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Tag: Heart

  • Federal Officials Promise to Restore Funding to Women’s Health Initiative

    Federal Officials Promise to Restore Funding to Women’s Health Initiative


    After an outcry from scientists and health experts, federal health officials on Thursday said they would restore funding to the Women’s Health Initiative, one of the largest and longest studies of women’s health ever carried out.

    The findings of the W.H.I. and its randomized controlled trials have changed medical practices and helped shape clinical guidelines, preventing hundreds of thousands of cases of cardiovascular disease and breast cancer.

    “These studies represent critical contributions to our better understanding of women’s health,” said Emily G. Hilliard, a spokeswoman for the Department of Health and Human Services.

    “We are now working to fully restore funding to these essential research efforts,” she added. The National Institutes of Health “remains deeply committed to advancing public health through rigorous gold standard research, and we are taking immediate steps to ensure the continuity of these studies.”

    The W.H.I., which began in the 1990s when few women were included in clinical research, enrolled over 160,000 participants across the nation. It continues to follow some 42,000 women, tracking data on cardiovascular disease and aging, as well as frailty, vision loss and mental health.

    Researchers have hoped to use the findings to learn more about how to maintain mobility and cognitive function and slow memory loss, detect cancer earlier, and predict the risks of other diseases.

    H.H.S. had informed the leaders of the research team that it would terminate contracts for the W.H.I.’s regional centers in September, although the clinical coordinating center, based at Fred Hutch Cancer Center in Seattle, would be funded through at least January 2026. As of early Thursday evening, the investigators had not been informed the grants were being restored.

    Senator Patty Murray, Democrat of Washington, said shutting down the trial would be “a devastating loss for women’s health research.”

    Not only did the initiative lead to major advancements in women’s health, “it has paved the way for a generation of researchers focused on women’s health — which has long been overlooked and underfunded,” Ms. Murray said.

    The W.H.I. included a number of randomized controlled trials and has contributed to more than 2,000 research papers. But it is probably best known for a study of hormone replacement therapy that was abruptly halted in 2002, after investigators found that older women who took a combination of estrogen and progestin experienced a small but significant increase in the risk of breast cancer.

    Until then, hormone replacement therapy was widely believed to protect women from cardiovascular disease. But the trial found that even though the hormone combination reduced colorectal cancer and hip fractures, it put women at higher risk for heart attacks, strokes and blood clots.

    Dr. JoAnn Manson, one of the long-term principal investigators of the study and a professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, called the announcement of funding cuts “heartbreaking.”

    The original decision to cut funding, she said, was perplexing, given statements by Robert F. Kennedy Jr., the nation’s health secretary, about the importance of reducing chronic disease in America.

    “There is no better example of the scientific impact of research on chronic disease prevention than the W.H.I.,” Dr. Manson said.

    The lessons learned from the hormone study have resulted in enormous savings in health care costs, researchers have found — about $35 billion between 2003 and 2012, according to one study, because of the number of cancer and cardiovascular disease cases that had been averted. For every dollar spent on the W.H.I., $140 was saved.

    One randomized trial carried out by the W.H.I. looked at the impact of a low-fat diet, high in fruits and vegetables. Though researchers initially found a reduction only in ovarian cancer, long-term follow-up showed that the diet also reduced deaths from breast cancer.

    Another study of calcium and vitamin D found that supplements provided a modest benefit for preserving bone mass and preventing hip fractures in older women, but did not prevent other fractures or colorectal cancer.

    The findings influenced medical guidelines, which currently do not recommend that all women routinely take the supplements.

    The participants in the initiative are now 78 to 108 years old, and some scientists conceded that an argument could be made for winding down the trial. But careful planning is typically given to closing out such a large and wide-ranging study.

    “There’s still so much we need to learn,” said Garnet Anderson, senior vice president and director of the public health sciences division at Fred Hutch Cancer Center and a principal investigator of the initiative.

    “No one has ever studied 13,000 women over the age of 90 to know: What are their health needs? How to live such a long and health life?” she said. “We’d love to know the secrets of success for healthy aging.”

    One reason that the study was begun in the 1990s was that there was a dearth of information and research on women’s health, and little evidence on which to base clinical recommendations, said Marian Neuhouser, who heads the cancer prevention program at Fred Hutch Cancer Center and is chair of the W.H.I. steering committee.

    “Women are half the population,” Dr. Neuhouser said, “but they had not been included in research. It had mostly been men, and the results were so-called extrapolated to women.”



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  • One-Third of Maternal Deaths Occur Long After Delivery, Study Finds

    One-Third of Maternal Deaths Occur Long After Delivery, Study Finds


    During a recent five-year period, a substantial portion of maternal deaths in America — almost one-third — took place more than six weeks after childbirth, at a time when most new mothers think they are in the clear, researchers reported on Wednesday.

    The study, published in JAMA Network Open, is one of the first to track maternal health complications during pregnancy and in the year after delivery.

    Pregnancy-related death rates in the United States rose almost 28 percent from 2018 to 2022, the researchers found, surging at the height of the Covid-19 pandemic in 2021 before subsiding somewhat.

    “Our study illustrates why we can’t take our eyes off maternal health,” said Dr. Rose L. Molina, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and one of the study’s authors.

    Women need “access to high-quality care from the moment of conception to a full year after birth,” she added. While there has been a growing emphasis on care in the year after childbirth, “we’re not there yet.”

    The study was based on data from the Centers for Disease Control and Prevention’s division of reproductive health, which monitors maternal mortality and identified the risk of so-called later maternal deaths — those that occur from six weeks to one year after the birth.

