Good Sleep Habits Tied to Lower Risk of Heart Failure

A combination of healthy sleep habits may help reduce the risk for heart failure, new research suggests.

Scientists studied 408,802 generally healthy people aged 27 to 73 between 2006 and 2010, collecting information on their sleep habits. Each person got a zero-to-five “healthy sleep score,” based on five healthy sleep practices: being a “morning person”; sleeping seven to eight hours a night; rarely or never snoring; rarely having insomnia; and rarely being excessively sleepy during the day.

Over an average follow-up of 10 years, there were 5,221 cases of heart failure. Compared with people who scored zero or one, those who scored two had a 15 percent reduced risk for heart failure; those who scored three had a 28 percent reduced risk; and those who scored four a 38 percent risk reduction. Those who scored a perfect five had a 42 percent lower risk of heart failure compared with those who scored zero or one.

The study, in the journal Circulation, controlled for smoking, alcohol intake, physical activity, diabetes, hypertension and other variables. It is an observational study, however, so it does not prove causality.

“We should consider all of these sleep behaviors together rather than treating them as separate phenomena,” said the senior author Dr. Lu Qi, a professor of epidemiology at Tulane University. “People regulate their sleep as a whole, not as separate events.”

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SPORTS MEDICINE: Take heart from latest COVID-19-related news | John Doherty

Dr. Sean Swearingen is a cardiologist with Community Care Network in Munster, who works with the athletic department at Purdue Northwest. He explained what “mild” symptoms of COVID-19 are and what they are not.

“It is symptoms that are not in any way inhibiting their day-to-day function and they are for less than 10 days,” he said, “then that is what falls in the category of mild symptoms and they don’t need any further cardiac workup. From the patients I have (had tested), they haven’t had to be hospitalized but they have had relatively significant symptoms where they have been out of commission for several days, haven’t been able to attend their online classes (because) they’ve been so fatigued. To me, I would consider that moderate symptoms.”

Symptomatic or not, cardiac tested or not, all athletes who have been diagnosed with COVID-19 need to be cautious as they return to sport, according to Swearingen.

While I questioned the Big Ten’s 21-day minimum in comparison to the ACC’s 10-day minimum in this space earlier this month, Swearingen finds it more than reasonable.

“The 21-day Big Ten protocol (allows) for a week-long ramp period in the final week,” he explained. “I am a big supporter of this — a gradual monitored increase in activity allows for another layer of safety so that players can be monitored for signs and symptoms before they are putting themselves at risk in full-on competition. The monitored physical activity is just as important as the testing itself and it seems like a lot of people are ignoring that final part in the guideline, the gradual increase in activity.”

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Rise in nighttime blood pressure increases heart disease risk, study finds

Nov. 2 (UPI) — People who have high blood pressure at night are at increased risk for heart disease, even if their blood pressure is within normal ranges during the day, according to a study published Monday by the journal Circulation.

A nighttime systolic blood pressure — the “top” number — that is 20 millimeters of mercury — or mm. Hg, the unit of measure for blood pressure — above daytime readings raises a person’s risk for heart disease by 18%, the data showed.

That same rise in nighttime blood pressure also increases a person’s risk for heart failure by 25%, the researchers said.

“Nighttime blood pressure is increasingly being recognized as a predictor of cardiovascular risk,” study co-author Dr. Kazuomi Kario said in a statement.

“This study provides much more in-depth information about the cardiovascular risk associated with high nighttime blood pressure,” said Kario, a professor of cardiovascular medicine at Jichi Medical University in Japan.

Nearly half of all adults in the United States — or 108 million people — have high blood pressure, the Centers for Disease Control and Prevention estimates.

Research suggests that up to 40% of people experience rises in systolic blood pressure at night, whether or not their blood pressure is considered normal or healthy — between 90 mm. Hg and 120 mm. Hg — during the day.

For this study, researchers measured daytime and nighttime systolic blood pressure in 6,359 adults from across Japan between 2009 and 2017, using an at-home, wearable, ambulatory monitor.

Blood pressure was recorded during daily activities and sleep for at least 24-hours at a time, and device data were periodically downloaded at a healthcare clinic, the researchers said.

Nearly half of the study participants were male, and more than half were aged 65 years and older, according to the researchers.

All of the study participants had at least one risk factor for heart disease — although none had been diagnosed with it — and 75% of them were taking blood pressure medications when the study began, the researchers said.

