Category: Cardiovascular Disease

Categories : Cardiovascular Disease NeurologyTags :

Could a Transient Ischaemic Attack Leave Lasting Fatigue?

On By ModernMedia
Photo by Karolina Grabowska on Pexels

A transient ischaemic attack (TIA) is typically defined as a temporary blockage of blood flow to the brain that causes symptoms that go away within a day, but a new study finds that people who have this type of stroke may also have prolonged fatigue lasting up to one year. The study is published in Neurology®, the medical journal of the American Academy of Neurology (AAN).

The study does not prove that TIAs, also known as mini-strokes, cause lasting fatigue; it only shows an association. “People with a transient ischaemic attack can have symptoms such as face drooping, arm weakness or slurred speech and these resolve within a day,” said study author Boris Modrau, MD, PhD, of Aalborg University Hospital in Denmark. “However, some have reported continued challenges including reduced quality of life, thinking problems, depression, anxiety and fatigue. Our study found that for some people, fatigue was a common symptom that lasted up to one year after the transient ischaemic attack.”

The study involved 354 people with an average age of 70 who had a mini-stroke. They were followed for a year.

Participants completed questionnaires about their level of fatigue within the first two weeks of the mini-stroke and again at three, six, and 12 months later. One questionnaire looked at five different types of fatigue, including overall tiredness, physical tiredness, reduced activity, reduced motivation and mental fatigue. Scores ranged from four to 20 with higher scores indicating more fatigue. Participants had an average score of 12.3 at the start of the study. At three months, the average score decreased slightly to 11.9, at six months to 11.4 and at twelve months to 11.1.

Researchers looked at how many participants experienced fatigue as defined as a score of 12 or higher. Of the participants, 61% experienced fatigue two weeks after the mini-stroke and 54% experienced fatigue at each of the three other testing time periods at three, six and 12 months.

Participants also had brain scans. Researchers found that the presence of a blot clot on a scan was equal between people with long term fatigue and those without it, so this did not explain the reason for the level of fatigue.

Researchers did find that previous anxiety or depression was twice as common in those participants who reported lasting fatigue.

“Long-term fatigue was common in our group of study participants, and we found if people experience fatigue within two weeks after leaving the hospital, it is likely they will continue to have fatigue for up to a year,” said Modrau. “For future studies, people diagnosed with a transient ischaemic attack should be followed in the weeks and months that follow to be assessed for lingering fatigue. This could help us better understand who might struggle with fatigue long-term and require further care.”

A limitation of the study was that while participants were asked to complete the questionnaires themselves, it is possible some responses may have been completed with assistance from relatives or caretakers and this may have influenced responses, including those around fatigue.

Source: American Academy of Neurology

Categories : Cardiovascular DiseaseTags :

Elevated Risk of Death or Complications from Broken Heart Syndrome

On By Peter Van Dyk
Credit: American Heart Association

Takotsubo cardiomyopathy, also known as broken heart syndrome, is associated with a high rate of death and complications, and those rates were unchanged between 2016 and 2020, according to new research published in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.

Takotsubo cardiomyopathy is a stress-related heart condition in which part of the heart temporarily enlarges and doesn’t pump well. It is thought to be a reaction to a surge of stress hormones that can be caused by an emotionally or physically stressful event, such as the death of a loved one or a divorce. It can lead to severe, short-term failure of the heart muscle and can be fatal. Takotsubo cardiomyopathy may be misdiagnosed as a heart attack because the symptoms and test results are similar.

This study is one of the largest to assess in-hospital death rates and complications of the condition, as well as differences by sex, age and race over five years.

“We were surprised to find that the death rate from Takotsubo cardiomyopathy was relatively high without significant changes over the five-year study, and the rate of in-hospital complications also was elevated,” said study author M. Reza Movahed, MD, PhD, an interventional cardiologist and clinical professor of medicine at the University of Arizona’s Sarver Heart Center in Tucson, Arizona. “The continued high death rate is alarming, suggesting that more research be done for better treatment and finding new therapeutic approaches to this condition.”

Researchers reviewed health records in the Nationwide Inpatient Sample database to identify people diagnosed with Takotsubo cardiomyopathy from 2016 to 2020.