    The Trump administration shuttered the division last week amid mass layoffs and a restructuring of the agency, even though the United States has far higher maternal mortality rates than any other industrialized nation, with stark disparities among racial and ethnic groups. The division’s research aimed at understanding and narrowing those health gaps.

    Cardiovascular disease was the leading cause of pregnancy-related deaths overall, as well as the leading cause of late maternal deaths. Other major causes were cancer, mental and behavioral disorders, and drug- and alcohol-induced deaths. (Accidents, homicides and certain other deaths were not included in the analysis.)

    The risks facing women in the first year after a delivery were not well understood until recently. They take their toll after what traditionally is the new mother’s last recommended checkup, six weeks after childbirth — a period when attention is focused primarily on the health of the new baby.

    The American College of Obstetricians and Gynecologists now recommends that all women see a doctor within the first three weeks after having a baby, with follow-up and ongoing care as needed, and a comprehensive postpartum visit no later than 12 weeks after birth.

    “If you have any hypertensive disorders, I’m going to see you three to five days after delivery,” said Dr. Tamika Auguste, the chair of women’s and infants’ services at MedStar Washington Hospital Center and an author of the new guidelines.

    “No longer are we saying, ‘Let’s wait six weeks’,” she added. “Anyone else, even without hypertension, I want to see within two weeks.” Patients should also be screened carefully for depression and mental health issues during that period, Dr. Auguste said.

    Attention to late maternal deaths helped push most states to extend Medicaid coverage from 60 days to a full year after a delivery. Medicaid insures nearly half of all pregnant women, but proposed federal cuts may jeopardize the coverage, women’s health advocates say.

    The study also documented stark racial, ethnic and regional disparities.

    Native American and Alaska Native women died during pregnancy and the year after childbirth at rates 3.8 times as high as those among white women, while Black women died at rates 2.8 times as high. Hispanic women and Asian women died at the lowest rates.

    Death rates also varied more than threefold between states. Southeastern states generally had higher pregnancy-related mortality rates: Alabama had the highest, followed by Mississippi. Nationwide, California had the lowest rate, followed by Minnesota.

    Pregnancy-related deaths spiked during the Covid-19 pandemic to 44.1 deaths per 100,000 live births in 2021, up from 25.3 deaths in 2018, before declining to 32.6 deaths in 2022 — still higher than in the earliest years of the pandemic.

    Late maternal deaths also rose during this period, subsiding somewhat in 2022 after a sharp rise in 2021.

    Overall, the surge in deaths was observed in all age groups, but a disproportionate increase was seen among women ages 25 to 39. Cardiovascular disease played a leading role.

    Pregnancy can affect the cardiovascular system and aggravate underlying conditions like hypertension. At the same time, cardiovascular disease is becoming more prevalent in younger adults, Dr. Molina said.

    “We seem as a society to be getting sicker earlier, which is why we’re seeing this in that particular age group,” Dr. Molina said.



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  • Eli Lilly Drug Reduces Mysterious Lp(a) Particle Involved in Heart Attack Risk

    Eli Lilly Drug Reduces Mysterious Lp(a) Particle Involved in Heart Attack Risk


    As many as one in five people — an estimated 64 million in the United States — have elevated levels of a tiny particle in their blood. It can greatly increase the risk of heart attacks and strokes.

    But few know about it, and almost no doctors test for it, because there was not much to be done. Diet does not help. Neither does exercise. There have been no drugs.

    But in the near future, that may change.

    On Sunday, cardiologists announced that an experimental drug made by Eli Lilly, lepodisiran, could lower levels of the particle, Lp(a), by 94 percent with a single injection. The effects lasted for six months and there were no significant side effects.

    But it is not yet confirmed that reducing Lp(a) levels also reduces the risk of heart attacks and strokes. That awaits large clinical trials that are now underway.

    The Lilly research was presented Sunday at the annual meeting of the American College of Cardiology and simultaneously published in the New England Journal of Medicine. At least four other companies are also testing innovative drugs that block the body’s production of Lp(a), a mix of lipids and a protein.

    Dr. David Maron, a preventive cardiologist at Stanford not involved in the Lilly research, said the evidence of profound and long-lasting reduction in lipoprotein levels with lepodisiran was “thrilling.”

    Dr. Martha Gulati, a preventive cardiologist at Cedars-Sinai Medical Center also not involved in the trial, said the study was “really elegant.”

    Eli Lilly is now conducting a large clinical trial asking if its drug can prevent heart attacks or strokes or cardiovascular deaths. It will conclude in 2029. Clinical trials of other drugs targeting Lp(a) will conclude sooner. The first will be a study of a Novartis drug, injected monthly, with results expected in 2026.

    Cardiologists caution, though, that there is no guarantee the drugs will protect people. They remember too well a lesson learned from assuming that altering a risk factor can alter risk. Cardiologists once were enthusiastic about drugs that raised levels of HDL, known as the “good cholesterol.” People with naturally high HDL levels had lower rates of heart disease. Those HDL-raising drugs did not help.

    Lp(a)-lowering “is a huge new frontier in cardiovascular medicine,” said Dr. Daniel Rader, a preventive cardiologist at the University of Pennsylvania’s Perelman School of Medicine. Dr. Rader is a member of the scientific advisory board for Novartis and wrote an editorial to accompany the new paper.

    Treatments targeting Lp(a) have been a long time coming.

    The lipoprotein was identified in 1974 as a risk factor for heart disease that is controlled by genes rather than lifestyle or environment.

