Cataracts Tied to Higher Odds of Death From Heart Disease

Robert Preidt and Ernie Mundell wrote . . . . . . . . .

Cataracts, a common eye disorder that often comes with age, may also be linked to a heightened risk of death from heart disease, new research shows.

Experts stressed that the finding doesn’t mean that cataracts somehow cause heart trouble, and the study wasn’t designed to prove cause and effect.

“A variety of medical conditions like [high blood pressure], diabetes or smoking have been associated with increased cataracts and these diseases are also associated with vascular mortality, which may explain the relationship,” said Dr. Matthew Gorski, an ophthalmologist at Northwell Health in Great Neck, N.Y. He believes cataracts may be an important signal of underlying health, however.

“Patients should use the results of this study as a reminder of the importance of having regular eye exams with your eye doctor, especially as you get older or if you have certain medical conditions,” said Gorski, who wasn’t involved in the new study.

The research was conducted in Australia, and was led by Dr. Mingguang He of the Centre for Eye Research Australia at the University of Melbourne. His team analyzed data obtained between 1999 and 2008 on nearly 15,000 American patients, aged 40 and older. More than 2,000 (9.6%) of them said they’d undergone a cataract surgery.

Over a median follow-up of nearly 11 years, close to 4,000 (19%) of the participants died.

After accounting for a number of health and socioeconomic factors, the researchers found that the risk of death from any cause was 13% higher and the risk of death from heart disease was 36% higher in people who’d had a cataract surgery.

Oxidative stress (an imbalance in natural oxidation processes affecting cells) and depression may be common factors that could impact the formation of cataracts and also raise a person’s risk of death from heart disease, He’s team said in their study.

The study authors pointed to prior research, which has shown that DNA damage caused by oxidative stress contributes to cataract formation while also spurring an unhealthy narrowing of the arteries.

According to the Australian team, people with cataracts are also more likely to develop depression than those without the eye condition, even after they’ve had cataract surgery, and people with depression have an increased risk of heart disease.

Overall, the study “found significant associations of self-reported cataract surgery” with a raised risk of death from any cause, and from heart-related causes in particular, the authors said.

Dr. Mark Fromer is an ophthalmologist at Lenox Hill Hospital in New York City. Reading over the findings, he said that “it is certainly not a surprise to expect cataract patients to have other underlying illnesses as most cataract patients are elderly.”

Fromer noted that people are typically having cataracts surgically removed at an earlier age than they might have a few decades ago. “This has led to patients living for a longer time after their surgery than was reported just decades ago,” he said. “Seeing better following surgery also leads to a better quality of life and may prevent accidents which can lead to death and injury due to poor sight.”

The study was published in the British Journal of Ophthalmology.

Source : HealthDay

Broken Heart Syndrome Is on the Rise, Especially Among Older Women

Thor Christensen wrote . . . . . . . . .

Broken heart syndrome, a life-threatening condition whose symptoms mimic a heart attack, is on the upswing, according to new research that shows the sharpest increases among women 50 and older.

Published Wednesday in the Journal of the American Heart Association, the study examined 135,463 cases of broken heart syndrome in U.S. hospitals from 2006 to 2017. It found a steady annual increase among both women and men, with women making up 88.3% of the cases.

The overall increase wasn’t unexpected as the condition has become increasingly recognized among medical professionals, said Dr. Susan Cheng, the study’s senior author. But researchers were taken aback to find the rate of the condition was at least six to 12 times higher in women ages 50 to 74 than it was in men or in younger women.

“These skyrocketing rates are both intriguing and concerning,” said Cheng, director of the Institute for Research on Healthy Aging in the department of cardiology at the Smidt Heart Institute at Cedars-Sinai in Los Angeles.

The condition, also known as Takotsubo cardiomyopathy, has been studied for decades in Japan and elsewhere. But it wasn’t well known internationally until 2005, when the New England Journal of Medicine published research on it.

Triggered by physical or emotional stress, broken heart syndrome causes the heart’s main pumping chamber to temporarily enlarge and pump poorly. Patients experience chest pain and shortness of breath, symptoms similar to those of a heart attack.

If they survive the initial phase of the disease, people often can recover in days or weeks. However, the longer-term effects are still being studied. Despite apparent recovery of heart muscle function, some studies show people who have had broken heart syndrome are at heightened risk for future cardiovascular events.

Cheng said more research is needed to understand the risks and reasons why broken heart syndrome seems to disproportionately affect middle-aged to older women.

The end of menopause may play a role, she said, but so might an uptick in overall stress.

“As we advance in age and take on more life and work responsibilities, we experience higher stress levels,” she said. “And with increasing digitization around every aspect of our lives, environmental stressors have also intensified.”

The study arrives at a time when public health organizations have been delving deeper into the mind-heart-body connection. In January, the American Heart Association published a scientific statement on the connection, saying there were “clear associations” between psychological health and cardiovascular disease risk.

While the study was done before the rise of COVID-19, Cheng said the stress of the pandemic has likely led to a rise in the number of recent cases of broken heart syndrome, many of them undiagnosed.

