Tag Archives: American Heart Association

The kissing bug—cause for concern?

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If you come across a suspected triatomine, the CDC recommends placing it in a container with alcohol and taking it to your local health department. It can be tested for Chagas disease. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


It sounds like something out of a horror film: A blood-hungry insect feeds on its prey’s faces while they sleep, leaving behind a parasite that can cause stroke and heart disease.


But the triatomine, or so-called “kissing bug,” is all too real and found regularly in Latin America, but also has been found in several areas of the United States, as far north as Illinois and Delaware.


And while it often targets faces, the insect will settle for any patch of exposed skin.


With summer barbecue season on the horizon, how worried should people be?


It’s important to keep things in perspective, said Dr. Caryn Bern, a professor of epidemiology and biostatistics at the University of California School of Medicine.


After an acute flu-like period that lasts from weeks to months, most people who test positive for Chagas disease show no symptoms.


“The estimate is that 20 percent to 30 percent of people with Chagas disease will eventually develop heart or gastrointestinal disease, although heart disease is much more common,” Bern said. “That’s over a lifetime and it usually doesn’t show up until years after the infection occurred.”


It’s not the bug that causes Chagas disease, but rather a parasite that lives in its poop.


When a person inadvertently rubs the bug’s feces into the bug wound, their eye or another mucous membrane, the parasite sometimes makes itself at home.


Chagas disease also can be transmitted from mother to fetus, from contaminated blood transfusions, via an infected organ donor or, in rare cases, through food or drink.


While about 300,000 people in the United States have Chagas disease, most of them contracted it while living in Mexico, Central America and South America, where the Centers for Disease Control and Prevention estimates up to 6 million to 8 million have been infected.


All told, the disease causes more than 10,000 deaths a year worldwide, according to the World Health Organization.


But it’s important to keep in mind that since 1955, there have been fewer than 50 documented cases of people who have acquired the parasite from exposure to the triatomine in the U.S., said Dr. Susan Montgomery, who leads an epidemiology team in the Parasitic Diseases Branch of CDC’s Division of Parasitic Diseases and Malaria.


“The parasite has to get into a human’s body or an animal’s body by contaminating the wound,” Montgomery said. “It’s pretty complicated.”


But there is cause for concern, said Paula Stigler Granados, an assistant professor at Texas State University who leads the Texas Chagas Taskforce.


Stigler Granados and her team work to raise awareness about Chagas in a state where more than 60 percent of triatomines test positive for the parasite that causes the disease.


“The more we look, the more we find,” Stigler Granados said, noting that since the American Red Cross started screening new blood donors for Chagas disease, they have identified many people infected with the disease. “Although the blood donation tests are extremely sensitive and sometimes have false positives, that’s an indicator that it could be a bigger problem we should be monitoring.”


There is a treatment for people who have Chagas disease.


In 2017, the Food and Drug Administration approved benznidazole, a 60-day medication regimen for people ages 2 to 12.


Once Chagas disease becomes chronic, the medication may not cure it but could slow the progression in younger people.


For older people who are affected, experts recommend doctors and patients weigh the individual benefits with the possible side effects of the medication, which can include rash, abdominal discomfort and numbness or tingling in the hands and feet.


The best bet is to avoid infection altogether.


The CDC advises people to use window screens, seal any gaps in the home, allow pets to sleep indoors and eliminate things near the house that attract insects, including lights and wood, brush and rock piles.


If you do come across a triatomine, don’t kill it, the CDC recommends.


Instead, capture it with a container and either fill it with rubbing alcohol or freeze it.


Then take it to your local health department or university laboratory for identification. Testing can help to determine if it is a triatomine, and if so, whether it carries the parasite.


In the meantime, experts agree on one thing: People should stay calm.


“The important thing to remember is that these bugs are more interested in staying out in the woods and feeding on animals than they are in feeding on you,” Montgomery said. “It’s important to prevent Chagas disease if you can, but it’s very hard to get this infection and it’s not happening often.”


Reprinted with permission from Spectrum Health Beat.


Want to get fit? You’re never too old

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In your later years, it matters less what type of movement you choose—it’s all about the fact that you’re up and moving. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


As people age, physical activity still needs to be part of the game plan for living a healthy, happy life—and experts say it’s never too late to get active and build strength.


“We try to tell people the body can still adapt and it can still improve,” said Barbara Nicklas, a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine.


Those who engage in more occupational or leisure time physical activity have a lower risk of disease and death—and the health benefits of movement can extend to all ages, Nicklas explained in an editorial in the Journal of the American Geriatrics Society.


Nicklas cautions against placing all “older adults” who are age 60 and up into one category. Rather than basing exercise and activity goals on age, they should be geared to one’s “physical functional status.”


“What can the person do?” she said. “Not everybody is the same.”


Whether you’re 65 or 85, or a runner, a tennis player or perhaps someone who has difficulty getting around, one constant remains: the importance of moving.


“Any time you can incorporate more movement throughout the day, it is good,” said Nicklas, who urges “starting where you’re at and doing what you can.”


The U.S. Health and Human Services Department and the American Heart Association recommend at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes of vigorous activity or a combination of both, as well as muscle-strengthening activity.


For those who have been living a sedentary lifestyle, walking is the best way to begin getting physically active, Nicklas said. She suggests going with a friend or enrolling in a walking program like the one her university offers. It adds accountability, a social component and safety, to guard against falls.


Using a “walking tool,” such as a cane or walker, if it’s needed, can help you stay active, Nicklas said.


