Skipping breakfast ups risk of CHD in middle-aged men!


Skipping breakfast is not a healthy way to start the day!

This is proved by a new study published online. Compared with men who ate breakfast, those who skipped breakfast had a 27% increased risk of heart attack or death from coronary heart disease (CHD).

The study, based on data from the Health Professionals Follow-up Study (HPFS), was published online July 22, 2013 in Circulation, with first author Dr Leah E Cahill (Harvard School of Public Health, Boston, MA).

The investigators followed approximately 27 000 middle-aged and older US male health professionals for more than 16 years. During that time, 1527 men had incident CHD, defined as fatal MI or nonfatal CHD.

“This was a pretty large study, with a very long follow-up, and a substantial number of incident CHD end points. So from that standpoint, the relationship [between skipping breakfast and increased risk of CHD] is pretty strong,” senior author Dr Eric B Rimm (Harvard School of Public Health) told heartwire. Of note, younger but not older men were at significantly increased risk, he pointed out.

“It’s a pretty simple public health message, one that is cheap, [and involves habits that are] not hard to change compared with other diet and lifestyle factors,” Rimm said. Physicians should advise patients to “eat regularly, and specifically eat in the morning,” he advised.

So, Grab your bowl of cereals and have breakfast like a King!



via Skipping breakfast ups risk of CHD in middle-aged men |

“Caution” warranted if consuming artificial sweeteners.


Consumption of noncaloric, artificially sweetened beverages (ASBs) is associated with an increased risk for obesity, type 2 diabetes, metabolic syndrome, and cardiovascular disease, according to an opinion article by Dr Susan E Swithers (Purdue University, West Lafayette, IN) published online July 10, 2013 in Trends in Endocrinology & Metabolism.

“This somewhat counterintuitive result may reflect negative consequences of interfering with learned relationships between sweet tastes and typical postingestive outcomes.” Swithers writes.

The prospective studies Swithers reviewed found an elevated risk for weight gain and obesity, metabolic syndrome, type 2 diabetes, coronary heart disease, and hypertension in those who consumed ASBs. No decreased risk for weight gain or increased body fat percentage was associated with ASB intake.

It was often difficult to compare the magnitude of increased risk with that of participants who consumed sugar-sweetened beverages (SSBs), in part because of differences in intake.


Studies that separately assessed risk among those who were not overweight or obese at baseline found that the risks of becoming overweight or obese, developing type 2 diabetes, and experiencing vascular events were increased.

So, Caution would be advised while consuming artificial sweeteners.

It would be best to follow a healthy lifestyle and diet along with exercise to ward off obesity in the long run!


via “Caution” warranted if consuming artificial sweeteners |

Air pollution ups heart failure deaths, hospitalizations and costs.


Modest reductions in air pollution could prevent almost 8000 hospitalizations for heart failure and save hundreds of millions of healthcare dollars in the US alone, authors of a new study estimate.

Dr Anoop SV Shah and colleagues University of Edinburgh, Scotland combined data from 35 studies addressing the health effects of air pollution that included heart-failure end points. In all, data from 12 countries were included in their review, published online in the Lancet.


They found that of the common airborne pollutants, carbon monoxide was the most frequently studied and was associated with the largest increase in heart-failure hospitalizations or death, although all “gaseous and particulate air pollutants” with the exception of ozone were associated with increased HF hospitalization or HF mortality.


HF hospitalization or mortality was increased by 3.52% for every 1-ppm increase in carbon monoxide. For sulfur dioxide and nitrogen dioxide, the corresponding increase in risk was 2.36% and 1.70%, respectively, for every 10-ppb increase. For every 10-µg/m3-increase in particulate matter, HF hospitalizations or mortality was increased by 2%.


Of note, hospitalizations and deaths from HF peaked at times when air quality was the worst, Shaw and colleagues observed.


via Air pollution and heart failure |

Stay happy, stay heart healthy!

Mental health has been one of the neglected areas of medicine. Whenever one visits a cardiologist, its common to get advice on weight, diet and exercise. But rarely does the physician speak on mental health and its effects on the heart.

Multiple studies have studied the relation ship between mental health and heart disease, in particular coronary artery disease.

