Jun
01
2003

Exercise Saves Lives In Women Over 65

By | Cancer, Fitness, Health, Heart Disease, Prevention, Stroke, Women’s Diseases

A recent study released in the Journal of the American Medical Association (JAMA Vol. 289 No. 18, May 14, 2003) has found a profound effect of exercise on the survivial of elderly women. Dr. Gregg et al. have followed 9518 women aged 65 or older for a total of 12.5 years with a follow-up visit in between at about the 6 year point. They found that women who exercised (walking, aerobics etc.) and who were compared with a control group who was sedentary (no form of exercise), had the following improved survival rates.

These findings were independent of other factors up to an age of 75 years. In other words, age, smoking, weight and a number of pre-existing diseases did not influence these improved survival figures from the effect of exercise. However, when a woman had a significant chronic disease or was older than 75 years of age, the survival improval from exercise was not as strong as indicated in the table above. Also, the follow-up visits showed that those women who exercised continually, had the highest survival advantage.

Exercise Saves Lives In Women Over 65

Exercise Saves Lives In Women Over 65

The bottom line: increasing and maintaining a physical exercise program will likely lead to a longer life. At the same time the exercise program needs to be started early enough to be of benefit to those who are older than 75 years of age.

Disease and death rate reduction from exercise in women aged 65 and over
Reduction of:
 Effect of risk reduction:
overall death rates 48%
cardiovascular disease 36%
cancer 51%

Some of the Associations that were contributing to this important study were: The National Center for Chronic Disease Prevention and Health Promotion (Atlanta, Ga), the Graduate School of Public Health, University of Pittsburgh (Pittsburgh, Pa), the Prevention Sciences Group, Departments of Medicine and Epidemiology and Biostatistics, University of California (San Francisco) and the University of Minnesota and Section of General Internal Medicine, Veterans Affairs Medical Center, Minneapolis.

Here is a fitness link: http://www.nethealthbook.com/articles/fitness.php

Last edited December 9, 2012

May
01
2003

Allergies, Asthma And Diabetes All Helped By Fish Oil

By | Allergies, Arthritis, Diabetes, Heart Disease

Cod liver oil was what your grandmother told you to take. It turns out she was right as two studies from Manchester/England and Boston/US have shown. The common denominator are omega-3-fatty acids, which are found in fish oil, cod liver oil, mackerel, salmon and other fish, generally speaking all sea food that feasts on plankton.

1. A prospective study with a cohort of 1100 children from before their birth until their 5th birthday, which will be next year, is being conducted in Manchester/England.

A smaller pilot study with 37 children (4-year-olds from this cohort) was recently analyzed as reported in Denver by Dr. Clare Murray, a pediatric lung specialist from the University of Manchester. The investigators have done detailed diet analyses with the help of the parents. They found that children with severe asthma were taking in a lot less omega-3-fatty acids than a healthy control group. Further analysis showed that the asthmatic group took in a lot of the inflammation provoking omega-6-fatty acids, whereas the control group had a much better balance between these two unsaturated fatty acids. Apparently it is the ratio between omega-6 to omega-3 fatty acids that determines whether the prostaglandin metabolism is switched versus pro-inflammatory (ratio more than 3 to 1) or versus anti-inflammatory (ratio 3 to1 or less). This article can be found in the Medical Post, Vol39, No.17 (page 19), April 29, 2003.

2. Another study is mentioned on the same page of the Medical Post: Dr. Frank Hu from the Harvard School of Public Health is the lead author of a study published in Circulation: Journal of the American Heart Association. 5103 female nurses with established type 2 diabetes have been followed for about 18 years and their medical histories, life styles and eating habits were updated every two years.

