Tag Archives: heart disease

Gout could increase heart disease risk

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Gout is not just a pain in the toe, it affects other organs, too, including the heart. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay


Having a type of inflammatory arthritis called gout may worsen heart-related outcomes for people being treated for coronary artery disease, according to new research.


The study, published in The Journal of the American Heart Association, sought to clarify older research on the link between cardiovascular disease and gout, which occurs in people with high levels of uric acid in the blood.


In the U.S., gout affects nearly 6 million men and 2 million women, or about 4 percent of the population, according to the Arthritis Foundation.


The buildup of uric acid can form needle-like crystals in a joint and cause sudden pain, tenderness, redness, warmth and swelling, often in the big toe. But it’s also associated with a greater risk of kidney disease, diabetes, cancer and sleep apnea.


Researchers from Duke University studied data from more than 17,000 patients, including 1,406 who had gout at the start of the study and were being treated for cardiovascular risk factors. After following patients for an average of 6.4 years, researchers found that “in spite of aggressive medical therapy,” the gout was linked to worse outcomes and death.


“Among patients who had gout at the beginning of the study or who developed it during follow-up, their risk of either dying of cardiovascular disease or having a heart attack or stroke was 15 percent higher than patients who never developed gout,” said the study’s lead author, Dr. Neha Pagidipati, a cardiologist and assistant professor at Duke University School of Medicine in Durham, N.C.


Patients who had gout at any point during the study had a twofold increased risk of heart failure death compared to people who never developed gout.


While past research showed people with gout have an increased risk of cardiovascular disease, “a lot of those studies were done decades ago, before modern preventative therapy like statins became extremely common,” Pagidipati said. “We wanted to take a more contemporary look at the relationship between gout and future heart disease in patients with known coronary artery disease.”


Many patients don’t even realize a link exists between gout and heart problems, she said, and the new findings show the need for patients to talk to their physicians about added risks.


“Also, from a physician’s perspective, it’s important to consider that patients with gout may be at increased risk for cardiovascular disease even if they’re already treating them with all the standard therapies. It’s something to have on their radar,” Pagidipati said.


Although it’s unclear why gout might increase the risk of cardiovascular disease, she said possible reasons include increased oxidative stress and inflammation.


“We know that people who have a high level of inflammation are at an increased risk for cardiovascular disease, and we also know gout is characterized by periods of acute inflammation: The link may have to do with that,” she said.


Dr. Jasvinder Singh, who was not involved in the study, said the new research may help the public understand how insidious gout can be.


“Gout is not just a disease of the joints: It’s a disease that causes inflammation in the joints and in the body. It’s not just a pain in the toe, it affects other organs, too, including the heart,” said Singh, a gout researcher and professor of medicine and epidemiology at the University of Alabama at Birmingham.


Singh said the new study underscores the potential dangers of ignoring even occasional episodes of gout.


“Patients may say, ‘I have an attack every two years, so shouldn’t I wait (for treatment) until it becomes more frequent?’ But in light of studies such as this one,” he said, “patients might want to take that into account and know that leaving gout untreated might be affecting their cardiovascular health.”


Reprinted with permission from Spectrum Health Beat.


Could antibiotics up heart disease risk?

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Research suggests antibiotic use be kept to as short a period as possible, given the potentially adverse effects of prolonged use. (Courtesy Spectrum Health Beat)

By Robert Preidt, HealthDay


Antibiotics can be lifesaving, but using them over a long period might raise the odds of heart disease and stroke in older women, a new study suggests.


Researchers tracked the health of nearly 36,500 U.S. women over an average follow-up of nearly eight years. During that time, more than a thousand developed heart disease.


The study found that women aged 60 and older who used antibiotics for two months or longer were 32% percent more likely to develop heart disease than those who did not use antibiotics.


Women aged 40 to 59 who took antibiotics for longer than two months had a 28% higher risk than those who did not take the drugs, said a team led by Lu Qi. He directs the Tulane University Obesity Research Center in New Orleans.


Said another way, the results mean that for older women who take antibiotics for two months or more, 6 per 1,000 would go on to develop heart disease, compared with 3 in 1,000 among those who did not take the drugs.


There was no increased risk of heart disease among women aged 20 to 39 who took antibiotics, according to the study published recently in the European Heart Journal.


“This is an observational study and so it cannot show that antibiotics cause heart disease and stroke, only that there is a link between them,” Qi said in a journal news release. “It’s possible that women who reported more antibiotic use might be sicker in other ways that we were unable to measure, or there may be other factors that could affect the results that we have not been able take account of.”


However, the researchers did take into account other factors, including age, race, sex, diet and lifestyle, reasons for antibiotic use, overweight or obesity, other diseases and medication use.


The most common reasons for antibiotic use among women in the study were respiratory infections, urinary tract infections and dental problems.


So what could be the link between antibiotics and heart risk?