Its been found that acute mental illness like Depression and long term stress like anxiety, work related stress, panic attacks can have a bad effect on cardiac health.

Individuals with serious mental illnesses like depression, bipolar mood disorders and schizophrenia have increased incidence of obesity, altered dietary habits and eventually increased incidence of coronary artery disease. Also long term mild problems like anxiety and work related stress cause an increase in heart disease problems.

Also patients with heart attacks who develop depression later fare badly in the long term when compared to ones without depression.

Its imperative for the Cardiologist to look for mental disorders and its symptoms in their patients to prevent and treat these disorders in the early stage.


Some general guidelines to improve mental health:

Walk/ exercise everyday. Exercise is a great mood elevator and stress buster. Walking half hour a day at a brisk pace can have profound effect on physical and mental health.

Eat well. Eating every 2-3 hours in small portions keep the mind satiated. One can avoid binge eating which is associated with stress and anxiety.

Meditate daily for 15 minutes. Just sitting still and breathing slowly with one concentrating on his/her breath relaxes one’s body and mind.

Be more social. Go out and make friends. Spend time with your relatives.

Always think positive. 


So, Stay Happy and Heart Healthy!

Sufficient sleep further lowers CVD risk.


Getting at least seven hours of sleep a night further lowers the risk of CVD (cardiovascular disease) events—on top of the lowered risk from following four traditional healthy habits.

The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN) study looked at how adequate sleep might enhance the benefits of being physically active, eating a healthy diet, not smoking, and drinking alcohol in moderation. (published in the July 2, 2013 issue of the European Journal of Preventive Cardiology).

In the current study, researchers analyzed data from 6672 men and 7967 women who participated in MORGEN, a prospective study of people aged 20-65 years living in the Netherlands who replied to a lifestyle questionnaire in 1994 to 1997.

Researchers defined five healthy lifestyle habits, as follows:

Spending 3.5 or more hours a week cycling or doing other sports at a moderate to vigorous intensity.

A modified Mediterranean diet score of five or higher.

One drink of alcohol or more a month.

Not smoking.

Sleeping seven hours or more a night.

The population was fairly healthy: 52% were sufficiently active, 37% consumed a healthy diet, 91% of men and 78% of women consumed alcohol, 65% were nonsmokers, and 80% of men and 86% of women obtained sufficient sleep.

During the 10-14 year follow-up, there were 607 composite CVD events: 129 fatal CVD events, 367 nonfatal heart attacks, and 111 nonfatal strokes.

Each factor on its own reduced the risk of CVD. The reduced risk for composite CVD ranged from 12% lower for following a healthy diet to 43% lower for not smoking; the risk of fatal CVD ranged from 26% lower for being physically active to 43% lower for not smoking. Getting a good night’s sleep reduced the risk of composite CVD by 22% (HR 0.78) and fatal CVD by 43% (HR 0.57) compared with having insufficient sleep.

Not surprisingly, compared to people with fewer than two traditional healthy lifestyle habits, those who adhered to four traditional habits had a 57% lower risk of composite CVD and 67% lower risk of fatal CVD. People who added sufficient sleep to these four habits had an even greater benefit: a 65% lower risk of a composite CVD event and an 83% lower risk of fatal CVD.


So, Get healthy and catch a good nights sleep!


via Sufficient sleep further lowers CVD risk |

Know more about AF (atrial fibrillation).


Atrial Fibrillation (AF) is a common condition affecting the elderly. The prevalence of AF increases with age. It is estimated that 1% of individuals above the age of 60 and 8% of individuals above the age of 80 years must be suffering from AF


AF means fast beating of the upper chambers (atria) of the heart. The atrial rate is expected around 400-600 beats per minute. At this rate there is no effective contraction of the upper chambers and this causes blood to stagnate. This can cause small clots which can then migrate to the brain causing stroke. The other symptoms of this condition may be palpitations and breathlessness. A fast heart rate for a long time may also cause the heart pumping to go down and cause a condition called heart failure.


AF increases stroke risk!

The most devastating consequence of this heart beat disorder is stroke. The elderly (aged > 65 years) are at high risk of stroke. The other risk factors for stroke are blood pressure, heart failure, diabetes and patients who have had strokes in the past.


