Headlines (Scroll down for complete stories):
1. Who Gets Heart Failure?
2. Blood Pressure Predicts
Stroke Risk
3. Omega-3 Affects Depression, Inflammation
4. Managing Your Moods Can Benefit Your Health
1. Who Gets Heart Failure?
Diabetes and high blood pressure, two conditions rooted in genetics and environmental surroundings, play a much greater role than race alone in determining who is mostly likely to develop heart failure, according to the latest study from cardiologists at Johns Hopkins. Each year, nearly 300,000 Americans die from heart failure.
Experts say that racial disparities have long been known to exist in who actually develops risk
factors for the condition, with African-Americans nearly twice as likely to be diagnosed with diabetes and more than a third as likely to have high blood pressure than Caucasian Americans. But researchers have only now determined the precise role played by race in comparison to other risk factors, including socio-economic factors, age, gender, smoking, family history, and other health problems, as well as diabetes and hypertension.
The Hopkins team will present its findings March 27 in New Orleans at the American College of Cardiologys annual Scientific Sessions in New Orleans.
In the study, researchers monitored nearly 7,000 men and women, ages 45 to 84, of different ethnic backgrounds and with no existing symptoms of heart disease. African Americans developed heart failure at significantly higher rates (4.6 cases per 1,000 per year) than all other races, including Hispanics and Caucasians. Their rate was almost five times that of Chinese
Americans (1 case per 1,000 per year) and almost twice that of Caucasians (2.4 cases per 1,000 per year).
However, these apparent risk differences among races almost disappeared (dropping from twice as likely, a significant difference, to no more than one-and-a-half times as likely, an insignificant difference) when researchers used statistical techniques to exclude the two traditional risk factors for heart disease.
When all major factors are taken into account, the differences between races for heart failure largely evaporate in the absence of diabetes and hypertension among African-Americans, says senior study investigator João Lima, M.D.
According to Lima, an associate professor of medicine and radiology at The Johns Hopkins University School of Medicine and its Heart Institute, these early results add to other interesting findings from the so-called Multiethnic Study of Atherosclerosis (MESA).
The study, started in
2001, is monitoring its ethnically diverse participants for six to eight years to see who develops heart failure and who does not. It is the first large-scale analysis of racial or ethnic differences in heart function. So far, 79 study participants have developed congestive heart failure.
Other results presented at the meeting showed differences among races in heart strain, or contraction, which may contribute to disparities in heart failure, albeit to a lesser extent. Indeed, African-American hearts were found to contract less strongly than those of Hispanic, Caucasian, or Chinese-American backgrounds.
Lima cautions, however, that much remains to be understood about the root causes of racial disparities and how to fix them.
He points out that while African-Americans are at much higher risk of heart failure, there is no similarly higher number for risk of suffering heart attack, which, like diabetes and hypertension, often leads to
heart failure.
In MESA, researchers found a reverse relationship, with African-Americans having the lowest rates of heart failure due to myocardial infarct (at 25 percent), while other races had a much higher proportion: Caucasians (40 percent), Hispanics (42 percent), and Chinese Americans (100 percent.)
Lima says the difference could be due to successful disease prevention efforts among all racial groups, except for African-Americans, at controlling hypertension.
A lot of public health attention has already been paid to getting high blood pressure under control, so it may be just that this risk factor is under tighter control in some ethnic groups than in others, he says. African-Americans are clearly getting heart failure from causes other than heart attack.
According to lead researcher Hossein Bahrami, M.D., M.P.H., the message to physicians is clear, warding off heart failure in African-Americans requires
aggressive treatment of diabetes and hypertension. Whether through increased screening or greater emphasis on drug therapies, these are two risk factors that must be brought under control.
Bahrami says the teams next steps are to determine why different rates exist for these risk factors and the role played by biological and environmental factors.
Editor's Note:
2. Blood
Pressure Predicts Stroke Risk
Systolic blood pressure is an important predictor of stroke risk among men and women and across racial groups , according to a report in the American Journal of Hypertension.