The study participants were instructed to rest or sleep during nighttime hours and maintain their usual daytime activities, and they recorded their daily activities and sleep and wake times in a diary.

Nearly every participant recorded 20 daytime and seven nighttime automated blood pressure measurements.

By the end of the study period, participants experienced a total of 306 cardiovascular events, including 119 strokes, 99 diagnoses of coronary artery disease and 88 diagnoses of heart failure.

Those with a disrupted circadian blood pressure rhythm — or higher blood pressure at night than during the day — had a 48% higher risk for heart disease and were nearly three times as likely to experience heart failure, the data showed.

Circadian rhythms are the body’s natural, internal process that regulates a person’s sleep-wake cycle and repeats with each rotation of the Earth, or roughly every 24 hours, according to the American Heart Association.

Blood pressure typically fluctuates with a pattern that follows the

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Some HF Patients Discard LVAD After ‘Heart Recovery’ Protocol

Although structural and functional heart “recovery” sometimes follows implantation of a left ventricular assist device (LVAD) in patients with end-stage heart failure (HF), allowing pump removal, such cases are rare in practice and the supportive medical therapy and monitoring isn’t standardized.

But what if there were a protocol for aiming patients with an LVAD specifically toward the goal of myocardial recovery followed by pump explantation, one featuring an especially aggressive drug regimen to promote reverse remodeling? Many more patients, potentially, might receive a pump with bridge to recovery as the intent and eventually have their devices removed, propose researchers who published their experience with such a strategy October 26 in Circulation.

About half of 40 adult patients who had received HeartMate II (Thoratec, now Abbott) axial-flow pumps at six major LVAD centers participating in the prospective Remission from Stage D Heart Failure (RESTAGE-HF) study were able to have their pumps explanted after following the protocol.

Their rate of survival free from transplantation or another LVAD implantation was about 90% 1 year after explantation and 77% 3 years after.

The heart recovery rate after LVAD explantation exceeds what has been previously reported, and such recoveries were achieved at all participating centers, “a key component for its broader application,” the group writes. “This suggests that the explant rate after LVAD could be much higher if this strategy were more widely used, and supports promoting and testing systematically for recovery after LVAD implantation.”

The findings build on a recent published experience in which 18 patients with LVADs explanted on a similar protocol achieved results at cardiopulmonary exercise testing comparable to those in 97 healthy control participants.

The current protocol’s key elements included optimization of the LVAD speed, or rate of continuous flow, for as much ventricular unloading as safely possible; a drug regimen designed to intensify the reverse remodeling process; close echocardiographic follow-up, the scans obtained at reduced pump speeds to capture native contractile function; and functional testing as needed.

The drug regimen, initiated with uptitration once the patient is implanted and weaned off inotropic agents, is so aggressive it wouldn’t normally be tolerated in a patient with HF not on mechanical circulatory support, observed lead author Emma Birks, PhD, MBBS, University of Kentucky, Lexington, for theheart.org | Medscape Cardiology.

Initially, ventricular unloading on the LVAD itself rests the heart and sets the stage for recovery, so it’s important that the pump be set to a speed that optimizes that process, Birks explained. The other crucial element is the intensive use of conventional HF medications, which at standard dosages the patients no longer tolerated. “They dropped their blood pressure and affected their kidneys,” she said.

But as soon as the pump is engaged, “all of a sudden they’re supported, the kidneys are better. So you can not only use the drugs, we use them at huge doses.”

The regimen, started and uptitrated as soon as the newly implanted patient weans off inotropic agents, features carvedilol, digoxin, spironolactone, an ACE inhibitor (lisinopril),

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Soft Drinks: Under 1 Cup/Day Still Bodes Poorly for Heart Health

It didn’t take very much soft drink consumption for people to see elevated risk of cardiovascular disease (CVD), a large cohort study in France suggested.

People who drank the most sugary drinks (a median 185 ml or 6.26 fl oz per day — barely half a can of ordinary soda) were more likely to experience a CVD event compared with non-consumers of these drinks (HR 1.20, 95% CI 1.04-1.40), according to a group led by Eloi Chazelas, a PhD candidate at Sorbonne Paris Nord University.

Similarly, those who drank relatively more artificially sweetened beverages (176.7 ml or 5.97 fl oz per day) had higher CVD risk over a median 6.6 years of follow-up compared with non-consumers of the drinks (HR 1.32, 95% CI 1.00-1.73), the investigators reported in a research letter online in the Journal of the American College of Cardiology.

