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Heart Disease

Episodes

alcohol

The Truth About Alcohol: Risks, Benefits, and Everything In-Between | Dr. Rhonda Patrick

Posted on June 27th 2024 (12 months)

In this episode, we’re taking a deep dive into alcohol. We’ll explore the science, misconceptions, controversies, and health effects of this widely used drug.

rhonda
Premium

Q&A #60 with Dr. Rhonda Patrick (6/1/24)

Posted on June 13th 2024 (about 1 year)

Dr. Rhonda Patrick discusses fish oil and Afib risk, hyperbaric oxygen therapy, supplements for kids, and curcumin's impact on testosterone.

exercise

HIIT – contraindications and considerations for older adults | Dr. Martin Gibala

Posted on October 4th 2023 (over 1 year)

In this clip, Dr. Martin Gibala weighs the risks vs. benefits of interval training across ages, highlighting its advantage over sedentary life.

Topic Pages

  • Aerobic exercise

    Aerobic exercise enhances endothelial nitric oxide production, improves lipid metabolism and insulin sensitivity, attenuating inflammation and atherosclerotic heart disease progression.

  • Berberine

    Berberine activates AMPK, upregulates LDL receptor expression, and improves endothelial function, mitigating dyslipidemia and atherogenesis in heart disease.

  • Breast milk and breastfeeding

    Breastfeeding reduces maternal and offspring heart disease risk by modulating adiposity, insulin sensitivity, lipid profiles, and systemic inflammation.

  • Cold exposure

    Cold exposure induces sympathetic vasoconstriction, elevating blood pressure and coagulation, acutely precipitating ischemic events in predisposed heart disease patients.

  • Creatine and Cardioprotection

    In ischemic heart disease, impaired creatine kinase-phosphocreatine shuttle reduces ATP buffering; creatine supplementation restores energy buffering, affording cardioprotection.

  • Myocardial infarction (Heart attack)

    In coronary heart disease, atherosclerotic plaque rupture precipitates thrombotic coronary occlusion, producing myocardial infarction via ischemic cardiomyocyte necrosis.

  • Polyphenols

    Polyphenols attenuate heart disease pathogenesis by scavenging reactive oxygen species, boosting endothelial nitric oxide signaling, and suppressing LDL oxidation.

  • Sirtuins

    Cardiac sirtuins NAD⁺-dependently deacetylate metabolic and antioxidant regulators, reducing oxidative stress and fibrosis, countering heart disease.

News & Publications

  • Omega-3 supplementation combined with exercise improves body composition and cardiometabolic health more effectively than exercise alone, including a notable 10% decrease in triglyceride levels. pubmed.ncbi.nlm.nih.gov
    Exercise Heart Disease Omega-3 Weight Loss

    Taking an omega-3 supplement may do more than support heart health—it might enhance the effects of your workout. A recent study found that combining omega-3 supplementation with exercise training improved body composition and cardiometabolic health better than exercise alone.

    Researchers conducted a systematic review and meta-analysis of 21 studies comparing exercise training combined with omega-3 supplementation to exercise training alone. The studies involved 673 adults aged 30 to 70, with an average body mass index (BMI) of 24 to 37. The analysis focused on outcomes such as body fat, blood pressure, blood fats, blood sugar, inflammation, and muscle mass, while accounting for variations across the studies.

    They found that adding omega-3 supplements to an exercise routine resulted in modest improvements. Participants lost just over 1 kilogram (2.3 pounds) more body fat and lowered their triglyceride levels by 10% compared to those who exercised without supplements. They also experienced drops in blood pressure—around 4 mmHg lower for both systolic and diastolic pressures—and slightly reduced levels of tumor necrosis factor-alpha, a marker of inflammation. However, LDL cholesterol increased slightly. Notably, participants also improved their lower-body strength but observed no additional benefits in other areas such as BMI, lean body mass, or blood glucose control.

    These findings indicate that omega-3 supplements enhance certain health benefits of exercise, particularly in decreasing fat mass, lowering blood pressure, and boosting muscle strength. Although the changes were modest, they could accumulate over time, especially for adults aiming to improve their cardiometabolic health. Some evidence suggests that omega-3s exert anabolic effects, too. Learn more in this episode featuring Dr. Chris McGlory.

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  • Engaging in 30 minutes of vigorous daily exercise can offset up to five years of age-related heart health decline, but long sitting durations may undermine this benefit. journals.plos.org
    Exercise Aging Heart Disease Genetics

    Even if you work out, spending most of your day sitting may still adversely affect your health in ways that don’t become apparent until later in life. A recent study found that 35-year-olds who engaged in 30 minutes of vigorous exercise each day had cholesterol levels comparable to those of sedentary 30-year-olds, suggesting that vigorous exercise can offset up to five years of age-related decline in heart health.

    Researchers analyzed data from adults aged 28 to 49 who participated in the Colorado Adoption/Twin Study of Lifespan Behavioral Development and Cognitive Aging. They tracked the time participants spent sitting each day and how often they engaged in moderate or vigorous physical activity. To isolate the effects of behavior from shared genetics and environment, the researchers also compared identical twins with differing activity and sitting patterns. They examined two key health markers: body mass index and the ratio of total to high-density lipoprotein cholesterol—a strong predictor of heart disease risk.

    They found that people who spent more time sitting tended to have higher body mass index and worse cholesterol ratios as they aged. However, among those who sat for the same amount of time—about four hours daily—participants who exercised vigorously for at least 30 minutes daily had cholesterol profiles that resembled those of people five years younger. In some cases, vigorous activity was associated with health markers typical of people up to 10 years younger, but the protective effect weakened with longer sitting durations. In other words, exercise helped—but only to a point.

    These findings suggest that while vigorous exercise offers clear benefits, reducing sitting time is just as important for maintaining good health. “Exercise snacks” can offset the harmful effects of prolonged sitting. Learn more in this clip featuring Dr. Rhonda Patrick and Brady Holmer.

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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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  • 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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  • Supplemental urolithin A enhances cardiac function by preserving mitochondrial function and reducing pro-inflammatory lipids. www.cell.com
    Diet Aging Heart Disease Mitochondria Supplements Urolithin A

    Aging impairs mitochondrial function, disrupting the heart’s energy supply. Over time, this energy shortfall undermines cardiac cell function, driving the heart’s gradual decline. A recent study found that supplemental urolithin A—a bioactive compound derived from pomegranates and walnuts—boosts mitochondrial health and reduces pro-inflammatory lipids called ceramides, ultimately enhancing cardiac function.

    Researchers investigated the effects of supplemental urolithin A in models of natural aging in mice and heart failure in rats and assessed its effects on plasma ceramide levels in healthy older adults. Mice received 50 milligrams per kilogram of urolithin A daily (in food) for eight weeks, rats received 50 milligrams per milliliter (in water) for 24 hours following a simulated heart attack, and the older adults took 1 gram of urolithin A (via supplement) or a placebo daily for two to four months.

    Supplemental urolithin A improved systolic and diastolic cardiac function in models of natural aging and heart failure—an effect of the restoration of mitochondrial structure and enhanced mitophagy at the cellular level. Four months of urolithin A supplementation in healthy older adults significantly lowered plasma ceramides.

    Ceramides are a class of bioactive lipids that contribute to cardiovascular disease by promoting inflammation, insulin resistance, and lipid accumulation in arteries. Elevated ceramide levels are linked to a higher risk of atherosclerosis and adverse cardiac events.

    Urolithin A is a byproduct of gut microbial metabolism of ellagic acid, a bioactive compound found in pomegranates and walnuts. The capacity to form urolithin A from ellagic acid varies considerably from person to person (depending on gut microbial composition) and decreases with age. Pterostilbene, a compound found in blueberries and some supplements, boosts urolithin A conversion. Learn more in this clip featuring Dr. Rhonda Patrick.

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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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  • Regular resistance training improves heart function in older women in just six months. link.springer.com
    Exercise Aging Heart Disease

    Keeping our hearts strong and healthy becomes increasingly challenging as we age, especially for older women. However, physical activity, especially resistance training, may benefit the heart. A recent study found that a 24-week resistance training program improved heart function in older women.

    Researchers assigned 73 physically independent older women (average age, 68) to either an exercise training or sedentary group. The training group participated in a supervised resistance training program three times weekly for 24 weeks, using machines and free weights. Each session included exercises targeting the whole body, with three sets of eight to 12 repetitions each. The researchers measured the participants' cardiac function before and after the program.

    They found that women in the training group experienced several improvements in heart function, including: - A 10.6% decrease in left ventricular volume versus a 1.1% increase in the sedentary group. - A 9.1% decrease in left atrial volume versus a 3.9% increase in the sedentary group. - Better heart relaxation, indicated by a 4.8% reduction in the diastolic function index.

    These findings suggest that regular resistance training improves heart structure and function in older women, potentially reducing the risk of age-related cardiac decline. Finding the time for resistance training can be difficult, however. Listen as Drs. Brad Schoenfeld and Stuart Phillips describe time-efficient ways to incorporate resistance training into a busy schedule.

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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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  • Sudden physical exertion and intense emotions triple the risk of a heart attack within an hour. www.ahajournals.org
    Exercise Heart Disease Mental Health

    Physical exertion and strong emotions activate the body’s stress response, triggering the release of hormones that restrict blood flow to the body’s tissues, including the heart. A 2016 study found that these stressors increase the risk of myocardial infarction (heart attack).

    Researchers conducted a case-control study involving more than 12,000 cases of acute MI among people living in 52 countries. They asked the participants about their physical activities and emotional state in the hours before the onset of symptoms. They estimated the odds of acute MI within one hour of triggers.

    They found that 28 percent of those who experienced an acute MI had engaged in physical activity or were emotionally upset one hour before symptom onset. The likelihood of experiencing an acute MI was 2.31 times higher after physical exertion and 2.44 times higher after emotional upset. However, those who reported both physical exertion and emotional upset were 3.05 times more likely to experience an acute MI within one hour. The increased risk was consistent regardless of the participants' geographical location, sex, baseline physical activity, or age.

    These findings suggest that sudden physical exertion and emotional upset increase the risk of acute MI. However, robust evidence demonstrates that regular physical activity is crucial for preventing cardiovascular disease, including acute MI, especially among inactive people. The authors of this report recommended that clinicians continue to advocate for regular physical exercise and caution patients that intense physical activities could trigger an acute MI in those at risk.

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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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  • 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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  • 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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  • 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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  • 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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  • Omega-3s protect the heart and muscles against damage incurred during endurance running. www.ncbi.nlm.nih.gov
    Exercise Heart Disease Omega-3 Inflammation Muscle

    The physical stress of marathon running can promote exercise-induced muscle damage, reducing muscle force production, elevating blood cytokines, and driving systemic inflammation. Consequently, despite having high cardiorespiratory and neuromuscular fitness, marathon runners are susceptible to lower extremity muscle injuries, cardiac dysfunction, and arrhythmia, particularly as running intensity escalates. A recent study shows that supplemental omega-3 fatty acids ameliorate some of the harmful effects of endurance running.

    The study involved 24 male long-distance runners. Half of the runners received 3,000 milligrams (mg) of omega-3s (852 mg EPA; 1,602 mg DHA) daily for three weeks, and the other half took a placebo. After the third week of supplementation, the participants performed a downhill running exercise test. The researchers measured the participants' cardiac markers, inflammatory cytokines, and blood lipids and assessed their Omega-3 Index, a measure of omega-3 concentrations in red blood cell membranes.

    They found that the participants' Omega-3 Indices increased from 3.9 to 4.8, roughly 23 percent relative to baseline when they took supplemental omega-3s. Markers of cardiac injury (troponin and creatine kinase isoenzyme MB) and the inflammatory cytokine TNF-alpha decreased. Participants' HDL cholesterol levels also increased.

    These findings suggest that supplemental omega-3s ameliorate some of the harmful effects of endurance running, possibly due to omega-3s' potent anti-inflammatory properties. Learn more about the health effects of omega-3s in this episode featuring Dr. Bill Harris.

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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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  • Deep sleep supports cardiovascular health by boosting left ventricular function. www.sciencedaily.com
    Brain Sleep Heart Disease

    Deep sleep, characterized by slow brain waves, heart rate, and respiration, is essential for memory formation and immune function. Evidence suggests deep sleep influences cardiovascular health, too. A recent study found that deep sleep enhances left ventricular function – how well the heart’s left ventricle pumps blood throughout the body with each heartbeat.

