Men and heart attacks – It’s the hormones

Sex, or to be fair, hormones are now shown to be the reason why men are more prone to – and likely to die of – heart disease compared with women of a similar age. I thought it was just they worked harder, and worried more, but am always happy to be proved wrong! A new study from the Department of Cardiovascular Sciences at the University of Leicester, suggest that this “male disadvantage” may be related to the effects of their naturally occurring sex hormones, and yes they do have more than one: estradiol, estrone, testosterone and androstenedione. The researchers studied how each of these interacted with the three major risk factors of heart disease: cholesterol, blood pressure and weight. For once, it is not testosterone that is in the dock because they found that two of these sex hormones (estradiol and estrone, both oestrogens) are linked to increased levels of bad cholesterol (LDL-cholesterol) and low levels of good cholesterol (HDL-cholesterol) in men and that they may be important risk factors of heart disease – even before men present symptoms of coronary artery disease or stroke.

In women, oestrogen helps protect women from heart disease so why it affects men differently is interesting – but the research didn’t throw up why this happens, only that it does. However, men concerned about their heart health could ask their doctor for a blood test to determine their level of these two oestrogens to see if they are at risk.

Flu vaccine not as effective for heart patients

Obviously if you have heart disease, or cardiac problems, then the focus is solely on keeping the heart healthy. However, a report presented at a meeting of the American College of Cardiology by Dr Orly Vardeny, of the University of Wisconsin seems to imply that “heart failure goes beyond the heart, that there are other systems challenged by the condition.” This arose from his study which indicated heart failure patients may not have as strong an immune response to flu vaccine as healthy patients. This is not the time of year to be thinking of flu vaccines, but I am a great believer in looking ahead and being prepared. The report showed that patients with heart failure had a significantly lower antibody response to one of the three influenza virus strains found in the flu vaccine used for the study, compared with healthy patients. It has been previously established that heart failure patients are at an increased risk for developing influenza, which is why yearly vaccination is recommended for them, but it was reported by Dr. Vardeny that there are still high numbers of hospitalisations and deaths from influenza in heart failure patients, They do not yet know why the impaired response happens but believe it may be due to increased neurohormone levels, such as norepinephrine and angiotensin II. Further study is being done on the specific effects of norepinephrine or beta-adrenergic mechanisms in response to vaccines, but they do not suggest that patients with heart failure should stop getting immunised just yet.

The answer might lie in more preventive measures such as boosting the immune system through natural means by methods such as meditation, exercise and supplements such as additional vitamin C and immune boosters like ginseng and Echinacea. Belt and braces has always been good advice if you are vulnerable to infections and if in any doubt, please talk to your doctor about how a flu vaccine might affect you.

Lets hear it for nuts!

This is another natural food that can get a bad press. They are shunned because people – particularly those on a diet – believe that they are bad for you as they are high in natural fats and oils, but this is far from being the case. Raw, not processed or salted, nuts can help fight depression, heart disease and bad cholesterol. That last one may be a bit of a shock, but although it is true that nuts in general contain as much as 80 per cent fat, but there are good fats and bad ones. The type of fat found in nuts is unsaturated fat – specifically monounsaturated and polyunsaturated fat and both of these unsaturated fats are known for their ability to reduce low-density lipoprotein (LDL), also called “bad” cholesterol, when consumed in moderation.

A few months ago in the USA, a survey examined and reported on the diets of more than 31,000 Seventh Day Adventists – chosen for the similarity of their lifestyle choices – and it was found tha t those who ate nuts more than four times per week experienced 51% fewer heart attacks compared to those who ate nuts less than once per week.

If you want to stick to the most healthy nuts around, these are the top 5 to go for:

1 Pistachios can produce a 10 point drop in your triglycerides and a 16 point decline in your LDL (bad) cholesterol, according to the Journal of the American College of Nutrition.

2 Walnuts Contains omega 3s which may help ward off depression and heart attack, according to Harvard research. Maybe you should stuff those sardines with lemon and walnuts for extra benefit!

3 Brazil nuts contain selenium, a mineral linked to prostate cancer protection, according to scientists at the University of Arizona.

4 Pecans have the most antioxidants of any nut. Could help reduce the risk of cancer, heart disease and Alzheimer’s disease.

5 Hazelnuts a handful daily boosts HDL (good) cholesterol levels by 12 percent, according to a study in the European Journal of Clinical Nutrition.

Women smokers at greater risk for heart attacks

Traditionally women have enjoyed a natural shield against a major cardiac event such as a heart attack. Being a woman has ensured a huge nine year barrier before women become more prone to heart disease, but now a new finding has been reported by the American Heart Association. A study of more than 7,000 men and women undertaken at Johns Hopkins University in Baltimore has found that women who smoke eliminate that beneficial barrier and their risk of a heart attack is exactly the same as a man’s.

In real terms, this means that up to now, women who do not smoke would not normally present with heart problems until on average around the age of 71 but women smokers are being seen with heart problems at around the age of 62. That is a loss of nine years, but if you need an even greater incentive to give up – or persuade the woman in your life to do so = then the researchers also found that if a woman quits smoking for at least six months, her risk factors for heart attacks reverts to average.

Interestingly, the analysis of men showed virtually the same, although men only lost 3.8 years because of smoking. Men who didn’t smoke tended to show up with a heart attack at age 61; men who smoked showed up at the emergency room when they were 57.

A final cheery note from the director of the New York University Women’s Health Program. “Smoking among women causes heart attacks, lung disease, and wrinkles so this study is just another reason for women to quit or never start. It takes nine years off your life.”

High blood pressure in pregnancy may pose long-term risk

High blood pressure is closely monitored during pregnancy but there is new evidence from a study at the Mayo Clinic in the USA that it is an under-recognized risk factor for cardiovascular disease. Compared with women who have had normal blood pressure throughout their pregnancies, those who had high blood pressure are at greater risk of heart disease later in life. One reason could be that having high blood pressure in pregnancy has some of the same risk factors for cardiovascular disease such as diabetes or obesity. Another theory is that hypertension in pregnancy could induce long-term metabolic and vascular abnormalities that might increase the overall risk of heart disease later in life. Anyone with a family history of heart disease is well advised to have their blood pressure very closely monitored during pregnancy.

ADHD drugs and risk of heart disease

The number of children on anti depressants and other behaviour altering drugs has quadrupled in the last ten years. In 2005 GP’s wrote more than 631,000 prescriptions for drugs such as Prozac to under 16′s as against 146,00 in the mid 1990′s. This disturbing trend sees drugs being the first line in the situation instead of other options such as counselling which might be more appropriate. In line with the fact that the use of Ritalin to control stress and aggressive behaviour in children has also increased tenfold in the same period, there is a timely study being undertaken in the USA to look at the potential heart risks from medicines used to treat attention deficit hyperactivity disorder (ADHD).

The U.S. Food and Drug Administration, in collaboration with the Agency for Healthcare Research and Quality, will examine clinical data of about 500,000 children and adults who have taken ADHD drugs, including Ritalin. The analysis is expected to take about two years and will include all drugs currently marketed for treating ADHD. There are millions of people taking these medicines worldwide and it is known they can increase heart rate and blood pressure, and this has raised concerns they may therefore raise the risk of heart attacks, strokes or other cardiovascular problems. There have been cases reported of heart problems in both adults and children who receive drug treatment for ADHD, but these patients have had known underlying risk factors. What is not known is whether or not these events are directly related to the drug treatment and the study hopes to get further information to protect from potential risks from heart disease.

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