Impact of one daily cigarette on risk of heart disease and stroke greater than previously thought
Impact of one daily cigarette on risk of heart disease and stroke greater than previously thought
Research strongly suggests that patients taking anticoagulants for irregular heartbeat could be protected against dementia and stroke
Blood-thinning drugs could protect against dementia and stroke in people with an irregular heartbeat, research suggests.
A study found that patients being treated for atrial fibrillation (AF) were less likely to develop dementia if they were taking anticoagulants. Their risk was reduced by up to 48% compared with others with the same condition who were not prescribed the drugs.
Scientists analysed health record data from more than 444,000 Swedish AF patients.
While the findings could not prove cause and effect, they strongly suggested blood-thinning pills protect against dementia in patients with the condition, the team said.
Atrial fibrillation increases the risk of stroke and blood clots, which some experts think may appear in the brain and help trigger dementia.
Dr Leif Friberg from the Karolinska Institute in Stockholm, Sweden, who co-led the study, said: As a clinician I know there are AF patients who have a fatalistic view on stroke. Either it happens or it does not. Few patients are fatalistic about dementia, which gradually makes you lose your mind.
No brain can withstand a constant bombardment of microscopic clots in the long run. Patients probably want to hang on to as many of their little grey cells for as long as they can.
In order to preserve what youve got, you should take care to use anticoagulants if you are diagnosed with AF, as they have been proved to protect against stroke and, which this study indicates, also appear to protect against dementia.
The researchers identified everyone in Sweden who had been given a diagnosis of AF between 2006 and 2014. Monitoring each persons progress provided 1.5m years of follow-up during which 26,210 patients were diagnosed with dementia.
Prescribed blood thinners include the drugs warfarin, apixaban, dabigatran, edoxaban and rivaroxaban. Their protective effect was greater the earlier treatment started after a diagnosis of AF, the scientists found.
Friberg said patients should begin taking the drugs as soon as possible and continue using them.
He added: Doctors should not tell their patients to stop using oral anticoagulants without a really good reason. To patients, I would say dont stop unless your doctor says so.
The study, published in the European Heart Journal, found no difference in dementia prevention between the older blood-thinning drug warfarin and newer anticoagulants.
Prof Jeremy Pearson, associate medical director at the British Heart Foundation, said: Strokes caused by a clot blocking the blood vessels in the brain are a major cause of dementia, and atrial fibrillation is an important risk factor as it increases the chances of these clots forming.
By treating AF patients with blood-thinning drugs, you reduce the risk of both stroke and dementia.
Dr Carol Routledge, head of science at Alzheimers Research UK, said: The findings highlight a need to investigate this link further, but the nature of the study prevents us from firmly concluding that anticoagulants reduce the risk of dementia.
It will be important to see the results of other ongoing studies in this area, as well as teasing apart the exact relationship between anticoagulants and the risk of different types of dementia.
How peoples capacity for forgetfulness and lies may have impacted on research tying stroke and dementia to diet drinks
They were supposed to be the healthy alternative to their sugar-rich siblings. But now lovers of diet colas and other low-calorie drinks have been hit by news that will radically undermine those credentials: a counterintuitive study suggesting a link to stroke and dementia.
The study in the journal Stroke may cause a rethink among those worried about obesity, diabetes or a possible early heart attack from sugar-rich drinks who have been considering making a change. It comes to the alarming conclusion that people polishing off one can a day of artificially sweetened drink are nearly three times as likely to have a stroke or develop dementia.
Its a shocking conclusion. But the first reason to pause is that the study found no such risk in people who drank standard sugary lemonades and colas.
There is little previous evidence with regard to dementia, which is why the researchers were looking at it, but the link between sugar and stroke is very well known. Too much sugar raises the risk of obesity, diabetes, heart attacks and stroke. Its altogether a bad thing, which is why the World Health Organisation is telling us all to cut down. So what was going on in this study?