    Researchers recruited 18 healthy adult males to participate in a sleep study. They measured their brain and heart activity, blood pressure, and carotid pulse-wave velocity (a measure of arterial stiffness). When the participants reached deep sleep, the researchers exposed them to short bursts of pink noise (white noise with the high frequencies filtered out).

    They found that the pink noise enhanced the participants' slow-wave brain activity. Interestingly, it also improved their left ventricular function, as indicated by enhanced pumping and filling capacities. Exposure to pink noise increased systolic blood pressure slightly but did not influence arterial stiffness.

    Sleep occurs in distinct stages, the most prominent of which is non-rapid eye movement (NREM) sleep – typically referred to as “deep sleep” or “slow-wave sleep.” It comprises approximately 75 to 80 percent of a person’s total sleep time. During NREM sleep, the body produces growth hormone, which plays a role in metabolism.

    The findings from this small study suggest that pink noise promotes deep sleep, driving improvements in cardiovascular function. Other evidence suggests that deep sleep provides a homeostatic recalibration of blood pressure, further supporting cardiovascular health. Learn more in this clip featuring Dr. Matthew Walker.

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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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  • 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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  • Bright light exposure may protect the heart by increasing gene activity related to circadian rhythms. www.sciencedaily.com
    Heart Disease Circadian Rhythm

    A 2019 study found that bright light may protect the heart by increasing the activity of a gene involved in circadian rhythms. Bright light also promotes blood flow to the heart.

    Researchers exposed 17 healthy adults to bright light (10,000 LUX, comparable to ambient daylight) for 30 minutes every morning for five days. They collected blood samples from the participants before and after the light exposure at the beginning and end of the intervention.

    They found that bright light triggered the activity of PER2, a gene that regulates the body’s circadian rhythms. Activating PER2 protected against hypoxia – a condition in which low oxygen levels (caused by reduced blood flow) can damage the heart. They also found that bright light triggered the release of adenosine, a chemical that plays a role in regulating blood flow.

    These findings suggest that bright light exposure activates genes involved in circadian rhythms, potentially improving cardiovascular health. This was a very small study, however, and its findings need to be confirmed in larger groups. However, an abundance of research has shown that bright light exposure promotes sleep, which in turn improves many aspects of human health. Learn more in this clip featuring Dr. Matt Walker.

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  • Common estrogen receptor genotype may double HDL cholesterol increase in response to estrogen therapy in postmenopausal women. (2002) www.sciencedaily.com
    Hormones Heart Disease Cholesterol Genetics Estrogen

    From the article:

    In an analysis of 309 women with heart disease who took hormone replacement therapy or placebo, Herrington found that women with a common mutation in the estrogen receptor alpha gene had dramatic increases in high-density lipoprotein (HDL), or the “good” cholesterol.

    “The increase in HDL was more than twice as much as in women without the gene variant,” said Herrington.

    […]

    Herrington found that 18 percent of women had a genetic predisposition to high levels of HDL cholesterol when taking estrogen. The HDL increase was dramatic – it was two or three times what is normally achieved with cholesterol drugs used to raise HDL.

    From the publication:

    Postmenopausal women with coronary disease who have the ER-α IVS1–401 C/C genotype, or several other closely related genotypes, have an augmented response of HDL cholesterol to hormone-replacement therapy.

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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 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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  • Estrogen protected rats against heart attack-related depression by preventing the production of inflammation-causing chemicals in the brain. (2018) www.sciencedaily.com
    Hormones Heart Disease Depression Estrogen

    From the article:

    Adult female rats without ovaries – mimicking menopause – were compared to adult males and adult females with ovaries. Half of the “menopausal” rats received estrogen supplements while the other half did not. Sex-matched rats without heart failure served as controls. The animals were given several standardized tests to assess depression-like behavior, learning, memory and the ability to experience pleasure. The researchers also took blood samples to measure inflammation levels in the brain (neuroinflammation).

    The male rats, but not the female rats, with heart failure showed signs of depression and brain inflammation compared to their controls. In contrast, the menopausal females displayed higher rates of depression-like behavior than all of the males studied. However, the group receiving estrogen showed no depression – their levels were on par with the control females with ovaries – and no increase in inflammation in brain areas involved in mood and pleasure.

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  • ‘Gene silencing’ therapy reduces lipoprotein(a), an important risk factor of heart disease, by up to 98% www.sciencedaily.com
    Heart Disease Cholesterol Genetic Engineering Lipoprotein A

    From the article:

    In the trial, participants who received higher doses of SLN360 – a small interfering RNA (siRNA) therapeutic that “silences” the gene responsible for lipoprotein(a) production – saw their lipoprotein(a) levels drop by as much as 96%-98%. Five months later, these participants' lipoprotein(a) – also known as Lp(a) – levels remained 71%-81% lower than baseline.

    […]

    Participants receiving 300 mg and 600 mg of SLN360 had a maximum of 96% and 98% reduction in Lp(a) levels, and a reduction of 71% and 81% at five months compared to baseline. Those receiving a placebo saw no change in Lp(a) levels. The highest doses also reduced LDL cholesterol by about 20%-25%.

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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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  • 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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  • Low testosterone levels may be linked to a twofold risk of premature death from heart disease and all causes. (2010) www.sciencedaily.com
    Hormones Heart Disease Testosterone Blood Pressure

    From the publication:

    The researchers base their findings on 930 men, all of whom had coronary artery heart disease, and had been referred to a specialist heart centre between 2000 and 2002. Their heart health was then tracked for around 7 years.

    On referral, low testosterone was relatively common. One in four of the men was classified as having low testosterone, using measurements of either bioavailable testosterone (bio-T) – available for tissues to use – of under 2.6 mmol/l [74.9 ng/dL] or total testosterone (TT) of under 8.1 mmol/l [233.4 ng/dL]

    These measures indicate clinically defined testosterone deficiency, referred to as hypogonadism, as opposed to a tailing off in levels of the hormone as a result of ageing.

    During the monitoring period almost twice as many men with low testosterone died as did those with normal levels. One in five (41) of those with low testosterone died, compared with one in eight (12%) of those with normal levels.

    The only factors that influenced this risk were heart failure (left ventricular dysfunction), treatment with aspirin or a high blood pressure drug (beta blocker) and low bio-T levels.

    A low bio-T level was an independent risk factor for premature death from all causes and from heart disease, after taking account of other influential factors, such as age, other underlying health problems, smoking and weight.

    Borderline levels of low total testosterone (15.1mmol/l) [435.1 ng/dL] also increased the risk of an early death.

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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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  • 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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  • Risk of heart attack may double shortly after beginning testosterone therapy. (2014) www.sciencedaily.com
    Hormones Heart Disease Testosterone

    From the article:

    So successful has the marketing for this testosterone therapy been that, according to Drugs.com, an independent medicine website, sales of the testosterone gel Androgel in 2013 exceeded sales of Viagra.

    Now, a new joint study by UCLA, the National Institutes of Health and Consolidated Research Inc., has shown there is a twofold increase in the risk of a heart attack shortly after beginning testosterone therapy among men under 65 who have a history of heart disease. Further, the study confirmed earlier studies that found a twofold increase in heart attack risk shortly after treatment began in men older than 65.

    They examined the health care records of 55,593 men who had been prescribed testosterone therapy – 48,539 under the age of 65 and 7,054 who were 65 or older.

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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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  • 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. www.sciencedaily.com
    Heart Disease Coffee

    Coffee is perhaps best known for its stimulating properties, which arise primarily from its caffeine content. However, coffee is also rich in other bioactive compounds, including polyphenols and alkaloids – many of which exert potent antioxidant, cardioprotective, and neuroprotective effects. Findings from a recent study suggest that coffee reduces the risk of cardiovascular disease and promotes longevity.

    The research involved nearly 450,000 adults (median age, 58 years) who were enrolled in the UK Biobank study. Participants provided information about their daily coffee consumption, including the types (instant, ground, or decaffeinated) and number of cups of coffee consumed, demographics, and overall health. Researchers categorized participants according to coffee intake and tracked them for about 12 years.

    Approximately three-fourths of the participants consumed some coffee each day. Even after considering age, sex, ethnicity, obesity, high blood pressure, diabetes, sleep apnea, smoking status, and tea and alcohol consumption, coffee drinkers were less likely to develop cardiovascular disease or arrhythmias (abnormal heart rhythms) or die prematurely. Drinking 2 to 3 cups of coffee per day provided the greatest protection against premature death and cardiovascular disease; drinking 4 to 5 cups per day provided the greatest protection against arrhythmias.

    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

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  • Vitamin K2 reduces the risk of coronary artery disease. bmjopen.bmj.com
    Nutrition Heart Disease Vitamin K

    Coronary artery calcification is a pathological condition in which calcium deposits accumulate in the blood vessels that supply the heart. The extent of coronary calcification typically correlates with the severity of coronary artery disease. Findings from a recent study suggest that vitamin K2 reduces the risk of coronary artery disease.

    Vitamin K2 is an umbrella term for a family of molecules called menaquinones. This diverse collection of molecules is synthesized by the gut microbiota, but they can also be found in fermented foods and some animal products, especially liver. High dietary menaquinone intake is associated with reduced coronary artery calcification.

    The study involved nearly 3,000 adults (aged 46 to 49 years) who were enrolled in a community-based health study. Researchers collected information about the participants' dietary intake (to include vitamin K-rich foods), physical activity, smoking status, and education and then monitored the participants' health for several years.

    They found that 112 of the participants developed coronary artery disease. Dietary intake of vitamin K1 had little effect on coronary artery disease risk, but vitamin K2 intake reduced risk by nearly half when comparing the highest quarter of intake to the lowest.

    These findings suggest that vitamin K2 plays important roles in reducing the risk of coronary artery disease. Learn more about vitamin K in this clip featuring Dr. Bruce Ames.

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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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  • 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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  • Interleukin-6, CRP and triglycerides are likely shared causal risk factors for depression and coronary heart disease. (2019) www.sciencedaily.com
    Brain Heart Disease Inflammation Depression Triglycerides IL-6 CRP

    From the article:

    Together, these results suggest that the link between heart disease and depression cannot be explained by a common genetic predisposition to the two diseases. Instead, it implies that something about an individual’s environment – such as the risk factors they are exposed to – not only increases their risk of heart disease, but at the same time increases their risk of depression.

    […]

    Of these common biomarkers, they found that triglycerides (a type of fat found in the blood) and the inflammation-related proteins IL-6 and CRP were also risk factors for depression.

    Both IL-6 and CRP are inflammatory markers that are produced in response to damaging stimuli, such as infection, stress or smoking. Studies by Dr Khandaker and others have previously shown that people with elevated levels of IL-6 and CRP in the blood are more prone to develop depression, and that levels of these biomarkers are high in some patients during acute depressive episode. Elevated markers of inflammation are also seen in people with treatment resistant depression. This has raised the prospect that anti-inflammatory drugs might be used to treat some patients with depression. Dr Khandaker is currently involved in a clinical trial to test tocilizumab, an anti-inflammatory drug used for the treatment of rheumatoid arthritis that inhibits IL-6, to see if reducing inflammation leads to improvement in mood and cognitive function in patients with depression.

    While the link between triglycerides and coronary heart disease is well documented, it is not clear why they, too, should contribute to depression. The link is unlikely to be related by obesity, for example, as this study has found no evidence for a causal link between body mass index (BMI) and depression.

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  • Mice that were socially isolated before a heart attack had increased TNF-alpha levels and 5 to 8 times more brain neuron damage. (2008) www.sciencedaily.com
    Brain Heart Disease TNF-Alpha

    From the article:

    Results showed that the mice that were socially isolated prior to the heart attack showed five to eight times more damage to their neurons compared to mice that were housed together, said Weil, who is now a post-doctoral researcher at Rockefeller University in New York.

    Socially isolated mice also showed evidence of greater inflammation in the hippocampus, when compared to socially housed and control mice.

    […]

    Socially isolated mice showed increased activation of microglia, a type of immune cell in the central nervous system that responds to damaged neurons, the study found.

    One of the ways microglia respond is by releasing tumor necrosis factor alpha (TNF-a), one of a large family of proteins called cytokines – chemical messengers that are mobilized when the body is injured or has an infection. These cytokines cause inflammation in their effort to repair an injured or infected area of the body.

    Levels of TNF-a were elevated in isolated mice, but not in socially housed mice, compared to the control mice.

    The higher levels of TNF-a in the socially isolated mice, and the inflammation it caused, was the main reason for the increased neuronal damage in these animals, Nelson said.