The analysis found:

  • The death rate was considered high at 6.5%, with no improvement over period.
  • Deaths were more than double in men at 11.2% compared to the rate of 5.5% among women.
  • Major complications included congestive heart failure (35.9%), atrial fibrillation (20.7%), cardiogenic shock (6.6%), stroke (5.3%) and cardiac arrest (3.4%).
  • People older than age 61 had the highest incidence rates of Takotsubo cardiomyopathy. However, there was a 2.6 to 3.25 times higher incidence of this condition among adults ages 46-60 compared to those ages 31-45 during the study period.
  • White adults had the highest rate of Takotsubo cardiomyopathy (0.16%), followed by Native American adults (0.13%) and Black adults (0.07%).
  • In addition, socioeconomic factors, including median household income, hospital size and health insurance status, varied significantly.

“Takotsubo cardiomyopathy is a serious condition with a substantial risk of death and severe complications,” Movahed said. “The health care team needs to carefully review coronary angiograms that show no significant coronary disease with classic appearance of left ventricular motion, suggesting any subtypes of stress-induced cardiomyopathy. These patients should be monitored for serious complications and treated promptly. Some complications, such as embolic stroke, may be preventable with an early initiation of anti-clotting medications in patients with a substantially weakened heart muscle or with an irregular heart rhythm called atrial fibrillation that increases the risk of stroke.”

He also noted that age-related findings could serve as a useful diagnostic tool in discriminating between heart attack/chest pain and Takotsubo cardiomyopathy, which may prompt earlier diagnosis of the condition and could also remove assumptions that Takotsubo cardiomyopathy only occurs in the elderly.

Among the study’s limitations is that it relied on data from hospital codes, which could have errors or overcount patients hospitalized more than once or transferred to another hospital. In addition, there was no information on outpatient data, different types of Takotsubo cardiomyopathy or other conditions that may have contributed to patients’ deaths.

Movahed said further research is needed about the management of patients with Takotsubo cardiomyopathy and the reason behind differences in death rates between men and women.

Source: American Heart Association

Categories : Cardiovascular DiseaseTags :

Lack of Sleep can Increase the Risk of Cardiovascular Disease

On By ModernMedia
Photo by Andrea Piacquadio

Even a few nights with insufficient sleep promote molecular mechanisms linked to a greater risk of heart problems. This has been shown in a new study in which the researchers investigated how sleep deprivation affects biomarkers (in this case, proteins) associated with cardiovascular disease. The Uppsala University-led study is published in the journal Biomarker Research.

“Unfortunately, nearly half of all Swedes regularly experience disturbed sleep, and this is particularly common among shift workers. That is why we wanted to try to identify mechanisms that affect how lack of sleep can increase the risk of cardiovascular disease. Ultimately, the purpose was to identify opportunities to address these problems,” says Jonathan Cedernaes, physician and docent at Uppsala University, who led the study.

A chronic lack of sleep is a growing public health problem and in large population studies it has been linked to an increased risk of heart attack, stroke and atrial fibrillation. Heart health is influenced by several lifestyle factors, including sleep, diet and exercise. In order to separate out the effects of sleep, a number of conditions were controlled in the laboratory environment such as diet and physical activity.

How the study was conducted

The authors studied 16 healthy young men of normal weight. They all had healthy sleep habits. The participants spent time in a sleep laboratory where their meals and activity levels were strictly controlled in two sessions. In one session, participants got a normal amount of sleep for three consecutive nights, while during the other session, they got only about four hours of sleep each night. During both sessions, morning and evening blood samples were taken, and following high-intensity exercise lasting 30 minutes.

Inflammatory proteins increased after sleep loss

The researchers measured the levels of around 90 proteins in the blood and were able to see that the levels of many of these that are associated with increased inflammation rose when the participants were sleep-deprived. Many of these proteins have already been linked to an increased risk of cardiovascular disease such as heart failure and coronary artery disease.

“Many of the larger studies that have been done on the link between sleep deprivation and the risk of cardiovascular diseases have generally focused on slightly older individuals who already have an increased risk of such diseases. That is why it was interesting that the levels of these proteins increased in the same way in younger and previously perfectly healthy individuals after only a few nights of sleep deprivation. This means that it’s important to emphasise the importance of sleep for cardiovascular health even early in life,” says Jonathan Cedernaes.