The evidence it analyses is pulled from the well-respected Framingham Heart Study a cohort of more than 5,000 people in Massachusetts, US, whose diets and lifestyles have been monitored for nearly 50 years, with the main objective of finding out more about heart disease. Along the way, researchers have looked at other health outcomes.
What they are up against is peoples capacity for forgetfulness and lies. This is the case with every study into the food we eat except for those rare ones, almost impossible to do today, which have in effect imprisoned their subjects and controlled every sip and mouthful they took.Researchers understand this and try to take account of it, but it is difficult.
There are several possible other reasons why an increased stroke risk was associated with diet drinks and not sugary drinks. One is what is called reverse causality. People who come to realise that they are ill and have a high risk of a stroke then switch their behaviour by choosing diet drinks long after sugary drinks have helped cause the problem.
When it came to dementia, the link with diet drinks that researchers saw disappeared once they took some elements of the health of the people in the study into account. When the researchers accounted for other risk factors for Alzheimers, such as risk genes, diabetes, heart disease, cholesterol levels and weight, this significant association was lost, suggesting that these drinks are not the whole story, said Dr Rosa Sancho, head of research at Alzheimers Research UK.
The researchers point to it themselves: We are unable to determine whether artificially sweetened soft drink intake increased the risk of incident dementia through diabetes mellitus or whether people with diabetes mellitus were simply more likely to consume diet beverages, they write. But they call for more research and others will support them in that.
Artificial sweeteners have been viewed with suspicion by a lot of consumers for many years and not entirely deservedly. They are not natural, in the way that sugar is natural, being grown from beet or cane. Some of the hostility comes from those who worry about ingesting man-made chemicals. But while some artificial flavourings have been shown to carry health risks, studies have failed to find similar problems with artificial sweeteners.
Aspartame has been extremely controversial since its approval for use by several European countries in the 1980s, says NHS Choices. In 1996, a study linked it to a rise in brain tumours. However, the study had very little scientific basis and later studies showed that aspartame was in fact safe to consume, says the NHS.
Large studies have also been carried out to look at whether the sweetener increased cancer risks, and gave it a clean bill of health. The European Food Safety Authority said in 2013 it was safe even for pregnant women and children, except for anyone with a rare genetic condition called phenylketonuria.
Dumping aspartame from its low calorie bestseller did not give PepsiCo the halo effect it hoped. In 2015, it announced it was taking the sweetener some people love to hate out of Diet Pepsi and replacing it with sucralose. A year later, when it became clear Coca Cola would not follow suit and that fans preferred their drink the way it used to be, it did a U-turn and put aspartame back in.
There have been huge efforts to develop artificial sweeteners that will taste as good as sugar and be acceptable to the doubters. Stevia, a plant extract, is marketed as a natural sweetener to the increasingly sceptical health-conscious.
Now it is not just drinks. Public Health England is putting pressure on food companies to cut 20% of sugar from their products by 2020. That will probably mean smaller chocolate bars, where artificial sweeteners just wont deliver the same taste. But they will be part of the answer in other foods.
Sweeteners such as sucralose, which is 650 times sweeter than sugar, have long been in breakfast cereals and salad dressings, while saccharin is in store-bought cakes, despite a scare over bladder cancer which caused the Canadian government to ban it as an additive in 1977. It lifted the ban in 2014. The safety debate will go on, but artificial sweeteners are likely to play a bigger part in our diet as the squeeze on sugar ramps up.
There are those, however, who think artificial sweeteners will never be the answer to obesity and the diseases that follow in its wake. The problem, in their view, is our sweet tooth and the answer is to reduce our liking for sweetness. So they want to see the gradual reduction of the amount of sugar in our drinks and our food and snacks without it.
It worked with salt, says Cash, the campaign for action on salt and health, which did much to bring down the salt levels in our food without our noticing it. The same should be possible for sugar. But not if artificial substitutes are used to keep our food and drinks tasting just as sweet as they did before.