The statistics reflected adjustment for other dietary habits, including consumption of alcohol, red and processed meats, whole grains, legumes, and fruits and vegetables, as well as overall calorie counts and comorbidities such as hypertension and type 2 diabetes.

The data suggest that artificially sweetened beverages may not be a healthy substitute for sugary drinks containing 5% or more sugar, Chazelas and colleagues concluded, noting the current debate on taxes, labeling, and regulation of both types of drinks.

The researchers noted that sugar substitutes are thought to have various metabolic effects, including gut microbiota perturbation.

For the study, the team counted first incident cases of stroke, transient ischemic attack, myocardial infarction, acute coronary syndrome, and angioplasty in the CVD endpoint.

At lower intake levels, neither sugary drinks (median 46.7 ml or 1.58 fl oz per day; HR 1.05, 95% CI 0.92-1.20) nor artificially sweetened drinks (40.0 ml or 1.35 fl oz per day; HR 1.15, 95% CI 0.94-1.42) showed a link to CVD.

The study was based on the French NutriNet-Santé cohort launched in 2009. The 104,760 people who volunteered had been asked to complete 24-hour dietary records every 6 months. The investigators linked their files to records from the French national health insurance system and the French national mortality registry.

Study participants had a mean age of 42.9 years, and 78.6% were women. Average body mass index was 23.7, and 17.2% of people were current smokers at baseline. Nearly one in three had a family history of CVD. The prevalence of type 2 diabetes was 1.4%, of high cholesterol was 8.0%, of hypertension was 8.2%, and of hypertriglyceridemia was 1.4%.

The researchers collected an average 5.7 dietary records per person over follow-up.

Study limitations, Chazelas and co-authors said, included potential residual confounding despite the adjustments for covariates. They attempted to account for reverse causality by excluding CVD events in the first 3 years of follow-up. Establishing a causal relationship between sugar substitutes and CVD will require replication in other large-scale prospective cohorts and further mechanistic investigation, the team added.

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    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

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Do You Have the Heart for Marijuana?

His team reported, “Although marijuana is smoked with fewer puffs, larger puff volumes and longer breath holds may yield greater delivery of inhaled elements.” In other words, when compared to tobacco smoking, exposure to chemicals damaging to the heart and lungs may be even greater from smoking marijuana.

Dr. Vaduganathan said he was especially concerned about the increasing number of heart attacks among marijuana users younger than 50. In a registry of cases created by his colleagues, in young patients suffering a first heart attack, “marijuana smoking was identified as one factor that was more common among them.” The registry revealed that, even when tobacco use was taken into account, marijuana use was associated with twice the hazard of death among those under age 50 who suffered their first heart attack.

Other medical reports have suggested possible reasons. A research team headed by Dr. Carl J. Lavie of the John Ochsner Heart and Vascular Institute in New Orleans, writing in the journal Missouri Medicine, cited case reports of inflammation and clots in the arteries and spasms of the coronary arteries in young adults who smoke marijuana.

Another damaging effect that has been linked to marijuana is disruption of the heart’s electrical system, causing abnormal heart rhythms like atrial fibrillation that can result in a stroke. In one survey of marijuana smokers, the risk of stroke was increased more than threefold.

These various findings suggest that a person need not have underlying coronary artery disease to experience cardiovascular dysfunction resulting from the use of marijuana. There are receptors for cannabinoids, the active ingredients in marijuana, on heart muscle cells and blood platelets that are involved in precipitating heart attacks.

Cannabinoids can also interfere with the beneficial effects of various cardiovascular medications, including statins, warfarin, antiarrhythmia drugs, beta-blockers and calcium-channel blockers, the Boston team noted.

The researchers found that in an analysis of 36 studies among people who suffered heart attacks, the top three triggers were use of cocaine, eating a heavy meal and smoking marijuana. And 28 of 33 systematically analyzed studies linked marijuana use to an increased risk of what are called acute coronary syndromes — a reduction of blood flow to the heart that can cause crushing chest pain, shortness of breath or a heart attack.

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Work by Minnesota researchers reveals deadly combo: COVID and major heart attacks

Complications from COVID-19 can make the most dangerous kinds of heart attacks even more deadly, according to a new study.

The finding has special implications for African American and Hispanic residents, as well as diabetics, since those three groups are at greater risk of having severe heart attacks and contracting COVID-19.