The effects of exercise can be affected by lack of sleep

Physical exercise generated a slightly different response after lack of sleep. However, a number of key proteins increased equally, whether the person was sleep-deprived or not. Thus, proteins that can be linked to the positive effects of exercise increased, even if the person had too little sleep. The researchers have previously shown that exercise in the presence of sleep deprivation can result in a slightly increased load on the heart’s muscle cells.

“With this study, we have improved our understanding of what role the amount of sleep we get plays in cardiovascular health. It’s important to point out that studies have also shown that physical exercise can offset at least some of the negative effects that poor sleep can cause. But it’s also important to note that exercise cannot replace the essential functions of sleep,” says Jonathan Cedernaes.

Hopefully help to develop better guidelines

“Further research is needed to investigate how these effects might differ in women, older individuals, patients with heart disease, or those with different sleep patterns. Our ongoing research will hopefully help to develop better guidelines on how sleep, exercise and other lifestyle factors can be harnessed to better prevent cardiovascular diseases,” says Jonathan Cedernaes.

Source: Uppsala University

Categories : Cardiovascular Disease Obstetrics & GynaecologyTags :

Does Anaemia During Pregnancy Affect Newborns’ Risk of Heart Defects?

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Source: Pixabay CC0

New research published in BJOG: An International Journal of Obstetrics & Gynaecology found that mothers who are anaemic in early pregnancy face a higher likelihood of giving birth to a child with a heart defect.

The study assessed the health records of 2776 women with a child diagnosed with congenital heart disease who were matched to 13 880 women whose children did not have this condition.

Investigators found that 4.4% of children with congenital heart disease and 2.8% of children with normal heart function had anaemia. After adjusting for potential influencing factors, the odds of giving birth to a child with congenital heart disease was 47% higher among anaemic mothers.

“We already know that the risk of congenital heart disease can be raised by a variety of factors, but these results develop our understanding of anaemia specifically and take it from lab studies to the clinic. Knowing that early maternal anaemia is so damaging could be a gamechanger worldwide,” said corresponding author Duncan B. Sparrow, PhD, of the University of Oxford. “Because iron deficiency is the root cause of many cases of anaemia, widespread iron supplementation for women—both when trying for a baby and when pregnant—could help prevent congenital heart disease in many newborns before it has developed.”

Source: Wiley

Categories : Cardiovascular Disease VaccinesTags :

Shingles Vaccine Reduces Heart Disease Risk for up to Eight Years

On By ModernMedia
Photo by Gustavo Fring on Pexels

People who are given a vaccine for shingles have a 23% lower risk of cardiovascular events, including stroke, heart failure, and coronary heart disease, according to a study of more than a million people published in the European Heart Journal.

The protective effect of the vaccine lasts for up to eight years and is particularly pronounced for men, people under the age of 60 and those with unhealthy lifestyles, such as smoking, drinking alcohol and being inactive.

The study was led by Professor Dong Keon Yon from the Kyung Hee University College of Medicine, Seoul, South Korea. He said: “Shingles causes a painful rash and can lead to serious complications, especially in older adults and those with weak immune systems. Previous research shows that, without vaccination, about 30% of people may develop shingles in their lifetime.

“In addition to the rash, shingles has been linked to a higher risk of heart problems, so we wanted to find out if getting vaccinated could lower this risk.”

The study included nearly 1.3 million people aged 50 or older living in South Korea. Researchers gathered data, from 2012 onwards, on whether people received a shingle vaccine and combined this with data on their cardiovascular health and data on other factors that can influence health, such as age, sex, wealth and lifestyle.

The vaccine was a live zoster vaccine, meaning it contained a weakened form of the varicella zoster virus that causes shingles. In many countries, this type of vaccine is now being replaced with a non-live, recombinant vaccine, meaning it contains a protein from the varicella zoster virus.

The study showed that among people who received the vaccine, there was a 23% lower risk of cardiovascular events overall, with a 26% lower risk of major cardiovascular events (a stroke, heart attack or death from heart disease), a 26% lower risk of heart failure and a 22% lower risk of coronary heart disease.