“We know there have been profound effects on the heart-brain connection during the pandemic. We are at the tip of the iceberg in terms of measuring what those are,” she said.

Dr. Erin Michos, who helped write the AHA’s scientific statement but was not involved in the new research, said the findings underscore how important it is for doctors to screen patients for mental health conditions.

She also called for more research to understand a disease about which little is known.

“We should all be worried about why its incidence is on the rise,” said Michos, an associate professor of medicine and director of Women’s Cardiovascular Health at Johns Hopkins School of Medicine in Baltimore.

The study, she said, serves as a potent reminder that everyone needs be proactive about their mental health, especially those with cardiovascular risks.

“We can’t avoid all stress in life, but it is important for patients to develop healthy coping mechanisms. Some strategies include mindfulness meditation, yoga, exercise, eating healthy, getting adequate sleep and cultivating social relationships for support systems,” Michos said. “For patients with significant psychological stress, a referral to a clinical psychologist or other clinician with expertise in mental health is recommended.”

Source: American Heart Association

Could Too Little Iron Boost Your Risk for Heart Disease?

Steven Reinberg wrote . . . . . . . . .

Iron is vital to health, and too little in your diet might lead to heart disease, European researchers report.

They said about 1 in 10 new cases of heart disease in middle-aged people might be prevented if they had sufficient levels of iron in their diets.

“Our findings are based on an observational study and can therefore only report on associations, not on causality,” said lead researcher Dr. Benedikt Schrage.

“This being said, our findings indicate that iron deficiency might be a suitable target for preventive measures in the general population and support the conduction of trials which explore the efficacy of iron supplementation in individuals with functional iron deficiency,” said Schrage, of the general and interventional cardiology department at University Medical Center in Hamburg, Germany.

The connection between iron deficiency and heart disease isn’t clear. But iron is essential for equilibrium in the body and energy metabolism, which might be a potential link, Schrage said.

People who are deficient in iron usually don’t consume enough of the mineral in their diet or can’t process the iron they do get, he said. Iron-rich foods include meat; poultry; eggs; seafood, including tuna, scallops and shrimp; vegetables such as spinach and sweet potatoes, and beans, according to the American Red Cross. Other good dietary sources include enriched breads and pasta, and fruits like strawberries and watermelon.

“Iron supplementation per se plays a minor role, as long as the overall uptake is sufficient,” Schrage said. “However, some individuals might not be able to absorb enough iron via the intestines. For these individuals, intravenous iron therapy might be an option.”

Earlier studies have found that iron-deficient patients with cardiovascular diseases are more likely than others to be hospitalized or die. Giving intravenous iron improved symptoms, function and quality of life in heart failure patients with iron deficiency, the researchers noted.

The current study included more than 12,000 European men and women with a median age of 59. Over roughly 13 years, the researchers looked for heart disease and stroke, death due to cardiovascular disease and death from any cause.

At the study’s start, almost two-thirds of the participants had what’s called functional iron deficiency. This means they have enough iron, but not enough in the blood for the body to work properly, Schrage said. These individuals were more likely to develop heart disease and were also more likely to die during the next 13 years, he said.

During follow-up, 18% of the participants died, 5% of them from cardiovascular disease. Also, 9% were diagnosed with heart disease and 6% with stroke.

Iron deficiency was tied to a 24% higher risk of heart disease, a 26% increased risk of dying from cardiovascular disease and a 12% higher risk of dying from any cause, compared with no iron deficiency, the researchers found.

When Schrage and his colleagues calculated the effect of iron deficiency over 10 years, they found that 5% of all deaths, 12% of cardiovascular deaths and 11% of new heart disease diagnoses could be attributed to iron deficiency.

But don’t rush out and buy iron supplements just yet, according to a heart expert not involved with the study.

Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center, said there is mixed evidence about the connection between iron and heart disease.

“There is clinical trial evidence which demonstrates patients with heart failure and iron deficiency derive benefit from intravenous iron treatment,” he said. “There is no comparable data supporting oral iron supplementation in heart failure.”

For heart disease, the findings so far regarding iron levels and risk are complex, said Fonarow.

“Both iron deficiency and iron overload have been associated with increased coronary heart disease event risk,” he noted.

People shouldn’t supplement their iron intake to ward off heart disease, he said.

“Further studies and, ultimately, prospective randomized trials are needed before treatment with any form of iron should be considered for modification of the risk of coronary heart disease,” Fonarow said.

The report was published in the journal ESC Heart Failure.

Source: HealthDay

Elevated Stress Hormones Linked to Higher Risk of High Blood Pressure and Heart Events

Adults with normal blood pressure and high levels of stress hormones were more likely to develop high blood pressure and experience cardiovascular events compared to those who had lower stress hormone levels, according to new research published today in Hypertension, an American Heart Association journal.

Studies have shown that cumulative exposure to daily stressors and exposure to traumatic stress can increase cardiovascular disease risk. A growing body of research refers to the mind-heart-body connection, which suggests a person’s mind can positively or negatively affect cardiovascular health, cardiovascular risk factors and risk for cardiovascular disease events, as well as cardiovascular prognosis over time.

