Dec
01
2008

Disease Of Peripheral Blood Vessels Occurs With Metabolic Changes

By | Diabetes, Heart Disease, High Blood Pressure, Prevention, Weight loss

Metabolic syndrome has serious health consequences: diabetes, high blood pressure and heart disease are just a few conditions that are associated with it. It is also known that diabetic patients are prone to pressure sores and ulcers of their feet and if the leg became gangrenous, the patient would lose it due to the need to amputate. Peripheral artery disease or PAD has recently been studied by Dr. Aruna D. Pradhan, and the prospective study involved 27,000 women. At the beginning of the study the middle aged women were free of cardiovascular disease, but a quarter of them had the hallmarks of metabolic syndrome. Twenty five percent of those with the condition also were diabetic. During the 13 years of follow-up 114 women developed peripheral artery disease and those patients with metabolic syndrome were 62% more likely to develop the disease. The individuals with metabolic syndrome had other features: they were less likely to exercise, more likely to smoke and their weight was higher. But 7,000 women with metabolic syndrome had another important feature in their lab tests: they had markedly higher levels of biomarkers of systemic inflammation, which was manifested in higher levels of C-reactive protein.

Disease Of Peripheral Blood Vessels Occurs With Metabolic Changes

Metabolic syndrome causes peripheral artery disease

 

 

Once all the criteria are stacked up against each other, it becomes obvious that the presence of metabolic syndrome alone is not responsible for the most significant increase in peripheral artery disease. It is not the high cholesterol levels or the high triglyceride readings that are the villains in this condition. The driving force is systemic inflammation, as documented by the high C-reactive protein levels in blood tests.

More information about hardening of arteries: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

American Heart Association, New Orleans, Nov. 8 to 12, 2008

Last updated Nov. 6, 2014

Apr
01
2008

High Blood Pressure Decreases Cognitive Function

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

It is known that high blood pressure that is left untreated gives rise to a host of health problems, some of which are heart attacks and strokes. It is not surprising to Dr. Jose Luchsinger of Columbia University Medical Center in New York that high blood pressure (hypertension) can be related to all kinds of cognitive impairment, which is connected to vascular damage in the brain. A cohort study which was published in the December issue of Archives of Neurology included 918 subjects age 65 or older with no history of mild cognitive impairment (MCI) or dementia at baseline. All participants underwent neurophysical and medical testing every 1 ½ years for more than 4 ½ years. The majority of the individuals had high blood pressure. During the course of the study 334 of the participants developed MCI. 174 cases had impairment in domains such as language and executive function or visual-spatial elements were impaired. 160 individuals had amnestic MCI (affecting memory), which is thought to have the strongest link to Alzheimer’s disease.

High Blood Pressure Decreases Cognitive Function

High Blood Pressure Decreases Cognitive Function

The study showed that hypertension played a significant role in the higher risk of developing any form of cognitive impairment. Detection of hypertension and proper treatment will not only protect against strokes, but certainly also extend its benefits to cognitive function.

More information how strict blood pressure control prevents trouble: http://nethealthbook.com/news/stroke-risk-present-even-borderline-high-blood-pressure/

Reference: The Medical Post, February 5, 2008, page 65 and Dec.2007 issue of Archives of Neurology

Last edited November 3, 2014

Mar
01
2007

Depression Increases Stroke Risk

By | Mental Health, Prevention, Stroke

Strokes have been observed mainly in the aging population, and various lifestyle factors play a role in the risks. It is generally well known that smoking is one of them. High blood pressure that is left untreated will have a stroke as a consequence. Even though in the past the development of a stroke was more commonly seen in older patients, it has become something to be reckoned with for patients that are middle aged.
While some risk factors are the same in all the age groups, researches scrutinized the age group under 65 for additional risk factors. The one that stands out is depression.
Margaret Kelly-Hayes Ed.D. and her colleagues evaluated data from the Framingham Heart Study, looking at 4,120 participants aged 29-100 years who were followed for 8 years. In the course of their research they checked for symptoms of depression by administering the Center for Epidemiological Studies Depression Scale (CES-D). If patients were taking medication for depression they were included in the study. In participants under 65 with depressive symptoms the stroke risk was found to be four times higher than in the population of the same age group without depressive symptoms.