The protective effect was strongest in the two to three years after the shingles vaccine was given, but researchers found that the protection lasted for up to eight years.

Professor Yon said: “Our study suggests that the shingles vaccine may help lower the risk of heart disease, even in people without known risk factors. This means that vaccination could offer health benefits beyond preventing shingles.

“There are several reasons why the shingles vaccine may help reduce heart disease. A shingles infection can cause blood vessel damage, inflammation and clot formation that can lead to heart disease. By preventing shingles, vaccination may lower these risks. Our study found stronger benefits in younger people, probably due to a better immune response, and in men, possibly due to differences in vaccine effectiveness.

“This is one of the largest and most comprehensive studies following a healthy general population over a period of up to 12 years. For the first time, this has allowed us to examine the association between shingles vaccination and 18 different types of cardiovascular disease. We were able to account for various other health conditions, lifestyle factors and socioeconomic status, making our findings more robust.

“However, as this study is based on an Asian cohort, the results may not apply to all populations. Since the live zoster vaccine is not suitable for everyone, more research on the recombinant vaccine is needed. While we conducted rigorous analysis, this study does not establish a direct causal relationship, so potential bias from other underlying factors should be considered.”

Professor Yon and his colleagues also plan to study the impact of the recombinant vaccine to see if it has similar benefits for reducing heart disease.

Source: European Society of Cardiology

Categories : Cardiovascular Disease General InterestTags :

Two Heart Transplants, One Epic Ride

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Four Cyclists Take on the 2025 KAP sani2c to Inspire South Africans with a Message of Hope

L-R_Steph Bester CEO of AllLife with Billy McLeod

From 8 to 10 May 2025, four cyclists will take on one of South Africa’s most iconic and challenging mountain bike stage races – the KAP sani2c. Covering 265 kilometres over three days from the Southern Drakensberg to Scottburgh on the KwaZulu-Natal South Coast, the event is known for its tough terrain, stunning scenery, and relentless pace. But this year, one team will be racing with more than just medals in mind.

Team Change of Heart is made up of two heart transplant recipients – Billy Macleod (56) and Pedro Basson (20) – and their two experienced cycling partners: Steph Bester, CEO of AllLife, and long-time cycling companion Guy Dudley. Together, they’re not just riding to finish – they’re riding to inspire.

Billy, once an accomplished cyclist and triathlete, was sidelined for six years by heart disease and given just two weeks to live before receiving his transplant.          

He made a remarkable comeback in 2024 when he became the first South African heart transplant recipient to complete the KAP sani2c. This year, Billy returns with a renewed purpose – not just to ride, but to support 20-year-old Pedro through his very first stage race. For Billy, this ride is about passing the baton of hope and helping another transplant recipient believe in the impossible.

Pedro, the youngest team member at just 20 years old, will be attempting his first-ever mountain bike stage race. Having received his transplant as a teenager, Pedro’s journey to recovery has been nothing short of remarkable. Taking on sani2c is a bold and symbolic step, one he hopes will encourage other young people with chronic health conditions to dream big and push boundaries.

“This is more than a race – it’s a celebration of life and second chances,” says Steph Bester, who was set to ride alongside Billy last year but had to withdraw at the last minute due to a sudden illness. “Missing out in 2024 was heartbreaking for me, especially because this cause and this team are so close to my heart. I can’t wait to finally be on the bike with them this year. Billy and Pedro are living proof that your story doesn’t end with a diagnosis. At AllLife, we believe in the power of resilience, and this team embodies that belief. It’s an honour to support them – not only on the bike but in sharing their powerful message with the country.”

The team will be riding on e-bikes, enabling them to manage pace, terrain, and energy levels more effectively while still tackling the full challenge of the race. For Pedro, who has never raced before, the support of his three teammates – all experienced sani2c finishers – is crucial.

“Knowing I have a team behind me who understands the journey and is there to support every climb and descent makes all the difference,” Pedro shared. “It’s not just about the bike – it’s about proving to myself that anything is possible.”

AllLife is once again using this race to raise awareness for Hero777, a non-profit foundation focused on increasing organ and tissue donor registrations in South Africa. The foundation is deeply personal to the AllLife family as they deal with so many people in need of transplants daily.