Systolic blood pressure the top reading of the blood pressure has been shown to be a better predictor of stroke than diastolic blood pressure the lower reading among apparently healthy white men, the authors explain, but it is unclear whether this holds true for women and African-Americans.
Dr. David W. Brown and colleagues from the Centers for Disease Control and Prevention in Atlanta, investigated whether various blood pressure parameters individually and in combination improved the prediction of stroke events, using data from the Second National Health and Nutrition Examination Survey (NHANES II) Mortality Study.
The study population included 3,295 men and 3,462
women. Over a median follow-up of nearly 15 years, 113 fatal strokes occurred.
Brown's team found that increasing systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure were individually associated with an increased risk of fatal stroke.
Adding any other parameter to systolic blood pressure did not improve its ability to predict stroke, the results indicate. Specifically, for every 10 mm Hg increase in systolic blood pressure, the relative risk of stroke was 1.19 for men, 1.15 for women, 1.17 for whites, and 1.28 for African-Americans.
These results "agree with those from previous studies and show that systolic blood pressure is an important risk predictor for fatal stroke . . . and provide further evidence of the need to control systolic blood pressure in the population," the investigators conclude.
SOURCE: American Journal of Hypertension, March 2007.
© Reuters 2007.
Editor's Note:
3. Omega-3 Affects Depression, Inflammation
A new study suggests that people whose diets contain dramatically more of one kind of polyunsaturated fatty acid than another may be at greater risk for both clinical depression and certain
inflammatory diseases.
The report, published online this week in the journal Psychosomatic Medicine, suggests that we need to balance out our intake of omega-6 and omega-3 fatty acids. The current typical American diet contains 20 times more omega-6 than omega-3, a ratio that researchers say should be lowered to 4-to-1, or even 2-to-1.
This is the most recent in a long series of experiments Ohio State University researchers have conducted on the links between psychological stress and immunity. The addition of dietary questions to studies that have previously focused solely on emotional and biochemical markers may yield important new clues about the immune system.
In this study, we're looking at the intersection of behavior, immune function and diet. In past experiments, we concentrated only on the first two, explained Jan Kiecolt-Glaser, professor of psychiatry and psychology at Ohio State and lead author on the paper.
It now appears that diet is a very important variable in the equation as to how people respond to depression and stress.
The study, conducted in OSU's Institute for Behavioral Medicine Research, focused on a group of 43 middle-aged to elderly men and women, nearly half of which were the caregiver spouses of people with Alzheimer's or other dementias. By including caregivers who typically report greater stress and more depression than similar adults who are not caregiving, the researchers could look at how depression and diet might interact to affect inflammation.
The analysis showed that participants who had much more omega-6 compared to omega-3 fatty acids, and who also were reporting more symptoms of depression, had much higher levels of two cytokines which enhance inflammation.
The data suggest that higher depression and a poorer diet in terms of omega-3 can work together to promote inflammation. Other
researchers have shown that clinically depressed people those with more severe depression often have lower omega-3 levels in their blood, and several studies have shown that supplementing diets with omega-3 improves depression, Kiecolt-Glaser said, although the reason isn't clear.
However Dr. Russell Blaylock, author of NewsMaxs Blaylock Wellness Report, would tell you that we do indeed know the cause: vegetable oils and lack of fruit. As he writes in his
special report on omega-3:
Widespread use of vegetable oils places [Americans] consumption ratio of omega-6 to omega-3 fats anywhere from 10-to-1 to as high as 20-to-1. This is a dangerous disparity. The proper ratio is one omega-6 fat to every omega-3. Your ratio should never be more than 2-to-1.
Doctors learned a lot about
the effects of excessive immune system activation [which results in chronic inflammation] on depression by studying patients who received injections of specific immune cytokines.
Omega-3 oils suppress deadly inflammation very safely and efficiently, as do many of the flavonoids found in fruits and vegetables. Combining these two classes of nutrients can significantly reduce depression, as well as the risk of most neurodegenerative diseases, such as Alzheimer's and Parkinson's."