Treatment of AF:

Treatment of AF is two-fold.

1. The primary goal is to prevent strokes.

Patients with the highest risk should receive blood thinners. Warfarin and Dabigatran are the commonest drugs used. Individuals at lower risk can be treated with Aspirin.

2. The second goal of treatment is to control or prevent AF.

Patients who have had AF for a long duration are on drugs which slow down the heart rate and thereby reduce palpitations. In the initial stages of the disease, the recurrence of the condition  (AF) can be prevented by medications. There are multiple drugs available and should be taken in consultation with physicians.


The main goal of treatment still remains Stroke Prevention.

Controlling BP and cholesterol: Only 1/3rd achieve targets!


How many individuals have their blood-pressure and cholesterol levels under control?

Less than one third!

Less than one in three patients in the US have their blood-pressure and cholesterol levels under control, according to a new analysis of the National Health and Nutrition Examination Surveys (NHANES). Researchers say there exist significant opportunities for improving hypertension and cholesterol control.

People with high blood pressure have about double the risk of coronary heart disease, but treating hypertension only reduces heart attack risk by only 25%. It is important to treat and control both high blood pressure and cholesterol.

In the study, published online July 1, 2013 in Circulation, the researchers assessed concurrent hypertension and hypercholesterolemia control in NHANES 1988 to 1994, 1999 to 2004, and 2005 to 2010.

Across the three surveys, 60.7% to 64.3% of the individuals with hypertension also had high cholesterol levels.

The control of LDL-cholesterol levels increased over time, up from 9.2% in 1988-1994 to 45.4% in 2005-2010.

In 2005-2010, approximately 54% of all hypertensive patients had good blood-pressure control, defined as <140/90 mm Hg. In total,  21.5% of all hypertensive patients were treated and uncontrolled.


For patients with high blood pressure and elevated cholesterol levels, the concomitant control of both risk factors increased approximately sixfold from 1988-1994 to 2005-2010. The control of blood pressure and LDL-cholesterol levels increased from 5.0% in 1988-1994 to 30.7% in 2005-2010.


“What we find is that while there has been a lot of progress in controlling both blood pressure and cholesterol, still about 70% of patients who have high blood pressure and high cholesterol don’t have both risk factors controlled,” said Egan, the lead author of the study.


via Controlling BP and cholesterol |

Large Israel registry study links adolescent BMI to midlife deaths.

Worrisome new results from Israel hint that gains seen in life expectancy over the past 50 years are likely to be attenuated by rising obesity rates among adolescents.  The data was collected from the medical database of the Israeli defense force and the  national death registry.

The results were presented at the American Diabetes Association 2013 Scientific Sessions. Dr Gilad Twig Chaim Sheba Medical Center, Tel-Hashomer, Israel stressed that the analysis looked only at all deaths unrelated to military service so could not single out deaths from CVD or other causes.

But because military service is mandatory in Israel, and all conscripts must undergo a physical exam at the time of recruitment, the analysis provide a unique snapshot of the health and longevity of more than two million young men and women age 16-20 over the past 40 years.

Fighting obesity

The analysis included 2.16 million adolescent males (60%) and females, who had a mean age of 17.4 at the time of their first military medical tests and an overall prevalence of overweight and obesity of 11.7% at the time of recruitment.

The primary outcome for the study was mortality before the age of 50: this was seen in 1.21% of males and <1% of females.

Compared with mortality among conscripts whose BMIs put them in the 25th to 50th percentile, mortality for recruits in higher percentiles for BMI increased continuously up the BMI spectrum.

In men, being underweight (BMI<18.5) was associated with a 11% increase in mortality before age 50, while being overweight (BMI 25-29.9) and obese (BMI> 30)  were associated with increased risks of 40% and 88%, respectively.

A similar pattern was seen in women increases of 11%, 44%, and 105% for underweight, overweight, and obese, respectively, although the relative risk ratios were not statistically significant for the underweight group.

More worrying still, even higher body-mass-index BMI levels within the “normal” range in teens were associated with midlife mortality. More interesting was the 11% increase in mortality for underweights with BMI <18.5.

The data seems to suggest that a normal BMI would be associated with longest survivals.


via Large Israel registry study links adolescent BMI to midlife deaths |