The findings were commented on by Dr. Francisco Javier Carod-Artal, of the Sarah Hospital in Brasilia, Brazil. He found that a growing body of evidence suggests that biological mechanisms underlie a bidirectional link between depression and many neurological illnesses. Mood disorders can influence the development of disease.

Depression Increases Stroke Risk

Depressed patients 4 times more at risk of getting stroke

Pinpointing exactly why depressive symptoms are increasing the risk for strokes is a challenge. Dr. David Spiegel from Stanford (Cal.) University was interviewed and he believes that the problem is environmental as well as biologic. People who are depressed may smoke more, avoid social contact, may lack self care and neglect taking blood pressure medication.
In any event it is important to treat depression, and to take care of all the known steps in stroke prevention.

More information about:

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

2. Depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

Reference: MD Consult News, January 29, 2007

Last edited November 2, 2014

Dec
01
2006

Cinnamon And Multivitamins May Boost Fertility

By | Health, Nutrition, obstetrics, Vitamins and supplements, Women’s Diseases

Prenatal vitamin supplements are the norm, as folic acid has been known to play a role in the prevention of neural tube defect. Generally they are taken once pregnancy has been confirmed.
Dr Jorge Chavarro from the department of nutrition at the Harvard School of Public Health in Boston pointed out, that multivitamin supplementation has its place earlier than just after the pregnancy test has become positive. In one of the largest studies involving 18,000 married pre-menopausal women, regular use of multivitamin supplements were associated with a decrease of infertility. The key is in the regular use. Women who took two multivitamin tablets per week had similar infertility rates as women who did not take supplements at all. Those who took 6 or more multivitamins had a 40% lower risk of anovultation, a condition where no eggs are released by the ovaries.
Most of the women were Caucasian between the ages 24 and 42.
The importance of nutrition is coming increasingly into the forefront in reproductive medicine. One condition known as polycystic ovary syndrome (PCOS) is often a reason for infertility. It is one of the red flags that point to the condition of insulin resistance, and it manifests itself in menstrual irregularity and higher levels of androgens, often showing as increased facial hair. As the metabolism is headed for trouble, diabetes, high blood pressure, high cholesterol and heart disease would tend to develop.
Researchers at Columbia University in New York conducted a pilot study to see if insulin sensitivity in women with PCOS could be improved. Cinnamon, a well-known spice, has been known to have a favorable effect on the insulin response of the body. Researchers found that eight weeks of treatment with cinnamon extract significantly decreased fasting glucose and insulin resistance in women with polycystic ovary syndrome.

Cinnamon And Multivitamins May Boost Fertility

Cinnamon And Multivitamins May Boost Fertility

Dr. Jeff Wang who conducted the study reported that no side effects or adverse reactions were reported throughout the study period. If large-scale prospective studies confirm these findings, then recommending cinnamon as a dietary factor may be a simple, inexpensive lifestyle change that can be easily followed. Reducing insulin resistance is a key to improve the overall health status in patients with PCOS, and it ties in with reproductive health benefits as well.

