Tag: heart attack

Doctors struggle with how to help patients struggling with heart conditions after COVID-19

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Firefighter and paramedic Mike Camilleri once had no trouble hauling heavy gear up ladders. Now battling long COVID, he gingerly steps onto a treadmill to learn how his heart handles a simple walk.

“This is, like, not a tough-guy test so don’t fake it,” warned Beth Hughes, a physical therapist at Washington University in St. Louis.

Somehow, a mild case of COVID-19 set off a chain reaction that eventually left Camilleri with dangerous blood pressure spikes, a heartbeat that raced with slight exertion, and episodes of intense chest pain.

He’s far from alone. How profound a toll COVID-19 has taken on the nation’s heart health is only starting to emerge, years into the pandemic.

“We are seeing effects on the heart and the vascular system that really outnumber, unfortunately, effects on other organ systems,” said Dr. Susan Cheng, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.

It’s not only an issue for long COVID patients like Camilleri. For up to a year after a case of COVID-19, people may be at increased risk of developing a new heart-related problem, anything from blood clots and irregular heartbeats to a heart attack –- even if they initially seem to recover just fine.

Among the unknowns: Who’s most likely to experience these aftereffects? Are they reversible — or a warning sign of more heart disease later in life?

“We’re about to exit this pandemic as even a sicker nation” because of virus-related heart trouble, said Washington University’s Dr. Ziyad Al-Aly, who helped sound the alarm about lingering health problems. The consequences, he added, “will likely reverberate for generations.”

Patient Mike Camilleri works with physical therapist Beth Hughes in St. Louis, Mo., on March 1, 2023. Somehow, a mild case of COVID-19 set off a chain reaction that eventually left Camilleri with dangerous blood pressure spikes, a heartbeat that raced with slight exertion, and episodes of intense chest pain.

Angie Wang / AP

Heart disease has long been the top killer in the nation and the world. But in the U.S., heart-related death rates had fallen to record lows in 2019, just before the pandemic struck.

COVID-19 erased a decade of that progress, Cheng said.

Heart attack-caused deaths rose during every virus surge. Worse, young people aren’t supposed to have heart attacks but Cheng’s research documented a nearly 30% increase in heart attack deaths among 25- to 44-year-olds in the pandemic’s first two years.

An ominous sign the trouble may continue: High blood pressure is one of the biggest risks for heart disease and “people’s blood pressure has actually measurably gone up over the course of the pandemic,” she said.

Cardiovascular symptoms are part of what’s known as long COVID, the catchall term for dozens of health issues including fatigue and brain fog. The National Institutes of Health is beginning small studies of a few possible treatments for certain long COVID symptoms, including a heartbeat problem.

But Cheng said patients and doctors alike need to know that sometimes, cardiovascular trouble is the first or main symptom of damage the coronavirus left behind.

“These are individuals who wouldn’t necessarily come to their doctor and say, ‘I have long COVID,’” she said.

Doctors warn COVID hospitalizations are rising

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In St. Louis, Camilleri first developed shortness of breath and later a string of heart-related and other symptoms after a late 2020 bout of COVID-19. He tried different treatments from multiple doctors to no avail, until winding up at Washington University’s long COVID clinic.

“Finally a turn in the right direction,” said the 43-year-old Camilleri.

There, he saw Dr. Amanda Verma for worsening trouble with his blood pressure and heart rate. Verma is part of a cardiology team that studied a small group of patients with perplexing heart symptoms like Camilleri’s, and found abnormalities in blood flow may be part of the problem.

How? Blood flow jumps when people move around and subsides during rest. But some long COVID patients don’t get enough of a drop during rest because the fight-or-flight system that controls stress reactions stays activated, Verma said.

Some also have trouble with the lining of their small blood vessels not dilating and constricting properly to move blood through, she added.

Hoping that helped explain some of Camilleri’s symptoms, Verma prescribed some heart medicines that dilate blood vessels and others to dampen that fight-or-flight response.

Back in the gym, Hughes, a physical therapist who works with long COVID patients, came up with a careful rehab plan after the treadmill test exposed erratic jumps in Camilleri’s heart rate.

“We’d see it worse if you were not on Dr. Verma’s meds,” Hughes said, showing Camilleri exercises to do while lying down and monitoring his heart rate. “We need to rewire your system” to normalize that fight-or-flight response.

Camilleri said he noticed some improvement as Verma mixed and matched prescriptions based on his reactions. But then a second bout with COVID-19 in the spring caused even more health problems, a disability that forced him to retire.

Patient Mike Camilleri works with physical therapist Beth Hughes in St. Louis, Mo., on March 1, 2023. Somehow, a mild case of COVID-19 set off a chain reaction that eventually left Camilleri with dangerous blood pressure spikes, a heartbeat that raced with slight exertion, and episodes of intense chest pain.

Angie Wang / AP

How big is the post-COVID heart risk? To find out, Al-Aly analyzed medical records from a massive Veterans Administration database. People who’d survived COVID-19 early in the pandemic were more likely to experience abnormal heartbeats, blood clots, chest pain and palpitations, even heart attacks and strokes up to a year later compared to the uninfected. That includes even middle-aged people without prior signs of heart disease

Based on those findings, Al-Aly estimated 4 of every 100 people need care for some kind of heart-related symptom in the year after recovering from COVID-19.

Per person, that’s a small risk. But he said the pandemic’s sheer enormity means it added up to millions left with at least some cardiovascular symptom. While a reinfection might still cause trouble, Al-Aly’s now studying whether that overall risk dropped thanks to vaccination and milder coronavirus strains.

More recent research confirms the need to better understand and address these cardiac aftershocks. An analysis this spring of a large U.S. insurance database found long COVID patients were about twice as likely to seek care for cardiovascular problems including blood clots, abnormal heartbeats or stroke in the year after infection, compared to similar patients who’d avoided COVID-19.

A post-infection link to heart damage isn’t that surprising, Verma noted. She pointed to rheumatic fever, an inflammatory reaction to untreated strep throat –- especially before antibiotics were common — that scars the heart’s valves.

“Is this going to become the next rheumatic heart disease? We don’t know,” she said.

But Al-Aly says there’s a simple take-home message: You can’t change your history of COVID-19 infections but if you’ve ignored other heart risks –- like high cholesterol or blood pressure, poorly controlled diabetes or smoking -– now’s the time to change that.

“These are the ones we can do something about. And I think they’re more important now than they were in 2019,” he said.

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August 12, 2023
We’ve Had a Cheaper, More Potent Ozempic Alternative for Decades

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The Ozempic craze shows no signs of slowing. Demand for the drug, popularly used for weight loss, is so monumental that it is already changing the diet industry and spurring a “marketing bonanza” among the dozens of telehealth start-ups that now prescribe it. A highly public ad campaign from one start-up, Ro, banks on the drug’s simple premise: “A weekly shot to lose weight.”

Never before has a weight-loss treatment been hyped this way and been able to deliver on its promise. Ozempic itself is technically a diabetes drug, but its active ingredient, semaglutide, has been approved by the FDA for weight loss under the brand name Wegovy, and can reduce a person’s body weight by up to 20 percent through a weekly injection. An even more powerful drug, known as tirzepatide, or Mounjaro, may soon be approved for weight loss, and a host of new medications are coming down the pipeline. All signs suggest that America is on the verge of a weight-loss revolution.