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  • Pregnenolone sulphate could protect against heart disease. (2010) www.sciencedaily.com
    Heart Disease Pregnenolone

    From the article:

    The University of Leeds biologists have identified a previously-unknown ion channel in human blood vessels that can limit the production of inflammatory cytokines – proteins that drive the early stages of heart disease.

    They found that this protective effect can be triggered by pregnenolone sulphate – a molecule that is part of a family of ‘fountain-of-youth’ steroids. These steroids are so-called because of their apparent ability to improve energy, vision and memory.

    Importantly, collaborative studies with surgeons at Leeds General infirmary have shown that this defence mechanism can be switched on in diseased blood vessels as well as in healthy vessels.

    […]

    The effect that we have seen is really quite exciting and also unexpected,“ said Professor David Beech, who led the study. "However, we are absolutely not endorsing any claims made by manufacturers of any health supplements. Evidence from human trials is needed first.”

    A chemical profiling study indicated that the protective effect was not as strong when cholesterol was present too. This suggests that the expected benefits of ‘fountain of youth’ steroids will be much greater if they are used in combination with cholesterol-lowering drugs and/or other healthy lifestyle strategies such as diet and exercise.

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  • Association of serum interleukin-6 and C-reactive protein in childhood with depression and psychosis in young adult life. (2014) www.sciencedaily.com
    Brain Heart Disease Diabetes Depression Mental Health IL-6 CRP

    From the article:

    Now, researchers have carried out the first ever longitudinal study – a study that follows the same cohort of people over a long period of time – to examine the link between these markers [cytokines such as interleukin-6] in childhood and subsequent mental illness.

    A team of scientists led by the University of Cambridge studied a sample of 4,500 individuals from the Avon Longitudinal Study of Parents and Children – also known as Children of the 90s – taking blood samples at age 9 and following up at age 18 to see if they had experienced episodes of depression or psychosis. The team divided the individuals into three groups, depending on whether their everyday levels of IL-6 were low, medium or high. They found that those children in the ‘high’ group were nearly two times more likely to have experienced depression or psychosis than those in the ‘low’ group.

    […]

    The research indicates that chronic physical illness such as coronary heart disease and type 2 diabetes may share a common mechanism with mental illness. People with depression and schizophrenia are known to have a much higher risk of developing heart disease and diabetes, and elevated levels of IL-6 have previously been shown to increase the risk of heart disease and type 2 diabetes.

    Professor Peter Jones, Head of the Department of Psychiatry and senior author of the study, says: “Inflammation may be a common mechanism that influences both our physical and mental health. It is possible that early life adversity and stress lead to persistent increase in levels of IL-6 and other inflammatory markers in our body, which, in turn, increase the risk of a number of chronic physical and mental illness.”

    […]

    This potential common mechanism could help explain why physical exercise and diet, classic ways of reducing risk of heart disease, for example, are also thought to improve mood and help depression. The group is now planning additional studies to confirm whether inflammation is a common link between chronic physical and mental illness.

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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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  • Alcohol consumption increases the risk of cardiovascular diseases such as aortic aneurysms and reduces life expectancy. (2018) www.eurekalert.org
    Heart Disease Alcohol Blood Pressure Stroke Aneurysm

    From the article:

    The upper safe limit of drinking was about 5 drinks per week (100g of pure alcohol, 12.5 units or just over five pints of 4% ABV2 beer or five 175ml glasses of 13% ABV wine).

    However, drinking above this limit was linked with lower life expectancy. For example, having 10 or more drinks per week was linked with 1-2 years shorter life expectancy1. Having 18 drinks or more per week was linked with 4-5 years shorter life expectancy.

    […]

    The researchers also looked at the association between alcohol consumption and different types of cardiovascular disease. Alcohol consumption was associated with a higher risk of stroke, heart failure, fatal aortic aneurysms, fatal hypertensive disease and heart failure and there were no clear thresholds where drinking less did not have a benefit.

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  • Hypertensive smoking women have up to 20-fold higher risk of brain aneurysm ruptures. (2013) www.sciencedaily.com
    Heart Disease Cholesterol Tobacco Blood Pressure Stroke Aneurysm

    From the article:

    • If smoking women with high systolic blood pressure values have 20 times higher rate of these brain bleeds than never-smoking men with low blood pressure values, it may very well be that these women diagnosed with unruptured intracranial aneurysms should be treated. On the other hand, never-smoking men with low blood pressure values and intracranial aneurysms may not need to be treated at all.

    In this largest SAH risk factor study ever, the study group also identified three new risk factors for SAH: previous myocardial infarction, history of stroke in mother, and elevated cholesterol levels in men. The results revise the understanding of the epidemiology of SAH and indicate that the risk factors for SAH appear to be similar to those for other cardiovascular diseases.

    • We have previously shown that lifestyle risk factors affect significantly the life expectancy of SAH survivors, and now we have shown that the same risk factors also affect dramatically the risk of SAH itself.

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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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  • 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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  • Hunger inhibition hormone leptin directly contributes to cardiovascular disease in those desensitized by obesity by increasing cardiovascular activity www.sciencedaily.com
    Brain Obesity Heart Disease Satiety Blood Pressure Metabolic Syndrome

    From the article:

    In both cell culture and animal models, the researchers have shown that fat-derived leptin directly activates aldosterone synthase expression in the adrenal glands, resulting in production of more of the steroid hormone aldosterone.

    High aldosterone levels are known to contribute to widespread inflammation, blood vessel stiffness and scarring, enlargement and stiffness of the heart, impaired insulin sensitivity and more.

    Aldosterone, which is produced by the adrenal gland, has a direct effect on blood pressure by regulating salt-water balance in the body. High levels of aldosterone are an obesity hallmark and a leading cause of metabolic and cardiovascular problems. But exactly how it gets high in obesity was a mystery.

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  • Effects of omega-3 polyunsaturated fatty acids on left ventricular remodeling in chronic heart failure www.cambridge.org
    Heart Disease Omega-3

    Omega-3 fatty acids improve aspects of heart failure.

    More than 26 million people worldwide currently live with heart failure, a serious condition characterized by diminished capacity of the heart’s ventricles to fill with or eject blood and cardiomyocyte death. Adaptive responses to heart failure induce ventricular remodeling – structural and functional accommodations of the left ventricle that hinder contractility and impair ventricular filling. Findings from a recent systematic review and meta-analysis suggest that omega-3 fatty acids improve aspects of left ventricular remodeling in people with heart failure.

    Omega-3 fatty acids are polyunsaturated fats that play critical roles in human health. They exert powerful cardioprotective effects via their participation in pathways involved in blood clotting, arterial contraction and relaxation, inflammation, and many other physiological processes. 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 reviewers searched the scientific literature for randomized controlled trials investigating the effects of omega-3 fatty acids on left ventricular remodeling in the setting of heart failure. 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.

    Their analysis identified 11 trials, involving more than 2,000 participants, ranging in age between 51 and 74 years. They found that dosage and duration varied among the trials, ranging from 1.0 to 5.2 grams of total combined EPA and DHA per day, for three to 12 months. Participants who received omega-3 fatty acid supplementation showed marked improvements in left ventricular ejection fraction as well as decreased left ventricular end-systolic volume – two critical measures of heart function. Notably, these improvements were observed only when participants achieved an accumulated dose of 600 grams or more.

    These findings suggest that omega-3 fatty acids exert potent cardioprotective effects in a dose- and duration-dependent manner. One of the mechanisms that may drive these effects involves byproducts of omega-3 fatty acid metabolism called specialized pro-resolving mediators. Scientists have identified four families of specialized pro-resolving mediators, including the resolvins, lipoxins, protectins, and maresins. These remarkable and diverse molecules reduce the inflammation that promotes many chronic diseases, including heart failure. Learn more about specialized pro-resolving mediators in this clip featuring Dr. Bill Harris.

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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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  • Salt may increase blood pressure partly through reducing the production of ketone beta-hydroxybutyrate www.sciencedaily.com
    Exercise Gut Diet Microbiome Ketosis Heart Disease Blood Pressure

    From the article:

    “Our team found that high salt consumption lowered levels of circulating beta hydroxybutyrate. When we put beta hydroxybutyrate back in the system, normal blood pressure is restored,” said Dr. Bina Joe, Distinguished University Professor and chair of UT’s Department of Physiology and Pharmacology and director of the Center for Hypertension and Precision Medicine. “We have an opportunity to control salt-sensitive hypertension without exercising.”

    The effects may be microbiome mediated. Read the following excerpt from discussion in a Cell spotlight:

    Changes in the microbiota, specifically a decrease in Lactobacillus spp., in rats fed a high-salt diet have also been implicated in drivingthe progression of hypertension. The authors found that Lactobacillus spp. and Proteobacteria were reduced and Prevotella spp. were increased by a high-salt diet. The changes in the microbiota were associated with a decrease in gluconeogenesis and ketone metabolism, which was not restored by supplementation with 1,3-butanediol. Interestingly, after 1,3butanediol treatment, Proteobacteria and Prevotella shifted back toward the low-salt relative abundance and also correlated with an increase in protective Akkermansia levels.

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  • Elevated blood pressure as low as 135/85 may result in enhanced brain aging: damage may build up over years, starting in a person's twenties www.sciencedaily.com
    Brain Heart Disease Dementia Blood Pressure

    Currently selected for this coming member’s digest by team member Melisa B.

    From the article:

    “Compared to a person with a high blood pressure of 135/85, someone with an optimal reading of 110/70 was found to have a brain age that appears more than six months younger by the time they reach middle age.”

    […]

    “By detecting the impact of increased blood pressure on the brain health of people in their 40s and older, we have to assume the effects of elevated blood pressure must build up over many years and could start in their 20s. This means that a young person’s brain is already vulnerable,” he said.

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  • 20 minutes of running/cycling per day beginning at age 70 reduces the risk of heart attacks, CHD, and heart failure by 52 percent in men www.eurekalert.org
    Exercise Heart Disease Aerobic

    Just 20 minutes of exercise daily reduces heart disease risk in older adults. The benefits of regular physical exercise on cardiovascular health are well established. However, most studies investigating the benefits of exercise have been conducted in younger adults rather than older ones, for whom cardiovascular disease risk is greatest. Findings from a recent study demonstrate that 20 minutes of exercise daily reduces the risk of cardiovascular disease in older adults.

    The authors of the study drew on data from the Progetto Veneto Anziani, a long-term cohort study of more than 3,000 older adults (65 years and older) living in northern Italy. They identified participants with cardiovascular disease based on information gleaned from medical exams or hospital records. Every five years (at 65, 70, 75, 80, and 85 years of age), the authors assessed the participants' physical activity levels based on information provided in questionnaires.

    The risk of cardiovascular-related events or premature death was lower among older adults who were physically active. Men, in particular, were half as likely to experience a cardiovascular event if they were physically active. The effects of exercise were dose-dependent, with 20 minutes of moderate- to vigorous-intensity exercise daily providing the greatest benefits, especially when performed earlier in one’s later years, between the ages of 70 and 75 years. Exercising more than 40 minutes daily provided no additional benefits.

    Although the authors of this study did not differentiate between the effects of different types of exercise, their findings demonstrate that aerobic exercise is particularly beneficial for cardiovascular health. Learn more about aerobic exercise in our overview article.

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  • Curcumin may improve exercise tolerance through antioxidant-regulating protein Nrf2. journals.physiology.org
    Exercise Heart Disease Curcumin Antioxidant NRF2

    Curcumin is the principal bioactive compound present in the yellow spice turmeric. An abundance of scientific evidence indicates that curcumin has antioxidant, anti-inflammatory, anticancer, and neuroprotective properties in humans. Findings from a 2019 study suggest that curcumin improves exercise tolerance in mice with heart failure via its activation of Nrf2.

    Heart failure, commonly referred to as the end stage of heart disease, affects more than 26 million people worldwide. Exercise intolerance is a common feature of heart failure and is typically attributed to low ejection fraction – a measure of ventricular efficiency. A critical driver of low ejection fraction is oxidative stress.

    Nrf2 is a cellular protein that regulates the expression of antioxidant and stress response proteins via participation in the Keap1-Nrf2-ARE biological pathway. Nrf2 activates the transcription of cytoprotective proteins that protect against oxidative stress due to injury and inflammation.

    The study investigators gauged the effects of curcumin in mice that had heart failure with reduced ejection fraction and in mice with healthy hearts. A subset of the mice received daily curcumin supplementation, while the others did not. The investigators measured the animals' heart function via echocardiogram, assessed their exercise performance on a treadmill, and measured the expression of Nrf2 and its target proteins in their muscles.

