Category Archives: Cardiovascular Health

Mediterranean Diet Good for Women’s Heart Health

May 12-18 is celebrated as National Women’s Health Week, and in recognition of this important week today’s post will examine research studying the effects of a Mediterranean-style diet on cardiovascular risk factors in women.

For those who are unfamiliar with the Mediterranean Diet, it is loosely based on the traditional cooking styles of those countries that border the Mediterranean Sea. Some of the important tenants of the diet include eating lots of vegetables and whole grains, using olive oil as a substitute for butter and margarine, eating more fish and less red meat, and choosing nuts as a healthy snack.

In a recently published paper, researchers affiliated with Harvard Medical School examined the effects of a Mediterranean-style diet upon cardiovascular risk factors in a group of women participants. This particular study involved nearly 26,000 women. To assess the women’s dietary habits, a food-frequency questionnaire which included 131 items was administered at enrollment in the study. The researchers then calculated what they termed the “Med Score” for each participant. The Med Score ranged in scale from 0 to 9, with a higher score indicating better adherence to the Mediterranean Diet. The subjects were then placed into three different categories (Low, Medium, High) based on their Med Score. Multiple lab markers were taken as well, including LDL, HDL, CRP, fibrinogen, and lipoprotein (a).

This group of women was then followed for about 12 years. They were monitored for cardiovascular events such as heart attack and stroke. The researchers discovered that the subjects in both the Medium Med Score group and the High Med Score group had significant cardiovascular risk reduction, compared to the Low Med Score group. The risk reduction was 28% in the High Med Score group, and 23% reduction in the Medium Med Score group, compared to the Low Med Score Group.

This is a very well done study, which adds to previous research on the benefits of the Mediterranean Diet. This is a large group of women, who were considered healthy at baseline, which is important to note. Here we have a relatively simple dietary modification that had a profound positive impact on women’s cardiovascular health. The Mediterranean Diet seems to be a low-risk diet, that is worthy of consideration by women, and men as well.

“No disease that can be treated by diet should be treated with any other means.”– Moses Maimonides

(Source- JAMA Network Open, 2018:1(8))

This bog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Tea Lowers Bad Cholesterol

April 21st is National Tea Day in the UK, and this post is the second in recognition of this important day. This post will examine research regarding black tea and cholesterol.

Tea remains one of the world’s most widely consumed beverages. It is estimated that the size of the global tea market is more than $70 billion. While coffee remains more popular than tea in the US, Americans still drink their fair share of tea, averaging over 8 gallons per capita consumption. Nearly a quarter of Americans drink tea daily.

A group of researchers in China investigated the relationship between black tea consumption and cholesterol parameters. They performed a review and meta-analysis of ten studies, which included over 400 participants.

The researchers discovered that the consumption of black tea led to a significant reduction in LDL concentration. LDL is the low density or so-called “bad cholesterol”. LDL contributes to the build-up of fat in the arteries, or atherosclerosis.

Given the possible reduction in “bad cholesterol”, consider tea as a healthy beverage choice. And celebrate National Tea Day!

“But indeed I would rather have nothing but tea.” – Jane Austen

(Source- Clinical Nutrition, 2014)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Enjoy a Cup of Tea Today (or three)

April 21st is National Tea Day in the UK, and in recognition of this today’s post will examine research regarding tea consumption and cardiovascular outcomes.

Tea is one of the most widely consumed beverages in the world. Tea is derived from Carmellia sinesis leaves, and leaf buds. Carmellia sinesis is an evergreen shrub or small tree, which grows at elevation in warmer weather climates. Approximately 40% of the global tea production comes from China, with India producing about 22%. Other leading producers include Kenya, Sri Lanka, and Turkey. Turkey is the largest per capita consumer of tea, at 5 1/2 pounds per person per year. According to statistics from the Tea Association of the USA, Americans consumed over 84 billion servings of tea last year. Over 84% of that was black tea, with about 15% being green tea.

Tea is purported to have a range of health benefits, from cardiovascular benefits, to lowering risks of certain cancers, to improvement in cognitive health. Tea is composed of hundreds of bioactive compounds, including flavonoids. Flavonoids are thought to have antioxidant properties, and may be the source of some of the beneficial properties of tea.

Researchers in China performed a meta-analysis of published prospective observational studies to examine the relationship between tea consumption and various cardiovascular outcomes. Twenty-two different studies were included in the analysis, including participants from the US, Europe, and Asia. More than 850,000 subjects were enrolled in these various trials.