But for people with obesity, semaglutide isn’t even the most effective weight-loss treatment around—not even close. Bariatric surgery, which has existed for many decades, is still significantly more potent. This class of procedures, which, broadly speaking, reconfigure the digestive system so people feel less hungry and more full, is considered to be the “gold standard” for treating obesity, Holly Lofton, an obesity-medicine physician at NYU, told me. Most people experience weight loss of 50 percent and, with one procedure, up to 80 percent, according to the Cleveland Clinic.

Despite the impressive abilities of the new crop of weight-loss drugs—and bold assertions that such drugs could someday replace surgery outright—several doctors told me that surgery will likely continue to be the top-line treatment for obesity, even as the medications improve. People may seek out treatment with the new drugs because they’re so popular, but “long term, there will be an increase in surgery,” Shauna Levy, a professor specializing in bariatric surgery at Tulane University School of Medicine, told me. The new drugs, however potent, may be less a revolutionary fix for obesity and more a powerful tool for treating it—one of many that already exist.

Unlike semaglutide, bariatric surgery, first introduced in the 1950s, took several decades to become accepted by the medical community. Initial attempts made people so sick that, at times, the surgery had to be reversed. The term bariatric surgery refers to several different procedures that reshape the gastrointestinal tract so that it absorbs fewer nutrients, holds less food, or both. These days, the most commonly performed surgery is called a Roux-en-Y, which shrinks the stomach to the size of a walnut—so people need less food to feel satisfied—and then reconnects it to the small intestine in a Y shape, rather than linearly. This gastric bypass lets food circumvent most of the stomach, leaving fewer opportunities for the body to harvest nutrients. In another common procedure, surgeons sculpt the stomach into a banana-size “sleeve” and toss the rest; another common type involves rerouting the intestines in a way that minimizes the area where calories can be absorbed.

But bariatric surgery does more than shrink gastrointestinal real estate. It exerts a less visible but equally powerful effect on the many different hormones that control hunger. Some procedures remove the part of the gut that produces the “hunger hormone,” ghrelin, while the rerouting of food through a Roux-en-Y ramps up the release of “incretin” hormones that create the feeling of fullness after eating.

In a sense, the new weight-loss drugs are essentially trying to re-create the effects of bariatric surgery: The success of these drugs is due to their ability to mimic the incretin hormones and get people to feel satisfied with less food. Semaglutide masquerades as the hormone GLP-1, whereas Mounjaro poses as both GLP-1 and GIP. But these are just two hormones; bariatric surgery “touches on multiple different hormones and different pathways” and, as such, is “more comprehensive,” Levy said. In one study, Mounjaro, considered the most powerful of the current crop of medications, led to 20 percent or more weight loss in 57 percent of people who took the highest dose—an impressive feat, but still a far cry from what is possible with surgery. Similarly, Ozempic and Mounjaro, both technically diabetes drugs, have powerful effects on blood-sugar levels over time, but many surgery patients “leave the hospital already in remission from their diabetes,” Levy said.

In addition to sheer potency, surgery is also much more affordable than these weight-loss drugs. Unlike the drugs, bariatric surgery is covered by Medicare if the patient meets certain criteria, including having a BMI equal to or greater than 35 and at least one comorbidity related to obesity. Many private insurers cover it too, albeit to varying degrees. Out of pocket, surgery costs $15,000 to $25,000—not cheap, but still cheaper than shelling out m ore than $1,000 a month indefinitely. “The patient must understand that they have to continue taking medication forever,” Lofton said. People who stop taking semaglutide generally regain the weight they lost. Lofton told me about one patient who had to forgo rent just to pay for the drugs: Factoring in insurance, “you can pay for three months of medicine and then have surgery at the same price.”

Neither treatment, of course, is without its potential downsides. Semaglutide can cause temporary but nasty side effects such as nausea, vomiting, and diarrhea—and though it is considered safe for treating obesity, long-term data on this usage span just two years. Because many surgeries are done laparoscopically—using only tiny incisions—mortality is vanishingly low, and many patients go home after two or three days; full recovery usually takes four to six weeks. In the long term, complications such as hernias, gallstones, and low blood sugar can develop.

But there’s a reason bariatric surgery has not led to a weight-loss revolution of the kind that now gets associated with semaglutide. Despite its dramatic effects, and obesity’s prevalence across America, only 1 percent of people eligible for surgery actually get it. People hesitate for many reasons, medical and otherwise, but the most pervasive issue is a lack of awareness that surgery is even a safe or realistic option for weight loss. Bariatric surgery is plagued by stigma even within the medical community: In the 1990s, it was dismissed as a “barbaric” way to address an issue that, many believed, could be treated with diet and exercise. “There are a lot of primary-care doctors who are not talking enough about surgery” because they were trained with that old mindset, Levy said. It doesn’t help that bariatric surgery hasn’t exactly been a media sensation, with few high-profile patient advocates beyond Al Roker and Mariah Carey. In contrast, stories of celebrities on weight-loss drugs abound. Unlike surgery, semaglutide has the potential to be taken recreationally.

The advantages that surgery has over weight-loss drugs may change as the drugs become more potent and eventually cheaper. But for now, semaglutide won’t dramatically shift the way obesity is treated, doctors told me—in fact, these new drugs may act as a conduit to surgery itself. Levy predicts that their sheer popularity will trigger a brief dip in the bariatric-surgery rate, but as price remains an issue, and people with obesity are unable to reach their weight-loss goals on the drugs alone, “they may start opening their mind to surgery.”

Certainly, in some patients, weight-loss drugs alone could lead to lasting weight loss. And they can benefit those who are overweight but don’t qualify for surgery. But more widely, these drugs will likely be used in tandem with bariatric surgery to produce more dramatic, longer-lasting results, experts told me. “I don’t see this as an either/or,” Fatima Cody Stanford, an obesity-medicine physician at Massachusetts General Hospital and Harvard Medical School, told me. “I see it as surgery plus medicine.”

Drugs can help fill in any gaps that surgery leaves behind. Weight can rebound after a procedure, because the body has a way of rebalancing itself; hormones that were tamped down due to bariatric surgery, Stanford said, can “start to reemerge with a vengeance.” About a fifth of people, and perhaps even more, regain a significant amount of weight—15 percent or more—two to five years after surgery. All of the doctors I spoke with said that medication could be a powerful tool to prevent post-surgery weight rebounds—though to keep that weight off, the medication would still have to be taken in perpetuity. Stanford estimated that more than 90 percent of her patients are on weight-loss drugs after surgery—and not necessarily semaglutide; older medications often suffice. Drugs could also be used to help people prepare for surgery, Lofton said. Some doctors encourage patients to lose weight beforehand to decrease the risk of complications such as blood clots, heart attack, and infection.

Despite the hype, weight-loss drugs were never a perfect treatment for obesity. Neither is bariatric surgery, for that matter. “It is not a cure,” Lofton told me. A cure, she explained, would ensure that hunger doesn’t return and that fat cells don’t get bigger, a hallmark of obesity: “We have nothing that does that”—not even more potent next-gen drugs will provide a permanent fix. But the effect of combining surgery and medication could come close, she said.

That no cure for obesity exists is evidence of its complexity. All of the experts I spoke with pointed out that obesity has long been misunderstood as a failure of personal will, as laziness or gluttony. That misunderstanding has led to inadequate care: Many people who regain weight after a bariatric procedure are made to feel by their doctors like they “wasted the surgery,” even if human biology is to blame, Stanford said. Ozempic and other weight-loss medications frame obesity as a condition that can be treated with drugs—in other words, a disease. Patients on those medications may realize, “Hey, maybe it’s not just me being lazy this whole time—maybe there is science to it and an actual disease here,” said Levy. Collectively understanding obesity as an illness that exists alongside heart disease and cancer—diseases routinely treated with medication and surgery—instead of as a matter of personal inadequacy will have far more profound impacts on people with obesity than any drug alone.