More information about infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

Reference: The Medical Post, November 14, 2006, page 32

Last edited November 2, 2014

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Jun
01
2005

Lose Fat With Omega-3 Fish Oil And Exercise

By | Health, Men's Health, Nutrition, Prevention, Weight loss, Women’s Diseases

Omega-3 fish oil has been recognized to have significant benefits for healthy blood vessels and heart health. Ideally fish, which is rich in omega-3 fats, should be eaten several times per week, and salmon, mackerel or sardines are excellent choices. Some individuals are not fond of these choices and do not get enough of omega-3 fats. There is still the alternative to take fish oil. Most people would cringe at the idea of swallowing a spoonful of cod liver oil, but fish oil, which can be taken encased in a gelatin capsule is no longer a “yuck” experience.
It is certainly worthwhile to take a closer look at omega-3 fish oil, as new research from Adelaide, Australia has come into the forefront, associating fish oil with health benefits. Dr. Peter Howe, PhD from the South Australian University’s School of Health Sciences supervised research on patients with metabolic syndrome. They were overweight, had high blood pressure, a high insulin level and high blood fat or triglyceride levels. The patients participated in a 12-week program, which not only included moderate aerobic exercise three times per week, but also the intake of fish oil or sunflower oil. A control group received sunflower oil combined with exercise. The difference was quite significant: those on a regimen of exercise and fish oil supplementation lost more body fat mass than those who were using sunflower oil and adhered to an exercise program.
Exercise alone and fish oil alone did not produce these effects. It was the combination that made the difference! The researchers state that omega-3 fatty acids cause a switch to enzymes that burn fat, but exercise is the driver, which increases the metabolic rate, so fat loss becomes possible. It was also found that the winning combination of fish oil and exercise promoted a decrease in blood pressure and triglyceride levels.

Lose Fat With Omega-3 Fish Oil And Exercise

Lose Fat With Omega-3 Fish Oil And Exercise

Dr. Howe noted that not only did it reduce body fat (weight loss mostly noticeable in the abdominal area), but also it was beneficial to the patients’ general health. It is the protective effect of omega-3 fish oil on blood vessels, which is making them more elastic and more efficient in transporting nutrients to the muscles.

More information of good and bad fatty acids: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/fat-good-bad-fatty-acids/

Reference: The Medical Post, May 3, 2005, page 15

Last edited October 28, 2014

Apr
01
2005

Pre-eclampsia Is Predictable

By | High Blood Pressure, kidney disease, obstetrics, Women’s Diseases

Pre-eclampsia is a condition, which can threaten a woman’s health and also the unborn baby. It can occur in the second and third trimester. These latter stages of pregnancy (there are 3 stages) are where the doctor should check for early pre-eclampsia signs. In the past this would go unchecked and develop to the full-blown condition of eclampsia and be a significant cause of maternal mortality rate
and fetal mortality rate. With prenatal visits and check-ups the early signs are easily recognized: the pregnant woman would complain that her rings would not fit her any more. Significant weight increase due to fluid retention where her legs and the area of her shinbone would be puffy, is called edema. The dipstick test would tell more: it would indicate the presence of protein in the urine sample. These changes are a cause of high blood pressure, which is another important clinical sign and can be readily checked. For these reasons it is imperative that regular pre-natal visits take place at the doctor’s office.

Pre-eclampsia occurs, when substances are released from the placenta into the bloodstream of the mother, and they affect the kidneys. If the condition progresses to eclampsia, it can lead to kidney damage and seizures, and the outcome will be fatal.
For a long time it was a puzzle to physicians, why some women would show pre-eclamptic symptoms and others would remain problem-free.
New research on patients’ medical history from the John Radcliffe Hospital, Department of Obstetrics and Gynecology in Oxford, Great Britain has been able to point out predisposing risks for pre-eclampsia in pregnant women.

Pre-eclampsia Is Predictable

Pre-eclampsia Is Predictable

A family history and history of previous eclampsia increases the risk, but also certain health problems make it more likely that pre-eclampsia will occur in the later stages of pregnancy: diabetes mellitus, kidney disease and high blood pressure are medical conditions that increase the risk. Beside these health conditions an increased body mass index at the start of pregnancy can be a predisposing factor, and a high maternal age-women over 40 years of age- are more likely to have the complication of pre-eclampsia. It is obvious that the risk gets higher, if several of these predisposing factors are present. The highest risk is found in women with a rare inherited variation of lupus, called anti-phospholipid syndrome, where blood clots are a problem and pre-eclampsia is a high risk with pregnancy.

