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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Over-45s at greater risk of STIs, new study finds

Middle-aged adults face a greater risk of catching sexually transmitted infections than ever before — because society is unwilling to talk about older people having sex, a new study has found.



a hand holding a baby on a bed: Social stigma was a key barrier to sexual health in the over-45s, researchers said.


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Social stigma was a key barrier to sexual health in the over-45s, researchers said.

Negative attitudes toward sexual health and limited knowledge of the needs of over-45s mean some older people are unaware of the dangers of unprotected sex, researchers from the UK, Belgium and the Netherlands have warned.

Experts associated with the SHIFT sexual health initiative surveyed 800 adults across the south coast of England and northern regions of Belgium and the Netherlands — with some 200 respondents identified as facing socioeconomic disadvantage.

Almost 80% of respondents in the general population group were aged between 45 and 65, while 58% of those considered socioeconomically disadvantaged were aged 45-54.

Researchers said “major changes” in sexual behavior in recent decades have seen rising numbers of sexually active older people — but many barely consider the possibility of STIs.

The most cited reason for not using contraception was that participants deemed themselves to be monogamous, exclusive to one relationship, experts said, followed by participants believing they were not at risk of pregnancy.

“Over-45s at most risk are generally those entering new relationships after a period of monogamy, often post-menopause, when pregnancy is no longer a consideration, but give little thought to STIs,” Ian Tyndall, senior lecturer at Britain’s University of Chichester, one of the project’s partner organizations, said in a statement.

Researchers found that more than 50% of respondents in both the general population and in the socioeconomically disadvantaged group had never been tested for a sexually transmitted infection.

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Stigma and shame were identified as the greatest barriers to adults accessing sexual healthcare services, with many participants indicating that they felt that sexual health was a “dirty” term, discouraging people from seeking regular health checks.

“A big barrier to people accessing services is societal stigma, and assumptions that older people are asexual and that sex is no longer part of their lives. This really limits the awareness of sexual health services among this group,” Tess Hartland, research assistant with the SHIFT project, told CNN.

A “significant number” of survey respondents were also unaware of the risks of sexually transmitted infections, researchers said, while 42% of general respondents in the UK and the Netherlands did not know where their nearest sexual health service was located.

“A lot of services and sexual health promotion is really tailored towards young people,” Hartland told CNN, noting that some people in the over-45 age category may have received limited sexual health education at school, affecting their attitudes today.

Participants also reported that their healthcare professionals, such as doctors and nurses, lacked appropriate sexual health knowledge.

“A lot of respondents preferred to go to their GP or their doctor rather than a specific sexual health service,” Hartland

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All gatherings pose virus spread risk

LOS ANGELES (AP) — Gatherings large and small are likely to blame for a slight uptick in daily coronavirus cases in California’s largest county, according to a top health official who warned Monday that upcoming holiday parties pose a risk for renewed spread and a spike in hospitalizations.



FILE - In this Oct. 11, 2020, file photo, Los Angeles Lakers fans celebrate outside of Staples Center in Los Angeles, after the Lakers defeated the Miami Heat in Game 6 of basketball's NBA Finals to win the championship. Gatherings large and small are likely to blame for a slight uptick in daily coronavirus cases in California's largest county. That's according to a top Los Angeles County health official who warned Monday, Nov. 2, 2020, that upcoming holiday parties pose a risk for the renewed spread and a spike in hospitalizations. (AP Photo/Christian Monterrosa, File)


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FILE – In this Oct. 11, 2020, file photo, Los Angeles Lakers fans celebrate outside of Staples Center in Los Angeles, after the Lakers defeated the Miami Heat in Game 6 of basketball’s NBA Finals to win the championship. Gatherings large and small are likely to blame for a slight uptick in daily coronavirus cases in California’s largest county. That’s according to a top Los Angeles County health official who warned Monday, Nov. 2, 2020, that upcoming holiday parties pose a risk for the renewed spread and a spike in hospitalizations. (AP Photo/Christian Monterrosa, File)

There’s been a steady increase in the number of residents of Los Angeles County who have been getting together with people from outside their households, according to weekly survey data from the University of Southern California Center for Social and Economic Research.