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Yasmin Tayag

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April 25, 2023
High-Salt Diet a Danger Even With Normal Blood Pressure

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April 10, 2023 – It is well-known that high blood pressure is a risk factor for heart attacks and strokes.

Now, new research from Sweden has shown that too much salt in the diet is an important risk factor for clogged arteries in the neck and heart, increasing the risk of heart attacks and strokes even if you don’t have high blood pressure.

The study was published online in European Heart Journal Open.

The finding raises the possibility that salt could cause damage even before someone develops high blood pressure, said study author Jonas Wuopio, MD, of the Karolinska Institutet, Huddinge, and Clinical Research Center at Uppsala University in Sweden.

Salt is bad for heart health because of its link to high blood pressure, also known as hypertension, but the role salt plays in the development of plaque in the arteries has not been examined, Wuopio said.

“Ours is the first study to examine the association between a high salt intake and hardening of the arteries in both the head and neck. The association was linear, meaning that each rise in salt intake was linked with more atherosclerosis,” he said.

The study included 10,778 adults ages 50 to 64. The research team measured the amount of salt found in the their urine to estimate their salt consumption.

The researchers then captured images of the arteries of the heart to check for calcium and blockages or stenosis, and ultrasound to detect blockages in the carotid arteries in the neck.

They found that the more salt people consumed, the higher their risk of calcifications in the heart and neck arteries.

The findings were seen even after the researchers excluded people with high blood pressure.

“This means that it’s not just patients with high blood pressure or heart disease who need to watch their salt intake,” Wuopio said.

He tells his patients to follow guidance from the World Health Organization and other groups to limit salt to about a teaspoon a day.

“It can be hard to estimate how much salt we eat, so I advise patients to limit the use of table salt, or to replace salt with a salt substitute,” he said.

Food is Medicine

The lower you can get your blood pressure, the better, said Alon Gitig, MD, an assistant professor and director of cardiology for Mount Sinai Doctors in Westchester, NY.

“Everybody knows that high blood pressure is associated with future cardiovascular disease risk, but what many don’t realize is that that risk starts to increase” even at the upper end of what is considered normal. “Most of the people in the U.S. over the age of 60 have hypertension,” Gitig said.

A good way to lower your blood pressure is through diet, exercise, and maintaining a healthy weight, he said.

The Dietary Approaches to Stop Hypertension (DASH) diet – which suggests several servings of fruits and vegetables a day, with few refined carbohydrates, flour, and sugar – has been shown in a study to dramatically lower blood pressure, Gitig said.

“There are two reasons for that. One is that fruits and vegetables have many phytonutrients that are good for our arteries. The other is that most of U.S. adults have insulin resistance, and insulin resistance leads to high blood pressure,” he said.

Eating more fruits and vegetables and lean meats while limiting sugar and flour will improve insulin resistance. Do that, Gitig said, “and you can bring your blood pressure down that way.”

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April 10, 2023
11 Possible Heart Symptoms You Shouldn’t Ignore

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If something went wrong with your heart, would you know it?

Not all heart problems come with clear warning signs. There is not always an alarming chest clutch followed by a fall to the floor like you see in movies. Some heart symptoms don’t even happen in your chest, and it’s not always easy to tell what’s going on.

“If you’re not sure, get it checked out,” says Charles Chambers, MD, director of the Cardiac Catheterization Laboratory at Penn State Hershey Heart and Vascular Institute.

That’s especially true if you are 60 or older, are overweight, or have diabetes, high cholesterol, or high blood pressure, says Vincent Bufalino, MD, an American Heart Association spokesman. “The more risk factors you have,” he says, “the more you should be concerned about anything that might be heart-related.”

Especially watch out for these problems:

1. Chest Discomfort

It’s the most common sign of heart danger. If you have a blocked artery or are having a heart attack, you may feel pain, tightness, or pressure in your chest.

“Everyone has a different word for that feeling,” Chambers says. “Some people say it’s like an elephant is sitting on them. Other people say it’s like a pinching or burning.”

The feeling usually lasts longer than a few minutes. It may happen when you’re at rest or when you’re doing something physical.

If it’s just a very brief pain — or if it’s a spot that hurts more when you touch or push on it — it’s probably not your heart, Chambers says. You should still get it checked out by a doctor. If the symptoms are more severe and don’t go away after a few minutes, you should call 911.

Also, keep in mind you can have heart problems — even a heart attack — without chest pain. That’s particularly common among women.

2. Nausea, Indigestion, Heartburn, or Stomach Pain

Some people have these symptoms during a heart attack. They may even vomit, Chambers says.

Women are more likely to report this type of symptom than men are.

Of course, you can have an upset stomach for many reasons that have nothing to do with your heart. It could just be something you ate, after all. But you need to be aware that it can also happen during a heart attack.

So if you feel this way and you’re at risk for heart problems, let a doctor find out what’s going on, especially if you also have any of the other symptoms on this list.

3. Pain that Spreads to the Arm

Another classic heart attack symptom is pain that radiates down the left side of the body.

“It almost always starts from the chest and moves outward,” Chambers says. “But I have had some patients who have mainly arm pain that turned out to be heart attacks.”

4. You Feel Dizzy or Lightheaded

A lot of things can make you lose your balance or feel faint for a moment. Maybe you didn’t have enough to eat or drink, or you stood up too fast.

But if you suddenly feel unsteady and you also have chest discomfort or shortness of breath, get medical help right away.

“It could mean your blood pressure has dropped because your heart isn’t able to pump the way it should,” Bufalino says.

5. Throat or Jaw Pain

By itself, throat or jaw pain probably isn’t heart related. More likely, it’s caused by a muscular issue, a cold, or a sinus problem.

But if you have pain or pressure in the center of your chest that spreads up into your throat or jaw, it could be a sign of a heart attack. Call 911 and seek medical attention to make sure everything is all right.

6. You Get Exhausted Easily

If you suddenly feel fatigued or winded after doing something you had no problem doing in the past — like climbing the stairs or carrying groceries from the car — make an appointment with your doctor right away.

“These types of significant changes are more important to us than every little ache and pain you might be feeling,” Bufalino says.

Extreme exhaustion or unexplained weakness, sometimes for days at a time, can be a symptom of heart disease, especially for women.

7. Snoring

It’s normal to snore a little while you snooze. But unusually loud snoring that sounds like a gasping or choking can be a sign of sleep apnea. That’s when you stop breathing for brief moments several times at night while you are still sleeping. This puts extra stress on your heart.

Your doctor can check whether you need a sleep study to see if you have this condition. If you do, you may need a CPAP machine to smooth out your breathing while you sleep.

8. Sweating

Breaking out in a cold sweat for no obvious reason could signal a heart attack. If this happens along with any of these other symptoms, call 911 to get to a hospital right away. Don’t try to drive yourself.

9. A Cough That Won’t Quit

In most cases, this isn’t a sign of heart trouble. But if you have heart disease or know you’re at risk, pay special attention to the possibility.

If you have a long-lasting cough that produces a white or pink mucus, it could be a sign of heart failure. This happens when the heart can’t keep up with the body’s demands, causing blood to leak back into the lungs.

Ask your doctor to check on what’s causing your cough.

10. Your Legs, Feet, and Ankles Are Swollen

This could be a sign that your heart doesn’t pump blood as effectively as it should.

When the heart can’t pump fast enough, blood backs up in the veins and causes bloating.