    They found that both groups of mice that received curcumin (including those with healthy hearts) had improved exercise capacity compared to those that did not receive the compound. They also found that Nrf2 expression and antioxidant proteins increased in the mice with heart failure that received curcumin.

    These findings suggest that impaired Nrf2 drives oxidative stress in skeletal muscle in those who have heart failure with low ejection fraction. Curcumin counters these effects by upregulating antioxidant defenses in skeletal muscle, likely mediated by Nrf2 activation. Many plant-based dietary compounds induce Nrf2 activity, including sulforaphane, a compound derived from broccoli and broccoli sprouts. Learn more about Nrf2 and sulforaphane in this episode featuring Dr. Jed Fahey.

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  • Lifting weights for less than an hour a week may reduce your risk for a heart attack or stroke by 40 to 70 percent, according to a new study www.sciencedaily.com
    Exercise Heart Disease Strength Stroke

    Current public health guidelines recommend that adults engage in muscle-strengthening activities such as resistance training at least twice a week. Research indicates that resistance exercise provides a wide range of health benefits, including increased muscle mass and strength, greater bone density, and improved mood. Findings from a 2019 study also suggest that resistance exercise reduces the risk of the number one killer worldwide: cardiovascular-related disease and death.

    The study involved more than 12,000 adults (average age 47 years) who were enrolled in the Aerobics Center Longitudinal Study - an ongoing prospective investigation of links between exercise and cardiovascular health. Participants underwent a comprehensive examination that included collection of a detailed medical history, assessment of cardiovascular and metabolic health parameters, and information-gathering about the participants’ resistance exercise habits.

    They found that participants who engaged in resistance exercise one to three times (or a total of up to 59 minutes) per week were 40 to 70 percent less likely to experience a cardiovascular disease-related event than those who never engaged in resistance exercise. Engaging in resistance exercise more than four times (or more than an hour) per week did not confer any additional protection. The authors' analysis indicated that the decreased risk was due in part to resistance exercise’s effects on lowering body mass index, a known risk factor for cardiovascular disease.

    These findings suggest that resistance exercise promotes cardiovascular health. Aerobic exercise is also important for cardiovascular health. Learn about the cardiovascular benefits of aerobic exercise in our overview article.

    Read more
  • Curcumin treatment improved muscle function, exercise capacity in mice with heart failure and healthy controls www.sciencedaily.com
    Exercise Heart Disease Curcumin NRF2

    Curcumin is the principal bioactive compound present in the yellow spice, turmerice. An abundance of scientific evidence indicates that curcumin exerts antioxidant, anti-inflammatory, anticancer, and neuroprotective properties in humans. Findings from a 2019 study suggest that curcumin improves exercise tolerance in mice with heart failure via its activation of Nrf2.

    Heart failure, commonly referred to as the end stage of heart disease, affects more than 26 million people worldwide. Exercise intolerance is a common feature of heart failure and is typically attributed to low ejection fraction – a measure of ventricular efficiency. A critical driver of low ejection fraction is oxidative stress.

    Nrf2 is a cellular protein that regulates the expression of antioxidant and stress response proteins via participation in the Keap1-Nrf2-ARE biological pathway. Nrf2 activates the transcription of cytoprotective proteins that protect against oxidative stress due to injury and inflammation.

    The study investigators gauged the effects of curcumin in mice that had heart failure with reduced ejection fraction and in mice with healthy hearts. A subset of the mice received daily curcumin supplementation, while the others did not. The investigators measured the animals' heart function via echocardiogram, assessed their exercise performance on a treadmill, and measured the expression of Nrf2 and its target proteins in their muscles.

    They found that both groups of mice that received curcumin (including those with healthy hearts) had improved exercise capacity compared to those that did not receive curcumin. They also found that Nrf2 expression and antioxidant proteins increased in the mice with heart failure that received curcumin.

    These findings suggest that impaired Nrf2 drives oxidative stress in skeletal muscle in mice that have heart failure with low ejection fraction. Curcumin counters these effects by upregulating antioxidant defenses in skeletal muscle, likely mediated by Nrf2 activation. Many plant-based dietary compounds induce Nrf2 activity, including sulforaphane, a compound derived from broccoli and broccoli sprouts. Learn more about Nrf2 and sulforaphane in this episode featuring Dr. Jed Fahey.

    Read more
  • Why HIIT is so effective for the heart and rhythm disorders: improves a number of mechanisms allowing cells to pump out vs. store calcium www.sciencedaily.com
    Exercise Heart Disease Aerobic

    Disorders like atrial fibrillation and other rhythm disorders may be particularly advantaged by improvements to calcium management induced by HIIT:

    “The interval training also significantly improved the rats' conditioning. After the training period, their fitness level was actually better than that of the untrained rats that hadn’t had a heart attack,” says Stølen.

    […]

    “We found that interval training improves a number of mechanisms that allow calcium to be pumped out of the cells and stored more efficiently inside the cells. The leakage from the calcium stores inside the cells also stopped in the interval-trained rats,” says Stølen.

    The effect was clear when the researchers tried to induce ventricular fibrillation in the diseased rat hearts: they only succeeded at this in one of nine animals that had completed interval training. By comparison, they had no problems inducing fibrillation in all the rats with heart failure who had not exercised.

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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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  • Colorful compounds in berries promote brain and heart health. www.mdpi.com
    Nutrition Brain Heart Disease Polyphenol

    Berries are a colorful and nutritious food containing many types of bioactive compounds, including anthocyanins, a type of polyphenol with blue/purple pigment. Anthocyanins from berries such as blueberries, black raspberries, chokeberries, and bilberries are recognized for their ability to protect against cardiovascular and neurodegenerative diseases. Findings of a recent systematic review provide robust evidence demonstrating the beneficial effects of anthocyanins on cognitive performance and cardiovascular disease risk factors.

    Cognitive performance refers to a set of mental skills such as attention, memory, psychomotor speed, and executive function that develop through early adulthood and then decline in old age. As the world population ages, cognitive impairment is a growing public health concern that requires targeted strategies for prevention. Impaired vascular function, a factor that contributes to poor brain health and cognitive performance with age, may be modifiable with diet and lifestyle changes. Previous research has demonstrated that eating blueberries improves vascular function (measured with flow mediated dilation) in healthy men; but further research is needed to understand the molecular mechanisms.

    Polyphenols are a large class of bioactive compounds found in fruits, vegetables, teas, coffee, wine, and olive oil with antioxidant properties because of their many phenol rings. Due to their special cyclized electron structure, phenols capture and neutralize oxygen radicals and reflect light at unique wavelengths, giving them vibrant color. A previous systematic review of research on blueberries found good evidence to support their ability to improve memory, executive function, and psychomotor function in adults with mild cognitive impairment; however, less research has focused on total anthocyanins in the diet.

    The authors searched for studies investigating the six most anthocyanin-rich fruits (i.e., blackcurrant, black raspberry, blueberry, bilberry, chokeberry, and elderberry). They selected all randomized, placebo-controlled intervention studies in humans that investigated at least one cardiometabolic or cognitive performance parameter for inclusion in their analysis. Although methods of data collection used among the studies widely varied, the authors extracted data from their selected studies and combined it into clusters for comparison.

    The authors of the review investigated the effects of berry anthocyanin supplementation on memory in 14 studies with mostly older adult participants, revealing improved memory, especially verbal memory, and symptoms of mild cognitive impairment. In young and middle-aged adults, multiple studies found improvements in attention and psychomotor speed with anthocyanin supplementation. The research revealed that short-term berry supplementation was sufficient to produce benefits on attention and psychomotor speed, but long-term supplementation was best for memory.

    All studies that measured flow mediated dilation, the most accurate measure of vascular function, found an improvement following anthocyanin supplementation except for one study in smokers. Long-term berry supplementation also lowered blood pressure in adults at high risk for cardiometabolic disease, but not healthy adults, indicating that individual characteristics alter a person’s response to anthocyanin supplementation.

    This large systematic review provides robust evidence for the beneficial effects of berry anthocyanins on multiple markers of cognitive and cardiovascular performance.

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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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  • Eating walnuts lowers LDL cholesterol. www.sciencedaily.com
    Heart Disease Omega-3

    Heart disease is the leading cause of death among people living in the United States, claiming the lives of roughly 655,000 people every year. Having high levels of low-density lipoprotein (LDL), or “bad” cholesterol, increases a person’s risk of heart disease. Findings from a new study suggest that eating walnuts reduces LDL cholesterol.

    Walnuts contain a variety of bioactive compounds that exert antioxidant, anti-inflammatory, and anti-cancer properties. They are also excellent sources of alpha linolenic acid (ALA), an omega-3 fatty acid that plays important roles in human health. ALA is necessary for the production of eicosanoids, a class of signaling molecule that regulates blood clotting, blood pressure, blood lipid levels, immune function, inflammation, pain and fever, and reproduction.

    The investigation was part of the Walnuts and Healthy Aging study, an intervention study of health and cognition in approximately 700 healthy older adults (63 to 79 years old) recruited from diverse geographical locations in the United States and Spain. Over a period of two years, half of the participants in each location followed their normal diets but added one serving (a small handful) of walnuts to their diet per day. The other half followed their normal diets but did not add walnuts.

    The study investigators measured the participants' triglycerides, total cholesterol, LDL, and high-density lipoprotein (HDL) blood concentrations at the beginning and end of the intervention. They also measured intermediate-density lipoproteins (IDL) and LDL particle number. IDL is a precursor to LDL. In recent years it has emerged as an important cardiovascular risk factor independent of LDL cholesterol. LDL particle number is a measure of small LDL particles in a person’s blood. Evidence suggests small LDL particles are more atherogenic than large ones.

    The effects of adding walnuts to the diet were consistent across both geographical locations. Among those who ate walnuts, total cholesterol concentrations decreased by 4.4 percent, LDL decreased by 3.6 percent, and IDL decreased by 16.8 percent. Triglycerides and HDL cholesterol concentrations did not change. Total LDL particles decreased by 4.3 percent, and small LDL particle number decreased by 6.1 percent. Interestingly, the LDL-lowering effects of the walnut diet differed by sex, with a 7.9 percent decrease in LDL among men and a 2.6 percent decrease among women.

    These findings suggest that walnuts exert potent lipid-lowering effects in healthy older adults and align with previous research demonstrating that foods rich in omega-3 fatty acids benefit cardiovascular health.

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  • A high saturated fat diet increases heart disease marker, TMAO. news.vumc.org
    Microbiome Heart Disease Fat

    Heart disease is the number one cause of death in the United States, owing to a constellation of risk factors including a sedentary lifestyle, disrupted sleep patterns, stress, and poor diet. The average American adult consumes 29 grams of saturated fat per day (the amount in about four tablespoons of butter, four slices of pepperoni pizza, or 1.5 cups of ice cream), possibly contributing to heart disease risk through interactions with the gut microbiota. Findings of a new report link high saturated-fat diets to increased heart disease biomarkers among mice with high levels of E. coli bacteria.

    The gut microbiota, the community of bacteria, archaea, fungi, and viruses that lives in the human intestine, is highly influenced by changes in diet. Dietary fats that are not absorbed in the small intestine travel to the large intestine where microbes metabolize them. The same is true for other nutrients not absorbed by the gut, including choline, an essential nutrient found in high amounts in organ meats, egg yolks, and legumes. Choline is an important component of cellular membranes, a precursor for the production of neurotransmitters, and is incorporated into bile acids needed for the digestion of fats; however, some gut microbes convert choline into trimethylamine (TMA), which is absorbed by the intestine and converted to trimethylamine N-oxide (TMAO) in the liver. High serum levels of TMAO have been shown to increase the risk of major cardiovascular events such as heart attack and stroke by increasing the deposition of cholesterol in arterial walls (i.e., atherosclerosis).

    Clostridia and Enterobacteriaceae are the only two bacterial families common to the human gut microbiota that are known to produce TMAO, but only Enterobacteriaceae abundance is substantially increased on a high-fat diet. Oxygen content in the gastrointestinal tract decreases through the small and large intestines so that bacteria in the colon are mostly anaerobic (meaning they do not use oxygen for metabolism). This low oxygen environment is needed to promote the growth of more beneficial bacteria such as Clostridia and suppress the growth of more detrimental bacteria such as Enterobacteriaceae. In order to maintain this low oxygen environment, the mitochondria of colon cells must consume high levels of oxygen; however, a diet high in saturated fat may impair mitochondrial function, facilitating the growth of TMAO-producing bacteria and increasing heart disease risk.

