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Cardiovascular

Creatine and Cardioprotection featured article

Creatine is a naturally occurring compound that is critical in storing and releasing cellular energy. It also participates in many biological processes driving pregnancy outcomes, maintaining bone mineral density and muscle mass in older adults, improving neurological function, and aiding the immune system to fight cancer. Creatine is best known for its widespread use as a dietary supplement to enhance physical performance.

Creatine, phosphocreatine, creatine transporters, and creatine kinase enzymes are expressed in the endothelial cells that line our blood vessels and play an integral role in delivering high-energy phosphates to ion channels that maintain vascular tone and regulate endothelial function. Creatine may positively impact vascular health through several mechanisms, including its role as an antioxidant, its effects on nitric oxide (NO) bioavailability, its support of endothelium-derived hyperpolarization factors...

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Episodes

cardiovascular

How to Lower ApoB With Omega-3s

Posted on January 22nd 2025 (5 months)

In this clip, Dr. Rhonda Patrick explains ApoB's role in cardiovascular health, omega-3 mechanisms, diet impacts, and concerns about heavy metals in fish.

cardiovascular

Peter Attia on What It's Like Getting a VO2 Max Test (key markers to look for)

Posted on January 16th 2025 (6 months)

In this clip, Drs. Peter Attia and Rhonda Patrick discuss VO2 max testing, peak fat oxidation, and the longevity benefits of elite cardiovascular fitness.

exercise

How Exercise Prevents & Reverses Heart Aging | Dr. Benjamin Levine

Posted on May 27th 2024 (about 1 year)

Dr. Levine details his research findings that show how a structured exercise regimen can reverse up to 20 years of heart aging.

Topic Pages

  • Alcohol

    Ethanol modulates cardiovascular homeostasis via autonomic imbalance, oxidative endothelial injury, altered lipid profiles, and coagulation changes.

  • Cocoa flavonoids (chocolate)
    stub

    Cocoa flavanols activate endothelial nitric oxide synthase, elevating nitric oxide, thus enhancing vasodilation and lowering blood pressure.

  • Creatine and Cardioprotection

    In the cardiovascular system, myocardial creatine increases phosphocreatine-mediated ATP buffering, mitigating ischemia-reperfusion injury and conferring cardioprotection.

  • Exercise Intensity

    Increasing exercise intensity augments sympathetic activation, elevating heart rate, stroke volume, cardiac output, and arterial pressure to satisfy metabolic demand.

  • Microplastics

    Circulating microplastics provoke endothelial oxidative stress and inflammation, disrupt vascular homeostasis, and accelerate atherosclerotic plaque development.

  • Myocardial infarction (Heart attack)

    Myocardial infarction constitutes a cardiovascular lesion where coronary artery thrombosis ceases myocardial perfusion, precipitating irreversible ischemic necrosis.

  • Nicotinamide mononucleotide

    Nicotinamide mononucleotide elevates cellular NAD+, activating SIRT1-mediated pathways that enhance endothelial function and mitigate cardiovascular dysfunction.

  • Nicotinamide riboside

    Nicotinamide riboside raises cellular NAD+, activating SIRT1/3, enhancing myocardial mitochondrial biogenesis and endothelial nitric oxide–mediated vasodilation.

  • Resveratrol

    Resveratrol activates endothelial nitric oxide synthase through SIRT1-mediated deacetylation, enhancing vasodilatory capacity and cardiomyocyte ischemic tolerance.

  • Small vessel disease

    Small vessel disease constitutes microvascular manifestation of systemic cardiovascular pathology, driven by endothelial dysfunction, chronic inflammation, arteriolosclerosis, impaired autoregulatory perfusion.

  • Sodium (Salt)

    High sodium intake expands plasma volume, activates neurohormonal vasoconstriction, and chronically raises blood pressure, stressing cardiovascular structures.

News & Publications

  • Unhealthy dietary patterns nearly double the prevalence of high-risk plaque in coronary arteries, potentially increasing heart attack risk. academic.oup.com
    Cardiovascular Diet Heart Disease

    Diet plays a critical role in cardiovascular health, influencing disease risk and the biological processes underlying plaque formation in the arteries. However, emerging evidence suggests that not all plaque is equal, with some types more prone to rupture and trigger heart attacks. A recent study found that adults with the least healthy diets were nearly twice as likely to have high-risk plaque in their coronary arteries as those with the healthiest diets.

    Researchers analyzed data from more than 24,000 adults aged 50 to 64, none of whom had been diagnosed with cardiovascular disease. They developed a dietary index to score how closely each person’s eating habits aligned with an anti-inflammatory diet—one rich in vegetables, fruits, whole grains, nuts, and healthy oils and low in red meat, processed meat, and sugary drinks. Then, they scanned the participants' heart arteries to identify plaque, including high-risk plaque that is more likely to rupture and cause a heart attack.

    The scans showed that people with the least healthy diets had coronary plaques more often than those with the healthiest diets (44% vs. 36%). They were also more likely to have substantial artery blockages (6% vs. 3.7%) and nearly twice as likely to have high-risk plaques (1.5% vs. 0.9%)—those that are non-calcified, cause major narrowing of the artery, and have characteristics such as low tissue density, all of which are associated with an elevated risk of rupture and heart attack. These differences remained even after accounting for age, sex, and smoking status. Measures like waist size, triglyceride levels, and high blood pressure appeared to partly explain the connection.

    These findings suggest that diet influences not only whether plaque forms in the arteries, but also whether that plaque is the kind that leads to heart attacks. A diet rich in fiber and plant-based foods—and low in red meat and added sugars—may help prevent the buildup of dangerous plaque by improving metabolic health and reducing inflammation. Learn how exercise can help prevent the buildup of harmful arterial plaque, too, in this episode featuring Dr. Ben Levine.

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  • Hot water immersion more than doubles core body temperature rise compared to traditional saunas, potentially boosting vasodilation, cardiac output, and immune activity. link.springer.com
    Cardiovascular Heat Stress Sauna

    Passive heat therapies, such as hot baths and saunas, raise core body temperature and activate physiological responses that support cardiovascular and immune health, including increased cardiac output, enhanced vasodilation, and elevated immune activity, which may help reduce inflammation. A recent study found that hot water immersion raised core temperature by approximately 1.1°C (2°F)—roughly twice the increase seen with a traditional sauna and considerably more than with a far-infrared sauna.

    The study included 20 healthy adults, half of them women, who each completed three sessions of passive heating spaced at least one week apart. The sessions included 45 minutes in hot water at 40.5°C (105°F), three 10-minute rounds in a traditional sauna at 80°C (176°F), and 45 minutes in a far-infrared sauna, ranging from 45°C to 65°C (113°F to 149°F). Researchers measured core temperature every five minutes, assessed heart function before, midway, and after each session, and collected blood samples to examine inflammatory markers and immune cells up to 48 hours after each session.

    Hot water immersion caused the greatest physiological changes, including the largest rise in core body temperature—about 1.1°C (2°F)—compared to just 0.4°C (0.7°F) with the traditional sauna and essentially no change with the far-infrared sauna. Cardiac output increased by 3.7 liters per minute with hot water immersion, roughly 60% more than that observed with the traditional sauna. It was also the only method to provoke a detectable immune response, including a post-heating rise in interleukin-6 levels and an increase in the numbers of natural killer cells and CD8+ T cells 24 to 48 hours later. The other two modalities induced smaller or negligible changes in these measures.

    This small study’s findings suggest that hot water immersion is the most effective method for raising core temperature and stimulating cardiovascular and immune responses. Soaking in a hot bath also improves deep sleep. Learn more in this episode featuring Dr. Rhonda Patrick.

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  • Elite bodybuilders face a risk of sudden cardiac death up to five times higher than amateurs, with risks persisting even after retirement from competition. academic.oup.com
    Cardiovascular Exercise

    Some bodybuilders push their bodies to extremes in pursuit of the ideal physique—but that pursuit may come at a steep cost. Reports of sudden deaths among elite competitors have raised new concerns about the long-term health risks of this demanding sport. A recent study found that bodybuilders, especially professionals, may be up to five times more likely to die of sudden cardiac death, often linked to enlarged hearts and cardiovascular complications.

    The study involved more than 20,000 male athletes who participated in International Federation of Bodybuilding and Fitness events over a fifteen-year period. Researchers identified deaths during the study period and calculated death rates based on whether the athletes were still actively competing at that time.

    During the study period, researchers noted 121 deaths. Of these, 73 were sudden, including 46 confirmed sudden cardiac deaths. Approximately one-third occurred in bodybuilders who were still actively competing, often during or just after a contest. Sudden cardiac deaths were most common among professional bodybuilders, who were more than five times more likely to die from heart-related causes than amateurs. Interestingly, unlike other elite athletes, bodybuilders in this study exhibited a higher overall death rate, even after retiring from competition.

    These findings suggest that bodybuilding may carry considerable—and often overlooked—health risks. It’s noteworthy that resistance training (the foundation of bodybuilding) promotes pathological changes in the heart’s structure. However, incorporating aerobic exercise into a resistance training schedule can counter these effects. Learn more in this clip featuring cardiologist Dr. Ben Levine.

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  • Chemical additives in plastics are associated with more than 350,000 cardiovascular deaths worldwide in a single year, with the Middle East, South Asia, and Africa bearing the greatest burden. www.thelancet.com
    Cardiovascular Environment

    Plastics may be a hidden contributor to heart disease: chemical additives that disrupt hormone function and damage blood vessels. Evidence indicates that di-2-ethylhexylphthalate (DEHP)—a phthalate used to soften plastics—drives oxidative stress, metabolic dysfunction, and cardiovascular disease. A recent study found that this plastic additive may have contributed to more than 350,000 cardiovascular deaths worldwide in 2018.

    To estimate the global burden of cardiovascular disease linked to DEHP exposure, researchers combined country-level cardiovascular death rates with regional exposure estimates. They calculated the number of deaths and years of life lost that were likely due to the chemical, drawing on published hazard ratios and biomonitoring data.

    They found that DEHP exposure contributed to 356,000 cardiovascular deaths in 2018—around 13% of heart-related deaths among adults aged 55 to 64. Exposure varied widely by region. The Middle East and South Asia had the highest levels of several DEHP metabolites, including mono (2-ethylhexyl) phthalate at 19.460 micromoles per liter—six times higher than levels in Europe. Africa also showed high concentrations, including the highest recorded level of mono (2-ethyl-5-carboxypentyl) phthalate at 65.452 micromoles per liter. The Middle East, South Asia, and Africa bore the greatest exposure burden, while Europe had the lowest.

    These findings suggest that chemical additives in plastics pose a serious threat to cardiovascular health, especially in regions with growing plastic production or weaker environmental protections. As plastic products break down, they shed tiny fragments known as microplastics, which carry considerable health risks. Learn more in this episode featuring Dr. Rhonda Patrick.

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  • A nearly four-decade-long study reveals that maintaining and improving a few key habits from a young age dramatically lowers the risk of cardiovascular disease after age 45. jamanetwork.com
    Aging Cardiovascular

    One means of assessing cardiovascular health is the American Heart Association’s Life’s Essential 8, which takes into account one’s diet, physical activity, nicotine exposure, sleep, body mass index, blood pressure, cholesterol levels, and blood sugar. Maintaining high scores across these factors throughout young adulthood can reduce the risk of cardiovascular disease later in life. A recent study found that people with higher Life’s Essential 8 scores from ages 18 to 45 and those who showed improvement over this period were nearly 90% less likely to develop cardiovascular disease after age 45.

    Researchers followed more than 4,800 participants from the Coronary Artery Risk Development in Young Adults study across four United States centers, collecting cardiovascular health data from 1985 to 2020. They analyzed the relationship between cumulative Life’s Essential 8 scores (measured over time from ages 18 to 45) and the risk of cardiovascular disease after age 45.

    They found that participants with higher cumulative Life’s Essential 8 scores had considerably lower risks of both cardiovascular disease and early death. Those in the top quartile of scores had up to 88% lower risk of cardiovascular disease and 71% lower risk of mortality than those in the lowest quartile. And those whose Life’s Essential 8 score improved over the study period also experienced a reduced risk of developing cardiovascular disease in midlife.

    These findings suggest that maintaining and improving cardiovascular health during young adulthood is crucial for lowering the risk of developing cardiovascular disease later in life. Sauna use is an excellent strategy for boosting cardiovascular health. Learn more in this episode featuring Dr. Rhonda Patrick.

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  • Morning-only coffee drinkers demonstrate a 16% lower risk of death from any cause and a 31% lower risk of cardiovascular death—benefits that exceed all-day coffee consumption, regardless of whether it's caffeinated or decaffeinated. academic.oup.com
    Cancer Coffee Caffeine Cardiovascular

    That morning cup of coffee might do more than boost alertness—it might promote longevity. While many studies link moderate coffee drinking to better health, the timing of those effects is less clear. However, a recent study found that morning-only coffee drinkers were more than 30% less likely to die from cardiovascular disease.

    Researchers analyzed data from more than 40,000 adults in the National Health and Nutrition Examination Survey and 1,400 adults in the Women’s and Men’s Lifestyle Validation Study. They searched for patterns in the timing of coffee consumption and tracked participants for an average of nearly 10 years to monitor deaths from all causes, cardiovascular disease, and cancer.

    Two coffee-drinking patterns emerged: a morning-only pattern (4 a.m. to noon) and an all-day pattern. Compared with people who didn’t drink coffee at all, those who drank coffee only in the morning had a 16% lower risk of dying from any cause and a 31% lower risk of dying from cardiovascular disease, indicating that the health benefits of drinking more coffee were strongest among morning-only drinkers. Surprisingly, caffeine didn’t explain the difference. When the researchers adjusted for both caffeinated and decaffeinated coffee intake, the timing of coffee drinking still mattered.

    These findings suggest that drinking coffee earlier in the day offers more health benefits than drinking it over the course of the day. Coffee induces autophagy–a critical process that helps reduce the risk of cancer and other chronic diseases. Learn more in this clip featuring Dr. Guido Kroemer.

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  • Strawberry consumption boosts thinking speed and lowers systolic blood pressure by 3% in older adults. www.sciencedirect.com
    Nutrition Diet Heart Disease Memory Blood Pressure Polyphenol Cardiovascular

    Cognitive decline and cardiovascular disease often go hand in hand—and both become more common with age. Nutrition plays a key role in protecting brain and heart health, and certain fruits rich in antioxidants may offer targeted benefits. A recent study found that consuming fresh strawberries daily improved cognitive function and lowered systolic blood pressure by an average of 3% in older adults.

    Researchers provided 35 healthy adults, ages 60 to 78, a strawberry powder or a placebo each day for eight weeks. Each person tried both options in random order, with a four-week break in between. The strawberry powder, made from freeze-dried fruit, delivered the same nutrients and antioxidants as two cups of fresh strawberries. The researchers measured the participants' cognitive function using standard tests and tracked markers of heart health, including blood pressure, waist size, blood lipids, and antioxidant levels.

    The participants' thinking speed improved during the strawberry phase, while episodic memory improved modestly during the placebo phase. After eight weeks of strawberry consumption, systolic blood pressure dropped by an average of 3%, and waist size decreased slightly. Participants' blood antioxidant capacity increased with strawberries but decreased with the placebo. Triglycerides increased during the placebo period but remained stable with strawberries.

    The findings from this small study suggest that regular strawberry intake supports brain and heart health in older adults. Strawberries are rich in polyphenols. Learn more about polyphenols in our overview article.

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  • High-intensity interval training reduces arterial plaque size by 1.2% in coronary artery disease patients after six months, potentially slowing or reversing disease progression. academic.oup.com
    Exercise Heart Disease Cardiovascular

    Heart disease is the leading cause of death worldwide, and clogged arteries—caused by a buildup of fatty plaques—are a major culprit. While some plaques remain stable, others can rupture and trigger heart attacks. A recent study found that high-intensity interval training (HIIT) may help shrink fatty arterial plaquesin people with coronary artery disease who have undergone stent placement, reducing plaque size by 1.2% in just six months.

    Researchers randomly assigned 60 patients with stable coronary artery disease to a supervised HIIT program or standard preventive care twice a week. After six months, they used intravascular ultrasound to measure changes in plaque size inside the coronary arteries.

    They found that patients who did HIIT had a 1.2% reduction in plaque size, while those who followed standard preventive care saw no change. The total plaque volume in the HIIT group also dropped by about 9 cubic millimeters, but it remained the same in the standard care group. Even small reductions in plaque size can be meaningful because they reflect a slowing—or even a reversal—of coronary artery disease progression.

    These findings suggest that HIIT may help slow or even reverse the progression of coronary artery disease. It’s important to note that these patients were closely supervised to minimize risk. Learn about some of the contraindications and considerations for HIIT in this episode featuring Dr. Martin Gibala.

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  • Sugar-sweetened beverages are linked to 9.8% of new type 2 diabetes cases and 3.1% of new cardiovascular disease cases globally. www.nature.com
    Diet Diabetes Sugar Sugar-Sweetened Beverages Cardiovascular

    Sugar-sweetened beverages contribute to weight gain and increase the risk of severe health concerns, such as type 2 diabetes and cardiovascular disease. A recent study revealed that in 2020, sugar-sweetened drinks were linked to 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease globally.

    Researchers utilized the Global Dietary Database to assess the global, regional, and national effects of type 2 diabetes and cardiovascular disease associated with sugar-sweetened beverage consumption in 184 countries, comparing data from 1990 to 2020. They also considered factors such as age, sex, education, and whether people lived in urban or rural areas to provide further context for the findings.

    They found that sugar-sweetened beverages were associated with 9.8% of new type 2 diabetes cases and 3.1% of new cardiovascular disease cases in 2020. The burden was greatest in Latin America and the Caribbean, where sugar-sweetened beverages accounted for 24.4% of type 2 diabetes cases and 11.3% of cardiovascular disease cases. Sub-Saharan Africa also experienced a marked increase in type 2 diabetes and cardiovascular disease related to sugar-sweetened beverages over the past three decades.

    These findings suggest that sugar-sweetened beverages have deleterious effects on human health and underscore the need for targeted interventions to reduce their consumption. Learn more about sugar-sweetened beverages in our overview article.

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  • A daily dose of coenzyme Q10—100 milligrams or less—reduces blood pressure by about 4mmH systolic and 3mmHG diastolic in people with type 2 diabetes, potentially lowering cardiovascular risk. www.clinicaltherapeutics.com
    Diabetes Blood Pressure Antioxidant Cardiovascular

    Most people with type 2 diabetes know they need to manage their blood glucose levels, but many may not realize they are at higher risk for heart disease. One potential option for reducing that risk is coenzyme Q10, a naturally occurring antioxidant. A recent study found that supplementing with coenzyme Q10 (CoQ10) helps lower blood pressure in people with type 2 diabetes.

    Researchers reviewed data from 16 clinical trials that measured CoQ10 levels in people with type 2 diabetes. They focused on changes in blood pressure and cholesterol levels, comparing those who took the supplement to those who did not.

    Their analysis revealed that CoQ10 lowered systolic blood pressure by about 4 mmHg and diastolic blood pressure by about 3 mmHg. While it didn’t improve cholesterol levels overall, some subgroup analyses showed better results with lower doses (100 milligrams daily or less) and shorter study durations (less than 12 weeks). Notably, these findings were more pronounced in studies with larger participant groups (more than 50 people) and participants aged 55 or younger.

    A reduction of 4 mmHg in systolic blood pressure may seem modest, but even small reductions can lower the risk of heart disease and stroke. For example, a comprehensive analysis found that a 5-mmHg decrease in systolic blood pressure reduced the risk of major cardiovascular events by approximately 10%00590-0/fulltext).

    These findings suggest that CoQ10 could be a useful addition to diabetes treatment for managing blood pressure and reducing cardiovascular risk. A common feature of diabetes and cardiovascular disease is inflammation. Learn how to reduce chronic inflammation in Aliquot #84: Putting the Brakes on Chronic Inflammation

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  • Higher muscular strength and cardiorespiratory fitness can help reduce the risk of premature death in cancer patients by up to 46%. bjsm.bmj.com
    Exercise Cancer Muscle Mortality Cardiovascular

    Cancer remains one of the leading causes of death globally, with millions of new cases and deaths each year. Despite treatment advancements, cancer patients are at a greater risk of death due to muscle loss, heart complications, and inadequate physical activity. A recent study found that higher muscle strength and cardiorespiratory fitness reduce the risk of death in cancer patients, with a 31% to 46% lower likelihood of premature death.

    Researchers conducted a systematic review and meta-analysis of 42 studies involving more than 47,000 cancer patients across various types and stages to examine how muscle strength and cardiorespiratory fitness influence survival rates. They sought to determine whether higher fitness levels were associated with better outcomes in terms of overall and cancer-specific death.

    Their analysis revealed that patients with higher muscle strength or cardiorespiratory fitness were 31% to 46% less likely to die prematurely from any cause than those with lower fitness levels. Each increase in muscle strength was associated with an 11% lower risk of all-cause mortality. Furthermore, patients with advanced cancer stages, as well as those with lung and digestive cancers, saw significant reductions in death risks—ranging from 8% to 46% lower for all-cause mortality. Increments in cardiorespiratory fitness were particularly important, with each improvement in cardiorespiratory fitness linked to an 18% reduced risk of dying specifically from cancer.

    These findings suggest that boosting muscle strength and cardiorespiratory fitness can improve cancer patients' survival rates. Given the strong connection between physical fitness and mortality risk, health professionals should prioritize fitness assessments for cancer patients as part of their treatment strategies. Learn more about the role of exercise in cancer prevention and recurrence in this episode featuring Dr. Kerry Courneya.

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  • Interrupting sedentary behavior every 30 minutes aids blood sugar control and may mitigate the risk of cardiometabolic disorders, according to a meta-analysis. onlinelibrary.wiley.com
    Exercise Diabetes Blood Sugar Cardiovascular

    Sitting for long periods isn’t just harmful to your back—it may also increase your risk of cardiometabolic disorders, such as diabetes and cardiovascular disease. Some research indicates that breaking up sedentary time with movement can enhance cardiometabolic health, but scientists are uncertain about the best frequency for these breaks. A recent study discovered that taking frequent breaks—at least every 30 minutes—might be more effective at managing blood sugar than having less frequent interruptions.

    Researchers conducted a systematic review and meta-analysis of randomized crossover trials that compared different frequencies of activity breaks during prolonged sitting. They included data from 13 studies with 211 participants, examining the effects of more frequent movement breaks (every 30 minutes or less) versus less frequent ones (every 30 minutes or more) on glucose, insulin, triglycerides, blood pressure, and vascular function.

    Their analysis revealed that taking more frequent movement breaks—every 30 minutes or more—reduced blood glucose levels more effectively than less frequent breaks. However, they found no significant differences between the two approaches for insulin levels, blood pressure, triglycerides, or vascular function. In addition, they rated the overall quality of evidence as low, highlighting the need for further research.

    These findings suggest that interrupting sedentary time at least every 30 minutes is a practical strategy for improving blood sugar control. An effective way to interrupt sedentary time is to engage in “exercise snacks"—short bursts of activity that improve cardiorespiratory fitness. Watch this video to learn about a two-minute exercise snack that improves blood glucose, mitochondrial health, and more.

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  • Long-term, high-dose omega-3 supplementation—2 to 4 grams daily—effectively improves heart function in people with heart failure. pubmed.ncbi.nlm.nih.gov
    Heart Disease Omega-3 Inflammation Mortality Cardiovascular

    Omega-3 fatty acids have long been praised for their health benefits, but their role in treating heart failure has been unclear. While some studies suggest they improve heart function, others have produced mixed results. A recent meta-analysis found that high-dose omega-3 supplementation for a year or more markedly improved heart function and exercise capacity in people with heart failure.

    Researchers analyzed the findings of 14 randomized controlled trials, including more than 9,000 participants with heart failure. They examined the effects of different omega-3 doses and treatment durations on heart function, exercise capacity, biomarkers of heart failure, and overall quality of life. They also analyzed safety outcomes, including dropout rates and overall death rates.

    They found that people who took high doses of omega-3 fatty acids (2,000 to 4,000 milligrams daily) for at least one year had better heart function and improved oxygen consumption during exercise than those in control groups. Lower doses or shorter treatment periods did not produce the same benefits. Importantly, omega-3 supplementation did not increase the risk of adverse events or death.

    These findings suggest that long-term, high-dose omega-3 supplementation effectively improves heart function in people with heart failure. Omega-3s reduce inflammation, a potent contributor to heart failure. Learn more about omega-3s' anti-inflammatory effects in this episode featuring Dr. Bill Harris.

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  • High exposure to plastics, such as those in disposable takeout containers, is associated with a 13% greater risk of heart disease, potentially through changes to gut bacteria and increased inflammation. www.sciencedirect.com
    Pollution Environment Cardiovascular

    The environment plays a decisive role in heart health, with factors like air pollution, diet, and chemical exposures influencing cardiovascular disease risk. As plastic production and waste continue to rise, concerns about its effects on human health are increasing. A recent study found that frequent exposure to plastics, including those from disposable takeout containers, is associated with a 13% higher likelihood of developing cardiovascular disease.

    Researchers surveyed more than 3,000 people about their plastic exposure and heart health. They also provided rats with water that had been in contact with disposable plastic takeout containers at high temperatures for varying lengths of time. After three months, they analyzed the rats' heart tissue, blood markers, and gut bacteria to assess changes.

    They found that people with high plastic exposure had a 13% greater risk of congestive heart failure than those with lower exposure. In the rats, plastic exposure altered gut bacteria and increased markers of oxidative stress and inflammation in the heart. The structural changes observed in heart tissue suggest potential long-term damage.

    These findings suggest that plastic exposure increases the risk of heart disease and highlight the need to reduce exposure. Learn how to reduce your exposure to plastics and microplastics in this episode featuring Dr. Rhonda Patrick.

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  • Exercise boosts language comprehension in monolingual older adults by enhancing cardiorespiratory fitness. www.tandfonline.com
    Exercise Brain Cardiovascular

    Regular exercise has long been known to protect cognitive functions such as attention, memory, and processing speed as we age. A recent study found that exercise may also improve older adults' language comprehension by enhancing cardiorespiratory fitness—the body’s capacity to deliver and use oxygen-rich blood.

    The study included 160 monolingual or bilingual older adults. Half of the participants followed a 26-week home-based high-intensity interval training (HIIT) program with three weekly sessions, starting with a four-week familiarization period. Afterward, they aimed for over 80% of their peak heart rate. Researchers measured their cardiorespiratory fitness and language comprehension before and after the intervention, using reaction times to spoken-word monitoring tasks.

    They found that monolinguals who participated in the HIIT program responded faster on comprehension tasks than non-exercisers. This improvement was linked to increased VO2peak (a measure of cardiorespiratory fitness), supporting the idea that exercise boosts language processing abilities in older adults. However, bilinguals did not experience these improvements, suggesting that the effects of exercise on language processing may be influenced by language proficiency.