It takes a community that truly understands both the unique challenges individuals face and the deep love for cycling to make something like this possible. The team is incredibly grateful for the support from AllLife, the wider cycling community, and especially race founder Glen Haw (Farmer Glen). Pedro will ride an e-bike generously sponsored by Cannondale, allowing him to tackle this life-affirming challenge alongside his team.

Whether it’s climbing steep hills or sharing laughs around the campfire, Team Change of Heart is ready to show that with support, courage, and a whole lot of heart – anything is possible.

Follow their journey on Instagram and Facebook (https://www.facebook.com/AllLifeSA and https://www.instagram.com/alllife_sa), and visit www.odf.org.za to learn more about organ and tissue donation or register as a donor today.

Categories : Cardiovascular DiseaseTags :

Micronanoplastics Found in Artery-clogging Plaque in the Neck

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Transmission Electron Microscopy (TEM) picture of nanoplastic particles derived from carotid plaque. Copyright University of New Mexico

People with plaque in the blood vessels of their neck have a higher amount of tiny plastic particles in those vessels compared to people with healthy arteries. This increase was significantly higher in people who had experienced a stroke, mini-stroke or temporary loss of vision due to clogged blood vessels, according to preliminary research presented at the American Heart Association’s Vascular Discovery 2025 Scientific Sessions: From Genes to Medicine.

Micronanoplastics are tiny pieces of plastic created in industrial processes or from larger plastic objects as they degrade in the ocean or the soil. Micronanoplastics are not uniform in size and are a mixture of micro and nano plastic sizes. While microplastics are sometimes visible at less than 5 millimetres in size, nanoplastics are microscopic (invisible to the naked eye), less than 1000 nanometres across. This makes them more easily dispersed and able to penetrate cells and tissues in living organisms. Researchers suggest that terminology should gradually transition to nanoplastics because that is more precisely what is being studied.

“These types of plastics are commonly found in the environment, especially in ocean garbage patches. Over many years, these plastics break down, mix into the soil and water, and can build up in the food chain,” said lead study author Ross Clark, MD, MBA, RPVI, a vascular surgeon-scientist at the University of New Mexico in Albuquerque. “Many people think that micro and nanoplastics mainly come from using plastic utensils, cutting boards, packaging, water bottles and other plastic items. However, the main source is the food and water we eat and drink.”

In 2024, researchers in Italy reported finding micronanoplastics in plaque from some people without symptoms who underwent surgery to remove carotid artery plaque. Symptoms caused by carotid plaque buildup may include stroke, mini-stroke or temporary blindness. Followed for almost three years after surgery, people with micronanoplastics in their carotid plaque were significantly more likely to die or to have a non-fatal heart attack or stroke.

The current study, which included fewer than 50 participants, was built on the previous research conducted in Italy. Researchers compared the levels of micronanoplastics found in the carotid arteries of three groups: people with healthy arteries; those with plaque but no symptoms; and those experiencing symptoms due to plaque buildup. Researchers also compared plaques with low and high plastic levels to assess the effects of micronanoplastics on markers of inflammation, the gene activity of immune cells called macrophages and stem cells that help stabilise plaque.

The analysis found that the concentration of micronanoplastics in carotid arteries was:

  • 16 times higher (895 micrograms/gram vs. 57 micrograms/gram) in plaque among people without symptoms compared to the levels found in artery walls of deceased tissue donors of similar age with no plaque; and
  • 51 times higher (2888 micrograms/gram vs. 57 micrograms/gram) in plaque from people who had experienced stroke, mini-stroke or temporary loss of vision due to blockage of blood flow to the retina, in comparison to samples from age-matched, deceased tissue donors.

Comparing high-plastic and low-plastic plaque levels, the analysis found:

  • no link between the amount of micronanoplastics and signs of sudden inflammation; and
  • differences in gene activity in plaque-stabilizing cells and less activity in anti-inflammatory genes of plaque macrophage immune cells.

“These findings indicate that the biological effects of micronanoplastics on fatty deposits are more complex and nuanced than simply causing sudden inflammation,” Clark said. In their next phase of work, they will focus on better understanding the immunological effects of micronanoplastics in clogged arteries.

“It’s very important to study what these materials do to our bodies. However, we should be cautious about the early results of this study. We won’t fully understand the biological effects for many years to come,” Clark said.