“Slow and steady—the tortoise pace—is better than the rabbit pace when you’re starting out or starting over,” she said.


Resistance or strength training—through free weights, weight machines, pushups or pull-ups—can help with range of motion around joints and improve muscle mass, muscle strength and bone strength. It can help in the ability to perform everyday activities, improve balance and may reduce the risk of falls.


Fred Bartlit, 87, proves the point that chronological age isn’t the determining factor when it comes to strength and feeling young.


A former U.S. Army ranger, Bartlit always had been physically active. He also was an avid skier and golfer. As he reached his 50s, at the urging of his future wife, he intensified his workouts and began strength training at a gym.


Today, the Colorado attorney and author said he is stronger than when he was in the Army at age 22. In addition to practicing law, he makes it his mission to inform older adults about battling sarcopenia, the loss of muscle with aging.


“Our bodies, they’re crying out for physical activity,” he said. “And now the world is sedentary.”


For someone as active as Bartlit, strength training helps him ski challenging mountains trails with his 58-year-old son and 16-year-old granddaughter.


Multiple scientific studies point out that building strength is important in performing everyday activities and in avoiding or managing chronic disease.


Bartlit suggests working with a trainer at first, if possible, and trying to fit in strength training three times per week.


“You have to create habits,” said Bartlit. “It’s about living a full life. It changes the way you think, the way you feel, your confidence in doing things.”


Boosting physical activity and strength helps aging adults do the things they want to do in daily life—and that can be motivating, Nicklas said. It may be as simple as going to the grocery store on your own or having the energy to take grandchildren to the park or to a soccer game.


Older adults are disproportionately affected by conditions such as diabetes, arthritis and heart disease, with 80% of people over 65 having at least one of those chronic conditions, according to the National Council on Aging.


But even though some health setbacks may occur with advancing age, they don’t have to completely derail an exercise plan. “This is just reality and it’s going to happen,” Nicklas said.


“Steady improvement” should be the aim, she said. “The body is still capable of adapting.”


Reprinted with permission from Spectrum Health Beat.




Want a fitter ticker? Drop the clicker

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Want to live a long life? Consider breaking up your TV. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


People who watch less TV and are physically active live more years free of heart disease, according to a new study.


Past research has shown people who are highly physically active tend to live more years free of cardiovascular disease.


But researchers of a study published recently in the Journal of the American Heart Association wanted to look specifically at how TV viewing habits fit into the equation.


Using data from 13,534 people ages 45 to 64, investigators studied three factors—how much TV people generally watched, how often they were physically active in their leisure time and how long they lived without having a stroke, heart failure or coronary heart disease.


After an average of 27 years, people who were highly active and watched little or no TV lived about two and a half years longer free of stroke, heart failure and coronary heart disease than those who often watched TV and weren’t active.


TV watching impacted health regardless of physical activity, the study found.


Those who seldom watched or never watched TV lived about a year longer free of each type of cardiovascular disease than those who often watched TV.


“This study suggests that engaging in any physical activity and viewing less TV could help you live more years free of (cardiovascular) disease,” said Carmen Cuthbertson, the study’s lead author.


“Because there’s such a large cardiovascular disease burden in the U.S., we wanted to focus on how to extend the years you live in health,” said Cuthbertson, a postdoctoral fellow in the epidemiology department at the University of North Carolina at Chapel Hill.


The study was limited, she said, by the fact that participants were asked only about “leisure time” activity and not about household chores or physical activity during work or commuting.


She said she’d like future studies to incorporate wearable devices to track physical activity and sedentary time.


Bethany Barone Gibbs, a professor of health and physical activity at the University of Pittsburgh who was not involved in the study, applauded the research for focusing not on death, but on how people can live longer lives free of cardiovascular diseases.


While the results don’t prove frequent TV watching causes heart disease, she said, its findings help clarify how physical inactivity affects health.


“Studies have shown that people who sit for hours at a time develop various vascular dysfunctions—blood begins pooling in the legs and circulation gets worse, especially in the extremities, which we think causes vascular damage that can lead to the long-term development of heart disease,” said Gibbs, vice chair of the American Heart Association’s Physical Activity Committee.


“TV watching is just one domain of sedentary behavior, but it’s also a really modifiable behavior,” she said.


The study began in the late 1980s before smartphones and the internet impacted how long people sit in front of screens, Gibbs said. She called for new in-depth research into how cardiovascular health is affected by overall sitting time as well as binge-watching TV.


“Now, we can sit back and not even have to lift a finger to watch the next show on Netflix,” she said. “I think television-watching is becoming an even more important target when it comes to behavior change and reducing our risk of cardiovascular disease.”


Reprinted with permission from Spectrum Health Beat.




Gout could increase heart disease risk

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Gout is not just a pain in the toe, it affects other organs, too, including the heart. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


Having a type of inflammatory arthritis called gout may worsen heart-related outcomes for people being treated for coronary artery disease, according to new research.


The study, published in The Journal of the American Heart Association, sought to clarify older research on the link between cardiovascular disease and gout, which occurs in people with high levels of uric acid in the blood.


In the U.S., gout affects nearly 6 million men and 2 million women, or about 4 percent of the population, according to the Arthritis Foundation.


The buildup of uric acid can form needle-like crystals in a joint and cause sudden pain, tenderness, redness, warmth and swelling, often in the big toe. But it’s also associated with a greater risk of kidney disease, diabetes, cancer and sleep apnea.