Risk Factors For Pre-Eclampsia According To Meta Analysis (published
in the Brit.Med.Journal, March 12, 2005)

Pre-eclampsia Risks

Pre-eclampsia Risks
Explanation of independent risk factors: A= Previous History Of Pre-eclampsia; B= In Women With Anti-Phospholipid Antibodies; C= Pre-existing Diabetes; D= Twin Pregnancy; E= First Child; F= Family History; G= High Blood Pressure; H= High Body Mass Index;
I= Maternal Age 40 or more

While it is absolutely imperative that regular pre-natal checks are part of proper health care, there are other consequences. There would be reason to be especially watchful with predisposing conditions. Last not least, prevention also has its place.

It is important that health concerns are already addressed as part of planning for a healthy pregnancy. Avoidance of alcohol and quit smoking are of extreme importance, followed by achieving a normal weight. Good eating habits are needed throughout the entire pregnancy. Opting for pregnancy after age 40 seems trendy in some celebrity circles, but with the knowledge of risk factors, it should be looked at with caution. Nature equipped the human species to have children in the age of 20 to 30, and even though a forty year old may have a youthful appearance, the genetic material is aged, and the biological clock cannot be fooled. Prevention also means that any health condition like preexisting diabetes should be well controlled before a pregnancy.
With a proactive and common-sense approach pre-eclampsia can be either avoided or recognized and treated early, resulting in healthy outcome for mother and baby.

More information about high risk pregnancies: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/%20High%20Risk%20Pregnancies/

References: British Medical Journal 2005;330:565(12 March)

Last edited October 28, 2014

Mar
01
2005

Metabolic Syndrome Threatens Mental Functioning

By | Health, Hormones, Mental Health

It used to be called syndrome of hyperinsulinism or syndrome X, but in the meantime the term Metabolic Syndrome stands for a derailment of the metabolism, which manifests itself in excessive weight, type 2 diabetes, high blood pressure and inflammatory processes in the body. The condition, which is largely preventable by healthy lifestyle choices, also paves the way for heart disease, stroke, arthritis and some cancers.
A study from the University of California at San Francisco by Dr. Kristine Yaffe points to yet another health problem that results from the metabolic syndrome and which mars the “golden years” of a large number of seniors: lack of cognitive function, short term memory loss, and forms of dementia.
The study was based on 2632 participants with an average age of 74 years. The likelihood to develop cognitive impairment was 20% higher in those participants of the study who had metabolic syndrome. Things were getting worse, if patients had metabolic syndrome and laboratory tests showed high inflammation with elevated blood levels of interleukin 6 and the C- reactive protein test: the likelihood to develop cognitive impairment rose to 66%.

Metabolic Syndrome Threatens Mental Functioning

Metabolic Syndrome Threatens Mental Functioning

So much for the bad news. The good news, however, is that lifestyle can be a powerful armor in the prevention of disability and disease.

Reference: The Medical Post, January 25,2005, page 45

Last edited October 27, 2014

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Jan
01
2005

Doctor Recommended Diet Against Obesity

By | Diabetes, Health, Heart Disease, Nutrition, Weight loss

After overindulging over the holidays, new years resolutions often have diets and life style choices high on the list.
These concerns are not something new. Doctors have had concerns about heart disease, diabetes, bulging waistlines and elevated cholesterol. For over three decades there have been concerns that elevated insulin levels may be associated with heart disease, and the constellation of symptoms was called “syndrome X” and later the “insulin resistance syndrome”.

Most recently the evils that are associated with body fat have been called the “metabolic syndrome”.The problem has assumed epidemic proportions: by 2001, 30% of US adults were considered obese with a body mass index of over 30, and 50% were overweight with a body mass index over 25. The form of type 2 diabetes (the adult onset of the disease) is predicted to double in the next 20 years. Physicians are reporting that they are seeing increasing numbers of children who are obese and suffer of type 2 diabetes. The major concern with an accumulation of body fat is the area of the abdomen (think of the “apple shape” with fat around the abdomen). This visceral fat tissue is not just innocently sitting there stopping you from closing buttons and zippers. It is very metabolically active and the substances it releases are a threat to your health. These fat cells secret pro-inflammatory substances called “cytokines.”