    The investigators performed their experiments using two mouse strains with altered gut microbiota: mice that do not carry Enterobacteriaceae in their gut microbiota (E. negative) and germ-free mice, which are raised in a sterile environment and do not have a microbiota. They fed mice either a high-fat (60 percent of calories from fat) or low-fat (10 percent of calories from fat) diet for 10 weeks. The main source of fat in the high-fat diet was lard with casein protein, sugar, and micronutrients added. The researchers added a choline supplement to both the high-fat and low-fat diets one week before administering a single dose of a probiotic containing E. coli, a member of the Enterobacteriaceae family, to both E. negative and germ-free mice. All mice consumed their assigned diet for a total of 14 weeks. The researchers measured changes to epithelial cells in the colon including mitochondrial metabolism, inflammation, and cancer signatures.

    Both E. negative and germ-free mice that gained weight on the high-fat diet had increased inflammation and cancer signatures, suggesting some of the detrimental diet effects were independent of the microbiota. Germ-free mice on a low-fat diet had colon epithelial cells with appropriately low levels of oxygen; however, germ-free mice on a high-fat diet had colon epithelial cells with increased oxygen levels and reduced mitochondrial metabolism. Following E. Coli exposure, E. negative mice fed a high-fat diet supplemented with choline gained more weight and had higher levels of oxygen, inflammation, and signatures of cancer in their colons than E. negative mice fed a low-fat diet. These changes were associated with an increased concentration of fecal E. coli. In germ-free mice exposed to E. coli, a high-fat diet supplemented with choline significantly increased serum TMAO levels compared to all other groups.

    These results elucidate the mechanisms by which diets high in saturated fat may contribute to heart disease through interactions with choline metabolism by the gut microbiota. However, there are several important factors to consider in translating these results into relevant information for humans. Mouse diets often contain just one or two sources of fat such as lard and soybean oil, as was used in this study. Human diets contain a wider variety of fats, including various saturated and unsaturated fats. These diets also often contain high amounts of simple sugars, such as the sucrose and maltodextrin used in this study. The diet used in this study is also not representative of a standard human diet and limits the ability to distinguish between the effects of saturated fat and sugar. So, while animal studies are a vital foundation for human research, they should not be the basis for individual health recommendations. To hear Dr. Rhonda Patrick review the evidence on saturated fat and heart disease, listen to this episode of the FoundMyFitness podcast.

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  • Vitamin K benefits heart health. www.sciencedaily.com
    Heart Disease Vitamin K

    Heart disease, including atheroslcerotic cardiovascular disease, is a leading cause of death worldwide. Its associated inflammation and metabolic dysfunction can be prevented with a diet high in nutrient dense foods such as those commonly found in the Mediterranean diet. Findings of a new report indicate that a high intake of vitamin K - a micronutrient found at high levels in common Mediterranean meals - might reduce the incidence of atherosclerotic disease.

    Atherosclerosis refers to the hardening of arteries due to the formation of plaques composed of fats, cellular debris, white blood cells, fibrous connective tissue, and calcium. White blood cells called macrophages deposit calcium in these plaques to stabilize them, but the plaques become stiff and fragile over time, increasing the risk of blood clots, heart attack, and stroke. Vitamin K is needed to produce proteins necessary for blood clotting and controls the concentration of calcium in the bones and other tissues. Vitamin K1, called phylloquinone, is found in photosynthetic plants, such as green leafy vegetables. Vitamin K2, called menaquinone, is found in fermented foods, such as cheese and sauerkraut. The recommended daily intake of vitamin K (K1 and K2 combined) is 120 micrograms per day for adult males and 90 micrograms per day for adult females.

    The authors analyzed data from the Danish Diet, Cancer, and Health Study, which included over 50,000 participants between the ages of 52 and 60 years old who did not have atherosclerostic cardiovascular disease. At baseline, participants completed questionnaires to assess habitual food intake, which allowed the researchers to estimate their total vitamin K intake. Medical records were then used to measure the number of hospital admissions for cardiovascular diseases that these participants endured over an average of 21 years.

    At baseline, intake of vitamin K1 ranged from 80 to 151 micrograms per day and intake of vitamin K2 ranged from 31 to 61 micrograms per day. Margarine, lettuce, broccoli, whole-brain bread, and spinach were the main sources of vitamin K1, while eggs, butter, and hard cheeses were the main sources of vitamin K2. Participants in the bottom 20 percent of consumption were considered to have low intake, while participants in the top 20 percent of consumption were considered to have high intake.

    Participants with high vitamin K1 intake had a 21 percent lower risk of hospitalization due to atherosclerotic cardiovascular disease than participants with the lowest intakes. Participants with high vitamin K2 intake had a 14 percent lower risk of hospitalization due to atherosclerotic cardiovascular disease than participants with the lowest intakes. These risk reductions also took into account factors such as physical activity, education, smoking, and overall diet quality.

    The authors concluded that high intake of both vitamin K1 and vitamin K2 are protective against atherosclerotic cardiovascular disease. For a great way to add more vitamin K to your diet, check out this micronutrient smoothie from 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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  • Coffee consumption is associated with a reduced risk of irregular heartbeats. jamanetwork.com
    Heart Disease Coffee

    Coffee consumption is popular worldwide and is associated with reduced risk of cancer, diabetes, and Parkinson’s disease. However, the American College of Cardiology and American Heart Association recommend avoiding caffeine to reduce the risk of cardiac arrhythmias. Findings from a recent observational report suggest coffee consumption may reduce, not increase, the risk of cardiac arrhythmias.

    Cardiac arrhythmias occur when the electrical impulses that control heart rate pulse too quickly, called tachycardia, or too slowly, called bradycardia. Coffee is the primary source of caffeine for most people. Because caffeine increases serum levels of catecholamines (e.g., adrenaline), it is plausible that coffee may increase the risk of cardiac arrhythmias. Although results from one observational study from 1980 support an increased risk of arrhythmias with increased coffee consumption, newer and more comprehensive evidence is needed.

    The authors collected data regarding habitual coffee consumption and the incidence of cardiac arrhythmias from over 380,000 participants of the United Kingdom Biobank, a long-term registry study of United Kingdom citizens. The researchers assigned participants to one of eight categories of coffee consumption: zero, less than one, one, two, three, four, five, or six or more cups daily. Participants also provided a DNA sample for the sequencing of genes related to coffee metabolism.

    Coffee consumption was associated with a reduced risk of cardiac arrhythmia. For each cup of coffee consumed daily, the risk of arrhythmia was reduced by three percent. This means an individual consuming three cups of coffee would have a nine percent risk reduction. This relationship was significant even after taking age, sex, race, metabolic health, smoking, alcohol and tea consumption, and exercise into account. Participants with genetic variants associated with slower caffeine metabolism drank less coffee, but did not have an increased risk of arrhythmia.

    Greater coffee consumption was associated with a reduced risk of cardiac arrhythmias, a result that contradicts earlier evidence. Learn how coffee consumption may induce autophagy to improve other aspects of health in this clip featuring Dr. Guido Kroemer.

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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 supplementation improves cognitive performance in cognitively healthy older adults with coronary artery disease. academic.oup.com
    Brain Heart Disease Omega-3 Supplements

    Dementia is a large and growing health concern facing older adults, with approximately 15 to 20 percent of people aged 65 years and older living with mild cognitive impairment. Omega-3 fatty acids have benefits for those with mild cognitive impairment and coronary artery disease, a risk factor for dementia because it restricts blood flow to the brain. Findings of a recent report demonstrate the effects of omega-3 supplementation on cognitive decline in cognitively healthy older adults with coronary artery disease.

    The omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) protect the aging brain by decreasing oxidative stress and inflammation and increasing neurogenesis. Dietary consumption of omega-3 rich foods such as fish is associated with a decreased risk of Alzheimer’s disease, while low blood levels of DHA are associated with smaller brain volume, a hallmark of cognitive decline. To date, there have been few studies measuring the impact of long-term omega-3 supplementation on cognitive function in adults without cognitive impairment or dementia.

    The researchers enrolled 285 adults (average age, 63 years) who had stable coronary artery disease and were taking cholesterol-lowering statin medication. They assigned half of the participants to consume an EPA and DHA supplement (approximately 3 grams of omega-3 fatty acids total) for 30 months while the other half consumed no supplement. Participants completed a battery of cognitive tests at baseline, 12 months, and 30 months, measuring global cognition, language, verbal fluency, visual-motor coordination, psychomotor speed, and memory.

    After 30 months of omega-3 supplementation, participants had significantly better scores for verbal fluency, language, and memory than participants who did not supplement. Participants who supplemented also performed significantly better on two measures of visual-motor coordination. These improvements were measurable at just 12 months of supplementation.

    The investigators concluded that combined EPA and DHA supplementation improved cognition in cognitively healthy older adults with coronary artery disease. These results demonstrate the ability of omega-3 fatty acids to protect brain health even in those with coronary artery disease, a risk factor for dementia.

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  • A Mediterranean diet pattern supplemented with low to moderate amounts of beef decreases LDL cholesterol. www.sciencedaily.com
    Diet Heart Disease

    The Mediterranean dietary pattern, which is low in saturated fats and high in unsaturated fats, is widely-recognized as a heart-healthy diet when compared to the standard American dietary pattern, which is high in saturated fats. Red meat is traditionally minimized in the Mediterranean dietary pattern to less than 120 grams (about four ounces) per week - roughly the size of a small burger patty; however, this recommendation is largely based on epidemiological evidence, not interventional trials. Authors of a new report aimed to determine the dose-dependent effects of lean beef consumption as part of a Mediterranean dietary pattern on heart disease risk.

    Recent research suggests that lean, unprocessed red meat can be included in a heart-healthy dietary pattern. One randomized clinical trial found that consumption of a Mediterranean dietary pattern supplemented with 500 grams (about 17 ounces) of red meat per day over five weeks reduced total and LDL cholesterol.

    Fifty-nine generally healthy participants of varying weight status between the ages of 30 and 65 years completed the trial. Participants consumed a Mediterranean dietary pattern (8 percent saturated fat) supplemented with either 0.5, 2.5, or 5.5 ounces of lean, unprocessed beef per 2,000 calories consumed per day. As a comparison diet, participants also consumed an American dietary pattern (12 percent saturated fat). All participants consumed each diet for four weeks in a randomized order and had their blood drawn at multiple time points for cholesterol testing.

    Compared to the American dietary pattern, all three Mediterranean dietary patterns significantly reduced LDL cholesterol (0.5 ounces: −10.3 milligrams per deciliter; 2.5 ounces: −9.1 milligrams per deciliter; 5.5 ounces: −6.9 milligrams per deciliter). The authors also reported reductions in LDL particle number for all three Mediterranean dietary patterns, although this reduction was significant for the diets supplemented with 0.5 ounces or 2.5 ounces of red meat but not 5.5 ounces. All four diets resulted in reductions of HDL cholesterol and HDL particle number compared to baseline.

    The researchers concluded that the cholesterol-lowering effects of a Mediterranean dietary pattern were not diminished by the inclusion of up to 2.5 ounces of lean, unprocessed beef. They noted that future research should test a similar diet in patients with worse health status than this generally healthy population.

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  • Cocoa consumption protects vascular function during mental stress. www.sciencedaily.com
    Heart Disease

    Mental stress negatively affects the cardiovascular system, inducing a wide range of impairments in vascular function. In fact, exposure to even a single-episode stressor, such as a natural disaster or other traumatic situation, can trigger an acute cardiovascular event. Findings from a new study suggest that consuming cocoa can protect vascular function during a stressful event.

    Cocoa is derived from the cacao tree and is the principal component of chocolate. It is rich in flavanols, a class of bioactive compounds found not only in cocoa but also in apples, berries, grapes, and tea. Flavanols are potent antioxidants that exert cardioprotective effects in humans.

    The cross-over intervention study involved 30 healthy young males between the ages of 19 and 36 years. After an overnight (12-hour) fast, the participants consumed a cocoa beverage prepared with 8.3 grams of either high- or low-flavanol cocoa powder dissolved in 300 milliliters of low-nitrate water. The high-flavanol cocoa provided approximately 681 milligrams of flavanols, while the low-flavanol cocoa provided approximately 4 milligrams of flavanols. Then they took an eight-minute Paced Auditory Serial Addition Test, a measure of attention and vigilance. At various timepoints surrounding the test, the authors of the study measured aspects of the participants' vascular function, including heart rate, blood pressure, flow-mediated dilation, forearm blood flow, and heart rate variability. Participants repeated the test one week later with the opposite form of the beverage consumed in the first intervention.