Researchers discovered that increased tea consumption was associated with a reduction in cardiac death, cerebral infarction, heart disease, intracerebral hemorrhage and stroke. More importantly, tea consumption was associated with a reduction in total mortality. These results were with a serving of three cups of tea per day.

This was a robust meta-analysis, with a large number of study participants, spanning the globe. Given these results, consider tea as a healthy beverage choice, and salute National Tea Day!

“There are few hours in life more agreeable than the hour dedicated to the ceremony known as afternoon tea.”  Henry James

(Source- European Journal of Epidemiology (2015) 30)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Increasing Glucose Leads to Heart Attacks and Strokes

Today is Diabetes Alert Day, and in recognition our post will review a recently published study on change in fasting glucose levels and subsequent risk of heart attack, stroke and all-cause mortality.

A reasearch group in Korea analyzed data from over 260,000 Korean adults enrolled in the Korean Health Insurance Service. These were adults over 40 years old, and with no diagnosis of diabetes or cardiovascular disease at time of enrollment in the study. The study included both men and women.

At initial enrollment, subjects were divided into two groups- a normal fasting glucose group (glucose <100 mg/dL) and an impaired fasting glucose group (glucose 100-125.9 mg/dL). Data such as smoking status, body mass index, blood pressure, physical activity level, total cholesterol, and alcohol consumption was also collected.

The subjects had a second examination in two years. At this second visit, any changes in fasting glucose between the two visits was noted. On average, these participants were then followed for up to eight years. Data on the number of heart attacks, strokes, and all-cause mortality were collected.

Researchers discovered that those participants who shifted from the normal fasting glucose group into diabetes (glucose >126 mg/dL) were associated with a much higher risk of stroke and all-cause mortality, compared to the participants who remained in the normal glucose group. In addition, those participants initially diagnosed with impaired fasting glucose who later moved into diabetes had a much higher risk of heart attack and all-cause mortality.

The statistics for diabetes are a cause for alarm- it is estimated that the total cost for diabetes in 2017 was $327 billion. About 84 million Americans are currently in the pre-diabetic category, with one of three adults age twenty and older now being pre-diabetic. Given the results of this very robust study, with over two million person-years of follow-up, serious consideration should be given to those interventions which help those who currently have normal or impaired glucose levels from progressing into diabetes.

“No one had ever told me junk food was bad for me. Four years of medical school, and four years of internship and residency, and I never thought anything was wrong with eating sweet rolls and doughnuts, and potatoes, and breads, and sweets.”– Robert Atkins

(Source- Cardiovascular Diabetology (2018) 17:51)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Poor Dental Health Linked to Increased Risk of Heart Disease in Women

March 20th is World Oral Health Day, and in recognition of this our post today will examine the relationship between periodontitis and cardiovascular disease in post-menopausal women.

Statistics from the CDC indicate that heart disease is the leading cause of death for women in the U.S., accounting for nearly 1 in 4 female deaths. It is estimated that heart disease costs the U.S. about $200 billion annually.

For this study, researchers enrolled 57,000 females from the Women’s Health Initiative Observational Study, between the years 1993-1998. The women were from 40 health centers nationwide, between the ages of 50 to 79. The participants periodontal status was assessed by a questionnaire at five years. There was also annual follow-up through 2010.

Results of the study demonstrated that total mortality risk was significantly higher in women with either edentualism or periodontitis. Also, women who were edentulous had a significantly higher risk of coronary vascular disease and coronary heart disease. These higher risks held even after data was adjusted for potential confounding factors.

This is a very robust study- a large group of post-menopausal women, a cohort that is generally underrepresented in medical research. Given the results of the study, good oral hygiene may be worthy of consideration as a way to potentially lower risk of cardiovascular disease later in life.

On World Oral Health Day, please remember to thank your dentist and hygienist for all their efforts on behalf of your health!

“You don’t have to brush your teeth- just the ones you want to keep.”– Anonymous

(Source- Journal of the American Heart Association, 2017)

This bog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Good Oral Hygiene May Prevent High Blood Pressure

In recognition of World Oral Health Day on March 20th today’s post will examine the relationship between periodontal disease and prehypertension, as well as hypertension.

According to statistics from the CDC, more than 25% of the adults in the U.S. have untreated tooth decay. In addition, almost half of U.S. adults have some signs of gum disease. Periodontitis is defined as the inflammation of the gums and support structures of the teeth. It is caused by certain bacteria, and in turn these bacteria cause inflammation. It is thought that perhaps if this inflammatory state becomes chronic, it may have implications for inflammation elsewhere in the body, such as in cardiovascular health.