Researchers from Duke University studied data from more than 17,000 patients, including 1,406 who had gout at the start of the study and were being treated for cardiovascular risk factors. After following patients for an average of 6.4 years, researchers found that “in spite of aggressive medical therapy,” the gout was linked to worse outcomes and death.


“Among patients who had gout at the beginning of the study or who developed it during follow-up, their risk of either dying of cardiovascular disease or having a heart attack or stroke was 15 percent higher than patients who never developed gout,” said the study’s lead author, Dr. Neha Pagidipati, a cardiologist and assistant professor at Duke University School of Medicine in Durham, N.C.


Patients who had gout at any point during the study had a twofold increased risk of heart failure death compared to people who never developed gout.


While past research showed people with gout have an increased risk of cardiovascular disease, “a lot of those studies were done decades ago, before modern preventative therapy like statins became extremely common,” Pagidipati said. “We wanted to take a more contemporary look at the relationship between gout and future heart disease in patients with known coronary artery disease.”


Many patients don’t even realize a link exists between gout and heart problems, she said, and the new findings show the need for patients to talk to their physicians about added risks.


“Also, from a physician’s perspective, it’s important to consider that patients with gout may be at increased risk for cardiovascular disease even if they’re already treating them with all the standard therapies. It’s something to have on their radar,” Pagidipati said.


Although it’s unclear why gout might increase the risk of cardiovascular disease, she said possible reasons include increased oxidative stress and inflammation.


“We know that people who have a high level of inflammation are at an increased risk for cardiovascular disease, and we also know gout is characterized by periods of acute inflammation: The link may have to do with that,” she said.


Dr. Jasvinder Singh, who was not involved in the study, said the new research may help the public understand how insidious gout can be.


“Gout is not just a disease of the joints: It’s a disease that causes inflammation in the joints and in the body. It’s not just a pain in the toe, it affects other organs, too, including the heart,” said Singh, a gout researcher and professor of medicine and epidemiology at the University of Alabama at Birmingham.


Singh said the new study underscores the potential dangers of ignoring even occasional episodes of gout.


“Patients may say, ‘I have an attack every two years, so shouldn’t I wait (for treatment) until it becomes more frequent?’ But in light of studies such as this one,” he said, “patients might want to take that into account and know that leaving gout untreated might be affecting their cardiovascular health.”


Reprinted with permission from Spectrum Health Beat.


Use energy drinks when cramming for exams?

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For a healthy boost during studying, try high-intensity exercise, or even just a quick run up and down the stairs. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


Final exams–and the ensuing all-night study sessions they cause–are looming large for many students across the country. But reaching for energy drinks to perk up those drooping eyelids and boost study performance could do more harm than good.


Recent research shows just one energy drink can affect blood vessel function. And other studies have shown these caffeine-and-herbal concoctions can increase stress hormones and are linked to changes in blood pressure and the heart’s electrical activity.


“What I say to people who are studying is to avoid energy drinks. And to people who are exercising, avoid them,” said Dr. John Higgins, chief of cardiology at Lyndon B. Johnson Hospital, a sports cardiologist and a professor at McGovern Medical School at UTHealth in Houston.


Higgins led a study that looked at the effects of energy drinks on blood vessel function on 44 non-smoking, healthy medical students who were in their 20s. He and his colleagues tested the students’ blood vessel, or endothelial, function and then tested it again 90 minutes after they had consumed a 24-ounce energy drink.


The preliminary results, presented earlier this month at the American Heart Association’s Scientific Sessions conference, suggest the drink reduced by about half how much the participants’ blood vessels were able to dilate, or expand.


“During exercise or under stress, your arteries have to open up because they need to get blood to the muscles, heart and brain,” Higgins said. “If there is impairment during exercise or mental stress, it could lead to adverse effects.”


The market for caffeine-infused energy drinks has grown during the last decade, with new blends adding vitamins and other ingredients touting everything from memory enhancement to concentration benefits. According to research company Statista, energy drink sales reached $2.8 billion in 2016, with consistent increases since 2011. A 2016 Statista survey of 18- to 69-year-olds showed 1 in 4 people had an energy drink almost every day.


Coffee and its caffeine have gotten the green light, in moderation, from the U.S. Department of Agriculture. Federal dietary guidelines published every five years as a go-to source for nutrition advice say three to five cups a day, which can be up to 400 milligrams a day of caffeine, can be part of a healthy diet.


But Higgins said energy drinks are more than just caffeine.


“We suspect it has to do with their blends,” he said. “They have lots of sugar and caffeine, but also taurine, an amino acid, guaranine (from a South American plant), another source of caffeine, and they sometimes have vitamins. But they have these substances at levels in excess of the recommended daily allowance, sometimes even 10 times or more.”


On campus, there’s a common pattern, said LaVelle Hendricks, an associate professor of counseling and a student affairs coordinator at Texas A&M University-Commerce, about an hour northeast of Dallas. When students are dealing with stress and lack of sleep, “when they get close to exam time, they turn to these drinks,” he said. “They get this boost of energy, but then they have headaches and they crash. As a way to re-energize and get that same boost, they repeat the cycle.”


The tough-but-true advice is there are no shortcuts.


“You have to stick to a regimen,” Hendricks said. “It entails going to class, studying, eating right, exercising right and getting the proper amount of sleep.”


A Journal of American College Health study in 2011 said the consumption of energy drinks has been associated with perceived stress levels of college students. Middlebury College in Vermont banned the on-campus sale of energy drinks. In Britain, many supermarkets have begun banning sales to children under 16, and the government is considering other restrictions.