Allergies, Asthma And Diabetes All Helped By Fish Oil

Allergies, Asthma And Diabetes All Helped By Fish Oil

In the beginning of the study every patient was free of heart disease and cancer. The big surprise was that eating fish 5 times per week diminished the risk for developing heart disease by 65%. Even the women in the study who ate fish once or twice per week had 40% less heart disease than those who did not eat fish. In addition, fish eaters survived those who were not fish eaters much better (lower mortality). Controls of women without diabetes who ate fish five times per week had also a reduction of heart disease by 35% compared to non fish eating controls. Dr. Hu stated that it is the omega-3 fatty acids in fish that are the active ingredient. They are known to reduce irregular heart beats (arrhythmias) that can lead to sudden death. Omega-3 fatty acids also reduce blood fat levels (triglycerides), clot formation and improve blood vessel function. He also noted that both genders have the same benefit (no difference between male and female), just that the study was done on female nurses.

Comments: For your information the table below shows what foods contain omega-3 and omega-6 fatty acids.

Omega-3 and omega-6 fatty acids in our food
Type of unsaturated fatty acid: Foods that contain this type of unsaturated fatty acid:
omega-3 fatty acid flaxseed oil, walnuts, macadamia nuts, fishoil, canola oil, mackerel, salmon, sardines, tuna and most cold water fish
omega-6-fatty acid corn oil, cotton seed oil, grape seed oil, safflower oil, soybean oil and sunflower oil

In the past 50 years the food industry has changed the ratio of omega-6 to omega-3 fatty acids in many common foods to the point that the ratios are now 12 to 1 and up to 25 to 1. It is cheaper to produce these foods in that manner as they often have a longer shelve life. Read food labels. Inform yourself about omega-3 fatty acids. Take 2 capsules of a high strength, molecularly distilled (to remove PCB’s, mercury and other heavy metals) fish oil once per day and include more fish in your meals. Avoid deep fried foods, as they contain omega-6 fatty acids.

Here are some links explaining this more:

Link about balanced nutrition.

More details about fat and fatty acids.

Last edited October 26, 2014

May
01
2003

Blood Clot Dissolving Therapy Saves Lives

By | Heart Disease, Prevention, Stroke

Clot dissolving therapy (fibrinolytic therapy) has saved many lives when it is applied fast enough with patients who have a heart attack. In younger patients up to age of 65 to 70 years this method was applied without questioning by the treating physicians.

Several studies have shown that elderly patients have more complications such as strokes, where there can be a brain hemorrhage causing another disaster, namely a stroke from a hemorrhage as a side-effect of the clot dissolving medicine. It’s a case of too much of a good thing overthinning the blood. A new study from Sweden, which was published in the Archives of Internal Medicine on April 29, 2003 (Arch Intern Med 2003;163:965-971) showed that elderly patients with a heart attack can also benefit from this clot dissolving therapy. The main investigators, Drs. Ulf Stenestrand and Lars Wallentin, have followed 6,891 patients who have sustained their heart attacks between 1995 and 1999. They were at least 75 years of age and older, but not older than 85 years. Of these patients 3,897 received fibrinolytic therapy and 2,994 did not. Combined survival statistics and statistics of whether or not the patients suffered a stroke as a result of the clot dissolving therapy were recorded over the next year.

There was a drop of 13% of deaths and of strokes in the treatment group when compared to the controls. There were some other ways that the investigators analyzed the data statistically, but the treatment group was always better off.

Blood Clot Dissolving Therapy Saves Lives

Blood Clot Dissolving Therapy Saves Lives

The investigators concluded that there is no reason to withhold this clot dissolving treatment from elderly patients as the practice had been up to then. Until randomized studies with more details can be done, they stated, one should treat elderly patients who have acute heart attacks until the age of 85 with clot dissolving treatments.

Here are some links that may be of interest:

This link explains what a heart attack is.

Last edited December 9, 2012

Apr
01
2003

Flu Shots Prevent Heart Disease, Lung Disease, Strokes And Deaths

By | Heart Disease, Infectious Disease, Lung Disease, Prevention, Stroke

It has been known for some time that flu shots would be beneficial. But it was not known until now whether in larger field studies people who are 65 years or older would benefit significantly and to what degree from yearly influenza vaccinations (“flu shots”).