    These findings support the growing evidence demonstrating that cardiorespiratory fitness protects cognitive function. HIIT robustly improves cardiorespiratory fitness. Learn more in this clip featuring Dr. Martin Gibala.

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  • Fat deposits in muscles increase the risk of major cardiovascular events by 53%. pubmed.ncbi.nlm.nih.gov
    Muscle Cardiovascular

    Fatty deposits that run through a steak—known as marbling—improve the meat’s quality, making it more tender, juicy, and flavorful. However, evidence indicates that fatty deposits in human muscles may have adverse health effects. A recent study found that higher fat levels within muscles were associated with a 53% increase in the risk of major cardiovascular events, such as heart attacks or heart failure.

    The study included 669 people undergoing routine cardiac evaluations. Researchers assessed their coronary flow reserve, which measures the capacity of the coronary arteries to increase blood flow during stress or exertion. They also measured body mass index (BMI—a proxy for body fatness), skeletal muscle mass, and fat levels beneath the skin and within the muscles. They monitored the participants for major cardiovascular events for about six years.

    The researchers found that higher BMI, lower muscle mass, and more fat inside the muscles were linked to reduced blood flow in the coronary arteries, but fat under the skin was not. For every unit decrease in blood flow, the risk of a major cardiovascular event increased by 78%, and for every 10 cm² increase in fat inside the muscles, the risk increased by 53%. In contrast, larger muscles and more fat under the skin were associated with an 11% and 6% reduction in the risk of a major cardiovascular event, respectively.

    These findings suggest that higher muscle fat content increases the risk of major cardiovascular events. Evidence suggests that exercise reduces muscle fat content, potentially explaining how exercise reduces cardiovascular risks. Learn more about how exercise protects the heart in this episode featuring Dr. Ben Levine.

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  • GLP-1 receptor agonists may lower risks for major illnesses like dementia and seizures. www.nature.com
    Diabetes Drug Dementia Weight Loss Cardiovascular

    Ozempic, Wegovy, and other glucagon-like peptide-1 (GLP-1) drugs have catapulted into the mainstream of diabetes care, with more than 15 million people in the U.S. currently taking one. Evidence suggests GLP-1 drugs have many off-target effects—both good and bad—but healthcare providers don’t currently know the full extent of the drugs' effects. However, a recent analysis found that GLP-1s may reduce the risk of dementia, seizures, respiratory illnesses, cardiometabolic disorders, and certain infections more effectively than other diabetes drugs and typical care.

    Using the U.S. Department of Veterans Affairs healthcare databases, researchers identified roughly two million people with diabetes who were using a GLP-1 drug, one of three common anti-diabetes drugs (sulfonylureas, DPP4 inhibitors, or SGLT2 inhibitors), or continuing their usual care without adding new therapies. They tracked the participants' health for about 3.6 years.

    They found that GLP-1 use was associated with a reduced risk of dementia (8%), seizures (10%), respiratory illnesses (10% to 25%), cardiometabolic disorders (7% to 22%), and certain infections (12% to 25%). However, the drugs were associated with an increased risk of gastrointestinal issues (5% to 20%), low blood pressure (10%), kidney problems (10% to 15%), arthritic disorders (10% to 16%), and pancreatitis (15% to 20%).

    These findings suggest that GLP-1 receptor agonists offer promising benefits for people with diabetes while highlighting potential risks. Further research will illuminate the full range of the drugs' effects. Learn more about GLP-1 drugs in this clip featuring Dr. Rhonda Patrick.

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  • Poor cardiorespiratory fitness may double the risk of early death, regardless of body weight. bjsm.bmj.com
    Exercise Obesity Cardiovascular

    How fit you are may matter more than how much you weigh when it comes to your risk of dying early. A recent review and meta-analysis found that poor cardiorespiratory fitness increases the risk of early death from cardiovascular disease and other causes, regardless of body weight.

    Researchers analyzed the findings of 20 studies investigating the effects of cardiorespiratory fitness and body weight on the rates of early death from cardiovascular disease and all other causes. The various studies included nearly 400,000 participants and compared the risks among people who were overweight or obese to those who were normal weight.

    They found that overweight, fit people were about 50% more likely to die from cardiovascular disease and had roughly the same overall risk of early death as those with normal weight. Obese, fit people were 62% more likely to die from cardiovascular disease and had an 11% higher overall risk of early death, but these differences were not statistically significant.

    However, being unfit was linked to a much higher risk of death. Normal-weight people who were unfit were about twice as likely to die from cardiovascular disease and all causes. Overweight, unfit people had roughly 2.5 times the risk of cardiovascular death and 82% higher overall risk of early death. Obese, unfit people had more than triple the risk of cardiovascular death and twice the risk of dying from any cause compared to those with normal weight.

    These findings suggest that cardiorespiratory fitness robustly predicts the risk of early death from cardiovascular disease and other causes. Vigorous exercise, such as high-intensity interval training, is a great way to boost cardiorespiratory fitness and prevent early death. Learn more in this episode featuring Dr. Rhonda Patrick.

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  • Drinking more than eight sugar-sweetened drinks a week increases the risk of cardiovascular diseases by up to 31%. pubmed.ncbi.nlm.nih.gov
    Diet Sugar Sugar-Sweetened Beverages Cardiovascular

    It’s no surprise that sugar-sweetened drinks can contribute to weight gain, dental problems, and metabolic impairments. But emerging evidence suggests they can also harm your heart. A recent study found that consuming more than eight sugar-sweetened drinks weekly increases the risk of various cardiovascular diseases by as much as 31%.

    Researchers investigated links between sugar intake and cardiovascular disease among nearly 70,000 people. They asked participants about their sugar intake from various sugar-sweetened foods and drinks. Then, using national disease registers, they ascertained the incidence of various cardiovascular diseases, including ischemic and hemorrhagic stroke, myocardial infarction (heart attack), heart failure, aortic stenosis (narrowing of the aorta), atrial fibrillation (abnormal heart rhythm), and abdominal aortic aneurysm (ballooning of the major blood vessel in the abdomen).

    They found that the risk of developing cardiovascular disease varied according to disease type and sugar source. However, drinking more than eight sugar-sweetened beverages weekly carried the greatest risk, increasing a person’s chances of ischemic stroke by 19%, heart failure by 18%, atrial fibrillation by 11%, and abdominal aortic aneurysms by 31%.

    The investigators posited that sugar in beverages is readily metabolized, increasing its potential for harm. Learn more about the health effects of sugar-sweetened beverages in our overview article.

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  • High-protein breakfasts in teens may mitigate future heart disease risk by increasing gene expression associated with blood vessel growth and staving off inflammation. www.sciencedirect.com
    Diet Development Cardiovascular

    Breakfast is often touted as the most important meal of the day. But for teenagers, the composition of that breakfast may be more critical than previously thought. A recent study found that eating a high-protein breakfast increases gene expression associated with cardiovascular health, potentially protecting teens against heart disease later in life.

    The study included 30 teens who routinely skipped breakfast. For six months, 10 of the teens ate a normal-protein breakfast (10 grams of protein) daily, 10 ate a high-protein breakfast (30 grams of protein), and 10 continued skipping breakfast. The normal-protein and high-protein breakfasts both provided 350 calories. Researchers measured the teens' levels of microRNAs (small, non-coding RNA molecules that regulate gene expression) associated with higher cardiovascular disease risk.

    They found no difference in miRNA levels among the three groups. However, they observed a significant pattern over time for one microRNA—miR-126-3p—which increased more in those eating high-protein breakfasts than those who skipped breakfast. miR-126-3p regulates angiogenesis (the formation of new blood vessels) and helps maintain blood vessel integrity. It also reduces inflammation—a driver of cardiovascular disease.

    This small study suggests that eating a high-protein breakfast can have lasting effects on teens who regularly skip breakfast, potentially reducing their risk of cardiovascular disease later in life. Skipping breakfast coupled with late-night eating can have harmful effects on metabolic health, too. Learn more in this clip featuring Dr. Ruth Patterson.

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  • Creatine supplementation ameliorates age-related cardiovascular decline, restoring blood vessel flexibility and efficiency in older adults. www.mdpi.com
    Diet Cardiovascular Supplements

    The primary contributor to cardiovascular disease risk is simply age. Our blood vessels become thicker and less flexible as we get older, rendering them less efficient. However, a recent study found that creatine supplementation restores aspects of cardiovascular function, including blood vessel flexibility and efficiency, in older adults.

    Researchers conducted a small pilot study involving 12 sedentary but healthy older adults. Half of the participants consumed 20 grams of creatine monohydrate daily for five days, followed by 5 grams daily for 23 days. The other half consumed a placebo for 28 days. The researchers measured aspects of the participants' cardiovascular health, including flow-mediated dilation (how flexible a blood vessel is), microvascular perfusion rates (how quickly and efficiently tiny blood vessels fill), blood glucose levels, and triglycerides.

    They found that participants who consumed creatine experienced small but meaningful improvements in their cardiovascular markers, including increased flow-mediated dilation, improved microvascular perfusion rates, and decreased blood glucose and triglycerides. Those who consumed the placebo did not experience these beneficial effects, suggesting that creatine restored their cardiovascular function.

    Creatine is a nitrogen-containing compound that plays an essential role in the recycling of ATP. It is widely used as a dietary supplement to build and maintain muscle mass. Although creatine is available in many forms, most of the research on the compound has focused on creatine monohydrate. Learn more about creatine in this clip featuring Dr. Stuart Phillips.

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  • Cardiovascular risk and obesity accelerate brain atrophy in men a decade before similar effects occur in women, potentially increasing dementia risk. jnnp.bmj.com
    Brain Obesity Cardiovascular

    Cardiovascular health affects more than the heart—it shapes the brain. A recent study found that cardiovascular risk and obesity contribute to brain atrophy in men and women, with effects manifesting earlier in men.

    Researchers analyzed data from more than 34,000 adults aged 45 to 82 enrolled in the UK Biobank study. They measured the participants' grey matter volume, assessed their cardiovascular risk, and calculated the fat volume under their skin and around their internal organs.

    They found that men experienced considerable grey matter volume losses linked to cardiovascular risk and obesity between ages 55 and 64. However, volume losses in women manifested a decade later, between ages 65 and 74. These patterns were evident regardless of whether participants carried the APOE4 gene, a key genetic risk factor for Alzheimer’s disease.

    These findings suggest that cardiovascular disease-related dementia risks manifest earlier in men, underscoring the importance of tailoring interventions based on sex. One of the mechanisms linking cardiovascular disease, obesity, and dementia is vascular dysfunction, which contributes to blood-brain barrier failure. Learn more about vascular dysfunction in this clip featuring Dr. Axel Montagne.

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  • Irregular sleep schedules, regardless of sleep duration, are linked to an increased risk of major cardiovascular events. jech.bmj.com
    Sleep Heart Disease Blood Pressure Cardiovascular

    Most people know that sleep quality matters, but few recognize the importance of consistent sleep schedules. Evidence suggests that inconsistent bedtime and wake-up routines could harm heart health. A recent study found that irregular sleep patterns increase the risk of major cardiovascular events, such as heart attacks or strokes, even among people who get enough sleep overall.

    Researchers analyzed data from more than 72,000 adults aged 40 to 79 participating in the UK Biobank study. Participants wore wrist devices for one week to track sleep patterns and regularity. The researchers categorized sleep regularity as irregular, moderately irregular, and regular, and linked these patterns to hospital and death records over eight years to assess the risk of heart attacks, strokes, or heart failure.

    People with irregular sleep schedules were 26% more likely to experience major cardiovascular events than those with regular sleep patterns, while those with moderately irregular sleep had an 8% higher risk. Meeting age-specific sleep duration recommendations helped lower the risk for moderately irregular sleepers but did not fully protect those with highly irregular sleep patterns.

    These findings suggest that maintaining a consistent sleep schedule may be as important as getting enough sleep for cardiovascular health. Learn how to optimize your sleep in this Aliquot featuring Drs. Matt Walker, Satchin Panda, and Rhonda Patrick.

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  • High-flavanol cocoa protects blood vessels during stress, with function surpassing pre-stress levels at 90 minutes when paired with high-fat meals. pubs.rsc.org
    Diet Stress Polyphenol Cardiovascular Cocoa

    Stress damages the heart and blood vessels, increasing the risk of cardiovascular events like heart attack or stroke. Stress can also drive people to make poor dietary choices, often leading to overeating or consuming high-fat, low-nutrient foods instead of healthier options like fruits and vegetables. A recent study found that cocoa flavanols help counteract the harmful effects of stress and unhealthy meals on the heart and blood vessels.

    The study involved 23 healthy young adults. Each participant ate a high-fat meal (buttered croissants, cheese, and whole milk) paired with either a high-flavanol cocoa drink or a low-flavanol cocoa drink before completing an eight-minute stress task. Researchers measured their blood vessel function, brain oxygen levels, blood flow, blood pressure, and mood multiple times before and after the stress challenge.

    Participants who drank the high-flavanol cocoa maintained better blood vessel function after stress than those who consumed the low-flavanol drink. Blood vessel function declined considerably within 30 minutes of the stress task in the low-flavanol group but was preserved with high flavanol intake. At 90 minutes, blood vessel function improved beyond pre-stress levels in the high-flavanol group. The two groups had similar stress-related changes in blood pressure, brain oxygenation, and mood.

    The findings from this small study suggest that flavanol-rich foods help protect the cardiovascular system during stressful periods, even when accompanied by unhealthy meals. Flavanols are polyphenolic compounds in dark chocolate, berries, apples, and tea. Evidence suggests flavanols exert potent antioxidant and anti-inflammatory properties. Learn more about flavanols and other polyphenols in our overview article.

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  • A daily cup of coffee could reduce your risk of heart disease and diabetes by half. academic.oup.com
    Sleep Heart Disease Diabetes Biomarkers Coffee Green Tea Caffeine Stroke Cardiovascular

    Drinking your daily cup of coffee or tea might do more than give you a boost—it could lower your risk of developing multiple serious cardiometabolic conditions simultaneously, like diabetes, heart disease, or stroke. A recent study found that moderate coffee or caffeine consumption may cut your risk of cardiometabolic multimorbidity by as much as 50%.

    Researchers analyzed data from more than 172,000 participants enrolled in the UK Biobank who had no cardiometabolic diseases at the start. Participants reported their coffee, tea, and caffeine consumption; about half provided blood samples for metabolic marker analysis.

    They found that people who drank about three cups of coffee daily (or consumed 200 to 300 milligrams of caffeine daily) were 40% to 50% less likely to develop multiple cardiometabolic diseases than those who drank little or no caffeine. They also discovered that specific blood markers, such as certain lipid components, were linked to coffee and caffeine consumption and a lower risk of cardiometabolic conditions.

    These findings suggest that moderate coffee or caffeine intake reduces the risk of developing cardiometabolic diseases but also slows their progression if they occur. Other evidence points to the many health benefits associated with coffee and caffeine, but it’s crucial to remember their effects on sleep. Learn more in this Aliquot featuring Drs. Guido Kroemer, Satchin Panda, Elissa Epel, Matthew Walker, and Rhonda Patrick

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  • Women with the highest levels of the inflammatory marker hs-CRP were 70% more likely to experience a cardiovascular event than those with the lowest levels. www.nejm.org
    Cholesterol Cardiovascular CRP Lipoprotein A

    Nearly half a million women in the US die from cardiovascular disease every year, making early identification of those at risk crucial. Traditional identification methods, which focus on age, blood pressure, smoking status, cholesterol levels, and family history, address short-term risks, but longer-term predictions may improve outcomes. A recent study found that measuring specific blood markers can predict cardiovascular events over a 30-year period in women.

    The study involved nearly 28,000 healthy US women. Researchers measured three key biomarkers: high-sensitivity C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL), and lipoprotein(a) [Lp(a)]. Then, they tracked the women’s health for 30 years to observe their first major cardiovascular event, including heart attack, stroke, or death from cardiovascular causes.

    They found that women with the highest levels of hs-CRP were 70% more likely to experience a cardiovascular event than those with the lowest levels. Similarly, those with the highest LDL and Lp(a) levels were 36% and 33% more likely, respectively, to have a heart attack or stroke. Each biomarker contributed independently to overall cardiovascular risk, with the strongest predictive power coming from a combination of all three markers.

    These findings suggest that long-term cardiovascular risk prediction in women can be improved by measuring these biomarkers early in life. This proactive approach could lead to earlier interventions, potentially reducing heart disease risk over several decades.

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  • Xylitol and its relationship with platelet coagulation. t.co
    Sugar-Sweetened Beverages Cardiovascular

    Xylitol is a sugar alcohol commonly used as a sugar substitute in various processed foods, such as chewing gum and candies. A recent study found that xylitol consumption may increase the risk of major cardiovascular events. However, these findings should be interpreted with caution.

    Researchers analyzed metabolic markers in blood samples from more than 1,100 people undergoing elective cardiac evaluations and measured blood xylitol levels in more than 2,100 healthy volunteers. Then, they assessed the effects of xylitol on platelet function and clot formation. Finally, they gave 10 healthy volunteers a xylitol-sweetened drink to determine how xylitol consumption influenced platelet function.

    They found that people with the highest xylitol levels had a 57% higher risk of a major cardiovascular event than those with the lowest levels. Xylitol increased several markers of platelet reactivity and clot formation.

    Xylitol and its relationship with platelet coagulation.

    Study link: https://t.co/dSYmWwDZPT

    Xylitol is a sugar alcohol commonly used as a sugar substitute in various processed foods, such as chewing gum and candies. A recent study found that xylitol consumption may increase the risk of major cardiovascular events.

    Researchers analyzed metabolic markers in blood samples from more than 1,100 people undergoing elective cardiac evaluations and measured blood xylitol levels in more than 2,100 healthy volunteers. Then, they assessed the effects of xylitol on platelet function and clot formation. Finally, they gave 10 healthy volunteers a xylitol-sweetened drink to determine how xylitol consumption influenced platelet function.

    They found that people with the highest xylitol levels had a 57% higher risk of a major cardiovascular event than those with the lowest levels. Xylitol increased several markers of platelet reactivity and clot formation.

    These findings suggest that xylitol increases cardiovascular risks; however, they should be interpreted with caution. Learn more about this study and its interpretation in this recent Q&A with Dr. Rhonda Patrick.

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  • Aging isn't linear—it may occur in two distinct bursts in our mid-40s and again around age 60. www.nature.com
    Aging Metabolism Immune System Cardiovascular

    We often think of aging as a steady, downhill slope, but a new study suggests aging happens in two distinct bursts—in our mid-40s and again around age 60—when massive shifts in crucial molecules involved in metabolism and other critical processes occur. These shifts may explain why our disease risk and other hallmarks of aging tend to spike at these pivotal times in our lives.

    The study involved 108 adults aged 25 to 75 years living in the U.S. Researchers assessed changes in 135,000 molecular markers in the participants' blood, feces, and bodily fluids for up to seven years, yielding more than 246 billion data points.

    They found that molecular changes occurred in two massive bursts rather than gradually, with changes in cardiovascular health, lipids, and alcohol metabolism appearing around 44 years of age, followed by shifts in crucial biological processes such as immune regulation and carbohydrate metabolism around 60 years.

    These findings suggest that the progression of aging and related diseases is marked by distinct phases at specific ages. Some lifestyle behaviors can delay the changes that drive aging. Learn more about these powerful habits in this episode featuring Dr. Rhonda Patrick.

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  • Omega-3 and omega-6 fatty acids reduce lipoprotein(a) levels in healthy men, influencing cardiovascular disease risk. www.atherosclerosis-journal.com
    Cholesterol Omega-3 Genetics Cardiovascular Lipoprotein A

    Lipoprotein(a) [Lp(a)] is a type of low-density lipoprotein (LDL). High Lp(a) levels increase a person’s risk for atherosclerosis, heart disease, and stroke. A recent study found that alpha-linolenic acid (ALA) and linoleic acid (LA) both reduce Lp(a) concentrations in healthy men, but ALA is more effective at lowering cholesterol.

    The study involved 130 men enrolled in an ongoing cohort study in Finland. Researchers provided the participants with diets enriched in either ALA, an omega-3 fatty acid, or LA, an omega-6 fatty acid, for eight weeks.

    They found that serum Lp(a) concentrations dropped 7.3% among those who ate the ALA-rich diet and 9.5% among those who ate the LA-rich diet. Reductions were greater among those with higher baseline Lp(a) concentrations. However, those who ate the ALA diet experienced greater reductions in LDL cholesterol, apolipoprotein B, and other cholesterol components. Whether the participants carried the FADS1 rs174550 genotype did not influence their response to the diets.

    The FADS1 rs174550 is a genetic variant that influences the body’s ability to convert certain fatty acids. This variant can affect how efficiently omega-3 and omega-6 fatty acids are metabolized, potentially influencing lipid levels and overall health.

    These findings suggest that ALA and LA exert similar Lp(a)-lowering effects, but ALA may be more effective at lowering cholesterol and other atherogenic factors. Learn more about Lp(a) in this Q&A featuring Dr. Rhonda Patrick.

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  • Consuming olive oil reduces the risk of early death from all causes by 20%. www.nature.com
    Nutrition Cancer Diet Inflammation Mortality Antioxidant Polyphenol Cardiovascular

    Olive oil is rich in bioactive compounds, including polyphenols, carotenoids, and oleic acid. It’s a fundamental component of the Mediterranean diet and is associated with a wide range of health benefits. A recent study found that high olive oil intake—more than 3 tablespoons daily—reduces the risk of early death from all causes by 20%.

    Researchers analyzed data from nearly 23,000 adults enrolled in a long-term cohort study in Italy. Participants completed questionnaires about their olive oil consumption, defined as high (3 tablespoons or more daily) or low (1.5 tablespoons or less daily). The researchers collected information about the participants' lifestyles, assessed their overall diet quality, and measured their biomarkers associated with chronic disease risk.

    They found that compared to low olive oil intake, high intake lowered the risk of early death from all causes by 20%, cancer by 23%, and cardiovascular disease by 25%. However, They found that the effect of high olive oil intake on reducing the risk of dying from all causes and cancer was slightly lower when considering the participants' biomarkers.

    These findings suggest that olive oil reduces the risk of early death from all causes, including cancer and cardiovascular disease. The polyphenols in olive oil exert potent antioxidant, anti-inflammatory, and anti-cancer effects. Learn more about the health benefits of polyphenols in our overview article.

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  • Chronic loneliness increases stroke risk by 56%, independent of depressive symptoms or social isolation. www.thelancet.com
    Mental Health Stroke Cardiovascular

    Loneliness, a pervasive emotional state that adversely affects mental and physical health, increases the risk of many chronic health disorders, including cardiovascular diseases. A recent study found that loneliness increases the risk of stroke by as much as 56%.

    Researchers analyzed data from the Health and Retirement Study, which included adults aged 50 years or older who were stroke-free at the start. Participants ranked their loneliness on a scale of three to nine, with scores above six considered “high.” Researchers tracked the incidence of stroke among the participants over 10 to 12 years.

    They found that higher loneliness scores at baseline were associated with an increased risk of stroke, with a one-point increase in loneliness score corresponding to a 5% higher likelihood of stroke. Participants with high loneliness scores were 25% more likely to experience a stroke, even after accounting for social isolation without depressive symptoms. Notably, participants with consistently high loneliness over time were 56% more likely to experience stroke than those with consistently low loneliness.

    These findings suggest that chronic loneliness is a major risk factor for stroke, independent of depressive symptoms or social isolation. Addressing loneliness may be crucial for stroke prevention, and regular assessments of loneliness in clinical settings could help identify people at higher risk.

    Interestingly, sleep and loneliness are inherently linked, and poor sleep increases the risk of stroke. Not getting enough sleep triggers the onset of a “loneliness phenotype,” driving people who are sleep-deprived to avoid social interaction. Learn more about the effects of sleep on feelings of loneliness in this clip featuring Dr. Matt Walker.

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  • Taurine supplementation can help regulate blood glucose and lower blood pressure, reducing risk factors associated with metabolic syndrome. pubmed.ncbi.nlm.nih.gov
    Obesity Diabetes Cholesterol Triglycerides Blood Pressure Metabolic Syndrome Taurine Stroke Cardiovascular Supplements

    Metabolic syndrome is a cluster of conditions that includes hypertension, high blood glucose, excess abdominal fat, and abnormal blood lipids. Having metabolic syndrome markedly increases a person’s risk of cardiovascular disease, type 2 diabetes, and stroke. A recent meta-analysis found that taurine supplementation improves conditions associated with metabolic syndrome.

    Researchers analyzed the findings of 25 studies (with more than 1,000 participants) investigating links between taurine supplementation and metabolic syndrome. They also explored the effects of taurine dose and examined secondary outcomes of taurine supplementation, including body composition, lipid profile, and blood glucose control.

    They found that taurine doses ranged from 0.5 to 6 grams, with study durations ranging from five days to one year. On average, taurine supplementation reduced systolic blood pressure by 4 mmHg, diastolic blood pressure by 1.5 mmHg, fasting blood glucose by 6 milligrams per deciliter, and triglycerides by 18 milligrams per deciliter. The researchers did not observe an effect on high-density lipoprotein cholesterol. The reduction in diastolic blood pressure and fasting blood glucose was dose-dependent, with higher doses eliciting more robust effects.

    These findings suggest that taurine supplementation improves factors associated with metabolic syndrome. Interestingly, other research shows that an acute bout of exercise increases blood taurine levels, providing a mechanistic link between exercise and better metabolic health.

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  • Microplastics were identified in 80 percent of surgically removed blood clots, potentially elevating the risk and severity of heart attacks, strokes, and respiratory issues. www.thelancet.com
    Pollution Environment Cardiovascular

    Blood clots that form in the heart, arteries, and veins – called thrombi – are a major risk factor for heart attack, stroke, and respiratory problems. Evidence suggests that environmental factors contribute to thrombi formation. A recent study identified microplastics in 80 percent of surgically removed thrombi.

    Researchers surgically removed thrombi from patients scheduled for arterial or venous thrombectomy in the brain, heart, or legs using plastic-free surgical implements and storage techniques. Using mass spectrometry, they assessed the thrombi for microplastic particle content and determined the particles' sizes, shapes, and numbers.

    They found that 80 percent of the thrombi contained microplastics, including polyamide 66, polyvinyl chloride, and polyethylene. Higher concentrations of microplastics were associated with greater disease severity.

    This study was small, but its findings suggest microplastics are present in human thrombi and further increase disease risk. Microplastics are pervasive environmental contaminants present in land, water, and air. They have also been detected throughout the human body, including the sputum, lungs, heart, liver, blood, endometrium, testis, amniotic fluid, and placenta. Recent research found that microplastics in human arterial plaques increase the risk for cardiovascular disease-related events nearly fivefold.