    The authors found that several measures of vascular function were improved when participants consumed the high-flavanol beverage. Flow-mediated dilation was impaired 30 minutes after the stressor in both groups of participants, but to a lesser degree among those who consumed the high-flavanol beverage. This difference was maintained even at 90 minutes after the stressor. Consuming high-flavanol cocoa improved forearm blood flow before and during the stressor. Stress-induced increases in heart rate, heart rate variability, and blood pressure were similar with both high- and low-flavanol cocoa beverages.

    These findings suggest that cocoa, a flavanol-rich food, modulates the cardiovascular responses to stress. Check out this recipe for a flavanol-rich smoothie.

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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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  • 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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  • NAD+ may be beneficial in treating a common form of heart failure. stm.sciencemag.org
    Nutrition Heart Disease

    Nicotinamide adenine dinucleotide (NAD+) plays an essential role in multiple physiological processes, including energy metabolism, DNA repair, and immune activation. Cellular NAD+ production declines with age, however, and its depletion has been implicated in the onset and progression of a wide range of age-related conditions. Findings from a new study suggest that NAD+ is beneficial in treating heart failure with preserved ejection fraction.

    The heart’s ejection fraction is a measure of how much blood the left ventricle pumps with each contraction. Heart failure with preserved ejection fraction, a condition in which the heart muscle contracts normally but the ventricles don’t properly relax, is a leading cause of hospitalization in older adults. Few therapies for the condition exist, but caloric restriction has been shown to improve disease status in people with heart failure with preserved ejection fraction. Increasing cellular levels of NAD+ mimics the effects of caloric restriction.

    The study involved both rodents and humans. In the rodent portion of the study, the authors gave nicotinamide, a precursor to NAD+, to mice and rats that had cardiovascular dysfunction related to aging, salt-sensitivity, or obesity. The animals' heart function improved in each of the three scenarios via enhanced diastolic function, improved heart bioenergetics, and reduced comorbidities, including blood pressure and body fat.

    The human study drew on nutritional and death rate data from a prospective, population-based survey of atherosclerosis among 40- to 79-year-old men and women. The data indicated that higher dietary intake of NAD+ precursors reduced the risk of all causes of premature death, especially those related to cardiovascular diseases. People who consumed more NAD+ precursors were also less likely to have high blood pressure. These findings held true even after taking into account other factors, including age, sex, smoking, diabetes, alcohol intake, body mass index, and total cholesterol.

    These findings demonstrate that NAD+ precursors show promise as a means of treating heart failure with preserved ejection fraction. The FMF team has developed a collection of articles related to NAD+ and its precursors, nicotinamide mononucleotide and nicotinamide riboside.

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  • Coenzyme Q10 may be beneficial in treating heart failure. pubmed.ncbi.nlm.nih.gov
    Heart Disease

    Coenzyme Q10 (CoQ10) is a fat-soluble nutrient that helps convert food into energy and protects cells against damage from reactive oxygen species. It is produced by the body and is particularly abundant in the heart, liver, kidneys, and pancreas. Findings from a 2014 studied demonstrated that CoQ10 is beneficial in treating heart failure.

    People who have heart failure often have low levels of CoQ10 in their heart tissue. Low levels correlate with the severity of symptoms and the extent of left ventricular dysfunction – the inability of the ventricle to fill appropriately. Low plasma CoQ10 levels are independent predictors of death among people with heart failure.

    The study, called Q-SYMBIO, was a prospective, randomized, double-blind, placebo-controlled, multicenter trial involving 420 heart failure patients at 17 European, Asian, and Australian hospitals. Roughly half of the participants took 100 milligrams of CoQ10 three times daily for two years, while the remainder took a placebo. The authors of the study monitored the patients for changes in their changes in New York Heart Association (NYHA) functional classification, capacity to perform a six-minute walk test, and levels of N-terminal pro–B type natriuretic peptide (NT-proBNP) after 16 weeks of the intervention. NT-proBNP is a pro-hormone that increases as heart failure worsens and decreases when the condition is stable. The authors also tracked whether the participants experienced a major cardiovascular event during the two-year period.

    No changes in the participants' NYHA classification, walk test, or NT-proBNP were noted after 16 weeks of the intervention. However, after two years, 26 percent in the placebo group experienced a major cardiovascular event, whereas only 15 percent of the patients in the CoQ10 group did. Those who took CoQ10 were less likely to die from cardiovascular-related causes or other causes of premature death and were less likely to require hospitalization. Those who took CoQ10 also saw significant improvements in their NYHA classification after two years.

    These findings suggest that CoQ10 is beneficial in the treatment of heart failure and may reduce the risk of cardiovascular-related or other causes of premature death.

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  • Supplemental magnesium ameliorates symptoms associated with heart failure. pubmed.ncbi.nlm.nih.gov
    Heart Disease Magnesium

    Heart failure is commonly referred to as the end stage of heart disease – the culmination of all forms of cardiovascular disease. More than 26 million people worldwide have heart failure. Findings from a 2007 study suggested that supplemental magnesium ameliorates symptoms associated with heart failure.

    Magnesium is an essential mineral and a cofactor for hundreds of enzymes. It is involved in many physiologic pathways, including energy production, protein synthesis, ion transport, and cell signaling. Magnesium deficiency is linked with increased risk of cardiovascular disease and metabolic disorders, including hypertension and type 2 diabetes. Current magnesium intakes among people living in the United States are below recommended levels of 400-420 milligrams per day for men and 310-320 milligrams per day for women.

    The double-blinded, randomized intervention study involved five patients with chronic heart failure. Fifteen of the patients received 800 milligrams of supplemental magnesium oxide daily for three months, while the remainder took a placebo. The study investigators measured small and large arterial elasticity and compliance, hemodynamic parameters, exercise capacity, and quality of life at the beginning of the study and again at one week and three months after the intervention. Several of the patients dropped out of the study, with only five completing the full three-month intervention.

    Patients who took the magnesium supplement had improved small arterial compliance, a measure of endothelial function. Reduced compliance is an indication of abnormalities in vascular structure.

    This study suggests that supplemental magnesium improves endothelial function in symptomatic heart failure patients. However, this was a very small study group, so further study in a larger group of participants is warranted.

    Read more
  • Combining aerobic exercise and strength training may be the best strategy for improving healthspan. www.bmj.com
    Exercise Cancer Heart Disease Aerobic Strength

    Current public health guidelines recommend that adults engage in regular physical activity for optimal health. Findings from a new study suggest that a combination of both aerobic and strength activities reduces the risk of death from all causes as well as specific causes.

    According to the guidelines, adults should engage in at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity each week, or an equivalent combination of both. They should also engage in muscle-strengthening activities of moderate or greater intensity on two days or more each week.

    The population-based cohort study, which involved nearly 480,000 adults, drew on data from the National Health Interview Survey, an ongoing, cross-sectional survey of people living in the United States. The study participants reported how much leisure time aerobic and strength physical activity they engaged in each week. Then the authors of the study categorized them as having insufficient activity, aerobic activity only, strength activity only, and both aerobic and strengthening activities, based on the guidelines.

    The authors found that the participants who engaged in recommended amounts of aerobic or muscle-strengthening activity had a lower risk of death from all causes, and these benefits were even greater if they engaged in both types of activities. They noted similar reductions in risk of death from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.

    These findings suggest that adherence to public health guidelines for exercise reduce the risk of disease and death and provide support for interventions to improve compliance.

    Read more
  • 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.

    Read more
  • 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.

    Read more
  • Fragmented sleep contributes to increased risk of atherosclerosis. news.berkeley.edu
    Sleep Heart Disease

    Atherosclerosis is a disease of the arteries characterized by the deposition of fatty plaques on the arteries' inner walls. Roughly half of all deaths in developed countries are attributed to atherosclerosis. A new study suggests that a pro-inflammatory pathway triggered by poor sleep contributes to the risk of developing atherosclerosis.

    The study involved more than 1,600 ethnically and racially diverse adults (average age, 68 years) enrolled in the Multi-Ethnic Study of Atherosclerosis. The authors of the study measured the participants' home sleep and activity levels over a period of a week and assessed their brain activity during one night in a sleep laboratory. They also ran blood tests to identify biomarkers associated with disease processes and determined the participants' coronary artery calcification scores, which provide reliable measures of atherosclerosis.

    They found that poor, fragmented sleep led to increased levels of proinflammatory molecules and white blood cells (neutrophils and monocytes). Together, these factors promote inflammation, a key driver in the pathogenesis of not only atherosclerosis but many other diseases as well. Poor sleep also predicted the degree of coronary artery calcification. Their findings held true even after ruling out factors related to age, ethnicity, gender, body mass index, sleep disorders, blood pressure, and smoking.

    These findings underscore the fact that sleep has far-reaching effects on many aspects of health. Learn more in this clip featuring sleep expert Dr. Matthew Walker, in which he describes how the different stages of sleep influence both mental and cardiovascular health.

    Read more
  • Prescription omega-3 fatty acid drugs reduce high or very high triglyceride levels. www.sciencedaily.com
    Heart Disease Omega-3

    Triglycerides are molecules composed of a glycerol molecule bound to three fatty acids. They are the primary component of very-low-density lipoproteins and serve as critical sources of energy. Having high triglycerides (200 to 499 mg/dL) or very high triglycerides (higher than 500 mg/dL) can increase the risk of cardiovascular disease. A recent science advisory from the American Heart Association summarizes the data surrounding the use of prescription omega-3 fatty acids to lower triglyceride levels.

    Omega-3 fatty acids are essential for human health. They 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 Food and Drug Administration has approved prescription omega-3 fatty acids containing EPA and DHA for the treatment of high or very high triglycerides. Most formulations are in doses that provide more than three grams of EPA and DHA (combined) or EPA alone daily.

    The authors of the advisory stated that treating very high triglycerides with 4 grams per day of combined EPA and DHA can reduce patients' triglycerides by 30 percent or more. However, at these doses, patients often experience increases in their LDL cholesterol. When given as EPA alone, LDL typically remains unchanged. Treating high triglycerides with combined EPA and DHA or with EPA alone effectively reduces triglycerides and doesn’t increase LDL.

    Findings from a large trial investigating the use of 4 grams of EPA per day (along with a statin) to reduce triglycerides demonstrated a 25 percent reduction in major cardiovascular events. Current trials are underway investigating the effectiveness of using combined EPA and DHA in the treatment of high triglycerides.

    The authors of the advisory concluded that 4 grams per day of EPA and DHA are effective and safe for reducing triglycerides either alone or as an adjunct to cholesterol-reducing drugs like statins.

    Read more
  • Strokes in COVID-19 are rare but are more severe, occur in younger patients, and have higher mortality rate. www.eurekalert.org
    Heart Disease Mortality COVID-19

    During the study period of March 15 through April 19, 2020, out of 3,556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging-proven ischemic stroke. They compared those 32 patients admitted with stroke and COVID-19 to those admitted only with stroke (46 patients) and found that the patients with COVID-19:

    tended to be younger, average age of 63 years vs. 70 years for non-COVID stroke patients; had more severe strokes, average score of 19 vs. 8 on the National Institutes of Health Stroke Scale; had higher D-dimer levels, 10,000 vs. 525, which can indicate significant blood clotting; were more likely to be treated with blood thinners, 75% vs. 23.9%; were more likely to have a cryptogenic stroke in which the cause is unknown, 65.6% vs. 30.4%; and were more likely to be dead at hospital discharge, 63.6% vs. 9.3%. Conversely, COVID-19 stroke patients were less likely than those stroke patients without the novel coronavirus to have high blood pressure (56.3% vs. 76.1%) or to have a prior history of stroke (3.1% vs. 13%).

    Read more
  • Magnesium intake reduces risk of coronary artery calcification. www.sciencedirect.com
    Heart Disease Magnesium

    Coronary artery atherosclerosis, a narrowing of the heart’s arteries caused by a buildup of plaque, is the principal cause of coronary artery disease and the single leading cause of death worldwide. Coronary artery calcification provides a reliable measure of atherosclerosis. A 2014 study found that magnesium intake is inversely related to coronary artery calcification.

    Magnesium is an essential mineral and a cofactor for hundreds of enzymes. It is involved in many physiological pathways, including energy production, nucleic acid and protein synthesis, ion transport, and cell signaling. Magnesium deficiency is linked with an increased risk of cardiovascular disease, osteoporosis, and metabolic disorders, including hypertension and type 2 diabetes. Dietary sources of magnesium include legumes, nuts, seeds, whole grains, and green leafy vegetables (such as spinach).