The April 3rd, 2003 issue of The New England Journal of Medicine published the answer to this question. Dr. Nichol from the University of Minnesota, Minneapolis, and his collegues have followed 140,055 patients of whom 55.5% were vaccinated against the flu in the 1998/1999 flu season.

They also followed 146,328 subjects during the 1999-2000 flu season of whom 59.7% were vaccinated against the flu. Below is a breakdown how they fared when compared to non-immunized controls (see table).

Flu Shots Prevent Heart Disease, Lung Disease, Strokes And Deaths

Flu Shots Prevent Heart Disease, Lung Disease, Strokes And Deaths

The examiners of this study concluded that high risk patients (asthma patients, patients with diabetes, cancer, elderly patients, arthritic patients and patients with high blood pressure) should have a yearly Flu vaccination.

Patients after Flu vaccinations. How did they do?
(based on 1998/99 and 1999/2000 flu seasons)
Complications: Observation:
 Comments:
Heart disease: reduced 19% this included heart failure and heart attacks
Hospitalization for stroke: reduced 16% to 23% often hospitalization for stroke patients can be weeks and months, often resulting in other complications due to bacterial superinfections, falls or clots
Pneumonia and
influenza rate: 		reduced
29% to 32%		 this can lead to heart attacks and deaths from bacteria in the blood
Death rates: reduced 48% to 50% all of the deadly complications from getting the Flu remarkably reduced by Flu shots!

However, in my opinion anybody would benefit from regular Flu vaccinations as this boosts the immune system in general protecting against other infections and colds as well.

Here is a link to a chapter on the flu in Net Health Book.

Last edited October 25, 2014

Feb
01
2003

CRP Test Better Than Cholesterol Test

By | Heart Disease, Hormones, obstetrics, Weight loss

At the 75th Annual Scientific sessions of the American Heart Association in Chicago several presentations centered around the use of the C-reactive protein test to evaluate risks for heart attacks, strokes and the risk of restenosing after doing a cardiac procedure to reopen stenosed coronary arteries.

I have previously reported about the use of the C-reactive protein (CRP) test in a review regarding Dr. Paul Ridker’s study in the New England Journal of Medicine.

This study is ongoing and is known under the name “Women’s Health Study”. He followed a large group of women and found that an increase of the CRP was closely associated with heart attacks. Other investigators found now that an increase of CRP is closely linked with obesity, with the metabolic syndrome (also known under “insulin resistance”) and hormone replacement therapy.

CRP Test Better Than Cholesterol Test

CRP Test Better Than Cholesterol Test

There appears to be a pivotal shift among cardiologists in that it is now clear that inflammation seems to be at the center of the process of hardening of the arteries, not just in a few cases, but in everybody who has heart disease.  Below I  summarized some of the features of CRP in a table.

C-reactive protein (CRP) and risk for heart disease
Facts: Comments:
CRP is produced by the endothelial cells that line the arteries CRP is intimately involved with arteriosclerosis. It has been identified as the culprit, which produces hardening of the arteries together with LDL cholesterol
CRP interferes with nitric oxide release from the endothelial cells, which is required for normal function this leads to a dysfunction of the lining of the arteries, atheromatous plaque formation and it stimulates scavenger cells, called macrophages, to take up LDL. CRP also causes plaque destabilization and clotting
these factors elevate CRP: obesity, the metabolic syndrome, hormone replacement in menopause with artificial hormones, but NOT with bio-identical hormones
these factors lower CRP: low carbohydrate diet, exercise, statins, rosiglitazone (Avandia), lowering of insulin

There will be a lot of information coming out in the next few years. Two major trials have been started where patients with a normal cholesterol, but an abnormally high CRP, will be followed along.