Martha Belury, an associate professor of human nutrition, endocrinology, diabetes and metabolism at Ohio State and co-author of the study, said the design of the study was important.
We looked at people who were experiencing real depression, not those whose depression arose as a part of some experiment, and we could clearly see a relationship between lower omega-3 fatty acids and certain markers of depression and inflammation.
Belury said
that current recommendations allow up to two servings each week of cold-water fish the best source of omega-3 such as salmon or trout. This would not apply to pregnant women, she said, where concerns are greater about the heavy metal contamination such fish might contain. Omega-3 is also available as nutritional supplements
This study has shown that even in people who did not take supplements, maybe just a little bit more omega-3, could help reduce their markers for both stress and depression, Belury said.
The important message for consumers is that they don't have to take mega-doses of omega-3 to have some impact. It might not take a whole lot to have a significant clinical impact, Belury said.
The researchers are now starting a larger, more comprehensive randomized and controlled trial of omega-3 in adults between the ages of 50 and 80 in hopes of testing the questions raised in this pilot study.
Ron
Glaser, professor of internal medicine, molecular virology, immunology and medical genetics; David Beversdorf, an assistant professor of neurology; Stanley Lemeshow, dean of the College of Public Health, and Kyle Porter, a statistician in the Center for Biostatistics, were also part of the project. The research was supported in part by the National Institutes of Health.
Editor's Note:
4. Managing Your Moods Can Benefit Your Health
Learning how to deal with negative emotions and create positive ones may help you avoid many health problems.
Your emotions may originate in your brain, but they dont confine themselves to your mind. They express themselves in your body as well in your heartbeat, your respiratory rate, your blood pressure, and many other physical functions.
Usually, strong emotions come and go, and normal physiological equilibrium is restored. But when emotional stressors endure for long periods of time, they can tip the balance of chemicals in brain and body and affect your health, often for the worse.
Learning to recognize the physiological consequences of your emotions, and finding ways to establish emotional balance in your life, can help you avoid many health problems that may result from the way you react to the world around you.
Consider susceptibility to the common cold, for example. A study published in the November/December 2006 issue of the journal Psychosomatic Medicine suggests emotional factors can affect resistance to cold and flu symptoms. Researchers interviewed 193 healthy volunteers daily for two weeks about the positive and negative emotions they had experienced each day, recording the results. They then exposed subjects to a cold or flu virus.
Fewer positive-thinkers became infected, and positive thinkers who did become infected, had less pronounced symptoms than subjects with more negative emotions.
Only 28 percent of infected individuals who often reported positive emotions developed symptoms such as cough or congestion, compared to 41 percent of those who rarely reported positive emotions.
Positive emotions are thought to be beneficial to health, said Darin D. Dougherty, M.D., Massachusetts General Hospital. But when we experience
negative emotions in excess, they can be physically and psychologically harmful. Chronic excess anger, for example, is linked to a higher risk of hypertension, diabetes, and heart disease.
For this reason, its important to strive to stabilize your emotions. The good news is that we can minimize health problems associated with emotional stressors by seeking out circumstances that make us feel positive, avoiding as much as possible situations that cause us distress, and by using stress reduction techniques to address the stresses that we cant control.
Responses to emotion-evoking events that involve conscious thought are generated within the cortex, a region of the brain responsible for reasoning, voluntary muscle movement, and memory. Even more rapid reactions occur without conscious control. This is the work of the limbic system, a network of brain regions involved in many primary emotions. It responds to emotional triggers by activating the
autonomic nervous system, which controls the automatic functions of the body, such as circulation, digestion, and respiration.
The autonomic nervous system physically prepares the body for action when necessary, and helps restore a normal, relaxed state when the need for action passes. The limbic system generates physiological and behavioral responses to emotions that are stereotypic patterns displayed by every human being.
These responses often involve outward manifestations of emotion, such as facial expressions and muscle tightening. The patterns such as the downcast facial expression of sadness are so universal we recognize them in others. But many physical and behavioral effects generated by the limbic system may be hidden from view inside our bodies. These include responses to emotion such as increases in heart rate and blood pressure, constriction of blood vessels, and gastrointestinal disturbances.
