Cardiovascular disease

Posted on Cardiovascular disease, Diet

Adding high-quality plant-based foods to the diet decreases the risk of death from heart disease

Adding high-quality plant-based foods to diet decreases risk of deaths from heart disease
Adding high-quality plant-based foods to diet decreases risk of deaths from heart disease

 

As long as you don’t count French fries and soda as healthy choices, it’s never too late to increase your longevity and cut your risk of heart disease death by adding fruits and vegetables to your diet, according to preliminary research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2019, a premier global exchange of the latest advances in population based cardiovascular science for researchers and clinicians.

“Not all plant-based diets are equal, but boosting the intake of high-quality plant-based foods over time lowers the risk of death even among people who started off with poor-quality diets,” said Megu Y. Baden, M.D., Ph.D., lead author of the study and postdoctoral research fellow in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

Previous studies have shown that eating a high-quality plant-based diet can reduce the risk of diabetes and heart disease, but this is the first to look at how positive or negative changes in diet may influence a person’s risk of dying – no matter where they started. In the current study, researchers developed three diet scales that took into account the overall consumption of plant-based foods, the consumption of healthful plant-based foods (such as whole grains, fruits, vegetables and nuts), and the consumption of lower-quality plant-based foods (such as fruit juices, refined grains, potatoes and sweets).

The study included 47,983 women (average age 64 years) participating in the Nurses’ Health Study and 25,737 men (average age 64 years) participating in the Health Professionals Follow-Up Study. None had a history of heart disease or cancer when they entered the study in 1998. Using dietary reports, participants were assessed on changes in their diet over the 12 years prior to entering the study.

Compared to those who had fairly stable diets, during a 12-year follow-up period (1998-2014) the researchers found that deaths from all causes were:

  • 8 percent lower in those with the biggest increase in an overall plant-based diet;
  • 10 percent lower in those with the biggest increase in a healthy plant-based diet;
  • 11 percent higher in those with the biggest increase in an unhealthy plant-based diet.

A 10-point increase in score on the healthy plant-based diet scale (which can be achieved for example by replacing 1 serving/day intake of refined grains with whole grains, increasing fruit intake by 1 serving/day and vegetable intake by 1 serving/day, and decreasing sugary beverage intake by 1 serving/day) was associated with a 10 percent lower risk of death from cardiovascular disease, while a 10-point increase in score on the unhealthy plant-based diet scale was associated with a 6 percent high risk of cardiovascular-disease death.

“Over a period of time, consuming more whole grains, fruits, vegetables, while decreasing your intake of refined grains, sweets and desserts, and animal foods such as animal fat meat, and miscellaneous animal-based foods, may lower your risk of death from heart disease and other causes,” Baden said.

Results were adjusted for several factors, including age, race, initial diet score, body mass index, weight change, family history of diabetes, heart attack, or cancer, heart disease risk factors, medications, menopausal status and hormone use, initial and changes in smoking and other lifestyle influences, and weight change. Because the study was not a randomized trial, it cannot prove a cause-and-effect relationship between the dietary changes and the risk of death. Although there is no reason to think that consuming high-quality plant foods would not be good for everyone, these results in health professionals who were predominantly of European ancestry might not be generalizable to other groups of people.

The most recent dietary guideline, by the American Heart Association and American College of Cardiology, recommends that adults follow a dietary pattern that emphasizes vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts; and limits intake of saturated fats, sodium, sweets, sugar-sweetened beverages and red meats.

Posted on Cancer, Cardiovascular disease, Pain Management

New research may explain the unexpected effects of common painkillers like cancer or heart disease

Do You Know The Warning Signs of Heart Disease? - YouTube

 Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin are widely used to treat pain and inflammation. But even at similar doses, different NSAIDs can have unexpected and unexplained effects on many diseases, including heart disease and cancer.

