If You Have An Irregular Heartbeat, Take Blood Thinners

The American Academy of Neurology on Monday issued new guidelines on the use of blood thinners for people with an irregular heartbeat, after last considering the issue in 1998. Since then, several new anticoagulants have proven at least as effective as the traditional warfarin treatment for non–valvular atrial fibrillation, and is safe for those who’ve survived stroke or its precursor, a transient ischemic attack.

Dr. Antonio Culebras, an Academy fellow at SUNY Upstate Medical University, says blood thinners are especially important for people at risk of stroke. “The World Health Organization has determined that atrial fibrillation is nearing epidemic proportions, affecting 0.5 percent of the population worldwide,” he said in a statement.

Although presenting no immediate danger, an irregular heart rhythm allows blood to collect in the heart’s upper chambers, where it may clot. Eventually, blood clots forming in the heart may flow to the brain, obstructing vessels and arteries. Approximately one in 20 Americans with an untreated irregular heartbeat will suffer stroke this year, the Academy says. To date, doctors have exercised caution in prescribing blood thinners, wary of the risk of bleeding. However, new drugs on the market carry a reduced risk of bleeding in the brain, with much greater convenience. Patients on warfarin today require frequent blood testing to monitor risk for bleeding.

But wait, there’s more. A greater safety profile for blood thinners extends the range of patients who might benefit. Such drugs may now help more elderly patients, including those with dementia and those at moderate risk of falls — factors considered too dangerous for the old-line of anticoagulants.

“Of course, doctors will need to consider the individual patient’s situation in making a decision whether or not to use anticoagulants, and which one to use, as the risks and benefits can vary for each person,” Culebras said.

Source: Medical Daily


Extra weight may add to elderly fall risk

For Australians over age 65 included in a new study, being obese raised the risk of experiencing a fall by 31 percent.

“Falls are one of the most common causes of injury for older individuals and as the world population ages, the number of fall-related injuries are projected to increase rapidly,” said lead author Rebecca Mitchell.

“Likewise, rates of overweight and obesity among older individuals are also increasing,” added Mitchell, a researcher with Neuroscience Research Australia at the University of New South Wales.

Mitchell and her colleagues wanted to determine whether overweight and obesity added to the risk of falling among older adults, as well as the risk of being injured in a fall.

The researchers used information from the New South Wales Prevention Baseline Survey, a large Australian population study started in 2009.

A total of 5,681 people 65 years of age and older were asked about their history of falling, their perception of their own risk of falling, their general health status, medication use and activity levels.

Participants who had fallen one or more times in the previous 12 months as a result of accidentally losing their balance, tripping or slipping were also asked how many of those falls resulted in injury and how many required medical attention or led to hospital admission.

According to the results published in the Australian and New Zealand Journal of Public Health, 23 percent of healthy-weight respondents had fallen once during the previous 12 months and 34 percent had fallen more than once.

About 30 percent of obese respondents fell once and another 45 percent fell more than once, making the overall fall risk 31 percent higher in the obese group.

The obese participants who fell didn’t have any higher risk of fall-related injuries compared to healthy-weight people who fell, but they were more likely to have other health conditions – such as heart disease, diabetes and high blood pressure – and to report being in moderate or extreme discomfort.

Those who were obese and fell were also more likely to be taking four or more prescription medications.

“It is difficult to know for certain why the risk of falling increases for obese individuals, but it is likely to be as a result of reduced peripheral sensation, general physical weakness and instability when standing or walking,” Mitchell said.

There are a number of common risk factors that can increase any older person’s risk of falling, she added.

“These can include individual factors such as: poor health, instability when standing or walking, some health conditions, such as poor vision or dementia, lack of physical activity, use of multiple medications that can affect balance, and a poor diet,” Mitchell said.

Risks can also be in an older person’s environment, including “uneven or slippery floors, unsecured floor coverings, such as rugs, inappropriate footwear or eyewear, or inadequate lighting,” she said.

“As to why fall-related injuries do not increase for obese individuals this is likely to be as a result of adipose tissue (fat) protecting bone,” Mitchell said.

Compared to the healthy-weight group, the obese participants in the study were more likely to be sedentary for eight or more hours a day, to walk less, to have problems walking and to believe that nothing could be done to prevent falls.

Mitchell and her colleagues point out that obesity is associated with a higher risk of certain chronic illnesses, but also that chronic conditions such as lung disease and arthritis can limit activity, leading to weight gain.

To reduce the risk of falls among obese older people, tailored activity programs, such as strength and balance training, as well as home safety assessments and eyesight checks could all be of benefit, they write.

“Everybody knows how falls can be life-changers for older people, from breaking a hip to hitting your head, so if we can prevent them that’s always better and there’s a lot that can be done,” Dr. Sharon Brangman told Reuters Health.