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  • Sedentary time in childhood contributes to pathological heart changes, but light activity and moderate-to-vigorous exercise can combat these harmful effects. news.exeter.ac.uk
    Exercise Heart Disease Cardiovascular

    Pathological increases in the heart’s left ventricle typically arise from diseases or unhealthy behaviors, such as increased sedentary time, and can negatively affect heart function. These changes usually manifest in adulthood and are robust predictors of cardiovascular disease-related death. Physiological increases in the left ventricle, on the other hand, are beneficial adaptations that occur in response to healthy activities, such as moderate-to-vigorous physical activity. These changes promote a stronger and more efficient heart muscle without the adverse effects associated with pathological enlargement. A recent study found that sedentary behavior induces pathological increases in left ventricular mass in children.

    Researchers monitored the health and activity levels of more than 1,600 children enrolled in the Avon Longitudinal Study of Parents and Children from age 11 to 24 years. The children wore accelerometers during waking hours on two or more weekdays and one weekend day at least once during the 13-year study. They underwent echocardiography at the ages of 17 and 24 years.

    At age 11, the children averaged six hours of sedentary time daily, increasing to nine hours by age 24. Cumulative sedentary time contributed to 40 percent of the pathological increase in left ventricular mass during adolescence, regardless of the children’s sex, body weight, or blood pressure. Children who were more sedentary had higher body fat, inflammation, blood pressure, lipid levels, and left ventricular mass, increasing their future cardiovascular risks.

    Conversely, cumulative light physical activity (about three hours daily) reduced pathological increases in left ventricular mass by 49 percent. Each minute of moderate-to-vigorous physical activity induced physiological increases in left ventricular mass of 5 percent.

    These findings suggest that sedentary time in childhood induces pathological changes in the heart’s left ventricle, but light activity can mitigate these harmful effects. Moderate-to-vigorous activity, however, induces beneficial physiological changes. Resistance training is a safe and effective way to boost kids' activity levels. Learn more about kids and resistance training in this clip featuring Dr. Brad Schoenfeld.

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  • Adding omega-3s to statin therapy significantly reduces the residual risk of major cardiovascular events. www.sciencedirect.com
    Heart Disease Cholesterol Omega-3 Drug Mortality Cardiovascular

    Statins are among the most widely prescribed drugs in the U.S., with more than 92 million users reported in 2018. Although the drugs are generally effective, nearly 22 percent of statin users with cardiovascular disease will experience a major adverse cardiovascular event within five years of drug initiation – a phenomenon known as “residual risk.” Findings from a recent meta-analysis indicate that combined statin-omega-3 therapy markedly reduces the risk of major adverse cardiovascular events and improves lipid and inflammatory markers.

    Researchers analyzed the findings of 14 randomized controlled trials involving more than 40,000 participants. The trials investigated links between statin use, omega-3s, and the risk of cardiovascular disease and related death. Omega-3 doses varied, ranging from 930 milligrams to 4,000 milligrams daily. However, most studies provided a dose of 1,800 milligrams daily.

    They found that combined statin-omega-3 therapy reduced the residual risk of experiencing myocardial infarction (heart attack) by 28 percent, a major adverse cardiovascular event by 15 percent, angina (chest pain) by 25 percent, and hospitalization for angina by 25 percent. Those receiving the combined treatment also experienced decreased cholesterol, triglycerides, and hsCRP (a marker of inflammation). However, the combined therapy did not reduce the residual risk of fatal and non-fatal stroke, coronary revascularization, and cardiovascular disease-related death.

    These findings suggest that combined statin-omega-3 therapy reduces the residual cardiovascular risks associated with statin therapy alone. Learn more about statins in this episode featuring Dr. Peter Attia.

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  • Aerobic or combination aerobic/resistance exercise reduces cardiovascular disease risk better than resistance exercise alone. academic.oup.com
    Exercise Mortality Aerobic Cardiovascular

    Cardiovascular disease claims the lives of nearly 20 million people worldwide every year. Exercise reduces the risk of cardiovascular disease, but experts aren’t sure which form of exercise is optimal for reducing that risk. A recent study found that aerobic exercise alone or combined with resistance exercise is more effective at reducing cardiovascular disease risk than resistance exercise alone.

    The study involved 406 middle-aged adults with high blood pressure and either overweight or obesity. Participants engaged in one of three training regimens – resistance, aerobic, or combined resistance and aerobic – for one hour, three times weekly, for one year. A fourth group remained sedentary. Researchers scored the participants' cardiovascular disease risk based on measures of their systolic blood pressure, low-density lipoprotein (LDL) cholesterol, fasting glucose, and percent body fat before and after the interventions.

    They found that participants who engaged in the aerobic or combined aerobic/resistance regimens showed improved cardiovascular disease risk scores at the one-year point. However, those who engaged in only resistance or were sedentary showed no improvements in their risk scores. When the researchers looked at individual risk factors, they found that all three exercising groups lost body fat, but their systolic blood pressure, LDL cholesterol, and fasting glucose did not decrease.

    These findings suggest that aerobic exercise alone or combined aerobic plus resistance reduces the cardiovascular disease risk profile in people with overweight or obesity. Other evidence indicates that high-intensity interval training (HIIT)’s cardiovascular benefits rival or surpass those of traditional aerobic exercise. Learn more about the benefits of HIIT in this episode featuring Dr. Martin Gibala.

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  • Daily cannabis use more than doubles the chance of stroke among non-tobacco users, suggesting cannabis use alone could contribute to cardiovascular disease risk. www.ahajournals.org
    Heart Disease Cannabinoid Tobacco Stroke Cardiovascular

    Cannabis, commonly known as marijuana, is a plant used for its psychoactive properties and influences on perception, mood, and consciousness. People consume cannabis for both recreational and medicinal purposes, seeking relief from pain, anxiety, and other conditions. A recent study found that regular cannabis use increases the risk of cardiovascular disease, particularly among those who don’t use tobacco.

    Researchers analyzed data collected from more than 434,000 adult participants who provided information about their cannabis use. They looked at how often participants used cannabis in the past month and whether they reported having coronary artery disease, a heart attack, or a stroke. They conducted a separate analysis for participants who didn’t use tobacco.

    They found that daily cannabis users were about 16 percent more likely to have coronary heart disease, 25 percent more likely to experience a heart attack, and 42 percent more likely to have a stroke. When they combined all three heart-related issues, they found that daily cannabis users were 28 percent more likely to face any of them than non-users.

    However, when they focused on participants who had never smoked tobacco and only used cannabis, the findings were even more striking. Daily cannabis users who had never used tobacco were 49 percent more likely to experience a heart attack and 116 percent more likely to have a stroke. When the researchers combined all three heart-related issues, they found that daily cannabis users who had never used tobacco were 77 percent more likely to face any of the cardiovascular conditions.

    These findings suggest that daily cannabis use increases the risk of cardiovascular disease, especially among non-tobacco users, indicating that cannabis use alone could contribute to cardiovascular risk. Compounds in cannabis have profound effects on the human body and can even pass into breast milk, affecting breastfed infants. Learn more in this episode featuring Dr. Rhonda Patrick.

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  • High-dose statin impairs mitochondrial energy output by more than 30 percent in adults with overweight. pubmed.ncbi.nlm.nih.gov
    Cholesterol Mitochondria Drug Muscle Cardiovascular

    Statins comprise a large class of drugs that lower blood cholesterol levels by blocking the production of an enzyme involved in cholesterol synthesis. Although statins are generally well tolerated, as many as 10 to 20 percent of people taking the drugs experience complications, including myopathy (muscle damage), liver damage, and cognitive problems. A recent study found that atorvastatin, a commonly prescribed statin, reduces muscle cells' energy production.

    The study involved eight inactive but otherwise healthy adults with overweight who took a high dose of atorvastatin (80 milligrams) daily for 56 days. Researchers collected muscle samples from the participants before they took the statin and then again after 14, 28, and 56 days to assess their muscle cells' capacity for energy production.

    They found that over the 56 days, the muscle cells' ability to produce energy via oxidative phosphorylation diminished by more than 30 percent. Additionally, the muscle’s capacity to use oxygen, a key indicator of cardiorespiratory fitness, dropped by as much as 45 percent. The study investigators attributed this decline to the statin’s inhibition of specific components (complexes III and IV) within the mitochondria that are vital for energy production.

    The findings from this very small study shed light on how high-dose atorvastatin therapy can significantly reduce the energy production in muscle cells, driving a decrease in muscle and aerobic fitness. They also underscore the importance of further research in larger groups to balance the health benefits of statins with their potential effects on muscle function. Learn more about statins in this deep-dive discussion with Dr. Peter Attia.

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  • Even regular stretching exercises reduce the risk of premature death by 20 percent and boost cardiovascular health, study finds. www.ncbi.nlm.nih.gov
    Exercise Aging Mortality Cardiovascular

    A recent study found that older adults who engaged in flexibility (stretching) exercises were 20 percent less likely to die prematurely than those who didn’t stretch.

    The study involved more than 34,000 adults between the ages of 20 and 79 years. Participants provided information about the frequency and duration of their engagement in moderate- and vigorous-intensity aerobic physical activities, including aerobic, resistance, and flexibility exercises. Researchers tracked the participants' health for roughly 10 years and noted any deaths.

    They found that engaging in just flexibility exercises like stretching or yoga five times per week reduced the risk of premature death from all causes by 20 percent and the risk of death from cardiovascular disease by 25 percent.

    Stretching can take three forms – static, dynamic, and proprioceptive neuromuscular facilitation (PNF). Static stretching involves holding a stretch for 10 to 30 seconds, as seen in yoga poses, such as “downward-facing dog.” Dynamic stretching involves active movements, such as arm circles (used in warm-ups without holding the stretch) or elements of Tai Chi. PNF stretching is used primarily in physical therapy for flexibility and rehabilitation.

    A 2014 review found that stretching’s effects vary by context. Dynamic stretching before exercise tends to improve strength, power, speed, and agility, enhancing sprint and agility test outcomes. Integrating dynamic stretching with exercises like front squats may further boost performance, but overdoing it can promote fatigue and hinder results. Although its effects on endurance sports are less certain, dynamic stretching is generally recommended in warm-ups for its benefits in speed and agility-focused activities.

    Some evidence suggests that stretching may be particularly beneficial for older adults and those who are sedentary. For example, a comprehensive meta-analysis found that stretching exercises reduce arterial stiffness, heart rate, and diastolic blood pressure while improving vascular endothelial function in middle-aged and older adults. Stretching may reduce the risk of fall-related injuries in older adults by improving balance.

    An abundance of research consistently singles out aerobic activities, especially at moderate to vigorous intensities, as the premier choice for improving health and extending life, as further supported by this study’s conclusions. However, the findings from this study point to the potential value of flexibility exercises. Although they may not offer the same cardiovascular benefits as aerobic activities, their beneficial effects on overall health are noteworthy. Embracing a diverse exercise regimen that includes aerobic and flexibility training may provide myriad health advantages. Learn more about the benefits of vigorous exercise in this episode featuring Dr. Martin Gibala.

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  • Microplastic accumulation in arterial plaques increases the risk for cardiovascular disease-related events nearly fivefold. www.nbcnews.com
    Heart Disease Inflammation Bisphenol A Pollution Oxidative Stress Cardiovascular

    Tiny plastic particles, often called microplastics – ranging between 5 millimeters and 100 nanometers – are ubiquitous environmental pollutants. Scientists have identified microplastics in food (especially seafood), soil, drinking water, fresh- and saltwater bodies, and air. A recent study found that microplastics accumulate in human arterial plaques, increasing the risk for cardiovascular disease-related events, such as heart attack or stroke, nearly fivefold.

    The study involved 257 patients undergoing carotid endarterectomy, a procedure in which a surgeon removes plaques from the heart’s arteries. Researchers analyzed the plaque for the presence of microplastics, measured the patients' inflammatory biomarkers, and tracked their health for about three years.

    They found that more than half of the patients (58.4 percent) had microplastics in their arterial plaques, appearing as jagged-edged foreign particles. Those with microplastics in their plaques were 4.53 times more likely to experience a cardiovascular disease-related event during the three-year follow-up than those without microplastics. They were also more likely to be male, younger, and have diabetes, cardiovascular disease, abnormal blood lipids, and higher inflammatory markers.

    These findings suggest that microplastics, a ubiquitous environmental pollutant, accumulate in arterial plaques, markedly increasing the risk of cardiovascular disease-related events. Evidence indicates that microplastic exposure is associated with many other adverse health outcomes. For example, a comprehensive review of the effects of microplastics revealed that microplastics induce oxidative stress and increase the risk for metabolic dysfunction, neurotoxicity, and some cancers. Some of these effects may be due to compounds commonly associated with plastic manufacturing, such as bisphenol A, or BPA, phthalates, and heavy metals that are present in and on microplastics.

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  • Women see a 24 percent drop in premature death risk with just 140 minutes of weekly activity – half the time men need for similar benefits. www.cedars-sinai.org
    Exercise Mortality Cardiovascular

    Women generally have a longer life expectancy than men, a phenomenon often attributed to biological, behavioral, and lifestyle factors. Now, findings from a recent study demonstrate that women achieve greater benefits from equivalent amounts of moderate-to-vigorous activity than men do, reducing their risk of premature death from all causes by 24 percent.

    Researchers asked more than 412,000 healthy men and women in the United States to provide information about their physical activities, including the frequency, duration, intensity, and type. Then, they looked for links between physical activity and the risk of premature death from all causes and cardiovascular disease.

    They found that physical activity reduced the risk of premature death from all causes in women by 24 percent and men by 15 percent compared to inactivity. Interestingly, the reduction in risk seen in men topped out at 19 percent, achieved at about 300 minutes per week of moderate-to-vigorous activity. Women, on the other hand, achieved the same risk reduction at just 140 minutes per week, topping out at 24 percent at 300 minutes. They found similar effects for aerobic and strength training activities, with men reaching their peak benefit from three roughly half-hour sessions per week and women gaining the same benefit from about one strength-training session per week.

    These findings suggest that women can achieve substantial health benefits with shorter workouts than men. They also serve as a powerful encouragement, underscoring how limited time for physical activity can lead to considerable health advantages for women. Learn how to incorporate strength training into your workouts, maximizing your efforts in less time, in this clip featuring Dr. Brad Schoenfeld.

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  • Omega-3 fatty acids reduce the risk of cardiovascular disease-related death by up to 23 percent, especially in people with high triglyceride levels. www.sciencedirect.com
    Heart Disease Cholesterol Omega-3 Triglycerides Cardiovascular

    Coronary artery disease, a cardiovascular condition characterized by the gradual buildup of plaque within the heart’s arteries, is the third leading cause of death worldwide, claiming the lives of nearly 18 million people each year. A recent meta-analysis found that omega-3 fatty acids reduced the risk of dying from cardiovascular disease by 18 percent and myocardial infarction (heart attack) by 23 percent, underscoring omega-3s' effectiveness as an adjunct therapy for coronary artery disease.

    The investigators analyzed the findings of 12 studies involving more than 29,000 people with coronary artery disease. The various studies lasted between one and five years and used both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), marine forms of omega-3 fatty acids. Doses ranged between 0.84 and 3.46 grams daily for EPA + DHA and between 1.8 and 4 grams daily for EPA alone.

    The analysis revealed that omega-3s reduced the risk of premature death from all causes by 10 percent, cardiovascular disease by 18 percent, myocardial infarction by 23 percent, sudden cardiac death by 33 percent, and hospitalization for heart failure or unstable angina pectoris (chest pain caused by lack of blood flow to the heart) by 25 percent in patients with coronary artery disease. These effects were strongest among patients receiving EPA only and those with high triglycerides.

    These findings suggest that omega-3s, especially EPA, reduce the risk of cardiovascular disease, particularly among people with high triglycerides. Triglycerides play critical roles in the pathophysiology of coronary artery disease. Elevated triglyceride levels often accompany other conditions, such as obesity, diabetes, and high LDL (“bad”) cholesterol, further exacerbating the risk of developing coronary artery disease. Learn about the early research showing omega-3s' effects on reducing triglycerides.

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  • Increased intake of sugar-sweetened drinks raises cardiovascular disease risk by 18 percent with each additional serving, regardless of physical activity. ajcn.nutrition.org
    Exercise Heart Disease Sugar Sugar-Sweetened Beverages Cardiovascular

    Sugar-sweetened beverages encompass a wide variety of drinks, including soft drinks/sodas, sports drinks, energy drinks, and coffees. People who are physically active often consume sugar-sweetened sports drinks to replenish the electrolytes lost during exercise. While this can be beneficial during prolonged, intense physical activities, the added sugar content in many sports drinks might not be necessary for routine exercise or for people engaging in moderate physical activity. A recent study found that for every additional serving of sugar-sweetened beverages consumed daily, the risk of cardiovascular disease increased by 18 percent for physically active people and 12 percent for those who were inactive.

    The study involved more than 105,000 adults enrolled in the Nurses' Health Study and the Health Professionals Follow-up Study who were healthy at the time of enrollment. Researchers gathered information from the participants regarding their physical activity, cardiovascular health, and consumption of sugar-sweetened beverages.

    They found that participants who consumed more than two servings of sugar-sweetened beverages per day were 21 percent more likely to develop cardiovascular disease than those who rarely or never consumed them. For each additional serving of sugar-sweetened beverages consumed daily, the risk of cardiovascular disease increased by 18 percent for people who met physical activity guidelines and by 12 percent for those who did not, indicating that physical activity did not compensate for high sugar-sweetened beverage consumption. Participants who did not meet physical activity guidelines and consumed two or more servings per week of sugar-sweetened beverages were 47 percent more likely to develop cardiovascular diseases than those who were physically active and rarely or never drank them.

    These findings suggest that consuming sugar-sweetened beverages markedly increases a person’s risk for cardiovascular disease. Furthermore, physical activity does not offset this risk. Learn more about the health effects of sugar-sweetened beverages in our overview article.

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  • Epicatechin-rich cocoa boosts endogenous antioxidant production and mitochondrial function while protecting against muscle damage in people with peripheral artery disease. pubmed.ncbi.nlm.nih.gov
    Mitochondria Polyphenol NRF2 Cardiovascular Cocoa

    Peripheral artery disease affects roughly 230 million people worldwide and arises when plaque accumulation in the arteries impairs the delivery of oxygen-rich blood to the muscles, causing pain with physical activity. A recent study found that cocoa flavanols promote the production of endogenous antioxidants and proteins involved in mitochondrial function in people with peripheral artery disease.

    The study involved 16 people with peripheral artery disease who were enrolled in COCOA-PAD, a six-month randomized controlled trial in which participants who received a cocoa beverage containing 15 grams of cocoa (providing 75 milligrams of epicatechin, a flavanol compound) daily showed marked improvements in walking performance and less pain with activity. Researchers examined muscle samples taken before and after the trial to study changes in muscle fibers, endogenous antioxidants (heme oxygenase-1 and NAD(P)H dehydrogenase [quinone] 1), and energy-related proteins.

    They found that participants who received the cocoa beverage had higher levels of endogenous antioxidants, correlating with less muscle damage. They also had higher levels of UQCRC2, a protein critical for energy production in the mitochondria.

    These findings suggest that cocoa flavanols promote the synthesis of endogenous antioxidants and proteins involved in energy production and point toward a mechanism for the beneficial effects observed in COCOA-PAD. Because heme oxygenase-1 and NAD(P)H dehydrogenase [quinone] 1 are targets of nuclear factor erythroid 2-related factor 2 (Nrf2), the investigators posited that the mechanism driving the beneficial effects of cocoa flavanol supplementation is Nrf2 activation.

    Nrf2 is a protein typically found in the cytoplasm of mammalian cells. Nrf2 can relocate to the nucleus, where it regulates the expression of hundreds of antioxidant and stress response proteins that protect against oxidative damage triggered by injury and inflammation. Although this study found that cocoa induces Nrf2, one of the most robust inducers of Nrf2 is sulforaphane, a compound derived from broccoli. Learn more about sulforaphane and Nrf2 in this clip featuring Dr. Jed Fahey.

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  • A combined aerobic-resistance training regimen proves equally effective for cardiovascular health as aerobic alone. pubmed.ncbi.nlm.nih.gov
    Exercise Aerobic Cardiovascular

    Most cardiovascular health interventions emphasize aerobic exercise, which challenges the heart, lowering blood pressure and increasing cardiac output. However, a recent study found that a combination of aerobic exercise and resistance training provides similar cardiovascular benefits to those of aerobic exercise alone.

    Researchers conducted a randomized controlled trial involving 406 adults with overweight or obesity and elevated blood pressure. They randomly assigned participants to one of four exercise intervention groups: aerobic only, resistance only, a combination of aerobic and resistance, or no exercise. Participants exercised for one hour daily, three times weekly, for one year.

    The researchers found that the participants in the aerobic-only and aerobic and resistance combination groups benefited equally from the one-year intervention, with both groups showing nearly identical improvements in risk profiles. The resistance-only and no-exercise groups did not improve.

    These findings suggest that aerobic exercise alone or combined aerobic plus resistance exercise reduces cardiovascular disease risk in adults with overweight or obesity. Interestingly, resistance exercise can have aerobic effects. Learn more in this clip featuring Dr. Martin Gibala.

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  • What are the optimal time-restricted eating patterns for cardiovascular wellness? pubmed.ncbi.nlm.nih.gov
    Diet Obesity Diabetes Cholesterol Time-Restricted Eating Blood Pressure Cardiovascular

    Time-restricted eating is a dietary pattern that restricts the time during which a person eats to a specific window, such as a “16:8" pattern, where they fast for 16 hours a day and consume food only during the remaining eight hours. Evidence suggests that time-restricted eating improves cognitive function, supports weight loss, and reduces systemic inflammation. Findings from a recent review and meta-analysis suggest that time-restricted eating also reduces the risk of cardiovascular disease.

    Researchers analyzed the findings of 33 studies involving 1,725 participants investigating the effects of time-restricted eating on markers of cardiovascular health. They conducted a sub-group analysis to determine how age, health characteristics, and eating patterns influenced the effects of time-restricted eating.

    They found that the effects of time-restricted eating on cardiovascular disease varied according to a person’s risk factors, age, and when they ate. The table below presents their findings for the optimal time-restricted eating for different groups.

    This meta-analysis and review identifies the optimal time-restricted eating interventions for blood pressure, obesity, lipids, and glucose. It effectively provides a best-practices guide for people interested in implementing time-restricted eating as a lifestyle modification to improve cardiovascular health. Learn more about time-restricted eating in this episode featuring Dr. Satchin Panda.

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  • Omega-3s dramatically reduce the incidence of high-risk plaque – down to 3.8 percent versus 38 percent in non-users – suggesting a marked correlation with cardiovascular health. www.clinicalnutritionjournal.com
    Diet Heart Disease Omega-3 Cardiovascular

    Coronary artery disease is a cardiovascular condition characterized by the gradual buildup of plaque within the coronary arteries, reducing blood flow to the heart muscle. This narrowing of the arteries can result in chest pain (angina), heart attacks, and impaired heart function, posing a considerable risk to cardiovascular health. A recent study found that omega-3 fatty acids reduce plaque burden in patients with low-to-moderate coronary artery disease risk.

    Researchers recruited 106 patients with low-to-moderate coronary artery disease risk who underwent computed tomography angiography (CTA) – an imaging test that visualizes the coronary arteries. Half of the patients were taking omega-3 fatty acids, and the other half were not. The researchers ranked the patients based on the extent of their coronary artery plaque accumulation and other aspects of arterial disease.

    They found that those who took omega-3s had less total and non-calcified plaque burden than those who didn’t. The risk of having high-risk (lipid-rich) plaque was lower among those who took omega-3s (3.8 percent versus 32 percent). On average, those who took omega-3s had been doing so for about three years.

    These findings demonstrate an association between omega-3s and lower coronary high-risk plaque and total non-calcified plaque burden, suggesting that omega-3s exert direct anti-atherogenic effects.

    Omega-3 fatty acids (DHA and EPA) likely provide vascular protection through various mechanisms involving lipid metabolism and anti-inflammatory and anti-clotting pathways. In addition, evidence suggests that DHA and EPA are directly incorporated into vessel walls, lowering triglycerides. Byproducts of omega-3 metabolism called specialized pro-resolving mediators (SPMs) may play roles, too. Learn more about omega-3s heart-healthy effects in this short video featuring Dr. Rhonda Patrick.

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  • Morning exercise outperforms afternoon workouts in enhancing cardiometabolic health in people with metabolic syndrome. physoc.onlinelibrary.wiley.com
    Exercise Metabolism Diabetes Insulin Metabolic Syndrome Cardiovascular

    The idea that exercise benefits metabolic health is widely accepted. But whether the benefits of exercise are greater depending on when one exercises – morning versus afternoon – is a matter of considerable debate. A recent study shows that morning exercise reduces blood pressure, fasting insulin, and insulin resistance better than afternoon exercise in people with metabolic syndrome.

    Metabolic syndrome is a constellation of conditions characterized by abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoproteins. Having metabolic syndrome increases a person’s risk of cardiovascular disease and type 2 diabetes. Roughly one-third of adults between the ages of 20 and 60 have metabolic syndrome.

    The study involved 139 adults with metabolic syndrome who agreed to participate in three supervised high-intensity interval training sessions every week for 16 weeks. About a third of the participants performed their exercise in the morning, a third did so in the afternoon, and a third didn’t engage in any exercise. Researchers measured the participants' body composition, cardiorespiratory fitness, maximal fat oxidation, blood pressure, and blood metabolites before and after the intervention.

    They found that both exercise groups demonstrated greater body fat loss, reduced waist circumference (nearly an inch), and lower diastolic blood pressure than those who didn’t exercise. However, when comparing the morning exercise group to the afternoon group, they found that morning exercise was more effective at reducing systolic blood pressure (4 percent drop vs. 1 percent), lowering fasting insulin (12 percent drop vs. 5 percent), and decreasing insulin resistance (14 percent drop vs. 4 percent).

    These findings suggest that morning exercise boosts cardiometabolic health better than afternoon exercise. The investigators posited that these effects may be related to circadian rhythms, which influence the body’s response to exercise and dietary intake.

    Finding the time or motivation to exercise in the morning may be challenging for many. Fortunately, most experts agree that some exercise is better than none, as long as it’s not too close to bedtime. Learn more in this clip featuring Dr. Rhonda Patrick.

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  • Alarming gender disparities in hypertension-related cardiovascular risks: Women with an average blood pressure of 160 mm Hg or higher face a 113 percent increased risk of cardiovascular death. www.medscape.com
    Aging Sex Blood Pressure Stroke Cardiovascular

    Roughly half of all adults living in the U.S. have hypertension, with men affected more than women (48 percent versus 43 percent, respectively). However, the sex differences in hypertension prevalence aren’t consistent throughout the lifespan: Women who are 65 and older are more likely to have hypertension than men, raising concerns that current blood pressure recommendations should consider sex. Now, findings from a new study suggest that having an average systolic blood pressure of 160 mm Hg or higher increases the risk of dying from cardiovascular disease (CVD) among women by 113 percent.