The study has several limitations. It cannot prove that micronanoplastics in plaque were the cause of symptoms of carotid artery disease; micronanoplastics might be a sign of another health issue that caused these symptoms. Researchers did not have access to data detailing the sex or race/ethnicity of the tissue donors. Additionally, pyrolysis gas chromatography-mass spectrometry, used to measure plastic in biological samples may have limitations. This technique allows measurements to include nanoplastics and larger microplastic particles and uses high temperatures to break down plastics into smaller organic molecules. However, parts of the biological samples may also break down into similar molecules. For instance, fatty acids found in artery-clogging plaque could break down into compounds appearing similar to polyethylene.

“We are constantly improving our method to reduce the amounts of lipids in the samples to lessen their impact on the results. Lipids have a very similar spectral signature on gas chromatography as some plastic polymers (in particular polyethylene). It can be challenging to distinguish between the lipids and the polyethylene in the results. That’s why removing the lipids is so important. We believe our methods are currently the best way to address this specific criticism. However, new discoveries might change how we understand this data in the future,” Clark said.

“This is a very interesting and troubling study. To date, we have not considered exposure to plastic micronanoparticles a modifiable risk factor for stroke. Although it is important to understand the mechanism at play in the pathophysiology of symptomatic carotid atherosclerosis, this association presents a novel potential target for stroke prevention,” said Karen L. Furie, MD, MPH, FAHA, volunteer vice chair of the American Heart Association Stroke Brain Health Science Subcommittee and professor and chair of neurology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. Furie was not involved in this study.

Study details, background and design:

  • Researchers tested 48 samples of carotid arteries from 48 different adults collected in 2023-2024 at the University of New Mexico and the Office of the Medical Investigator (a state agency and part of the Department of Pathology at the University of New Mexico).
  • About one-third of the samples were from people aged 60 to 90 who had surgery to remove plaque from their carotid arteries. These people had symptoms including stroke, mini-stroke or temporary blindness (called amaurosis fugax).
  • About one-third of the samples came from people of similar age with no symptoms. They were having surgery to remove plaque buildup in their carotid arteries because a blockage was found during screening or a physical exam.
  • The last one-third of the samples came from tissue donors. These age-matched donors had died of any cause and did not have carotid artery blockage.
  • The researchers also compared plaques with low vs high amounts of micronanoplastics on inflammation-related measures. All samples were analysed to measure inflammation by looking at levels of inflammatory molecules TNF-α and IL-6. The levels were compared to the amount of plastics to find any connections. For the RNA sequencing studies, researchers examined samples with the highest and lowest concentrations of plastics.

Source: American Heart Association

Categories : Cardiovascular Disease Environmental EffectsTags :

Cardiovascular Disease Deaths Worldwide Linked to Widely Used Phthalates

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Phthalates are commonly used in plastic medical equipment

Photo by Marcelo Leal on Unsplash

Daily exposure to certain chemicals used to make plastic household items could be linked to the more than 356 000 global deaths from cardiovascular disease that occurred in 2018 alone, a new analysis of population surveys shows.

Although the chemicals, called phthalates, are in widespread use globally, the Middle East, South Asia, East Asia, and the Pacific bore a much larger share of the death toll than others – about three-fourths of the total.

For decades, experts have connected health problems to exposure to certain phthalates found in cosmetics, detergents, solvents, plastic pipes, bug repellents, and other products. These chemicals break down into microscopic particles and are ingested, and studies have linked such exposure to an increased risk of conditions ranging from obesity and diabetes to fertility issues and cancer.

Led by researchers at NYU Langone Health and published in eBioMedicine, the current study focused on a kind of phthalate called di-2-ethylhexyl phthalate (DEHP). This chemical is used to increase the flexibility and softness of food containers, medical equipment, and other plastic items. Exposure has been shown in other studies to prompt inflammation in the heart’s arteries, which over time is associated with increased risk of heart attack or stroke. In their new analysis, the authors estimated that DEHP exposure contributed to 356 238 deaths, or more than 13% of all global mortality from heart disease in 2018 among men and women ages 55 through 64.

