A Smarter Way to Prevent Heart Attacks


Under new guidelines, one third of adults in the U.S. should consider using statins based on their overall health profile, not just their cholesterol number

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The well-established strategy among doctors for reducing cardiovascular disease has been to lower bad cholesterol, or LDL, to specific targets (below 100 or below 70 for people at high risk). No more. New clinical guidelines unveiled Tuesday take a more broad approach to assess a patient’s risk of heart disease and to prescribe twice as many Americans (one third of all adults) cholesterol-lowering statin drugs, the Wall Street Journal reports.

The cholesterol numbers have been deemed arbitrary and worse predictors of heart risk than doctors originally thought. Now, doctors are being told to dive more deeply into a patient’s background to assess their potential risk for heart attacks and to prescribe cholesterol-lowering statin drugs to high-risk patients. The formula for whether a patient ought to be prescribed a drug will include age, gender, race and factors beyond cholesterol, like whether someone smokes.

Though doctors say the new approach will limit how many people will be put on statins because of their cholesterol number, under the new formula, 33 million Americans — 44 percent of men and 22 percent of women — would meet the requirements to consider taking a statin. The current guidelines only recommend statins for 15 percent of adults.

And for the first time the treatment is focusing on strokes, not just heart attacks. ”We’re trying to focus the most appropriate therapy to prevent heart attack and stroke…in a wide range of patients,” said Neil J. Stone, professor of medicine at Northwestern University Feinberg School of Medicine and head of the panel that wrote the cholesterol guidelines.

In the U.S., 600,000 people per year die from heart disease (accounting for about one in four deaths).

Anesthetic reduced frequency of menopausal hot flashes by half.


Menopausal women treated with a stellate ganglion blockade showed a 50% reduction in moderate-to-severe hot flashes, according to preliminary data presented at Anesthesiology 2013.

Bupivacaine is currently indicated for local or regional anesthesia or analgesia.

“This is the first effective, non-hormonal treatment for hot flashes, which for many women have a serious negative effect on their lives. This treatment will also help breast cancer patients who suffer from hot flashes as a side effect of their treatments of medication. Some breast cancer patients stop taking their medication (tamoxifen) because of hot flashes,”David R. Walega, MD, chief of the division of pain medicine and program director of the multidisciplinary pain medicine fellowship department of anesthesiology at Northwestern University Feinberg School of Medicine, said in a press release.

Researchers randomly assigned 40 menopausal women aged 30 to 65 years with more than 25 vasomotor symptoms per week to an injection of 0.5% bupivacaine 5 mL or sterile saline.

There was a 19% reduction in hot flashes 4 to 6 months after the injection in the bupivacaine group, according to researchers.

Analyses revealed hot flashes decreased 34% from baseline to 6 months among patients in the bupivacaine group vs. placebo. Further, reductions in moderate-to-severe hot flashes were significantly greater among the bupivacaine group vs. the placebo group (RR=0.5; 95% CI, 0.34-0.73), according to data.

“This is a fast, relatively painless, long-lasting and cost-effective treatment for hot flashes,” Walega said. “It has tremendous potential to help not only menopausal women, but also breast cancer patients and women in surgical menopause (whose ovaries have been removed), who have had to put up with ineffective treatments or simply ‘grin and bear it.’”

Source: Endocrine Today.

HKDC1, BACE2 could predict gestational diabetes before pregnancy.


Data collected from the Hyperglycemia and Adverse Pregnancy Outcomes Study have led researchers to identify variants in two novel genes which they said are associated with measures of glucose and insulin levels among pregnant women.

 “With additional study and verification of these and other risk genes, we could one day have genetic risk profiles to identify individuals at elevated risk for developinggestational diabetes,” M. Geoffrey Hayes, PhD, from the division of endocrinology, metabolism, and molecular medicine at Northwestern University Feinberg School of Medicine, said in a press release.

 

Hayes and colleagues conducted a discovery genome-wide association study in a large cohort of pregnant mothers from various ancestries from the Hyperglycemia and Adverse Pregnancy Outcomes Study (n=4,437). The women were administered an oral glucose tolerance test at approximately 28 weeks gestation to determine genetic loci linked to measures of maternal metabolism, researchers wrote.

The researchers identified two novel genome-wide significant associations in glucose metabolism and HKDC1 and insulin secretion and BACE2 within two genes. Researchers wrote that these data suggest the genes’ underlying roles could play a significant role in hypoglycemia during pregnancy compared with women who are not pregnant.

“Together with the results of earlier studies, our findings suggest that the roles of HKDC1 in glucose metabolism and BACE2 in insulin secretion are more important during pregnancy than in the nongravid state,” researchers wrote.

Source: Endocrine Today

 

Testosterone Surge after Exercise May Help Remodel the Mind .


