Nov
01
2008

Low Testosterone And Heart Disease

More men than women seem to be affected by cardiovascular illness, and the reasons have been manifold. At one time work stress was cited for the prevalence of heart disease in men. Other lifestyle factors, lack of exercise, being overweight, poor dietary choices and smoking have been found to play significant roles. The risk for cardiovascular disease increases with age, as does the likelihood for hypertension, elevated cholesterol levels and glucose intolerance.

Some attention has been paid to the fact that hormones can also play a role, and research has now shown that testosterone has some direct cardiovascular effects. Testosterone has been found to dilate blood vessels. The effect can be likened to the calcium channel blocker Nifedipine. It has also been substantiated that males with coronary artery disease and heart failure tend to have low levels of testosterone. If testosterone deficient men receive replacement therapy, vasodilatation (dilation of blood vessels) has been demonstrated in males who have received testosterone replacement for a few months. Male hormone replacement therapy has also been found to relieve the symptoms of angina in patients with heart failure. The question, how testosterone fits into the concept of disease prevention, comes up in this context. Researchers have found enough evidence that a low testosterone blood level has an independent association with accelerated atherosclerosis (hardening of arteries).

Low Testosterone And Heart Disease

Testosterone in men prevents heart disease

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding is the fact that this condition is reversible by replacement of testosterone. Male hormone therapy has received a lot of bad press in the case of overtreatment with androgens to achieve muscle growth in body building. However, in this case there was no testosterone deficiency and athletes and their coaches were using doses that were too high. This type of administration entails grave health risks and has nothing to do with good medicine. In case of hormone deficiency replacement the normal body function of a younger male is restored with bioidentical testosterone, which can be a tool to better health for the aging male. Anti-aging physicians are very familiar with this treatment modality.

More on the heart vessel protecting effect of bio-identical hormones:

http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Journal of Men’s Health – Volume 5, Issue Suppl (September 2008)

Last updated Nov. 6, 2014

Oct
01
2008

Lifestyle Can Be A Killer For Middle Age Women

Generally it is assumed that persons in their thirties and forties should be in their prime, and health concerns are cropping up in the higher middle age or only in old age.
Also, women were thought to generally enjoy better health and life expectancy, but the large Nurses’ Health Study on 77,782 women in the age group of 34 to 59 years shows other aspects.
Even in females who had no heart problems and no cancer at the onset of the study, lifestyle choices can make it or break it. At the end of the study that spanned 24 years, it became obvious that a total of 28% of all the mortalities could be attributed to smoking. If risky lifestyle choices were combined in the form of smoking, being overweight, having a lack of physical activity and a qualitatively poor diet, this number jumped to 55%. Alcohol intake did not change this estimate significantly.

Lifestyle Can Be A Killer For Middle Age Women

Lifestyle Can Be A Killer For Middle Age Women

It is obvious that for the benefit of better health and less mortality in middle age women, diet, exercise, a healthy body weight and eradicating smoking are key factors.

Reference: BMJ 2008;337:a1440

Comment on Nov. 18, 2012: So how many years longer will a woman live, if she quits at age 30? The Million Women Study found out that she will live 10 years longer than the control group of smoking women (see link). Nothing has changed since 2008. Lifestyle issues remain at the forefront.

Last edited December 3, 2012

Mar
01
2008

High Death Rate In India Due To Smoking

Dr. Prabhat Jha of the Centre for Global Health Research, Toronto has published research regarding the risk of mortality associated withs smoking in India, involving data from 1.1 million Indian homes. Data of deceased individuals, all of them in the age group between 30 and 69 years of age, showed that 37% of the men and 5% of the women had been smokers, and smoking doubled the risk for both sexes due to medical causes. Smoking did not only rate as a risk for lung and respiratory cancers but also for tuberculosis, vascular and respiratory disease. Smoking as a causal relationship was estimated to be responsible for 1 in 5 deaths in men and 1 in 20 deaths in women. With the population growth in India the number of death in the age group of 30 to 69 related to smoking is estimated to increase by 3% per year. Currently available data suggests that the rate of smoking is high especially among men in India. Data from other nations show, that smoking bans in public places are effective in turning these statistics around. Italy used to be one of the European nations, where smoking in public was common and as a result the exposure to second hand cigarette smoke was not only an inconvenience but a serious health risk. Cardiovascular events like heart attacks showed a decrease among men and women in Italy after the smoking ban in public places was put into effect in 2005. The findings were related to the improved indoor air quality.

High Death Rate In India Due To Smoking

High Death Rate In India Due To Smoking

There was an increase of sales in stop smoking aids like nicotine replacement products. Sales of cigarettes showed a decrease. Giulia Cesaroni from a local health unit in Rome remarked that even a small reduction in the incidence of cardiovascular disease can have enormous public health implications, as coronary artery disease is the leading cause of deaths in Italy. Compared to before the ban heart attack rates of middle aged (35- to 64-years) Italians dropped by 11%, 65- to 74-year-olds had a reduction of 8%, but those in the 75-84 year age group showed no benefit (as coronary artery disease in them likely was irreversible).

