
“The narrowing gap of gender disparities for the treatment of heart disease is a promising sign of improvement in overall health care,” said Dr. Rachel Bond, associate director of women’s heart health at Lenox Hill Hospital in New York City.
This suggests heart health programs for women have worked, said Bond, who was not involved with the study.
“I take these findings as a validation of those programs, but continued efforts need to be made,” Bond said.
“The next target population should be those of younger ages and focused around prevention,” she added.
Dr. Byron Lee is a cardiologist and electrophysiologist at the University of California, San Francisco.
“In addition to the risk factor reduction reported in this study, we have also seen a significant decrease in actual heart attacks and strokes over the same time frame,” said Lee, who also wasn’t involved in the study.
Many factors likely have contributed to the decline in heart attacks and strokes, he said.
However, “I mainly credit our aggressive approach to lowering cholesterol with medicines like statin drugs,” Lee added.
According to the study, the average number of cardiovascular risk factors decreased among both men and women. The biggest improvement was seen among people in their 60s, Crimmins said.
However, men experienced steady improvement over the whole 20 years, while improvements for women came later, between 2000 and 2010.
Hearts risks among women aged 40 to 60 actually increased between 1990 and 2000, but fell off by 2010, the findings showed.
Both sexes benefited from cholesterol medications, the researchers reported. The percentage of men whose cholesterol levels were under control rose from about 63 percent to over 96 percent. Among women, controlled cholesterol levels rose from 65 percent to 88 percent.
Improvements might have been greater if obesity and diabetes had not increased, the study authors noted.
Although these overall gains continued through 2015, Crimmins predicted that future progress may be less striking.
“We have reached a place where we are not going to be able to make much more improvement because we’re already pretty good at controlling cholesterol and [high blood pressure],” Crimmins said.
To make more significant progress, the focus must shift to lifestyle changes, such as a healthy diet and daily exercise, she suggested.
Also, Crimmins said increased prevalence of the abnormal heart rhythm called atrial fibrillation and rising obesity could end up offsetting these important gains.
The report was published online recently in the journal Aging Clinical and Experimental Research.
For more on heart health, visit the U.S. National Institute on Aging.