Heart failure can also make it harder for the kidneys to remove extra water and sodium from the body, which can lead to bloating.

11. Irregular Heart Beat

It can benormal for your heart to race when you are nervous or excited or to skip or add a beat once in a while.

But if you have started feeling palpitations, check in with your doctor. Call 911 if you have palpitations or an irregular heartbeat that persists or if you also have any chest pain or pressure, dizziness, or shortness of breath.

“In most cases, it’s caused by something that’s easy to fix, like too much caffeine or not enough sleep,” Bufalino says. But occasionally, it could signal a condition called atrial fibrillation that needs treatment. So ask your doctor to check it out.

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April 7, 2023
Flu Boosts Short-Term Odds for Heart Attack 6-Fold

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By Cara Murez

HealthDay Reporter

WEDNESDAY, March 29, 2023 (HealthDay News) — Getting the flu isn’t fun for many reasons, but it can also trigger a heart attack, a new study suggests.

A heart attack is six times more likely in the week after a person is diagnosed with flu than in the year before or after, according to Dutch researchers.

This emphasizes the need for flu patients and those caring for them to be aware of heart attack symptoms. It also underscores the importance of getting a flu shot, the authors said.

The findings are scheduled to be presented April 18 at a meeting of the European Congress of Clinical Microbiology and Infectious Diseases, online and in Copenhagen, Denmark.

“With the potential public health implications of an association between influenza virus infection and acute heart attacks, showing robustness of results in a different study population is important,” said researcher Annemarijn de Boer, of the Julius Center for Life Sciences and Primary Care at UMC Utrecht in the Netherlands.

“Our results endorse strategies to prevent influenza infection, including vaccination. They also advocate for a raised awareness among physicians and hospitalized flu-patients for symptoms of heart attacks,” de Boer said in a meeting news release.

While the findings don’t make it clear whether those with less severe flu are also at risk, de Boer said they should also be aware of the link.

While the connection between flu and heart attacks was also made in a 2018 Canadian study, it included only hospitalized people and not those who died of heart attacks elsewhere.

In this study, researchers relied on test results from 16 laboratories, covering around 40% of the Dutch population, along with death and hospital records.

More than 26,000 cases of influenza were confirmed by the labs between 2008 and 2019.

The researchers found that 401 individuals had at least one heart attack within a year of their flu diagnosis, with a total of 419 heart attacks.

Of the 419 heart attacks, 25 were in the first seven days after flu diagnosis; 217 in the year before diagnosis; and 177 in the year after flu diagnosis but not including the first seven days.

About one-third of the 401 patients died of any cause within a year of being diagnosed with flu.

The researchers calculated that the individuals studied were 6.16 times more likely to have a heart attack in the week following a flu diagnosis than in the year before or after. The Canadian study found they were 6.05 times more likely to have a heart attack in those seven days.

Excluding data from death records, as in the Canadian study, reduced the increase in heart attack risk in the first week to 2.42 times. Dutch researchers said this underscores the impact of incomplete data on study findings.

Researchers also said that differences in testing practices in the two countries may help explain the differences. It’s less common to test for flu outside the hospital in the Netherlands than it is in Canada, according to researchers.

The Dutch researchers said the association is still significant and that they were able to confirm that the increase in risk applies across different populations.

The influenza virus is known to increase clotting of blood. This, along with the inflammation that is part of the body’s immune response against the virus, can weaken fatty plaques that have built up in the arteries, the authors said. If a plaque ruptures, a blood clot can form, blocking the blood supply to the heart and cause a heart attack, they explained.

Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

More information

UCLA Health has more on the connections between heart disease and flu.

SOURCE: European Congress of Clinical Microbiology and Infectious Diseases, news release, March 28, 2023

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March 29, 2023
Basketball referee reunites with player who saved his life after on-court heart attack

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Basketball referee reunites with player who saved his life after on-court heart attack – CBS News

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John Sculli suffered an on-court “widow maker” heart attack while officiating a semi-pro basketball game last June. Player Myles Copeland rushed to Sculli’s side, performed CPR, and saved his life. The two recently reunited in the gym where it all happened. Steve Hartman has their story in “On the Road.”

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March 25, 2023
CBS Evening News, March 24, 2023

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CBS Evening News, March 24, 2023 – CBS News

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Trump criticized for violent rhetoric against Manhattan DA’s office; Basketball referee reunites with player who saved his life after on-court heart attack

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March 24, 2023
Demi Lovato Puts Rock Twist On Classic Single “Heart Attack”

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We all know Demi Lovato – some of us have even grown up with her. We’ve witnessed her stunning vocal performances at countless awards shows, on a handful of tours, and even throughout her time on Disney Channel.

Now, Queen Demi is back with an alternative take to her already mega-successful single, “Heart Attack.” A song that already had the flair and rage to become a rock masterpiece, “Heart Attack” features a hearty chorus that went 4x platinum following its original release in 2013.

Demi first debuted the rock version of “Heart Attack” during her 2022 tour: HOLY FVCK. And with the growing popularity of rock covers, this song only made perfect sense to release to the public. Demi’s album, HOLY FVCK, also featured rock influences and collabs with pop-punk artists like Yungblud.

This new rock era for Demi shows the limits in which her vocals can be taken to, while still blending her strong pop lyrics with an alternative punk-y sound that just works. Demi says,

“I’m so happy to be able to give a new life to ‘Heart Attack’ with a sound that reflects where I am with my music. This one is for the fans who have shown so much love to the song over the last decade, thank you for riding with me!”

You can listen to “Heart Attack (Rock Version)” here:

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Jai Phillips

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March 24, 2023
Promising drug could provide alternative to statins for those at risk of heart disease, new study finds

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A new study has found that a drug could replace statins for those who cannot tolerate them, a promising finding for millions of people who are at risk of heart disease.

The study, published in the New England Journal of Medicine Saturday, found that in patients with increased cardiovascular risk, bempedoic acid was found to decrease heart-related complications, such as heart attacks, or the need for procedures like a bypass operation or a stent placement.

“I take care of these patients,” cardiologist Dr. Steven Nissen of the Cleveland Clinic, who led the study, told CBS News. “They say, ‘Dr. Nissen, I know I need to lower my cholesterol. I’ve tried all these different statins. My muscles hurt. I can’t take those drugs.’”

An editorial accompanying the study called the results “compelling,” and said they “will and should increase the use of bempedoic acid” in appropriate patients.

“Let me first tell you what the drug didn’t do,” Dr. Nissen said, when asked about potential side effects from bempedoic acid. “It didn’t cause muscle pain. That was very important. It did increase the risk of gout by about an absolute of 1%. And it did increase the risk of gallstones by about one absolute percent. Neither of those do we consider to be particularly serious.”

Bempedoic acid was approved by the Food and Drug Administration in 2020 as a way to reduce low-density lipoprotein (LDL) cholesterol levels.

“Yes, it’s approved, but not widely used,” Dr. Nissen said. “If you really want a drug to be widely used, it has to show evidence of benefit on the really important things. The kind of bad things that happened to patients with high cholesterol we now know can be reduced with bempedoic acid. And that’s what gives the drug now the opportunity to be paid for by the payers, and to be more available to patients.”

Drugs like PCSK9 inhibitors and ezetimibe are other alternatives to statins, but Dr. Nissen said bempedoic acid is an important addition.

“It’ll absolutely change the practice of medicine,” Dr. Nissen said of bempedoic acid.