High blood pressure can lead to heart attack, stroke or kidney failure if left untreated. But for some people, a higher-than-normal reading may be triggered just by visiting a doctor.
“White Coat Hypertension has been defined as the person who comes into the physician’s office and the blood pressure is elevated, but when they go back home or outside the physician’s office it’s within the normal range,” explains Dr. Gary Goforth, a family physician with Lee Memorial Health System.
Although it may not truly reflect a patient’s condition, white coat hypertension or syndrome is very real, elevating blood pressure even 15-20 points whenever a susceptible patient walks through the door.
“Some people say it’s the doctors white coat that makes people nervous and their blood pressure goes up – so we have our nurses take it but it still goes up for them too.”
Blood pressure can rise and fall throughout the day for a variety of reasons. But if it’s jittery nerves that are behind the boost, experts suggest you take several readings at home if possible – because there’s strength in numbers.
“You need to get multiple readings on different days. If they have a device that they can measure it accurately I’ll just have them check it at home and have them bring those numbers,” says Dr. Goforth.
Once dismissed as ‘not serious’ research finds that 50% people who suffer from white coat hypertension go on to get the real thing. So before you discount it, try to listening to your heart. And use the opportunity to make healthy changes
View More Health Matters video segments at leememorial.org/healthmatters/
Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.
If left untreated, hypertension can lead to the thickening of arterial walls causing its lumen, or blood passage way, to narrow in diameter. As a result, the heart must work harder to pump blood through the narrowed arterial openings. In addition, people with hypertension may be more susceptible to stroke.
High blood pressure dangers: Hypertension's effects on your body
High blood pressure is a risk factor for more than heart disease. Discover what complications high blood pressure can cause.
High blood pressure (hypertension) can quietly damage your body for years before symptoms develop. Left uncontrolled, you may wind up with a disability, a poor quality of life or even a fatal heart attack. Fortunately, with treatment and lifestyle changes, you can control your high blood pressure to reduce your risk of life-threatening complications.
Here's a look at the complications high blood pressure can cause when it's not effectively controlled.
Damage to your arteries
Healthy arteries are flexible, strong and elastic. Their inner lining is smooth so that blood flows freely, supplying vital organs and tissues with adequate nutrients and oxygen. If you have high blood pressure, the increased pressure of blood flowing through your arteries gradually can cause a variety of problems, including:
Artery damage and narrowing. High blood pressure can damage the cells of your arteries' inner lining. That launches a cascade of events that make artery walls thick and stiff, a disease called arteriosclerosis (ahr-teer-e-o-skluh-ROE-sis), or hardening of the arteries. Fats from your diet enter your bloodstream, pass through the damaged cells and collect to start atherosclerosis (ath-ur-o-skluh-ROE-sis). These changes can affect arteries throughout your body, blocking blood flow to your heart, kidneys, brain, arms and legs. The damage can cause many problems, including chest pain (angina), heart attack, heart failure, kidney failure, stroke, blocked arteries in your legs or arms (peripheral artery disease), eye damage, and aneurysms.
Aneurysm. Over time, the constant pressure of blood moving through a weakened artery can cause a section of its wall to enlarge and form a bulge (aneurysm). An aneurysm (AN-yoo-riz-um) can potentially rupture and cause life-threatening internal bleeding. Aneurysms can form in any artery throughout your body, but they're most common in the aorta, your body's largest artery.
Damage to your heart
Your heart pumps blood to your entire body. Uncontrolled high blood pressure can damage your heart in a number of ways, such as:
Coronary artery disease. Coronary artery disease affects the arteries that supply blood to your heart muscle. Arteries narrowed by coronary artery disease don't allow blood to flow freely through your arteries. When blood can't flow freely to your heart, you can experience chest pain, a heart attack or irregular heart rhythms (arrhythmias).