Most of the praise associated with exercise is typically geared toward its cardiovascular benefits and its role in weight loss and muscle toning/strength.

Often overlooked is the phenomenal role exercise plays in supporting your brain health and even spurring the creation of new brain cells (a process called neurogenesis).

Now researchers have revealed one of the mechanisms that makes exercise such a powerful tool for brain health: a natural boost in testosterone.

Exercise Boosts Brain Testosterone Levels, Builds New Brain Cells

The hippocampus is a major component of your brain. It belongs to the primitive part of your brain known as the limbic system and plays an important role in the consolidation of information from your short-term memory to long-term memory and spatial navigation. A new animal study found that not only does mild exercise activate hippocampal neurons, it actually promotes their growth. In the brain, this also, in turn, helps with the creation of new brain cells.1 Even though the study included only male rats, the scientists believe the results apply to humans.

Interestingly, researchers at Northwestern University‘s Feinberg School of Medicine in Chicago have discovered a couple of other mechanisms that help explain how exercise helps new brain cells to form.

It appears that exercise lowers the activity of bone-morphogenetic protein or BMP, which slows the production of new brain cells. At the same time, exercise increases Noggin, a brain protein that acts as a BMP antagonist. The more Noggin present in your brain, the less BMP activity there is, and the more stem cell divisions and neurogenesis (production of new brain cells) takes place.2

What’s the Best Type of Exercise for Boosting Testosterone?

Researchers from the featured study found that even mild to moderate exercise boosts testosterone enough to improve brain health. Short periods of intense exercise also have a proven positive effect on increasing testosterone levels and preventing its usual age-related decline (which typically begins around age 30 in men).

Additionally, combining short bursts of high-intensity exercise like Peak Fitness with intermittent fasting will also boost your growth hormone levels. Intermittent fasting boosts testosterone by increasing the expression of satiety hormones including insulin, leptin, adiponectin, glucagon-like peptide-1 (GLP-1), colecystokinin (CKK) and melanocortins, all of which are known to potentiate healthy testosterone actions, increase libido and prevent age-related testosterone decline.

You can find more information about this in an article previously written on intermittent fasting, and here’s a summary of what a typical high-intensity Peak Fitness routine might look like:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should feel like you couldn’t possibly go on another few seconds
  • Recover at a slow to moderate pace for 90 seconds
  • Repeat the high intensity exercise and recovery 7 more times

As you can see, the entire workout is only 20 minutes. That really is a beautiful thing. And within those 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You’re really only working out intensely for four minutes. It’s hard to believe if you have never done this, that you can actually get that much benefit from only four minutes of intense exercise, but that’s all it is

If You Want a Healthy Brain, Exercise is a Must

Exercise boosts brain health through multiple pathways, many of them likely yet to be discovered. One study, for instance, revealed that when mice exercised, they grew an average of 6,000 new brain cells in every cubic millimeter of tissue sampled.3 The growth occurred in the hippocampus, which is considered the memory center of your brain, and the mice showed significant improvements in the ability to recall memories without any confusion.

Exactly why exercise has this effect isn’t entirely known, but researchers speculated it could be due to higher levels of hormones released, as discussed earlier, increased blood flow to your brain, or even stress reduction (the stress hormone cortisol may inhibit the growth of new brain cells).

Animal tests have illustrated that during exercise their nerve cells release proteins known as neurotrophic factors. One in particular, called brain-derived neurotrophic factor (BDNF), triggers numerous other chemicals that promote neural health, and has a direct benefit on cognitive functions, including enhanced learning. Further, exercise provides protective effects to your brain through:

  • The production of nerve-protecting compounds
  • Greater blood flow to your brain
  • Improved development and survival of neurons
  • Decreased risk of heart disease and stroke

So if you value your brainpower, you’ll want to make certain that exercise is a regular part of your life. Staying active with a variety of activities is best, as each type of exercise may offer unique benefits for your brain health and may even help your brain to grow as you get older, rather than shrink – which is the norm, sadly, as many people do not stay active as they age. Exercise is so powerful, yet it remains one of the most neglected areas of health. If you’re not already an avid exerciser, what’s holding you back?

Perhaps you believe your size is preventing you from exercising, or that it won’t make a big difference. Perhaps you have a handicap, or feel like you’re too old, too out of shape, or too frail to exercise.

Whatever your reason might be, try reading these examples of exercise inspiration. By the end, I suspect you may be ready to change your tune, and I hope, for your sake, that you are.

Exercising sets into motion a beneficial feedback loop that leads to greater levels of health body-wide, while lack of exercise makes your health spiral downward and opens the door to disease and premature aging. Health benefits of exercise expand far beyond even your muscles and your brain to include:

Improving your brainpower and boosting your IQ Lowering your risk of heart disease and cancer Building strong bones
Lowering your blood pressure Curing insomnia Losing weight
Relieving pain Balancing your mood and fighting depression Increasing your energy levels
Acquiring fewer colds Lowering your risk of diabetes and reversing pre-diabetes Slowing down your aging process
   

Source: Dr. Mercola

 

Normal weight at diabetes diagnosis associated with higher mortality among adults.