    Researchers drew on data from more than 53,000 middle-aged adults enrolled in the NHANES studies. Over about ten years, they measured the participants' blood pressures three times and averaged the measures. They also tracked the participants' CVD-related death rates.

    They found that links between blood pressure measures and CVD-related deaths differed by sex. Women experience a 61 percent increased risk of cardiovascular death when systolic blood pressure reaches between 130-139 mm Hg, and it soars to 113 percent when at 160 mm Hg or higher. In comparison, men see a 76 percent increased risk only when systolic measures are 160 mm Hg or higher.

    When considering diastolic blood pressure, men had a higher risk of dying from CVD if measures were too low (below 70 mm Hg) or too high (80 mm Hg or more), compared to the risk associated with measures between 70 and 80 mm Hg. Again, for women, the risk was higher with diastolic measures that were too low (below 50 mm Hg) or too high (80 mm Hg or higher).

    These findings suggest that having high blood pressure markedly increases the risk of death from CVD, and this risk begins at much lower measures among women than men.

    Nearly two-thirds of adults in the United States have high blood pressure, defined as having a systolic pressure of 130 mmHg or higher or a diastolic pressure of 80 mmHg or higher. High blood pressure increases a person’s risk for heart disease and stroke and contributes to small vessel disease, a major risk factor for cardiovascular disease, dementia, and stroke. However, lifestyle factors, such as sauna use, help maintain healthy blood pressure. Learn more in this clip featuring Dr. Jari Laukkanen.

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  • Having a late chronotype increases coronary artery calcification risk by 90 percent. www.sciencedirect.com
    Sleep Cardiovascular

    A person’s chronotype – their innate tendency to sleep at a particular time during a 24-hour period – is based on genetically determined circadian rhythms. Disruption of a person’s chronotype schedule can influence mood, productivity, and disease risk. A recent study shows that having a late chronotype increases a person’s risk of coronary artery calcification, a marker of atherosclerosis.

    Researchers assessed the extent of coronary artery calcification in 771 middle-aged adults using computer tomography (CT). They monitored the participants' physical activity levels and asked them to identify their chronotype: extreme morning, moderate morning, intermediate, moderate evening, or extreme evening.

    They found that extreme evening chronotypes were 90 percent more likely to have coronary artery calcification than extreme morning types. In addition, the later a participant’s chronotype, the greater their coronary artery calcification, roughly doubling from 22 percent for extreme morning types to 41 percent for extreme evening types.

    These findings suggest that chronotype influences a person’s risk for atherosclerosis. They also align with other research showing that people with evening chronotypes are at greater risk for cardiovascular disease and premature death than morning types. Learn more about chronotypes and their effects on human health in this clip featuring Dr. Matthew Walker.

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  • Vegan diets linked to cardiovascular and metabolic benefits, with marked improvements in body weight, LDL cholesterol, and fasting insulin. www.ncbi.nlm.nih.gov
    Diet Metabolism Insulin Vegetarian Cardiovascular

    Plant-based dietary patterns are typically higher in fiber, vitamins, minerals, and phytonutrients than other dietary patterns. Consequently, they may confer health benefits that reduce the risk of cardiovascular and metabolic disorders. A recent study found that a vegan diet reduced body weight, LDL (“bad”) cholesterol, and fasting insulin in healthy adults.

    To negate any genetic influences that diet might have on cardiometabolic fitness, researchers recruited 22 pairs of female twins to participate in the study. Within each twin pair, one twin followed a healthy vegan diet for eight weeks, and the other followed a healthy omnivorous diet. The researchers measured the twins' cardiometabolic markers before and after the intervention.

    They found that compared to twins who ate an omnivorous diet, twins who followed a vegan diet experienced reduced body weight, LDL cholesterol, and fasting insulin. Participants following a vegan diet had a lower protein, dietary cholesterol, and vitamin B12 intake and a higher vegetable and dietary iron intake than those on the omnivorous diet. They also reported lower satisfaction with their dietary options.

    The findings from this small study suggest that following a vegan diet confers cardiometabolic benefits in healthy young women, aligning with previous research demonstrating that vegan diets reduce the risk of cardiometabolic disease. They also underscore the considerable influence that diet has on cardiometabolic health. Learn how to avoid dietary deficiencies when following a vegan diet in this clip featuring Rich Roll.

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  • A new study reveals a surprising link between triglycerides and reduced risk of dementia in older adults. www.sciencedaily.com
    Dementia Triglycerides Metabolic Syndrome Cardiovascular

    Triglycerides, the most common type of fat in the body, serve as a vital energy source and aid in absorbing fat-soluble vitamins. However, elevated levels of triglycerides, often associated with unhealthy dietary habits and certain metabolic conditions, have been linked to an increased risk of atherosclerosis, cardiovascular disease, and other metabolic disorders. Now, findings from a recent study suggest that higher triglyceride levels reduce the risk of dementia by as much as 18 percent.

    Researchers drew on data from more than 86,000 healthy older adults enrolled in the UK Biobank and ASPREE studies. They measured the participants' triglyceride levels and assessed different aspects of their cognition, such as memory, language, and reasoning. Then, they determined the effects of triglyceride levels on these cognitive measures.

    They found that participants with higher triglyceride levels (normal to high-normal) were 18 percent less likely to develop dementia and experienced a slower decline in their overall cognitive abilities over time than those with lower triglyceride levels. Those with the highest levels of triglycerides were 36 percent less likely to develop dementia than those with the lowest levels. These results were consistent even after considering other factors that could affect the outcomes.

    These findings suggest that higher triglyceride levels protect against dementia, counter to current thinking about triglycerides. They also highlight the need for further investigation to understand whether this link is causal and whether components of triglycerides benefit cognitive function.

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  • Higher cardiorespiratory fitness mitigates high blood pressure risks, reducing cardiovascular disease-related death. www.sciencedaily.com
    Exercise Sauna Blood Pressure Cardiovascular

    Nearly 1.3 billion people worldwide have high blood pressure, the primary risk factor for cardiovascular disease-related death. However, findings from a recent study suggest that greater cardiorespiratory fitness offsets some of the risks associated with having high blood pressure.

    The study involved nearly 2,300 middle-aged men enrolled in the Kuopio Ischemic Heart Disease Risk Factor Study, an ongoing study of heart disease risk factors among men and women living in Finland. Researchers measured the participants' blood pressures (classified as normal or high) and cardiorespiratory fitness levels (classified as low, medium, or high).

    They found that high blood pressure increased a person’s risk of cardiovascular disease-related death by 39 percent, and low fitness increased risk by 74 percent. These findings were consistent even after considering other risk factors, including age, body mass index, cholesterol levels, smoking status, type 2 diabetes, coronary heart disease, physical activity, socioeconomic status, and high sensitivity C-reactive protein (a marker of inflammation).

    Men with high blood pressure and low fitness levels were more than twice as likely to die from cardiovascular disease than those with normal blood pressure and high fitness levels. However, men with high blood pressure and high fitness levels were only 55 percent more likely to die from cardiovascular disease.

    These findings suggest that exercise markedly reduces the risk of dying from cardiovascular disease, even among men with high blood pressure. Interestingly, sauna use also reduces blood pressure and the risk of cardiovascular disease-related death. Learn more in this clip featuring Dr. Jari Laukkanen (one of the authors of this study.)

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  • Accelerated biological aging is linked to a 40 percent higher risk of vascular dementia and stroke. medicalxpress.com
    Aging Dementia Environment Cardiovascular

    Aging is the collective physiological, functional, and mental changes that accrue in a biological organism over time. However, people age at different rates, a consequence of both genetic and environmental factors. A recent study found that people whose biological age is five years older than their chronological age are roughly 40 percent more likely to develop vascular dementia or experience a stroke than those whose biological and chronological ages align.

    Using 18 routinely measured clinical biomarkers, researchers calculated the biological ages of more than 325,000 people enrolled in the UK Biobank study. Then, they evaluated how older biological age influenced the occurrence of neurological conditions, including dementia of all types, stroke, Parkinson’s disease, and motor neuron disease, over a nine-year follow-up period.

    They found that nearly 1,400 participants developed dementia, and more than 2,500 experienced a stroke. Having an older biological age that was five years older than chronological age increased the participants' risk of dementia by 26 percent, vascular dementia by 41 percent, and stroke by 39 percent. The findings were consistent even after considering various disease-specific risk factors.

    These findings suggest that accelerated biological aging markedly increases the risk of dementia and stroke. Age acceleration can result from intrinsic factors, such as normal metabolism and genetics, or extrinsic factors, such as diet, smoking, and exercise. Learn how epigenetic changes influence biological aging in our overview article.

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  • 'Weekend warrior' exercise pattern may be surprisingly effective: Condensing weekly exercise into one or two days offers benefits highly similar to spreading it out, as long as total active minutes are similar. healthnews.com
    Exercise Heart Disease Aerobic Cardiovascular

    Current exercise guidelines recommend that adults engage in at least 150 to 300 minutes of moderate-intensity aerobic physical activity or 75 to 150 minutes of vigorous-intensity aerobic physical activity weekly to promote cardiovascular health. However, finding the time to exercise often presents challenges, with many people squeezing in a couple of weekend workouts – often called the “weekend warrior” pattern. A recent study found that people whose physical activity occurred over one or two days had similar cardiovascular disease risks as those with more evenly distributed activity.

    Researchers analyzed the accelerometer-based physical activity patterns of nearly 90,000 adults enrolled in the UK Biobank study. They categorized the participants according to three activity patterns: inactive (fewer than 150 minutes), active weekend warrior (150 minutes or more, mostly over one or two days), and active regular (150 minutes or more, spread throughout the week).

    They found that both activity patterns – weekend warrior vs. regular – had comparable effects on cardiovascular disease risk, reducing the risk of atrial fibrillation (22 percent vs. 19 percent), heart attack (27 percent vs. 35 percent), heart failure (38 percent vs. 36 percent), and stroke (21 percent vs. 17 percent).

    These findings suggest that engaging in aerobic physical activity, either regularly throughout the week or in a more condensed pattern during the weekends, reduces the risk of cardiovascular disease. Aerobic exercise strengthens the heart muscle, lowers blood pressure, and reduces inflammation, promoting improved cardiovascular health. Learn how even resistance training can be aerobic in this clip featuring Dr. Martin Gibala.

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  • Chronic alcohol consumption impairs mitochondrial function in heart cells, increasing cardiovascular risks. onlinelibrary.wiley.com
    Heart Disease Alcohol Mitochondria Cardiovascular

    Alcohol has profound, adverse effects on the human body, compromising liver function and cognitive performance and increasing the risk for various cancers. A recent study demonstrates that alcohol impairs mitochondrial function and cellular metabolism and increases inflammation in heart cells.

    Researchers grew human-induced pluripotent stem cells into three-dimensional heart cell structures called cardiac spheroids and exposed them to clinically relevant amounts of ethanol (the type of alcohol found in alcoholic beverages) for five weeks. They then examined various aspects of the heart cells, including mitochondrial function, gene expression patterns, and metabolite production.

    They found that prolonged ethanol exposure reduced the heart cells' mitochondrial function, increased reliance on glycolysis (a less efficient energy production process), hindered fatty acid breakdown, and impaired cardiac structure development. The cells exhibited changes in gene expression related to metabolic processes, heart development, and responses to hypoxia. They also produced more inflammation-associated metabolites.

    Chronic alcohol consumption increases the risk for various heart-related issues, including arrhythmias (irregular heartbeats), cardiomyopathy (heart muscle disease), and heart failure. In addition, chronic heavy alcohol use has adverse effects on bone health, increasing the risk of fractures during weight-bearing activities.

    These findings highlight the harmful effects of chronic alcohol consumption on heart cells at the molecular level. Avoiding alcohol can be challenging, but vigorous aerobic exercise can help reduce alcohol cravings. Learn more in this video featuring Dr. Rhonda Patrick.

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  • Time-efficient sprint interval training matches traditional exercise for cardiometabolic health. www.ncbi.nlm.nih.gov
    Exercise Metabolism Aerobic Cardiovascular

    Traditional moderate-intensity continuous exercise training (MICT) promotes cardiometabolic health but requires a considerable time commitment, a factor many people often cite as a reason for not exercising. Evidence suggests sprint interval training (SIT) offers similar benefits for insulin sensitivity and heart health as MICT. A 2016 study found that 12 weeks of SIT improved cardiometabolic health as effectively as MICT – with one-fifth of the time commitment.

    SIT typically involves short bursts of high-intensity exercise followed by low-intensity recovery periods. It is sometimes described as a “sprint from danger” pace, equating to one’s top running speed, executed for five to ten seconds.

    The study involved 27 young, sedentary men who engaged in SIT, MICT, or no exercise (a control group) for 12 weeks. Those who engaged in SIT performed three 20-second high-intensity intermittent exercise sets within a 10-minute cycling session, while those who engaged in MICT performed 50 minutes of continuous cycling exercise at a moderate intensity. Both groups underwent muscle biopsies and body composition analyses before and after the interventions.

    SIT and MICT improved peak oxygen uptake by 19 percent, indicating improved cardiorespiratory fitness. In addition, both groups demonstrated enhanced insulin sensitivity and increased levels of citrate synthase, a marker of muscle mitochondria content.

    Although this was a small study, its findings suggest that SIT can be an effective and time-efficient strategy to improve cardiometabolic health among sedentary people. The findings also underscore the importance of considering alternative exercise strategies that may be more feasible for people with limited time for workouts. Learn more about SIT in this clip featuring Dr. Martin Gibala.

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  • Challenging cardio exercise guidelines: One intense weekly workout reduces heart disease risk by 40 percent. pubmed.ncbi.nlm.nih.gov
    Exercise Heart Disease Mortality Aerobic Cardiovascular

    Current exercise guidelines recommend that adults engage in at least 150 to 300 minutes of moderate-intensity physical activity or 75 to 150 minutes of vigorous-intensity aerobic physical activity (or an equivalent combination of the two) weekly to promote cardiovascular health. However, a 2006 study challenged those recommendations, suggesting that a single weekly bout of vigorous exercise reduced the risk of cardiovascular disease-related death by 40 percent.

    The study involved more than 56,000 people who were free of cardiovascular disease at enrollment. Researchers tracked the participants' health for roughly 16 years to assess their activity levels and risk of death from heart disease or stroke.

    They found that even a single weekly session of intense exercise, lasting 30 minutes or longer, markedly reduced the risk of dying from heart disease or stroke compared to no exercise at all. Interestingly, exercising more frequently or for longer durations each week didn’t provide additional benefits. Another finding was that as men got older, the protective effect of exercise against cardiovascular death became more pronounced. However, this age-related benefit wasn’t evident in women.

    Vigorous-intensity exercise is physical activity that demands a significant and challenging effort, promoting a substantial increase in heart and breathing rates. It requires considerable energy expenditure and typically involves activities like running, cycling at high speeds, or intense aerobics. During vigorous-intensity exercise, a person’s target heart rate is approximately 60 to 85 percent of their maximum heart rate.

    These findings from this observational study suggest that even one vigorous, 30-minute or longer workout a week can have substantial cardiovascular health benefits. Current exercise guidelines may need to be revised to account for the effects of HIIT on cardiorespiratory fitness. Learn more about the health benefits of HIIT in this episode featuring Dr. Martin Gibala.

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  • Poor cardiorespiratory fitness linked to 70 percent higher risk of premature death and 56 percent greater heart and cardiovascular disease risk. jamanetwork.com
    Exercise Mortality Cardiovascular

    Cardiorespiratory fitness is a measure of the body’s aerobic capacity – the ability to deliver oxygen to skeletal muscles – during sustained physical activity. A 2009 meta-analysis found that people with low cardiorespiratory fitness were 70 percent more likely to die prematurely and 56 percent more likely to experience a heart or cardiovascular disease-related event.

    Researchers evaluated data from 33 studies examining connections between cardiorespiratory fitness and the risk of premature death from all causes (more than 102,000 participants) and combined heart disease and cardiovascular disease events (more than 84,000 participants). They used maximal aerobic capacity, measured in metabolic equivalent (MET) units, to estimate cardiorespiratory fitness. They grouped participants into three categories based on their cardiorespiratory fitness levels: low (<7.9 METs), intermediate (7.9-10.8 METs), and high (≥10.9 METs).

    They found that for each 1-MET increase in maximal aerobic capacity (equivalent to a 1-kilometer per hour increase in running/jogging speed), the risk of death from all causes and heart disease/cardiovascular disease events. Compared to participants with high cardiorespiratory fitness, those with low cardiorespiratory fitness were 70 percent more likely to die prematurely and 56 percent more likely to experience a heart disease/cardiovascular disease event. However, even intermediate cardiorespiratory fitness conferred substantial benefits. Compared to participants with intermediate cardiorespiratory fitness, those with low cardiorespiratory fitness were 40 percent more likely to die prematurely and 47 percent more likely to experience a heart disease/cardiovascular disease event.

    These findings demonstrate that having low cardiorespiratory fitness markedly increases one’s risk of dying prematurely or developing heart or cardiovascular disease. The most accurate way to assess cardiorespiratory fitness involves measuring maximal oxygen uptake, often referred to as VO2 max, during a graded exercise test in a laboratory, clinical, or research setting. However, online calculators, such as the World Fitness Level, can predict VO2 max based on various personal factors. Learn more about VO2 max and the World Fitness Level calculator in this episode featuring Dr. Martin Gibala.

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  • Breastfeeding for six months or more appears to reduce the risk of cardiovascular problems developing in mothers for at least three years after delivery, according to new study. www.scimex.org
    Metabolic Syndrome Breast Milk Cardiovascular

    Breastfeeding benefits mothers by promoting post-partum weight loss and reducing the risk of certain types of cancer later in life. A new study suggests that breastfeeding also supports maternal cardiometabolic health. Women who breastfed for at least six months were leaner and had lower blood pressure than those who didn’t.

    Researchers conducted health check-ups on 160 mother-child pairs enrolled in Screening Tests to Predict Poor Outcomes of Pregnancy, a long-term study that assessed women’s risk for pregnancy complications. They assessed the women’s cardiometabolic health via blood pressure, body measurements, and serum metabolic markers (glucose and lipids). They determined breastfeeding duration via the children’s health records.

    They found that the cardiometabolic health of women who breastfed for at least six months was considerably better than those who did not breastfeed, as evidenced by lower body mass index (BMI) and blood pressure. These differences persisted even after considering factors like BMI, socioeconomic status during early pregnancy, prenatal smoking, and maternal age during early pregnancy. In women who had experienced pregnancy complications (such as preeclampsia or gestational diabetes), breastfeeding for at least six months reduced blood pressure, insulin, and triglycerides, while increasing HDL cholesterol levels.

    These findings suggest that breastfeeding for a minimum of six months benefits the cardiovascular health of mothers, particularly those who experienced pregnancy complications. They also highlight the importance of breastfeeding as a potential means to reduce the risk of cardiovascular issues in women following childbirth. However, the investigators conceded that this was a small study, potentially hindering its translatability to a broad audience. Learn more about the maternal benefits of breastfeeding in our overview article.

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  • Unlocking cardiovascular fitness: Cocoa flavonols enhance peak oxygen consumption by nearly 10 percent in older adults. pubs.rsc.org
    Aging Polyphenol Cardiovascular Cocoa

    Cardiovascular aging is characterized by marked functional decline and increased cardiovascular disease risk. Evidence suggests that flavonols, a broad class of bioactive compounds found in cocoa and other fruits, exert cardioprotective effects, bolstering cardiorespiratory fitness. A recent study shows that older adults who took cocoa flavonols experienced a nearly 10 percent gain in peak oxygen consumption, a marker of cardiorespiratory fitness, during exercise.

    Researchers conducted a study involving 68 healthy older adults aged 55 to 79. Half of the participants took 1,000 milligrams of cocoa flavonols daily for a month, while the other half took a placebo. The researchers measured the participants' peak oxygen consumption during exercise and assessed other aspects of their cardiovascular health, including blood pressure and blood vessel health.

    They found that participants who took the cocoa flavonols showed marked improvements in their cardiorespiratory fitness. Their oxygen use during exercise increased by nearly 10 percent, and their exercise capacity increased by more than 6 percent. Their resting systolic and diastolic blood pressures decreased by 5.4 mmHg and 2.9 mmHg, respectively, and their blood vessel function improved by 1.3 percent. Those who took the placebo didn’t demonstrate these improvements.

    These findings suggest that cocoa flavonols benefit older adults' cardiovascular health by improving fitness levels and other health markers, potentially promoting better heart health in aging. Interestingly, the benefits of cardiorespiratory fitness extend to cognitive function, too. Learn more in this clip featuring Dr. Axel Montagne.

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  • Daily multivitamin supplementation boosts memory in older adults, particularly those with cardiovascular disease. neurosciencenews.com
    Aging Memory Micronutrients Cardiovascular Supplements

    Short-term memory – such as remembering a list of items or numbers shortly after hearing them – is particularly vulnerable as we age. But a new study shows that multivitamin/multimineral supplementation bolsters short-term memory in older adults, especially those with cardiovascular disease.

    The study involved more than 3,500 older adults (average age, 71 years) enrolled in the COSMOS trial. About half of the participants took a daily multivitamin/multimineral supplement for three years, and the other half took a placebo. All participants completed a battery of cognitive tests at the one-, two-, and three-year points.

    The tests revealed that those who took the supplement performed better on short-term memory tests than those who took the placebo, an effect that endured over the entire three-year study. Participants with cardiovascular disease scored lower on memory tests initially, but after taking the multivitamin/multimineral supplements for a year, their memory scores improved, reaching a level comparable to those without cardiovascular disease.

    These findings suggest that multivitamin/multimineral supplementation benefits short-term memory in older adults. The study’s authors proposed that the cognitive effects of multivitamin/multimineral intervention may occur by activating vitamin and mineral receptors in the hippocampus, given its prominent role in recall memory. Learn how vitamins and minerals influence other aspects of aging in this episode featuring Dr. Bruce Ames.

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  • Connection identified between sleep disturbances and stroke risk. www.medscape.com
    Sleep Stroke Cardiovascular

    Sleep disturbances may increase a person’s risk of stroke, according to a new study. People who had trouble falling or staying asleep, snored, or had sleep apnea were more likely to have a stroke than those with normal sleep patterns.

    Researchers gathered information about the sleep patterns of more than 4,500 adults. Roughly half of the participants had experienced a recent stroke.

    They found that compared to participants who slept seven hours a night, those who slept fewer than five hours per night were more than three times as likely to have had a stroke, and those who slept more than nine hours were more than twice as likely to have had a stroke. Participants who had symptoms of apnea were roughly three times as likely to have had a stroke.

    These findings suggest that disturbed sleep markedly increases a person’s risk of stroke. However, the researchers noted that it’s not clear whether sleep disturbances directly cause stroke, or if they are simply markers of other underlying health issues that increase the risk of stroke. Learn more about the health risks associated with poor sleep in this episode featuring Dr. Matthew Walker.

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  • Higher cardiovascular fitness may delay the onset of dementia by 9.5 years. www.medscape.com
    Exercise Brain Aging Dementia Cardiovascular

    Higher cardiovascular fitness delays brain aging and the onset of dementia in women, a 2018 study showed. Women with high cardiovascular fitness levels experienced nearly a decade’s delay in dementia onset than those with moderate fitness levels.

    The study involved 191 middle-aged women. Participants completed a cycling test to gauge their cardiovascular fitness and underwent regular neuropsychiatric testing to determine if they developed dementia during their lifetime.

    Compared to women with moderate cardiovascular fitness levels, women with high cardiovascular fitness levels were 88 percent less likely to develop dementia. However, those with low fitness levels were 41 percent more likely to develop dementia. Higher fitness delayed the onset of dementia by 9.5 years compared to those with moderate fitness.

    Cardiovascular fitness is a measure of how well the heart, lungs, and blood vessels transport oxygen to the muscles during exercise. Exercise contributes to cardiovascular fitness because it exerts robust effects on the cardiovascular system, boosting heart rate, blood pressure, and cardiac output. Interestingly, sauna use exerts similar effects on the cardiovascular system. Learn more in our overview article.

    These findings suggest that cardiovascular fitness protects against dementia in women. Learn more about the effects of cardiovascular fitness on brain health in this short video featuring Dr. Rhonda Patrick.

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  • Vigorous intensity exercise may be even more time-efficient than previously thought. academic.oup.com
    Exercise Cancer Mortality Cardiovascular

    People who regularly engaged in vigorous-intensity exercise were less like to die from cancer, cardiovascular disease, or other causes, according to a new study. Engaging in vigorous-intensity exercise for as little as 54 minutes per week provides optimal mortality reduction – but the catch is that it must be sufficiently vigorous.

    Using wrist-worn accelerometers, nearly 72,000 middle-aged adults enrolled in the UK Biobank study tracked their activity. Researchers monitored the participants' health for approximately six years.

    They found that the participants' risk of dying during the study period varied based on their activity level. The risk of dying among those engaging in no vigorous-intensity activity per week was 4.17 percent; zero to less than 10 minutes, 2.12 percent; 10 to less than 30 minutes, 1.78 percent; 30 to less than 60 minutes, 1.47 percent; and for 60 minutes or more, 1.10 percent. They determined that the “optimal” dose of vigorous-intensity activity was approximately 54 minutes per week, and the “minimal” dose – sufficient to reduce the risk of dying from cancer, cardiovascular disease, or all other causes – was approximately 15 minutes.

    Vigorous-intensity exercise is defined as activity that achieves a heart rate that is 70 to 80 percent of one’s maximum. High-intensity interval training, often referred to as HIIT, is a popular form of vigorous exercise involving short bursts of intense aerobic exercise interspersed with periods of rest or lower-intensity exercise. During a typical HIIT session, exercisers typically achieve 80 to 100 percent of their VO2max (a measure of respiratory function) or maximum heart rate. Most HIIT workouts are brief, lasting just 15 to 30 minutes.

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  • Gut barrier dysfunction impairs butyric acid uptake into the blood – potentially increasing the risk of carotid atherosclerosis. www.nature.com
    Gut Butyrate Intestinal Permeability Cardiovascular

    Poor gut barrier function may contribute to carotid atherosclerosis – a narrowing of the blood vessels that supply the brain – according to a new study. People with carotid atherosclerosis demonstrated increased markers of gut barrier damage and inflammation, both of which impair butyric acid uptake into the blood.

    Researchers conducted a study involving 43 people with carotid atherosclerosis and 44 healthy people. They measured butyric acid levels in the participants' blood and feces and assessed their gut health and inflammation.

    The people who had carotid atherosclerosis had higher levels of butyric acid in their feces but not in their blood, despite robust gut microbial production of butyric acid. They also had higher levels of markers that indicate gut barrier damage and inflammation and tended to be heavier, carry more weight around their waist, have poor blood glucose control, and have higher markers of inflammation.