“The stress hormones norepinephrine, epinephrine, dopamine and cortisol can increase with stress from life events, work, relationships, finances and more. And we confirmed that stress is a key factor contributing to the risk of hypertension and cardiovascular events,” said study author Kosuke Inoue, M.D., Ph.D., assistant professor of social epidemiology at Kyoto University in Kyoto, Japan. Inoue also is affiliated with the department of epidemiology at the Fielding School of Public Health at the University of California, Los Angeles.

“Previous research focused on the relationship between stress hormone levels and hypertension or cardiovascular events in patients with existing hypertension. However, studies looking at adults without hypertension were lacking,” Inoue said. “It is important to examine the impact of stress on adults in the general population because it provides new information about whether routine measurement of stress hormones needs to be considered to prevent hypertension and CVD events.”

Study subjects were part of the MESA Stress 1 study, a substudy of the Multi-Ethnic Study of Atherosclerosis (MESA), a large study of atherosclerosis risk factors among more than 6,000 men and women from six U.S. communities. As part of MESA exams 3 and 4 (conducted between July 2004 and October 2006), white, Black and Hispanic participants with normal blood pressure from the New York and Los Angeles sites were invited to participate in the substudy MESA Stress 1. In this substudy, researchers analyzed levels of norepinephrine, epinephrine, dopamine and cortisol – hormones that respond to stress levels. Hormone levels were measured in a 12-hour overnight urine test. The substudy included 412 adults ages 48 to 87 years. About half were female, 54% were Hispanic, 22% were Black and 24% were white.

Participants were followed for three more visits (between September 2005 and June 2018) for development of hypertension and cardiovascular events such as chest pain, the need for an artery-opening procedure, or having a heart attack or stroke.

Norepinephrine, epinephrine and dopamine are molecules known as catecholamines that maintain stability throughout the autonomic nervous system—the system that regulates involuntary body functions such as heart rate, blood pressure and breathing. Cortisol is a steroid hormone released when one experiences stress and is regulated by the hypothalamic-pituitary-adrenal axis, which modulates stress response.

“Although all of these hormones are produced in the adrenal gland, they have different roles and mechanisms to influence the cardiovascular system, so it is important to study their relationship with hypertension and cardiovascular events, individually,” Inoue said.

Their analysis of the relationship between stress hormones and development of atherosclerosis found:

  • Over a median of 6.5-year follow-up period, every time the levels of the four stress hormones doubled was associated with a 21-31% increase in the risk of developing hypertension.
  • During a median of 11.2-years of follow-up, there was a 90% increased risk of cardiovascular events with each doubling of cortisol levels. There was no association between cardiovascular events and catecholamines.

“It is challenging to study psychosocial stress since it is personal, and its impact varies for each individual. In this research, we used a noninvasive measure — a single urine test — to determine whether such stress might help identify people in need of additional screening to prevent hypertension and possibly cardiovascular events,” Inoue said.

“The next key research question is whether and in which populations increased testing of stress hormones could be helpful. Currently, these hormones are measured only when hypertension with an underlying cause or other related diseases are suspected. However, if additional screening could help prevent hypertension and cardiovascular events, we may want to measure these hormone levels more frequently.”

A limitation of the study is that it did not include people who had hypertension at the study’s start, which would have resulted in a larger study population. Another limitation is that researchers measured stress hormones via a urine test only, and no other tests for stress hormone measurement were used.

Source: American Heart Association

More Evidence Ties Gum Disease With Heart Disease

New research offers further evidence of a link between gum disease and heart disease.

The ongoing Swedish study previously found that gum disease (“periodontitis”) was much more common in first-time heart attack patients than in a group of healthy people.

In this follow-up study, the researchers examined whether gum disease was associated with an increased risk of new heart problems in both heart attack survivors and healthy people the same age and sex, and living in the same area.

“The risk of experiencing a cardiovascular event during follow-up was higher in participants with periodontitis, increasing in parallel with the severity. This was particularly apparent in patients who had already experienced a [heart attack],” said study author Giulia Ferrannini, from the Karolinska Institute in Stockholm.

The researchers suspect that damage to the gum tissue in people with gum disease may allow germs to enter the bloodstream. “This could accelerate harmful changes to the blood vessels and/or enhance systemic inflammation that is harmful to the vessels,” Ferrannini added.

In total, the study included nearly 1,600 participants with an average age of 62. Dental examinations between 2010 and 2014 showed that 985 had good dental health, 489 had moderate periodontitis and 113 had severe periodontitis.

During an average follow-up of just over six years, people with gum disease were 49% more likely to die from any cause, have a nonfatal heart attack or stroke, or to develop severe heart failure.

The risk of those outcomes increased with the severity of gum disease, according to the study presented Friday at a virtual meeting of the European Society of Cardiology. Such research is considered preliminary until published in a peer-reviewed journal.

When assessed separately, the relationship between gum disease severity and the risk of negative outcomes was significant only for those who had experienced a heart attack in the past.

“Our study suggests that dental screening programs including regular check-ups and education on proper dental hygiene may help to prevent first and subsequent heart events,” Ferrannini concluded in a meeting news release.

Source: HealthDay