Higgins said he’d like more short- and long-term studies that show how these energy drinks – and their blends of ingredients – work on the body. So far, the evidence has been inconsistent, he said, with some showing improved performance, some reduced and others no effect.


Higgins warns that some people are more at risk for the effects from energy drinks, including people under 18; people of small stature; people who don’t normally drink caffeine or are sensitive to it; pregnant or breastfeeding women; people taking stimulants for conditions such as attention deficit disorder; and people with certain medical or cardiovascular conditions.


For a healthy boost during studying, Higgins suggests high-intensity exercise, or even just a quick run up and down the stairs. Getting outside, “stretching the eyes” with relaxed nature-watching or a power nap also can help, he said.


“If you are really that tired and coffee isn’t keeping you awake, you should probably go to sleep. You aren’t going to remember anything for the test anyway.”


Reprinted with permission from Spectrum Health Beat.


Science probes mutant cholesterol gene

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Familial hypercholesterolemia can be diagnosed with a simple blood test and a look at family history. Genetic testing can confirm the diagnosis. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


High cholesterol is a risk factor for heart disease, but not all forms of it are the same.


An underdiagnosed genetic condition called familial hypercholesterolemia can cause dangerously high levels of cholesterol at an early age.


While scientists have determined familial hypercholesterolemia is caused by genetic mutations that affect the body’s ability to remove LDL, or “bad” cholesterol, they haven’t pinned down all the genes involved for nearly 1 in 3 people who have it.


But that may be beginning to change.


Scientists presented preliminary research at the American Heart Association’s Vascular Discovery conference in Boston this week showing more clues to the genetic roots of familial hypercholesterolemia.


National Heart, Lung, and Blood Institute researchers screened 19,114 genes and identified transgelin as one of the genes of interest. Previous studies have found this gene could be associated in LDL metabolism.


When researchers disabled the gene in cells, some cells tried to compensate.


“The cell tries to make more cholesterol because cholesterol is vital for the cell to survive,” said Diego Lucero, the study’s lead author and a postdoctoral fellow at the institute. “Understanding this is important because it might have impacts on the magnitude of the clinical presentation of the disease.”


People with familial hypercholesterolemia are exposed to chronically high levels of LDL from an early age and their risk for premature heart disease is 20 times greater than the general population, according to the Familial Hypercholesterolemia Foundation.


Over time, the condition can lead to atherosclerosis—the buildup of plaque and narrowing of artery walls. As a result, signs of heart disease can show up decades earlier in people with familial hypercholesterolemia compared to the general population.


The condition affects approximately 1 in 250 U.S. adults. Yet, it remains largely underdiagnosed and undertreated.


“Less than 10 percent of those who have (familial hypercholesterolemia) have actually been diagnosed, which leads to a lot of premature morbidity and mortality,” said Dr. Samuel Gidding, chief medical officer for the foundation.


Someone who carries the altered gene has a 50% chance of passing it on to their children.


Yet, the challenge is diagnosing familial hypercholesterolemia.


Health care providers may not understand the difference between general high cholesterol and familial hypercholesterolemia and may not screen high-risk people, said Gidding, who was not involved in the new study.


Familial hypercholesterolemia can be diagnosed with a simple blood test and a reported family history of cardiovascular disease. Doctors look for LDL levels over 190 in adults and over 160 in children, and onset of heart disease before age 60 in men and before 50 in women. Genetic testing can confirm the diagnosis.


Once identified, there are effective ways to treat the condition, Gidding said. Early treatment with medications, as well as maintaining a heart-healthy lifestyle, can lower the risk of premature heart attacks and strokes.


The new research and further work identifying new genes involved in the development of familial hypercholesterolemia could lead to better diagnosis and treatment, Gidding said.


“Anytime an individual gene like this could help explain variations in lipid level, it could be a drug target.”


Reprinted with permission from Spectrum Health Beat.


A blood test may reveal your heart health

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A test that measures the protein troponin could one day help your doctor identify if you’re at high risk of heart attack or stroke. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


Imagine getting a simple blood test to help doctors predict your risk for having a heart attack or stroke.


That test exists—and that scenario could become reality, according to a new study.


The test is often used now to help hospital medical staff diagnose heart attacks in people who come in with chest pain or other symptoms. It involves analyzing blood samples for specific proteins released by the heart muscle when damaged.


In recent years, these tests have become so refined that some can detect very low levels of these proteins, known as troponin.


Researchers determined that troponin levels in healthy middle-aged to older adults could help predict their risk for eventually developing cardiovascular disease.


Their findings were published recently in the American Heart Association journal Circulation.


“What we’re finding out is that these tests can be used in the general population to give us information as to who is most likely to have a future problem, whether it be a heart attack, stroke or heart failure,” said Dr. Christie Ballantyne, the study’s senior author and cardiology chief at Baylor College of Medicine in Houston.


Researchers examined a group of 8,121 people, ages 54 to 74, with no history of cardiovascular disease. Troponin levels were detected in 85 percent of the group. Higher levels of the protein were associated with a greater chance of developing cardiovascular disease, particularly heart failure.


The study found that highly sensitive troponin tests were especially good at predicting cardiovascular events when added to the results of a special equation commonly used to calculate a person’s 10-year risk of having a heart attack or stroke.


While the troponin tests have been used to diagnosis heart attack in the United States, Ballantyne said they have not been approved as a risk assessment strategy. The report said additional studies on troponin tests could help pave the way for using them as part of a globally accepted formula on assessing risk for cardiovascular disease.