A research group in Japan performed a prospective cohort study on a group of university students, examining whether periodontal disease was related to the development of prehypertension, or to hypertension. Over 2500 students enrolled in the study, ages 18-27 years.

Dentists assessed the oral health of each student. Periodontal health was evaluated using the Community Periodontal Index (CPI), which is commonly used to measure periodontal disease. The CPI is an objective measure of periodontal health, and also suggests the proper treatment for the given CPI score. In addition to the CPI, the dentists also measured the Bleeding Upon Probing (BOP), which is felt to be a simple way to assess inflammation. While dentists assessed oral health, the resting blood pressure and body mass index of the subjects was also measured. The participants also completed a questionnaire, which assessed both dental and general health measures.

The Japanese university students were followed over a period of three years. What the researchers discovered was that the risk of developing hypertension over the three years was significantly associated with periodontal disease.

Given the results of this study, consider practicing good oral health as a way to lower your risk for developing high blood pressure. And don’t forget to thank your dentists and hygienists on World Oral Health Day, or the next time you see them.

“I told my dentist my teeth are going yellow, he told me to wear a brown tie.” – Rodney Dangerfield

(Source- American Journal of Hypertension, March 2016)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Eat Your Veggies- Help Your Heart

In recognition of registered dietician nutritionist day, our post today will look at how some dietary factors impact cardiovascular health.

A recent study examined a group of Swedish women and their dietary habits. Nearly 39,000 women completed a 96 item food frequency questionnaire. The questionnaire asked about how certain food or beverages had been consumed over the prior year. Researchers then calculated estimates of the total antioxidant capacity of each respondents diet. Four categories including fruit and vegetable consumption, whole grain consumption, and coffee consumption were used. The participants in the study were followed for approximately ten years. Women in the highest ranking group of total antioxidant capacity of diet, compared to the lowest ranking group, had a 20% lower risk of a heart attack.

This study is an interesting one as it examines a group of women. Women have been typically underrepresented in medical research. This was also a large study of nearly 39,000 subjects, and large is better in this regard.

Finally, which one of us has not encouraged our children to “eat more vegetables”? Now we can add that it is good for their heart as well!

“I eat more vegetables than the average vegetarian.”– Dr. Robert Atkins

(Source- American Journal of Medicine, Vol 125, No. 10, Oct. 2012)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

 

Sauna Lowers Risk of High Blood Pressure

This is the second post in recognition of Helsinki Sauna Day, which is March 9th. In this post we will examine research regarding sauna bathing and subsequent development of hypertension.

Sauna is a part of life in Finland, and an important element in Finnish culture. Saunas go back at least 2000 years, and perhaps even much longer. The first saunas were simply dug into embankments, and later free-standing log structures were developed. There are more saunas than cars in FInland.

A prospective cohort study was completed as part of the Kuopio Ischemic Heart Disease Study, this was the same study group that was discussed in our last post. The sample size included over 1600 men, ages from 42 to 60 years. It is important to note that these men did not have high blood pressure at baseline.

The subjects were enrolled in the study between 1984 to 1989. Information such as smoking habits, body mass index, serum creatinine (kidney function), glucose and cholesterol were collected. Sauna bathing habits were assessed via a self-administered questionnaire. The median age was 52.9 years. The average duration of a single sauna session was 14.4 minutes.

The mean time of follow-up was 22 years. During this time, subjects were monitored for the development of hypertension. The researchers discovered that the higher frequency of sauna bathing was independently associated with a lower risk of the development of high blood pressure, in a dose-response manner.

This is an important study- none of the subjects had hypertension when they enrolled into the study. Also, the more sauna sessions a participant had each week, the lower the risk of developing hypertension.

While this study shows impressive results in an all-male study, it should be repeated in a population of female participants to see if the results would still apply. Also, it would be interesting to see if the results would apply in a more diverse population, such as we have in the United States. In any case, taking a sauna bath certainly seems like a low risk endeavour that could potentially lead to the prevention of high blood pressure.

“Build the sauna, then the house.”–  Finnish Saying

(Source- American Journal of Hypertension 30(11), November 2017)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Sauna Is Good For Your Heart

March 9th is Helsinki Sauna Day, and in recognition of this day our post will review research related to Finnish sauna bathing and cardiovascular events. This will be our first of three posts on the benefits of sauna bathing.