    The researchers hypothesized that the participants' higher fecal (but not blood) levels of butyric acid were due to poor gut barrier function, which could impair butyric acid absorption and in turn reduce its uptake into the blood. Other research has found that high fecal levels of butyric acid are associated with intestinal permeability, obesity, metabolic dysfunction, and high blood pressure.

    Butyric acid, a short-chain fatty acid, is best known for its roles in maintaining gut barrier function and preventing intestinal permeability. However, butyric acid also protects the vascular endothelium – the lining of the blood vessels. Having low butyric acid levels in the blood could contribute to the risk of developing carotid atherosclerosis.

    [Learn about butyrate, a compound related to butyric acid, in our overview article.] (https://www.foundmyfitness.com/topics/butyrate)

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  • Size of estrogen dose may be critical in determining whether estrogen therapy leads to cardiovascular or kidney disease, mouse study suggests. (2008) www.sciencedaily.com
    Hormones Estrogen Cardiovascular

    From the article:

    For a 60 day period ovariectomized (OVX) mice received the estrogen hormone 17β—estrodial (E2), a drug very similar to that used in treating the symptoms of menopause. The mice received one of four dosing levels every day throughout the study period: a very low (VL) dose (0.001 µg/d); a low (L) dose (0.42 µg/d); a moderate (M) dose (4.2 µg/d); or a high (H) dose (28.3 µg/d).

    The researchers found that:

    – Moderate and high doses of ERT increased the plasma estrogen levels in the mice more than four fold (4.5). This was associated with fluid retention in the uterus, amounts of protein in the urine, and dilated kidneys.

    – By contrast, low doses of E2 restored plasma estrogen to levels similar to the control rats and neither fluid retention nor renal damage was found in this group of mice.

    – Moderate and high doses of E2 also increased atrial natriuretic peptide (ANP), a cardiac hormone that is increased as a marker of severity of heart failure. At low level dosing this did not occur.

    – Overall blood pressure and cardiac function were not changed by ERT at any given dose.

    […]

    Other factors such as the ratio of estrogen to progestin, the age when the therapy begins and the cardiovascular health_ of the patient when treatment starts may also be important factors to investigate.

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  • Taking estradiol may slow progression of atherosclerosis in healthy postmenopausal women. (2001) www.sciencedaily.com
    Hormones Heart Disease Cholesterol Estrogen Cardiovascular

    From the article:

    Called the Estrogen in the Prevention of Atherosclerosis Trial (EPAT) the study monitored how much artery walls thickened over two years in 222 healthy postmenopausal women who took unopposed estrogen or a placebo.

    Women on estrogen therapy saw their atherosclerosis rate decrease by .0017 millimeters (mm) per year over two years, while artery wall thickness increased by .0036 mm per year over two years in women who took a placebo.

    As a guideline, Hodis says, an increase of .033 mm per year translates to a two-to-three-fold increase in risk of events such as heart attacks, and a starting thickness of .8 mm or greater also puts an individual at high risk.

    […]

    Also, EPAT investigators could compare women who used cholesterol-lowering drugs against women who did not take such medication. Besides taking estrogen or a placebo, all women who started the trial with levels of 160 or higher of low-density lipoprotein (often called LDL or “bad” cholesterol) were put on a cholesterol-lowering medication.

    Among the group of women who took no cholesterol-lowering medications in EPAT, those on estrogen therapy had .0147 mm per year slower atherosclerosis progression than those who took a placebo.

    Interestingly, women who received both estrogen and cholesterol-lowering drugs had about the same decrease in atherosclerosis progression as women who took cholesterol-lowering drugs alone.

    Researchers do not know why the combination of estrogen and cholesterol-lowering drugs does not result in even further atherosclerosis improvement. “But the effects of lipid-lowering drugs are quite powerful,” Hodis says. “You’re probably not seeing any effect above that.”

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  • Estrogen may help lower LDL cholesterol levels in the blood by inhibiting the protein PCSK-9. (2014) www.sciencedaily.com
    Hormones Cholesterol Estrogen Blood Pressure Cardiovascular

    From the article:

    Dr. Ross Feldman, a clinical pharmacologist at London Health Sciences Centre and a scientist at the Schulich School of Medicine & Dentistry’s Robarts Research Institute, and his colleagues showed that the G-protein coupled estrogen receptor 30 (GPER) when activated by estrogen helps lower LDL cholesterol levels in the blood by inhibiting the protein PCSK-9.

    […]

    The study, which looked at two populations of women in northern Alberta and London, Ontario, also found that women who carry a common gene variant for GPER have a significant increase in LDL cholesterol levels. The gene variant, found in about 20 per cent of the population, impairs the ability of GPER to function and was shown in a previous study by the same authors to be associated with significant increases in blood pressure in women.

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  • Loss of estrogen receptor alpha led to aspects of metabolic syndrome, inflammation, and acceleration of atherosclerosis in mice. (2011) www.sciencedaily.com
    Hormones Insulin Resistance Inflammation Estrogen Blood Sugar Metabolic Syndrome Cardiovascular

    From the article:

    This early preclinical study in female mice demonstrated that removing estrogen regulator alpha alone was enough to reduce the immune system’s protective process and promote increased fat accumulation and accelerate atherosclerosis development. Without this protein, the mice developed additional aspects of metabolic syndrome such as glucose intolerance, insulin resistance and inflammation.

    This estrogen receptor is also expressed in many other non-reproductive tissues such as fat, muscle and liver and can also act independent of the hormone estrogen. However, little is known about the receptor’s actions in these tissues that are involved in blood-sugar regulation, which plays an integral role in metabolic syndrome.

    […]

    “Impairment of this receptor’s function could also play a role in the heightened incidence of metabolic syndrome being seen in younger women,”

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  • Pomegranate juice improves blood pressure and reduces arterial plaques in people with atherosclerosis. www.clinicalnutritionjournal.com
    Blood Pressure Polyphenol Cardiovascular

    Pomegranate juice reduces symptoms associated with the narrowing of arteries that supply the brain, a small study has found. Patients who drank pomegranate juice for one year experienced improvements in blood pressure, antioxidant status, and carotid artery thickness (an indicator of the extent of plaque buildup in the arteries).

    The study involved 19 people who had atherosclerosis with carotid artery stenosis, a condition in which the arteries that supply the brain thicken and narrow due to the accumulation of plaque. Ten of the participants drank 50 milliliters (about 1.7 ounces) of pomegranate juice daily for one year, while the remaining nine participants did not consume any pomegranate juice. The researchers assessed various aspects of the participants' cardiovascular health before, during, and after the intervention.

    They found that several parameters of cardiovascular health improved after one year of pomegranate juice consumption. For example, the participants' carotid artery thickness decreased by up to 30 percent and their blood pressure decreased by 21 percent. In addition, their total antioxidant status increased by 130 percent. Participants who didn’t drink pomegranate juice did not experience these improvements, and in some cases, their cardiovascular measures worsened.

    This small study shows that drinking pomegranate juice may improve symptoms associated with narrowing of the arteries. Pomegranates are rich in various bioactive polyphenols, including tannins, ellagic acid, and anthocyanins, that exert potent antioxidant, anti-inflammatory, or cardioprotective effects in humans.

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  • Age-related depletion of nitric oxide synthase cofactors may change the antihypertensive effect of estrogen into a prohypertensive effect. (2005) www.sciencedaily.com
    Hormones Estrogen Nitric Oxide Blood Pressure Oxidative Stress Cardiovascular

    From the article:

    They were studying estrogen’s effects on blood vessels, focusing on its impact on the smooth muscle cells that allow blood vessels to contract, thereby regulating blood pressure and blood flow. These researchers found that estrogen targets nitric oxide synthase 1, one of three versions of the enzyme that makes the powerful vasodilator, nitric oxide.

    “What we were finding is that estrogen seems to be what you might call a natural nitroglycerin; nitroglycerin also works by making nitric oxide,” Dr. White says.

    Then they tried to block estrogen’s activity by blocking nitric oxide. “What surprised the heck out of me was after we blocked nitric oxide production and added estrogen, we got a contraction,” says Dr. White. “Estrogen now had turned into a constrictor agent, an agent that would increase blood pressure.”

    They looked further and found that normal aging decreases levels of the cofactors L-arginine and tetrahydrobiopterin – both critical to nitric oxide synthase’s production of nitric oxide.

    […]

    “Under normal conditions, such as a pre-menopausal woman, this enzyme, nitric oxide synthase, makes nitric oxide,” says Dr. White. “But if you block the production of nitric oxide, this nitric oxide synthase now has a secondary product that normally isn’t made in an appreciable form. Now it makes a compound called superoxide. It’s an oxidant, and oxidation is bad in general. It causes a lot of cellular damage. But what we also have found is that now, instead of causing relaxation, it causes constriction. So you completely flip-flop the response here.

    “One of the things this means is that menopause is a good thing, a sort of revolutionary endocrinology idea,” says Dr. White.

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  • Estrogen may exert inhibitory effects on immune cells, leading to reduced vascular inflammation and protection against cardiovascular disease. (2011) www.sciencedaily.com
    Hormones Heart Disease Immune System Estrogen Cardiovascular

    From the article:

    The results could help explain why cardiovascular disease rates tend to be higher in men and why they soar in women after the menopause.

    The researchers compared white blood cells from men and pre-menopausal women blood donors. They found that cells from premenopausal women have much higher levels of protein called annexin-A1 on the surface of their white blood cells.

    The scientists also found that annexin-A1 and estrogen levels were strongly linked throughout the menstrual cycle.

    White blood cells play a vital role in protecting the body from infections. When they are activated they stick to the walls of blood vessels. This process normally helps the cells to tackle infection but if it happens too much, it can lead to blood vessel damage, which in turn can lead to cardiovascular disease. However, when annexin-A1 is on the surface of these white blood cells, it prevents them from sticking to the blood vessel wall.

    The new research shows that estrogen can move annexin-A1 from inside the white blood cell, where it is normally stored, to the surface of the cells, thereby preventing the cells from sticking to blood vessel walls and causing vascular damage. This may have important implications in cardiovascular disease.

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  • Unlike transdermal estrogen therapy, oral use may increase the risk of blood clots almost threefold. (2016) www.sciencedaily.com
    Hormones Estrogen Cardiovascular

    From the article:

    This large population study of more than 800 Swedish women who had VTEs and nearly 900 age-matched controls who took no hormones is helping answer those questions.

    In this study, risk of having VTE [venous thromboembolism] was almost twofold higher (OR 1.72) in the women who took hormones than in those who took no hormones, which is similar to other studies, including the WHI. What’s more, women who took combined estrogen-progestogen therapy had nearly three times the VTE risk of those who took no hormones. Women who took estrogen only (because they had had hysterectomies and didn’t need a progestogen) had a much lower overall increase in their odds of VTE–a little less than one and half times higher (OR 1.31) compared with those who took no hormones. Women using combined estrogen-progestogen had a twofold higher risk of VTE than those taking estrogen only.

    However, this study had good news about the way estrogen is delivered. There was no increased risk of VTE in this study for women who used transdermal estrogen (such as patches), either alone or in combination with a progestogen. And women who used vaginal estrogen alone to ease vaginal dryness and other symptoms of genitourinary syndrome of menopause (GSM) also had no increased risk of VTE. Many menopause experts don’t expect vaginal estrogen to raise the risk because absorption into the bloodstream is small and results in levels similar to those in postmenopausal women who use no hormones. But studies on this question have been rare, noted the authors, so this finding is a big help for decision making.

    Whether the type of progestogen makes a difference in risk has also been an important question for women and clinicians, and there haven’t been many studies on this. Some imply that the VTE risk is higher with medroxyprogesterone acetate (the progestogen used in the WHI) than with norgestrel. But this study didn’t show any statistically significant difference in risk between the two synthetic progestins. What it did show was that having a uterus and taking both oral estrogen and a synthetic progestin increased the risk of VTE the most, particularly compared with estrogen only.

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  • A meta-analysis of more than 884 studies (RCTs) finds omega-3, folic acid and CoQ10 among the micronutrients that reduce cardiovascular risk. (2022) www.sciencedaily.com
    Vitamin D Vitamin C Omega-3 Melatonin Magnesium Curcumin Selenium Folate Zinc Polyphenol Carotenoids Cardiovascular Supplements

    Omega-3 fatty acids, folic acid, and CoQ10 reduce the risk of cardiovascular disease.

    Some nutritional components benefit cardiovascular health, but others have no effect on cardiovascular health or may even harm it, according to a recent study. Nutritional components providing the greatest benefit include omega-3 fatty acids, folic acid, and coenzyme Q10 (CoQ10), a vitamin-like compound produced in the body.

    Researchers analyzed the findings of more than 880 trials involving more than 880,000 participants that investigated the benefits of various macronutrients, micronutrients, and bioactive compounds on cardiovascular health.

    They found that the nutritional components had varied effects on cardiovascular health. For example, while omega-3 fatty acids, folic acid, and CoQ10 reduced the risk of cardiovascular disease, selenium and vitamins C, D, and E had no effect on the risk for either cardiovascular disease or type 2 diabetes (which often coincides with cardiovascular disease). On the other hand, beta-carotene (a vitamin A precursor) increased the risk of death from all causes. The researchers did not investigate the effects of the various nutritional components in combination versus alone.

    This analysis demonstrates that nutrition plays important roles in maintaining cardiovascular and metabolic health and supports the findings of large, epidemiological studies that have demonstrated that adherence to dietary patterns that are rich in omega-3 fatty acids, folic acid, and CoQ10, such as the Mediterranean Diet, for example, improves cardiometabolic health.

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  • Estrogen increases blood-forming stem-cell self-renewal in females and during pregnancy, mouse study suggests. (2014) www.sciencedaily.com
    Hormones Stem Cells Pregnancy Estrogen Cardiovascular

    From the article:

    [The study authors] discovered that blood-forming stem cells divide more frequently in females than in males due to higher estrogen levels. The research, conducted using mice, demonstrated that the activity of blood-forming stem cells was regulated by systemic hormonal signals in addition to being regulated by local changes within the blood-forming system.

    “This discovery explains how red blood cell production is augmented during pregnancy,” said Dr. Morrison. “In female mice, estrogen increases the proliferation of blood-forming stem cells in preparation for pregnancy. Elevated estrogen levels that are sustained during pregnancy induce stem cell mobilization and red cell production in the spleen, which serves as a reserve site for additional red blood cell production.”

    The study involved treating male and female mice over a period of several days with amounts of estrogen needed to achieve a level consistent with pregnancy. When an estrogen receptor that is present within blood-forming stem cells was deleted from those cells, they were no longer able to respond to estrogen, nor were they able to increase red blood cell production The results demonstrate that estrogen acts directly on the stem cells to increase their proliferation and the number of red blood cells they generate.

    “If estrogen has the same effect on stem cells in humans as in mice, then this effect raises a number of possibilities that could change the way we treat people with diseases of blood cell-formation,” said Dr. Morrison. “Can we promote regeneration in the blood-forming system by administering estrogen? Can we reduce the toxicity of chemotherapy to the blood-forming system by taking into account estrogen levels in female patients? Does estrogen promote the growth of some blood cancers? There are numerous clinical opportunities to pursue.”

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  • Honey may benefit cardiometabolic health. www.sciencedaily.com
    Diet Metabolism Cardiovascular

    Consuming honey improves blood glucose and cholesterol levels, a recent analysis shows. Raw, unprocessed honey from a single floral source provides the greatest health benefits.

    Researchers reviewed the findings of 18 studies that investigated the effects of honey consumption on various cardiometabolic risk factors, including body fat, glucose levels, blood lipids, blood pressure, inflammatory markers, and others. They also noted the effects of processing and sourcing on honey’s effects.

    They found that honey lowered fasting blood glucose, LDL (“bad”) cholesterol, and triglycerides and increased HDL (“good”) cholesterol and some markers of inflammation. Raw honey – which is unprocessed – had the greatest beneficial effects, especially if it was from a single source, particularly black locust or clover.

    Honey is a complex mixture of sugars, enzymes, proteins, minerals, vitamins, and other bioactive substances that exert antioxidant, antibacterial, and antiseptic effects in humans. Evidence suggests that honey benefits cardiovascular, metabolic, neurologic, and gastrointestinal health.

    These findings demonstrate that, despite its naturally high sugar content, honey differs from other natural sweeteners and may benefit cardiometabolic health. Refined sugar, on the other hand, has profound, negative effects on the human body. Learn more in this episode featuring Dr. Rhonda Patrick.

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  • Vitamin D deficiency increases the odds of all-cause mortality by 25%, a mendelian randomization study suggests. (2022) doi.org
    Vitamin D Cancer Mortality Cardiovascular

    From the publication:

    Participants: 307 601 unrelated UK Biobank participants of White European ancestry (aged 37 to 73 years at recruitment) with available measurements of 25-hydroxyvitamin D (25-(OH)D) and genetic data.

    Measurements: Genetically predicted 25-(OH)D was estimated using 35 confirmed variants of 25-(OH)D. All-cause and cause-specific mortality (cardiovascular disease [CVD], cancer, and respiratory) were recorded up to June 2020.

    Results: There were 18 700 deaths during the 14 years of follow-up. The association of genetically predicted 25-(OH)D with all-cause mortality was L-shaped, and risk for death decreased steeply with increasing concentrations until 50 nmol/L. Evidence for an association was also seen in analyses of mortality from cancer, CVD, and respiratory diseases. Odds of all-cause mortality in the genetic analysis were estimated to increase by 25% for participants with a measured 25-(OH)D concentration of 25 nmol/L compared with 50 nmol/L.

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  • Lifelong aerobic exercise maintains vascular health and ameliorates some of the harmful effects of a poor diet. www.ncbi.nlm.nih.gov
    Exercise Diet Cardiovascular

    A high-fat, high-sugar diet accelerated normal vascular aging in mice, according to a 2021 study. However, regular, lifelong aerobic exercise maintained vascular health and ameliorated some of the harmful effects of a poor diet.

    Researchers studied the effects of diet and exercise on cardiovascular health in mice that exhibit many of the key features of age-related vascular dysfunction in humans. Starting at the age of three months and continuing until their natural deaths, half of the mice ate a normal diet, while the other half ate a diet that was high in fat and sugar and low in dietary fiber – much like the typical Western diet. Because mice voluntarily run in the wild and in captivity, half of each group of mice was allowed access to a running wheel for exercise, while the other mice were sedentary.

    The researchers found that as the mice aged, they exhibited signs of declining cardiovascular health. In particular, they exhibited impaired endothelium-dependent dilation, a condition that occurs in the early stages of vascular disease and is a precursor to atherosclerosis. This effect was exacerbated by the high-fat/high-sugar diet. However, the researchers found that exercise ameliorated some of the harmful vascular effects of the high-fat/high-sugar diet throughout the lifespan, likely due to lower levels of oxidative stress and inflammation.

    This study in mice demonstrates that aerobic exercise exerts profound protective effects on the cardiovascular system, even in the setting of a poor diet. Learn more about the benefits of aerobic exercise in our overview article.

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  • Existing studies do not provide a clear answer to the question of the benefits and risks of testosterone for the cardiovascular system. (2019) www.nature.com
    Hormones Testosterone Cardiovascular

    From the publication:

    – Population studies suggest that low serum levels of endogenous testosterone are a risk factor for cardiovascular events, although these studies cannot establish causality or exclude reverse causality, and some of these associations might result from residual confounding.

    – Although many retrospective studies show no association, some retrospective studies of prescription databases have shown a higher risk of cardiovascular events in men receiving testosterone, with the risk increasing early after treatment initiation.

    – Meta-analyses of randomized, controlled trials of testosterone replacement therapy report conflicting findings, probably because the included trials lacked power or the duration was too short to assess cardiovascular events.

    – The TRAVERSE trial, the first trial of testosterone therapy that is adequately powered to assess cardiovascular events, began in 2018, and its findings might take a decade to become available.

    – Until the results of the TRAVERSE trial are available, clinicians should individualize testosterone treatment after having an informed discussion with their patients about the risks and benefits of testosterone replacement therapy.

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  • A group of international experts takes strong stance on testosterone deficiency treatment. (2016) www.sciencedaily.com
    Cancer Hormones Diabetes Testosterone Prostate Cardiovascular

    From the article:

    After examining the best available scientific evidence, Morgentaler and colleagues – who included experts with specialties in urology, endocrinology, diabetes, internal medicine, and basic science research – agreed on the following:

    – TD [testosterone deficiency] is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health and quality of life.

    – Symptoms and signs of TD occur as a result of low levels of testosterone and may benefit from treatment regardless of whether there is an identified underlying origin.

    – TD is a global public health concern.

    – Testosterone therapy for men with TD is effective, rational, and evidence-based.

    – There is no testosterone concentration threshold that reliably distinguishes those who will respond to treatment from those who will not.

    – There is no scientific basis for any age-specific recommendations against the use of testosterone therapy in adult males.

    – The evidence does not support increased risks of cardiovascular events with testosterone therapy.

    – The evidence does not support increased risk of prostate cancer with testosterone therapy.

    – The evidence supports a major research initiative to explore possible benefits of testosterone therapy for cardiometabolic disease, including diabetes.

    “It will be surprising to those unfamiliar with the literature to learn how weak the evidence is supporting the alleged risks of cardiovascular disease and prostate cancer,” said Michael Zitzmann, MD, vice-chair of the conference and a Professor in the Centre for Reproductive Medicine and Andrology at the University of Muenster in Germany. “Indeed, there is substantial data suggesting there may actually be cardio-protective benefits of testosterone therapy.”

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  • Testosterone treatment of older men didn`t affect functional status or cognition but increased lean body mass and had mixed metabolic effects. (2008) www.sciencedaily.com
    Hormones Cholesterol Testosterone Muscle Bone Insulin Weight Loss Cardiovascular

    From the article:

    Marielle H. Emmelot-Vonk, M.D., of University Medical Center Utrecht, the Netherlands, and colleagues conducted a randomized, placebo-controlled study to assess the effects of testosterone supplementation on functional mobility, cognition, bone mineral density, body composition, lipids, quality of life, and safety parameters in older men with testosterone levels less than 13.7 nmol/L (less than the average level in this age group) during a period of six months. The trial, conducted from January 2004 to April 2005, included 207 men between the ages of 60 and 80 years. Participants were randomly assigned to receive 80 mg of testosterone undecenoate or a matching placebo twice daily for six months.

    The researchers found that during the study, lean body mass increased and fat mass decreased in the testosterone group compared with the placebo group but these factors were not accompanied by an increase of functional mobility or muscle strength. Cognitive function and bone mineral density did not change. Insulin sensitivity improved but high-density lipoprotein cholesterol (the “good” cholesterol) decreased. By the end of the study, 47.8 percent in the testosterone group vs. 35.5 percent in the placebo group had the metabolic syndrome (a strong risk factor for cardiovascular disease and type 2 diabetes, a group of several metabolic components in one individual including obesity and dyslipidemia). This difference was not statistically significant.

    Quality-of-life measures did not differ aside from hormone-related quality of life in the testosterone group. Adverse events were not significantly different in the two groups. Testosterone supplementation was associated with an increase in the concentrations of blood creatinine, a measure of kidney function, and hemoglobin and hematocrit, two red blood cell measures. No negative effects on prostate safety were detected (some reports have suggested that testosterone therapy could increase the risk of development or progression of prostate disease or cancer).

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  • In older men with low testosterone levels, testosterone replacement therapy improved risk factors for cardiovascular disease and diabetes. (2008) www.sciencedaily.com
    Hormones Diabetes Cholesterol Testosterone Triglycerides Metabolic Syndrome Weight Loss Cardiovascular

    From the article:

    All 95 men in the studies (ages 34 to 69 years) had the metabolic syndrome. To receive this diagnosis, patients must have three of the following five risk factors: increased waist circumference (abdominal fat), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure, and high blood sugar.

    The first study showed that testosterone treatment significantly reduced waist circumference, total cholesterol, LDL (“bad”) cholesterol, triglycerides, and body mass index (a measure of body fat). Treatment also increased “good” cholesterol. Improvements were progressive over 12 months, indicating that benefits may continue past a year, Saad said.

    In the second study, the researchers divided the patient population into three groups by age: less than 57 years, 57 to 63 years, and more than 63 years. They found that the oldest men had similar improvements in metabolic risk factors to the youngest men.

    Additionally, the investigators looked at the degree of testosterone deficiency before treatment. This beginning level of testosterone deficiency did not predict the beneficial outcome, they found. Men whose subnormal testosterone levels were not as low as the others had similar improvements in metabolic risk factors to men with the lowest levels, according to Saad.

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  • Testosterone therapy following angiography may be linked with increased risk of adverse outcomes. (2013) www.sciencedaily.com
    Hormones Heart Disease Testosterone Cardiovascular

    From the article:

    Rebecca Vigen, M.D., M.S.C.S., of the University of Texas at Southwestern Medical Center, Dallas and colleagues evaluated the association between the use of testosterone therapy and all-cause mortality, myocardial infarction (MI; heart attack), and stroke among male veterans and whether this association was modified by underlying coronary artery disease (CAD). The study included 8,709 men with low testosterone levels (<300 ng/dL) who underwent coronary angiography in the Veterans Affairs (VA) system between 2005 and 2011. There was a high level of co-existing illnesses among this group, including prior history of heart attack, diabetes, or CAD. Of the 8,709 patients, 1,223 (14.0 percent) initiated testosterone therapy after a median (midpoint) of 531 days following angiography. The average follow-up was approximately 2 years, 3.5 months. The primary measured outcome for the study was a composite of all-cause mortality, heart attack, and ischemic stroke.

    The researchers found that the proportion of patients experiencing events 3 years after coronary angiography was 19.9 percent in the no testosterone therapy group (average age, 64 years) and 25.7 percent in the testosterone therapy group (average age, 61 years), for an absolute risk difference of 5.8 percent. Even accounting for other factors that could explain the differences, use of testosterone therapy was associated with adverse outcomes and was consistent among patients with and without CAD. The increased risk of adverse outcomes associated with testosterone therapy use was not related to differences in risk factor control or rates of secondary prevention medication use because patients in both groups had similar blood pressure, low-density lipoprotein levels, and use of secondary prevention medications.

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  • Testosterone may protect against inflammation by reducing phospholipase D activity in immune cells, cell study suggests. (2011) www.sciencedaily.com
    Hormones Inflammation Immune System Testosterone Cardiovascular

    From the publication:

    “In a series of analyses we have shown that cells from men and women react in a different manner to inflammatory stimuli,” Dr. Carlo Pergola from the Institute of Pharmacy of University Jena explains. Thus, certain immune cells of women produced nearly twice as many pro-inflammatory substances than those of men. Together with colleagues from Tübingen (Germany), Stockholm (Sweden) and Naples (Italy) the Jena researchers pursued the molecular basis for these differences and published their findings in their current study. To this aim, they isolated immune cells of male and female donors and analyzed in test tubes the activity of the enzymes responsible for the production of pro-inflammatory substances. They found that in male cells the enzyme phospholipase D is less active than in the female ones. “Interestingly, the activity of the enzyme is reduced after treatment with testosterone also in the female immune cells“, Dr. Pergola defines a crucial result.