“Research in this area is leading us toward individualized care more and more, so we can better predict who’s at risk for developing adverse cardiovascular outcomes,” said Dr. Rebecca Vigen, assistant professor of internal medicine at UT Southwestern Medical Center in Dallas. She was not involved in the research. “This study is a step in the direction of personalizing care.”


Ballantyne said the ability to use the results from a simple blood test to help predict cardiovascular disease could help people avoid “the number one cause of pain, suffering, death and medical expenses” in the country.


People might be more inclined to work harder to reduce their cholesterol level, keep their blood pressure under control, and exercise, he said.


“If you can treat someone much earlier, before you have symptoms, you will be far more effective in preventing events,” Ballantyne said.


“Our major problem is that we do too little too late. If the first time you find out that you’re at risk for heart failure is when you actually start getting short of breath and you end up in the hospital, you probably have advanced heart disease already, and it is going to be harder to treat than if that person took steps years earlier.”


Reprinted with permission from Spectrum Health Beat.



Research links HPV to heart disease

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HPV—one of the most common sexually transmitted diseases—has been linked to increased risk of cardiovascular disease and stroke. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


Human papillomavirus, or HPV, is the most common sexually transmitted infection in the country.


In several studies, it’s also linked to the nation’s leading cause of death—cardiovascular disease.


There are more than 150 strains of HPV, including the ones responsible for cancers of the cervix, penis, anus and the back of the throat.


In a study published earlier this year in Circulation Research, researchers found that Korean women infected with these “high-risk” strains of HPV were 22 percent more likely to develop heart disease or have a stroke than women not infected with the virus.


The risk was calculated after adjusting for other common cardiovascular risk factors, including smoking, physical activity and body mass index.


A 2011 study also connected HPV with heart attacks and strokes in women.


“But at this stage, we’re not completely clear on what the link is,” said Dr. Christine Jellis, a cardiologist at The Cleveland Clinic.


Jellis said HPV may encourage chronic inflammation in the body, which can contribute to atherosclerosis, or the hardening of fatty plaque along the lining of arteries.


“But there may be some other social factors that make people both more prone to developing coronary artery disease—atherosclerosis—and also HPV,” she said. “At the moment, we don’t have that information but this … definitely warrants further evaluation.”


The link between HPV and cardiovascular risk is not restricted to women.


A 2017 study of mostly men tied HPV to an increased risk of stroke in people who received radiation therapy for head and neck cancer.


Dr. Tomas Neilan, the lead author of that study published in the Journal of the American Heart Association, said the results show HPV infection has consequences beyond the cervical lesions and cervical cancer typically associated with the virus.


“Specifically, and importantly, this also has implications for men beyond transmission” of the virus, said Neilan, director of the cardio-oncology program at Massachusetts General Hospital in Boston.


HPV is such a common virus that an estimated 80 percent of the population will be infected at some point in their life, according to the Centers for Disease Control and Prevention. About 14 million Americans, including teens, become infected with HPV each year. Most infections go away on their own, but those that don’t can lead to certain types of cancer.


That’s where prevention can help, Neilan said.


HPV vaccines, which have been available for females since 2006 and for males since 2009, have proven effective in decreasing HPV incidence and preventing precancerous growths or infections.


The CDC recommends all girls and boys get two doses of the vaccine before they turn 13. Children who start the vaccine series on or after their 15th birthday need a third dose for complete protection.


Jellis hopes to see more research about the HPV connection to cardiovascular disease, as well as other types of studies that look beyond the factors already known to contribute to heart attacks and strokes.


“We certainly see patients who don’t have any of the traditional cardiovascular risks, but they still have atherosclerotic disease,” she said. “So, whether they have additional genetic factors or additional lifestyle factors, for those patients, maybe these other things like a presence of HPV will end up being the reason why they are at higher risk.”


Reprinted with permission from Spectrum Health Beat.



More than a fancy handstand

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Research suggests yoga may impart a multitude of health benefits, including reduced blood pressure and lower stress levels. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


For years, aerobic exercise has been touted for its numerous health benefits, including improved cardiovascular health, better mood, increased energy and stronger bones and muscles.


But there’s another form of physical activity that’s grabbing headlines—yoga.


Some studies suggest the mind-body practice may be good for heart health, from reducing blood pressure and cholesterol to lowering stress and body mass index.


While yoga often is associated with images of limber practitioners, it is more than just stretching and handstands.


Originated in India, yoga includes physical poses (asana), breathwork (pranayama) and meditation. There are many yoga styles, including Hatha, Iyengar, restorative and hot yoga, each with a specific emphasis such as alignment or relaxation.


Recently, more Americans are stepping onto the mat.


According to the Centers for Disease Control and Prevention, 14.3 percent of U.S. adults—or 35.2 million—practiced yoga in 2017, up from 9.5 percent in 2012.


Many take up the practice as a holistic approach to health and wellness and for its stress-busting effect.


“There’s a huge body of literature that says psychosocial stressors such as work and marital stress, as well as anxiety and depression, are associated with increased risk for cardiovascular disease,” said Dr. Puja Mehta, an assistant professor of medicine in the division of cardiology at Emory University School of Medicine in Atlanta.


“With chronic stress, the sympathetic nervous system is in overdrive,” which can lead to inflammation and increased blood pressure, Mehta said.


Yoga may help put the brakes on the body’s stress response by activating the parasympathetic nervous system, or the “rest and digest” system, through deep breathing and relaxation, Mehta said.


Cultivating mindfulness also may encourage participants to engage in other habits that boost cardiovascular health by promoting self-awareness and self-care behaviors.