That may be partly because of championship runs by the Los Angeles Lakers and Dodgers in recent weeks that brought fans together through watch parties and celebrations.

“With our case numbers already on the rise, we are concerned about the upcoming holiday gatherings and cooler weather, where people are more likely to gather indoors are perfect conditions for spreading COVID-19,” said Barbara Ferrer, the county’s public health director. “And while it’s easy to believe that the virus won’t spread among your family and friends, and that none of you are infected, there are so many examples that prove otherwise.”

For the week ending Oct. 20, more than 10% of respondents reported that they’d been at a gathering of 10 or more people in the past seven days, Ferrer said. She warned that if just 10% of Los Angeles County’s 10 million residents attended a gathering outside their households, that translates to about a million people.

“And if we assume that 2% of people can be infected, we could possibly have 20,000 people capable of infecting others who are milling about at these gatherings, each week,” she said.

Los Angeles County, the nation’s most populous, reported more than 1,400 new cases Monday for a total of 310,595. There have been more than 7,000 deaths in the county.

The state is moving more slowly than the reopening last spring that brought with it a dramatic spike in cases, hospitalizations and deaths. California, the most populous state, is second in the nation with more than 930,600 confirmed cases. There have been a total of 17,672 deaths in the state.

Statewide hospitalizations have increased by about 11% in the last week to 2,537 while the seven-day daily average is 4,231 confirmed cases, down about 1% from previous week.

Many businesses remain closed as Los Angeles County remains in California’s most restrictive tier, purple.

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CDC: Pregnant women with COVID-19 have higher risk for preterm birth

Nov. 2 (UPI) — Pregnant women infected with COVID-19 are about 25% more likely to deliver their babies preterm, according to data released Monday by the U.S. Centers for Disease Control and Prevention.

About 13% of babies born to mothers with the disease were delivered preterm, or at less than 37 weeks, the data showed.

Just over 10% of babies in the United States are born preterm, according to the CDC.

“The proportion of preterm live births among women with [COVID-19] infection during pregnancy was higher than that in the general population in 2019, suggesting that pregnant women with [the disease] infection might be at risk for preterm delivery,” agency researchers wrote.

Still, the findings are “preliminary and describe primarily women with second and third trimester infection, and … subject to change pending completion of pregnancy for all women in the cohort,” they said.

For the analysis, the CDC researchers reviewed data on pregnancy and infant outcomes among 5,252 women with laboratory-confirmed COVID-19 from 15 states and Puerto Rico reported between March 29 and Oct. 14.

Among 3,912 live births with known gestational age, 12.9% were preterm, the agency said.

However, fewer than 3% of infants for whom test results were available had evidence of the virus, and most of them were born to mothers who had been infected within one week of delivery, the agency said.

Among 610 infants with reported test results, 2.6% tested positive for COVID-19, the data showed.

Previous studies have shown that pregnant women are unlikely to pass the disease on to their children.

However, data released by the CDC in June indicated that expecting mothers may be at increased risk for severe illness from the virus.

These concerns appear to have been confirmed in a separate analysis the agency released Monday, which found that pregnant women infected with COVID-19 were more than twice as likely to require treatment in a hospital intensive care unit and nearly three times as likely to need mechanical ventilation than “non-pregnant” women.

However, “the absolute risks for severe outcomes for women were low,” according to the CDC.

“Pregnant women were at increased risk for severe COVID-19-associated illness,” the CDC researchers said.

“To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptom sand measures to prevent [coronavirus] infection should be strongly emphasized for pregnant women and their families,” they said.

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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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Do Leisure Activities Really Mitigate Dementia Risk?

Contrary to some previous research, new findings question whether leisure activities in middle age really do help mitigate subsequent dementia risk.

The study showed no association between taking part in more leisure activities at age 56 and the risk of dementia over the next 18 years. There was some benefit when leisure activity participation was assessed later in life.

“Of course there are many reasons to participate in leisure activities and this finding does not question the importance of keeping active for general health and well-being, but it does suggest that simply increasing leisure activity may not be a strategy for preventing dementia,” study investigator Andrew Sommerlad, PhD, from University College London, United Kingdom, said in a news release.

