Category: Cardiovascular Disease

New Guidance Pivot on Daily Aspirin Advice

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In a distinct on previous advice, new draft recommendations posted by the U.S. Preventive Services Task Force (USPSTF) advise against adults 60 and older to begin taking aspirin to lower their risk of a first heart attack or stroke. 

They further advise that people aged 40 to 59 at higher risk for cardiovascular disease, but without a history of it, should talk to a health care provider before starting an aspirin regimen.

The proposed guidance is based on new evidence that suggests the potential harms of taking aspirin can outweigh the benefits. While daily aspirin use reduces the odds of a first heart attack or stroke, it increases the risks of gastrointestinal and intracerebral bleeding, which progressively increase with age.

“The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended,” UPTSTF member Chien-Wen Tseng, MD, a professor at the University of Hawaii John A. Burns School of Medicine, said in a statement. “However, this Task Force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician.”

The new guidance will be finalised after public comments close in November. It pivots from previous recommendations issued in 2016, which suggest that people ages 50 to 59 with a risk of cardiovascular disease ≥ 10% in the next decade and a low risk for bleeding take a daily low-dose aspirin (≤ 100mg/day) to reduce the likelihood of suffering a heart attack or stroke. According to the 2016 recommendations, the decision to start taking aspirin for preventive reasons should be “an individual one” for adults ages 60 to 69 who are at risk for cardiovascular disease

At present, neither the American Heart Association nor the American College of Cardiology recommend aspirin use for the prevention of heart attack and stroke in the general population; this only applies for some people between the ages of 40 and 70 who have never had a heart attack or stroke but have an increased risk for cardiovascular disease and a low risk for bleeding. The groups recommend that adults 70 and up should not take aspirin for first stroke or heart attack prevention.

Still, aspirin use for cardiovascular risk prevention is widespread in the US, “and is often self-initiated rather than recommended by a physician,” the latest USPSTF report states. A 2017 National Health Interview Survey (NHIS) found that 23.4 percent of adults age 40 or older and without cardiovascular disease took aspirin for primary prevention; among adults 60-69 years, 34.7 percent reported aspirin use.
Tomas Ayala, MD, a cardiologist at Mercy Personal Physicians, said that this pivot had been anticipated by doctors.

“It is not that aspirin is less effective at reducing heart attacks or strokes than it once was,” he told Health. “Rather, it is that we have other therapies at our disposal that have reduced the overall population risk of these conditions, so the relative benefit of aspirin is less, and in many cases, is outweighed by the risks.” 

Source: AARP

Not Enough Women in Stroke Clinical Trials

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A new study published in Neurology shows that women are underrepresented in stroke clinical trials compared to the proportion who have strokes in the general population. 

“Making sure there are enough women in clinical studies to accurately reflect the proportion of women who have strokes may have implications for future treatment recommendations for women affected by this serious condition,” said study author Cheryl Carcel, MD, of The George Institute for Global Health in Sydney, Australia. “When one sex is underrepresented in clinical trials, it limits the way you can apply the results to the general public and can possibly limit access to new therapies.”

The study analysed 281 stroke trials conducted between 1990 and 2020, with a total of 588 887 participants. Of these, only 37.4 % were women. The average prevalence of stroke in women across the countries included was 48%.

Results were calculated in participation-to-prevalence ratio, a relative measure that weights the percentage of women in a trial compared to their proportion in the total population with that disease. A ratio of one indicates that the percentage of women in the study is the same as the percentage of women with the disease in the general population. An acceptable range for an ideal ratio of female participation is between 0.8 and 1.2.

Overall, women were found to be underrepresented relative to their prevalence in the underlying population, with a consistent ratio of 0.84 over time. They found the greatest differences in trials of intracerebral haemorrhage, with a ratio of 0.73; trials with average participant age under 70, with a ratio of 0.81; non-acute interventions, with a ratio of 0.80; and rehabilitation trials, with a ratio 0.77.

“Our findings have implications for how women with stroke may be treated in the future, as women typically have worse functional outcomes after stroke and require more supportive care,” Dr Carcel said. “We will only achieve more equitable representation of women in clinical trials when researchers look at the barriers that are keeping women from enrolling in studies and actively recruit more women. People who fund the research also need to demand more reliable, sex-balanced evidence.”