    Based on these findings, the Jena pharmacists concluded that the male sex hormones play a key role in the modulation of the immune response. This would also explain another phenomenon that has been previously noticed, that is, testosterone can protect men from arteriosclerosis.

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  • Diabetic men with low testosterone had a sixfold higher risk of increased carotid artery thickness and endothelial dysfunction. (2014) www.sciencedaily.com
    Hormones Diabetes Testosterone Cardiovascular

    From the publication:

    The cross-sectional prospective study published in JCEM examined testosterone levels and key atherosclerotic markers, including intimal media thickening of the layers in the carotid artery, the presence of atherosclerotic plaques, function of the endothelial cells that line the heart and blood vessels, and inflammatory markers in 115 men with Type 2 diabetes. The participants were younger than age 70 and had no history of cardiovascular disease. Researchers measured the levels of testosterone in each participant’s blood. Among the participants, more than half of patients with diabetes were found to have low testosterone levels.

    The study found men who had low testosterone and Type 2 diabetes were six times more likely to have increased thickness of the carotid artery and endothelium dysfunction compared to men with normal serum testosterone levels. A total of 54 percent of the men with low testosterone and 10 percent of the men with normal testosterone were found to be at higher risk for vascular disease.

    “We still need to determine whether testosterone is directly involved in the development of atherosclerosis or if it is merely an indicator of advanced disease,” Farias said.

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  • Testosterone replacement may help mobility limited older men improve and maintain aerobic capacity. (2014) www.sciencedaily.com
    Exercise Aging Hormones Aerobic Cardiovascular Lactate

    From the article:

    To investigate whether testosterone supplementation improves measures of aerobic function ― the peak oxygen uptake and the gas exchange lactate threshold ― Dr. Storer and his colleagues analayzed data from subjects in a larger randomized controlled study of men over age 65 who had low testosterone levels and difficulty performing the usual physical activities of daily living. For 6 months, 28 men in one group received 10 milligrams of testosterone gel and 36 men in a second group received a placebo gel. All subjects completed a cycle exercise test to measure their peak aerobic fitness before and after the 6 month study.

    The men taking testosterone displayed a slight improvement in aerobic fitness while those taking placebo showed a slight decline. This small increase in aerobic capacity in the testosterone group eliminated the expected decrease that men generally experience with natural aging.

    Among the men taking testosterone, the age-related decline in the peak oxygen uptake was 3.4 times less than expected, while the rate of decline among the men taking placebo accelerated to nearly twice the expected rate. The decrease in gas exchange lactate threshold was significantly smaller in the testosterone group than in the placebo group. Longer term studies are needed to evaluate safety and durability of effect.

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  • Men may have a 2.5-fold increased 10-year risk of death if they have low testosterone, regardless of age. (2008) www.sciencedaily.com
    Cancer Hormones Heart Disease Testosterone Mortality Cardiovascular

    From the publication:

    In the study, Haring and co-workers looked at death from any cause in nearly 2,000 men aged 20 to 79 years who were living in northeast Germany and who participated in the Study of Health in Pomerania (SHIP). Follow-up averaged 7 years. At the beginning of the study, 5 percent of these men had low blood testosterone levels, defined as the lower end of the normal range for young adult men. The men with low testosterone were older, more obese, and had a greater prevalence of diabetes and high blood pressure, compared with men who had higher testosterone levels, Haring said.

    Men with low testosterone levels had more than 2.5 times greater risk of dying during the next 10 years compared to men with higher testosterone, the study found. This difference was not explained by age, smoking, alcohol intake, level of physical activity, or increased waist circumference (a risk factor for diabetes and heart disease), Haring said.

    In cause-specific death analyses, low testosterone predicted increased risk of death due to cardiovascular disease and cancer but not death of any other single cause.

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  • Cigarette smoking may negate the protective effect of normalizing testosterone levels on all-cause mortality and myocardial infarction. (2018) doi.org
    Hormones Heart Disease Testosterone Tobacco Cardiovascular

    From the publication:

    Data from 18,055 males with known CS status and low TT levels who received TRT at the Veterans Health Administration between December 1, 1999, and May 31, 2014, were grouped into (1) current smokers with normalized TT, (2) current smokers with nonnormalized TT, (3) nonsmokers with normalized TT, and (4) nonsmokers with nonnormalized TT.

    […]

    Our findings show that maintaining normal levels of testosterone in testosterone-deficient nonsmokers reduces all-cause mortality and MI [myocardial infarction]. Cigarette smoking negates the beneficial effects of testosterone level normalization after TRT on MI and all-cause mortality. Adequately powered randomized clinical trials would be needed for conclusive determination of the effects of CS [cigarette smoking] and TRT [testosterone replacement therapy ] on CV [cardiovascular] risk and mortality. However, conducting such a randomized clinical trial in the United States would be prohibitive because smoking is an established risk factor for CVD. Based on the present study, counseling and treatment for smoking cessation would be an important intervention before and during TRT. Acknowledging the limitations of a retrospective analysis, results presented in the article provide insight and information that may be valuable in clinical practice.

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  • International organizations suggest a cut-off level between 300 -350 ng/dl for testosterone deficiency. (2019)
    Cancer Hormones Heart Disease Testosterone Prostate Stroke Cardiovascular

    From the publication

    The purpose of this paper is to analyze the guidelines for TTh [testosterone therapy] from international organizations and compare their recommendations.

    […]

    All agree that TD [testosterone deficiency] is a clinical syndrome that requires a low testosterone level as well as signs and/or symptoms for a diagnosis to be made. The exact cut -off varies or is not provided, but the organizations suggest a cut -off level between 300 -350 ng/dl. All societies recommend routine laboratory monitoring within the first year and annually after. The guideline committees acknowledge limited data on cardiovascular disease and testosterone. The consensus is to withhold TTh within 3 -6 months of an MI or stroke or in patients with severe heart failure.(2, 4) Prostate cancer is another gray area. Although the consensus is that there is no data to suggest TTh causes prostate cancer.

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  • Patients undergoing testosterone-lowering therapy for prostate cancer had an 88% increased risk of Alzheimer's risk. (2015) www.sciencedaily.com
    Alzheimer's Cancer Hormones Diabetes Testosterone Prostate Cardiovascular

    From the article:

    Using two different methods of statistical analysis, the team showed that the ADT [androgen deprivation therapy] group, compared to the control group, had significantly more Alzheimer’s diagnoses in the years following the initiation of androgen-lowering therapy. By the most sophisticated measure, members of the ADT [androgen deprivation therapy] group were about 88 percent more likely to get Alzheimer’s during the follow-up period.

    The analyses also suggested a “dose-response effect.” The longer individuals underwent ADT the greater their risk of Alzheimer’s disease, they found. The longer-duration ADT patients also had more than double the Alzheimer’s risk of non-ADT controls.

    […]

    How low testosterone would lead to increased Alzheimer’s risk isn’t precisely known, but there is some evidence that testosterone has a general protective effect on brain cells, so that lowering testosterone would leave the brain less able to resist the processes leading to Alzheimer’s dementia. Studies in mice and in humans also have suggested that lower testosterone levels may allow greater production of the Alzheimer’s protein amyloid beta. Moreover, low testosterone may increase Alzheimer’s risk indirectly, by promoting conditions such as diabetes and atherosclerosis that are known to predispose to Alzheimer’s.

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  • Testosterone replacement therapy may decrease cardiovascular risks in men with low testosterone levels. (2014) www.sciencedaily.com
    Hormones Heart Disease Testosterone Cardiovascular

    From the article:

    Researchers at the Intermountain Medical Center Heart Institute in Murray, Utah, which is the flagship facility for the Intermountain Healthcare system, studied 5,695 men between the ages of 53 and 71. The men, all patients at Intermountain Healthcare hospitals, had initial low testosterone levels.

    Researchers found that men who received testosterone supplementation to achieve normal or high testosterone levels had reduced overall rates of major adverse cardiac events at one and three years after their initial low levels of testosterone were measured, compared to other men who had persistently low levels of testosterone. The lower rate of cardiac events included a reduction in the adjusted risk of death and a reduction in heart attacks.

    […]

    Smaller studies have been conducted on testosterone replacement therapy and its cardiovascular effects in men, with different results. While it is known that low levels of testosterone pose an increased cardiovascular risk, the risks versus benefits of supplementation have not been clearly identified.

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  • Testosterone predominance may increase the prevalence of metabolic syndrome during menopause. (2008) www.sciencedaily.com
    Hormones Testosterone Estrogen Metabolic Syndrome Cardiovascular

    From the article:

    “Menopause-related testosterone predominance appears to be implicated as a key hormonal change that is associated with the incidence of metabolic syndrome,” said lead investigator Imke Janssen, PhD, assistant professor, Department of Preventive Medicine at Rush University Medical Center.

    It was previously thought that estrogen exerted a direct positive effect on cardiovascular disease risk in women, a benefit that was lost as women transitioned from a premenopausal to a postmenopausal state and experienced a loss of estrogen.

    “Our study data shows that the change in estrogen level is, at best, a weak and nonsignificant predictor of metabolic syndrome risk,” said Janssen. “A more likely story is that the progressive testosterone predominance exerts a direct negative effect on cardiovascular risk.”

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  • Testosterone therapy may not be associated with adverse cardiovascular events in men with low testosterone. (2015) www.sciencedaily.com
    Hormones Heart Disease Testosterone Cardiovascular

    From the article:

    But this research also underscores the need for a long-term, prospective, randomized trial to truly understand whether testosterone therapy can be used without putting men at greater risk for cardiovascular events such as heart attacks, worsening of heart failure or sudden cardiac death.

    […]

    In the second study, researchers at Aurora Health Care, a large community-based health care system in Wisconsin, analyzed demographic and health data from 7,245 men with low testosterone levels from 2011-2014. After obtaining data from the electronic record systems of 15 hospitals and 150 clinics, the researchers looked at the combined cardiovascular event rate of heart attack, stroke and death in men with low testosterone who received testosterone therapy and in those who did not. They found the event rate at three years was low in both the treated group at 5.5 percent and in the untreated group at 6.7 percent, suggesting a potential cardiovascular benefit of testosterone replacement therapy on initial analysis. However, after adjusting for baseline differences including age, prior heart attack or stroke, cholesterol levels, smoking status and length of follow-up, researchers found no difference in cardiovascular event rates between the two groups.

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  • Testosterone administration to deficient older men did not affect atherosclerosis rates, sexual function, or health-related quality of life. (2015) www.sciencedaily.com
    Aging Hormones Sex Testosterone Prostate Cardiovascular

    From the article:

    Shalender Bhasin, M.B.B.S., of Brigham and Women’s Hospital, Harvard Medical School, Boston, and colleagues randomly assigned 308 men 60 years or older with low or low-normal testosterone levels to receive 7.5 g of 1 percent testosterone (n = 156) or placebo (n = 152) gel packets daily for 3 years. The dose was adjusted to achieve testosterone levels between 500 and 900 ng/dL. Characteristics were similar between groups at study entry: patients were an average age of 68 years; 42 percent had hypertension; 15 percent, diabetes; 15 percent, cardiovascular disease; and 27 percent, obesity.

    The researchers found that the rates of subclinical atherosclerosis progression, as measured by changes in common carotid artery intima-media thickness or coronary artery calcium, did not differ significantly between men assigned to the testosterone or placebo groups. Changes in intima-media thickness or calcium scores were not associated with change in testosterone levels among individuals assigned to receive testosterone.

    Sexual desire, erectile function, overall sexual function scores, partner intimacy, and health-related quality of life did not differ significantly between groups. Hematocrit (a measure of red blood cells) and prostate-specific antigen levels increased more in testosterone group.

    The authors write that this trial was not designed to determine the effects of testosterone on CVD events, and that a substantially larger trial would be needed to determine this.

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  • After 8 years of studying 656 men, none of testosterone-treated men died from cardiovascular events vs 19 without therapy. (2017) www.sciencedaily.com
    Hormones Heart Disease Testosterone Stroke Cardiovascular

    From the article:

    The researchers followed a group of men for eight years who had been on TTh [testosterone therapy] and compared them with another group of men who remained untreated for the same time period. They found there were only two deaths in the TTh group and neither was related to CV events. In the non-treated control group, there were 21 deaths, 19 of which were related to CV events. Furthermore, there were 26 non-fatal myocardial infarctions and 30 non-fatal strokes in the control group but none in the T-treated group.

    According to the researchers, long-term TTh [testosterone therapy] in men with hypogonadism appears to be an effective approach to achieve sustained improvements in cardiometabolic function and reduces the risk of CV events. “The low CV events observed in the T-group compared to the untreated (control) group strongly suggest that TTh is protective. We believe that the protective effect of T on the CV system provides clinicians with the opportunity to utilize this approach for secondary prevention for hypogonadal men with a history of CV events,” explained corresponding author Abdulmaged M. Traish, PhD, professor of biochemistry and urology at BUSM.

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  • Drinking coffee protects against heart disease and premature death. academic.oup.com
    Heart Disease Coffee Cardiovascular

    Drinking two to three cups of coffee a day is linked with a longer lifespan and lower risk of cardiovascular disease compared with avoiding coffee. This was the case for ground, instant and decaffeinated coffee.

    In a study including almost 450,000 adults, drinking 2-3 cups of ground coffee per day was linked to a 27% lower all-cause mortality - in other words dying from all non-accidental causes. 2-3 cups of instant coffee per day was linked to a 11% lower all-cause mortality, and 2-3 cups of decaf coffee per day linked to 14% lower all-cause mortality risk - compared to no daily coffee.

    Drinking 2-3 cups of ground coffee per day was linked to a 20% lower risk of CVD, 2-3 cups of instant coffee per day linked to a 9% lower risk of CVD, 2-3 cups of decaf coffee per day had a 6% lower risk of CVD compared to people that abstain from coffee.

    Caffeine is the most well-known component in coffee, but it contains more than 100 biologically active components - including many polyphenols. The benefits on longevity and lower risks of cardiovascular disease - the number one killer in most developed countries - were found in decaf coffee which does not contain much caffeine.

    But the caffeine had a surprising benefit. Ground and instant coffee, but not decaffeinated, was associated with an up to 17% reduction in arrhythmias including atrial fibrillation compared with non-coffee drinkers.

    While there seems to be mounting evidence that coffee is beneficial - it is important to keep in mind that it shifts the body’s internal clock and if consumed later in the day - may disrupt sleep which could counteract positive benefits.

    These findings suggest that regular consumption of ground coffee reduces the risk of premature death, cardiovascular disease, and arrhythmias, potentially prolonging lifespan. Evidence from other studies suggests that filtered coffee is more protective than unfiltered coffee. Watch Q&A #22 to learn more.

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  • After 3 years of testosterone therapy in 755 high-risk men, 22 with high doses suffered cardiovascular events vs. 125 without therapy. (2016) www.sciencedaily.com
    Hormones Heart Disease Testosterone Stroke Cardiovascular

    From the article:

    “The study shows that using testosterone replacement therapy to increase testosterone to normal levels in androgen-deficient men doesn’t increase their risk of a serious heart attack or stroke,” said cardiologist Brent Muhlestein, MD, co-director of cardiovascular research at the Intermountain Medical Center Heart Institute. “That was the case even in the highest-risk men – those with known pre-existing heart disease.”

    […]

    The research team studied 755 male patients at Intermountain Healthcare hospitals. The men were between the ages of 58 and 78, and all had severe coronary artery disease. They were split into three different groups, which received varied doses of testosterone administered either by injection or gel.

    The conclusions:

    – After one year, 64 patients who weren’t taking testosterone supplements suffered major adverse cardiovascular events, while only 12 who were taking medium doses of testosterone and nine who were taking high doses did.

    – After three years, 125 non-testosterone-therapy patients suffered major adverse cardiovascular events, while only 38 medium-dose and 22 high-dose patients did. “Although this study indicates that hypo-androgenic men with coronary artery disease might actually be protected by testosterone replacement, this is an observational study that doesn’t provide enough evidence to justify changing treatment recommendations,” Dr. Muhlestein said.

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  • Per 200 ng/dL of increased testosterone, bone density increased by 6.1% in deficient older men, but arterial plaque formation was also noted. (2017) www.sciencedaily.com
    Hormones Testosterone Bone Cardiovascular

    From the article:

    Researchers found that testosterone treatment improved bone density and estimated bone strength, as determined by quantitative computed tomography (CT). The treatment also increased hemoglobin concentrations, corrected the anemia of men who had no other identifiable cause of anemia and corrected the anemia of men who had an identifiable cause, such as iron deficiency. While these conclusions proved testosterone to be beneficial to the participants, testosterone treatment did not improve memory or any other measure of cognitive function.

    […]

    In the cardiovascular trial, researchers assessed coronary artery plaque buildup by CT angiography. That assessment showed more plaque buildup in men treated with testosterone than in men treated with placebo. Nonetheless, in all 788 men in the TTrials, the number of major adverse cardiovascular events was similar in the men treated with testosterone as in the men treated with placebo. However, Snyder added, “treating 788 men for one year is far too few to draw conclusions about the clinical significance of the increase in coronary artery plaque volume and the cardiovascular risk of testosterone treatment.”

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  • Testosterone may increase risk of heart attack and stroke by promoting vascular calcification. (2016) www.sciencedaily.com
    Hormones Heart Disease Testosterone Stroke Cardiovascular

    From the article:

    Scientists at the University of Edinburgh examined the effects of testosterone on blood vessel tissue from mice. They found that the hormone triggers cells from the blood vessels to produce bone-like deposits – a process called calcification. When the mouse cells were modified, by removing the testosterone receptor, so they could no longer respond to testosterone, they produced far less of the calcium deposits.

    The team also looked at blood vessel and valve tissue from people with heart disease who had undergone surgery for their condition. They found that cells from these tissues contained bone-like deposits and also carried the testosterone receptor on their surface. This suggests that testosterone may trigger calcification in people.

    Calcification causes blood vessels to harden and thicken, which means the heart has to work harder to pump blood around the body. It is strongly linked to increased risk of heart attack and stroke. Calcification can also affect the heart’s valves, meaning that the valves cannot open and shut properly and may need to be replaced.

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  • Testosterone replacement therapy can increase men's risk of stroke and heart attack by 21% during the first two years of use. (2019) www.sciencedaily.com
    Hormones Heart Disease Testosterone Stroke Cardiovascular

    From the article:

    The study analyzed a large database of electronic medical records of patients enrolled in primary care practices in the United Kingdom and formed a cohort of 15,401 men, aged 45 years or older, with low testosterone levels (hypogonadism). Users of TRT [testosterone replacement therapy] had a 21 percent greater risk of cardiovascular events compared with nonusers, corresponding to an additional 128 events. The increased risk appears to be transient, declining after two years of TRT use, which the investigators attribute to a phenomenon called “depletion of susceptibles.”

    “Our findings show that the use of TRT was associated with an increased risk of stroke, TIAs [transient ischaemic attack], or cardiac arrest during the first two years of use,” noted Christel Renoux

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  • Low testosterone levels may be associated with chronic disease, even in men 40 years of age and younger. (2018) www.sciencedaily.com
    Hormones Diabetes Cholesterol Depression Testosterone Triglycerides Blood Pressure Arthritis Cardiovascular

    From the aricle:

    Peterson and team then examined prevalence of nine chronic conditions, including type 2 diabetes, arthritis, cardiovascular disease, stroke, pulmonary disease, high triglycerides, hypercholesterolemia, hypertension and clinical depression.

    The researchers studied the prevalence of multimorbidity, or when two or more of the chronic conditions were present, among three age groups (young, middle-aged and older men) with and without testosterone deficiency. They found that low total testosterone [<300 ng/dL] was associated with multimorbidity in all age groups – but it was more prevalent among young and older men with testosterone deficiency.

    “We also found a large dose-response relationship between the age-specific low total testosterone and moderate total testosterone levels and multimorbidity, even after adjusting for obesity and muscle strength capacity,” Peterson says. “Which means that men should be concerned about declining total testosterone, even if it has not reached a level to warrant a clinical diagnosis (<300 ng/dL [10.4 nmol/L]).”

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  • Can chronic use of anti-inflammatory agents paradoxically promote chronic inflammation through compensatory host response? pubmed.ncbi.nlm.nih.gov
    Heart Disease Inflammation NSAID Cardiovascular

    NSAIDs may promote a paradoxical pro-inflammatory effect, increasing the risk of blood clots and cardiovascular events.

    Non-steroidal anti-inflammatory drugs, or NSAIDs, are among the most widely used drugs worldwide, available in both prescription and over-the-counter forms, such as aspirin, ibuprofen, naproxen, and others. Despite the drugs' anti-inflammatory effects, their chronic use is associated with a higher risk of acute clot-related cardiovascular events, such as heart attack, stroke, or deep-vein thrombosis. Authors of a 2005 article posited that NSAIDs induce a rebound effect that promotes inflammation, driving the formation of blood clots and predisposing a person to acute cardiovascular events.

    Inflammation is a protective response that involves immune cells, cell-signaling proteins, and pro-inflammatory factors. Acute inflammation occurs after minor injuries or infections and is characterized by local redness, swelling, or fever. Chronic inflammation occurs on the cellular level in response to toxins or other stressors and is often “invisible.” It plays a key role in the development of many chronic diseases, including cancer, cardiovascular disease, and diabetes. Inflammation initiates the clotting process and impairs the activity of natural anti-clotting mechanisms.

    Most NSAIDs, with the exception of aspirin, dampen inflammation via the inhibition of cyclooxygenases, a family of pro-inflammatory enzymes. However, evidence from animal studies suggests that when these enzymes are inhibited, the body responds by producing more of the enzymes. The authors posited that by turning off the body’s natural inflammatory processes, NSAIDs might drive a compensatory response – ramping up the activity of pro-inflammatory pathways.

    Lifestyle behaviors may reduce inflammation and the need for NSAIDs. For example, sauna use reduces levels of pro-inflammatory C-reactive protein and increases levels of anti-inflammatory protein interleukin (IL)-10. Similarly, cold exposure decreased the pro-inflammatory protein IL-2 and the inflammatory E2 series of prostaglandins while increasing the anti-inflammatory protein IL-10. Other lifestyle behaviors that may reduce inflammation include exercise, meditation, and dietary intake of polyphenols.

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  • Dysregulated tryptophan metabolism contributes to abdominal aortic aneurysm formation in mice. (2017) www.eurekalert.org
    Metabolism Cardiovascular Aneurysm

    From the article:

    “Our data found a previously undescribed causative role for 3-hydroxyanthranilic acid (3-HAA), a product of tryptophan metabolism, in abdominal aortic aneurysm formation,” said Dr. Ming-Hui Zou, director of the Center for Molecular and Translational Medicine at Georgia State and a Georgia Research Alliance Eminent Scholar in Molecular Medicine. “We believe agents that alter tryptophan metabolism may have therapeutic potential for preventing or treating abdominal aortic aneurysm. Our findings suggest that reducing 3-HAA may be a new target for treating cardiovascular diseases.”

    The kynurenine pathway is the major route for the metabolism of tryptophan, and other studies have found this pathway plays a key role in the increased prevalence of cardiovascular disease. The researchers sought to identify the role of the kynurenine pathway and its products in angiotensin II (AngII)-induced abdominal aortic aneurysm. AngII is a hormone that increases blood pressure by constricting the blood vessels and is the principal mediator for the development and progression of abdominal aortic aneurysm.

    The researchers generated mice with genetic deficiencies by crossbreeding, and then infused the mice with AngII.

    The study is the first to show that genetic deletion of indoleamine 2,3-dioxygenase (IDO) or the decrease in the gene expression of kynureninase (KNU) in the body restrained AngII-induced abdominal aortic aneurysm in mice deficient in apolipoprotein e.

    In addition, the researchers made the discovery that 3-HAA was responsible for AngII-induced abdominal aortic aneurysm in the body.

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  • Combined exercise and sauna bathing drastically improves cardiovascular fitness. journals.physiology.org
    Exercise Sauna Cardiovascular

    Physical activity is perhaps the most important lifestyle factor in the promotion of heart health because of the beneficial stress it puts on the heart. Sauna bathing puts similar stress on the heart by increasing cardiac output in an effort to cool the body, making it a good choice for people unable to meet exercise guidelines; however, people who combine activities may experience unique benefits. Findings from a report released this month demonstrate the robust beneficial effects of combined physical activity and sauna bathing on cardiovascular fitness and metabolic health.

    Both sauna use and exercise increase pulse and blood pressure, activating a negative feedback loop that lowers blood pressure after the activity is over and for an extended period afterward. Adaptations to the metabolic and mechanical stress of exercise include an increase in heart size and mitochondrial density associated with better cardiovascular output, increased elasticity of blood vessels, and a reduction in white blood cells and inflammation. Previous research shows that sauna bathing provides some of the same benefits; however, because sauna use has just recently moved into the mainstream of clinical research, less is known about its mechanisms of action and effects when combined with exercise.

    The authors recruited 47 participants (average age, 49 years) who did not exercise regularly and were at high risk of cardiovascular disease and randomly assigned them to complete eight weeks of exercise training with or without sauna or no exercise training at all. Participants in the exercise groups completed three days of exercise per week that included a 10-minute warm-up, 20 minutes of weight training, and 30 minutes of aerobic exercise. Participants in the sauna group followed their exercise training with 15 minutes of sauna bathing at 150 degrees Fahrenheit. The temperature of the sauna was increased by 40 degrees Fahrenheit every two weeks as participants acclimated to the heat stress. The participants completed a cardiorespiratory fitness test at the beginning and end of the study during which they peddled an exercise bike at increasing resistance levels to increase heart rate. They also provided blood samples and had their body composition measured.

    Eight weeks of exercise training increased maximal heart rate (measured by VO2max or maximal oxygen intake) and reduced fat mass; however, participants did not experience a significant reduction in blood pressure, arterial stiffness, or total cholesterol compared to the participants who did not exercise. Participants who completed sauna bathing in addition to exercise experienced an even greater increase in maximum heart rate and lower systolic blood pressure (reduction of 8 mmHg in systolic blood pressure and 3 mmHg in diastolic blood pressure) and total cholesterol (12 milligrams per deciliter reduction). Participants in the exercise without sauna group experienced no reduction in systolic blood pressure and only a minor reduction in diastolic blood pressure (0.6 mmHG).

    The findings of this study demonstrate the unique benefits of sauna use in addition to exercise. Future studies with a greater number of participants and more diverse sauna bathing conditions would be valuable additions to this research.

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  • A high-protein diet resulted in 100 percent remission of prediabetes in a small randomized-controlled trial. journals.physiology.org
    Exercise Heart Disease Sauna Blood Pressure Cardiovascular

    Type 2 diabetes is characterized by insulin resistance and chronically elevated blood sugar levels. Weight loss is often part of the primary treatment of type 2 diabetes; however, some weight loss diets may have more insulin-sensitizing effects than others. Findings of one report show that a high protein weight loss diet can reverse prediabetes by increasing insulin-sensitizing hormones.