In a first-of-its-kind effort, a group of North American heart hospitals examined nearly 600 patients and found a surprisingly high death rate among COVID-19 patients with the most severe heart attacks, caused by complete blockage of an artery supplying oxygen to the heart muscle.

“These patients are at very high risk,” said interventional cardiologist Dr. Santiago Garcia, primary investigator at the Minneapolis Heart Institute Foundation, where the data are being analyzed. “Mortality for heart attack patients … should be in single digits. We’re seeing mortality here that is 32%.”

The findings, announced at a medical conference this month, were the public’s first glimpse of results from the ongoing project known as NACMI, an international consortium compiling data from COVID-19 patients who have a so-called “STEMI” heart attack involving a completely blocked blood vessel.

The study examined 594 STEMI patients treated at 64 hospitals during the pandemic in Canada and the U.S. through Oct. 4 and found those with confirmed cases of COVID died in the hospital at almost triple the rate as those who tested negative for the viral illness.

About 20% of all heart attacks are thought to be STEMI.

The study also documented an increased risk of in-hospital strokes among COVID-positive heart-attack patients.

The NACMI findings aren’t published in a journal yet, but the initial data were presented Oct. 14 at the annual Transcatheter Cardiovascular Therapeutics conference.

Scientists widely believe COVID makes heart attacks and strokes more likely, and more dangerous, by causing changes in the heart, lungs and blood. The NACMI research can’t prove COVID triggers heart attacks and strokes — only that mortality rose when both were present.

But doctors say the correlation is noteworthy.

“Those are stunning numbers,” said Dr. Mladen Vido­vich, an interventional cardiologist and associate journal editor in Chicago who was not involved in the research. He said the death rate in the COVID group was similar to what was seen among heart-attack patients 50 years ago.

The risks are especially significant for African American and Hispanic patients, who tested positive for COVID more often than white and Asian patients in the first release of NACMI data. Organizers will be adding patients in Mexico and South America and tracking long-term outcomes.

Cardiologists say the early results underscore the longstanding recommendation that people feeling heart-attack signs should go to the hospital — even with hospitalizations for COVID-19 on the rise.

In Minnesota, 500 people have been admitted to the hospital for COVID-19 in the past week, including 106 cases sent to intensive care, the Minnesota Department of Health reported.

On Sunday, the Health Department added 1,684 new cases to the state’s tally, which now stands at 133,802. The deaths of 2,335 Minnesotans have

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Northwestern Medicine Central DuPage Hospital offers MitraClip, an alternative treatment to open heart valve surgery

In patients with mitral regurgitation, the mitral valve does not close completely, allowing blood to flow backward or “leak” into the upper chamber of the heart, causing shortness of breath, fatigue and dizziness. The debilitating condition can lead to congestive heart failure, atrial fibrillation, pulmonary hypertension, stroke or death.

Historically, patients with severe mitral regurgitation required open heart surgery. The Bluhm Cardiovascular Institute at Northwestern Medicine Central DuPage Hospital is now offering Mitraclip, a minimally invasive procedure for patients who may not be able to tolerate surgery.

        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

 

“As a national leader in transcatheter mitral valve treatment options, Northwestern Memorial Hospital has one of the highest-volume MitraClip programs in Illinois,” said Patrick McCarthy, MD, executive director of the Bluhm Cardiovascular Institute and chief of cardiac surgery at Northwestern Memorial Hospital. “By training our team at Central DuPage Hospital in Winfield, we are bringing advanced care to patients closer to where they live.”

During MitraClip implantation, a catheter is inserted through the femoral vein in the leg, up into the heart until it reaches the diseased mitral valve. The MitraClip implant is compressed and advanced along the guide wire so that it can be properly positioned to join or “clip” together a portion of the mitral valve, reducing or eliminating the backward flow of blood.

“Patients experience a noticeable difference in their symptoms and improved quality of life very quickly,” said Imran N. Ahmad, MD, interventional cardiologist and medical director of the Northwestern Medicine Central DuPage Hospital Cardiac Catheterization Laboratory. “With the less invasive procedure, patients spend only 24 to 48 hours in the hospital, compared to about five days for an open heart procedure.”

William Lenschow, of Sycamore, was the first patient to undergo the MitraClip procedure at Northwestern Medicine Central DuPage Hospital. The 84 year-old farmer was so weak from his leaking mitral valve that he found it difficult to walk. Within two weeks of the procedure, Lenschow was back at work on his farm harvesting the soybean crop.