The JUPITER trial will look at the effect of treating these patients with rosuvastatin (brand name: Crestor). About 15,000 patients will be enrolled in this trial and followed for about 4 years. The Canadian 4R trial (Risk Reduction with Ramipril in patients with high CRP) uses ramipril (brand name: Altace) for 12 weeks to see whether it reduces CRP levels. Much more research is needed, but the doctors already know enough about CRP to state that it is a major player when it comes to hardening of arteries. They also know that LDL cholesterol is not outdated, as both LDL cholesterol and CRP play important roles in this process.

Based on a cardiology update in the Medical Post, Dec. 31, 2002, page 17 to 19.

Comments on Dec. 10, 2012: The 4 R Canadian study showed a tendency towards a lowering of CRP with Ramipril, but it was statistically not significant due to numbers that were too low and the observation period was not long enough. The Jupiter trial had to be abandoned after two years as there was concern of diabetes being caused by Crestor and because the effect of prevention of heart attacks was not seen early enough (the number of treatments required before a beneficial effect could be seen was too high). Here is a review why  rosuvastatin (brand name: Crestor) should be approached with caution.

Here are other links to related topics that won’t have serious side-effects:

Heart disease: http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Two things will lead to a normal weight (as you likely have heard before):

Proper nutrition…http://www.nethealthbook.com/articles/nutrition.php

…and proper exercise (fitness): http://www.nethealthbook.com/articles/fitness.php

Last edited December 10, 2012

Jan
01
2003

Framingham Study…Obesity And Smoking Lead To Loss Of Life

By | Diabetes, Fitness, Health, Heart Disease, Nutrition, Prevention, Stroke, Weight loss

The Netherlands Epidemiology and Demography Compression of Morbidity Research Group has published an important medical research paper in the Jan. 7, 2003 edition of the Annals of Internal Medicine (Ann Intern Med 2003;138:24-32).

The lead researcher, Dr. Anna Peeters, explained that the group has revisited the Framingham Heart Study 40 years later and analyzed survival statistics of the group of men and women who enrolled in this longterm study between 1948 and 1951. The population at the beginning of the study was aged between 30 and 49. The snap shot, after 40 years had elapsed, is the subject of this analysis. In order to make it easier to understand, I have tabulated the data as seen below.

This study shows that life style choices do matter: being overweight shortens your life by 3 years on average, being obese shortens it by 6 to 7 years.

Add the risk of smoking, and you end up shortening your life by 7 years in the case of being overweight (4 years more than without smoking) or more than 13 years, if you are obese.

Framingham Study...Obesity And Smoking Lead To Loss Of Life

Framingham Study…Obesity And Smoking Lead To Loss Of Life

This study was based on 3,457 participants who 40 years ago had a life expectancy of 85 years, if they were in the normal weight category and did not smoke.

The death rates were much higher than the researchers expected. The researchers from the Erasmus Medical Center in Rotterdam stated as a conclusion: ” just think about two things: Don’t get fat and don’t smoke”.

Years of life lost 40 years after Framingham Heart Study Was Started:
Non-smokers: Smokers:
  Male Female   Male Female
overweight *: 3.1 3.3 overweight*: 6.7 7.2
obese** : 5.8 7.1 obese ** : 13.7 13.3
* overweight:BMI = 25 to 29.9 ** obese:BMI = 30 and higher

Here are some links to my Internet based Healthbook regarding risks for heart attacks and strokes:

Heart disease: http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Strokes: http://www.nethealthbook.com/articles/cardiovasculardisease_strokeandcerebralaneurysm.php

Two things will lead to a normal weight (as you likely have heard before):

Proper nutrition…

http://www.nethealthbook.com/articles/nutrition.php

…and proper exercise (fitness):

http://www.nethealthbook.com/articles/fitness.php

Last edited December 10, 2012

 

Dec
01
2002

What Goes Around Comes Around With Blood Pressure Medications

By | Heart Disease, High Blood Pressure, Prevention, Stroke

A large clinical study with 42,418 men and women 55 years and older has been published in the American Medical Association Journal recently(JAMA 2002:288:2981-2997,3039). The thiazide type water pill chlorthalidone(12.5 mg to 25 mg/day) is the clear winner in this trial, called the ALLHAT trial. It stands for “Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial” and is the largest hypertension trial that was ever performed going over a period of 5 years.