“By highlighting the connection between phthalates and a leading cause of death across the world, our findings add to the vast body of evidence that these chemicals present a tremendous danger to human health,” said study lead author Sara Hyman, BS, an associate research scientist at NYU Grossman School of Medicine.

In a past study from 2021, the research team tied phthalates to more than 50 000 premature deaths each year, mostly from heart disease, among older Americans. Their latest investigation is believed to be the first global estimate to date of cardiovascular mortality, or indeed any health outcome, resulting from exposure to the chemicals, said Hyman, who is also a graduate student at NYU School of Global Public Health.

For the research, the team used health and environmental data from dozens of population surveys to estimate DEHP exposure across 200 countries and territories. The information included urine samples containing chemical breakdown products left by the plastic additive. Mortality data was obtained from the Institute for Health Metrics and Evaluation, a research group in the United States that collects medical information worldwide to identify trends in public health.

Among the key findings, the study showed that losses in the combined region of East Asia and the Middle East and the combined region of East Asia and the Pacific accounted, respectively, for about 42% and 32% of the mortality from ardiovascular disease linked to DEHP. Specifically, India had the highest death count, at 103 587 deaths, followed by China and Indonesia. The larger heart death risks in these populations held true even after the researchers adjusted their statistical analysis to take into account population size within the studied age group.

A possible explanation, the authors say, is that these countries face higher rates of exposure to the chemicals, possibly because they are undergoing a boom in plastic production but with fewer manufacturing restrictions than other regions.

“There is a clear disparity in which parts of the world bear the brunt of heightened heart risks from phthalates,” said study senior author Leonardo Trasande, MD, MPP. “Our results underscore the urgent need for global regulations to reduce exposure to these toxins, especially in areas most affected by rapid industrialisation and plastic consumption,” added Dr Trasande, Professor of Pediatrics at NYU Grossman School of Medicine.

Dr Trasande, who is also a professor in the Department of Population Health, cautions that the analysis was not designed to establish that DEHP directly or alone caused heart disease and that higher death risks did not take into account other types of phthalates. Nor did it include mortality among those in other age groups. As a result, the overall death toll from heart disease connected to these chemicals is likely much higher, he says.

Dr Trasande says that the researchers next plan to track how reductions in phthalate exposure may, over time, affect global mortality rates, as well as to expand the study to other health concerns posed by the chemicals, such as preterm birth.

Source: NYU Langone Health / NYU Grossman School of Medicine

Categories : Cardiovascular Disease IT in HealthcareTags :

A New Way of Visualising BP Data to Better Manage Hypertension

On By ModernMedia
Photo by National Cancer Institute on Unsplash

If a picture is worth a thousand words, how much is a graph worth? For doctors trying to determine whether a patient’s blood pressure is within normal range, the answer may depend on the type of graph they’re looking at.

A new study from the University of Missouri highlights how different graph formats can affect clinical decision-making. Because blood pressure fluctuates moment to moment, day to day, it can be tricky for doctors to accurately assess it.

“Sometimes a patient’s blood pressure is high at the doctor’s office but normal at home, a condition called white coat hypertension,” said Victoria Shaffer, a psychology professor in the College of Arts and Science and lead author of the study published in the Journal of General Internal Medicine. “There are some estimates that 10% to 20% of the high blood pressure that gets diagnosed in the clinic is actually controlled – it’s just white coat hypertension – and if you take those same people’s blood pressure at home, it is really controlled.”

In the study, Shaffer and the team showed 57 doctors how a hypothetical patient’s blood pressure data would change over time using two different types of graphs. One raw graph showed the actual numbers, which displayed peaks and valleys, while the other graph was a new visual tool they created: a smoothed graph that averages out fluctuations in data.  

When the blood pressure of the patient was under control but had a lot of fluctuation, the doctors were more likely to accurately assess the patient’s health using the new smoothed graph compared to the raw graph.

“Raw data can be visually noisy and hard to interpret because it is easy to get distracted by outliers in the data,” Shaffer said. “At the end of the day, patients and their doctors just want to know if blood pressure is under control, and this new smoothed graph can be an additional tool to make it easier and faster for busy doctors to accurately assess that.”

