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Air Pollution Increases Risk Of Heart Disease

Air pollution is a recognized risk factor for cardiovascular disease, and new research indicates that it is especially detrimental for women with type 2 diabetes. Investigators at Brigham and Women’s Hospital in Boston and the Harvard T.H. Chan School of Public Health reviewed data from more than 100,000 women, comparing rates of cardiovascular disease in connection with air pollution. They found that among women who were affected by air pollution, type 2 diabetes was a more important factor than  age, family history of cardiovascular disease, a woman’s weight, smoking, and region of the country. For non-diabetics in the study, long-term exposure to air pollution led to small, but statistically insignificant increases in the risk of cardiovascular events. The researchers reported that for each increase of 10 micrograms per cubic meter of air pollution, a woman’s risk of cardiovascular disease rose by 44 percent if she had type 2 diabetes. The 10 micrograms increase in pollution is the equivalent of the difference in air quality between Los Angeles and St. Louis. The researchers suggested that women at higher risk of cardiovascular disease, and especially those with type 2 diabetes, take precautions to limit their exposure to air pollution. They also suggested following recommendations to lower the risk of cardiovascular disease by not smoking, eating a healthy diet and getting regular exercise.

Southern Diet Danger

The occasional splurge on fried chicken, or a dinner of liver with gravy with a tall glass of sweet tea probably won’t hurt you. But if your diet includes those and other traditional Southern food favorites as daily fare, your risk of heart disease could increase by 56 percent over the next six years. This news comes from a large study that examined the effects of 5 different diets on heart health, and included 17,000 white and African-American adults (with no known heart problems) age 45 or older. The participants were recruited throughout the United States, but only the traditional Southern diet yielded the negative results. None of the other diets was linked to the risk of heart disease in this study. The researchers, from the University of Alabama, Boston University and Harvard, characterized Southern fare as fried foods, fatty foods, eggs, processed meats, such as bacon and ham, and sugary drinks. They found that the highest consumers of the Southern diet tended to be male, African American, individuals who had not graduated from high school, and among those who lived in North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas and Louisiana.

Why Not Sleep Late On Weekends?

If you often sleep in on weekends, you may be increasing your risk of heart disease and diabetes. In fact, a study from the University of Pittsburgh suggests that the greater the difference between the time you usually get up on weekdays and how late you sleep on weekends the greater the risk. Researchers tracked 447 men and women ages 30 to 54 and determined that those who slept later on weekends had lower HDL (“good”) cholesterol, higher triglycerides, higher insulin resistance and higher body mass index than those who kept consistent sleep schedules throughout the week. The link between sleeping habits and these factors remained even after the researchers controlled for physical activity, caloric intake, drinking alcohol, and symptoms of depression. During the 7-day study the participants wore devices that recorded when they fell asleep and woke up, and also measured their movements night and day. Almost 85 percent of the participants woke later on days when they didn’t have to go to work. Earlier research revealed an association between shift work and an increased risk of heart disease and diabetes. It’s not yet known whether the effects seen in the study from sleeping in on weekends are long lasting. 

Working Too Much?

If you're putting in significant time at work - 55 hours or more per week - you may be bumping up your risk of stroke. New research from the UK suggests that stroke risk rises by 33 percent among people in Europe, the U.S. and Australia who work much more than the usual 35-40 hours per week. It also found that the risk of coronary heart disease was 13 percent higher among those whose workweeks exceeded 55 hours. The findings were based on data from about 600,000 workers after researchers controlled for other risks including smoking, physical activity, high blood pressure and high cholesterol. However, study leader Mika Kivimaki, of University College London, said his team found "no differences between men and women, or between older people and younger ones, or those with higher or lower socioeconomic status." Although the findings were statistically significant, a 55 percent increased risk isn't as scary as it may seem. Here's why: if the normal risk of stroke is one person in 100, a 55 percent increase means that 1.55 people of 100 are at risk. With a 13 percent increase, if 1 person in 100 normally has a heart attack, the risk rises to 1.13 per 100.