The sauna is an important part of Finnish culture. One of the first recorded writings on sauna baths are from the monk Nestor the Chronicler in 1112. Some versions of the Finnish sauna are thought to go back at least two thousand years. There is an average of one sauna per household in FInland, where saunas are a place to relax with family and friends. A traditional Finnish sauna usually has warm (80-100 C), dry (10-20% humidity) air.

A recent study looked at the association of the frequency as well as duration of sauna bathing and several cardiovascular markers, such as sudden cardiovascular death and fatal cardiovascular diseases. A prospective cohort study was performed by enrolling over 2300 men, ages 42-60 years, from eastern Finland. Subjects were from the Finnish Kuopio Ischemic Heart Disease Risk Factor Study.

The subjects were subdivided into groups based on the frequency of sauna bathing (1, 2-3, and 4-7 times each week) and also the duration of the sauna sessions (<11, 11-19, and >19 minutes per session). Baseline evaluations were conducted beginning in 1984 through 1989. On average, participants were followed for 18.8 years.

Results of the study demonstrated that the subjects with a higher frequency of sauna bathing per week had a lower risk of both fatal coronary heart disease and fatal cardiovascular disease. In fact, the risk of fatal coronary heart disease was 23% lower for 2-3 sauna sessions per week, and 48% lower for 4-7 sauna bathing sessions per week.

In addition, the frequency of sauna bathing was also inversely associated with all-cause mortality, with a 40% reduction in all-cause mortality when comparing 4-7 sessions per week of sauna bathing to one session per week.

The mechanism by which sauna bathing confers these protective cardiovascular benefits is not entirely clear. Heart rate may rise to 100-150 beats per minute during a sauna bath, which is comparable to some types of low and moderate exercise training. It is also believed that sauna bathing is beneficial for the endothelial lining of the blood vessels.

It would be helpful to perform this same study in a population of female participants, to see if the results would be comparable.

While sauna bathing may not be for everyone, again we have a simple low risk intervention that may yield great benefits. Happy Helsinki Sauna Day!

“The ideal sauna is a small building made of logs, set near a lakeshore, facing towards the sunset.”  Bernhard Hillila

(Source- JAMA Internal Medicine 2015: 175(4):542-548)

This bog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Worried About Your Heart? Don’t Skip Breakfast!

Today’s post is another in recognition of American Heart Month. Many of us can recall being reminded by our mother to “eat your breakfast” when we were young, usually as teenagers. It turns out that as is usually the case, mom was giving us good advice.

An interesting study from a research group primarily located in Spain and the US used data from PESA (Progression of Early Subclinical Atherosclerosis) and looked at the association of breakfast styles and cardiovascular risk factors and the presence of subclinical atherosclerosis.

The PESA study is an ongoing observational investigation of over 4000 employees who work at the Bank Santander Headquarters in Madrid, Spain. Female and male participants in the study were ages 40-54, and were free from cardiovascular disease at the time of enrollment in the study. The participants were asked to complete a computerized food questionnaire, which included over 800 food items. Based on this data the “energy consumed during breakfast” was calculated.

Three different categories of breakfast patterns were established. First were the “breakfast skippers”, whose breakfast intake did not exceed 5% of the their total daily energy intake. The next category was the “low energy” breakfast group, who consumed between 5% and 20% of their total daily energy intake at breakfast. The third group was the “high energy” breakfast group which consisted of those who consumed more than 20% of their total energy intake at breakfast. Of the over 4000 study subjects, 3% were in the “breakfast skipper” group, 69% were in the “low energy” group, and 28% were in the “high energy” breakfast group.

Ultrasound was used to assess for atherosclerotic plaques in the carotids, the abdominal aorta, and the illiofemoral arteries. The prevalence of subclinical atherosclerosis for the PESA subjects was 62.5% in the “breakfast skippers” group, 60.3% in the “low energy” group, and 13.4% in the “high energy” group.

Importantly, regularly skipping breakfast was associated with 2.57 higher odds for generalized atherosclerosis, and 1.55 higher odds for noncoronary atherosclerosis, independent of traditional cardiovascular risk factors (such as diabetes, high cholesterol, high blood pressure, and smoking).

So, make some time in the morning for breakfast. It turns out mom was right, again.

“Sometimes I’ve believed as many as six impossible things before breakfast”. Lewis Carroll

(Source- Journal of the American College of Cardiology, Vol. 70, No. 15, 2017)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.