        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

 

“Before the procedure I was so tired I slept more than I ever have in my life. I could only sit around and do nothing. I’ve never lived my life that way,” said Lenschow. “After the procedure, I felt better almost immediately. It feels good to be active and working again.”

Northwestern Memorial Hospital participated in the COAPT clinical trial, which found treatment with MitraClip leads to a reduction in hospitalizations for heart failure and death compared to medical therapy alone. As a result of these findings, the FDA approved MitraClip for patients with functional or secondary mitral regurgitation caused by diminished heart function

“Mitral valve disease is one of the most common valve disorder in the United States and one of the more difficult to treat,” said Jonathan Tomasko, MD, cardiac surgeon at Northwestern Medicine Central DuPage Hospital. “MitraClip arms us with another tool in

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My heart attack could have been coronavirus

Brian May thinks his heart attack may have been caused by coronavirus.



Brian May wearing a costume posing for the camera


© Bang Showbiz
Brian May

The 72-year-old rocker endured a “small heart attack” back in May this year, and at the time he said he was puzzled as to how the attack could have happened, because he is a “healthy guy” with “good blood pressure”.

And now, Brian thinks he might have gotten to the bottom of his health scare, as he believes he could have picked up coronavirus at the beginning of the year when his band Queen were still touring.

He said: “I think it’s possible that I had the COVID virus early on in the tour of Korea, Japan and Australia in January, and got through it, but it’s thickened the blood, which apparently it does, and that could have been the trigger that gave me the heart attack.

“I thought it was too early to get [COVID] but the evidence now seems to be that the virus was around.”

Brian previously said his heart attack lasted for “40 minutes”, and although he claimed he only experienced mild chest pain, he needed three tubes fitted into his arteries to help his blood flow.

And following his operation, Brian says it was his wife Anita who became his saving grace, as she helped nurse him back to health.

He added to the Daily Express newspaper: “She was incredible. She totally saved my life because I couldn’t do anything and she just kind of nursed me, so I will forever be in her debt. She did an incredible job on me.”

Brian’s heart attack was made worse by an unrelated gardening incident which occurred just days before, in which he suffered a torn muscle, and a compressed sciatic nerve.

Speaking about his injuries at the time, he said: “I had an MRI and yes, I did have a rip in my gluteus maximus. It’s so easy to make a connection, there’s a rip there so that must be the cause of the pain, end of story. And no other tests were done.

“Now, a week later I’m still in agony. I mean real agony. I wanted to jump at some points. I could not believe the pain. And people are saying, ‘That’s not like a ripped muscle’, so eventually I had another MRI.

“But this one I had one of the lower spine and sure enough we would discover that I had a compressed sciatic nerve, quite severely compressed, which is why I felt like someone had been putting a screwdriver in my back the entire time. It was excruciating …

“So that’s one side of the story, and I’m a lot better now. I’m free of that terrible pain that actually destroys your mind …”

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Arnold Schwarzenegger feels ‘fantastic’ after heart surgery

LOS ANGELES (AP) — Arnold Schwarzenegger says he is feeling “fantastic” after his recent heart surgery.



FILE - Arnold Schwarzenegger discusses "Terminator: Dark Fate" during the Paramount Pictures presentation at CinemaCon on April 4, 2019, in Las Vegas. Schwarzenegger says he feels "fantastic" after his recent heart surgery. The 73-year-old actor and former California governor said on social media Friday, Oct. 23, 2020, that he had a new aortic valve implanted in his heart. (Photo by Chris Pizzello/Invision/AP, File)


© Provided by Associated Press
FILE – Arnold Schwarzenegger discusses “Terminator: Dark Fate” during the Paramount Pictures presentation at CinemaCon on April 4, 2019, in Las Vegas. Schwarzenegger says he feels “fantastic” after his recent heart surgery. The 73-year-old actor and former California governor said on social media Friday, Oct. 23, 2020, that he had a new aortic valve implanted in his heart. (Photo by Chris Pizzello/Invision/AP, File)

The 73-year-old “Terminator” actor and former California governor said on social media Friday that he had a new aortic valve implanted in his heart. He posted a photo of himself with a thumbs up from his hospital bed.

“Thanks to the team at the Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery,” he wrote. The actor underwent heart surgery in 2018 to replaced a pulmonary valve that was originally installed in 1997.

Schwarzenegger also posted some photos of himself standing in front of a few monuments in Cleveland.

“I feel fantastic and have already been walking the streets of Cleveland enjoying your amazing statues,” he said.

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