Source: American Academy of Neurology

Moderate Carbohydrate Intake Helps CVD Health in Women

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In a surprise finding, Monash University researchers have reported that proportional carbohydrate intake and not saturated fat was significantly associated with cardiovascular disease benefit in Australian women.

Cardiovascular disease (CVD) is the leading cause of death in women. Poor diet is recognised as both an independent CVD risk factor and a contributor to other CVD risk factors, such as obesity, diabetes mellitus (DM), hypertension, and dyslipidaemia.

In middle-aged Australian women, it was found that increasing the percentage of carbohydrate intake was linked to reduced risks of CVD, hypertension, diabetes mellitus, and obesity.

Furthermore, a moderate carbohydrate intake between 41.0–44.3% of total energy intake was associated with the lowest risk of CVD, compared to women who consumed less than 37% energy as carbohydrates. However, no significant relationship was demonstrated between proportional carbohydrate intake and all-cause mortality.

Furthermore, increasing proportional saturated fat intake was not associated with cardiovascular disease or mortality in women; rather, increasing saturated fat intake correlated with lower odds of developing diabetes mellitus, hypertension, and obesity.

The findings are now published in the British Medical Journal.

The results contradict much of the historical epidemiological research that supported a link between saturated fat and CVD. Instead, the results mirror contemporary meta-analysis of prospective cohort studies where saturated fat was found to have no significant relationship with total mortality or CVD.

Historical studies neglected to adjust for fibre, which is known to help prevent plaque from forming in the arteries, which may explain this discrepancy with older literature.

“Controversy still exists surrounding the best diet to prevent CVD,” said Sarah Zaman, an associate professor at the University of Sydney.

“A low-fat diet has historically been the mainstay of primary prevention guidelines, but the major issue within our dietary guidelines is that many dietary trials have predominately involved male participants or lacked sex-specific analyses.”

She added: “Further research is needed to tailor our dietary guidelines according to sex.”

First author Sarah Gribbin, a Doctor of Medicine and BMedSc (Hons) student, said: “As an observational study, our findings only show association and not causation. Our research is purely hypothesis-generating. We are hoping that our findings will spark future research into sex-specific dietary research.”

Source: Monash University

An Extra Drug or More of the Same for Uncontrolled Hypertension?

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A new study may help people with uncontrolled hypertension and their doctors decide whether to increase the dose of one of their existing drugs, or add a new one, to bring down their blood pressure.

Reviewing data from veterans over age 65 receiving treatment over two years, researchers found that patients have a better chance of adhering to their medication regimen if their doctor maximises the dosage of one of the drugs they’re already taking. While both strategies decrease blood pressure, they found adding a new medication has a very slim advantage over increasing the dose of an existing medication, despite some of the patients being unable to stay on the new medication.

In the end, the researchers say, the new findings could add to discussions between physicians and patients whose blood pressure remains elevated despite starting medication treatment.

The findings, reported in the Annals of Internal Medicine, focus on patients whose initial systolic blood pressure was above 130mmHg.

By looking back at VA and Medicare data, the researchers were able to see patterns in treatment and blood pressure readings over time, in a kind of natural experiment. All the patients were taking at least one blood pressure medication at less than the maximum dose and had a treatment intensification at the start of the study period, indicating that their physicians thought they needed more intense treatment.

Intensifying treatment must be carefully considered, as there are many concerns — whether a drug interaction if a new drug is added, or an electrolyte imbalance with high doses, or fainting and falling if a person’s pressure gets too low .

This is the first time the two approaches have been compared, said first author Dr Carole E. Aubert.

“There’s increasing guidance on approaches to starting treatment in older adults, but less on to the next steps to intensify treatment, especially in an older and medically complex population that isn’t usually included in clinical trials of blood pressure medication,” she said. “How can we increase medications safely in a population already taking many medications for hypertension and other conditions.”

“Treatment guidelines do suggest starting treatment with multiple medications, and clinicians are comfortable with an approach of ‘starting low and going slow’ in older patients,” said senior author Dr Lillian Min. “But these results show that in older patients, we have further opportunity to tailor choices in intensifying drug therapy for hypertension, depending on the individual patient’s characteristics.”

She continued, “Is the patient more likely to stick to a simpler regimen? Then increase an existing medication. Or is the blood pressure very high and the clinician is more concerned about reducing it? Then consider starting a new medication now.”

