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Study finds how polluting nanoparticles get into blood and damage hearts

by UNTV News   |   Posted on Thursday, April 27th, 2017

A cyclist wears a mask as he cycles near Buckingham Palace in London April 2, 2014. REUTERS/Luke MacGregor

Inhaled nanoparticles like those pumped out in vehicle exhausts can work their way through the lungs and into the bloodstream where they can raise the risk of heart attack and stroke, scientists said on Wednesday.

In experiments using harmless ultra-fine particles of gold, the scientists were able for the first time to track how such nanoparticles are breathed in, pass through the lungs and then gain access to the blood.

Most worryingly, the researchers said at a briefing in London, the nanoparticles tend to build up in damaged blood vessels of people who already suffer from coronary heart disease – the condition that causes heart attacks – and make it worse.

“There is no doubt that air pollution is a killer, and this study brings us a step closer to solving the mystery of how air pollution damages our cardiovascular health,” said Jeremy Pearson, a professor and associate medical director at the British Heart Foundation charity, which part-funded the study.

Experts have long known that air pollution carries serious health risks and can trigger fatal heart attacks and strokes. According to the World Health Organization, outdoor air pollution in both cities and rural areas was estimated to cause 3.0 million premature deaths worldwide in 2012.

But until now, scientists had not been sure how particles inhaled into the lungs go on to affect heart health. The new findings, published on Wednesday in the journal ACS Nano, build on previous evidence and show that particles in the air we breathe get into blood and are carried to many different parts of the body, including arteries, blood vessels and the heart

“If reactive particles like those in air pollution … reach susceptible areas of the body then even (a) small number of particles might have serious consequences,” said Mark Miller, a senior research scientist at the University of Edinburgh, who led the study.

Miller’s team used specialist techniques to track harmless gold nanoparticles breathed in by volunteers. They found the nanoparticles can migrate from the lungs into the bloodstream within 24 hours and are still detectable three months later.

The researchers also analyzed surgically removed plaques from people at high risk of stroke and found that the nanoparticles tended to accumulate in the fatty plaques that grow inside blood vessels and cause heart attacks and strokes.

Nicholas Mills, a professor of cardiology who also worked on the study, said the findings showed the importance of cutting emissions and limiting peoples’ exposure to nanoparticles.
— By Kate Kelland | LONDON

(Editing by Catherine Evans)

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Flu increases the risk of heart attack

by UNTV News   |   Posted on Thursday, January 25th, 2018

 

FILE PHOTO: A mother and her son wear protective masks in Mexico City April 28, 2009. REUTERS/Daniel Aguilar

(Reuters Health) – Influenza is already known to be deadly, but a new study suggests that the risk of heart attack is six times greater than normal while people are ill with the flu.

“I was a little bit surprised by the strength of the association. It’s not every day you see a six-fold increase in the risk during the first seven days of lab-confirmed influenza,” chief author Dr. Jeffrey Kwong told Reuters Health in a telephone interview. “We were also surprised the risk dropped off to nothing by day 8 and beyond.”

He and his Canadian team also found that other respiratory diseases can also increase the chance of a heart attack, but not as nearly as dramatically.

The group, reporting in The New England Journal of Medicine, did not examine whether flu-associated heart attacks are deadlier.

The new study reinforces the importance of the flu vaccine and protective measures such as regular hand washing to guard against influenza and other infections, said Dr. Kwong, a scientist at the Institute for Clinical Evaluative Sciences in Toronto.

Doctors have suspected a link between flu and heart attacks since the 1930s, but in that era it was hard to know if the influenza virus or a flu-like illness had made a patient sick prior to the heart attack.

Kwong and his colleagues used confirmed cases of flu, analyzing 364 heart attacks from mid-2008 through mid-2015 among Ontario residents age 35 or older who were registered with the province’s publicly funded health insurance program.

The heart attack rate was 20.0 admissions per week during the seven days after diagnosis of the flu, versus 3.3 per week during the 52 weeks before and 51 weeks after that seven-day window.

The risk dropped off dramatically by the eighth day after diagnosis.

Dr. Erica Jones, director of the HeartHealth Program at Weill Cornell Medicine and New York-Presbyterian Hospital, who was not connected with the study, said the results aren’t surprising based on her experience with hospitalized heart attack patients.

“This time of year we frequently had people on the floor after the flu,” she told Reuters Health by phone. “It was often associated with pneumonia.”