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March 4, 2023
Getting Rehab at Home After Heart Attack Can Extend Lives

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By Steven Reinberg

HealthDay Reporter

WEDNESDAY, March 1, 2023 (HealthDay News) — After a heart attack, home rehab can literally be a lifesaver, a new study finds.

Taking part in a home-based cardiac rehabilitation program lowered the risk of dying from heart complications by 36% within four years, compared with patients who were not in a rehab program, researchers report.

“Cardiac rehabilitation programs save lives,” said lead researcher Dr. Mary Whooley, a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco.

According to the American Heart Association, which stresses the benefits of cardiac rehabilitation after a heart attack in preventing rehospitalization and deaths, rehab is greatly underused — with only about 44% of patients opting for it.

Cardiac rehabilitation programs stress not smoking, eating healthy, exercising, managing stress and taking medications to lower blood pressure and cholesterol.

Among patients hospitalized for a heart attack between 2007 and 2011, only 16% of Medicare patients and 10% of veterans took part in cardiac rehabilitation, the researchers said.

But if 70% of patients took part in cardiac rehab, 25,000 lives could be saved and 180,000 hospitalizations prevented each year, according to the Million Hearts Cardiac Rehabilitation Collaborative, sponsored by the U.S. Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services.

“Behavior change is really tough,” Whooley said. People are very motivated when they’re in the hospital and they’re sitting in a bed and thinking I never want to have a heart attack again. But then they go back home and it’s pretty hard to get motivated to get out there and exercise, eat healthy and take good care of yourself.”

At-home cardiac rehabilitation programs can be particularly effective, Whooley said.

“They can end up with more lasting effects because people integrate the behavior changes into their regular life instead of coming to the hospital and practicing something and thinking they’re cured and going home,” she explained. “The whole point is you need to change your lifestyle.”

For the new study, Whooley and her colleagues collected data on more than 1,100 veterans who were eligible for cardiac rehabilitation at the San Francisco VA Medical Center between August 2013 and December 2018. In all, 490 patients took part in the home rehabilitation program.

During the 12 weeks of the program, participants received up to nine coaching calls, motivational interviews, a workbook and a health journal to keep track of vital signs, exercise and diet. They also received a blood pressure monitor, a scale and a stationary bike. A nurse or exercise physiologist worked with patients to create physical activity goals. Participants were followed for an average of four years after hospitalization.

The study found that 4% of those who did not participate in the rehab program died within a year after hospitalization, compared with 2% of those in the home rehab program.

Over the four years of follow-up, 12% of rehabilitation patients died versus 20% of those who weren’t in the program, the researchers found.

The findings were published March 1 in the Journal of the American Heart Association.

Two heart experts not involved with the study acknowledge the importance of rehabilitation after a heart attack.

However, one barrier to home rehab is the lack of insurance coverage, said Dr. Benjamin Hirsh, director of preventive cardiology at North Shore University Hospital in Manhasset, N.Y.

A bill before U.S. Congress that would approve coverage for home cardiac rehabilitation for Medicare and Medicaid patients, but whether it will pass is still up in the air, Hirsh said. If it does, it is likely that private insurers will follow suit.

“Cardiac rehab is important because we know it improves quality of life and reduces the number of times patients come back for stents or have heart attacks and increases their longevity,” Hirsh said.

“You should be enrolling in a cardiac rehab program whether it’s through the hospital or through virtual programming,” he said. “It’s available, it’s out there, so if you seek it you will find it.”

This is a landmark study on home-based cardiac rehabilitation and its effect on death rates, said Dr. Randal Thomas, a professor of medicine at the Mayo Clinic Alix School of Medicine in Rochester, Minn.

“Its results will help strengthen the case for home-based cardiac rehabilitation as Medicare and other insurance carriers continue to decide on how they will cover these important services,” he said.

Many eligible people don’t receive cardiac rehabilitation due to various barriers, including other time demands, travel and lack of insurance. Also, many doctors fail to refer patients and some health systems don’t have home rehab programs. Insurance co-pays can also be a significant barrier, Thomas said.

“All patients should be encouraged to participate in a cardiac rehabilitation program if they have had a heart attack, heart stent placement, heart surgery, or if they have ongoing heart pain,” Thomas said. “On average, it will help them feel better, do better and live longer.”

More information

For more on cardiac rehabilitation, see the American Heart Association.

SOURCES: Mary Whooley, MD, professor, medicine, epidemiology and biostatistics, University of California, San Francisco; Randal Thomas, MD, professor, medicine, Mayo Clinic Alix School of Medicine, Rochester, Minn.; Benjamin Hirsh, MD, director, preventative cardiology, North Shore University Hospital, Manhasset, N.Y.; Journal of the American Heart Association, March 1, 2023, online

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March 1, 2023
Heart Attack Deaths Fell for Americans Over Past 20 Years

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By Cara Murez

HealthDay Reporter

THURSDAY, Feb. 23, 2023 (HealthDay News) — The United States saw a significant decline in the overall rate of heart attack-related deaths over the past 20 years, and the gap in the rate of heart attack deaths between white people and Black people narrowed by nearly half.

“It’s good news,” said study lead author Dr. Muchi Ditah Chobufo, a cardiology fellow at West Virginia University’s School of Medicine.

“People should know that even if we’re not there yet, we’re making progress in the right direction. I think the reasons are multifactorial, spanning all the way from health-promoting and prevention activities through treatment during and after a heart attack,” he said in a news release from the American College of Cardiology.

For the study, researchers analyzed data from the U.S. Centers for Disease Control and Prevention from 1999 to 2020.

Age-adjusted rates of heart attack fell by an average of over 4% per year across all racial groups over the two decades.

In 1999, there were about 87 deaths from heart attack per 100,000 people. By 2020, there were 38 deaths per 100,000 people.

Black Americans still had the highest death rates from heart attack, with 104 deaths per 100,000 people in 1999 and 46 deaths per 100,000 in 2020. Death rates from heart attack were lowest among Asians and Pacific Islanders.

It’s difficult to determine whether the decline is due to fewer heart attacks or better survival rates because of new diagnostic strategies and treatment options, according to the study authors.

One example of this is that hospitals now frequently test for troponin in the blood when a heart attack is suspected. This can help clinicians diagnose a heart attack sooner, leading to earlier and more sensitive heart attack detection.

The authors also noted that Americans have become more aware of the need to reduce heart risk factors, including quitting smoking and managing cholesterol.

And doctors better understand the signs of a heart attack. Hospitals are equipped with mechanical support devices to assist with heart attack treatment. New medications, such as potent antiplatelets, have become available. These may have improved survival rates and reduced the likelihood of a second heart attack.

The authors also noted the racial disparity differences in these past two decades. The difference in rates of heart attack were about 17 deaths per 100,000 between Black people and white people in 1999. That dropped to eight per 100,000 by 2020.

“That’s a big closure of the gap,” Chobufo said. “I didn’t think the disparities were going to drop this far this fast.”

Researchers noted a slight uptick in 2020, an exception to an overall steady decline in heart attack-related deaths. This is likely related to the COVID-19 pandemic but will require more study.

About 80% of premature heart attacks and strokes could be prevented with a heart-healthy lifestyle. That means eating a healthy diet, exercising and avoiding tobacco.

More than 800,000 people have a heart attack in the United States each year, according to the CDC. Common signs include shortness of breath and pain or discomfort in the chest, jaw, neck, back, arm or shoulder. Some people may feel weak, lightheaded or faint. Anyone experiencing this should call 911 and get to an emergency room.

The study findings will be presented March 5 at a meeting of the American College of Cardiology and the World Heart Federation, in New Orleans. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more on heart attacks.