    People with Lp(a) levels that are slightly higher than normal have about a 25 percent increased risk of a heart attack or a stroke. And very high levels — as seen in 10 percent of the population — can double the risk.

    Cardiologists say that often in patients with no obvious reason for having a heart attack or a stroke — whose cholesterol levels and blood pressure are normal and who do not smoke — they learn that the patients have high levels of Lp(a). Usually it turns out they also have family histories of unexplained heart disease.

    The same goes for people having heart attacks at a young age, said Dr. Steven Nissen, a preventive cardiologist at the Cleveland Clinic who is the academic leader for the Lilly drug trial and for clinical trials of three other new drugs.

    “If you go into the coronary care unit and see someone who is 40 years old with an acute myocardial infarction, you need to know the level of their Lp(a),” he said, referring to a heart attack. All too often, he said, their levels are 250 nanomoles per liter or even higher. The upper limit of normal is 75.

    Dr. Maron said his clinic was full of people who had no idea why they developed heart disease, until they found out they had high levels of Lp(a).

    One is Monte Wooden, a 71-year-old retired firefighter who lives in Redding, Calif. His LDL cholesterol levels were moderately elevated. His blood pressure was normal. He did not smoke. Yet he had his first heart attack in 2006 while taking a cholesterol-lowering statin.

    It seemed as if almost everyone in Mr. Wooden’s family died from heart disease.

    His paternal grandmother had her first heart attack when she was in her 40s. She died from a heart attack at age 63. His father and his father’s brother died from heart disease. Mr. Wooden’s brother died from a heart attack.

    When Dr. Maron tested Mr. Wooden’s Lp(a) level, it was greater than 400.

    Dr. Maron and other preventive cardiologists, like Dr. Gulati, Dr. Nissen and Dr. Rader, say they routinely test all their patients’ Lp(a) levels. Because Lp(a) levels are controlled by genes, they add, patients have to be tested only once.

    Dr. Nissen is blunt with his Lp(a) patients.

    “We say: You have a disorder with serious implications. I want to take every risk factor you have off the table,” he said.

    Yet, Dr. Gulati said, one study found that just 0.3 percent of the U.S. population has had an Lp(a) test — which is paid for by insurance — and just 3 percent of those with heart disease have been tested.

    She and other preventive cardiologists say all adults should have an Lp(a) test. If levels are high, doctors should aggressively treat every other risk factor.

    For Mr. Wooden, that meant taking a powerful cholesterol-lowering drug, Repatha, that got his LDL cholesterol level down to 30.

    Mr. Wooden’s case, though, didn’t end there. Dr. Maron got him into a clinical trial testing one of the new drugs that lower Lp(a) levels.

    During the trial, Mr. Wooden had no symptoms of heart disease — no chest pain, no breathlessness. When the trial ended, his symptoms came back, leading to a quadruple bypass operation.

    “It’s anecdotal,” Dr. Maron said, “but it speaks to the likelihood that these drugs prevent heart attacks.”



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  • ‘A Tiny Bit of Math’ Might Improve Your Heart Health, Study Suggests

    ‘A Tiny Bit of Math’ Might Improve Your Heart Health, Study Suggests


    Many people use a smartwatch to monitor their cardiovascular health, often by counting the number of steps they take over the course of their day, or recording their average daily heart rate. Now, researchers are proposing an enhanced metric, which combines the two using basic math: Divide your average daily heart rate by your daily average number of steps.

    The resulting ratio — the daily heart rate per step, or DHRPS — provides insight into how efficiently the heart is working, according to a study conducted by researchers at the Feinberg School of Medicine at Northwestern University and published today in the Journal of the American Heart Association.

    The study found that people whose hearts work less efficiently, by this metric, were more prone to various diseases, including Type II diabetes, hypertension, heart failure, stroke, coronary atherosclerosis and myocardial infarction.

    “It’s a measure of inefficiency,” said Zhanlin Chen, a third-year medical student at the Feinberg School of Medicine at Northwestern University and lead author of the new study; his coauthors included several Feinberg faculty physicians. “It looks at how badly your heart is doing,” he added. “You’re just going to have to do a tiny bit of math.”

    Some experts said they saw wisdom in DHRPS as a metric. Dr. Peter Aziz, a pediatric cardiologist at the Cleveland Clinic, said it appeared to be an advance on the information provided by daily steps or average heart rate alone.

    “What is probably more important for cardio fitness is what your heart does for the amount of work it has to do,” he said. “This is a reasonable way to measure that.”

    The metric does not look at heart rate during exercise. But, Dr. Aziz said, it still provided an overall sense of efficiency that, importantly, was shown by researchers to have an association with disease.

    The size of the study added validity to the findings, Dr. Aziz said. The scientists mapped Fitbit data from nearly 7,000 Smartwatch users against electronic medical records.

    Mr. Chen said that a simple way to grasp the value of the new metric was to compare two hypothetical individuals. Both take 10,000 steps a day, but one has an average daily resting heart rate of 80 — in the middle of the healthy range — while the other’s daily resting heart rate is 120.

    The first person would have a DHRPS of 0.008, the second 0.012. The higher the ratio, the stronger the signaling of cardiac risk.

    In the study, the 6,947 participants were divided into three groups based on their ratios; those with the highest showed a stronger association with disease than other participants did. The D.H.R.P.S. metric was also better at revealing disease risk than were step counts or heart rates alone, the study found.

    “We designed this metric to be low-cost and to use data we’re already collecting,” Mr. Chen said. “People who want to be in charge of their own health can do a little bit of math to figure this out.”