Drinking Beer and Women’s Hearts

First, the good news: drinking a beer or two per week could reduce the risk of heart disease in women by 30 percent. The bad news, however, is that drinking spirits (rather than beer or wine) could raise a woman’s risk of dying of cancer by 50 percent. These new findings come from a 32-year long Swedish study that included 1,500 women who were age 38 to 60 when they enrolled in the investigation. Over the course of 32 years, the women reported on their consumption of beer, wine or spirits, and the researchers tracked the participants’ medical concerns, including heart problems and cancer. Analysis of the data showed a reduced risk of developing heart disease in those women who drank a beer or two per week compared to women who didn’t drink alcohol at all and those who were heavy drinkers. However, the study did not confirm the results of previous results from other investigators suggesting that moderate wine consumption can lower the risk of heart disease. That outcome will have to be confirmed in a follow-up study, according to lead researcher Dominique Hange. The investigators, from the University of Gothenburg, also reported an apparent higher risk of dying of cancer among women who drank spirits more than once or twice a month over the course of the study compared to women who drank spirits less often than that.

A Bad Marriage Can Hurt Your Heart

Having an unhappy marriage can raise your risk of heart disease, particularly if you're female. Hui Liu, a sociologist at from Michigan State University, looked at five years of data from 1,200 couples - ages 57 to 85 - in order to discern how happy or unhappy marriage affected heart health. She found that bad marriages have a bigger impact on heart health than good ones - they have a negative effect while good marriages don't necessarily have beneficial effects. Participating couples were asked to respond to survey questions about the quality of their marriages and their heart health - whether or not they had had heart attacks, strokes, high blood pressure, and whether lab tests had shown high blood levels of C-reactive protein, a marker for inflammation in the body. Lui suggested that over time, stress from a bad marriage may worsen heart health because of age-related increased frailty and declining immune function and concluded that bad marriages have greater impacts on women's heart health than on men's, possibly because "women tend to internalize negative feelings and thus are more likely to feel depressed and develop cardiovascular problems."

Can Pollution Make You Fat?

Maybe so, and worse, it could lead to heart disease. A new study of seniors living in Massachusetts suggests that black carbon, a component of traffic-generated air pollution, influences levels of leptin. High levels of this hormone are associated with obesity, diabetes and heart disease.

A team of researchers from Brown University measured blood levels of leptin in 765 seniors living in Boston and found that levels of the hormone were 27 percent higher among those with the most exposure to black carbon. These individuals also had lower incomes and higher rates of high blood pressure and diabetes than others in the study. The research team didn't establish where the pollution was generated, reporting that the proximity of the nearest major highway was not apparently related to leptin levels. Rather, they suggested that black carbon exposure probably reflects overall pollution from traffic on a wider range of roads in the immediate vicinity of the participants' homes. The study doesn't prove that black carbon exposure increases leptin levels, but the researchers suggested that their findings may help explain increases in cardiovascular disease associated with air pollution.

Biggest Risk Factor for Heart Disease in Women Over 30?

You might guess the answer is smoking, high blood pressure, or being overweight, and all those contributors play a role, but a new study from Australia has shown that lack of physical activity presents the most significant risk of heart disease in women over 30. The researchers used a mathematical formula to determine reductions in heart disease if specific risk factors were eliminated, and followed more than 32,000 women in three age groups to arrive at their conclusion. Predictably, in women under 30, the biggest risk turned out to be smoking, but in all the women over 30 lack of physical activity proved the strongest risk. For women in their 70s, being active would lower the risk of heart disease nearly three times as much as quitting smoking and significantly more than lowering blood pressure or reaching a healthy body weight, the study showed. Overall, it found that for all women over 30 those who are inactive were nearly 50 percent more likely to develop cardiovascular disease in their lifetimes than women who regularly get at least 150 minutes of moderately intense exercise every week.