Brangman, who is Chief of Geriatrics at SUNY Upstate University Hospital in Syracuse, New York, and a past president of the American Geriatric Society (AGS), was not involved in the new study.

“We know that when people fall, the biggest problem afterwards is a fear of falling because then they move less or when they walk they hold themselves really rigid and tight which actually increases the risk for falling,” Brangman said.

The American Geriatric Society published fall prevention guidelines for physicians in 2012, she noted. Though they are intended for doctors, some of the suggestions may help families assess the risk in their homes (see: bit.ly/1cWjB86).

According to the U.S. Centers for Disease Control and Prevention, about one of every three Americans over age 65 suffers a fall, and every year 2 million of those falls result in emergency room visits.

The AGS guidelines were intended to encourage healthcare providers to ask about falls, according to Brangman, “because a lot of times it’s not asked and patients don’t volunteer it because they don’t want anyone to know. They’re so afraid that will mean they need to be placed in long-term care or something.”

Brangman said that sometimes patients who are overweight might need a little extra support to realize that their situation isn’t hopeless and that there are things they can do, such as starting an exercise program.

Strengthening the quadriceps muscle group at the front of the thighs is especially recommended.

“Exercise programs that are tailored to the individual can make a difference, and it’s really never too late to start doing something,” Brangman said. “Balance and strengthening exercises, especially exercises that strengthen the quads, are very important in preventing falls in the future.”

Source: US Web Daily

10 things that happen during a heart attack

The number of people who suffer from heart disease is constantly on the rise. Many die due to heart attacks and doctors tirelessly tell you about the classic symptoms of the condition. But do you know what exactly happens inside your body and to your heart during a heart attack? Well, here is a look at a heart attack from your body’s perspective.

1. Most heart attacks happen because of a blockage in the blood vessels that supply the muscles of the heart. This blockage happens because of plaque (a sticky substance that is made of fats, cholesterol and white blood cells) buildup on the arterial walls of the heart

2. When this plaque gets disturbed it breaks up into a number of tiny pieces that then go an lodge themselves in various places.

3. Thinking that there is a threat to your blood vessel, your red blood cells and white blood cells go an attach themselves to the plaque (just like the would in the case of a wound). While this is a repair mechanism, these cells end up blocking the blood vessel.

4. Once blocked the blood flowing through the heart stops and can no more reach the other parts of the heart muscle. Because of lack of oxygen those parts of the heart muscle start to die.

5. Your body then realizing that the heart is not working properly goes into the ‘fight or flight’ mode. It sends signal to the spinal cord that the heart in trouble.

6. The spinal cord in turn sends a message to your brain which it interprets as pain in the jaw, left hand and chest – also known as referred pain

7. In an attempt to survive your body starts to sweat profusely (this is actually a very useful mechanism since it makes you look ill and people are more likely to take you to the hospital).

8. Your breathing also becomes labored as your heart can no longer supply your lungs with blood and oxygen, so it also stops functioning optimally.

9. Apart from the lungs the brain also gets affected and one starts feeling dizzy. This is when you are likely to collapse from lack of oxygen to the essential organs of your body.

10. The muscles of your heart that have been deprived of oxygen die. The sad part is that once a part of the heart muscle dies it can never be regenerated.

Incidentally when you suffer a heart attack, the first one hour from onset is the most crucial time and your life could be saved if you are given adequate medical care within that time. Doctors call this the ‘golden hour’ as it is the only time that dying muscle fibers, the rest of the heart and other organs can be salvaged.

Source: Health India

The basic principles of healthy eating

Healthy eating is one of the most important things you can do to improve your general health.

Nutritious, balanced meals and healthy snacks may reduce your risk of heart disease and stroke by helping you increase your intake of heart-healthy nutrients, manage your weight, keep your blood pressure down, control your blood sugar levels and lower your cholesterol.

A healthy eating plan may also boost your overall feeling of well-being, giving you more energy and vitality. It may make you look better and feel good about yourself, inside and out.

How to make heart-healthy choices

With the vast array of food choices available today, it’s difficult to know where to begin. You may wish to start by aiming to include items from the four food groups: vegetables and fruit, whole-grain products, lower-fat milk products and alternatives, and lower-fat meat and alternatives. Eating Well with Canada’s Food Guide provides direction on the types and amount of food we should eat for overall health. It makes it easier than ever to plan your meals and snacks around a wide variety of delicious and heart-healthy foods.

When you’re grocery shopping, look for the Health Check symbol on food packaging, the Heart and Stroke Foundation’s food information program, based on Canada’s Food Guide. It’s your assurance that the product contributes to an overall healthy diet.