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  • Kilmer McCully, Pathologist Scorned for New Theory of Heart Disease, Dies at 91

    Kilmer McCully, Pathologist Scorned for New Theory of Heart Disease, Dies at 91


    Kilmer S. McCully, a pathologist at Harvard Medical School in the 1960s and ’70s whose colleagues banished him to the basement for insisting — correctly, it turned out — that homocysteine, an amino acid, was being overlooked as a possible risk factor for heart disease, died on Feb. 21 at his home in Winchester, Mass. He was 91.

    His daughter, Martha McCully, said the cause was metastatic prostate cancer. His death was not widely reported at the time.

    Still a debated idea today, Dr. McCully’s theory — that inadequate intake of certain B vitamins causes high levels of homocysteine in the blood, hardening the arteries with plaque — challenged the cholesterol-focused paradigm backed by the pharmaceutical industry.

    Dr. McCully didn’t think cholesterol should be ignored, but he thought it was malpractice to disregard the significance of homocysteine. His bosses at Harvard disagreed. First, they moved his lab below ground; then they told him to leave. He struggled to find work for years.

    “It was very traumatic,” he told the New York Times medical reporter Gina Kolata in 1995. “People don’t believe you. They think you’re crazy.”

    Dr. McCully, fashioning himself as a microbe hunter akin to Louis Pasteur, stumbled on homocysteine in the late 1960s at a medical conference in Boston. There he learned about homocystinuria, a genetic disease in which high amounts of homocysteine are found in the urine of some developmentally disabled children.

    Presenting the case of homocystinuria in a 9-year-old girl, doctors mentioned that her uncle had died from a stroke in the 1930s, when he was 8 and had the same disease. “How could an eight-year-old have died the way old people do?” Dr. McCully wrote, with his daughter, in “The Heart Revolution” (1999).

    “How could an eight-year-old have died the way old people do?” Dr. McCully wrote in “The Heart Revolution,” recalling the case that led to his controversial research.Credit…HarperCollins

    When Dr. McCully tracked down the autopsy report and tissue samples, he was astounded: The boy had hardened arteries, but there was no cholesterol or fat in the plaque buildup. A few months later, he learned about a baby boy with homocystinuria who had recently died. He also had hardened arteries.

    “I barely slept for two weeks,” he wrote.

    In 1969, Dr. McCully published a paper about the cases in The American Journal of Pathology. The next year, in the same journal, he described what happened after he injected rabbits with high doses of homocysteine. “The aortas of all 13 of the animals injected with homocysteine were moderately thickened,” he wrote, “compared to the controls.”

    Dr. McCully followed up with other studies. He suggested that people with low intake of folic acid and vitamins B6 and B12 should consume five servings of fruits and vegetables a day. He also recommended the development of blood tests for homocysteine.

    The medical profession responded with “stony silence,” Dr. McCully told The Times. In 1979, he said, the chairman of his department at Harvard told him, “We feel you haven’t proved your theory.” He decided to leave, and he was unemployed until 1981, when a Veterans Affairs hospital in Providence, R.I., hired him as a pathologist.

    “I felt for him, and I admired him,” J. David Spence, a professor emeritus at the University of Western Ontario who studies homocysteine, said in an interview. “He was neglected more than he ought to have been. It was sad.”

    That began to change in the early 1990s, when large-scale, long-term studies of the risks for heart disease revealed that Dr. McCully had, in fact, been heading down the right path when Harvard relegated him to the basement.

    Data from the Framingham Heart Study, initiated in 1948 and still being conducted, showed higher rates of hardened arteries connected to the brain among participants with elevated homocysteine levels. A study by the Harvard School of Public Health and Brigham and Women’s Hospital in Boston found that men with high homocysteine had a threefold greater risk of suffering a heart attack than men with lower levels.

    “At the end of the day, he was right in the sense that homocysteine is a marker for higher risk for cardiovascular disease,” Meir Stampfer, a Harvard epidemiologist who helped lead the study, said in an interview. “He gets the credit for developing this theory and helping to provide the evidence for it.”

    Kilmer Serjus McCully was born on Dec. 23, 1933, in Daykin, Neb., and grew up in Alexandria, Va., near Washington. His father, Harold McCully, was a specialist in counseling psychology for the U.S. Department of Education. His mother, Lulu (Litwinenco) McCully, was an artist and a piano teacher.

    As a teenager, Kilmer was enthralled by “Microbe Hunters,” Paul de Kruif’s 1926 book about Pasteur, Walter Reed, Robert Koch and others who investigated infectious diseases. He knew almost immediately that he wanted to become a scientist.

    He studied biochemistry, psychology and chemistry at Harvard, where he took classes with B.F. Skinner, and graduated in 1955. Known as Kim to his friends, he went on to earn his medical degree there in 1959. For part-time work, he babysat for the historian Arthur M. Schlesinger Jr. and served cocktails at Mr. Schlesinger’s many parties.

    Following an internship and postdoctoral fellowship at Massachusetts General Hospital, Dr. McCully joined Harvard Medical School’s pathology department in 1965.

    He married Annina Jacobs in 1955. She died in 2023.

    In addition to their daughter, Martha, he is survived by their son, Michael; two grandchildren; two great-grandchildren; and a sister, Marilyn McCully.

    After the studies in the 1990s supported his theory, Dr. McCully became something of a media star.

    The New York Times Magazine featured him in a 1997 article headlined “The Fall and Rise of Kilmer McCully.” On the NPR program “Fresh Air” in 1999, he told Terry Gross, the host, “It’s extremely satisfying to me, because when I was a young person, this is what I wanted to do with my life.”

