Posts Tagged ‘ heart disease ’

Childhood Trauma May Raise Heart Disease Risk

Friday, May 23rd, 2014

Children who suffer traumatic or severely stressful events as kids may bear the mark of their experiences on their blood vessels.  This effect, which is the subject of a new study published in the journal Hypertension, may put those children at higher risk of developing heart disease later in life.  More from Reuters:

[Jennifer] Pollock, part of the research team, co-directs cardio-renal physiology and medicine in the nephrology division at the University of Alabama at Birmingham.

She and her colleagues looked for elevations in blood pressure and other indicators of how well blood vessels constrict or relax, as well as signs of stiffness in blood vessel walls.

“All of this was highly correlated with people who have more of these stresses during childhood than the people who had no stressors in childhood,” she said.

Pollock said that household dysfunction was the most common adverse event, followed by neglect and abuse.

For their study, which was published in the journal Hypertension, Pollock and her colleagues analyzed data on 221 healthy adolescents and young adults recruited for a study of cardiovascular risk factors that started in 1989.

The research team looked at markers of blood vessel health including blood pressure, the heart’s output of blood, characteristics of the pulse and levels of a substance called endothelin-1, a protein that constricts blood vessels and increases blood pressure.

They calculated adverse childhood event (ACE) scores based on a questionnaire answered when the participants were about 21 years old. Those who reported one traumatic event were classified as having mild ACE and those with two or more traumatic events were classified as moderate or severe ACE.

The researchers found that participants who had one traumatic event in childhood had plasma endothelin-1 levels that were an average of 18 percent higher than those who had reported no traumatic events, and those who had two or more traumatic childhood events had levels that were 24 percent higher.

Participants with two or more adverse events also had elevated measures of blood pressure and blood vessel stiffness.

The study didn’t follow up to see if those young people ended up having more heart attacks, strokes or other illnesses. And it cannot prove that the early-life traumas were the cause of the cardiovascular differences.

Nonetheless, Pollock said that in the future she’d like to determine if behavioral therapies may change the course of the cardiovascular risk factors in people who have these early life stressors.

Image: Stressed child, via Shutterstock

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Number of Live Births, Cardiovascular Health Linked in Women

Friday, March 28th, 2014

Mom with Seven KidsWomen who have given birth four or more times are at increased risk for cardiovascular disease according to a new study. Compared to women who’ve had fewer pregnancies, in the study of more than 1,500 women, moms with more children showed increased evidence of plaque in the heart and thickening of arteries. More from American College of Cardiology:

Women who give birth to four or more children are much more likely to have evidence of plaque in their heart or thickening of their arteries – early signs of cardiovascular disease – compared with those having fewer pregnancies, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.

While earlier studies have shown an association between several aspects of pregnancy – physiological changes, complications, number of pregnancies – and future heart disease risk, many questions remain about how pregnancy might affect cardiovascular risk. To better understand the potential link, researchers at the University of Texas Southwestern Medical Center set out to determine whether the number of live births is associated with early signs of cardiovascular disease.

“This is not a recommendation for women to only have two or three children,” said Monika Sanghavi, M.D., chief cardiology fellow, University of Texas Southwestern Medical Center, and lead investigator of the study. This is the first study to look at two markers of subclinical atherosclerosis – a gradual narrowing and hardening of the arteries that can eventually block blood flow and lead to stroke and heart attack.

“Our findings add to the growing body of evidence that the changes associated with pregnancy may provide insight into a woman’s future cardiovascular risk and deserves further attention.”

The study included 1,644 women from the Dallas Heart Study, a multiethnic population-based cohort, who had both self-reported information about the number of live births and relevant imaging study data available. The average age at the time of analysis was 45 years and slightly more than half of the women (55 percent) were African-American. Coronary artery calcium (CAC) scores were measured using computed tomography imaging and aortic wall thickness (AWT) by magnetic resonance imaging to determine whether or not women had evidence of subclinical atherosclerosis in the heart and artery walls. CAC was positive if it was greater than 10 and AWT was abnormal if it was greater than the 75th percentile for age and gender. These tests were done as part of standard subject participation in the Dallas Heart Study.

Using women who had two or three live births as a reference, women who had given birth to four or more children had an approximately two-fold increased risk of having abnormal CAC or AWT. This association remained even after adjusting for socioeconomic status, education, race and factors known to heighten the risk of cardiovascular disease. Women who had more babies were more likely to be older, Hispanic, have high blood pressure, higher body mass index and lower socioeconomic status.