SOURCE: American College of Cardiology, news release, Feb. 23, 2023

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February 23, 2023
Disparities in heart disease risk and care

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Disparities in heart disease risk and care – CBS News

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When Black patients see Black doctors, they are more likely to get preventative care, according to the National Institutes of Health. However, fewer than 3% of cardiologists are Black, according to a study in the Journal of the American Medical Association, leading to disparities in care. Adriana Diaz reports.

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February 16, 2023
Heart attack warnings signs in women can be subtle

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When Dr. Sandra Nichols had a massive heart attack, she didn’t tell anyone outside her immediate family.

At the time, she was working too much, not sleeping enough and says she felt the burden of being everything to everyone.

“I was embarrassed,” she said.

Despite her medical training, she didn’t realize symptoms of congestion and shortness of breath meant a heart attack was around the corner.

“I knew I only had so many beats per hour, per day for so many years,” she said. “And I had used those up with my attitude, with my pushing myself to be beyond what my body, my family, sometimes even I expected of myself.”

Nichols is lucky to be alive. When she collapsed during the heart attack she fell on her curling iron and had a major burn. The doctors told her daughter that if she woke up, she’d be lucky not to be brain dead. As a result of her cardiac arrest, she also needed a heart transplant.

Heart disease is the leading cause of death in the U.S. for both men and women, but studies show women wait longer to seek medical care than men — sometimes because women don’t know their symptoms can be different.

The signs of heart distress in women can be subtle and stress is a major contributing factor, said Dr. Anum Minhas, a cardiologist at Johns Hopkins.

“The heart is not just one thing independent of the rest of the body,” said Minhas. “You’re a full person who goes beyond just the biologic functions. There are psychological functions, there’s an emotional side to everything and really nourishing every aspect of your health will overall make you a much healthier person.”

Most cardiac events can be prevented through proper diet, consistent sleep, knowing family history and trying to keep stress to a minimum.

Knowing the ways heart attacks can present in women can be lifesaving. The arm pain that many men experience isn’t as common in women, but neck or jaw pain, shortness of breath, nausea and fatigue are common.

Nichols is now an advocate for the American Heart Association, a sharp contrast to hiding her condition from her friends and coworkers when she first was diagnosed.

She says it’s important to stop and listen to your body.

“Because if not, they might find themselves flat on the floor, unresponsive, unconscious,” she said. “And I strongly hope no one has to go through what I’ve gone through.”

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February 13, 2023
Lessons From a Two-Time Heart Attack Survivor

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Jan. 20, 2023 — Channing Muller was 26 years old when she had her first attack. A vegetarian for a decade and a recreational runner, this shocked both her and her doctors.

“The first one happened the morning after I did a bar crawl,” Muller, now 37, says. “I took one step out of bed and my heart was racing, I was tingly all across my body and lost all the color in my face.”

She tried to curl up into fetal position and attempted to get back in bed, but her heart rate wouldn’t slow down.

“I could breathe but I couldn’t regulate my breath,” she recalls.

After calling her roommate for help, the two rushed to Georgetown Hospital in Washington, D.C., five blocks from her apartment.

“They immediately connected me to an EKG machine and gave me aspirin,” says Muller, who now runs her own marketing firm in Chattanooga, TN. “By the time my heart rate slowed down, I learned my heart was doing over 200 beats a minute during my 45-minute heart attack.”

After more testing, she was airlifted to the cardiac care unit at Washington Hospital Center, also in Washington, D.C., where she had even more testing. That’s where her doctors discovered she had a blockage in the left anterior descending artery (LAD), otherwise known as “widow-maker” as this blockage stops all blood flow to the left side of the heart.

“Still, because of my age I was sent home with medicinal therapy instead of a stent,” she says. “I was told to go to cardiac rehab and that I’d be monitored from there.”

A month later, she was back at work and feeling stressed when she began feeling serious tightness in her chest.

“I had nitroglycerin tablets with me but, after I took the second one, I knew I needed to go to the hospital because my heart rate wasn’t slowing down,” she says.

By the time she arrived at the hospital she was having a full-on heart attack and, after doctors inserted a catheter into her heart, learned that the artery was 95% blocked.

At that point, there was no choice but to place a stent and begin cardiac rehab again.

For Muller, these two things were life-changing in every way.

“Cardiac rehab was the best thing I did for myself because it taught me to trust that my body wasn’t going to give out on me again,” she says. “It also helped my mental state. Here I was a runner, a vegetarian, and at an appropriate weight and still this happened. I needed to come to terms with this, and cardiac rehab helped.”

Within a year, the damage caused by the heart attack had healed, thanks to her age and hard work in rehab.

“Unless you know I’m a person living with this, you’d never know I had any issues,” she says.

Best of all, she returned to her exercise regimen and ran her first half-marathon in 2019. In December 2021, she marked her 10-year anniversary of heart health by running her first of 12 marathons (she’s planning two more in the coming months). Not lost on her was the fact that she was going to run 26.2 miles and was 26 when she had her heart attack.

“What I want people, women especially, to know is that you have to advocate for yourself,” says Muller, who sits on the American Heart Association and Go Red For Women boards. “The biggest thing we worry about is that we don’t want to make a fuss or that we think it’s an anxiety attack or you’re stressed. Make the fuss.”

She also urges all of us to know the difference between a panic attack and a heart attack.

“For women, they feel very similar,” she says. “The difference is that if you’re having a panic attack and focus on a spot on wall and take deep breaths, you will be able to and your heart rate will slow. A heart attack doesn’t stop. You cannot focus your way out of it. It has to run its course.”

These days, Muller sees her cardiologist annually and takes four cholesterol medications, a baby aspirin, and blood pressure medication every day.

Muller says her heart attacks have forever changed her.

“I strongly believe that we are a product of our experiences and how we handle them,” she says. “Having this was the worst experience, but I managed to get through it and I learned how to become more in tune with my body.”

It also pushed her to dedicate her life to physical challenges.

“Who knows if I would be this dedicated to my marathons if I hadn’t already proven I could get through something this scary,” she says. “I was forced to become a much stronger person, so here I am!”

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January 20, 2023
Lisa Marie Presley hospitalized after suffering cardiac arrest

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Lisa Marie Presley was admitted to a Southern California hospital on Thursday after suffering a cardiac arrest, a source told CBS News. Elise Preston has the latest.

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January 12, 2023
‘Puss In Boots’ Star Antonio Banderas Opens Up About Life-Altering Heart Attack

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“Puss in Boots: The Last Wish” star Antonio Banderas, who suffered a heart attack in 2017, recalled walking away from the experience with a new outlook on life during a recent interview with Page Six.

Banderas, who stars in the latest addition to the “Shrek” film franchise, revealed his perspective after the heart attack that he said wasn’t serious and didn’t cause any damages in 2017.

The “Puss in Boots” star, who reportedly received stents in his arteries following the heart attack, told the publication that the experience “probably was one of the best things” to occur in his life.

“I realized that it probably was one of the best things that ever happened in my life because the things that were not important and I was worried every day about them, meaningless,” Banderas said.

“I was like, why am I worried about that if I’m going to die? I knew always [that I was going to die], but now I know. I’ve seen it right here.”

Antonio Banderas attends the premiere of “Puss in Boots: The Last Wish” at Jazz at Lincoln Center Frederick P. Rose Hall on Dec. 13 in New York.

Photo by Evan Agostini/Invision/AP

Banderas said his friends, his family – including his daughter Stella and his “vocation as an actor” stayed following the heart attack while other things he broke from things that he “thought were important before but weren’t really.”

