Alcohol May Have Immediate Effect on Atrial Fibrillation Risk, Events

Alcohol appears to have an immediate—or near-immediate—effect on heart rhythm, significantly increasing the chance that an episode of atrial fibrillation (AFib) will occur, according to new data presented at the American College of Cardiology’s 70th Annual Scientific Session.

The data revealed that just one glass of wine, beer or other alcoholic beverage was associated with twofold greater odds of an episode of AFib occurring within the next four hours. Among people having two or more drinks in one sitting, there was a more than threefold higher chance of experiencing AFib. Using an alcohol sensor placed on participants’ ankles, which passively monitored alcohol intake, the investigators found that every 0.1% increase in inferred blood alcohol concentration over the previous 12 hours was associated with an approximate 40% higher odds of an AFib episode. Evidence from those sensors also demonstrated that the total alcohol concentration over time also predicted the chance AFib would occur.

“Alcohol is the most commonly consumed drug in the world, and there is still a lot we don’t understand about what it does to our bodies and, in particular, our hearts,” said Gregory M. Marcus, MD, cardiologist and professor of medicine at the University of California, San Francisco, and the study’s lead author. “Based on our data, we found that alcohol can acutely influence the likelihood that an episode of AFib will occur within a few hours, and the more alcohol consumed, the higher the risk of having an event.”

AFib is the most common heart rhythm disorder. It is often characterized by a rapid, chaotic and fluttery heartbeat. Marcus said that people can experience a range of symptoms. Some may not feel anything, while others are overcome with severe shortness of breath, fatigue, fainting or near fainting spells and a disconcerting sensation that the heart is beating out of control. AFib also results in costly use of health care services, including visits to the emergency department, hospitalizations and procedures each year. Over time, AFib can lead to heart failure, stroke and dementia if untreated.

Researchers enrolled 100 patients with paroxysmal or intermittent AFib, which tends to go away within a short period of time (unlike chronic AFib). Patients in the study were 64 years old on average; the majority were white (85%) or male (80%). Past medical history, medications and lifestyle habits were assessed through chart reviews and patient interviews. Each participant was fitted with a wearable heart monitor that continuously tracked their heart rhythm and an ankle sensor to objectively detect when more than two to three drinks were consumed on a given occasion. Participants were asked to press a button on the heart monitor each time they had an alcoholic drink. Finger stick blood tests measuring alcohol consumption in the previous few weeks were also used to corroborate self-reported drinking events. Because researchers used repeated measurements from the same individual, they served as their own control over time. Overall, more than half (56) had an episode of AFib during the four-week study.

“Patients have been telling us that alcohol is a trigger for AFib for a long time, but it’s been hard, if not impossible, to study because there is a critical temporal relationship that requires a real-time assessment of alcohol intake and heart rhythm,” Marcus said. “This is the first study to objectively demonstrate and quantify the real-time relationship between alcohol consumption and AFib episodes. While this study was limited to people with intermittent AFib, it’s reasonable to extrapolate the fact that in many people alcohol may be the main trigger for an initial episode.”

Marcus said there may be other factors—such as race/ethnicity, sex, genetics or other environmental exposures—that influence alcohol’s effect on the heart in various ways and need to be studied. In addition, people often pair alcohol with foods that are high in sodium, while some pour a drink because they feel stressed, so there may be other things that play a role. The findings also run counter to previous reports about the potentially protective role of alcohol on heart health when used in moderation.

“There is conventional wisdom that alcohol is ‘good’ or ‘healthy’ for the heart, based on observational studies, but that relates to coronary heart disease and heart attack. These new data present an interesting conundrum regarding the overall risks versus benefits of alcohol in moderation,” Marcus said. “But the data is very clear that more is not better when it comes to alcohol; those who drink more have a higher risk of heart attack and death.”

Marcus added that this situation is a perfect example where precision medicine may play a clinically relevant role to help identify which patients are at high risk for alcohol-related AFib. Those who are not at high-risk of the harmful effects of alcohol might yet benefit from moderate alcohol consumption as another way to potentially protect them from coronary blockages and disease.

The general recommendation for daily alcohol consumption is no more than one standard alcoholic beverage a day for women and two for men.

“Still, when patients ask me what they can do to avoid an AFib episode, I tell them the evidence suggests that they should minimize, if not completely eliminate, alcohol. But we have to consider quality of life as well, which is both relevant to arrhythmia symptoms and the opportunity to enjoy a glass of wine once in a while for some. So, it’s not as simple as instructing everyone to avoid alcohol,” Marcus said.

As far as next steps, Marcus and his team will look at how these results, which are limited to those with intermittent AFib, may apply to the general population. They also hope to identify other factors that may influence the relationship between alcohol and AFib, including genetics.

Source: The American College of Cardiology

Estimated Number of Influenza Cases in the U.S. from 2010 to 2020

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Source: CDC

Researchers Identify Proteins That Predict Future Dementia, Alzheimer’s Risk

The development of dementia, often from Alzheimer’s disease, late in life is associated with abnormal blood levels of dozens of proteins up to five years earlier, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health. Most of these proteins were not known to be linked to dementia before, suggesting new targets for prevention therapies.