Curiously, women who had zero or just one live birth were also more likely to show evidence of subclinical atherosclerosis – revealing a U-shaped relationship.

Authors say it is unclear why this might be the case. But Sanghavi and others speculate they may have captured some women in this group who have an underlying condition that prevents them from carrying a first or second pregnancy to term, which may also predispose them to cardiovascular disease or risk factors. For example, women with polycystic ovarian syndrome can have menstrual irregularities and trouble getting pregnant, but they may also have other health changes such as excess body weight, diabetes, high blood pressure or high cholesterol.

Pregnancy itself sparks a cascade of changes that can place more strain on a woman’s cardiovascular system. For example, the volume of blood being pumped through the heart increases by 50 percent. In addition, other physiological and metabolic changes occur (e.g., increased insulin resistance and higher cholesterol levels).

“Pregnancy has been called ‘nature’s stress test,’ and for good reason,” Sanghavi said. “It may also help identify women who are at increased risk [for heart disease], even though right now they may not have any risk factors.”…

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Postpartum Exercise: Tips For New Moms
Postpartum Exercise: Tips For New Moms
Postpartum Exercise: Tips For New Moms

Image: Big happy family – a mother and seven children drawing a heart together at home via Shutterstock.

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About 1 in 3 Children Have High Cholesterol, Study Finds

Friday, March 28th, 2014

Childhood ObesityIn an alarming new study of more than 12,000 children with ages ranging from 9 to 11-years-old, 30 percent of them had “borderline” or “abnormal” cholesterol levels. And about 98 percent of those levels are caused by obesity, lack of exercise, and poor nutrition. According to the study’s author, high cholesterol levels in childhood are the greatest predictor of high cholesterol in adulthood. More from USA TODAY:

Nearly one-third of children may have worrisome levels of cholesterol, putting them at risk for cardiovascular problems decades later, according to a new study.

The study of more than 12,000 9- to 11-year-olds, presented today at the American College of Cardiology’s annual conference in Washington, found that 30 percent of those tested had “borderline” or “abnormal” levels of cholesterol.

“It’s a problem that’s underdiagnosed,” said study author Thomas Seery, a pediatric cardiologist at Texas Children’s Hospital and assistant professor at the Baylor College of Medicine, both in Houston.

The greatest predictor of high cholesterol in adulthood, Seery said, is the rate in childhood.

In 2011, an expert panel convened by the National Heart, Lung and Blood Institute issued guidelines that called, among other things, for cholesterol screening of all children before and at the end of adolescence. In the Houston study, researchers found that nearly 5,000 of the children were at risk for or had high cholesterol and roughly the same number were obese. It’s not clear whether they were tested for high cholesterol because they had a problem or if their screening was routine.

About 1 percent-2 percent of high cholesterol in children is due to inherited problems with cholesterol regulation, Seery said. The rest is caused by obesity, lack of exercise and a poor diet.

“There’s no question that we are seeing alarming increases in obesity and elevated cholesterol levels in children and adolescents,” said Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic in Ohio, who was not involved in the study.

Nissen said he is not convinced that screening all kids for high cholesterol is an effective way to approach the problem. He’s concerned that extra screening will lead doctors to prescribe more medications to children.

Any obese child should be counseled about making lifestyle changes, even without knowing his or her cholesterol levels, Nissen said. There’s no proof that screening improves patient health, but it would cost a significant amount to run blood tests on every child, he said.

Seery disagrees, as does Robert Eckel, former president of the American Heart Association. They say universal screening would at least prompt a conversation between doctor and patient about the need for a healthy lifestyle.

“We really need to emphasize prevention, and that begins in childhood,” said Eckel, an endocrinologist and professor of medicine at the University of Colorado’s Anschutz Medical Campus in Aurora. “This could be a good opportunity to sit down with parents and move them in the right direction.”

In other research presented at the conference today, doctors from New York University’s Langone Medical Center in Manhattan reported that married adults were less likely to have cardiovascular disease than people who are single, divorced or widowed. The study analyzed data on more than 3.5 million Americans and found that people who are married have a 5 percent lower risk of having any cardiovascular disease than being single.

In the study of 12,700 9- to 11-year-olds in Houston, researchers found:

• 37 percent had borderline or elevated levels of total cholesterol.

• 32 percent had borderline or low levels of “good” HDL cholesterol.

• 36 percent had borderline or elevated levels of non-HDL cholesterol.

