Jun
01
2003

Exercise Saves Lives In Women Over 65

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

Blood Clot Dissolving Therapy Saves Lives

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

Older Americans Need More Knowledge About High Blood Pressure

A telephone survey of 1,503 Americans age 50 or older was published recently by Dr. Brent Egan from the Medical University of South Carolina, Charleston, in the March 24, 2003 issue of the Archives of Internal Medicine. Although 94% had their blood pressure measured at least once in the past year, only 46% knew how much it was. Of all the patients who knew that they had a systolic blood pressure of 140 mm mercury or higher, 30% did not know that this was abnormal and was called “systolic hypertension (high blood pressure)”. 20% of patients with established high blood pressure did not take their medication or had on their own reduced the amount of medication they should have taken. In this group only about 1 in 5 complained that the cost of the medication would have been the reason for stopping the blood pressure pills.

Below are some more general results regarding this study in table form.

Apart from the remarks on the importance of education mentioned in the table I would like to stress how important it is for patients with high blood pressure to learn how to measure their own blood pressure at home.

Older Americans Need More Knowledge About High Blood Pressure

Older Americans Need More Knowledge About High Blood Pressure

The method of how to do this is not as important as the fact that you buy and use some kind of home blood pressure measuring device (either the conventional bood pressure cuff or the more expensive electronic device). You can measure and record your own blood pressure either daily or 3 to 4 times per week and bring this record with you to the doctor’s office with your next check-up. With this method you will gradually learn what life style factors bring your blood pressure up and how much medicine you need to take to control the blood pressure at all times. This will prevent major events such as heart attacks and strokes and preserve eye-sight and kidney function.
Here are the results of a telephone survey regarding older Americans and their understanding of high blood pressure (modified from March 24, 2003 issue of Archives of Internal Medicine).

Results of a telephone survey regarding older Americans and their understanding of high blood pressure
(modified from March 24, 2003 issue of Archives of Internal Medicine)
Findings:
Comments:
Older Americans have a higher rate of high blood pressure, particularly high systolic blood pressure This makes it even more important that they learn more about it and that they learn to measure
their blood pressure at home.
Older Americans are not as educated about high blood pressure than the younger generation Likely related to upbringing and different interests; in the past healthcare was left to physicians and nurses. Now we realize that only we can look after ourselves, the physicians
and nurses are “health consultants” whom we hire to advise us.
Older Americans prefer an integrated approach to the treatment of high blood pressure utilizing traditional, complementary and alternative treatments The authors concluded that a combination of education and holistic management strategies likely would work best. This needs to include new research on identifying the
most effective treatments. I would like to add that weight loss (in case of increased BMI), exercise and a zone-like diet would help complement traditional drug regimens
very effectively as well.

Here are various useful links regarding related topics.

Link regarding body mass index (BMI) .

Link regarding high blood pressure(hypertension)

Last edited December 9, 2012

Apr
01
2003

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

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

Jan
01
2003

Framingham Study…Obesity And Smoking Lead To Loss Of Life

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:BMI25 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
02
2002

Obesity (Excessive Weight) A Predictor Of High Risk For Stroke

In the Dec.9th issue of the Archives of Internal Medicine an important follow-up from the US Physicians’ Health Study was published. It examined the effect of obesity on the development of stroke later in life. 21,414 male physicians of the US have been followed now for 12.5 years in this study. At present there were 747 strokes (631 ischemic, 104 hemorrhagic, 12 others).

They found that the rates of strokes were in direct relation to the amount of excessive weight, in other words the higher the weight, the higher the risk to develop a stroke. It did not matter what kind of stroke it was (ischemic stroke or hemorrhagic stroke), a body mass index above 30 was always associated with a 1.9-fold risk to develop a stroke when compared to normal weight controls (body mass index less than 25). This risk of obesity was independent from other risk factors such as diabetes, high cholesterol or high blood pressure. Dr. Kurth from the Brigham and Women’s Hospital, Boston, said that this finding is very significant in view of the fact that many young adults in the US are either overweight or obese and they will be exposed to this risk for a longer period of time inreasing the risk to develop strokes even further. He hopes that physicians will concentrate on treating obesity more aggressively preventing a stroke. In industrial countries strokes are the main cause of disability and are on the third place on the list of causes of death.

Obesity (Excessive Weight) A Predictor Of High Risk For Stroke

Obesity (Excessive Weight) A Predictor Of High Risk For Stroke

(This info based on: Arch Intern Med 2002;162:2557-2562.)

Other information about strokes can be found through this link: http://www.nethealthbook.com/articles/cardiovasculardisease_strokeandcerebralaneurysm.php

Last edited December 10, 2012

Dec
01
2002

What Goes Around Comes Around With Blood Pressure Medications

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

Heart Attack And Stroke Risk Measured With C-Reactive Protein

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

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

Oct
18
2002

Work Stress Is A Killer…More Than 2-Fold Over A Period Of 25 Years

In mid October 2002 the British Medical Journal(BMJ 2002;325:p.857-860) published a paper by Dr. Mika Kivimäki from the University of Helsinki where 812 healthy factory workers were followed for about 25 years. The issue was whether stress from work would have negative consequences, which could be measured in terms of cardiovascular disease. Various risk groups were defined from low stress to high stress.

Low stress jobs were classified as people who often had more training, more responsibilities, better salaries, physically less strenuous jobs with more job security. High stress jobs involved the opposite(high demand/low job control/low salary/no job security). Depending on which subgroups of high versus low risks were compared, the investigators found a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease.The team measured other cardiovascular risk factors. They found a significant increase of cholesterol in the high stress job group after 5 years. After 10 years there was a marked weight gain in the stressed group with obesity becoming much more frequent. The authors noted that this likely led to a change of metabolism in the sense of hyperinsulinism, which is known to cause high cholesterol levels and leads to hardening of the arteries with heart attacks and strokes.

Work Stress Is A Killer...More Than 2-Fold Over A Period Of 25 Years

Work Stress Is A Killer…More Than 2-Fold Over A Period Of 25 Years

Visit these useful related links to chapters of my free Internet based Nethealthbook:
Hyperinsulinism or syndrome of insulin resistance:
http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

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

Stroke:
http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/hemorrhagic-stroke/

Last edited October 25, 2014