The flu “is a stressor to the system. It can increase inflammation. When you get an infection your heart is beating faster. It can activate platelets, increasing the chance that blood clots will form in the arteries that serve the heart. All of these can increase the chance of having a heart attack,” Dr. Kwong said.

Among the 332 people in the study who developed at least one heart attack while recovering from the flu, 69 percent had not received a flu shot. For 76 percent, it was their first heart attack, technically known as an acute myocardial infarction.

The heart attack risk increased slightly for adults over 65 and for people infected with influenza type B. But those increases were not statistically significant. The risk was 10 times higher with influenza B, five times higher with influenza A (the most common type during that period), 3.5 times greater for respiratory syncytial virus and nearly three times higher for other viruses.

The study “should not be interpreted as evidence of a lack of vaccine effectiveness, because this study was not designed to evaluate the effectiveness of influenza vaccines,” the researchers said. “Rather, since vaccination of adults is only approximately 40% to 60% effective in preventing laboratory-confirmed influenza infection, this study shows that if vaccinated patients have influenza of sufficient severity to warrant testing, their risk of acute myocardial infarction is increased to a level that is similar to that among unvaccinated patients.”

“We can’t say it enough – get a flu shot,” said Dr. Jones. “Even if the flu shot isn’t perfect, it may protect at least somewhat and the flu could be less severe, although this study didn’t address that. Also, wash your hands all the time and stay away from people who you know are sick.”

And if you get the flu, “don’t ignore symptoms” that might suggest a heart attack, she said. “Chest pains, shortness of breath might be more than you think.”

The time it takes for the flu to produce symptoms is about 1.4 days after infection with influenza A and 0.6 days with influenza B. Once symptoms begin, it only takes a day or two for them to peak.

The researchers cautioned that the people in their study were not suffering from mild flu symptoms.

“These are people who are sick enough to see a doctor and the doctor was worried enough to actually swab the patient” to test for the virus, said Dr. Kwong. “We don’t know if these results apply to people who have milder infections.”

SOURCE: bit.ly/2FU4ylA The New England Journal of Medicine, online January 24, 2018.

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Mother’s heart health tied to breastfeeding

by UNTV News   |   Posted on Thursday, June 22nd, 2017

WHO recommends exclusive breastfeeding for babies up to 6 months old and says it reduces child mortality and has proven health benefits that extend into adulthood. (REUTERS)

(Reuters Health) – A woman’s risk of suffering a heart attack or stroke later in life may be influenced by how long she breastfed her children, according to a new study from China.

Women who reported having breastfed for any amount of time were about 9 percent less likely than mothers who never breastfed to have signs of coronary heart disease, like a heart attack, in middle age and later and about 8 percent less likely to have a stroke.

“This study suggests that it reduces the mother’s risk of developing cardiovascular disease,” said study author Zhengming Chen, of the University of Oxford in the UK.

But, Chen told Reuters Health, the study does not prove a direct or causal link between not breastfeeding and poor cardiovascular health.

The American Academy of Pediatrics recommends that mothers exclusively breastfeed their children for the first six months of life, and continue to breastfeed for a year or more while introducing other foods.

Previous studies have linked breastfeeding to reduced risks of metabolic dysfunction, diabetes and high blood pressure among women later in life, Chen and colleagues note in the Journal of the American Heart Association.

Some studies have also suggested a link between breastfeeding and the risk of cardiovascular disease, they write.

For the new study, the researchers analyzed data on women who were recruited between 2004 and 2008, when they ranged in age from 30 to 79 years old, and were followed for about eight years. The analysis included 289,573 women living in 10 urban and rural areas of China, who provided information about their health and breastfeeding history. Researchers also gathered data about them from disease, death and insurance registries to see if they had heart-related events.

The women’s average age was 51 when they entered the study. Nearly all reported giving birth to at least one child, and the vast majority breastfed at some point.

Over about eight years, the researchers found nearly 50,000 cases of cardiovascular disease, which included 23,983 strokes and 16,671 cases of coronary heart disease.

Women who had breastfed were 12 percent less likely to have cardiovascular disease, 9 percent less likely to have coronary heart disease and 8 percent less likely to have a stroke over that time than women who had children but never breastfed.

In addition, the risk of coronary heart disease and stroke appeared to decrease as the amount of time women breastfed increased.

Compared to women who never breastfed, those who reported breastfeeding for six to 12 months were 7 percent less likely to have a heart attack while the risk was 18 percent lower among women who breastfed for more than two years. The results were similar for stroke risk.