The study also showed that some people who were later diagnosed with dementia stopped participating in leisure activities years before they were diagnosed, suggesting that changes in the amount of leisure activity may be an early sign of dementia.

“Dementia appeared to be the cause, rather than consequence, of low levels of leisure activities,” Sommerlad told Medscape Medical News.

The study was published online October 28 in the journal Neurology

Still Beneficial

The study included 8280 adults (mean age, 56 years) who were followed for an average of 18 years as part of the Whitehall II study. Participants reported their leisure activities at the beginning of the study, 5 years later, and again 10 years later.

They were placed in low, medium, and high groups based on their levels of participation in leisure activities such as reading, listening to music, taking classes, participating in clubs, visiting friends/ relatives, playing cards or games, taking part in religious activities, and gardening.

During the study, 360 people developed dementia at a mean age of 76.2 years. The overall dementia incidence rate was 2.4 cases for 1000 person-years.

In fully adjusted Cox regression analyses, taking part in more leisure activities at an average age of 56 was not associated with a lower risk of dementia 18 years later (hazard ratio [HR] 0.92, 95% CI, 0.79 – 1.06). 

However, those with higher participation in leisure activities later in life, at a mean age of 66, were less likely to develop dementia over the next 8 years than those with lower participation (HR, 0.82; 95% CI, 0.69 – 0.98).

In addition, a decline in leisure activity during the study was associated with an increased risk of dementia (HR, 1.38; 95% CI, 1.20 – 1.59). 

Of the 1159 people whose activity decreased during the study, 53 (5%) developed dementia, compared with 17 (2%) of 820 people who maintained their leisure activity level.

“More research is needed to confirm these results, but we know that early changes in the brain can start decades before any symptoms emerge,” Sommerlad said in the news release.

“It’s plausible that people may slow down their activity level up to 10 years before dementia is actually diagnosed, due to subtle changes and symptoms that are not yet recognized,” he added.

“There is no

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Viral load may predict ventilator need, death risk; coronavirus damages red blood cells



a man in a blue shirt: FILE PHOTO: The coronavirus disease (COVID-19) outbreak in Oldham


© Reuters/PHIL NOBLE
FILE PHOTO: The coronavirus disease (COVID-19) outbreak in Oldham

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Viral load predicts need for ventilator, death risk

When COVID-19 patients are admitted to the hospital because of pneumonia, doctors can estimate their risk of needing mechanical breathing support or dying based on their “viral load” – the amount of virus genetic material obtained by swabbing the back of the nose and throat, a new study suggests. “This risk can be predicted regardless of how sick they are when they are admitted, what other comorbidities they may have, their age or how many days they had symptoms,” coauthor Dr. Ioannis Zacharioudakis of NYU School of Medicine told Reuters. His team studied 314 patients, dividing them into three groups according to viral load upon hospital admission. The group with highest viral levels had 59% higher odds of becoming critically ill or dying than the lowest viral load group. The data, published on Friday in Annals of the American Thoracic Society, “will have practical implications in our ability to judge which patients will benefit the most from early escalation of care, treatment with antivirals and/or inclusion in trials of new therapeutics,” Zacharioudakis said. (https://bit.ly/3oJijtQ)

Coronavirus damages red blood cell membranes

The new coronavirus damages the membranes of oxygen-carrying red blood cells, contributing to the hypoxemia, or low blood concentrations of oxygen, common in COVID-19, researchers have found. Signs of hypoxemia can range from shortness of breath to organ and tissue damage. Studying blood samples from COVID-19 patients and healthy individuals, researchers found the virus did not appear to affect red cells’ ability to pick up oxygen and deliver it throughout the body. But patients had “clear damage” to red cell membranes, in particular to a membrane protein responsible for helping the cell survive injuries. As a result, patients’ red cells might be more vulnerable to so-called oxidative stress and other injury, coauthor Angelo D’Alessandro of the University of Colorado Denver said in an email. Red cells circulate for up to 120 days before the body replaces them with new ones, and they cannot synthesize new components to replace the damaged parts. This might help explain why some COVID-19 symptoms can last for months, D’Alessandro said. (https://bit.ly/3mMBq4A)