Patients who develop diabetes at a normal weight may be at higher risk for mortality compared with those who are overweight or obese at diagnosis, according to data from a pooled longitudinal analysis of five cohort studies.

The study included 2,625 patients (aged >40 years, 50% women) from the Atherosclerosis Risk in Communities (ARIC) study, Cardiovascular Health Study (CHS), Coronary Artery Risk Development in Young Adults (CARDIA) study, Framingham Offspring Study (FOS), and the Multi-Ethnic Study of Atherosclerosis (MESA) who developed incident diabetes.

Researchers chose the studies based on repeated measures of body weight, fasting glucose level and medication use. Other factors included demographic characteristics, health behaviors and clinical factors, as well as follow-up for events and mortality, researchers wrote.

Mercedes R. Carnethon, PhD, from the department of preventive medicine at Feinberg School of Medicine at Northwestern University, and colleagues found that the portion of patients who were normal weight at the time of incident diabetes ranged from 9% to 21% (overall 12%). Additional data found that 449 patients died during follow-up, including 178 from cardiovascular causes, 253 from noncardiovascular causes and 18 causes not classified.

Within the pooled patient sample, total (284.8 per 10,000 person-years); CV (99.8 per 10,000 person-years); and non-CV mortality (198.1 per 10,000 person-years) were higher in normal-weight patients, compared with rates among overweight or obese patients.

“These patterns are consistent for total and non-CV mortality within each cohort and present for CV mortality in CHS and FOS,” researchers wrote. “Mortality rates were markedly higher in CHS cohort participants who were older, on average, than other cohort participants.”

Once adjustments were made for demographic characteristics and BP, lipid levels, waist circumference and smoking status, HRs compared normal-weight patients with overweight/obese patients for total (HR=2.08; 95% CI, 1.52-2.85); CV (HR=1.52; 95% CI, 0.89-2.58); and noncardiovascular mortality (HR=2.32; 95% CI, 1.55-3.48).

Researchers concluded that the mechanisms to explain their findings remain unknown. They recommend further studies research normal-weight patients with diabetes as they apply to other mechanisms, such as inflammation, distribution and action of adipose tissue, atherosclerosis and position of fatty plaques and pancreatic beta-cell function.

  • Source: Endocrine Today.

 

Normal weight at diabetes diagnosis associated with higher mortality among adults.


Patients who develop diabetes at a normal weight may be at higher risk for mortality compared with those who are overweight or obese at diagnosis, according to data from a pooled longitudinal analysis of five cohort studies.

The study included 2,625 patients (aged >40 years, 50% women) from the Atherosclerosis Risk in Communities (ARIC) study, Cardiovascular Health Study (CHS), Coronary Artery Risk Development in Young Adults (CARDIA) study, Framingham Offspring Study (FOS), and the Multi-Ethnic Study of Atherosclerosis (MESA) who developed incident diabetes.

Researchers chose the studies based on repeated measures of body weight, fasting glucose level and medication use. Other factors included demographic characteristics, health behaviors and clinical factors, as well as follow-up for events and mortality, researchers wrote.

Mercedes R. Carnethon, PhD, from the department of preventive medicine at Feinberg School of Medicine at Northwestern University, and colleagues found that the portion of patients who were normal weight at the time of incident diabetes ranged from 9% to 21% (overall 12%). Additional data found that 449 patients died during follow-up, including 178 from cardiovascular causes, 253 from noncardiovascular causes and 18 causes not classified.

Within the pooled patient sample, total (284.8 per 10,000 person-years); CV (99.8 per 10,000 person-years); and non-CV mortality (198.1 per 10,000 person-years) were higher in normal-weight patients, compared with rates among overweight or obese patients.

“These patterns are consistent for total and non-CV mortality within each cohort and present for CV mortality in CHS and FOS,” researchers wrote. “Mortality rates were markedly higher in CHS cohort participants who were older, on average, than other cohort participants.”

Once adjustments were made for demographic characteristics and BP, lipid levels, waist circumference and smoking status, HRs compared normal-weight patients with overweight/obese patients for total (HR=2.08; 95% CI, 1.52-2.85); CV (HR=1.52; 95% CI, 0.89-2.58); and noncardiovascular mortality (HR=2.32; 95% CI, 1.55-3.48).

Researchers concluded that the mechanisms to explain their findings remain unknown. They recommend further studies research normal-weight patients with diabetes as they apply to other mechanisms, such as inflammation, distribution and action of adipose tissue, atherosclerosis and position of fatty plaques and pancreatic beta-cell function.

  • Source: Endocrine Today.