The intensity
of emotional responses and their effects on the body can be influenced by a number of physiological factors, including patterns of brain activation, levels of hormones, levels of brain chemicals called neurotransmitters, and patterns of autonomic nervous system activity. Research suggests that each emotion is associated with a characteristic set of physiological responses. Here are examples of common emotions, along with some observed physical consequences:
Anger: Increase in diastolic blood pressure, heart rate, and cardiac output; changes in respiration; dilation of blood vessels (flushing); dilation of pupils and tearing of eyes; tensing of muscles; hyperactivity (pacing, tapping feet, etc.); focused vision; sweating; stimulation of upper gastrointestinal (GI) contractions and acid secretion; suppression of immune response.
Fear/anxiety: Increase in systolic blood pressure, heart rate, and cardiac output; constriction of blood
vessels (pale skin); increased muscle tension; changes in respiration; tightening of throat; trembling; light-headedness; shortness of breath; sweating; nausea; inhibition of contractions and secretions of the upper GI tract (feelings of lack of appetite and fullness); stimulation of the motility and secretions of the lower GI (abdominal pain and diarrhea); suppression of immune response.
Shame/guilt: Flushing or warmth in the upper chest and face; irregular breathing; increased pro-inflammatory activity; increased vulnerability to stress
Joy/pleasure: Slowing of heart rate and respiration, lower blood pressure.
Sadness/grief: Tightness in throat and eyes; relaxation of arm and leg muscles; increased heart rate and elevated blood pressure; shortness of breath; insomnia; pain; gastrointestinal symptoms; fatigue; headache; chest pressure; backache; dizziness; suppression of immune response.
Disgust: Slowed heart rate; nausea; increased salivation.
Loneliness: Sleep disturbance; lack of appetite; reduced energy; headaches or stomach pain; high blood pressure; elevated stress hormones.
Love/desire: Slowed heart and respiration rate; muscle relaxation; enhanced immune response. When intense (love sickness), can be associated with dry throat, increased respiration; changes in appetite, and sleep disturbance.
Humor/laughter: Release of tension; lowered blood pressure, heart rate and respiration rate; elevated immune response; improved pain tolerance; increased levels of endorphins resulting in improved mood.
When emotional stressors such as anger or loneliness affect the body repeatedly, or over a long period of time, they can compromise the health of vulnerable individuals. Such prolonged stress is associated with a variety of disorders, including metabolic syndrome (a precursor
to Type 2 diabetes characterized by insulin resistance, hypertension, and elevated levels of unhealthy LDL cholesterol), cardiovascular problems, confusion, poor memory, allergies, ulcers, functional bowel disorders, insomnia, and rapid aging.
Fortunately, you can reduce your risk of health problems associated with emotional wear and tear by paying attention to your emotional reactions and taking steps to establish emotional balance. Minimize emotional stress by buffering yourself from upsetting situations as much as possible. Adopt a positive attitude toward life. Pursue activities that you enjoy, and seek out people with whom you can be yourself.
To build up resilience, eat a nutritious diet, avoid drugs, limit alcohol, exercise, get adequate sleep, and take time to relax. If you find you cant manage your emotions on your own, its important to get help, Dougherty says. There are effective therapies available that can help you reduce
unhealthy stress and restore a sense of calm and control to your life.
What you can do when emotions seem overwhelming, try these techniques for rapidly establishing more emotional balance:
Learn relaxation techniques. Yoga, deep-breathing exercises, meditation, and visualization can help you reduce emotional stress.
Do things that relax your senses. Play soothing music; go somewhere where you can see or walk in peaceful natural surroundings; get a massage.
Release energy. Take out your anxiety or anger through vigorous physical activity such as raking leaves, doing housework, or going for a brisk walk.
Talk about it. Make a date with a loved one or trusted friend and vent your feelings. Talking about what bothers you can be a good way to diffuse pent up emotions.
Editor's Note:
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