“(This) can have a profound effect on supporting the engagement of healthy behaviors of diet and physical activity,” said Dr. Gloria Yeh, associate professor of medicine at Harvard Medical School and director of mind-body research at Beth Israel Deaconess Medical Center in Boston.


Research also shows yoga may lower cardiovascular risk factors.


Yeh coauthored a 2014 review of clinical research published in the European Journal of Preventive Cardiology that found yoga had a significant impact on cardiometabolic risk factors compared to doing no exercise at all.


For example, yoga decreased total cholesterol by 18.48 mg/dl and triglycerides by 25.89 mg/dl more than the change seen in the control group. Blood pressure improved too. Systolic and diastolic blood pressure decreased 5.21 mmHg and 4.98 mmHg, respectively.


The benefits also extend to people with heart disease.


Among people with paroxysmal atrial fibrillation, in which symptoms come and go, doing 12 weeks of yoga combined with deep breathing resulted in a lower heart rate, lower blood pressure and higher mental health scores compared to those who didn’t do yoga, according to a 2016 study published in the European Journal of Cardiovascular Nursing.


Mehta said although these and other scientific studies show promising results, there are some limitations, such as a small number of participants.


In addition, because yoga encompasses a variety of elements, there isn’t a standard dose of yoga, which makes comparisons across studies difficult, she said.


Both Yeh and Mehta said more research is needed, including more randomized clinical trials and a better understanding of the exact mechanism behind yoga’s cardiovascular benefits.


“We need to better understand for whom yoga may be more beneficial and how,” Yeh said. “Because yoga is so heterogeneous with many different styles and emphases, we’d like to be able to match the right exercises with the right people at the right time. We need to understand how best to integrate yoga with other lifestyle measures.”


And the biggest research question remains, Mehta said: “Are you going to live longer and not have cardiovascular events like heart attack or stroke?”


For older adults and people new to yoga, Mehta recommends looking for gentle, restorative or chair-based classes.


People with heart disease or high blood pressure may need to modify some poses and avoid postures that place the head below the heart, she said. Experts also suggest pregnant women in particular steer clear of “hot yoga,” or yoga classes that take place in a heated room, because of the risk of overheating and dehydration.


The bottom line, Yeh said, is that yoga is exercise and “any exercise is better than no exercise, so the activity that someone will do—and enjoy doing—will be the one that provides the most benefit.”


Reprinted with permission from Spectrum Health Beat.

Sodium stealth bombs

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Simple table salt ought not trouble you at mealtime. The real concern is how much salt went into processing and preparing the meal itself. (Courtesy Spectrum Health Beat)

By Sarah Mahoney, Spectrum Health Beat


Quick, name a food that contains too much salt.


If you’re like most people, you won’t have any trouble identifying the usual suspects. (French fries, chips and pretzels—we’re looking at you.)


The leading sources of excess sodium in the average American diet are less obvious.


Packaged foods such as bread, desserts and even canned vegetables—vegetables, for Pete’s sake!—can be prepared with alarmingly high salt levels.


That should be a cause for universal concern.


While there’s been some debate about precise levels, current guidelines call for an intake of 2,300 milligrams of sodium a day.

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The American Heart Association goes even further, recommending all American adults try to limit themselves to 1,500 milligrams per day. This is also the level recommended for people with high blood pressure and heart disease.


African Americans are also advised to stick to the lower level.


The reality? The average American eats well over twice that amount, or about 3,400 milligrams a day, and sometimes more.


“Most people don’t realize that the problem isn’t using their salt shaker, but all the foods they eat with those hidden sources,” said Caren Dobreff, RD, projects dietitian at Spectrum Health.


Such as? “Toast and cereal,” Dobreff said. “Because sodium is widely used for flavor, as a leavening agent (think baking soda), as a preservative, it turns up in places you don’t expect.” Portion sizes can add to the confusion since few people limit themselves to a single slice of bread or a half cup of cereal.


The immediate impact of too much salt can be a bloated feeling due to water retention.


“Water retention can make your socks or shoes or waistband feel snug,” Dobreff said.


Over time, too much sodium may increase the risk of high blood pressure, stroke and heart failure, as well as osteoporosis, stomach cancer, kidney disease and headaches.


The best defense: Tune up your sodium radar.


Restaurant foods contribute to about a quarter of the typical American’s dietary sodium. Meals prepared at home account for another 10 percent. Surprisingly, less than 5 percent of dietary salt is added at the table.


This means the worst offenders—about 65 percent, reports the American Heart Association—are foods we buy at the store.

Here’s how to protect yourself from sneaky salt attacks:

Read the label

Manufacturers of packaged foods must list nutritional information on the label. This includes listing sodium content.


The fine print will help you discover, for example, that 3 ounces of deli meat such as ham or turkey can contain up to 1,050 milligrams of sodium. A cup of chicken noodle soup packs 940 milligrams, a slice of American cheese has 460 milligrams and a piece of bread has 230 milligrams. That’s pretty salty.


Check chicken labels, too, especially if the package notes, “Contains broth.” Meat processors often plump the chicken by injecting it with sodium, improving moisture retention. This enhanced chicken can increase sodium content as much as 440 milligrams.


Most red meat cuts have 100 milligrams or less, but processed meat—think cold cuts, sausages and hot dogs—can have hundreds of milligrams of added salt.

Research your restaurant favorites

While it’s harder to learn what’s in your favorite restaurant foods, most national chains have nutrition details on their websites.