They also form substances that influence blood-clotting, factors that increase insulin resistance, substances like angiotensin, which are signing responsible for high blood pressure as well. Among the host of damaging substances is also the C-reactive protein, which is recognized as a risk factor for heart disease.

Doctor Recommended Diet Against Obesity

Doctor Recommended Diet Against Obesity

There is only one solution: to reduce the risk, excessive weight has to be shed. A sensible diet to achieve that goal has to contain less saturated fat, more fiber, and low glycemic index carbohydrates. Proper dietary habits are only one part. The other as important measure is life style intervention, which includes 2.5 to 3 hours of moderate exercise per week.
Many of the current diets promise weight loss without compromising health. All of them promote weight loss, provided they are strictly adhered to.
The high protein diets (Atkins, Protein Power Plan) are useful for rapid initial weight loss, however due to the overload of protein long term use is highly questionable. Kidney dysfunction as a consequence is a threat to health and no benefit at all!
Moderate carbohydrate diets, moderate fat, as well as moderate protein will remain the answer for long-term life style changes. It is also of significance that the glycemic index of carbohydrates plays a major role. Food intake, which favors carbohydrates with a low glycemic index, is associated with less heart disease. It has also been documented that insulin levels are more stable. Low glycemic carbohydrates include most vegetables, beans, lentils, as well as fruit like apples, pears and oranges. In contrast, high glycemic carbohydrates result in a fast insulin release, which ultimately leads to insulin resistance. Among these items are potatoes, crackers and other flour products, rice, puffed or flaked breakfast cereals, and tropical fruit (papayas, pineapple, melons).

For short-term dieters, it is an option to embark on any of the current diets without deleterious effects, no matter whether they are high-carb or low-carb. But at this point only the diets with moderate carbohydrates have shown to have some benefits on heart health.
Ultimately the wiser choice is to consume foods with a low to moderate glycemic index, by increasing the intake of vegetable proteins and oils and by choosing increased servings of vegetables and fruit instead of highly processed items. So, when you next walk through your supermarket, remember that most of the good stuff is in the periphery, namely the area where all the fresh, unprocessed or minimally processed foods are found.

More info about Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

Reference: Metabolic Syndrome Rounds, Oct. 2004, Vol. 2, Issues 8, St. Michael’s Hospital, University of Toronto/On/Canada

Last edited October 27, 2014

Oct
01
2004

What Went Wrong With VIOXX

By | Arthritis, Heart Disease, Prevention, Stroke

Merck &. Co., Inc. announced on Sept. 30, 2004 that VIOXX® (rofecoxib), an arthritis and acute pain medication, would be withdrawn voluntarily worldwide. VIOXX was FDA approved as a new anti-inflammatory drug for osteoarthritis in 1999. Later it was also cleared for rheumatoid arthritis. As a Cox-2 inhibitor it was different from aspirin and the conventional anti-inflammatory drugs such as Naproxen, Motrin or Voltaren.

In a study called VIGOR , which is detailed more under this link, VIOXX was compared to Naproxen in terms of gastrointestinal side-effects. It was found that the risks of bleeding ulcers, perforation and bowel obstruction were 50% reduced (frequency of cases with naproxen 1.22% versus VIOXX with a frequency of 0.52%). Surprisingly, in this study of 4000 patients over 1 year the cardiovascular risks such as heart attacks, strokes, blood clots for VIOXX was 1.8%, 3-fold higher than Naproxen, which had only 0.6% such complications. In addition it was noted that high blood pressure was more common in rheumatoid patients. The FDA made Merck add a warning on the drug label regarding these added risks, but this went more or less unnoticed by the public.