    But homocysteine remains a controversial subject in medicine.

    Major medical organizations have not recommended testing for it, citing mixed results from studies examining whether lowering homocysteine leads to a reduction in cardiovascular events. (There is stronger evidence that it can help prevent strokes.)

    “It’s a strange business to me that people still don’t pay enough attention to this,” Dr. Spence said. “Maybe doctors didn’t like their biochemistry lessons.”

    As for Harvard, Dr. McCully’s family said he was never bitter about his treatment there. At a medical school reunion in 1999, his classmates presented him with a silver platter.

    It was inscribed, “To Kim McCully, who saw the truth before the rest of us, indeed before the rest of medicine, and who would not be turned aside.”



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  • Self-Care Tips For Young Professionals To Effectively Manage Stress – News18

    Self-Care Tips For Young Professionals To Effectively Manage Stress – News18


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    Long-term stress impacts our mind and body, causing inflammation that can have serious health impact adversely affecting important body organs like the heart

    The excessive demands of work and life can drain the body and mind, often leaving little room for self-care

    We have debated a lot on the merits of a 7-day workweek versus a 4-day one, but one thing remains undeniable – stress has become a part of our life. We hustle to achieve maximum productivity at work and to capture insta-worthy moments outside work. The excessive demands of work and life can drain the body and mind, often leaving little room for self-care.

    Long-term stress impacts our mind and body, causing inflammation that can have serious health impact adversely affecting important body organs like the heart. But what if we tell you that it is possible to manage our stress and improve productivity as well as our well-being. All we need are small yet meaningful lifestyle changes.

    According to Dr. Nikhil Bangale, Head of Medical Affairs, Bayer’s Consumer Health Division, “Young professionals are the driving force of growth and innovation in our country, bringing energy and fresh ideas to the table. However, our Supradyn Survey shows that 85%* of young Indians wake up feeling fatigued. To maintain their wellbeing, it is necessary for them to prioritize nutritious diet, rich in vitamin B complex and vitamin C , regular exercise and mindfulness practices. These habits help enhance productivity and support their physical and mental well-being, ensuring future success”.

    Here are self-care tips for young professionals to manage their stress.

    1. Eat nutritious meals every day to keep the stress at bay.

    What we eat can hugely impact our stress levels. A diet rich in fruits and vegetables4 can reduce stress, especially citrus fruits4 and leafy green vegetables4 are linked to lower stress levels. Fruits and vegetables contain antioxidants , water-soluble vitamins (vitamin C and B vitamins)5, and certain minerals (calcium, magnesium, and zinc)5 that help protect the body from oxidative stress, improve cognitive function and make our mood positive5. If you are unable to fulfill your daily vitamin requirements, consider including supplements to fill the gap. Just take the first step and make small adjustments to your diet to see better results.

    2. Catch on that quality sleep every night to feel unburdened and bright

    Young professionals often sacrifice their sleep and work harder to achieve their goals, but inadequate sleep is associated with mental distress . A well-rested brain improves productivity. Sleeping well helps with memory retention and reduces emotional stress. For the mind to function well, a minimum of 7 or more hours of sleep6 per night is necessary and anything less than this may contribute to conditions such as depression6. Sleep deprivation has a negative impact on a person’s cognitive function , it impairs their attention and memory7 and affects their decision-making ability8. 7-8 hours of sleep every night will help you work productively.

    3. Run, walk, skip, jump or dance, to power through and not miss a single chance

    When you are already tired because of a demanding work schedule, it may seem that physical exercise will increase this fatigue. But in fact, it’s quite the opposite! Physical exercise acts as an effective stress buster. Including physical exercise in your routine leads to the release of happy hormones, endorphins that improve mood, self-esteem and lower stress and anxiety levels. Practicing yoga daily helps to make the body and mind feel balanced . Low or moderate resistance training helps in reducing anxiety . Any kind of physical activity makes you feel energized throughout the day so that you can take up any challenges at work. Pick an activity that you love and see the difference yourself.

    By integrating these simple yet effective strategies into daily routines, working professionals can help enhance their focus, reduce anxiety and effectively manage stress.



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  • New Insights Into Older Hearts

    New Insights Into Older Hearts


    It turns out that the Isley Brothers, who sang that 1966 Motown hit “This Old Heart of Mine (Is Weak for You),” were onto something when they linked age to an aching and flagging heart.

    Heart disease, the nation’s leading cause of death and disability, has been diagnosed in about 6 percent of Americans ages 45 to 64, but in more than 18 percent of those over 65, according to the Centers for Disease Control and Prevention.

    Old hearts are physiologically different. “The heart gets stiffer as we age,” said Dr. John Dodson, director of the geriatric cardiology program at NYU Langone Health. “It doesn’t fill with blood as easily. The muscles don’t relax as well.”

    Age also changes the blood vessels, which can grow rigid and cause hypertension, and the nerve fibers that send electrical impulses to the heart. It affects other organs and systems that play a role in cardiovascular health, too. “After age 75 is when things accelerate,” Dr. Dodson said.

    But in recent years, dramatic improvements in treatments for many kinds of cardiovascular conditions have helped reduce both heart attacks and cardiac deaths.

    “Cardiology has been blessed with a lot of progress and research and drug development,” said Dr. Karen Alexander, who teaches geriatric cardiology at Duke University. “The medications are better than ever, and we know how to use them better.”