Enlarged left heart. High blood pressure forces your heart to work harder than necessary in order to pump blood to the rest of your body. This causes the left ventricle to thicken or stiffen (left ventricular hypertrophy). These changes limit the ventricle's ability to pump blood to your body. This condition increases your risk of heart attack, heart failure and sudden cardiac death.
Heart failure. Over time, the strain on your heart caused by high blood pressure can cause your heart muscle to weaken and work less efficiently. Eventually, your overwhelmed heart simply begins to wear out and fail. Damage from heart attacks adds to this problem.
Damage to your brain
Just like your heart, your brain depends on a nourishing blood supply to work properly and survive. But high blood pressure can cause several problems, including:
Transient ischemic attack (TIA). Sometimes called a ministroke, a transient ischemic (is-KEE-mik) attack is a brief, temporary disruption of blood supply to your brain. It's often caused by atherosclerosis or a blood clot — both of which can arise from high blood pressure. A transient ischemic attack is often a warning that you're at risk of a full-blown stroke.
Stroke. A stroke occurs when part of your brain is deprived of oxygen and nutrients, causing brain cells to die. Uncontrolled high blood pressure can lead to stroke by damaging and weakening your brain's blood vessels, causing them to narrow, rupture or leak. High blood pressure can also cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke.
Thomas Fogarty, founder of the Fogarty Institute for Innovation, makes it possible for cardiologists at El Camino Hospital – a community hospital in Mountain View, California – to offer patients with cardiovascular disease leading-edge cardiovascular care, and its primary goal is to research cardiovascular innovations that help prevent heart attacks, strokes and other life-threatening conditions. Dr. Fogarty is one of the top medial innovators in the cardiovascular field of the last few generations. The field of cardiology now deals with the treatment of cardiovascular diseases that encompass cardiac as well as vascular issues. Cardiologists treat aneurisms, afflictions of the lower extremities, arterial problems, including ones in carotid arteries, and may recommend treatments such as angioplasties or stenting. For more information:
Dr. Jonathan V. Wright discusses cholesterol and what you need to know about those cholesterol numbers. He also discusses causes of heart attacks and strokes and one little discussed thing that people can do to reduce their risks by 75% or more! Also, find out why women are less prone to heart attacks until menopause.
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Health information explaining what causes a heart attack. Also see the following parts: "What is a heart attack?", "How is a heart attack diagnosed?" and "How is a heart attack treated?".
What causes a heart attack?
== More Videos in this Series ==
**Cardiovascular System **
Heart Structure –
Blood flow through the Heart –
Electrical activity in the Heart –
Coronary Arteries –
**Circulatory System **
The Blood –
Blood Circulation –
**Coronary Heart Disease **
What is Angina –
What Causes Angina –
How is Angina Diagnosed –
How is Angina Treated –
What is a Heart Attack –
What causes a Heart Attack –
How is a Heart Attack Diagnosed –
How is a Heart Attack Treated –
**Heart Failure **
What is Heart Failure –
What Causes Heart Failure –
How is Heart Failure Diagnosed –
How is Heart Failure Treated –
**Hypertension — Blood Pressure **
What is Blood Pressure –
What Causes Blood Pressure –
How is Blood Pressure Diagnosed –
How is Blood Pressure Treated –
What are Palpitations –
What Causes Atrial Fibrillation –
How is Atrial Fibrillation Diagnosed & Treated –
Ventricular Arrhythmias –
What is Syncope –
What Causes Syncope –
How are the Causes of Syncope Diagnosed –
How is Syncope Treated –
**Valvular Heart Disease **
What is Valvular Heart Disease –
What Causes Valvular Heart Disease –
How is Valvular Heart Disease Diagnosed –
How is Valvular Heart Disease Treated –
Cardiovascular Institute cardiologist Dr. Samir Patel discusses how stroke is most commonly caused by the same issues that cause heart attack. Dr. Patel and Dr. Haghighat at CVI both offer carotid stent procedures as a minimally invasive way to treat carotid artery disease, a common cause of stroke.