Now, a new Yale-led study has uncovered a previously unknown process by which some NSAIDs affect the body. The finding may explain why similar NSAIDs produce a range of clinical outcomes and could inform how the drugs are used in the future.

The study was published May 23 in the journal Immunity.

Until now, the anti-inflammatory effects of NSAIDs were believed to arise solely through the inhibition of certain enzymes. But this mechanism does not account for many clinical outcomes that vary across the family of drugs. For example, some NSAIDs prevent heart disease while others cause it, some NSAIDs have been linked to decreased incidence of colorectal cancer, and various NSAIDs can have a wide range of effects on asthma.

Now, using cell cultures and mice, Yale researchers have uncovered a distinct mechanism by which a subset of NSAIDs reduce inflammation. And that mechanism may help explain some of these curious effects.

The research showed that only some NSAIDs — including indomethacin, which is used to treat arthritis and gout, and ibuprofen — also activate a protein called nuclear factor erythroid 2-related factor 2, or NRF2, which, among its many actions, triggers anti-inflammatory processes in the body.

“It’s interesting and exciting that NSAIDs have a different mode of action than what was known previously,” said Anna Eisenstein, an instructor at the Yale School of Medicine and lead author of the study. “And because people use NSAIDs so frequently, it’s important we know what they’re doing in the body.”

The research team can’t say for sure that NSAIDs’ unexpected effects are due to NRF2 — that will require more research. “But I think these findings are suggestive of that,” Eisenstein said.

Eisenstein is now looking into some of the drugs’ dermatological effects — causing rashes, exacerbating hives, and worsening allergies — and whether they are mediated by NRF2.

This discovery still needs to be confirmed in humans, the researchers note. But if it is, the findings could have impacts on how inflammation is treated and how NSAIDs are used.

For instance, several clinical trials are evaluating whether NRF2-activating drugs are effective in treating inflammatory diseases like Alzheimer’s disease, asthma, and various cancers; this research could inform the potential and limitations of those drugs. Additionally, NSAIDs might be more effectively prescribed going forward, with NRF2-activating NSAIDs and non-NRF2-activating NSAIDs applied to the diseases they’re most likely to treat.

The findings may also point to entirely new applications for NSAIDs, said Eisenstein.

NRF2 controls a large number of genes involved in a wide range of processes, including metabolism, immune response, and inflammation. And the protein has been implicated in aging, longevity, and cellular stress reduction.

Said Eisenstein, “That NRF2 does so much suggests that NSAIDs might have other effects, whether beneficial or adverse, that we haven’t yet looked for.”

Posted on Cardiovascular disease, Rheumatoid arthritis

Rheumatoid arthritis linked to atrial fibrillation

Rheumatoid arthritis linked to irregular heart rhythm
Rheumatoid arthritis linked to irregular heart rhythm


People with rheumatoid arthritis are at a greater risk of irregular heart rhythm (known as atrial fibrillation) and stroke compared with the general population, finds a study published on bmj.com today.

Rheumatoid arthritis is already linked to an increased risk of heart attacks and heart failure, and is an important risk factor for stroke. But no study has yet examined whether it increases the risk of atrial fibrillation – a condition associated with an increased long term risk of stroke, heart failure, and death.

So a team of researchers set out to examine the risk of atrial fibrillation and stroke associated with rheumatoid arthritis in the Danish population.

The study involved more than four million people, of which 18,247 had a diagnosis of rheumatoid arthritis. Participants were followed up for an average of five years, during which time cases of atrial fibrillation and stroke were recorded.

The results show that patients with rheumatoid arthritis had a 40% increased risk of atrial fibrillation compared with the general population (8.2 and 6 events per 1,000 person years respectively) with women at slightly higher risk than men. This corresponds to one new case of atrial fibrillation per 12 rheumatoid arthritis patients followed for 10 years after diagnosis.

Patients with rheumatoid arthritis also had a 30% increased risk of stroke compared with the general population (7.6 and 5.7 events per 1,000 person years respectively).