    That can complicate decision-making for heart patients in their 70s and beyond, however. Certain procedures or regimens may not markedly extend the lives of older patients or improve the quality of their remaining years, especially if they have already suffered heart attacks and are contending with other illnesses as well.

    “We don’t need to open an artery just because there’s an artery to be opened,” said Dr. Alexander, referring to inserting a stent. “We need to think of the whole person.”

    Recent research indicates that some frequently used medical approaches don’t pay off for older patients, while too few of them take advantage of one intervention that does.

    Here’s some of what researchers are learning about old hearts:

    An implantable cardioverter defibrillator, or I.C.D., is a small battery-powered device that is placed under the skin and delivers a shock in the case of sudden cardiac arrest. “It’s easy to sell these things to patients,” said Dr. Daniel Matlock, a geriatrician and researcher at the University of Colorado. “You say, ‘This can prevent sudden cardiac death.’ The patient says, ‘That sounds great.’”

    In 2005, an influential study persuaded Medicare to cover I.C.D.s in patients with heart failure, even those without high-risk arrhythmias, and “it just took off,” Dr. Matlock said.

    From 2015 through September 2024, surgeons implanted 585,000 such devices in patients’ chests, according to the American College of Cardiology’s registry. That’s probably an undercount, as not all hospitals participate in the registry.

    But in 2017, among patients with nonischemic heart failure (meaning that the heart isn’t pumping effectively but there is no blocked artery), another influential study showed that I.C.D.s did not reduce mortality for patients over 70. The device only prevented sudden cardiac deaths, the authors noted — and those occur more frequently in younger patients.

    Moreover, “at 85 or 90, sudden death is not necessarily the worst thing that can happen,” Dr. Matlock said, compared to death from “progressive heart failure, which can go quickly or last for years; it’s unpredictable.” The wallop of an I.C.D. shock can also frighten and distress older patients, who often are unaware that the device can be deactivated with a computer.

    Cardiologists and researchers still debate how much I.C.D.s benefit older patients. But because cardiac drugs have grown so much more potent since 2005, a major multisite study is underway to determine, among patients at lower risk of sudden death, whether medications alone might now be more effective.

    Medications alone already appear to be at least as effective in treating older people who have suffered the kind of heart attacks not caused by a suddenly and completely blocked artery. (Technically these are referred to as NSTEMI, for non-ST-segment elevation myocardial infarction.)

    Half of these occur in people over 70, said Dr. Vijay Kunadian, a professor of interventional cardiology at Newcastle University in England and the lead author of a recent study in The New England Journal of Medicine.

    “Older people often are underrepresented in research,” Dr. Kunadian said. “There are a lot of preconceived biases.” So her team recruited an older-than-typical sample (average age 82) in which to compare the benefits of conservative and invasive treatment.

    Half of the 1,500 patients in the study began a regimen of cardiac medications that included blood thinners, statins, beta blockers and ACE inhibitors. The other half had more invasive treatment, starting with an angiogram (an X-ray of the blood vessels). Then, roughly half of that group received a stent or, in much smaller numbers, underwent bypass surgery. These patients were also prescribed the same kinds of medications as the patients who were treated with drugs alone.

    Over four years, the team found no difference in the patients’ risk of cardiovascular death or a nonfatal heart attack. Although surgical risks generally rise with age, complications were low in both groups.

    Facing such situations, older patients and their families need to ask important questions, Dr. Alexander said: “How is this going to help me, and what are the other options, especially if it’s invasive? Is it necessary? What if I don’t do this?”

    Dr. Kunadian agreed. “One size does not fit all in this group,” she said. Invasive treatment did not benefit patients, but it didn’t harm them, either.

    Still, Dr. Kunadian said, “if they’re very frail, living in a nursing home with dementia, with a number of other conditions, it’s reasonable to say it’s in their best interest to use medical therapy alone.”

    One intervention known to benefit patients with heart disease is cardiac rehabilitation: a program of regular, supervised exercise that significantly reduces heart attacks, hospitalization and cardiovascular deaths.

    But cardiac rehab remains perennially underused. Only about one-quarter of eligible patients participate, Dr. Dodson said, and among older adults, who could benefit even more, the proportion is lower still.

    “There are barriers for people in the 70s and 80s,” he said. They have to show up at a facility to exercise, so sometimes “transportation is a problem.”

    And, he added, “people can get deconditioned or afraid of activity. They may worry about falling.”

    The in-person NYU Langone program involves three exercise sessions a week for three months, with nutritional and psychological counseling. Since enrollment among seniors had been disappointing, researchers tried replicating it with a remote program.

    They offered it to patients (average age 71) with ischemic heart disease (caused by narrowed arteries, which impede blood and oxygen flow to the heart) who had suffered a heart attack or undergone a stent procedure. Each received a tablet computer and broadband access so that they could undertake a rehab program at home. An exercise therapist checked in by phone weekly.

    At-home participation fell off over time, however. After three months, those assigned to remote rehab showed no greater functional capacity — measured by how far they could walk in six minutes — than a similar group who followed the usual care.

    Was that because seniors struggled with the technology? Or feared exercising with heart problems? Would working out in person, alongside others on treadmills and elliptical trainers, inspire more engagement?

    “We need to figure out the delivery system that’s most effective,” Dr. Dodson said. “What’s most motivating for older patients?” He’ll be trying again.



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  • The Physicians Really Are Healing Themselves, With Ozempic

    The Physicians Really Are Healing Themselves, With Ozempic


    When Dr. C. Michael Gibson, a cardiologist at Harvard Medical School, goes to heart disease meetings, he can’t help noticing a change.