More information about:

1. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

2. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

3. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

References: The Indian data based on www.nejm.org (February 13, 2008); the Italian study was published in Circulation 2008 (Feb. 11)

Last edited November 3, 2014

Mar
01
2007

Depression Increases Stroke Risk

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

Aug
01
2006

New Screening For Cardiovascular Disease

Checking out the patient’s heart disease risk factors used to be very basic. Lifestyle questions were one aspect: was the patient smoking? Did he have a lack of exercise? Did he have a risk of heart disease in the family? The patient’s diet was analyzed and the body weight was assessed. Cholesterol and triglyceride levels were the basic labs that provided more information. The risk factor assessment, as exemplified by criteria from the Framingham study, made a lot of sense.

In the meantime cardiologists are concerned that all these points are no longer sufficient in identifying individuals at risk for heart disease. Dr. Morteza Naghavi, president for the Association for the Eradication of Heart Attacks, is concerned that it is not only obesity and hypertension that bear the risk for heart attacks, but atherosclerosis. A lot of heart attacks occur in the low- and moderate risk groups. As far as he is concerned, every man aged 45-75 and every woman from 55-75 needs to be screened. We are better equipped to do something for people who have a high plaque burden (deposits in the blood vessels.) Statins are the medication of choice to help these patients.

Screening techniques have become less invasive, as imaging technology has made large progress in recent years. The condition of the carotid artery can be assessed by ultrasound (carotid intima-media thickness or CIMT). Coronary calcification score (CACS) can be measured by CT scanner. The tests are done in a few minutes, and the cost at the most is a few hundred dollars. A patient would only be screened every five years. Screening procedures work and save lives, as demonstrated in the screening for breast cancer. The SHAPE team (The Screening for Heart Attack Prevention and Education) has calculated that the screening cost is even better than breast cancer screening. There are other tests that improve the sensitivity of traditional criteria, like the blood test for C-reactive protein, but in assessing the patient’s risk, it does make sense to go to the source of disease. The striking color image that demonstrates the atherosclerotic burden will allow the patients to see the problem with their own eyes.

New Screening For Cardiovascular Disease

New Screening For Cardiovascular Disease

It may be a healing shock that has a beneficial effect on the compliance of patients. Test results of laboratory work are words, but here a picture is worth a thousand words when it comes to encourage the patient to actively work on prevention.

More information on heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: National Review Of Medicine, July 30, 2006, page 7

Last edited November 1, 2014

Oct
01
2005

Men Expected to Catch Up On Life Expectancy

Life expectancy between the sexes has always been different: females generally outlive males by several years, but close observation from the Office of Health Economics in Great Britain shows a shift in Life expectancy. Males have been catching up, and their life expectancy rates have been rising faster than those of females. There is still a difference for a boy born in 2002. He will have a life expectancy of 76 years, whereas his sister will live to age 81.

Researchers believe that the reason for the shift is lifestyle change in females. Many of them now face the same workplace stress that has been traditionally shouldered by males. Detrimental habits are also more common in females. Heavy drinking in young females has more than tripled in the last 17 years, and 10% of young females exceed the recommended drinking limit (compared to 12% males). Non-smoking campaigns are less successful in women. Males have cut their smoking habits. 51% smoked in 1974, and by 2002 only 28 % were smokers. Female smokers amounted to 41 % in 1974, but by 2002 there were still 26 % smokers. The results show most dramatically in cancer statistics. Since 1973 lung cancer rates in men have been reduced to half and the lung cancer survival rate has increased. In comparison lung cancer in females during the same time period has increased by 45%. As a result of sedentary lifestyles the body mass index has also shown an increase.

Men Expected to Catch Up On Life Expectancy

Men Expected to Catch Up On Life Expectancy

Estimates showed that by the year 2010, life expectancy will likely converge for both sexes at an age of 81.

Reference: BMJ 2005; 331:656 (24 September)

Last edited December 6, 2012

Jun
01
2005

Pancreatic Cancer And Processed Meats

A large multi-ethnic study analyzed data from 190,545 men and women at the Cancer Research Center at the University of Hawaii. In an average follow-up time of 7 years there were 482 incidents of pancreatic cancer, and it became obvious that processed meats play a role in the increase of pancreatic cancer. After taking other risk factors into consideration like a positive family history, age, smoking and diabetes mellitus, those patients who consumed the largest amount of processed meats had a 67% increased risk for pancreatic cancer as opposed to those who had the lowest intake of these foods. A diet rich in red meats increased the risk by about 50%.

Poultry, fish, dairy products and egg intake showed no pancreatic cancer risk factor, nor did it matter how much fat, saturated fat or cholesterol was consumed over the 7 year observation period.

The lead investigator of the study, Dr. Ute Noethlings, observes that the risk increase is a consequence of the meat preparation with carcinogens. The main culprit would very likely be sodium nitrite, which is a preservative that also enhances the meat color.