A little digging before you get there will help you discover that a slice of pizza at your local shop may well have 760 milligrams of sodium, while a cheeseburger has a whopping 1,690 milligrams. At some fast food joints, just 3 ounces of breaded chicken strips contain 900 milligrams of sodium.


And don’t be fooled when restaurants label something low- or reduced-sodium. Reduced-sodium soy sauce, for example, can still have as much as 500 milligrams per serving.

Cook from scratch

Cooking from scratch offers the most control over how much salt winds up on your plate. A tomato, for example, contains a mere 6 milligrams of sodium. But half a cup of canned low-sodium diced tomatoes has already more than tripled to 20 milligrams.


A helping of regular canned tomatoes is 10 times saltier, at 220 milligrams.


“Look for ways to create flavor explosions,” Dobreff said. She recommends high-impact seasoning like citrus, vinegar, herbs and spices, such as cumin and chili powder.

Don’t get duped

As appealing as some popular gourmet salts sound—pink Himalayan, Hawaiian black lava, grey sea salt, kosher salt and even dusting salt—they’re still just sodium chloride.


“Some people like to experiment with them for flavor and some are prepared more naturally,” Dobreff said. “But the sodium is roughly the same.”

Plan a counterattack

When you’ve got a major salt craving, play nutritional offense. Keep whole fresh fruits and vegetables and unsalted roasted nuts and seeds on hand. We tend to snack on what we can see and what our arms can reach.


“Buy a lower-sodium type of pretzels or chips, for example, and count out the amount of a single serving,” Dobreff said. “Then enjoy them. But be careful to balance them out with foods that day that are high in potassium, such as bananas, citrus fruits, papayas, avocados or potatoes.”


Reprinted with permission from Spectrum Health Beat.

Can you literally be scared to death?

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Can the occasional rush from an adrenaline surge be good for you? (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay

 

Can a person literally be scared to death?

 

The answer is a very conditional “Yes.” But, experts say, it’s extraordinarily unlikely to happen.

 

“Those circumstances are extremely rare when that happens,” and pre-existing conditions are typically a factor, said Dr. Mark Estes, a cardiologist and professor of medicine at the University of Pittsburgh Medical Center.

 

When a person is frightened or perceived to be in danger, the brain triggers a surge of adrenaline, which makes the heart beat faster and pushes the body instantly into “fight-or-flight” mode. It also affects the liver and pancreas, triggers perspiration and pushes blood toward major muscle groups.

 

“It’s measured on how big the scare is,” said Dr. Vincent Bufalino, a cardiologist and president of Advocate Medical Group in Downers Grove, Ill. He said the more dangerous adrenaline surges come from the body’s response to a life-threatening situation or the stress of discovering the deceased body of a loved one.

 

“You can have a sudden cardiac-related event related to an adrenaline surge, but I think it would be a stretch to say you could get that from someone coming in a werewolf costume to your front door,” he said. “This is the kind of thing that you can’t prepare for. If it happens, it happens, and you hope your body doesn’t overreact to that event.”

 

People can typically get an adrenaline rush from skydiving or bungee jumping—even while watching a horror flick from the couch. More dangerous adrenaline surges come from life-or-death moments such as getting out of the way of an oncoming car or fleeing a tornado.

 

“Swings of emotion and roller coasters are OK for people who are young, who have a healthy heart,” Estes said. “But certainly, in people with pre-existing risk factors or pre-existing cardiovascular disease, you want to reduce the environments in which you might be suddenly stressed like this.”

 

People are able to prepare themselves when they get on an amusement park ride, so their risk isn’t the same as when they find themselves in life-threatening danger.

 

“The human mind and the human body do have the ability to prepare themselves for situations that can be anticipated that might be stressful and generally handle them much, much better,” Estes said. “It is the sudden, unexpected things which tend to cause a dramatic increase in heart rate and blood pressure and put people with pre-existing cardiovascular disease at risk.”

 

A possibly dangerous result of sudden stress may come from takotsubo cardiomyopathy, a weakening of the heart’s main pumping chamber that is typically caused by emotional or physical stress. The temporary condition affects women significantly more than men.

 

Also known as broken-heart syndrome, takotsubo cardiomyopathy is different from a heart attack in that arteries are not blocked but blood flow is negatively affected nonetheless.

 

“Adrenaline is a funny thing,” Bufalino said. “We can’t measure it. The precipitating events are diverse. Your response to an event might be different than mine.”

 

Occasional rushes from adrenaline can be good for you, sometimes leading to increased cognitive function. But prolonged stress and an abundance of stress hormones over time can have negative effects, such as high blood pressure or anxiety.

 

“It’s hard for us to be precise in saying, ‘This event led to a certain amount of adrenaline that led to a cardiac event.’ They’re sporadic at best,” Bufalino said.

 

And there’s little that can be done to prevent being frightened to death, he said, but being in good shape may help.

 

“Those folks who are used to dealing with adrenaline with exercise probably have a blunted response” because their higher cardiovascular fitness level may allow their body to better handle an adrenaline surge, Bufalino said. “I would speculate that aerobic exercise might be preventative or at least modify the body’s response (to adrenaline).”

 

Reprinted with permission from Spectrum Health Beat.

Kids can drown quickly and silently

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By American Heart Association, HealthDay

 

Just back from a run with her husband, Laura Metro faced a parent’s worst nightmare: Her 6-year-old daughter, Maison, ran to her screaming, “I think Clay died! I think Clay died!”

 

Metro’s 3-year-old son, who was swimming with family friends, was found at the bottom of the pool with his towel. One friend started CPR—or the closest thing he knew based on what he’d seen on TV—on Clay’s blue, lifeless body.