In this trial a calcium channel blocker(amlodipine) and an ACE (=angiotensin converting enzyme)inhibitor(lisinopril) were tested as the initial medication and compared to chlorthalidone.There was a 15% higher risk to develop a stroke with lisinopril and a
38% increased risk with amlodipine to develop congestive heart failure when compared to the chlorthalidone group. The interesting conclusion from this study is that the least expensive therapy for high blood pressure turns out to be the safest. Another ineresting finding was that black patients responded much better to water pills than to ACE inhibitors, which had been noted before by other authors. When more than one medication is required to control high blood pressure, the dosage of the second medication can often be kept lower with a combined therapy thus reducing the likelihood of side-effects and complications.

What Goes Around Comes Around With Blood Pressure Medications

What Goes Around Comes Around With Blood Pressure Medications

Comments: Several decades ago the teaching was that the doctor would start a new high blood pressure patient with a water pill first, and combine this with a second or even third pill of a different medication class, if the water pill would not be effective enough on its own (it was called the “step care therapy”). For decades the side effects of the water pill consisting of low potassium blood levels brought the water pill treatment in disrepute. The original trials,however, were done with chlorthalidone doses of 50 and 100 mg per day, much higher than would now be recommended. It appears that with this study medicine has gone a full circle back to the old stand-by water pill, but at a much safer, lower dosage.

Here is a useful link (regarding hypertension): http://www.nethealthbook.com/articles/cardiovasculardisease_hypertension.php

Last edited December 10, 2012

Nov
01
2002

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

By | Health, Heart Disease, Hormones, Prevention, Women’s Diseases

Dr. David D. Waters of the University of California at San Francisco reported in Chicago at the American Heart Association’s Scientific Session 2002 about the WAVE trial. This stands for “Women’s Angiographic Vitamin and Estrogen” trial.

The results of this study were simultaneously published in the Journal of the American Medical Association(JAMA 2002;288:2432-2440). It was a “carefully designed randomized study” where 423 women with established blood vessel damage to their hearts (established by angiography) were put on a therapy and then followed for an average of 2.8 years. Essentially the question was whether or not estrogen (Premarine) and vitamins (Vit.E and C) would have a protective effect on the blood vessels. Surprisingly the worst outcome was in the group with estrogen replacement and vitamins. The placebo group (=no estrogen, only vitamins) had the lowest death rate. The authors felt that the beneficial effect of estrogen (speak “Premarine”) on heart vessels could not been verified in this study. The take home message to the physicians at the conference was that they should concentrate on lowering the known risk factors: weight reduction, blood pressure control, cholesterol lowering and increasing exercise. Estrogen should be given in low doses (Premarine 0.625mg per day) only to those women who are symptomatic with hot flashes, but not to every postmenopausal woman.

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

NOTE : This group of postmenopausal women is a selection of women more likely suffering from hyperinsulinism with a higher rate of cardiovascular disease (and also arthritis and possibly a higher risk for cancer as well). The most logical therapy for these women is to work on weight loss, to increase exercise and to change their diet to a zone diet as this is known to lower cholesterol. Hoping to cure these women with estrogen or vitamin manipulation alone does not make “medical common sense” to me. Also, those women who had not had a hysterectomy were not dealt with as a separate group, although they were put on medroxyprogesterone acetate (Prempro). This is called a “confounding bias” and should have been openly discussed, which it was not. This means the WAVE trial made waves, but it was not a properly designed randomized study.