It has been known for some time that aspirin (ASA) has polyp preventative action on the colon and thus reduces the risk of colon cancer. A specific study, called APPROVe (Adenomatous Polyp Prevention on VIOXX) trial, was designed to show that VIOXX could do the same as aspirin, but with less toxic side effects. In 2000 Merck started enrolling patients into this 3 year long trial.

What Went Wrong With VIOXX

What Went Wrong With VIOXX

After 18 months into the trial cardiovascular side-effects started to show up that were statistically significant when compared to controls. This is what prompted the recent press release that VIOXX would be taken off the market altogether.

More info on treatment of osteoarthritis: http://nethealthbook.com/arthritis/osteoarthritis/treatment-osteoarthritis/

Comments: One of the potential problems with receptor specific medications is that they can be so specific that the metabolism in the human body is changed. What’s good for the gut may not be good for the circulation, blood pressure and the heart. Merck did the right thing to withraw the medication altogether. It is not known at this time whether other similar medications such as Celebrex, which has a different molecular configuration, will stand up in the future to post-marketing testing.

Addendum on Nov. 6, 2012: In 2005 Bextra was also taken off the market by the FDA, but Celebrex was allowed to stay, but required to label their product with warnings about potentially serious side-effects.

Last edited October 27, 2014

Aug
01
2004

Too Much Fat Fuels Metabolic Syndrome

By | Heart Disease, High Blood Pressure, Hormones, Nutrition, Obesity

In a review article for physicians from the St. Michael’s Hospital of the University of Toronto (see reference below) Dr. Monge outlined some of the newer human research where links were found between the lining of the blood vessels and the hormones produced by fat cells that lead to the complications of the metabolic syndrome. In obese people there is a cluster of conditions such as high blood pressure, high blood sugar, high cholesterol, lipid abnormalities and high insulin levels, which is known as “metabolic syndrome”. Another name that was used for this condition in the 1990’s was “syndrome of insulin resistance”.

Dr. Monge pointed out that blood vessel health depends on the fine balance between two opposing forces. On the one hand there is a system that leads to blood vessel spasm, blood clotting, growth promoting, inflammation causing and oxidizing. On the other hand there is a system that is responsible for blood vessel relaxation, growth inhibition, blood clot dissolving, inhibiting inflammation and antioxidant activity. Complex changes occur in our metabolism when we put on pounds and accumulate too much fat. It is important to realize that fat is not just sitting there, but is composed of highly active fat cells that respond to insulin and growth factors and in turn produce a number of hormones and factors that affect the cells that are lining the blood vessels. Inflammatory cytokines are produced by fat cells that attack the blood vessels by producing atheromatous plaques, causing them to accumulate fat again and help in the processes that lead to rupture of the plaques.

Too Much Fat Fuels Metabolic Syndrome

Too Much Fat Fuels Metabolic Syndrome

The end result is that the deadly interplay between the fat cells and the endothelial cells lining the blood vessels tips the balance between the two systems mentioned above to the point where heart attacks and strokes suddenly occur.

There are two complex pathways that are involved in this process and that are linked to what was stated above. One crucial aspect of this involves nitric oxide, a small molecule that is normally produced by the endothelial lining cells and that is needed for normal circulation of the heart muscle, skeletal muscles and internal organs. This protective system is where much of the derangement of normal metabolism occurs with regard to the metabolic syndrome.

Dr. Monge pointed out that with these newer insights into the complex metabolic changes associated with the metabolic syndrome in obese people, there will be very practical results in the near future. Anti-inflammatory medications are already being utilized and some of the anti-diabetic medications have been shown to reduce the risk of heart attacks. It is hoped that sensitive tests will be developed to measure the hidden endothelial dysfunction at a time when preventative steps are still effective or early intervention can be done.

More info on the metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: Metabolic Syndrome Rounds (April 2004): J.C. Monge “Endothelial Dysfunction and the metabolic syndrome”

Last edited Oct. 26, 2014