Source: Heart & stroke foundation

Lifestyle changes for heart disease prevention

One can conquer heart diseases through lifestyle changes, which will help maintain artery health and prevent further progression of heart diseases.

Smoking, lack of physical activity, drinking and stress are major risk factors for heart diseases. But, adopting a healthy lifestyle can prevent heart diseases.

Sweat it out

About 30 minutes of moderate activity like brisk walking at least five days a week is essential for adults. Children and young adults can exercise for at least 60 minutes every day. Also, 30-60 minutes of moderate exercise every week burns around 600-1200 calories per week. You don’t have to sweat it out in a gym to achieve your exercise goals, rather, slowly increase the duration and intensity of your exercise to achieve bigger goals. Regular exercise also decreases the risk of cardiovascular diseases by almost 40 per cent.

Maintain a healthy weight

Being overweight can put you at risk of developing heart diseases, high cholesterol, high blood pressure and diabetes. Did you know that after 18 years, every one kilogram of weight gain increases your risk of heart diseases by three per cent. So the best way to calculate your weight is by checking your body mass index (BMI), which takes into account your weight and height to identify whether you have a healthy or unhealthy percentage of body fat. A BMI of 23 or a higher BMI is linked to blood fats, high BP, risk of stroke and heart diseases.

According to a study, it was estimated that, if every person maintained his or her optimal weight, this would lessen cardiovascular disease by 25 per cent and lower strokes or episodes of cardiac failure by 35 per cent. Reducing your weight by just 10 per cent can decrease your blood pressure, lower your blood cholesterol levels and reduce your risk of diabetes.

Stop Smoking

According to a large study done on Tobacco Control, ‘Smoking just one to four cigarettes a day almost triples a smoker’s risk of heart disease and lung cancer.’ Smoking and tobacco are one of the major risk factors for all heart diseases and smoking narrows your arteries leading to Atherosclerosis, which can cause a heart attack. Low nicotine cigarettes, smokeless tobacco and low-tar cigarettes might be promoted as healthy and safe but they are also risky.

Get regular health screenings

If you are suffering from diabetes mellitus, high blood pressure and high cholesterol than you are at a higher risk for other heart diseases. So it is advised to test your blood sugar levels regularly to understand your heart health. One can reduce the risk of heart disease by 60 per cent if he/she can control their blood sugar levels.

Dont worry too much

Make time for de-stressing activities like exercise and meditataion to live a long, healthy disease free life.

Source: Times of India


Children’s cardiovascular fitness declining worldwide

Many kids don’t run as far or fast as their parents did, according to research presented at the American Heart Association’s Scientific Sessions 2013.

The decline in running fitness may indicate worse health in adulthood, the researchers said.

“If a young person is generally unfit now, then they are more likely to develop conditions like heart disease later in life,” said Grant Tomkinson, Ph.D., lead author of the study and senior lecturer in the University of South Australia’s School of Health Sciences.

“Young people can be fit in different ways. They can be strong like a weightlifter, or flexible like a gymnast, or skillful like a tennis player. But not all of these types of fitness relate well to health. The most important type of fitness for good health is cardiovascular fitness, which is the ability to exercise vigorously for a long time, like running multiple laps around an oval track.”

Researchers analyzed 50 studies on running fitness between 1964 and 2010 that involved more than 25 million kids, ages 9 to 17, in 28 countries. They gauged cardiovascular endurance by how far kids could run in a set time or how long it took to run a set distance. Tests typically lasted five to 15 minutes or covered a half-mile to two miles.

Cardiovascular endurance declined significantly within the 46 years, the researchers found. Average changes were similar between boys and girls, younger and older kids, and across different regions, although they varied country to country.

The study is the first to show that kids’ cardiovascular fitness has declined around the globe since about 1975:

In the United States, kids’ cardiovascular endurance fell an average 6 percent per decade between 1970 and 2000.

Across nations, endurance has declined consistently by about 5 percent every decade.

Kids today are roughly 15 percent less fit from a cardiovascular standpoint than their parents were as youngsters.

In a mile run, kids today are about a minute and a half slower than their peers 30 years ago.

Declines in cardiovascular endurance performance are probably caused by social, behavioral, physical, psychosocial and physiological factors, Tomkinson said.

Country-by-country fitness findings are mirrored in measurements of overweight/obesity and body fat, suggesting one factor may cause the other. “In fact, about 30 percent to 60 percent of the declines in endurance running performance can be explained by increases in fat mass,” Tomkinson said.

Kids should engage in at least 60 minutes of daily activities that use the body’s big muscles, such as running, swimming or cycling, he said.

“We need to help to inspire children and youth to develop fitness habits that will keep them healthy now and into the future,” Tomkinson said. “They need to choose a range of physical activities they like or think they might like to try, and they need to get moving.”

Source: American Heart Association