Pandemic exacts toll on ER doctors’ mental health

COVID-19 is taking a toll on emergency physicians’ mental health and many are reluctant to seek help, according to poll results reported at the American College of Emergency Physicians (ACEP) annual meeting. Among a nationally representative group of 862 U.S. emergency physicians, 87% reported feeling more stressed since the pandemic began and 72% reported more burnout. More than 80% cited concern for their own health and safety, and the safety of their family and friends, around contracting COVID-19. Nearly half said they are uncomfortable seeking mental health services, 73% said

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COVID Exposure Risk Outside of Work Increasing for Clinicians

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

One third of COVID-19 exposures among health care providers (HCPs) in Minnesota are due to family or community exposure, not patient care, according to a study conducted by the Minnesota Department of Health (MDH) and published online October 30 in Morbidity and Mortality Weekly Report. And nonwork exposures were more likely to lead to COVID-19 infections.

Between March 6 and July 11, 2020, researchers with the MDH evaluated 21,406 incidences of HCP exposure to confirmed COVID-19 cases. Of those, 5374 (25%) were classified as higher-risk exposures, meaning the provider had close contact for 15 minutes or more, or during an aerosol-generating procedure.

Two thirds (66%) of the higher-risk exposures occurred during direct patient care and 34% were related to nonpatient care interactions (eg, coworkers, social and household contacts). Overall, 6.9% (373) of the HCPs with a higher-risk exposure received a positive SARS-CoV-2 test result within 14 days of the exposure. Notably, HCPs with household or social exposure had the highest positivity rate across all exposure types at 13%.

“Since the time period covered in this report, we’ve seen a significant increase in the proportion of HCPs who have had higher-risk exposures outside of work due to household or social contacts,” said lead author Ashley Fell, MPH, from the Minnesota Department of Health.

“HCPs with household or social exposures are also more likely to test positive than HCPs with higher risk exposures within the healthcare setting, which is an important message for both HCPs and the community at large that more COVID-19 spreading in our communities poses a greater risk to our HCPs and health care system,” Fell told Medscape Medical News.

When evaluating personal protective equipment (PPE) use among exposed HCPs, researchers found that 90% of providers in acute or ambulatory care were wearing a respirator or medical-grade face mask at time of exposure, compared with just 68% of HCPs working in congregate living or long-term care facilities.

Further, investigators found that an HCP with a positive SARS-CoV-2 test working in a congregate living or long-term care facility resulted in exposure of a median of three additional HCPs (interquartile range [IQR], 1-6) compared with a median of one additional HCP exposure in acute or ambulatory care (IQR, 1-3).

The researchers also found that, compared with HCPs in acute or ambulatory settings, HCPs working in long-term care or congregate living settings were more likely to return to work following a high-risk exposure (57% vs 37%) and work while symptomatic (4.8% vs 1.3%).

When asked whether these findings apply to HCPs in other states, Andrew T. Chan, MD, from Massachusetts General Hospital, Boston, noted: “These data are not surprising and confirm what many of us have been seeing in our own areas.

“Clearly, the risk of contracting COVID-19 is particularly high for front-line health care workers in long-term care facilities and nursing homes,” Chan said.

“Furthermore, the infection control practices in these care settings are often

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Epilepsy Meds During Pregnancy May Raise Autism Risk in Child | Health News

By Serena Gordon HealthDay Reporter

(HealthDay)

FRIDAY, Oct. 30, 2020 (HealthDay News) — Women who take the epilepsy medication valproic acid during pregnancy have more than twice the risk of having a child with autism, new research suggests.

The study also found that taking the drug during pregnancy almost doubled the odds that a child would have attention-deficit/hyperactivity disorder (ADHD), compared to children who weren’t exposed to the drug during pregnancy.

“These women are in a bind. Valproic acid is a first-line drug for epilepsy, and having uncontrolled epilepsy is also a risk to mom and baby. We’re not trying to point a finger at valproic acid, but we did see these associations,” said study author Kelsey Wiggs. She’s a doctoral candidate in the department of psychological and brain sciences at Indiana University in Bloomington.