The actor has previously been open about his heart attack over the years and told The Associated Press that filmmaker Pedro Almodóvar – who he worked with on the Golden Globe and Oscar-nominated movie “Pain and Glory” – told him not to “hide this thing” as they shot the flick.

“I knew exactly what he was talking about, because after you have a heart attack you receive a lot of information on what life is all about that is very difficult to describe in words, but it just set up a new way of understanding life itself,” Banderas told the news wire service in 2019.

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December 24, 2022
‘Holiday Heart’: Heart Attacks Spike in Last 2 Weeks of December

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By Cara Murez

HealthDay Reporter

MONDAY, Dec. 19, 2022 (HealthDay News) — The holiday season is filled with to-do lists, but one should rise to the top: Take care of your heart.

Whether from stress, cold weather or falling out of good habits in terms of eating, sleeping and drinking, heart attack rates spike as much as 40% between Christmas and New Year’s, according to cardiologist Dr. Donald Lloyd-Jones. He is chairman of preventive medicine at Northwestern University Feinberg School of Medicine, in Chicago.

“When we look across the year in terms of heart attack rates, what we see is fairly constant rates week by week with two exceptions: One is that there’s a broad, shallow dip in summer months and, two, there is a very short spike of about 30% to 40% in the last couple weeks of the year between Christmas and New Year’s,” Lloyd-Jones said in a university news release.

It’s important not to underestimate symptoms, he stressed.

“We have two kidneys and two lungs, but only one heart and one brain, so it’s much safer to err on the side of caution,” Lloyd-Jones said. “If there’s any doubt, get checked out in person. At best, hopefully you are aborting a heart attack or stroke. Time is heart muscle, time is brain cells, and so time is of the essence. The sooner you seek help in that situation, the sooner we can save your life or brain.”

Family stress is an issue for some, as well as falling out of healthy habits.

“During the holiday season, there are different stresses like dealing with your in-laws and travel arrangements that may add stress,” Lloyd-Jones said. “We’re often knocked off our eating and sleeping patterns, we tend to consume more alcohol, we’re not pursuing our typical physical activity and we may get thrown off our medication schedule.”

Weather is another culprit when it comes to winter heart issues.

“When we breathe cold air, it chills the blood in our lungs and causes constriction of blood vessels,” Lloyd-Jones said. “The first blood vessels downstream from the lungs are the coronary arteries, which are particularly affected by the cold weather. Pursuing cold-weather activities, like shoveling, may be especially hazardous because we might overdo it, plus we’re wearing extra layers, which could cause us to overheat. It’s a perfect storm to maximize stress on the heart.”

Classic heart attack symptoms in men are heavy, crushing pressure in the middle of the chest, or sudden, unexplained shortness of breath.

Symptoms for women can be the same or more diffuse, such as experiencing just shortness of breath or profound fatigue, or occasionally, dizziness and lightheadedness.

Signs of stroke can be remembered through the memory aid, “FAST.” That stands for: Face drooping; Arm or leg weakness on one side; Speech difficulty; and Time to call 911.

Heart attack and stroke are the leading causes of death in the United States and around the world.

More information

The U.S. Centers for Disease Control and Prevention has more on heart attack.

SOURCE: Northwestern Medicine, news release, Dec. 14, 2022

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December 19, 2022
Several Supplements May Give the Heart a Boost
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Dec. 8, 2022 – Certain antioxidant supplements – such as omega-3 fatty acids, folic acid, and coenzyme Q10 – may benefit your heart’s health, according to a new study published in the Journal of the American College of Cardiology.

Researchers looked at the findings from nearly 900 studies with almost 900,000 patients and found some of these micronutrients reduced the risks of cardiovascular disease, stroke, or death, while others appeared to have no effect, and still others appeared to be potentially harmful.

“Our study highlights the importance of micronutrient diversity and the balance of health benefits and risks,” says Simin Liu, MD, the senior study author and a professor of epidemiology and medicine at Brown University in Providence, RI.

“Identifying the optimal mixture of micronutrients is important, as not all are beneficial, and some may even have harmful effects,” he says.

The research team focused on cardiovascular disease risk factors, including blood pressure, blood sugar, and cholesterol, and things like heart attack or stroke.

Overall, the researchers found evidence that many micronutrients offer a potential boost to the heart, including:

Omega-3 fatty acids, found in fish, vegetable oils, nuts (especially walnuts), flax seeds, flaxseed oil, and leafy vegetables

Omega-6 fatty acids, polyunsaturated fats found in vegetable oils, nuts, and seeds

L-arginine, an amino acid that helps the body build protein. It can be found in protein-rich foods like fish, red meat, poultry, soy, whole grains, beans, and dairy products.

L-citrulline, a nonessential amino acid found in watermelon

Folic acid, a form of vitamin B9 used for deficiency and to prevent pregnancy complications. It is added to cold cereals, flour, breads, pasta, bakery items, cookies, and crackers, as required by federal law. Foods that are naturally high in folate include leafy vegetables, okra, asparagus, certain fruits, beans, yeast, mushrooms, animal liver and kidney, orange juice, and tomato juice.

Vitamin D, a fat-soluble vitamin that is naturally present in a few foods, added to others, and available as a dietary supplement. Fatty fish (such as trout, salmon, tuna, and mackerel) and fish liver oils are among the best sources.

Magnesium, which keeps blood pressure normal, bones strong, and your heart rhythm steady. In addition to supplements, magnesium can be found in green leafy vegetables like spinach, nuts, beans, peas, and soybeans, as well as whole-grain cereals.

Zinc, found in chicken, red meat, and fortified breakfast cereals

Alpha-lipoic acid, an antioxidant made naturally in the body and also found in foods. It is in red meat, carrots, beets, spinach, broccoli, and potatoes.

Coenzyme Q10, an antioxidant found in cold-water fish like tuna, salmon, mackerel, and sardines; vegetable oils; and meats

Melatonin

Plant-based polyphenols such as catechin, curcumin, flavanol, genistein, and quercetin
Many of these micronutrients lowered blood pressure, cholesterol, and insulin levels.

In particular, omega-3 fatty acid supplements were shown to lower cardiovascular disease deaths by 7%, coronary heart disease events by 14%, and heart attacks by 15%. Folic acid supplements also decreased stroke risk by 16%, and coenzyme Q10 decreased all-cause deaths by 32% in heart failure patients.

In contrast, supplements of beta-carotene (found naturally in plants, such as carrots, and fruits) increased stroke risk by 9%, all-cause deaths by 10%, and cardiovascular disease deaths by 12%. And finally, in the long term, vitamin C, vitamin D, vitamin E, and selenium showed no effect on cardiovascular disease outcomes or type 2 diabetes risk.

Previous studies have shown that antioxidants benefit the heart, likely because they reduce stress that contributes to heart disease. Heart-healthy diets, such as the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH), feature antioxidant-rich foods. But studies of particular antioxidant supplements have been mixed or inconsistent.

“Research on micronutrient supplementation has mainly focused on the health effects of a single or a few vitamins and minerals,” Liu says. “We decided to take a comprehensive and systematic approach to evaluate all the publicly available and accessible studies reporting all micronutrients.”

More studies are needed to find combinations that improve someone’s individual diet and heart health, the study authors wrote.

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December 8, 2022
Shingles Ups Odds of Stroke, Heart Attack By Almost 30%

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By Amy Norton

HealthDay Reporter

MONDAY, Dec. 5, 2022 (HealthDay News) — People who’ve had a bout of shingles may face a heightened risk of heart attack or stroke in later years, a new, large study suggests.