    Digestion of carbohydrates begins when sweetness receptors in the mouth are activated, leading to the release of insulin and hormones that augment insulin metabolism, such as incretins. In type 2 diabetes, incretins such as glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic peptide (GIP) are reduced, contributing to insulin resistance and increasing abdominal obesity. Pharmaceutical treatments for type 2 diabetes include GLP-1 activators, which can be effective at reducing blood sugar levels and increasing feelings of satiety after eating. High protein diets (30 percent of calories) have also been shown to enhance incretin signaling, making them an important strategy for treating prediabetes.

    The authors recruited 24 participants who had obesity and prediabetes and randomly assigned them to either a high-carb diet (55 percent carbohydrate, 30 percent fat, 15 percent protein) or a high-protein diet (30 percent protein, 30 percent fat, 40 percent carbohydrate) for six months. The diets were designed to produce a 500 calorie per day deficit so that participants would lose weight. Participants completed an oral glucose tolerance test, during which they consumed 75 grams of glucose (equivalent to the amount of sugar in two 12 ounce cans of soda). The researchers measured blood glucose, insulin, GLP-1, and GIP levels during the test.

    After six months, 100 percent of participants consuming the high-protein diet had remission of their prediabetes, while only 30 percent of participants consuming the high-carb diet experienced remission. Participants in both groups experienced weight loss (about 10 percent of their body weight) and improved insulin sensitivity; however, the participants consuming the high-protein diet had higher levels of GLP-1 and GIP and larger reductions in insulin resistance. Importantly, participants consuming the high-protein diet had increased lean muscle mass, while participants in the high-carb protein lost muscle mass.

    These results demonstrate that high protein diets may be an effective strategy for improving insulin sensitivity and reducing type 2 diabetes risk. Learn more about high-protein diets and how to implement them in our new interview with Dr. Stuart Phillips.

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  • Association Between Dietary Fiber Intake and All-Cause and Cardiovascular Mortality in Middle Aged and Elderly Adults With Chronic Kidney Disease www.ncbi.nlm.nih.gov
    Aging Fiber Cardiovascular

    High dietary fiber intake reduces the risk of premature death among people with chronic kidney disease.

    Chronic kidney disease, an umbrella term for a variety of conditions that impair kidney function, affects as many as 700 million people worldwide. The primary causes of chronic kidney disease are diabetes and hypertension32977-0/fulltext). Findings from a recent study suggest that high dietary fiber intake reduces the risk of premature death among people with chronic kidney disease.

    Dietary fiber refers to the indigestible components of plant-based foods. A growing body of evidence indicates that eating a fiber-rich diet decreases the risks of many chronic diseases, such as coronary heart disease, stroke, hypertension, diabetes, and some types of cancer, including breast cancer and colon cancer. Public health recommendations for fiber intake vary based on a person’s age and sex. For example, adult females need between 22 and 28 grams of fiber per day, and adult males need between 28 and 34 grams per day. Most people living in the United States only get about half of the recommended amounts of fiber daily.

    The study involved nearly 3,900 adults (average age, 63 years) who had chronic kidney disease and were enrolled in the Korean Genome and Epidemiology Study. The investigators collected information regarding the participants' diets (including fiber intake), lifestyle habits (such as smoking or exercising), alcohol intake, and overall health. They tracked the participants for about ten years and noted whether the participants died and, if so, their cause of death.

    During the ten-year period, 602 of the participants died; of these, 149 died from cardiovascular diseases. The participants' average daily fiber intake was approximately 5 grams per day. The participants who consumed the most fiber were 37 percent less likely to die from all causes of premature death than those who consumed the least, even when considering age, sex, body mass index, smoking, exercise, hypertension, diabetes, and abnormal blood lipids. When the investigators looked at specific causes of death, they found that participants who consumed the most fiber were 44 percent less likely to die from cardiovascular diseases than those who consumed the least.

    These findings suggest that dietary fiber markedly reduces the risk of premature death in people with chronic kidney disease. Interestingly, people with chronic kidney disease are often advised to reduce their intake of fiber-rich vegetables, fruits, nuts, legumes, and whole grains because these foods also contain phosphates and potassium, which carry risks in the setting of poor kidney function. However, dietary counseling regarding which foods to avoid can offset some of these risks and encourage healthy consumption of dietary fiber.

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  • Doses of omega‐3 fatty acid intake above the recommended 3 grams per day may be associated with additional benefits in lowering blood pressure www.ahajournals.org
    Heart Disease Omega-3 Blood Pressure Cardiovascular

    Higher omega-3 fatty acid intake may be necessary to reduce blood pressure.

    Nearly two-thirds of adults living in the United States have high blood pressure, defined as having a systolic pressure of 130 mmHg or higher or a diastolic pressure of 80 mmHg or higher. High blood pressure increases a person’s risk for heart disease and stroke and contributes to small vessel disease, a major risk factor for cardiovascular disease, dementia, and stroke. Although some evidence suggests that omega-3s reduce blood pressure, researchers have not identified the optimal dose necessary to achieve this effect. Findings of a recent meta-analysis suggests that 3 grams of omega-3 fatty acids daily reduce blood pressure.

    Observational data suggest that omega-3 fatty acids, especially fish-derived eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are cardioprotective. For example, a prospective study involving more than 20,000 healthy males found that those who ate one to two servings of fish twice a week had a lower risk of sudden cardiac death than those who ate fish less than once a month, likely due to the omega-3s found in fish. But the findings from the five decades of study have been remarkably inconsistent, with some studies showing benefits, and others not. Some of these inconsistencies have arisen from differences in study designs, which vary markedly in terms of study population, dose, and duration.

    The authors of the analysis searched the scientific literature for randomized controlled trials investigating associations between omega-3 fatty acids and blood pressure. Then they filtered their findings based on a set of criteria designed to identify high-quality studies. Finally, they combined data from these high-quality studies and reanalyzed them so they could interpret the results on a large scale.

    They identified 71 trials, involving nearly 5,000 participants. On average, those who consumed 2 to 3 grams of combined EPA and DHA daily experienced reductions in blood pressure of approximately 2 mm Hg (and as much as 3.5 mm Hg). Participants who had high blood pressure and consumed more than 3 grams of EPA and DHA daily experienced reductions of 4.5 mm Hg for those with hypertension, compared to about 2 mm Hg for those without. Higher doses (5 grams daily) of omega-3s did not confer any additional benefit, with blood pressure decreasing by approximately 4 mm Hg for those with hypertension and less than 1 mm Hg for those without.

    These findings suggest that 3 grams of combined EPA and DHA daily is the optimal dose of omega-3 fatty acids necessary to achieve reductions in blood pressure. Learn more about the heart-health benefits of omega-3s in this episode featuring Dr. Bill Harris.

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  • Four pathologies of SVD associate with dementia: white matter hyperintensities, cerebral microbleeds, lacunar infarcts, enlarged perivascular spaces www.sciencedaily.com
    Brain Dementia Cardiovascular Blood-Brain Barrier Small Vessel Disease

    The four pathologies that were detectable by MRI included:

    From the article:

    The subjects were given cognitive tests and brain MRIs. The MRIs were examined for four main components of small vessel disease (SVD). These four components, which include evidence of microbleeds and minor strokes, then were added to create a total SVD score. The score ranges from zero points (no SVD) to 4 points (severe SVD).

    The study found that that 61 percent of the subjects had zero points on the total SVD score, 20 percent had 1 point, 12 percent had 2 points, 5 percent had 3 points and 2 percent had 4 points. The higher the SVD score, the greater the cognitive decline. Researchers also found that each individual component of SVD predicted cognitive decline as well as the total SVD score did.

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  • Small-vessel disease could provoke amyloid pathology while Alzheimer's-associated cerebral amyloid pathology may lead to auxiliary vascular damage www.sciencedaily.com
    Brain Alzheimer's Cardiovascular Blood-Brain Barrier Small Vessel Disease

    Cerebral small vessel disease is associated with amyloid-beta deposition in the brain, especially among APOE4 carriers.

    Small vessel disease is a collection of conditions characterized by damage to arterioles and capillaries, resulting in reduced or interrupted blood flow to the affected organ. These conditions typically affect organs that receive substantial blood flow, such as the brain, kidney, and retina, and are principal drivers of chronic diseases such as strokes, renal failure, dementia, and blindness. Findings from a 2014 study suggest that people who have small vessel disease in the brain exhibit greater deposition of amyloid-beta plaques, especially if they are carriers of the APOE4 gene.

    Amyloid-beta is a toxic 42-amino acid peptide that aggregates and forms plaques in the brain with age. Amyloid-beta deposition is associated with Alzheimer’s disease, a progressive neurodegenerative disease that can occur in middle or old age and is the most common cause of dementia.

    APOE is a protein involved in lipid transport. A variant in the APOE gene, called apolipoprotein E4 (APOE4), is the major genetic risk factor for Alzheimer’s disease. Having one APOE4 allele increases a person’s Alzheimer’s disease risk as much as threefold; carrying two APOE4 alleles increases risk as much as 15-fold.

    The cross-sectional study included more than 900 patients enrolled in the Amsterdam Dementia Cohort study who had been diagnosed as having Alzheimer’s disease, vascular dementia, or self-reported memory complaints. The investigators analyzed the patients' cerebrospinal fluid for the presence of amyloid-beta and other markers of Alzheimer’s disease and genotyped the patients to assess APOE status.

    They also performed magnetic resonance imaging (MRI) of the patients' brains to identify the presence of white matter hyperintensities and microbleeds. White matter hyperintensities, areas in the brain that appear as intense white spots on MRIs, are often indicators of cerebral small vessel disease and are considered a risk factor for dementia. Microbleeds are small, chronic hemorrhages that are indicative of cerebral amyloid angiopathy, a condition in which amyloid-beta accumulates on the walls of brain arteries.

    They found that patients with Alzheimer’s disease had lower levels of amyloid-beta in their cerebrospinal fluid, an effect that was more pronounced among APOE4 carriers. Patients with low amyloid-beta levels in their cerebrospinal fluid were more likely to have white matter hyperintensities and microbleeds, indicating a direct relationship between a pathological hallmark of Alzheimer’s disease and small vessel disease.

    These findings suggest that Alzheimer’s disease and small vessel disease are intrinsically linked, especially among APOE4 carriers. [Learn more about small vessel disease in our overview article.](Coming soon)

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  • Cereal fiber is associated with a lower risk of cardiovascular disease. www.sciencedaily.com
    Fiber Cardiovascular IL-6

    Fiber from cereal grains reduces cardiovascular disease risk.

    Cardiovascular disease is the second leading cause of death worldwide. However, much of the risk associated with cardiovascular disease is modifiable via lifestyle, such as exercising, eating a healthy diet, and not smoking. Findings from a recent study suggest that eating foods rich in dietary fiber, especially the fiber present in cereal grains, reduces the risk of cardiovascular disease.

    Dietary fiber is a broad term that refers to the non-digestible components of plant-based foods. It is generally characterized by its solubility in water, viscosity (i.e., ability to form thick gels), and fermentability. Cereal grains contain a mixture of insoluble fibers that bulk stool, viscous fibers that slow digestion, and fermentable fibers that feed the gut microbiota. Gut microbes break down cereal fiber, releasing micronutrients trapped in the fiber matrix and producing beneficial metabolic byproducts, such as short-chain fatty acids. Compared to fruit and vegetable fibers, cereal grain fibers tend to reduce the glycemic effect of meals and improve blood lipids, while supporting a healthy and diverse microbiota.

    The investigation involved more than 4,100 participants (aged 65 years and older) enrolled in the Cardiovascular Health Study. Participants provided detailed information about their demographics, dietary intake, and medical history, including cardiovascular events. Because evidence indicates that cereal fibers reduce markers of inflammation, including C-reactive protein, the investigators measured various inflammatory markers, including CRP, IL-6, CD14, CD163, IL-2 receptor α, IL-1RA, IL-18, and TNF receptor 1, in the participants' blood.

    The investigators found that higher cereal grain fiber intake markedly reduced cardiovascular disease risk and lowered the inflammatory markers CRP, IL-6, and IL-1RA. However, statistical analysis revealed that this decrease in inflammation had a modest effect on reducing cardiovascular risk, mediating just one-sixth of the association between cardiovascular disease and cereal grain fiber intake.

    These findings suggest that eating foods rich in cereal grain fibers reduces the risk of cardiovascular disease and lowers inflammation. Additional studies are needed to tease out all the mechanisms that drive the protective effects of cereal fiber on cardiovascular health.

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  • Silencing TLR4 gene can stop process leading to cardiovascular disease in diabetics (animal study) www.sciencedaily.com
    Diabetes Immune System Blood Sugar Toll-Like Receptors Cardiovascular

    TLR4 plays a role in death of heart cells from high blood sugar.

    From the article:

    Researchers writing in BioMed Central’s open access Journal of Translational Medicine carried out a series of in vitro tests which demonstrated that TLR4 plays a critical role in hyperglycaemic cardiac apoptosis, and that silencing the gene using specific small interfering RNA (siRNA) can prevent it.

    […]

    They found that after 7 days of hyperglycemia, the level of TLR4 mRNA in myocardial tissue was significantly elevated, and signs of apoptosis were evident. Silencing TLR4 resulted in suppression of apoptotic cascades. According to Min, “This is the first demonstration of the prevention of cardiac apoptosis in diabetic mice through silencing of the TLR4 gene.”

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  • Serious mental illness increases cardiovascular disease risk. www.sciencedaily.com
    Heart Disease Mental Health Cardiovascular

    Serious neuropsychiatric disorders increase the risk of dying from cardiovascular disease.

    People who have serious neuropsychiatric disorders, such as bipolar disorder, schizophrenia, or schizoaffective disorder, are more likely to die of premature causes than their peers, often as much as 10 to 20 years earlier. Findings presented in a recent report suggest that people with serious neuropsychiatric disorders have an increased risk of dying from cardiovascular disease.

    Cardiovascular disease is a large class of diseases that involve the heart or blood vessels, including stroke, hypertension, thrombosis, heart failure, atherosclerosis, and others. A principal driver of cardiovascular disease is inflammation. Interestingly, robust evidence indicates that inflammation and neuropsychiatric disorders are also linked, and the two demonstrate a bidirectional relationship. For example, people who have depression tend to have high levels of systemic inflammation, and depression induces chronic activation of the immune system, driving inflammation.

    The authors of the report analyzed the medical records of nearly 600,000 people between the ages of 18 and 75 years. They calculated the participants' 10-year and 30-year cardiovascular disease risk using the atherosclerotic cardiovascular disease risk score for adults aged 40 to 75 years and the Framingham risk score for adults aged 18 to 59 years, respectively. They also identified participants who had been diagnosed with a serious neuropsychiatric disorder and collected participants' demographic data.

    They found that both the 10‐year and 30-year cardiovascular risk among participants with serious neuropsychiatric disorders was higher than among participants without, even after taking age, sex, race, and ethnicity into account. The primary contributors to the increased risk were higher body mass index and smoking. Participants with bipolar disorder were more likely to have higher 10-year risk; those with schizoaffective disorder were more likely to have higher 30-year risk.

    These findings suggest that having a serious neuropsychiatric disorder increases the risk of cardiovascular disease, and this risk is evident in early adulthood. Check out our overview articles to learn how lifestyle habits that reduce inflammation, such as aerobic exercise, sauna use, and cold exposure, may reduce cardiovascular disease risk and improve mental health status.

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  • Drinking tea may reduce the risk of cardiovascular disease and premature death. journals.sagepub.com
    Green Tea Cardiovascular

    Cardiovascular disease is the number one killer worldwide, claiming the lives of nearly 18 million people each year. Health experts estimate that more than 75 percent of all cardiovascular diseases are preventable through healthy lifestyle habits. Findings from a 2020 study suggest that drinking tea is a healthy lifestyle habit that reduces the risk of cardiovascular-related disease and death and all causes of premature death.

    Teas – black, green, or white – are among the most popular beverages in the world. Their consumption is linked to a wide range of health benefits, including lower blood pressure, improved blood sugar regulation, and greater weight loss in people with obesity.

    The researchers drew on data collected during the China-PAR project, an ongoing study of cardiovascular and metabolic disease risk among three cohorts of adults living in China. They used data from more than 100,000 participants to investigate links between tea consumption and cardiovascular-related disease and death, as well as all causes of premature death. Their analysis accounted for a wide range of demographic and lifestyle habits, including age, sex, family history, education, smoking, and dietary patterns, among others.

    They found that roughly one-third of the participants were regular tea drinkers, consuming three or more tea drinks per week. Regular tea drinkers were 22 percent less likely to die from cardiovascular disease and 15 percent less likely to die from all causes of premature death. Drinking tea also appeared to extend healthspan – the number of years lived disease-free. Regular tea drinkers lived 1.41 years longer free of cardiovascular disease and had 1.26 years longer life expectancy at the index age of 50 years compared to non-drinkers.

    These findings suggest that regular tea consumption reduces the risk of cardiovascular-related disease and death and all causes of premature death. Tea drinking may also extend the number of years a person lives disease-free.

    Teas are rich in polyphenols – a broad class of bioactive plant-based compounds that confer beneficial properties to humans. Learn more about polyphenols in our overview article.

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  • Breastfeeding reduces maternal risk of cardiovascular disease later in life. medicalxpress.com
    Heart Disease Cardiovascular

    Major health organizations recommend that infants breastfeed for the first two years of life; however, breastfeeding rates for children at 12 months of age are below 20 percent in most industrialized countries. Much of the public health messaging surrounding the benefits of breastfeeding have focused on improved health outcomes for infants. Findings of a new report show that mothers benefit from breastfeeding as well by experiencing reduced cardiovascular disease risk later in life.

    Breastfeeding produces many physiological and psychological effects for the mother, many of which are facilitated by the release of hormones such as oxytocin. Previous research has demonstrated that oxytocin has beneficial effects on the cardiovascular system, including lowering blood pressure, improving glucose tolerance, increasing antioxidant capacity, resolving inflammation, and reducing body fat stores. However, additional large-scale studies are needed to better understand how breastfeeding affects mothers long-term.

    The authors conducted a systematic review and meta-analysis. First, they searched the scientific literature for studies observing the effects of breastfeeding duration on one or more markers of cardiovascular disease risk. Next, they filtered their results based on a set of criteria designed to identify studies of high quality. Finally, they combined data from these high-quality studies and reanalyzed it so they could interpret the results on a large scale.

    The systematic review yielded eight relevant studies that included over one million mothers (average age, 51 years). Mothers who breastfed for any length of time had an 11 percent lower cardiovascular disease risk, 14 percent lower coronary heart disease risk, 12 percent lower stroke risk, and 17 percent lower risk of cardiac death compared to mothers who never breastfed. These results were dose-dependent, meaning that the reduction in disease risk increased as the length of breastfeeding increased, but only up to 12 months. Additional long-term data are needed to determine if breastfeeding longer than 12 months provides additional cardiovascular disease risk-lowering benefits.

    The results of this large-scale meta-analyses provide evidence that breastfeeding reduces risk for multiple cardiovascular diseases in a dose-dependent way, although additional data are needed to understand the cardiovascular benefits of breastfeeding beyond 12 months.

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  • Aspirin no longer recommended to reduce cardiovascular event risk in older adults without cardiovascular disease. www.smithsonianmag.com
    Heart Disease Cardiovascular

    Aspirin is the most commonly prescribed drug in the world for both primary and secondary prevention of cardiovascular events such as heart attacks and strokes. Although generally considered safe, taking aspirin carries some risks, including increased bleeding and kidney failure.. A recently released draft guideline from the United States Preventive Services Task Force recommends against prescribing aspirin to reduce cardiovascular event risk in older adults without cardiovascular disease.

    The mechanism of action by which aspirin helps prevent cardiovascular events is via its inhibition of the activity of enzymes involved in the production of thromboxane, a substance made by platelets that causes platelet aggregation – an important stage in the atherogenic process – as well as blood clotting and blood vessel constriction. Due to its anti-aggregation properties, aspirin is commonly referred to as a “blood thinner.”

    The task force analyzed data from 13 randomized clinical trials that reported on the benefits of aspirin use for the primary prevention of cardiovascular disease and death. The trials included more than 161,000 participants (age range, 53 to 74 years), with aspirin doses of 100 milligrams or less per day or every other day.

    They concluded that aspirin therapy should be based on individual risk. An important tool for use in determining risk is the American College of Cardiology/American Heart Association (ACC/AHA) 10-year cardiovascular disease risk calculator. The validated calculator considers age, cholesterol levels, systolic blood pressure level, blood pressure treatment, diabetes status, and smoking status to determine risk. It is important to note that age and race exert strong influence over the calculator’s output.

    The task force recommended that initiation of low-dose aspirin for the primary prevention of cardiovascular events in people who are between the ages of 40 and 59 years and whose 10-year cardiovascular event risk is greater than 10 percent should be on a case-by-case basis. They came to this conclusion because current scientific evidence indicates that the net benefit of aspirin use in this group is limited. The task force recommended against initiation of low-dose aspirin for the primary prevention of cardiovascular disease in people who are 60 years or older. People who are currently taking aspirin or have cardiovascular event risk factors should speak with their physician before changing their medication regimen.

    Interestingly, omega-3 fatty acids exert anti-clotting effects similar to those of aspirin. Learn more about the health effects of omega-3 fatty acids in this episode featuring Dr. Bill Harris, available on Apple Podcasts and Spotify.

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  • Exposure to phthalates increases risk of death from cardiovascular disease. nyulangone.org
    Hormones Cardiovascular

    Phthalates, sometimes referred to as “everywhere compounds,” are ubiquitous environmental toxicants used in industrial, chemical, and commercial applications. Exposure to phthalates is associated with increased risk of adverse health effects, including a wide range of chronic disorders, such as cardiovascular disease, diabetes, hypertension, melanoma, and non-Hodgkin’s lymphoma. Findings from a recent review suggest that phthalate exposure increases the risk of dying from cardiovascular disease.

    The many risks associated with phthalate exposure may be due to the compounds' effects as endocrine disruptors, which can mimic or impair the activity of the body’s natural hormones. Exposure to endocrine disruptors, even in small quantities, can have adverse effects on human development and physiology.

    The authors of the review drew on data collected from more than 5,000 adult participants (aged 20 years and older) in the National Health and Nutrition Examination Survey. They measured byproducts of phthalate metabolism in the participants' urine and tracked participants' death rates.

    They found that participants who had the highest concentrations of high-molecular weight phthalate metabolites, especially di-2-ethylhexylphthalate, were nearly 50 percent more likely to die from all causes of premature death compared to those with the lowest concentrations. Those who had high urinary concentrations of another phthalate metabolite, mono-(2-ethyl-5-oxohexyl) phthalate, were 74 percent more likely to die from cardiovascular disease, compared to those with the lowest concentrations. The authors estimated that these compounds contribute to as many as 107,000 deaths per year and cost as much as $47.1 billion in lost productivity.

    These findings suggest that phthalates increase the risk of premature death from all causes and cardiovascular diseases. Evidence indicates that the increased sweating that occurs during sauna use may help rid the body of phthalates. Learn more about the health effects of sauna use in this comprehensive open access review written by Dr. Rhonda Patrick.

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  • Omega-3s reduce risk of death from cardiovascular disease. pubmed.ncbi.nlm.nih.gov
    Heart Disease Omega-3 Cardiovascular

    The American Heart Association recommends that adults consume at least eight ounces of fish and shellfish each week, especially those that are rich in omega-3 fatty acids. Previous research supports the benefits of omega-3 consumption in preventing coronary heart disease and sudden cardiac death; however, additional research is needed to support the benefits of omega-3s for other cardiovascular disorders. Investigators reviewed the molecular, clinical, and epidemiological evidence for the effects of omega-3s on cardiovascular disease.

    Omega-3 fatty acids cannot be produced by the body and must be consumed in the diet. Major food sources of omega-3s include fatty fish, which are rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Plant sources of omega-3s include flax seeds, chia seeds, and walnuts, but the predominant omega-3 fat in these foods is alpha-linolenic acid, which must be converted to EPA before it can be used by the body. Omega-3s and their metabolites improve cardiovascular health through altering the composition of cell membranes and regulating gene expression, among other functions.

    The authors searched the literature for randomized controlled trials, in which researchers randomly assign participants to an intervention or a comparable control treatment, and observational studies, which observe a group of participants at a single time point. Randomized controlled trials are suitable for identifying cause-and-effect relationships, but because observational studies measure associations between behavior and health, they are not. Review papers aggregate data from previous research and compare results, a process that can be difficult because dose, sample size, and participant characteristics vary among studies.

    The analysis revealed that the dose of omega-3s utilized in the randomized controlled trials ranged from 376 milligrams to 1,800 milligrams. Some of these trials instructed participants to consume the recommended two servings of fish per week. Data from these trials showed that omega-3 consumption decreased cardiovascular disease, with risk reductions ranging from two to 32 percent among trials; however, some trials did not find a benefit of omega-3 consumption for reducing the risk of death from cardiovascular disease. In observational studies, the benefits of omega-3 consumption were strongest for coronary heart disease and sudden cardiac death, confirming previous reports. Evidence from the randomized controlled trials and observational studies was inadequate to support assertions that consumption of omega-3 fatty acids reduce the risk of heart attack, stroke, atrial fibrillation, arrhythmias, and heart failure.

    Current data support the consumption of omega-3s for reduced risk of death from cardiovascular disease. The authors concluded that future research should explore the effects of dose, source (i.e., seafood or supplements; plant or animal), and other molecular, physiological, and clinical effects.

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  • Blueberry anthocyanins improve cardiovascular health. academic.oup.com
    Diet Heart Disease Cardiovascular

    Aging induces a number of disease-related changes to the cardiovascular system, including dysfunction of the endothelial cells that line blood vessels. Eating fruits and vegetables, which are rich in a variety of beneficial bioactive compounds, may slow cardiovascular aging. Investigators tested the effects of anthocyanin compounds from blueberries on flow-mediated dilation.

    Flow-mediated dilation refers to the capacity of an artery to expand in response to increased blood flow. It is a widely accepted measure of vascular endothelial function, and poor flow-mediated dilation is a recognized feature of cardiovascular disease. Previous research has demonstrated a relationship between higher blueberry and strawberry intake and decreased risk of heart attack. Blueberries contain a number of bioactive compounds, including anthocyanins, procyanidins, flavonols, phenolic acids, and other phenolic compounds. The body subjects these compounds to a wide range of chemical processes, yielding bioactive metabolites. How these bioactive compounds differ in their effects on cardiovascular health is unclear.