You may want to read these useful related links to chapters of my free Internet based Nethealthbook: For links to arteriosclerosis, heart attacks and strokes see this link: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/
For a link to hyperinsulinism follow this link:
http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited October 25, 2014

Nov
01
2002

Heart Attack And Stroke Risk Measured With C-Reactive Protein

By | Heart Disease, Infectious Disease, Prevention, Stroke

An old blood test that has been popular in assessing how aggressive rheumatic illnesses such as rheumatoid arthritis or lupus are, is now considered as the newest test to assess the risk of heart attacks. Up to now subfractions of cholesterol, in particular the LDL cholesterol level, has been used to assess the risk for a heart attack, but this according to a new study in the New England Journal of Medicine (Nov. 14, 2002) by Dr. Paul Ridker should be supplemented by a blood test checking for the C-reactive protein. What is interesting about the C-reactive protein is that it originates from certain lining cells in blood vessels of liver tissue when inflammatory substances circulate in the body. Other research has shown in the past that arteriosclerosis is in part due to an inflammatory process in the lining of the blood vessels that leads to the production of the C-reactive protein. Unfortunately other chronic illnesses and infections also lead to an elevation of the C-reactive protein as does the common cold or the flu. However, when 28,000 women of the Brigham and Women’s Hospital study were followed for 8 years it turned out that the C-reactive protein was a more reliable predictor for who would eventually suffer from a stroke or a heart attack than the traditional LDL cholesterol. The investigators felt that the LDL cholesterol is predictive for who is more likely to develop fatty deposits (atheromatous plaques). On the other hand the C-reactive protein appears to be more predictive for who is at a high risk for rupture of these atheromatous plaques. The bottom line is prevention by eating a diet with less fatty meats, by eating more fruit and vegetables and by engaging in an exercise program.

Heart Attack And Stroke Risk Measured With C-Reactive Protein

Heart Attack And Stroke Risk Measured With C-Reactive Protein

Some patients need their cholesterol reduced with medication such as the statins. You may want to browse through these useful related links to chapters of my free Internet based Nethealthbook: For more details regarding the use of the C-reative protein test in rheumatoid arthritis see this link: http://www.nethealthbook.com/articles/rheumatologicaldisease_rheumatoidarthritis.php Regarding arteriosclerosis, heart attacks and strokes follow this link: http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Last edited December 10, 2012

Nov
01
2002

Nuts Cut Heart Attacks And Strokes In Half

By | Health, Heart Disease, Nutrition, Stroke

According to Dr. Elliot M. Berry of Hebrew University Hadassah Medical School in Jerusalem and Dr. Ram B. Singh of the Medical Hospital and Research Centre, Moradabad/India, the word is out that a Mediterranean diet with walnuts and almonds, fruits and vegetables can safe lives and prevent heart attacks.

In a paper, published in the medical journal Lancet 2002;360:1455-1461, 1000 Asian patients with a high risk for heart disease and strokes were put on two diets: a “control” heart smart diet and the experimental diet,which consisted of the Mediterranean diet.

Surprisingly,not only did the high risk patients benefit from the Mediterranean diet, but also the control group that had already been on a healthy heart smart diet. Over 2 years the heart attack
rates, death rates and heart disease event rates were all roughly cut into half on the Mediterranean diet. Cholesterol levels were significantly reduced,as much as would have been achieved with expensive cholesterol lowering medications. According to Dr.Berry the key to the understanding of this is found in the alpha-linoleic acid found in nuts and almonds. It is a precursor of the omega-3-fatty acids also found in fish oil, which in turn lower cholesterol, prevent blood clotting and are a natural remedy to prevent inflammation in the body.

Nuts Cut Heart Attacks And Strokes In Half

Nuts Cut Heart Attacks And Strokes In Half

Further investigations will be done by the research team to understand the mechanism of action of the healthy Mediterranean diet. In the meantime Dr. Berry stressed that other lifestyle changes must accompany the Mediterranean diet, namely an active exercise program and regular relaxation exercises such as yoga.

You may want to read these useful related links to chapters of
my free Internet based Nethealthbook:

Hardening of the arteries:
http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Last edited October 25, 2014