The findings are based on new analyses of blood samples of over ten thousand middle-aged and elderly people—samples that were taken and stored during large-scale studies decades ago as part of an ongoing study. The researchers linked abnormal blood levels of 38 proteins to higher risks of developing Alzheimers within five years. Of those 38 proteins, 16 appeared to predict Alzheimer’s risk two decades in advance.

Although most of these risk markers may be only incidental byproducts of the slow disease process that leads to Alzheimer’s, the analysis pointed to high levels of one protein, SVEP1, as a likely causal contributor to that disease process.

The study was published in Nature Aging.

“This is the most comprehensive analysis of its kind to date, and it sheds light on multiple biological pathways that are connected to Alzheimer’s,” says study senior author Josef Coresh, MD, PhD, MHS, George W. Comstock Professor in the Department of Epidemiology at the Bloomberg School. “Some of these proteins we uncovered are just indicators that disease might occur, but a subset may be causally relevant, which is exciting because it raises the possibility of targeting these proteins with future treatments.”

More than six million Americans are estimated to have Alzheimer’s, the most common type of dementia, an irreversible fatal condition that leads to loss of cognitive and physical function. Despite decades of intensive study, there are no treatments that can slow the disease process, let alone stop or reverse it. Scientists widely assume that the best time to treat Alzheimer’s is before dementia symptoms develop.

Efforts to gauge people’s Alzheimer’s risk before dementia arises have focused mainly on the two most obvious features of Alzheimer’s brain pathology: clumps of amyloid beta protein known as plaques, and tangles of tau protein. Scientists have shown that brain imaging of plaques, and blood or cerebrospinal fluid levels of amyloid beta or tau, have some value in predicting Alzheimer’s years in advance.

But humans have tens of thousands of other distinct proteins in their cells and blood, and techniques for measuring many of these from a single, small blood sample have advanced in recent years. Would a more comprehensive analysis using such techniques reveal other harbingers of Alzheimer’s? That’s the question Coresh and colleagues sought to answer in this new study.

The researchers’ initial analysis covered blood samples taken during 2011–13 from more than 4,800 late-middle-aged participants in the Atherosclerosis Risk in Communities (ARIC) study, a large epidemiological study of heart disease-related risk factors and outcomes that has been running in four U.S. communities since 1985. Collaborating researchers at a laboratory technology company called SomaLogic used a technology they recently developed, SomaScan, to record levels of nearly 5,000 distinct proteins in the banked ARIC samples.

The researchers analyzed the results and found 38 proteins whose abnormal levels were significantly associated with a higher risk of developing Alzheimer’s in the five years following the blood draw.

They then used SomaScan to measure protein levels from more than 11,000 blood samples taken from much younger ARIC participants in 1993–95. They found that abnormal levels of 16 of the 38 previously identified proteins were associated with the development of Alzheimer’s in the nearly two decades between that blood draw and a follow-up clinical evaluation in 2011–13.

To verify these findings in a different patient population, the scientists reviewed the results of an earlier SomaScan of blood samples taken in 2002–06 during an Icelandic study. That study had assayed proteins including 13 of the 16 proteins identified in the ARIC analyses. Of those 13 proteins, six were again associated with Alzheimer’s risk over a roughly 10-year follow-up period.

In a further statistical analysis, the researchers compared the identified proteins with data from past studies of genetic links to Alzheimer’s. The comparison suggested strongly that one of the identified proteins, SVEP1, is not just an incidental marker of Alzheimer’s risk but is involved in triggering or driving the disease.

SVEP1 is a protein whose normal functions remain somewhat mysterious, although in a study published earlier this year it was linked to the thickened artery condition, atherosclerosis, which underlies heart attacks and strokes.

Other proteins associated with Alzheimer’s risk in the new study included several key immune proteins—which is consistent with decades of findings linking Alzheimer’s to abnormally intense immune activity in the brain.

The researchers plan to continue using techniques like SomaScan to analyze proteins in banked blood samples from long-term studies to identify potential Alzheimer’s-triggering pathways—a potential strategy to suggest new approaches for Alzheimer’s treatments.

The scientists have also been studying how protein levels in the ARIC samples are linked to other diseases such as vascular (blood vessel-related) disease in the brain, heart and the kidney.

Source: Johns Hopkins Bloomberg School of Public Health

Egg Pancake with Preserved Turnip and Chives

Ingredients

50 g sweet preserved turnip (菜脯)
150 g chives
3 eggs
1 tbsp cornstarch
1/2 tsp salt
sesame oil

Method

  1. Wash and chop preserved turnip.
  2. Cut chives into 7 cm sections, discard the white stems.
  3. Mix cornstarch with 2 tablespoons of water, let it settle and slowly drain away the water on the surface.
  4. Beat eggs, and mix in wet cornstarch, salt and sesame oil.
  5. Stir-fry preserved turnip and chives for about 1 minute, then add to egg batter and mix well.
  6. Heat up 2 tablespoons of oil in a flat pan.
  7. Stir egg batter and pour into pan. Cook in medium heat, turn over and cook until both sides are brown.
  8. Serve hot.

Source: Hakka Cuisine


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