    The authors analyzed data from four studies involving a total of 60 participants and conducted a follow-up experiment in mice. In the first study, participants received one of five treatments on five separate days: a control beverage that mimicked blueberry juice; the control beverage with fiber added; the control beverage with added minerals and vitamins; pure anthocyanins; and a beverage made with freeze-dried blueberries. The investigators measured flow-mediated dilation at baseline and one, two, and six hours after participants ingested the beverages. In the second study, participants consumed capsules containing one of six concentrations of anthocyanins (0, 80, 160, 240, 320, or 480 milligrams) on six separate days. The investigators measured flow-mediated dilation at baseline and two and six hours after ingestion.

    The third study measured the effects of long-term blueberry consumption. Participants consumed 11 grams of wild blueberry powder (equivalent to about four ounces of fresh blueberries) dissolved in water twice daily for 28 days. The investigators measured flow-mediated dilation at baseline and at seven, 14, 21, and 28 days of consumption. In the fourth study, participants consumed a drink containing 11 grams of wild blueberry powder or a control beverage twice daily for at least 28 days. The investigators measured flow-mediated dilation at baseline and two hours after ingestion on the first day of the intervention and after at least 28 days of consumption. For the follow-up experiment, investigators gave mice an injection of bioactive metabolites that they had identified from the previous human experiments and measured the effects on flow-mediated dilation.

    Isolated anthocyanins improved endothelial function as measured by flow-mediated dilation in a dose-dependent manner, meaning that the effects were more robust as dose increased. The effects of these isolated anthocyanins were similar to those of wild blueberries. However, control beverages containing fiber, minerals, or vitamins and minerals had no significant effect on flow-mediated dilation. Twice daily wild blueberry consumption for one month also increased long-term flow-mediated dilation. Finally, injection of metabolites derived from the phenolic compounds found in blueberries improved flow-mediated dilation in mice.

    These results demonstrate the beneficial effects of blueberries on cardiovascular health and elucidates the function of anthocyanin compounds as major mediators of vascular function in mice and humans.

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  • Omega-3 fatty acids may reduce risk of death from cardiovascular disease. www.nature.com
    Omega-3 Mortality Cardiovascular

    Cardiovascular disease is an umbrella term that encompasses coronary artery disease, heart attack, stroke, hypertension, and other conditions. Together, they are the primary cause of death worldwide, claiming the lives of nearly 18 million people every year. Findings from a recent meta-analysis suggest that omega-3 fatty acids reduce the risk of developing cardiovascular disease.

    Omega-3 fatty acids are essential nutrients that play critical roles in cardiovascular function, due to their participation in pathways involved in blood clotting, inflammation, and the contraction and relaxation of arteries. Omega-3s with the greatest relevance for humans include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is found mainly in plant oils such as flaxseed, soybean, and canola oils. EPA and DHA are found in the meat and oils of fatty cold-water fishes and seafood. The human body can convert some dietary ALA into EPA and then to DHA, but the process is inefficient.

    The findings from studies investigating the health effects of omega-3s have been inconsistent, likely due to differences in study design, many of which rely on data from food frequency questionnaires, which are subject to recall bias, and nutrient databases, which can be inaccurate. Measuring omega-3 blood levels provides a more accurate assessment of exposure.

    The authors of the meta-analysis reviewed data from 17 studies that investigated links between blood levels of omega-3s and the risk for all causes of premature death. The studies included more than 42,000 adults (average age, 65 years) living in 10 countries. The authors classified the participants according to five categories of omega-3 intake, ranging from high to low.

    They found that participants with the highest blood levels of EPA and DHA combined were 18 percent less likely to die from all causes of premature death, compared to those with the lowest levels. When they analyzed death rates by specific causes, they found that those with the highest blood levels of EPA and DHA combined were 20 percent less likely to die from cardiovascular disease and 13 percent less likely to die from cancer.

    These findings suggest that omega-3s reduce the risk of premature death from all causes and from cardiovascular disease. The authors noted that their findings did not establish causality and may in fact be indicators of healthy lifestyles among the participants. Further study is warranted.

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  • Omega-3 fats reduce inflammation and cardiovascular disease risk. www.atherosclerosis-journal.com
    Omega-3 Cardiovascular

    Treatment strategies for cardiovascular disease that reduce inflammation are an important area of research. The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) both reduce inflammation by decreasing pro-inflammatory cytokines and increasing anti-inflammatory compounds, although EPA may be more cardioprotective. In a recent report, investigators tested the effects of EPA and DHA supplementation on vascular inflammation, a mediator of atherosclerosis.

    In epidemiological research, higher fish consumption is associated with lower risk of cardiovascular disease and death. In clinical trials, EPA supplementation reduced major cardiovascular events in those with high cholesterol; however, the role of inflammation in this research is unclear.

    In the first experiment, participants consumed 4 grams of either EPA only, DHA only, EPA + DHA (2:1 ratio), or a placebo for 30 days. They completed a health assessment and gave a sample of blood before and after treatment. The researchers used the serum collected from participants to culture human vascular cells and measured the response of those cells to an inflammatory stimulus. In a second experiment of acute inflammation, researchers treated mice with EPA (600 milligrams per kilogram of body weight), DHA (600 milligrams per kilogram body weight), olive oil, or no treatment daily for 30 days. They measured several markers of vascular inflammation and blood lipids before and after treatment. Finally, in a third experiment of chronic inflammation, the researchers fed mice a heart disease-promoting diet for 16 weeks. During the final eight weeks of the diet, they treated mice with the same EPA, DHA, olive oil, or no treatment conditions as the second experiment and measured markers of atherosclerosis and blood lipids.

    In humans, EPA supplementation reduced markers of vascular inflammation better than DHA only or fish oil. In mice from the second experiment, both EPA and DHA supplementation significantly reduced multiple markers of vascular inflammation without affecting cholesterol and triglyceride levels. EPA was more effective in reducing inflammation than DHA. In mice from the third experiment, DHA and EPA both reduced cholesterol and triglyceride levels, with DHA being more effective. EPA supplementation reduced multiple markers of vascular inflammation; however, neither treatment improved markers of atherosclerosis.

    The authors concluded the high-dose omega-3 supplementation can reduce vascular inflammation at early and late stages of cardiovascular disease. They also noted that the small sample size of their study may have limited their results and suggested that EPA supplementation should be tested in larger trials.

    Link to full study.

    Learn more about cholesterol and atherosclerosis in this episode featuring expert Dr. Ronald Krauss.

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  • Exercise reverses effects of sleep deprivation on cardiovascular health. link.springer.com
    Exercise Heart Disease Cardiovascular

    Just one night of sleep deprivation can impair arterial function, and chronically poor sleep increases the risk of developing cardiovascular disease. Conversely, high intensity interval exercise can improve multiple markers of heart health. In this report, researchers tested the effects of exercise on flow mediated dilation, a measure of vascular function, in sleep-deprived participants.

    Flow mediated dilation is a measure of how wide an artery expands in response to increased blood flow. Meals high in fat normally cause dysfunction in blood vessels, impairing their ability to dilate. Previous research reports that high intensity exercise improves flow mediated dilation following a meal.

    Fifteen healthy active men (average age, 31 years) completed three nights of sleep for this study. The first night, participants slept a full eight hours and ate a high-fat test meal the next morning. The second night, participants slept a full eight hours, then performed high intensity interval training before eating. The third night, participants slept three and one half hours or less, then performed the same exercise and ate the same meal. The researchers measured flow mediated dilation at multiple time points.

    After comparing the post-meal flow mediated dilation following a full night of sleep and a full night of sleep plus exercise, the authors found that exercise improved arterial function. Impressively, the benefit of exercise remained following a night of sleep deprivation. Flow mediated dilation rates were similar between exercise conditions regardless of sleep duration the night before.

    The authors concluded that high intensity exercise improves artery function and that these benefits remain even after a night of sleep deprivation. However, they recommended that people get a full night of sleep before strenuous exercise to get the most benefit.

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  • Eating ultra-processed foods increases the risk of premature death from all causes and cardiovascular disease. academic.oup.com
    Nutrition Cardiovascular

    Whole or minimally processed foods, such as fruits, vegetables, and whole grains, differ little from their original, intact forms. Ultra-processed foods, however, such as snacks, ready-to-eat meals, and soft drinks, bear little resemblance to intact food forms. These foods typically contain added flavors and colors, are inexpensive and ready to eat, and often have long shelf lives. Findings from a recent study suggest that consumption of ultra-processed foods increases the risk of premature death from all causes and cardiovascular disease.

    The study involved more than 22,00 men and women (average age, 55 years) enrolled in the Moli-sani Study, a large study of cardiovascular and cancer risks among people living in Italy. At the beginning of the study, participants completed questionnaires regarding their intake of 188 foods. The authors of the study categorized each of these foods according to the degree of processing: fresh or minimally processed foods, such as fruits, vegetables, meat, and fish; processed culinary ingredients, such as honey or butter; processed foods made with salt, sugar, or oil, such as canned vegetables, legumes, or fish; and ultra-processed foods such as carbonated beverages and processed meats.

    The participants who consumed the highest amounts of ultra-processed foods were 58 percent more likely to die from cardiovascular disease, 52 percent more likely to die from ischemic heart disease or cerebrovascular disease, and 26 percent more likely to die from all causes of premature death. The greatest contributor to the increased risk appeared to be high sugar content in the ultra-processed foods.

    These findings suggest that consumption of ultra-processed foods increases the risk of premature death and underscores current dietary guidelines to reduce intake of foods containing added sugars.

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  • High intake of refined grains increases risk of cardiovascular disease and death. www.sciencedaily.com
    Diet Heart Disease Cardiovascular

    Whole grains are rich in dietary fiber, vitamins, and minerals. Robust evidence indicates that people who consume whole grains as part of a healthy diet are less likely to develop cancer or cardiovascular disease or die prematurely. However, findings from a recent study suggest that consumption of refined grains increases a person’s risk of cardiovascular disease and premature death.

    Refined grains are processed to remove the bran and germ, imparting a finer texture to the grains and extending their shelf life. The refining process also removes many vitamins, minerals, and dietary fiber. Examples of refined grains include white flour and white rice. Refined grains are used to make many processed foods, such as white bread, breakfast cereals and pastries, and baked desserts. Evidence suggests that refined grain consumption is linked with higher levels of atherogenic small, dense LDL particles](https://jamanetwork.com/journals/jama/article-abstract/185711).

    The authors of the new study drew on data from a diverse population of more than 137,000 people living in 21 low, middle, and high income countries enrolled in the Prospective Urban and Rural Epidemiology study. Participants completed questionnaires about their socioeconomic status, health, physical activity, and diet.

    Analysis of the questionnaires revealed that eating 350 grams or more (about seven servings) of refined grain products per day, such as white bread, noodles, breakfast cereals, crackers, and bakery products, increased a person’s risk of stroke by 47 percent, cardiovascular disease by 33 percent, and premature death by 27 percent. Eating whole grains and rice did not increase risk.

    These findings suggest that consumption of refined grains increases a person’s risk of cardiovascular disease and premature death. However, this was an observational study and did not establish causation. The data were adjusted to account for several possible confounding factors such as body composition, physical activity, and socioeconomic status, but other factors could be at play.

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  • Glucosamine reduces risk of premature death from all causes and cardiovascular diseases. scienmag.com
    Cardiovascular

    Cardiovascular disease is a broad term that includes coronary artery disease, heart attack, and stroke, among others. It is the primary cause of death among people living the United States. Findings from a recent study suggest that glucosamine reduces risk of premature death from all causes as well as cardiovascular diseases.

    Glucosamine is a structural component of cartilage. It is often taken as a supplement (in conjunction with chondroitin) to alleviate joint pain associated with arthritis or activity-related joint pain, but little evidence supports this practice.

    The authors of the epidemiological study drew on National Health and Nutrition Examination Survey (NHANES) data. NHANES is an ongoing program of studies conducted among people living in the United States. The present study included nearly 17,000 participants, nearly 700 of whom had been taking glucosamine with chondroitin for a year or more. The authors of the study conducted a statistical analysis to identify associations between glucosamine/chondroitin supplement intake and death.

    Over an eight-year period, approximately 3,400 participants died. More than 20 percent of these deaths were due to cardiovascular disease. After taking the participants' ages into consideration, the authors found that those who took glucosamine/chondroitin supplements were 65 percent less likely to die from cardiovascular disease and 39 percent less likely to die from all causes, compared to those who did not take the supplements.

    These findings suggest that glucosamine/chondroitin supplements reduce the risk of premature death from all causes as well as cardiovascular diseases. More studies are needed to confirm these findings and elucidate the mechanisms associated with these effects.

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  • A woman's cardiovascular health influences her children's cardiovascular health. www.sciencedaily.com
    Development Cardiovascular

    Cardiovascular disease is an umbrella term that includes coronary artery disease, heart attack, and stroke, among others. Together, these diseases are the primary cause of death among people living in the United States. Findings from a recent study indicate that a woman’s cardiovascular health influences her children’s cardiovascular health.

    The study drew on data from nearly 6,000 mother-father-child triads of participants enrolled in the Framingham Heart Study, a long-term, ongoing study of cardiovascular disease risk among people living in Framingham, Massachusetts. The authors of the study scored the participants' cardiovascular health according to the American Heart Association scoring system, ranking them as having poor, intermediate, or ideal cardiovascular health.

    The study spanned nearly 72,000 person-years, during which 718 cardiovascular events occurred. Children of mothers whose cardiovascular health was ideal lived nine more years free of cardiovascular disease than those whose mothers had poor cardiovascular health. Onset of poor cardiovascular health occurred earlier among children whose mothers had poor cardiovascular health, with nearly twice the risk of early-onset cardiovascular disease compared with children of women with ideal cardiovascular health.

    These findings suggest that a woman’s cardiovascular health can predict that of her children’s and underscore the importance of public health and clinical interventions designed to improve cardiovascular fitness.

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  • Supplemental omega-3 fatty acids reduce risk of cardiovascular disease, including fatal heart attack. www.sciencedaily.com
    Omega-3 Cardiovascular

    Cardiovascular disease – a broad category of conditions that includes coronary artery disease, stroke, and hypertension – is the leading cause of death worldwide, claiming the lives of roughly 18 million people each year. Findings from a recent meta-analysis suggest that omega-3 fatty acid intake reduces the risk of cardiovascular disease.

    Omega-3 fatty acids are essential for cardiovascular health. They participate in pathways involved in the biosynthesis of hormones that regulate blood clotting, contraction and relaxation of artery walls, and inflammation. Omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is found mainly in plant oils such as flaxseed, soybean, and canola oils. DHA and EPA are found in fish and other seafood. The human body can convert some ALA into EPA and then to DHA, but the process is very inefficient.

    The authors of the meta-analysis evaluated evidence gleaned from 40 randomized clinical trials investigating the effects of omega-3 fatty acids (EPA and DHA) on cardiovascular outcomes in more than 135,000 people. The outcomes included myocardial infarction (heart attack), coronary heart disease, and cardiovascular disease events (which included angina, stroke, heart failure, peripheral arterial disease, sudden death, and cardiovascular surgical interventions), coronary heart disease deaths, and fatal myocardial infarction. They used the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework to assess the quality of the evidence.

    Their analysis revealed that EPA and DHA supplementation decreased a person’s risk of having a heart attack by 13 percent and decreased their risk of death from heart attack by 35 percent. Similarly, a person’s risk of having a coronary heart disease event decreased by 10 percent, and their risk of death from coronary heart disease decreased by 9 percent. These reductions in risk were dose dependent, with greater intake (1,000 milligrams of additional EPA and DHA per day) associated with nearly 6 percent less risk of cardiovascular events and 9 percent less risk of having a heart attack.

    These findings suggest that EPA and DHA intake reduces the risk of cardiovascular disease and underscore the need for public health interventions that promote dietary and supplemental omega-3 fatty acid intake.

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  • Replacing butter with linoleic acid-rich vegetable oils does not reduce risk of cardiovascular disease. www.sciencedaily.com
    Heart Disease Cardiovascular

    Current “heart-healthy” nutritional guidelines recommend replacing saturated fats with unsaturated fats, based on evidence that doing so reduces the risk of cardiovascular disease. Findings from a 2016 study suggest that these guidelines were established on incomplete evidence.

    The study drew on previously unpublished data from the Minnesota Coronary Experiment (MCE). The MCE was a double-blind randomized controlled trial involving more than 9,000 participants conducted between 1968 and 1973. The trial investigated whether replacing saturated fat with vegetable oils rich in linoleic acid (a polyunsaturated fat) reduced coronary heart disease and death by lowering serum cholesterol. The authors of the current study re-analyzed unpublished findings and raw data from the MCE using the hypotheses posed by the original research team. They also conducted a systematic review and meta-analysis of other similar randomized controlled trials.

    Their analyses showed that trials using vegetable oils rich in linoleic acids lowered cholesterol in the study participants but did not reduce risk of heart disease and death. In fact, participants with the lowest cholesterol levels in the MCE study were at higher risk, with every 30-point reduction in serum cholesterol equating to a 22 percent greater risk of death.

    These findings suggest that data from randomized controlled trials do not support the theory that the cholesterol-lowering effects associated with replacing saturated fat with vegetable oils rich in linoleic acid translate to a reduced risk of heart disease or death. The authors of the study posited that failure to publish negative or inconclusive results can contribute to skewed research priorities and public health interventions.

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  • Lean beef as part of a healthy dietary pattern may reduce cardiovascular disease risk. scienmag.com
    Heart Disease Cardiovascular

    Insulin resistance increases a person’s risk of developing type 2 diabetes and atherosclerosis. Findings from a new study suggest that lean beef as part of a healthy dietary pattern may reduce this risk in people with insulin resistance.

    The randomized, crossover, controlled trial, which involved 23 men and women (average age, 44 years) who were overweight or obese and had been diagnosed with prediabetes and/or metabolic syndrome, compared the effects of two dietary patterns on insulin sensitivity and cardiometabolic risk markers. One diet followed the USDA Healthy US-Style Eating Pattern, which is low in saturated fat and provides less than 40 grams of red meat per day. The other diet mirrored the first but provided an additional 150 grams (roughly five ounces) of lean beef per day as a replacement for carbohydrates (of nearly equal caloric content). Each participant consumed the two diets for four weeks, separated by a two-week washout period. At the end of each four-week diet period, the authors of the study assessed the participants' responses to the respective diets via measures of insulin sensitivity, lipid profiles, inflammation (measured by C-reactive protein), and blood pressure.

    The participants' responses to the diets did not differ significantly with the exception of a notable increase in larger, more buoyant low-density lipoprotein (LDL) particles when consuming the higher beef content diet. LDLs are formed in the liver and transport lipid molecules to cells. Often referred to as the “bad cholesterol,” LDLs can drive cardiovascular disease if they become oxidized within the walls of arteries. LDL particles exist in different sizes, ranging from large, “fluffy” molecules to small, dense molecules.

    Scientific evidence suggests that small LDL particles are more susceptible to oxidative modification. Conversely, more buoyant particles are associated with a reduced risk of atherosclerotic disease. Learn more about LDL particles and disease risk in this podcast featuring Dr. Ronald Krauss.

    Note: This study has industry funding sources, see press release for details.

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  • Current options for addressing cardiovascular complications of COVID-19. www.frontiersin.org
    COVID-19 Cardiovascular

    Current options for addressing cardiovascular complications of COVID-19. Although COVID-19 commonly presents as a respiratory infection, the illness targets multiple organ systems, including the cardiovascular system. In one study, patients with cardiac injury accounted for nearly one-fourth of severe cases of COVID-19. A recent article describes the inflammatory aspects of COVID-19, identifies current therapies used in regard to cardiac injury, and suggests guidelines for clinical practice.

    The authors of the article identify three primary drivers of cardiac injury in COVID-19: direct viral infection to cardiac tissues, cytokine storm, and aggravation of preexisting cardiovascular disease. They posited that direct infection of cardiac tissue might be related to increased expression of angiotensin-converting enzymes-2 (ACE2) receptors in the heart. SARS-CoV-2, the virus that causes COVID-19, exploits ACE2 to gain entry into cells. Cytokine storm can occur in COVID-19 when SARS-CoV-2 infection provokes an excessive immune response that, in turn, induces multiple organ dysfunction. COVID-19 infection severely burdens the cardiovascular system, aggravating preexisting cardiovascular morbidities and triggering grave events, such as exacerbation of heart failure or acute coronary syndromes.

    The authors also suggest that targeting inflammation – the underlying cause of the aforementioned drivers of cardiac injury – is critical to preserving cardiac health in COVID-19. They identify various drugs currently in use that target the central pathways associated with inflammation; balance the body’s immune responses; and reduce inflammation.

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  • Sugar-sweetened beverages linked to lipid imbalance, which increases cardiovascular disease risk. www.sciencedaily.com
    Heart Disease Sugar Triglycerides Blood Sugar Cardiovascular

    Sugar-sweetened beverages are among the leading contributors to sugar intake among people living in the United States. Examples of sugar-sweetened beverages include regular soda (not sugar-free), sports drinks, energy drinks, and coffees, teas, and waters that contain added sugars. Data from a new study indicate that sugar-sweetened beverage consumption is associated with dyslipidemia.

    Dyslipidemia is a condition in which blood levels of lipids (such as cholesterol or triglycerides) are abnormal. It is recognized as one of the primary risk factors for cardiovascular disease. Most dyslipidemias are characterized by high plasma cholesterol or triglycerides (or both), or low HDL cholesterol. Nearly half of all adults living in the United States have some form of dyslipidemia.

    The study involved more than 6,700 people enrolled in two different cohorts of the Framingham Heart Study. At various time points during the study, the participants provided complete medical histories, underwent physical exams, and completed lab tests to assess total cholesterol, HDL cholesterol, and triglyceride levels. They also completed questionnaires about their lifestyles and diet, including beverage intake. Participants were followed for an average of 12.5 years.

    The data revealed that consuming more than 12 ounces of sugar-sweetened beverages per day increased the risk of having high triglycerides by 53 percent and having low HDL cholesterol by 98 percent. Consuming low-calorie sweetened beverages (e.g., “diet” drinks) or up to 12 ounces of 100 percent fruit juice was not associated with dyslipidemia.

    These findings suggest that consumption of sugar-sweetened beverages increases the risk of dyslipidemia and underscores the role of nutrition in reducing risk factors that contribute to cardiovascular disease.

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  • FDA approves use of drug to reduce risk of cardiovascular events in certain adult patient groups www.reuters.com
    Omega-3 Triglycerides Cardiovascular

    Cardiovascular disease is the number one cause of death of people living in the United States (US). Having elevated (abnormal) triglyceride levels may contribute to atherosclerosis, which increases the risk of cardiovascular disease. The US Food and Drug Administration has approved the use of a drug to reduce the risk of cardiovascular events in adults who have elevated triglyceride levels.

    The drug, called Vascepa (icosapent ethyl), reduces blood triglyceride levels by one-third when accompanied by low-fat, low-cholesterol dietary modification. It has been shown to reduce the rate of heart attacks, strokes, and other cardiovascular events by 25 percent compared to a placebo.

    Candidates for Vascepa therapy must have triglyceride levels of 150 milligrams per deciliter or higher. They should also have established cardiovascular disease or type 2 diabetes and two or more additional cardiovascular disease risk factors.

    The active ingredient in Vascepa is eicosapentaenoic acid, a type of omega-3 fatty acid derived from fish oil. The drug, which is taken orally, has demonstrated a safety profile similar to placebos. Adverse events associated with Vascepa include atrial fibrillation and increased risk of bleeding. People who are allergic to fish or shellfish may be at risk for allergic reactions to Vascepa.

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  • Diets high in ultra-processed food linked to poor cardiovascular health. www.sciencedaily.com
    Heart Disease Blood Pressure Dairy Blood Sugar Cardiovascular

    The average American gets more than half of their daily calories from ultra-processed foods such as soft drinks, chips, cookies, processed meats, and other convenience food items. These types of foods are often high in unhealthy fats and refined sugars and low in beneficial fiber. Findings presented recently at the American Heart Association’s Scientific Sessions 2019 suggest that high intake of ultra-processed food is associated with poor cardiovascular health.

    The findings were based on data from more than 13,000 adults living in the United States who provided information about their dietary intake and cardiovascular health, gauged by several measures of cardiovascular function, such as blood pressure, as well as lifestyle choices, such as physical activity and tobacco avoidance.

    The data indicated that for every 5 percent increase in calories that a person obtained from ultra-processed foods, their cardiovascular health declined in a reciprocal fashion. For example, if a person obtained 70 percent of their daily calories from ultra-processed foods, they were half as likely to have good cardiovascular health compared to someone who ate 40 percent or less of their calories from ultra-processed foods.

    Cardiovascular disease is the number one killer of people living in the United States. Dietary interventions that include fewer ultra-processed foods could reduce cardiovascular disease-related deaths.

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  • Running associated with lower all-cause, cardiovascular, and cancer mortality. bjsm.bmj.com
    Exercise Cancer Heart Disease Depression Aerobic Cardiovascular

    Public health experts recommend that people get at least 150 minutes of moderate to vigorous physical activity, such as walking, running, or cycling, each week for optimal health. Running, in particular, is associated with improved aerobic fitness and cardiovascular function. A recent meta-analysis found that running, even for short periods, reduced the risk of mortality from all causes, especially cardiovascular- and cancer-related deaths.

    The authors of the study analyzed data from 14 studies of six prospective cohorts involving more than 230,000 people. The cohorts were followed over a span of 5 to 35 years. The data were adjusted for sociodemographic factors, other physical activity besides running, body fatness, health status, and unhealthy lifestyle habits such as smoking, alcohol consumption, and poor diet.

    They found that running was associated with a 27 percent lower all-cause mortality, 30 percent lower cardiovascular mortality, and 23 percent lower cancer mortality. Even the smallest amount of time spent running (less than 50 minutes per week) was linked to a significant reduction in all-cause mortality.

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  • LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature www.tandfonline.com
    Cholesterol Cardiovascular

    Not sure what to think of this. At this point my main reason for believing the cholesterol (or apoB) hypothesis are the genetic results showing 88% reduction of CVD rates among pcsk9- people (or actually, they would be pcsk9-/+ heterozygotes, given how rare the allele is) in the ARIC study:

    https://www.ncbi.nlm.nih.gov/pubmed/24518357

    That, if I’m being honest, and Thomas Dayspring’s anecdote about the terrible MI epidemic he dealt with as a resident (or was he an intern?) and the dramatic decline in such events after the advent of statins. He regaled us with this story during Peter Attia’s “Week of Dayspring” Drive Podcast:

    https://peterattiamd.com/tomdayspring1/

    And, I suppose @rhonda either your podcast or Attia’s podcast interview of Ron Krauss: https://www.foundmyfitness.com/episodes/ronald-krauss https://peterattiamd.com/ronkrauss/

    Where Krauss mentions almost off-hand being an author on a review paper pointing out the CHD effects of higher LCL-P levels and saying “which I would not have thought necessary” – meaning the case had been so thoroughly proven there was little point even undertaking the task.

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