Wiggs noted that the study wasn’t designed to prove cause-and-effect relationships, only associations.

She added that the study is important because of the associations it didn’t find, as well.

“We didn’t find an association with the antiseizure medications lamotrigine and carbamazepine,” Wiggs said.

Between three and seven women out of every 1,000 pregnant women have epilepsy — a seizure disorder. The main treatment for epilepsy is antiseizure medications, according to background information in the study. But valproic acid has been linked to a higher risk of birth defects and lower cognitive test scores (IQ and other tests), according to the U.S. Food and Drug Administration.

The drug has also been associated with a higher risk of ADHD and autism in smaller studies, the researchers noted.

The latest study included nearly 15,000 children who were born to women with epilepsy between 1996 and 2011. Nearly one in four of the mothers took antiseizure medication during their first trimester of pregnancy.

About 10% of the women took carbamazepine and 7% took the medication lamotrigine. Five percent of the women took valproic acid (699 children).

Of those who were exposed to valproic acid in pregnancy, 36 developed autism by the age of 10. There were just over 11,000 kids who weren’t exposed to any antiseizure medication. Just 154 of them were diagnosed with autism.

Fifty-four of the kids exposed to valproic acid developed ADHD by 10. In those with no exposure to the drugs, 251 out of 11,000 were diagnosed with ADHD, the study authors said.

Wiggs said it’s not clear how valproic acid exposure might trigger autism or ADHD. She said that the medication is associated with the increased metabolism of the nutrient folate. Folate is important in the development of nervous system cells, so it’s possible that may play a role.

Dr. Steven Pacia, vice chair of neurology at North Shore University Hospital in Manhasset, N.Y., said that folate might be one factor, but he suspects there are likely multiple reasons why this medication is associated with higher rates of autism and ADHD.

Pacia said this study is the largest to link valproic acid to autism and ADHD, but that the drug was already known to

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Grocery workers at greater risk for COVID without symptoms

Grocery workers are likely at greater risk of infection with the new coronavirus, a new study shows.

Not only that, but because a high percentage of them have no symptoms when they are infected, they could become sources of future spread, the researchers said.

For the study, Harvard University T.H. Chan School of Public Health scientists studied the test results of workers at a single grocery store in Boston. One in five workers (20%) tested positive for SARS-CoV-2, and three-quarters of those with the virus had no symptoms.

These essential workers could be an important reservoir of infection, the investigators said. “Once essential workers are infected with SARS-CoV-2, they may become a significant transmission source for the community they serve,” the researchers explained.

The percentage of those infected was much higher than the virus’s prevalence in the local community, which was 0.9% to 1.3% at that time. The grocery workers who had customer-facing jobs were five times more likely to test positive, the findings showed.

The study was published this week in the journal Occupational and Environmental Medicine. The grocery workers had the coronavirus tests in May as part of a mandatory testing policy in Boston.

The workers also answered questions about symptoms and exposures, and completed detailed questionnaires about their lifestyles, medical and employment histories, working patterns, role at the store, commuting to and from work, and the protective measures they were able to take against infection at work. Most also answered questionnaires focusing on anxiety and depression.

The study was small and specific to the one location, the researchers cautioned.

“This is the first study to demonstrate the significant asymptomatic infection rate, exposure risks, and associated psychological distress of grocery retail essential workers during the pandemic,” Justin Yang and colleagues said in a journal news release.

About one in four of the 99 employees who completed the mental health questions reported feeling at least mild anxiety. About half of those respondents weren’t able to consistently practice social distancing at work. Those who were able to practice social distancing tended to be less anxious, according to the report.

Eight of the employees were mildly depressed. They were less likely to practice social distancing at work and relied on shared rides or public transportation. Those who drove their own car, walked or biked were far less likely to report depression.

“Our significant mental health finding calls for action in providing comprehensive employee assistance services to help essential workers cope with the psychological distress during the COVID-19 pandemic,” the study authors said.

The researchers also recommended that employers and government officials implement routine COVID-19 employee testing, and strategies to reduce contact.

More information

The U.S. Centers for Disease Control and Prevention has tips for preventing COVID-19 in the workplace.

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