The researchers also adjusted the calculations to account for other factors that might influence the results like education, income, smoking status, blood pressure and physical activity.

“That didn’t really change our study findings at all,” Chen said.

The new study can’t explain the link between breastfeeding and heart health, but the researchers write that one possibility is breastfeeding helps women’s bodies lose weight gained with pregnancy and “resets” their metabolism to improve the way their body uses insulin and processes fats in the blood, for example. These kinds of post-pregnancy changes may help set breastfeeding mothers on a path to better long-term health.

Still, women should not breastfeed to lower their cardiovascular risk, cautioned Dr. Steve Nissen, who is chair of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at the Cleveland Clinic in Ohio.

“Obviously people who breastfeed are different than people who don’t breastfeed,” said Nissen, who wasn’t involved with the new study.

“A 10 percent difference is so small that almost any unmeasured factor here could explain it,” he told Reuters Health.

Nissen added that breastfeeding is favorable for infants. “We just don’t know if it’s favorable for the mother,” he said. — By Andrew M. Seaman

SOURCE: bit.ly/2sTYcQ9 Journal of the American Heart Association, online June 21, 2017.

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Regular exercise may improve odds of surviving a heart attack

by UNTV News   |   Posted on Saturday, April 22nd, 2017

 

People are seen in silhouette exercising under the fog covered Manhattan Bridge in New York December 14, 2015. REUTERS/Shannon Stapleton

(Reuters Health) – Just a few hours a week of moderate exercise may not prevent all heart attacks, but it could make the difference in who survives one, Danish researchers say.

Over several decades, the study found that regular moderate exercisers were half as likely to die when they had a heart attack, compared to people who were sedentary.

Despite this benefit, exercise did not seem to protect heart attack survivors from dying or experiencing heart failure later on, the researchers write in the European Journal of Preventive Cardiology.

“We already know that exercise protects you from heart attack, as well as a number of other beneficial effects,” said senior author Dr. Eva Prescott of the University of Copenhagen and Bispebjerg Hospital.

“The main finding here is that among people who do get a heart attack, the ones who exercise more seem to be more likely to survive a heart attack than people who exercise less,” Prescott said by email.

“Exercise is good for you, we know that. These findings confirm that and help us understand why,” she said.

To examine the potential influence of exercise on heart attack survival, the researchers analyzed data on more than 14,000 people participating in the Copenhagen City Heart Study, none of whom had experienced a heart attack or stroke at the beginning of the study period.

Participants reported on their level of physical activity at the baseline assessment between 1976 and 1978 and researchers followed their health over the years through 2013.

Based on their leisure time physical activity at the start of the study, participants were categorized into one of three groups: sedentary, meaning they engaged in only light activity for less than two hours per week; light exercise, which meant they did two to four hours of walking or equivalent activity each week; or moderate/high exercise, which meant greater than two hours of vigorous activity like biking weekly.

Over the study period, 1,664 people had heart attacks and 425 died right away. The average age at which people had a heart attack was 71.

Among those who had a heart attack, the majority, 54 percent, were in the light exercise category – and they were 32 percent more likely to survive than people who were sedentary. People who were moderate or high exercisers were 47 percent more likely to survive.

Having been an exerciser did not guard against future heart failure for heart attack survivors, however. People who exercised were just as likely as sedentary peers to develop heart failure in the five years following a heart attack, the study also found.

The same was true for death over the longer term. Among the heart attack survivors, 83 percent died during the seven-year period following their heart attack. There was no difference in the mortality rate between people who had moderate/high levels of exercise and those who exercised less or not at all.

Nonetheless, regular exercise can help lower blood pressure, said Antonio Crisafulli, who studies exercise and heart function at the University of Cagliari in Italy.

“In short, if we have a low blood pressure, the work required to the heart is reduced,” said Crisafulli, who was not involved in the study.

Exercise is not a miracle cure and even active people may face heart attacks, Crisafulli noted, but active people are more likely to survive heart problems.

Exercise signals to the body to create more pathways to bring oxygen to the heart, Prescott added. In this way, even if an artery becomes blocked and causes a heart attack, the heart will still have other ways to get oxygen.

“Exercise is one of the best and smartest ways to keep our body healthy and to survive if something wrong happens in our cardiovascular system,” Crisafulli added. —  By Madeline Kennedy

SOURCE: bit.ly/2oMgakh European Journal of Preventive Cardiology, online April 11, 2017.

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