    The study drew on data from the Framingham Heart Study, a long-term, ongoing epidemiological study of cardiovascular disease risk among people living in Framingham, Massachusetts. The study participants included more than 2,600 people who underwent computed tomography (CT) scanning to determine the presence of coronary artery calcification and completed food frequency questionnaires to provide information about their dietary and supplemental magnesium intake. The men in the study were 35 years of age and older, and the women were 40 years of age and older.

    The scans revealed that more than 43 percent of the participants exhibited signs of coronary artery calcification. Men were roughly 50 percent more likely to have calcification than women. The food frequency questionnaires indicated that the participants' magnesium intake averaged approximately 338 milligrams per day. Participants with the highest magnesium intake were 58 percent less likely to have coronary artery calcification than those with the lowest intake.

    These findings highlight the importance of magnesium intake in modulating cardiovascular health and suggest that dietary and supplemental interventions could reduce risk of cardiovascular disease.

    Read more
  • Cardiac injury commonly occurs in patients with COVID-19 and markedly increases risk of death among patients with preexisting cardiovascular disease. jamanetwork.com
    Heart Disease COVID-19

    People who have cardiovascular diseases such as coronary artery disease, atherosclerosis, or heart failure often have poor outcomes during acute illness. Cardiac injury commonly occurs with COVID-19 illness, exacerbating preexisting cardiovascular disease. A recent editorial summarizes the available data regarding adverse outcomes associated with cardiovascular disease and COVID-19.

    The authors of the editorial describe the findings from two recent studies conducted at a teaching hospital in Wuhan, China. One study compared the outcomes of hospitalized COVID-19 patients who had myocardial damage versus COVID-19 patients without myocardial damage. More than half (51 percent) of those with myocardial damage died while in the hospital, but only 4.5 percent of those without myocardial damage died in the hospital. Another study had similar findings, with higher death rates (59.6 percent) among patients with preexisting cardiovascular disease and elevated troponin (a marker of cardiac injury) compared to those with normal troponin levels (8.9 percent).

    The findings from these two studies suggest that cardiac injury commonly occurs in patients with COVID-19 and markedly increases risk of death among patients with preexisting cardiovascular disease. These patients might require more aggressive care than other patients.

    Read more
  • Study shows Vitamin C may lower blood pressure by nearly 5 mm Hg in hypertensive patients. www.sciencedaily.com
    Heart Disease Vitamin C Blood Pressure

    From the article:

    Miller and his colleagues reviewed and analyzed data from 29 randomized, controlled, previously published clinical trials that reported systolic and/or diastolic blood pressure values and also compared vitamin C intake to a placebo. What they found is that taking an average of 500 milligrams of vitamin C daily – about five times the recommended daily requirement – reduced blood pressure by 3.84 millimeters of mercury in the short term. Among those diagnosed with hypertension, the drop was nearly 5 millimeters of mercury.

    A comparison to common pharmacological treatment:

    By comparison, Miller says, patients who take blood pressure medication such as ACE inhibitors or diuretics (so-called “water pills”) can expect a roughly 10 millimeter of mercury reduction in blood pressure.

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  • Drinking a high flavanol cocoa beverage reduced symptoms of peripheral arterial disease. www.sciencedaily.com
    Heart Disease Blood Pressure Antioxidant Dairy

    Peripheral arterial disease (PAD), a narrowing of the blood vessels outside the heart and brain, is caused by the buildup of atherosclerotic plaques. This narrowing promotes arterial insufficiency – a reduction in overall blood flow. More than 8.5 million people living in the United States have PAD. A recent study suggests that drinking a cocoa beverage rich in flavanols improves symptoms associated with PAD.

    Cocoa contains the flavanol epicatechin, a bioactive food component that exerts antioxidant, anti-inflammatory, and anti-cancer properties. Previous work has demonstrated that cocoa in dark chocolate improved endothelial function and lowered blood pressure in people who were overweight.

    This double-blind, randomized clinical trial involved 44 adults with PAD (average age, 72 years) who drank either a cocoa beverage or a placebo beverage once daily for six months. The cocoa beverage contained 15 grams of cocoa (> 85 percent cacao) and provided 75 milligrams of epicatechin. The authors of the study assessed changes in physiological parameters associated with a 6-minute walk performed immediately after and 24 hours after consumption of the beverage.

    The data revealed that the participants who drank the cocoa beverage showed marked improvement in their walking performance, increasing their walking distance by nearly 43 meters immediately after consumption of the beverage and by nearly 18 meters 24 hours afterward. Those who drank the placebo decreased their walking distance by more than 24 meters. These findings held true regardless of the participants' race, smoking status, or body mass index.

    The participants' plasma levels of epicatechin and its related metabolites were higher among those who drank the cocoa beverage. Furthermore, biopsies of the participants' calf muscles revealed that cocoa improved mitochondrial function, blood flow, and capillary density, compared to the placebo, suggesting that cocoa shows promise as a therapeutic strategy for people who have PAD.

    Read more
  • 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.

    Read more
  • Abdominal obesity is associated with fatal heart attacks and strokes independent of other risk factors. www.escardio.org
    Obesity Heart Disease Weight Loss

    Myocardial infarction (MI), commonly referred to as heart attack, occurs when one of the heart’s coronary arteries is blocked suddenly or has poor blood flow. One of the principal risk factors for MI in men and women is abdominal obesity. The relative risk of recurrent cardiovascular disease-related death after having MI is approximately 30 percent higher than the risk among people without MI. Findings from a recent study suggest that abdominal obesity increases the risk of a fatal recurrent MI or stroke.

    According to the World Health Organization, the waist circumference range for increased cardiovascular risk is 94 to 102 centimeters for men and 80 to 88 centimeters for women. Values above this range place people at greatly increased risk. Waist circumference measurement is particularly relevant in people whose body mass index is normal or overweight.

    The study was based on data gathered from more than 22,000 people living in Sweden who were between the ages of 35 and 77 years old and had experienced their first MI. The participants were followed for approximately four years for recurrent cardiovascular events, including nonfatal MI, coronary heart disease death, or stroke.

    The findings indicated that during the follow-up period, 7.3 percent of the men and 7.9 percent of the women had a recurrent cardiovascular event. The majority of the study participants had a waist circumference that was higher than the WHO’s recommended thresholds. Having a larger waist circumference was associated with roughly 20 percent greater risk of recurrent cardiovascular-related event, regardless of age, body mass index, or other risk factors, especially in men. Interestingly, participants who were overweight were less likely to experience a recurrent cardiovascular disease-related event compared to those who were normal weight or obese.

    These findings demonstrate that waist circumference may be a useful tool in the clinical setting for identifying patients at increased risk for recurrent MI and suggest that strategies to reduce abdominal fat (such as lifestyle modification) may reduce the risk of fatal heart attacks and strokes.

    Read more
  • Meta-analysis finds that quercetin significantly lowers blood pressure. academic.oup.com
    Heart Disease Triglycerides Blood Pressure

    Cardiovascular disease is the number one cause of death worldwide, claiming the lives of more than 17 million people every year. A recent meta-analysis and systematic review suggests that quercetin may exert protective effects to reduce the risk of cardiovascular disease.

    Quercetin is a flavonol compound found in a wide variety of fruits and vegetables, including onions, apples, tea, and lettuce. Epidemiological data suggest that quercetin exerts protective effects against cardiovascular diseases, cancer, and other chronic diseases due to its anti-inflammatory actions.

    The analysis investigated the effects of quercetin intake on several risk factors for cardiovascular disease, including lipid profiles, blood pressure, and glucose levels. It was based on findings from 17 randomized controlled trials involving nearly 900 participants who took a standardized quercetin extract.

    The results of the analysis indicated that quercetin intake reduced systolic and diastolic blood pressures by approximately 3.09 mmHg and 2.86 mmHg, respectively. Quercetin intake did not appear to influence blood lipid profiles or glucose levels. However, a sub-group analysis demonstrated that longer trials of quercetin intake (8 weeks or more) had favorable effects on participants' HDL cholesterol and triglyceride levels.

    These findings suggest that quercetin may be useful in the clinical setting for the management of risk factors associated with cardiovascular disease.

    Read more
  • Low levels of omega-3 fatty acids are associated with early-onset coronary atherosclerosis. www.nature.com
    Heart Disease Omega-3

    Coronary artery atherosclerosis, a narrowing of the heart’s arteries caused by a buildup of plaque, is the single leading cause of death worldwide. It is the principal cause of coronary artery disease. A new study suggests that low levels of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with increased risk of early-onset coronary artery atherosclerosis.

    Coronary artery calcification (CAC) provides a reliable measure of atherosclerosis. A high CAC score is a robust indicator of a person’s 10-year cardiovascular event risk. It is more common among men than women.

    The study involved 71 male and female patients (average age, 68 years) who presented with atypical angina. The participants underwent non-contrast enhanced coronary CT scans and provided blood samples for fatty acid analysis.

    The CT scans revealed that 63 percent of the patients had detectable CAC scores. Of these, low blood levels of EPA and DHA were positively associated with early onset of coronary artery atherosclerosis, suggesting a protective role for omega-3 fatty acids in cardiovascular disease.

    Read more
  • Biological "aortic age" of the heart reduced by approximately four years in first-time marathon runners. www.inverse.com
    Exercise Heart Disease Blood Pressure

    Endurance exercise, such as long-distance running, swimming, and cycling, improves metabolism and reduces the risk of disease and death, especially from cardiovascular-related conditions. A new study found that marathon running, in particular, improves cardiovascular health by reversing age-related aortic stiffness.

    The aorta is the largest artery in the human body. It delivers oxygenated blood from the heart to peripheral tissues. Aortic stiffness, or inelasticity, is a hallmark of aging and cardiovascular disease. Alterations in the mechanical properties of the aorta drive aortic stiffness.

    The study involved 138 healthy adults who participated in a 6-month training program for a marathon. The study participants were between the ages of 21 and 69 years who ran between 6 and 13 miles per week.

    Measures of the participants' aortic blood pressure and aortic stiffness provided estimates of their biological “aortic age.” Post-training measures revealed that training reduced systolic and diastolic aortic blood pressures by 4 mm Hg and 3 mm Hg, respectively, translating to approximately four years of chronological age. Men and older marathon runners saw the greatest improvements in their cardiovascular health, compared to younger or female runners.

    Read more
  • 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.

    Read more
  • 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.

    Read more
  • Eating an avocado a day lowered small, dense LDL particles and lowered oxidized LDL, both of which are associated with heart disease. news.psu.edu
    Diet Heart Disease Fatty Liver Monounsaturated Fat Polyphenol

    Low-density lipoproteins (LDL) are formed in the liver and transport lipid molecules to cells. Often referred to as the “bad cholesterol,” LDL can drive cardiovascular disease if it becomes 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, dense LDL particles are more susceptible to oxidative modification. Findings from a new study suggest that diets that include avocados may help reduce LDL oxidation.

    The randomized, controlled trial involved 45 men and women between the ages of 21 and 70 years. The participants, who were overweight or obese and had elevated LDL cholesterol levels, followed three different diets for a period of five weeks each: a low-fat diet, a medium-fat diet with avocado, and a medium-fat diet with oleic acids (found in olive and canola oils).

    Avocados are rich sources of monounsaturated fatty acids. They also contain polyphenols and lutein, a carotenoid compound that quenches and scavenges reactive oxygen species.

    After five weeks on the diet with avocado, the participants' levels of oxidized LDL cholesterol (especially the small, dense LDL cholesterol particles) were lower than their baseline levels or after completing the low- or moderate-fat diets. Concentrations of large, fluffy LDL particles were unchanged. Participants also had higher levels of lutein. These findings suggest that consuming avocados as part of an overall heart-healthy diet may reduce the risk of developing cardiovascular disease.

    Read more
  • Fish oil supplementation associated with a lower risk of heart attack, heart disease, coronary heart disease and death from all those diseases. www.sciencedaily.com
    Heart Disease Omega-3 Iron

    Fish oil supplementation associated with a lower risk of heart attack, heart disease, coronary heart disease and death from all those diseases. This was particularly evident at higher doses (updated meta‐analysis including 13 randomized controlled trials).

    This study is an UPDATED meta-analysis that included the previously analyzed trials and 3 recently completed large-scale trials, which increased the sample size by 64%. In one analysis the REDUCE-IT trial, which was the high dose EPA study that found very large reductions in cardiovascular disease (CVD) were excluded and still reductions in CVD found.