For older adults already on various medications, overcomplicating it with another pill may be excessive. The risks of polypharmacy are already well known, Dr Min said.

Source: University of Michigan

Exercise Reduces Sleep Apnoea and Improves Brain Function

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In a small study, researchers found that exercise could help reduce sleep apnoea symptoms and improve brain function.

Sleep apnoea is characterised by loud snoring and disrupted breathing and is a risk factor for cardiovascular disease and cognitive decline. It is typically treated with continuous positive airway pressure, or CPAP, which is uncomfortable for patients and often not adhered to. 

“Exercise training appears to be an attractive and adjunctive (add-on) non-pharmacological treatment,” said lead investigator Linda Massako Ueno-Pardi, an associate professor at the School of Arts, Science and Humanities at the University of São Paulo in Brazil. She also is a research collaborator at the university’s Heart Institute and Institute of Psychiatry, Faculty of Medicine.

Sleep apnoea is more common in men than women and becomes more prevalent as people age.  According to a scientific statement by the American Heart Association, between 40% and 80% of people with cardiovascular disease have sleep apnoea. Cigarette smoking and type 2 diabetes are among the risk factors for sleep apnoea, as well as obesity, which narrows the airway when sleeping.

People with sleep apnoea have been shown to experience a decrease in brain glucose metabolism, which can impair cognitive function. The researchers sought to find out whether exercise could help correct that, building on a small 2019 study where aerobic activity improved brain glucose metabolism and executive functioning in Alzheimer’s patients.

The new study recruited 47 adults with moderate to severe obstructive sleep apnoea. Half did 60 minutes of supervised exercise three times a week for six months, and the other half were a control group.

Participants in both groups were given a series of tests to measure exercise capacity, brain glucose metabolism and cognitive function, including attention and executive function. Obstructive sleep apnoea symptom severity was measured, such as hypoxia.

At the end of six months, those in the exercise group showed an increased capacity for exercise; improvements in brain glucose metabolism; sleep apnoea symptom reduction; and a boost in cognitive function, including a 32% improvement in attention and executive function. The control group experienced no changes except a decline in brain glucose metabolism.

A “significant reduction” seen in the exercise group’s body fat may have improved sleep apnoea severity by decreasing body fat, especially around the airways.

Source: American Heart Association

High Altitude Protects against Stroke Risk

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While there are well-known common lifestyle and health factors that contribute to stroke risk, including smoking, high blood pressure, high cholesterol, and lack of physical activity, there is another overlooked factor that could also affect stroke risk – altitude.

Higher altitude means less oxygen availability, to which people living there have adapted. However, how this environment affects someone’s risk for stroke is still unclear. Anecdotal evidence suggests that short-term exposure to low oxygen can contribute to increased blood clotting and stroke risk, but the risk among people who permanently live at high altitude is not clear.

Researchers in Ecuador are in a unique position to explore these phenomena, as the presence of the Ecuadorian Andes means that people in the country live at a wide array of altitudes. Study lead author Esteban Ortiz-Prado, and Professor, Universidad de las Americas, explained:

“The main motivation of our work was to raise awareness of a problem that is very little explored. That is, more than 160 million people live above 2500 metres and there is very little information regarding epidemiological differences in terms of stroke at altitude. We wanted to contribute to new knowledge in this population that is often considered to be the same as the population living at sea level, and from a physiological point of view we are very different.”

The researchers drew on hospital records in Ecuador from between 2001 and 2017, and analysed rates of stroke hospitalisation and mortality among people who live at four different elevation ranges: low altitude (under 1500m), moderate altitude (1500­–2500m), high altitude (2500–3500m) and very high altitude (3500–5500m).

Analysis showed that people who lived at higher altitudes (above 2500m) tended to experience stroke at a later age compared with those at lower altitudes. Intriguingly, people who lived at higher altitudes had a lower stroke hospitalisation or mortality risk. This protective effect was greater between 2000 and 3500m, tapering off somewhat above 3500m. In South Africa, Johannesburg sits above 1700m altitude.

One explanation for this finding may be that people who live at high altitude have adapted to the low oxygen conditions, and more readily grow new blood vessels to help overcome stroke-related damage. They may also have a more developed vascular network in their brains that helps them to make the most of the oxygen they take in, but this could also protect them from the worst effects of stroke.