• 46 percent had borderline or elevated levels of triglycerides.

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Picky Eaters: 3 Ways To Encourage Healthy Eating
Picky Eaters: 3 Ways To Encourage Healthy Eating
Picky Eaters: 3 Ways To Encourage Healthy Eating


Image: Closeup view of scales on a floor and kids feet via Shutterstock.

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Disabled Baby Turned Down for Heart Transplant

Monday, December 2nd, 2013

A 5-month-old baby named Maverick who was born with a rare genetic defect in addition to severe heart problems does not qualify for a potentially life-saving heart transplant because of the genetic condition, doctors have told parents Autumn Chenkus and Charlie Higgs. The story, which is now the subject of a federal investigation because the parents are accusing doctors of withholding the heart unfairly because of fears Maverick could have severe disabilities later in life, highlights the debate within the medical community over how organ transplant decisions should be made. CNN.com has more on Maverick’s story:

Maverick was born with a severe heart defect, and even after two surgeries was in heart failure. Doctors had discussed a heart transplant with Maverick’s parents, but at the meeting they said he didn’t qualify for a new heart because he had a rare genetic defect that put him at a high risk for tumors and infections. A heart transplant would be too risky, they explained.

As Chenkus did her research on Maverick’s genetic condition, she couldn’t believe her eyes. Not one of the studies she read mentioned anything about an increased risk for tumors or infections. She e-mailed one study’s author, and he confirmed she was right.

Now they’ll do the transplant for sure, she told Maverick’s father excitedly. Our son doesn’t have to go home and die.

But it didn’t matter. The doctors still refused to give Maverick a new heart.

At first, Maverick’s mother was confused, but then she said it dawned on her: This supposed propensity for infections and tumors was a smokescreen.

She felt the real reason the doctors were denying their baby a life-saving transplant was that children with Maverick’s genetic condition grow up to have disabilities. They don’t want to give Maverick a heart because he won’t grow up to be “normal,” she thought.

At another meeting, she looked one of the doctors in the eye.

“You’re discriminating,” she said.

“That’s ridiculous,” she remembers the doctor responding.

“You don’t want to waste a heart on him,” Chenkus replied. “You’re trying to play God, and you’re lying to me.”

What happened next is the subject of a federal investigation and has pitted a family against the very doctors who were supposed to save their baby’s life.

There are few hard and fast rules to guide doctors as they select who will get a transplant, effectively selecting who will live and who will die.

And there’s no question some will die. Last year in the United States, 321 people, including 19 infants, lost their lives while waiting for a new heart. Right now, some 3,500 people await a heart transplant, and the situation is only getting more desperate as the waiting list grows but the number of donors remains about the same.

In the face of such scarcity, doctors try to select the patients most likely to get the longest life, and the highest quality of life, from a new heart.

“We have to be stewards of a very valuable resource. We want hearts to go to people who we think will benefit the most from them,” said Dr. David Taylor, immediate past president of the International Society for Heart and Lung Transplantation.

These decisions are, to some extent, subjective, as doctors sometimes disagree with each other about who should get an organ. Over the years, medical ethicists and patient advocates have accused transplant physicians of discriminating against one group in particular: the disabled.

“We absolutely know this happens. It’s a huge problem,” said David Magnus, director of the Center for Biomedical Ethics at Stanford University. “It’s real people sitting in a room making these tough decisions, and it’s not surprising their own prejudices and biases influence them.”

 

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Childhood Cancer Survivors May Face Later Heart Risks

Monday, November 18th, 2013

Children who undergo treatment for cancer may be at greater risk of developing heart disease later in childhood, as well as in adulthood, according to a new study presented to the American Heart Association.  Researchers recommended that pediatricians monitor heart health carefully in their patients who have undergone cancer treatments.  More from The New York Times:

Scientists have known for some time that survivors of childhood cancer are several times more likely to develop cardiovascular disease as adults, a result of the toll that lifesaving radiation and chemotherapy treatments can have on the heart. But the new study, presented at an American Heart Association conference over the weekend, is among the first to show that the risk is elevated while the survivors are still children.

The research looked at 319 boys and girls under the age of 18 who underwent chemotherapy treatments for leukemia or cancerous tumors. At the time of the study, the participants were a minimum of five years past the time of their diagnosis.

When the children were compared with 208 siblings of similar ages, the researchers found a nearly 10 percent decrease in arterial health and other signs of premature heart disease.

Image: Baby undergoing treatment, via Shutterstock

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