 

Paramedics arrived and got Clay’s heart beating again. He was taken by helicopter to the hospital and spent two days in a coma before making what Metro calls “nothing short of a miraculous recovery.”

 

“The doctors said, ‘We don’t know why he’s alive,’ ” Metro said. “The only thing—the only thing—we can attribute it to is the bystander CPR. … He didn’t see the inside of a hospital for an hour and a half [after almost drowning]. That was really what did it.”

 

Drowning is the third-leading cause of unintentional injury death worldwide, accounting for 7 percent of all injury-related deaths, according to the World Health Organization. The agency estimates there are 360,000 annual drowning deaths worldwide.

 

The Metros’ good fortune is anecdotal evidence of the findings from a study, published in the June 2017 edition of the journal Resuscitation, which found that chances for neurological recovery from a near-drowning increase when the victim receives CPR from a bystander.

 

“We would advocate for parents knowing CPR, and particularly if they have a pool, they should become familiar and get trained in mouth-to-mouth rescue breathing,” said Dr. Michael Sayre, a professor of emergency medicine at the University of Washington in Seattle. “Whereas hands-only CPR is typically focused on someone who is not in the water and collapses suddenly for other reasons, people underwater die because of lack of oxygen.”

 

After Clay’s recovery, Metro founded a nonprofit called CPR Party, using the model of at-home shopping parties to encourage people to teach and learn CPR. The lessons aren’t equal to official CPR certification, Metro said, but “they will know what to do and hopefully, we create a bridge to certification. We just give them that basic knowledge to empower them.”

 

About one in five people who die from drowning are 14 years old or younger, according to the U.S. Centers for Disease Control and Prevention. And for every child who dies from drowning, another five receive emergency department care for nonfatal injuries, often including brain damage. The numbers are particularly discouraging, experts say, because in many cases, drowning is preventable.

 

“The biggest thing we try to get through to people is you need to maintain constant, active supervision when people are in the water,” said Adam Katchmarchi, executive director of the National Drowning Prevention Alliance. “Regardless of age and swimming ability, you should never swim alone. You should always swim around someone who’s keeping that vigilant watch over the water, whether that be a parent in a backyard pool or whether you’re swimming in a lifeguarded area.”

 

Courtesy Spectrum Health Beat

On its website, the NDPA stresses what it calls “layers of protection,” including swimmer training, facility safety and parental responsibilities designed to prevent drowning. Drowning can happen quickly and silently, without warning, Katchmarchi said.

 

“We’re used to the Baywatch drowning, where people see on TV that someone’s going to be waving their arms and screaming for help,” he said.

 

“An actual drowning victim, when they’re in that 20- to 60-second fight for survival, they’re unable to call for help because all of their energy is being used to keep their head above water. A lot of times they’re bobbing up and down, going under and re-emerging and trying to get air, so it’s really difficult for them to call out for help,” Katchmarchi said.

 

“It’s really easy to say, ‘Oh, I’m watching my kids,’ but you’re scrolling through Facebook or your Twitter feed. … Even if you’re distracted for just a short period of time, it can happen really quickly and really silently.”

 

Get more water safety tips are available from the Spectrum Health Helen DeVos Children’s Hospital injury prevention program. You can also sign up for CPR courses through Spectrum Health Healthier Communities.

 

Reprinted with permission from Spectrum Health Beat.

 

 

Metro Health ‘gets with the guidelines,’ earns award

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By Jennifer Hoff

Metro Health – University of Michigan Health

 

Metro Health – University of Michigan Health has received the American Heart Association/American Stroke Association’s Get With The Guidelines® Stroke Gold Plus Quality Achievement Award with Target: Stroke Honor Roll Elite Award.

 

“Metro Health-University of Michigan Health is committed to striving for excellence in the acute treatment of stroke patients,” said Metro Health – University of Michigan Health Chief Medical Officer Dr. Peter Y. Hahn. “This recognition from the American Heart Association/American Stroke Association’s Get With The Guidelines Stroke further reinforces our team’s hard work and commitment. We are proud to have achieved this status.”

 

Get With The Guidelines® sets specific quality measures to ensure hospital teams follow the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. To receive these awards, Metro Health – University of Michigan Health has provided patient care at or above most achievement indicators for the last 24 consecutive months.

 

One of these quality measures is to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. This award recognizes that Metro Health – University of Michigan Health has been treating patients with intravenous tPA within 60 minutes in 75 percent or more of acute ischemic stroke patients.

 

“The American Heart Association and the American Stroke Association recognizes Metro Health – University of Michigan Health for its commitment to stroke care,” said Paul Heidenreich, M.D., M.S., national chairman of the Get With The Guidelines Steering Committee and Professor of Medicine at Stanford University. “Research has shown there are benefits to patients who are treated at hospitals that have adopted the Get With The Guidelines program.”

 

Get With The Guidelines® puts the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping hospital care teams ensure the care provided to patients is aligned with the latest research-based guidelines. Developed with the goal to save lives and improve recovery time, Get With The Guidelines® has impacted more than 3 million patients since 2003.

 

“A stroke patient loses 1.9 million neurons each minute stroke treatment is delayed,” Hahn said. “This recognition further demonstrates our commitment to delivering advanced stroke treatments to patients quickly and safely.”

 

According to the American Heart Association/American Stroke Association, stroke is the no. 5 cause of death and the leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds, someone dies of a stroke every 4 minutes, and nearly 800,000 people suffer a new or recurrent stroke each year.