    “We will sit around at dinner and halfway through the meal, we will simultaneously push our plates away,” Dr. Gibson said. “We look at each other and laugh and say, ‘You, too?’”

    They share what is becoming an open secret: They tried for years to control their weight but are now taking the new obesity drugs manufactured by Eli Lilly and Novo Nordisk.

    Dr. Robert Califf, the former chief of the Food and Drug Administration, says he hardly recognizes his colleagues. So many are now so thin.

    “Looking good,” he says he tells his fellow cardiologists at conferences and meetings.

    There are no studies documenting the percentage of doctors taking the drugs. But physicians “are a good litmus test for drugs that are highly effective,” Dr. Califf said. If doctors who read the papers describing clinical-trial results are rushing to get a new drug, that is an indication that it’s really promising.

    His colleagues’ use of Wegovy and Zepbound reminds him of the use of statins, drugs that lower cholesterol, in their early days. Cardiologists, who were most familiar with the consequences of high cholesterol levels, were among the first to take the drugs in large numbers.

    Many newly thin cardiologists and diabetes specialists, like so many of their patients, had risk factors for heart disease. Or their blood sugar was creeping up. Or just the physical strain of carrying excess weight made everyday life burdensome. They say they like their new looks but also their new health and energy. In a way, they feel like members of a club.

    Four years ago, Dr. Darren McGuire, a cardiologist at the University of Texas Southwestern, was struggling with obesity and Type 2 diabetes. Then he started taking Ozempic, the Novo Nordisk diabetes drug that is sold under the name Wegovy for obesity. He later switched to Mounjaro, from Eli Lilly, which is sold as Zepbound for obesity.

    He lost 30 percent of his weight and got his blood sugar under control. Now, he said, he’s “feeling better than ever.”

    He is also struck by the number of colleagues who seem to be using the medications.

    “People look pretty different,” said Dr. McGuire, who is on advisory boards for Novo Nordisk and Eli Lilly. “It is amazing.” He described one prominent diabetes specialist, Dr. John Buse of the University of North Carolina, who “has shrunk away.”

    Not quite, Dr. Buse said. But, he said, “I lost 25 percent of my body weight and it totally changed my life.” He had struggled with his size since childhood, gaining, losing and then gaining weight again.

    When he dieted, he “would get crazy hungry,” Dr. Buse said. With Wegovy, he said, his weight dropped effortlessly until he reached his goal. Then his appetite returned, which was scary. But instead of regaining pounds, he maintained a consistent weight as he continued to take the drug.

    Like other patients, he found that taking the drugs eliminated most of his desire to drink alcohol. Before he started Wegovy, he often would have two or three drinks with dinner. Now he has one, or none.

    Dr. Buse, who is a consultant for Novo Nordisk and Eli Lilly, said that he did not often ask people at diabetes meetings if they were taking one of the drugs but that “there are people who have changed a lot.” He said he would “bet dollars to doughnuts” that they were on weight-loss medication.

    Some cardiologists are still “in the closet,” Dr. Gibson said.

    One is a cardiologist in Boston. She said the person who prescribed Ozempic for her was also a female cardiologist who was taking it. She asked not to be identified because she had told only a few people she was on the drug. She was trying to keep her medical information private, although she suspected that her colleagues might have guessed. She added that she was pretty sure she knew who else was taking one of the drugs.

    “Yes, you can definitely tell,” she said. “And when you go to dinners, you can definitely see. We eat, like, an eighth of our meal. I know what’s going on here.”

    The doctors know they are privileged.

    At first, Dr. Buse’s health insurance paid for his Wegovy. But soon North Carolina stopped paying for obesity drugs for state employees, so he paid out of pocket. With a list price of $1,349 a month, it was a major expense.

    Then, at a meeting in Europe, he asked a colleague to prescribe Wegovy for him and got a six-month supply. Dr. Buse was able to purchase Wegovy for a quarter of what it cost in the United States.

    The doctors also know how to advocate for themselves and navigate the medical system better than many of their patients do.

    Dr. McGuire’s insurer initially declined to pay for his drugs. “I had to appeal,” he said. “I have a relationship with a primary care physician and know when to keep pushing.”

    His insurer agreed to pay.

    Dr. Gibson said that his insurer had paid without issue and that he wanted to discuss his decision to take Wegovy openly. (He recently switched to Lilly’s Zepbound, also covered by his insurance, because it elicits an even greater weight loss.)

    “A lot of people are of the mind-set that it is shameful, that it is cheating to use a drug,” Dr. Gibson said.

    But the obesity drugs changed his life, he said: “It’s the greatest thing I ever did.”

    And even Zepbound, powerful as it is, is just the beginning, Dr. Gibson said.

    “There are 120 new agents coming along,” he noted, referring to drugs in clinical trials. “I look forward to ones that may have even better safety and effectiveness.”



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  • Diabetes and Heart Disease Rise Alongside Sugary Drink Consumption

    Diabetes and Heart Disease Rise Alongside Sugary Drink Consumption


    “This replicates and reinforces what we already know about sugar-sweetened beverages,” he said, “but the findings highlight their severe costs on health and productivity, especially in Africa and Latin America.”

    The study detailed intriguing patterns in the consumption of sugary drinks. For example, researchers found that men had modestly higher rates of soda consumption than women. Intake was higher among the well-educated, especially in sub-Saharan Africa, South Asia and Latin America. In the Middle East and North Africa by contrast, the study found that soda consumption was higher among adults with comparatively lower levels of education.South Asia, Southeast Asia and East Asia had the lowest rates of excess cardiovascular disease and Type 2 diabetes linked to sugary drink consumption, the study found, though the authors noted that the data did not include sugar-sweetened tea and coffee, items that are popular in those parts of the world.