Source: Medical Xpress

Impact of Pandemic Delay to Cardiac Procedures

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A Canadian study found that after the onset of the COVID pandemic, there was a significant decline in referrals and procedures for common cardiac interventions. 

Patients awaiting coronary bypass surgery or stenting were at higher risk of dying while waiting for their procedure compared to before the pandemic, despite wait times not being longer. The study was published in the Canadian Journal of Cardiology.

“In the first wave of the COVID pandemic, we kept hearing stories from patients and other doctors that there were delays in care for patients with heart disease,” explained lead investigator Harindra C. Wijeysundera, MD, PhD, University of Toronto. “We decided to look into these claims using the Ontario database that keeps track of wait lists and wait times for individuals with heart disease who require a procedure or surgery.”

The researchers were able to link multiple population-based administrative data sources and clinical registries. The study looked at adult patients who were referred for four commonly performed cardiac procedures: percutaneous coronary intervention; isolated coronary bypass grafting; valve surgery; or transcatheter aortic valve implantation from January 1, 2014 to September 30, 2020, and the start of the pandemic was put at March 31 2020. Outcomes were defined as death while awaiting procedure and hospitalisation while waiting for procedure.

Of 584 341 patients identified, 37 718 were referred during the pandemic. As expected, a decline in referrals was observed at the outset of the pandemic, although those numbers steadily increased throughout the pandemic period, along with an initial decline in the number of procedures performed. Individuals waiting for coronary bypass surgery or stenting were at higher risk of dying while waiting for their procedure compared to before the pandemic. Mortality rates increased even though wait times did not during the pandemic, suggesting patients may have delayed in presenting to their doctors with symptoms.

“We found that the increase in wait list mortality was consistent across patients with stable coronary artery disease, acute coronary syndrome, or emergency referral,” said Dr Wijeysundera. “Coupled with reduced referrals, this raises concerns of a care deficit due to delays in diagnosis and wait list referral.”

A number of potential explanations were suggested by the researchers for the decline in referrals during the pandemic, from patient factors such as fear of contracting COVID in the hospital or concerns about missing work, to system factors including testing delays and pressures on hospital beds and staffing.

Source: EurekAlert!

Home BP Monitoring Gets the Thumbs-up From Patients

BP cuff for home monitoring, Source: Pixabay

Adults needing to track their blood pressure regularly for a hypertension diagnosis preferred home monitoring blood pressure versus at a clinic, kiosk or with a 24-hour wearable device, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2021.

According to the American Heart Association, about half of US adults have hypertension, and of those with high blood pressure (BP) over a third are unaware they have it. H

“Most hypertension is diagnosed and treated based on blood pressure measurements taken in a doctor’s office, even though the U.S. Preventive Services Task Force and the American Heart Association recommend that blood pressure measurements be taken outside of the clinical setting to confirm the diagnosis before starting treatment,” said lead study author Beverly Green, MD, MPH, senior investigator and family physician at Kaiser Permanente Washington Health Research Institute. “It is the standard that blood pressure monitoring should be done either using home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring prior to diagnosing hypertension.”

The “gold standard” for out-of-office measurement to determine a diagnosis of high blood pressure is 24-hour ambulatory blood pressure monitoring devices, worn day and night to take continuous blood pressure readings. Measuring BP on a home device with a normal BP cuff, can be more convenient.

The researchers studied adherence and acceptability of different blood pressure measuring methods among 510 adults with elevated BP but without a hypertension diagnosis. Participants in the study were an average age of 59 years old; half were male; the average BP was 150/88 mm Hg and were taking blood pressure-lowering medications.

Participants were randomised to either clinic measurements, home monitoring or kiosk blood pressure monitoring.

Those in the group for clinic measurements were asked to return to the clinic for at least one additional blood pressure check, as is routine in diagnosing hypertension in clinical practice. The home group received home blood pressure machines and the training to use them, and were asked to measure their blood pressure twice in a row, two times daily, for five days, for a total of 20 measurements. The kiosk group was asked to take their blood pressure at a kiosk in their clinic or at a nearby pharmacy three times each on three separate days, for a total of nine measurements. All participants were asked to complete their group-assigned diagnostic regimens within three weeks, and then to complete 24-hour ambulatory blood pressure monitoring. Researchers compared adherence to and the acceptability among each diagnostic method.