Anyone who ever had chickenpox can develop shingles — a painful rash that is caused by a reactivation of the virus that causes chickenpox. About one-third of Americans will develop shingles in their lifetime, according to the U.S. Centers for Disease Control and Prevention.

The new study, of over 200,000 U.S. adults, found that those who’d suffered a bout of shingles were up to 38% more likely to suffer a stroke in the next 12 years, versus those who’d remained shingles-free. Meanwhile, their risk of heart disease, which includes heart attack, was up to 25% higher.

The findings, published recently in the Journal of the American Heart Association, do not prove that shingles directly raises the risk of cardiovascular trouble.

But it is biologically plausible, according to the researchers: The reactivated virus can get into the blood vessels, causing inflammation, and that could contribute to cardiovascular “events” like heart attack and stroke.

Some past studies have found that cardiovascular risks can rise after shingles, but they have looked at the short term.

It hasn’t been clear how long that risk persists, said Dr. Sharon Curhan, the lead researcher on the new study.

“Our findings demonstrate that shingles is associated with a significantly higher long-term risk of a major cardiovascular event, and the elevated risk may persist for 12 years or more after having shingles,” said Curhan, of Brigham and Women’s Hospital, in Boston.

That’s an important finding, said Dr. Elisabeth Cohen, an ophthalmologist and professor at NYU Grossman School of Medicine, in New York City.

“What they’re showing is the short-term risk doesn’t just go away,” said Cohen, who studies shingles-related eye disease.

While shingles is very common, it is not taken as seriously as it should be, according to Cohen.

It all starts with the chickenpox virus, called varicella zoster. Once a person contracts that virus — as nearly every American born before 1980 has — it remains dormant in the body, hiding out in the nerves.

Generally, the immune system keeps the virus in check. But when a person’s immune function weakens — due to age, illness or medications, for instance — the varicella zoster virus can reactivate, causing shingles.

Typically, shingles causes a painful skin rash consisting of fluid-filled blisters, and usually clears up in a few weeks, according to the CDC.

In some cases, shingles affects the area around the eye — a condition called herpes zoster ophthalmicus — which can lead to serious problems like ulcers on the cornea and lasting vision loss. Meanwhile, between 10% and 18% of people with shingles develop postherpetic neuralgia (PHN), nerve pain that can last for months to years after the skin rash recedes.

Shingles eye disease, Cohen said, is linked to a greater risk of stroke in the short term, compared with milder shingles.

The latest study looked at shingles as a whole. Curhan said it’s not clear whether shingles complications, like PHN and eye disease, are tied to greater increases in the risks of heart disease and stroke in the long term.

Through much of the study period, there was no shingles vaccine.

The good news is there is now a highly effective one available, both doctors said.

“Shingles vaccination could provide a valuable opportunity to reduce the burden of shingles, and also possibly reduce the risk of cardiovascular complications,” Curhan said.

The CDC recommends that adults age 50 and older get two doses of the shingles vaccine, called Shingrix. It’s also recommended for people age 19 and up who have weakened immune systems due to disease or medical treatments.

The vaccine is over 90% effective at preventing shingles and PHN in healthy adults, with immunity remaining strong for at least seven years, the CDC says. It’s somewhat less effective for people with weakened immunity.

The latest findings are based on over 200,000 U.S. health professionals who were followed for up to 16 years. During that time, just over 3,600 had a stroke, while 8,620 developed heart disease.

Overall, people with a history of shingles were up to 38% more likely to suffer a stroke, with the risk being greatest five to eight years post-shingles. Similarly, their risk of heart disease was up to 25% higher, peaking at nine to 12 years after their shingles episode.

Those were the risks after the researchers took many other factors into account — including age, chronic health conditions, weight, exercise habits and smoking.

Anyone unlucky enough to have had shingles can, unfortunately, get it again, Cohen pointed out. So those people should be vaccinated when eligible, too.

“Most of us who’ve had shingles — and I’m one of them — never want to get it again,” Cohen said.

More information

The U.S. Centers for Disease Control and Prevention has more on shingles.

SOURCES: Sharon Curhan, MD, ScM, physician and epidemiologist, Brigham and Women’s Hospital, Harvard Medical School, Boston; Elisabeth Cohen, MD, professor, ophthalmology, NYU Grossman School of Medicine, New York City; Journal of the American Heart Association, Nov. 16, 2022, online

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December 5, 2022
Past Discrimination Tied to Worse Recovery After Heart Attack

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Nov. 28, 2022 – About one in three adults who survived a heart attack at a relatively young age say they have experienced discrimination, and the findings of a new study also showed that the experience was tied to worse recovery in the months afterward.

The discrimination or unfair treatment in everyday life was based on their race, gender, low family income, or other reasons.

People who experienced discrimination were more likely to have chest pain (angina) and report worse quality of life both 1 month and 1 year after they were hospitalized for a heart attack.

Andrew J. Arakaki, a PhD candidate at Yale School of Public Health in New Haven, CT, presented these study findings at a recent American Heart Association conference.

“It is important to acknowledge that patients cannot control the discriminatory actions of others in everyday life,” he said. “Social support from family, friends, or peers who are in a similar situation” may help young heart attack survivors cope with stress caused by discrimination, he suggested.

More research is needed “to understand how to support patients with high levels of perceived discrimination during heart attack recovery” and to see which ways to cope with the problem may help reduce stress.

For the study, the researchers looked at data from 2,670 adults who were 18 to 55 years old when they had a heart attack, and who took part in the Variation in Recovery: Role of Gender on Outcomes (VIRGO) study.

The patients replied to three questionnaires while in the hospital, and then 1 month and 12 months later.

About 35% said that they experienced discrimination in their daily lives rarely, sometimes, or often, with the remainder reporting they never experienced it. “We were surprised to discover how common perceived discrimination was among participants in our study sample,” Arakaki said in a news release.

These results agree with the results of many other studies that link psychological stress with poor outcomes in heart patients, says Viola Vaccarino MD, PhD, who was not involved with this research.

Vaccarino, a professor and chair of the Department of Epidemiology at Emory University in Atlanta, led a related study among others.

For young adults who have had a heart attack, she says, “It is important for you to reduce your stress. This is something to discuss with your doctor, and, if indicated, see if he or she can refer you to a counsellor or advise you on ways to counteract the stress in your life.”

In the current study, two-thirds of the patients were women, and most (76%) were white. They were asked to indicate the main source of the discrimination they experienced, if any, based on race, ethnicity, gender, age, income, language, physical appearance, sexual orientation, or other.

In the “other” category, patients reported perceived discrimination based on their occupation, education level, medical history or disability, or personal history (divorce, previous incarceration, past abuse, or drug use).

The patients replied to a 10-question Everyday Discrimination Scale, which has been used in other studies.

They were asked to answer “Never,” “Rarely,” “Sometimes,” or “Often” to each of the following questions:

“In your day-to-day life, how often do any of the following things happen to you?

1.You are treated with less courtesy than other people are.

2. You are treated with less respect than other people are.

3. You receive poorer service than other people at restaurants or stores.

4. People act as if they think you are not smart.

5. People act as if they are afraid of you.

6. People act as if they think you are dishonest.

7. People act as if they’re better than you are.

8. You are called names or insulted.

9. You are threatened or harassed.

10. People ignore you or act as if you aren’t there.”

The responses were scored as never (0 points), rarely (1), sometimes (2), and often (3) for each item, giving a total of 0 to 30.

The higher the experience of discrimination, the worse recovery appeared to be.

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November 28, 2022