New guidelines recommend annual screening for cardiovascular risk factors in patients with rheumatoid arthritis, and this should include screening for atrial fibrillation, say the authors.

They also suggest that, as inflammation plays a role in the development of atrial fibrillation and stroke, inflammation control is crucial for patients with rheumatoid arthritis, “not only for the management of joint symptoms, but also to reduce the need for drugs with potential adverse cardiovascular effects and, ultimately, to diminish the inflammation driven atherothrombotic process.”

Posted on Cardiovascular disease, Diabetes

Ceramides – Blood lipids provide new insights into the link between diet and diabetes and cardiovascular disease


Type 2 diabetes and cardiovascular disease are preceded by metabolic alterations. A current study by the DZD and DIfE indicates that specific lipid molecules (ceramides*), which are produced when the body metabolizes fats, are involved in the development of type 2 diabetes and cardiovascular diseases. The study also establishes a link between an unhealthy diet and unfavorable ceramide levels in the blood. This could explain, for example, why the risk of diabetes increases with frequent consumption of red and processed meat. As potential biomarkers, ceramides could enable more precise dietary approaches for the prevention of cardiometabolic diseases. The results of the study have now been published in Nature Communications.

Unhealthy dietary habits can contribute to the development of heart attack, stroke and type 2 diabetes (cardiometabolic diseases). However, it is not yet known exactly which biochemical processes underlie this. State-of-the-art high-throughput techniques make it possible to simultaneously assess a large number of metabolites in the blood and thus provide comprehensive metabolic profiles in large study groups. This shows that specific lipid molecules, ceramides and dihydroceramides, could be critical factors for long-term cardiometabolic health. Furthermore, diet influences the composition of ceramides and dihydroceramides.

Comprehensive studies on the influence of diet on ceramide levels in the blood and possible effects on the development of cardiometabolic diseases in humans have so far been lacking. The researchers therefore observed several thousand participants in the EPIC-Potsdam study** over a period of several years in order to assess whether the occurrence of cardiometabolic diseases can be predicted on the basis of specific ceramides influenced by diet. The study was conducted under the leadership of the German Institute of Human Nutrition (DIfE) and supported by the German Center for Diabetes Research (DZD) and the BMBF-funded project “FAME “***. The study results show that ceramide profiles provide insights into the development of cardiometabolic diseases and can improve the understanding of the influence of diet on disease risk.

Ceramide profiling

At the beginning of the study, all participants provided information about their diet and blood samples. None of the participants had type 2 diabetes or cardiovascular disease. In the following years, about 550 subjects developed cardiovascular disease and nearly 800 developed type 2 diabetes. Using a novel analytical platform called lipidomics, the researchers profiled the ceramides and dihydroceramides in the blood of the EPIC-Potsdam participants.

Specific ceramides mediate adverse effects of unhealthy eating

The researchers then investigated whether disease-relevant ceramides and dihydroceramides are also linked to food consumption. “People who eat a lot of meat have a higher risk of diabetes. We have now shown for the first time that high consumption of red and processed meat was associated with unfavorable levels of diabetes-related ceramides. Our results suggest that the association between meat consumption and diabetes risk may be mediated by the influence on ceramide levels in the blood,” said first author Clemens Wittenbecher, a member of the Department of Molecular Epidemiology at DIfE and the Harvard T.H. Chan School of Public Health. Matthias Schulze, head of the Department of Molecular Epidemiology at DIfE and last author of the study added: “Detailed metabolic profiles in large cohort studies help us to better understand the relationship between diet and disease risk. This ultimately contributes to evidence-based and more accurate dietary recommendations.”

Study opens up new prevention approaches

Cardiometabolic diseases such as heart attack, stroke and type 2 diabetes account for more than one-third of deaths worldwide. The results of the current study identified specific ceramides as potential biomarkers for the relationship between diet and disease risk, and thus could enable more precise nutritional approaches for the prevention of cardiometabolic diseases.