    Laura Lara-Castor, a nutritional epidemiologist at the University of Washington and another lead author of the Nature study, said the higher rates of consumption among educated adults in sub-Saharan Africa reflected in part the aspirational lure of soft drink brands associated with Western tastes and style — a result of the sophisticated and well-funded advertising campaigns by multinational beverage companies.

    “Consuming these drinks is often a mark of status,” she said.

    Despite the study’s grim findings, Dr. Lara-Castor and the other authors said the data also contained reasons for hope. Soda consumption in Latin America and the Caribbean is already beginning to decline, thanks in part to policies like soda taxes, marketing restrictions and package labels that seek to educate consumers about the dangers of products high in added sugar. (In the United States, consumption of sugar-sweetened beverages has dropped since its peak in 2000 but those declines have largely plateaued in recent years.)

    More than 80 countries have adopted measures aimed at decreasing sugary drink consumption.

    Paula Johns, executive director of ACT Health Promotion, an advocacy group in Brazil, said the Nature study showed that education alone was not enough to dampen consumer zeal for sweetened drinks. In recent years, she said that Brazil had adopted a number of policies that are beginning to dent the nation’s love affair with highly processed food and sugary drinks. They include better school-meal programs, bold front-of-package warnings and a new excise tax on beverages with added sugar.

    “There’s no magic bullet,” she said. “But all these policies, taken together, help send the message to the public that sugar-sweetened beverages are really bad for your health.”



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  • Listen to Your Heart – Understanding Your Body’s Signals – News18

    Listen to Your Heart – Understanding Your Body’s Signals – News18


    The heart is the most extraordinary organ. The size of your fist, it powers the entire circulatory system, pumping oxygen-rich blood to every cell of the body. Beating around 100,000 times a day, the heart, however, is vulnerable to disease. Heart disease is a leading cause of death globally, and in India, it accounts for 27% of deaths due to NCDs. Understanding the signals your body gives regarding the condition of your heart, especially the warning signs and taking proactive preventive measures can help you live a long, healthy life. Dr Sanjeev Kumar Kalkekar, Sr Consultant Interventional Cardiology, Apollo Hospitals Navi Mumbai shares all you need to know: 

    Risk Factors for Heart Disease

    Several risk factors contribute to cardiovascular disease, some of which are beyond our control, such as age and family history. However, many risk factors are lifestyle-related and can be managed with the right choices. Smoking, high blood pressure, high cholesterol, obesity, lack of physical activity, unhealthy diets, stress of modern lifestyle and excessive alcohol consumption are all significant contributors to heart disease.

    Smoking is particularly harmful, as it damages the lining of blood vessels, encourages fatty deposits in the arteries, and increases the risk of blood clots. Nicotine also accelerates the heart rate and raises blood pressure, putting additional strain on the heart. Excessive alcohol consumption also raises blood pressure and can lead to weight gain, further increasing the risk of cardiovascular issues. It is important to understand that these factors often work together, compounding the risk.

    Prevention is better than Cure!

    Preventive healthcare is key in managing heart health. There are steps everyone can take to minimize their risk. The first is adopting a more active lifestyle. Regular physical exercise not only strengthens the heart but also helps control weight, lowers blood pressure, and reduces cholesterol levels.

    Chronic stress has been linked to an increase in blood pressure and inflammation, both of which can damage the heart over time. Incorporating stress management techniques like yoga, meditation, or simple relaxation exercises can help reduce stress. Stress and smoking are important Contributin for heart diseases in younger children age.

    Diet plays an equally important role in heart health. A heart-healthy diet is rich in fruits, vegetables, whole grains, lean proteins, and healthy fats like those found in fish, nuts, and seeds. Reduce the intake of saturated and trans fats, commonly found in processed foods. These are unhealthy fats that contribute to the build-up of fatty deposits in the arteries, increasing the risk of a heart attack or stroke.

    Moderate your salt intake. Too much salt can lead to high blood pressure, putting strain on the heart. Sugar consumption should also be minimized, as it contributes to weight gain and increases the risk of diabetes—another significant risk factor for heart disease.

    Regular check-ups, especially after the age of 25 for male and 30 for female, can help detect conditions like high blood pressure, high cholesterol, or early-stage diabetes, allowing for timely intervention with medications or lifestyle changes to prevent the condition from worsening. Those with a family history of heart disease should consider beginning preventive screenings even earlier.

    Listen to Your Body

    Your heart sends signals when something isn’t right—don’t ignore them. Whether it’s an unusual pain, shortness of breath, or constant fatigue, these could be early signs of a serious condition. The key to heart health is recognizing these signals and seeking medical help.

    One of the most common symptoms is chest pain, also known as angina, which occurs when the heart isn’t receiving enough blood or oxygen. The severity can vary from a crushing pain to a mild discomfort. This pain can radiate to the neck, arms, stomach, jaw, or back. Angina is especially concerning if it occurs during physical activity or emotional stress and subsides with rest.

    However, other symptoms such as shortness of breath, fatigue, irregular heartbeat, and swelling in the legs, ankles, or feet also should not be ignored. If you experience any of these symptoms, you must seek medical attention immediately. In women, older adults, and people with diabetes, heart attacks can also present with subtle symptoms such as fatigue, nausea, or light-headedness.

    Your heart works tirelessly to keep you alive. Let us resolve to give our hearts the care and attention it deserves!



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