They measured adherence to monitoring by noting the percent of individuals in each group who completed their assigned measurement method as instructed. They measured acceptability with questionnaires.

Researchers found that overall acceptability was highest for the at-home group, followed by the clinic and kiosk groups, while 24-hour ambulatory blood pressure monitoring was the least popular. Adherence to the monitoring regimen was lowest in the kiosk group, but more than 90% in the home testing group; more than 87% in the clinic group; nearly 68% in the kiosk group; and 91% for 24-hour ambulatory monitoring among all participants.

“Home blood pressure monitoring was the most preferred option because it was convenient, easy to do, did not disturb their daily personal or work routine as much, and was perceived as accurate,” said Dr Green. “Participants reported that ambulatory blood pressure monitoring disturbed daily and work activities, disrupted sleep and was uncomfortable.”

When asked which diagnostic testing regimen they would prefer, more than half chose home blood pressure monitoring, especially if they were assigned to the home group, where almost 80% preferred home monitoring.

Dr Green suggests that clinicians routinely offer home blood pressure monitoring to their patients with elevated blood pressure.
“Health care professionals should work toward relying less on in-clinic visits to diagnose hypertension and supporting their patients in taking their blood pressure measurements at home,” Dr Green said. “Home blood pressure monitoring is empowering and improves our ability to identify and treat hypertension, and to prevent strokes, heart attacks, heart failure and cardiovascular death.”

Source: American Heart Association

Radiation Therapy Can Reprogram Faulty Heart Cells

Photo from Olivier Collett on Unsplash
Photo from Olivier Collett on Unsplash

New research published in Nature Communications suggests that radiation therapy can reprogram heart muscle cells to what appears to be a younger state, fixing electrical problems that cause life-threatening arrhythmia without the need for an invasive catheter ablation procedure.

In catheter ablation, a catheter is threaded into the heart, and the tissue that triggers ventricular tachycardia is burned, creating scars that block the errant signals. The new study, however, shows that noninvasive radiation therapy can reprogram the heart muscle cells to a younger and perhaps healthier state, fixing the electrical fault in the cells themselves without needing scar tissue to block the overactive circuits. Previous research showed that radiation therapy typically reserved for cancer treatment could be directed at the heart to treat ventricular tachycardia.

Radiation therapy could in theory reproduce the scar tissue of catheter ablation, in a quicker and totally noninvasive procedure, making the treatment available to more severely ill patients. The doctors found that, surprisingly, patients experienced large improvements in their arrhythmias just days to weeks after radiation therapy, much quicker than the months it can take scar tissue to form after radiation therapy, suggesting that a single radiation dose diminishes the arrhythmia without forming scar tissue. Analysis showed the radiation treatment was at least as effective as catheter ablation for certain patients with ventricular tachycardia, albeit for different, unknown reasons.

“Traditionally, catheter ablation creates scar tissue to block the electrical circuits that are causing ventricular tachycardia,” said senior author and cardiologist Stacey L. Rentschler, MD, PhD, an associate professor of medicine, of developmental biology and of biomedical engineering. “To help us understand whether the same thing was happening with radiation therapy, some of the first patients to have this new treatment gave us permission to study their heart tissue – following heart transplantation or if they had passed away for another reason, for example. We saw that scar tissue alone could not explain the remarkable clinical effects, suggesting that radiation improves the arrhythmia in some other way, so we delved into the details of that.”

Radiation treatment triggered heart muscle cells to begin expressing different genes, the researchers found. Increased activity was seen in a signaling pathway called Notch, which is known for its vital role in early development, including in forming the heart’s electrical conduction system.

A single dose of radiation temporarily activates Notch signalling – normally dormant in adult cells – and leading to a long-term increase in sodium ion channels in the heart muscle, a key physiologic change that can reduce arrhythmias.

“Arrhythmias are associated with slow electrical conduction speeds,” Rentschler said. “Radiation therapy seems to kick up the speed faster by activating early developmental pathways that revert the heart tissue back into a healthier state.”

The researchers studied these effects in mice and in donated human hearts. In human samples, the researchers found that these changes in heart muscle cells were only present in areas of the heart that received the targeted radiation dose.