My take? Women often don't realize that heart disease is as much of a threat to them as it is to men. True, the risk for men is higher when they're younger, but by the age of 65, the rate of heart disease in women equals that of men and is the leading cause of death in women, claiming nearly 500,000 lives per year (compared to about 40,000 for breast cancer, a disease women tend to fear more). This study’s findings emphasize the importance of daily physical activity for lowering women’s risk of heart disease. About 60 percent of American women don't get the recommended 30 minutes per day of moderate exercise. While a sedentary lifestyle may be the biggest risk, the others – smoking, high blood pressure, high cholesterol and being overweight – shouldn’t be ignored.

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Wendy J. Brown et al, “Comparing population attributable risks for heart disease across the adult lifespan in women,” British Journal of Sports Medicine, doi:10.1136/bjsports-2013-093090

Stay Positive for Heart Health

Maintaining a positive attitude seemed to help prevent death from any cause over five years among heart disease patientsSimply maintaining a positive attitude seemed to help prevent death from any cause over five years among heart disease patients, and also made it more likely that they would exercise, a new European study concludes. What’s more, the heart patients who did exercise were 50 percent less likely to die during the five-year study than those who didn’t work out. The participants were mostly men who had ischemic heart disease, a condition in which blood flow to the heart is reduced and may cause chest pain (angina). The researchers noted that patients with this form of heart disease often suffer from depression, anxiety and other negative emotions, all of which are linked to several major heart problems and death. The contribution of these negative influences seems to remain despite advances in treatment that have reduced deaths from ischemic heart disease.

Overall, the study showed that a positive outlook was more common in men who had higher education, were employed and had a lower likelihood of diabetes and chronic obstructive pulmonary disease than others in the study. They were also were less likely to have a prescription for a diuretic, use medications for depression, anxiety or other mental disorders, and less likely to be hospitalized (as were those who exercised).

My take? This study fits right in with prior findings that positive thinking can enhance health. Pessimism has been linked to a higher risk of dying before age 65, while optimism – and positive emotions in general - are associated with lowered production of the stress hormone cortisol, better immune function, and reduced risk of chronic diseases. Earlier studies have found that among patients recovering from coronary artery bypass graft surgery, those with a positive outlook recovered faster and were less likely to be re-hospitalized for post-surgical complications or other heart problems. None of this seems to bode well for pessimists, but some research has shown that optimism is at least partially learned, and that even the most negative personalities can be improved. I suggest reading a classic book on the subject, Learned Optimism: How to Change Your Mind & Your Life, by famed psychologist Martin Seligman, Ph.D.

Another Good Reason to Eat More Broccoli

Broccoli help lower the risks of both cancer and heart disease.Broccoli and other cruciferous vegetables including cauliflower, Brussels sprouts, cabbage, turnip greens and kale are rich in antioxidants, which help lower the risks of both cancer and heart disease. Population studies have shown that people who eat broccoli and other cruciferous vegetables regularly have lower rates of cancer than those who don't. And now a research team in England has reported on another potential health benefit: sulforaphane, a compound in broccoli, may help prevent arthritis of the knee. The British investigators found that when they laced mouse food with sulforaphane, the animals had significantly less cartilage damage and were less likely to develop osteoarthritis than mice that remained on their regular diet. In the laboratory, the investigators found that cartilage cells from humans (as well as those from cows) were less damaged by osteoarthritis when they were treated with sulforaphane. The same team now plans a small human study to see whether “super broccoli” containing high amounts of sulforaphane has any impact on osteoarthritis in 40 patients scheduled for knee replacement surgery.

Ian M. Clark et al, “Sulforaphane represses matrix-degrading proteases and protects cartilage from destruction in vitro and in vivo,”  Arthritis & Rheumatism, DOI: 10.1002/art.38133