Pancreatic Cancer And Processed Meats

Pancreatic Cancer And Processed Meats

For the consumer it means taking a critical look at processed meats before picking up sausages with your next shopping. Read the labels, avoid sodium nitrite. Your pancreas will thank you for it!

More information on pancreatic cancer: http://nethealthbook.com/cancer-overview/pancreatic-cancer-pancreas-cancer-or-cancer-of-the-pancreas/

Reference: The Medical Post, May 17, 2005, page 50

Last edited October 28, 2014

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Jun
01
2005

Smoking During Pregnancy Linked To Adult Asthma

Smoking during pregnancy has been found to be harmful to the unborn child, and secondary smoke has long been recognized as a health risk for children. Doctors and health care providers keep on pointing out the hazards: aside the risk for the mother-to-be there are the consequences for the children: low baby birth weights, respiratory problems for children.
In the meantime there is another good reason for the pregnant woman (and other household members) to quit. Passive smoking for the unborn child and in childhood seems to have a lasting effect on the airways. There is an increased risk for adult respiratory problems and asthma, reports Dr.Trude Duelien-Skoge, who is a respiratory physician at the University of Bergen, Norway. A long-term study was concluded between 1985 and 1996 involving 2,819 adults. Those participants, who had been exposed to tobacco smoke as unborn babies, were three times more likely to develop adult asthma than individuals whose mothers were non-smokers. Exposure to tobacco smoke in childhood alone was associated with a two-fold risk for adult asthma.

The worst consequences were born by the group that was exposed to tobacco smoke as unborn children and during childhood: they were three-and-a-half times more likely to develop asthma as adults. Several studies pointed to the fact that there are structural changes in the airways of children who had prenatal exposure to tobacco smoke. This does not come as a surprise, as many toxic chemicals from cigarette smoke pass freely across the placenta, and prenatal smoke exposure has been associated with a host of childhood illnesses. From early changes the road is paved to either slow progression of disease or inducing vulnerability in the airways, which only becomes evident with later exposures.

Smoking During Pregnancy Linked To Adult Asthma

Smoking During Pregnancy Linked To Adult Asthma

Due to the far-reaching health risk it is all the more important to be aware of prevention: neither should the unborn child be exposed to cigarette smoke, nor should the growing child be subjected to it, and all efforts should be made to convince the adult smoker of the benefits of quitting smoking.

More information on:

Asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

High risk pregnancies: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/high-risk-pregnancies/
Reference: The Medical Post, May 3, 2005, page 25

Last edited October 28, 2014

Aug
01
2003

Modify Risk Factors For Erectile Dysfunction (ED) In Elderly Men

Erectile dysfunction (ED, impotence) is a subject that is difficult to research because of its personal nature. Very few good studies are available regarding the question as to how common it would be among older men.

A team of medical experts under Dr. Constance G. Bacon from the Harvard School of Public Health and other institutions have investigated this problem in men older than 50 years and published the results in the August 5, 2003 issue of the Annals of Internal Medicine.

31,724 men aged 53 to 90 years were taking part in the Health Professionals Follow-up Study. Since 1986 they had been filling out detailed questionaires biennially. In 2000 detailed questions about sexual function were also included. Erectile dysfunction was defined as “having poor or very poor ability to have and maintain an erection sufficient for intercourse without treatment during the past 3 months”. The investigators found that about 1/3 of the men above the age of 50 had a sexual dysfunction. Such factors as orgasm, ability to have intercourse, sexual desire and overall sexual function were all affected more and more with every year after the age of 50. When this was further analyzed using multivariate analyses an interesting pattern of reasons for this emerged. The following factors were identified to be independent risk factors for the development of erectile dysfunction.

Modify Risk Factors For Erectile Dysfunction (ED) In Elderly Men

Modify Risk Factors For Erectile Dysfunction (ED) In Elderly Men

Each of the factors from this table is an independent risk factor and can be managed separately. For instance, the investigators found that a higher level of physical activity was associated with much less ED. The best group (men with no ED) was found among those who were always conscious about disease prevention and who had none of the conditions listed in this table or other chronic medical conditions. Leanness and physical activity were associated with good sexual functioning in this study.

Risk factors leading to erectile dysfunction (ED)
Symptoms: Comments:
increasing age
aging likely affects the blood supply to the swelling bodies of the penis; it also clamps down on testosterone production of the testicles
smoking accelerates aging and hardening of arteries
diabetes mellitus affects circulation and nerve impulse transmission
stroke
interferes with brain centers of arousal
antidepressant medication anticholinergic side-effect interferes with penile erection
beta-blocker medication reduction of libido (likely at the brain level from sympathetic nerve block)
alcohol consumption alcohol is a nerve poison that interferes with pudendus nerve function (lack of erections)
TV viewing time due to prolonged sitting there is a chronic lack of exercise that leads to nerve conduction and circulatory problems resulting in ED

This summary is based on a paper published in the medical journal of Annals of Internal Medicine 2003;139:161-168 by Dr. Constance G. Bacon and co-workers.

Here is a brief chapter on erectile dysfunction from Dr. Schilling’s web-based free Net Health Book.

Last edited October 26, 2014