    One important thing that was explored in this updated analysis was dose-response relationships between fish oil supplementation and CVD risks. This has not been addressed yet. Because most included trials with negative results included patients at high risk of CVD and with advanced atherosclerosis, a high dose of marine omega‐3 supplementation may be needed to achieve potential benefits in this setting.

    Read more
  • New data suggest the human heart evolved to endure regular bouts of sustained moderate-intensity endurance exercise and is partly dependent upon it. blogs.discovermagazine.com
    Exercise Heart Disease Blood Pressure

    Primate hearts are uniquely adapted to meet their species-specific physical activity needs. Whereas chimpanzee hearts are adapted to relatively low levels of activity interspersed with short bursts of resistance activities, the human heart has adapted to allow humans to engage in low- to moderate-intensity endurance activities to facilitate the acquisition and preparation of food. Findings from a new study suggest that human heart health is dependent upon moderate-intensity endurance exercise, and its absence likely contributes to hypertensive heart disease.

    The structure and function of the heart’s left ventricle are critical to heart health. Left ventricular dysfunction sets in motion a cascade of compensatory mechanisms that promote organ-level structural changes and elicit system-level hormonal adaptations, including hypertension. It is widely recognized as the end-stage of heart failure.

    The authors of this study compared the blood pressures and left ventricular function and structure of chimpanzees and humans. They found that the human left ventricle amplifies cardiac output, a measure of the amount of work the heart performs in response to the body’s need for oxygen. This adaptation facilitates endurance activities and is not present in chimpanzees. They also found that lack of endurance activity changes the shape of the human heart to reflect more of a chimpanzee-like heart.

    These findings suggest that human heart health is dependent upon regular low- to moderate-intensity activities that challenge the heart.

    Read more
  • A high dose of fish oil (4g/day) lowered triglyceride levels by 20-30% in people with high triglycerides. www.sciencedaily.com
    Heart Disease Omega-3 Triglycerides

    A high dose of fish oil (4g/day) lowered triglyceride levels by 20-30% in people with high triglycerides according to an analysis of 17 randomized controlled trials reviewed by the scientific advisory council at the American Heart Association.

    “In analyzing the current scientific data, the advisory panel found:

    •For most people with high triglycerides (200 to 499 mg/dL), prescription doses of omega-3 fatty acids using drugs with either EPA+DHA or EPA alone can reduce triglyceride by 20 to 30%.

    •Contrary to common perception, the formula that contains both EPA and DHA does not increase the “bad” form of cholesterol (LDL-C) among most people with high triglyceride levels (200-499 mg/dL). However, when the drug is given to people with very high triglyceride levels at 500 mg/dL or greater, LDL-C may increase.

    •The panel’s review found that prescription omega-3 fish oil is effective in reducing triglyceride levels regardless of whether people are on statin therapy.

    •In a recent large, randomized placebo-controlled study called REDUCE-IT, researchers found that the EPA-only medication combined with statin medication resulted in a 25% reduction in major cardiovascular events (heart attack, stroke and cardiovascular death) among people with high triglycerides."

    Read more
  • Stem cells derived from placenta were able to regenerate healthy heart cells after heart attacks in animals. www.eurekalert.org
    Heart Disease Stem Cells Pregnancy Neurons

    Stem cells derived from placenta were able to regenerate healthy heart cells after heart attacks in animals. The placental stem cells traveled to the site of the injury in the heart and formed beating heart cells that helped repair damage.

    To learn more about stem cells derived from placenta, check out the podcast I did a few years ago with Dr. Frans Kuyper who discovered how the human placenta is a rich source of pluripotent stem cells and yet the placenta is thrown away after delivery. We discuss how his lab has shown that the stem cells from the placenta can be transformed into neuron-like cells, fat cells, bone cells, endothelial cells (relevant for lung and blood vessels), and liver cells. His lab also developed a technique for harvesting 5 to 7 times more hematopoietic stem cells from placenta than is currently retrieved from cord blood, a more standard, established source that is used worldwide for a bone-marrow transplant.

    There are a couple of companies that bank placenta and cord blood after your baby is born. I chose to bank both placenta and cord blood after the birth of my son. I decided to go with Life Bank USA (no affiliation) to bank my cord blood and placenta because I really liked the research they are doing with placental stem cells. I hope to see more well-established cord blood companies start banking placental tissue…it is so worth it.

    Foundmyfitness placental stem cell episode: https://www.foundmyfitness.com/episodes/frans-kuypers

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  • VITAL study: How vitamin D and fish oil affect risk of heart attack, stroke and cancer www.eurekalert.org
    Vitamin D Cancer Heart Disease Omega-3 Vitamin A

    Finally, the highly anticipated result of the VITAL Study are in - at least for the major endpoints CVD and cancer.

    While at first sight they may seem disappointing and have already prompted the usual, overgeneralizing negative reports from many media outlets, there are some remarkable findings if you look more closely - such as a whopping 77% reduced risk for heart attacks in African Americans taking fish oil (all those media who are now sweepingly reporting that fish oil dies “not reduce CVD”, without mentioning this, such as MdMag*, musk ask themselves whether they are looking at the results through racist glasses, as the investigators certainly didn’t make a secret of this remarkable finding).

    With regard to vitamin D, the results certainly don’t support the strong effect on cancer risk suggested by some observational studies, but there seems to be a modest effect building up over time, and given the fact that 2000 IU is a rather modest dose indeed and not expected to raise the blood level by more than 10 ng/ml, the jury is far from out on vitamin D and cancer.

    Anyway, this is a very high quality trial providing the researchers with a treasure-trove of data that will be subject to many auxillary studies. I’m particularly curious about the upcoming studies regarding autoimmune and mental health endpoints.

    *https://www.mdmag.com/conference-coverage/aha-2018/vital-study-supplements-of-omega3s-or-vitamin-d-do-not-reduce-cvd-or-cancers

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  • Supplementation with the omega-3 EPA (4g/day) reduced cardiovascular-related death by 25% compared to placebo. www.nejm.org
    Heart Disease Omega-3 Triglycerides

    Supplementation with the omega-3 EPA (4g/day) reduced cardiovascular-related death by 25% in people with high triglycerides on statins compared to those taking a placebo (randomized, double-blind, placebo-controlled trial in 8,179 people from around the world).

    The supplement used in this study was a highly pure EPA and the placebo was mineral oil. There has been some concern that the mineral oil may have had adverse effects on lipids since the placebo was associated with a 6% increase in LDL; however, that increase would only translate to a 4% increased heart attack risk. Furthermore, a similar study in Japan using 4g/day of EPA showed a 19% reduction in cardiovascular-related death but there was no placebo control.

    Additionally, the effects of the highly purified EPA might be independent of lipid-lowering effects. EPA also decreases inflammation, has effects on blood thinning and cell membrane fluidity…any of these might affect sudden cardiac death.

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  • Beta-hydroxybutyrate production from fasting or a ketogenic diet may reduce the production of senescent cells associated with vascular aging www.sciencedaily.com
    Aging Ketosis Heart Disease DNA Damage Fasting Ketogenic Diet

    Fasting or beta-hydroxybutyrate administration reduces cellular senescence.

    Beta-hydroxybutyrate (BHB) is a ketone produced by the body during times of carbohydrate scarcity such as those encountered while practicing a ketogenic diet, fasting, or exercise, which have all demonstrated the ability to extend healthspan and lifespan. However, the precise effects of beta-hydroxybutyrate on the cellular mechanisms of aging are not well understood. Findings of one report show that BHB administration and fasting both reduce senescence in mice.

    Senescence occurs when a damaged cell terminates its normal cycles of growth and reproduction for the purpose of preventing the accumulation of damaged DNA or mitochondria. While senescence plays a vital role in human development and wound healing, the accumulation of senescent cells is associated with diseases of aging such as Alzheimer’s disease, Parkinson’s disease, cardiovascular disease, type 2 diabetes, and glaucoma. Lifestyle habits or drugs that increase beta-hydroxybutyrate may extend healthspan and reduce disease risk by slowing the rate of senescence.

    The researchers conducted an experiment that involved culturing human vascular endothelial (i.e., blood vessel cells) from the umbilical cord and aorta, followed by an experiment with mice. To compare the effects of BHB supplementation and fasting, the researchers fed one group of mice a normal diet, then randomly assigned them to receive an injection of BHB or a placebo after they had fasted for just five hours. Using a second group of mice, the researchers randomly assigned half of the group to fast for 72 hours and the other half to eat normally. In both the cell culture and mice experiments, the researchers measured changes in gene expression and metabolic activity.

    The researchers found that BHB reduced senescence in vascular cells due to increased expression of the transcription factor Oct4, which is a protein that binds to DNA and regulates cell regeneration and stem cell differentiation. Compared to mice who received a placebo injection, mice who received BHB had reduced senescence in vascular cells through the same Oct4 pathway as in cell culture. Mice who fasted also robustly activated Oct4, leading to activation of senescence-associated markers such as mTOR inhibition and AMPK activation, two pathways that modulate lifespan.

    Prior to this study, it was not known whether Oct4 was active in adult cells; however, these results show fasting or BHB administration activates youth-associated DNA factors that reduce senescence in mice and cell culture. Future studies are needed to translate these results into relevant use for humans because humans have very different nutritional needs than mice to cells in culture.

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  • Pilot study finds supplementation with nicotinamide riboside improves blood pressure/arterial health particularly in individuals with hypertension. www.genengnews.com
    Aging Heart Disease Mitochondria Vitamin A Blood Pressure Dairy

    A pilot study finds supplementation with nicotinamide riboside (500 mg, twice a day) improves blood pressure and arterial health particularly in individuals with mild hypertension (compared to placebo). The decrease in blood pressure could translate to a 25% reduction in heart attack risk.

    The study also found that 1,000 mg daily of nicotinamide riboside boosted levels increased NAD+ by 60%.

    Nicotinamide riboside is a form of vitamin B3 that is converted into NAD+. NAD+ is a cofactor for many metabolic enzymes and becomes depleted across various tissues as we age. This causes the mitochondria to suffer and mitochondrial decay is also thought to also be a key driver of aging.

    To learn more about the role of nicotinamide riboside and NAD+ in aging…check out my conversation with Dr. Eric Verdin. Click on the timeline for the exact time point when we discuss nicotinamide riboside.

    Dr. Eric Verdin Episode: https://www.foundmyfitness.com/episodes/eric-verdin

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  • Using the sauna 4x per week lowered hypertension by 46% in men. www.medicalnewstoday.com
    Heart Disease Heat Stress Blood Pressure

    Using the sauna 3x per week was associated with a 24% reduction in high blood pressure. This study included close to 2,000 middle-aged men that were followed for 20 years. The results were adjusted for many possible confounding factors including baseline age, alcohol consumption, BMI, physical exercise, socioeconomic status, systolic blood pressure, smoking status, type 2 diabetes, previous heart attack, resting heart rate and serum low-density lipoprotein cholesterol. Anyone that follows me knows that I talk about saunas A LOT. I interviewed the senior author of this study, Jari Laukkanen, M.D., Ph.D. Dr. Laukkanen has been conducting long-term trials looking at the health effects of sauna use in a population of over 2,000 middle-aged men in Finland. The results? Massive reductions in mortality and memory disease in a dose-response fashion at 20-year follow-up. In the podcast, we talk about the details of how long each sauna session was and the average temperature of the saunas. It is a short episode (~25 minutes) that is well worth a listen! Video podcast: https://www.youtube.com/watch?v=jL7vVG_CFWA

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  • Taking common non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for only a week may increase heart attack risk by as much as 50%. www.telegraph.co.uk
    Heart Disease Drug NSAID Mortality Nitric Oxide

    Multiple studies have now linked chronic use of these painkillers with an increased risk of heart attack and stroke. They mechanisms appear to be mediated through the inhibition of an enzyme known as Cox 2. There have been a couple of mechanisms investigated in animal studies. First, NSAIDs have been shown to inhibit the production of a molecule called prostacyclin that relaxes blood vessels and “unglues” platelets. Second, they have been shown to inhibit the production of nitric oxide (which cox 2 also regulates to some degree).

    Other studies have shown that people taking 2 grams of phytosomal curcumin (called Meriva) had pain reduction equivalent to 800 mg of ibuprofen.

    To hear a longer discuss surounding NSAIDS and heart attack risk, as well as the relevance of curcumin in pain-relief make sure to check out JRE#773 or, more recently, Tim Ferriss Show #237 where both topics are discussed.

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