This proof-of-concept study is the foundation for Shaffer’s ongoing research with Richelle Koopman, a professor in the School of Medicine, which includes working with Vanderbilt University and Oregon Health & Science University to determine whether the new smoothed graph can one day be shown to patients taking their own blood pressure at home. The research team is working to get the technology integrated with HIPAA-compliant electronic health records that patients and their care team have access to.

This could alleviate pressure on the health care system by potentially reducing the need for in-person visits when blood pressure is under control, reducing the risk for false positives that may lead to over-treatment.

 “There are some people who are being over-treated with unnecessary blood pressure medication that can make them dizzy and lower their heart rate,” Shaffer said. “This is particularly risky for older adults who are more at risk for falling. Hopefully, this work can help identify those who are being over-treated.”

The findings were not particularly surprising to Shaffer.

“As a psychologist, I know that, as humans, we have these biases that underlie a lot of our judgments and decisions,” Shaffer said. “We tend to be visually drawn to extreme cases and perceive extreme cases as threats. It’s hard to ignore, whether you’re a patient or a provider. We are all humans.”

Given the increasing popularity of health informatics and smart wearable devices that track vital signs, the smoothed graphs could one day be applied to interpreting other health metrics.

“We have access to all this data now like never before, but how do we make use of it in a meaningful way, so we are not constantly overwhelming people?” Shaffer said. “With better visualisation tools, we can give people better context for their health information and help them take action when needed.”

Source: EurekAlert!

Categories : Cardiovascular Disease Regenerative MedicineTags :

This Injected Polymer Boosts Healing after a Heart Attack

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Human heart. Credit: Scientific Animations CC4.0

Researchers have developed a new therapy that can be injected intravenously right after a heart attack to promote healing and prevent heart failure. The therapy both prompts the immune system to encourage tissue repair and promotes survival of heart muscle cells after a heart attack. Researchers tested the therapy in rats and showed that it is effective up to five weeks after injection.

The research team, led by bioengineers at the University of California San Diego and chemists at Northwestern University, published their findings in Advanced Materials.

“Preventing heart failure after a heart attack is still a major unmet clinical need,” said Karen Christman, one of the study’s corresponding authors and a professor of bioengineering at UC San Diego. “The goal of this therapy is to intervene very soon after someone suffers a heart attack to keep them from ultimately going into heart failure.”

Side by side comparison of heart muscle cells with and without treatment. Damage to the cells is shown in blue. On the left, tissue has been injected with saline and the damaged area is considerably larger. On the right, the issue was treated with the PLP platform and the damaged area is significantly smaller.

The therapy could have broader applications, said Nathan Gianneschi, the paper’s other corresponding author and a professor in the Department of Chemistry at Northwestern.

“This therapeutic platform has tremendous potential for several diseases, including everything from macular degeneration to multiple sclerosis and kidney disease,” Gianneschi said.

The platform aims to block the interaction of two key proteins that intervene in the body’s response to stress and inflammation. When the protein Nrf2 is activated, cells resist the degradation brought on by inflammation. But KEAP1 binds with Nrf2 to degrade it in turn. After a heart attack, this process of degradation has to be stopped so that tissues can health better.

The protein-like polymer, or PLP, platform is made from a polymer that mimics Nrf2. Once injected intravenously, it finds KEAP1 and binds to it, preventing it from binding to the actual Nrf2 protein and degrading it.

Researchers injected rat models after a heart attack with either the PLP platform or a saline solution. The team was blinded to which animals received the polymer or saline. After five weeks, the rodents underwent MRIs while sedated. The animals injected with the polymer showed better cardiac function and significantly more healing in their heart muscle tissue. Other tests also showed that genes that promote healing of tissues were expressed more.

Researchers describe the study as a proof of concept. Before moving on to tests in larger mammals, they want to optimize the design and dosage, and conduct further analysis.

“Proteins are the molecular machines that drive all essential cellular function, and dysregulated intracellular protein-protein interactions are the cause of many human diseases,” Gianneschi said. “Existing drug modalities are either unable to penetrate cells or cannot effectively engage these large disease target domains. We are looking at these challenges through a new lens.”

The therapy method was developed by Gianneschi, while he was a faculty member at UC San Diego, where he is now an adjunct faculty. He continued working on the technology at Northwestern.

Source: University of California – San Diego