One possible reason could lie in the fact that antibiotics do alter the balance of gut microbes, destroying good bacteria and increasing the proportion of viruses, bacteria or other microbes that can cause disease, Qi suggested.


“Antibiotic use is the most critical factor in altering the balance of microorganisms in the gut,” he said, and “previous studies have shown a link between alterations in the microbiotic environment of the gut and inflammation and narrowing of the blood vessels, stroke and heart disease.”


Study first author Yoriko Heianza is a research fellow at Tulane University. She noted that, as the women in the study aged, “they were more likely to need more antibiotics, and sometimes for longer periods of time, which suggests a cumulative effect may be the reason for the stronger link in older age between antibiotic use and cardiovascular disease.”


According to Qi, the take-home message from the new study is that “antibiotics should be used only when they are absolutely needed. Considering the potentially cumulative adverse effects, the shorter time of antibiotic use, the better.”


Dr. Eugenia Gianos directs Women’s Heart Health at Lenox Hill Hospital in New York City. She wasn’t involved in the new research but said the findings are “interesting and warrant further analysis.”


Gianos agreed that the study couldn’t prove cause and effect.


“It is very possible that patients who require antibiotics for an infection have a worse underlying infectious or inflammatory process and that the systemic effects of these diseases are what cause cardiovascular disease,” she reasoned.


But the interplay between antibiotics, the gut’s “microbiome” and the cardiovascular system could be important as well, Gianos said.


Reprinted with permission from Spectrum Health Beat.


Growing threat for vets: Heart disease

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Courtesy Spectrum Health Beat

By Robert Preidt, HealthDay


More U.S. veterans are at increased risk for heart disease, a looming public health problem, researchers say.


They analyzed data from more than 153,000 people who took part in the National Health Interview Survey, conducted by the U.S. Centers for Disease Control and Prevention, in 2012, 2013, 2014 and 2015.


Vets between the ages of 35 and 70 reported significantly more heart conditions than non-veterans, the data showed.


After age 70, non-veterans reported more, but the study’s author suspects that might be because fewer vets survived into old age due to heart disease.


“I think it’s sort of the first indication of a coming public health crisis for veterans,” said study author Ramon Hinojosa, assistant professor of sociology at the University of Central Florida.


“Because of the wars in Afghanistan and Iraq, we have a relatively large, new younger generation of veterans who are going to survive for 30 or 40 years after their war experience,” he said in a university news release.


The study suggests that what’s known as the “healthy soldier effect” is no longer guaranteed. That’s the tendency for members of the military to be more fit and less overweight than same-age civilians.


Hinojosa said the change could be due the nature of modern warfare, changes in diet, leisure and exercise, more obesity among younger vets and higher rates of drinking, smoking and mental illness.


“It’s concerning to know that the physical benefits of military service seem to be not holding as well for the younger veterans,” he said.


“This suggests the health protective benefits of military service are not what they used to be,” Hinojosa said. “I think that should cause us to really look at what’s going on among the veterans after they leave military service.”


Being aware of this emerging problem can help health care providers offset the likelihood of early onset heart disease, Hinojosa noted.


The study was recently published in the Journal of the American Board of Family Medicine.


Reprinted with permission from Spectrum Health Beat.

Metro Health hosts free screenings for peripheral artery disease Saturday

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peripheral_arterial_diseaseCold feet. Cramping in the legs. Legs falling asleep. These are all signs of peripheral artery disease or PAD.

 

This Saturday, Oct. 1, Metro Health Hospital will be hosting free screenings for PAD. The screenings are painless, usually involving taking a person’s blood pressure in the arms and ankles, with the screenings taking about 30 minutes. Screenings are available from 8 a.m. to 12:30 p.m. at Metro Health Hospital, 5900 Byron Center Ave. SW. Space is limited and registration is required. To register call, 616-242-4880 or visit metrohealth.net/pad.

 

“Peripheral artery disease is where there is blockage and plaque buildup in the arteries that supply blood to the legs,” said Dr. Fadi Saab,  who specializes in cardiovascular disease at Metro Health, during a recent interview. Saab said the same can happen in the arteries to the heart or brain with people having PAD being a higher risk for cardiovascular disease.

 

People who have PAD usually have other health issues such as hypertension, diabetes, or high cholesterol, Saab said. Those at-risk include those over 50 with diabetes, those who are obese or those who have a family history of heart disease. High blood pressure, high cholesterol, smoking, other circulatory problems and a family history of PAD also put patients at advanced risk. Those who are African-American and Native-American also are at a higher risk.

 

The free PAD screenings can help high-risk patients learn about the disease early enough so they can make lifestyle changes to help their circulatory system. The goal is to detect issues early enough in patients to reduce the risk of amputation.

 

legs_of_womanAnyone experiencing leg cramping or pain with walking or leg pain at rest should get screened. Slow-healing wounds or sores on legs or feet also call for a screening.

 

Results will be provided to the participant to take back to their physician for further review. For more information, visit the Metro Health website.