“Radiation does cause a type of injury, but it’s different from catheter ablation,” said co-author and radiation oncologist Julie K. Schwarz, MD, PhD, a professor of radiation oncology and director of the Cancer Biology Division in the Department of Radiation Oncology. “As part of the body’s response to that injury, cells in the injured portion of the heart appear to turn on some of these early developmental programs to repair themselves. It’s important to understand how this works because, with that knowledge, we can improve the way we’re treating these patients and then apply it to other diseases.”

The researchers also found that the beneficial effects of radiation continued for at least two years in surviving patients. And importantly, they were able to demonstrate in mice that a lower dose of the radiation produced the same effect. A lower radiation dose could reduce long-term side effects and allow such treatment in other types of heart arrhythmias. And while Notch was a big player in these effects, Prof Schwarz said it’s not the only pathway involved. The researchers are continuing to investigate how radiation triggers heart cells to revert to a healthier state.

Source: Washington University School of Medicine

High Fat Dairy Intake not Tied to CVD Risk

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In a study of countries with high dairy consumption, higher intakes of dairy fat, as measured by bloodstream levels of fatty acids, had a lower risk of cardiovascular disease (CVD) compared to those with low intakes. Higher intakes of dairy fat were not linked to an increased mortality risk.

In a study published in PLoS Medicine, researchers combined results from 4000 Swedish adults with those from 17 similar studies in other countries, creating the most comprehensive evidence to date on the relationship between this more objective measure of dairy fat consumption, risk of  and death.

Dr Matti Marklund from The George Institute for Global Health, Johns Hopkins Bloomberg School of Public Health, and Uppsala University said that with rising dairy consumption around the world, a better understanding of the health impact was needed.

“Many studies have relied on people being able to remember and record the amounts and types of dairy foods they’ve eaten, which is especially difficult given that dairy is commonly used in a variety of foods.

“Instead, we measured blood levels of certain fatty acids, or fat ‘building blocks’ that are found in dairy foods, which gives a more objective measure of dairy fat intake that doesn’t rely on memory or the quality of food databases,” he added.

“We found those with the highest levels actually had the lowest risk of CVD. These relationships are highly interesting, but we need further studies to better understand the full health impact of dairy fats and dairy foods.”

Sweden has one of the world’s highest consumption of dairy. An international team of researchers assessed dairy fat consumption in 4150 Swedish 60-year-olds by measuring blood levels of a particular fatty acid that is mainly found in dairy foods and therefore can be used to reflect intake of dairy fat.

The participants were then followed up for an average of 16 years, recording heart attacks, strokes and other serious circulatory events, and all cause mortality.

After adjustment for other known CVD risk factors including things like age, income, lifestyle, dietary habits, and other diseases, the CVD risk was lowest for those with high levels of the fatty acid (which reflects a high intake of dairy fats). Those with the highest levels had no increased all-cause mortality risk.

These findings highlight the uncertainty of evidence in this area, which is reflected in dietary guidelines, noted  Dr Marklund.

“While some dietary guidelines continue to suggest consumers choose low-fat dairy products, others have moved away from that advice, instead suggesting dairy can be part of a healthy diet with an  emphasis on selecting certain dairy foods — for example, yoghurt rather than butter — or avoiding sweetened dairy products that are loaded with added sugar,” he said.

Combining these results with 17 other studies with a total of almost 43 000 participants from the US, Denmark, and the UK confirmed these findings in other populations.

“While the findings may be partly influenced by factors other than dairy fat, our study does not suggest any harm of dairy fat per se,” Dr. Marklund said.

Lead author Dr Kathy Trieu from The George Institute for Global Health pointed out that consumption of some dairy products, especially fermented products, have been shown to be linked to cardiovascular benefits.

“Increasing evidence suggests that the health impact of dairy foods may be more dependent on the type — such as cheese, yoghurt, milk, and butter — rather than the fat content, which has raised doubts if avoidance of dairy fats overall is beneficial for cardiovascular health,” she said.

“Our study suggests that cutting down on dairy fat or avoiding dairy altogether might not be the best choice for heart health.”

“It is important to remember that although dairy foods can be rich in saturated fat, they are also rich in many other nutrients and can be a part of a healthy diet. However, other fats like those found in seafood, nuts, and non-tropical vegetable oils can have greater health benefits than dairy fats,” Dr Trieu added.

Source: The George Institute for Global Health