cardiac


Can 4 Red Bull really kill a man ?

2 years ago, a Bolivian man working in Oxfordshire, UK died of heart attack after consuming 4 cans of the ‘It gives you wings’ energy drink, Red Bull

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Last week, Oxfordshire coroner recorded a verdict of “death by unascertained natural causes” which he compared the death to sudden adult death syndrome which is linked to cardiac illness.

What killed Alfredo Duran since the coroner stated that he was healthy and Red Bull has such a long sale record as far back as 1982 and had since sold 3.5 billion drinks in 140 countries in 2007?

Overdose of caffeine and an enlarged heart are probably the resultant cause.

As he had to work up to five night shifts a week, 40-year-old Alfredo, a father-of-two was known to consume at least 4 cans of the Red Bull each night. The amount of caffeine found in him although not fatal by itself, could have triggered a card­iac arrest for someone who has already an enlarged heart. According to the pathologist, this will not have any effect in people with a normal heart.

Looking at a chart from the American Beverages Association, taking a can of Red Bull is pretty close to a cup of instant coffee (hmm, Sprite & 7-Up no caffeine).

Although caffeine is not addictive, a consumer may go for additional can of energy drink to stay awake once he starts to lose that peppy feeling.

However, it is also known that when people take too much caffeine, side effects like nervousness, insomnia and elevated blood pressure will be experienced. That being the case, one can imagine how it will be like downing 4 cans of the Red Bull. In fact, some countries banned it because of fears of causing high blood pressure.

Still, Red Bull said that “clin­ical tests and toxicological evaluations by independent experts had concluded it was safe to drink for adults” . Just don’t drink more than 2 cans, they said. Understandably, they are in a market which according to market research firm ACNielsen clocked $4.7 billion in 2007 up from $3.5 billion in 2006 and expecting to grow to $10 billion by 2010.

Yes, many consumers will swear by it as several studies have indicated that energy drinks may help boost cognitive performance, verbal reasoning and attention levels. However, other experts are saying that there is nothing unique in them that sustain the alertness. Rather, it is the work of the high sugar and caffeine in them which one can easily get from other sources like coffee and candy bars.

For me, no coffee during my “night-shift” writing this blog. I will just head for the aromatic kopitiam’s coffee-O in the morning.

5 + 4 about Good Cholesterol.

Cholesterol, the fat-like substance is the word that most people especially the middle-age group and above hate to hear.

It is a constant advice that we should all cut down or avoid red meats, seafood and products from animal fats because they are high in cholesterol or are high saturated fatty acids which will raise the triglycerides (a form of fat made in the body) and cholesterol levels in the body. However, for most people, without the wonderful delicious pork, beef, mutton, liver, skin of poultry, ham, bacon; drunken prawns, chilly/pepper “Sri Lanka” crabs, “hum/tua tao/lala” (clam), “sotong” (squid, cuttlefish), lobsters; butter, lard, egg yolk, etc., life will be meaningless.

That is just negative which we remembers. The flipped side is that our body needs cholesterol for functions such as making hormones. Besides being found in those products above, it is also produced in our body.

There are good and bad cholesterols. They can’t dissolve in the blood and have to be transported through the bloodstream in different carriers called lipoproteins. Low-density lipoproteins (LDL or “bad” cholesterol) deliver cholesterol to the body, while high-density lipoproteins (HDL or “good” cholesterol) take cholesterol out of the bloodstream to the liver which will then passes them out of the body.

We are told the higher your HDL cholesterol, the better it is. Now, I learned that biological reality is more complex as genes direct the body’s production of HDL and that many of us might not be lucky enough to inherit genes that result in a lot of HDL. Luckily, genes are only part of the story because lifestyle factors and, to a smaller extent, medications can strongly influence HDL levels.

The National Cholesterol Education Program (NCEP) and the American Diabetes Association advise people to aim for HDL levels of at least 40 mg/dL. An even more protective goal, according to the NCEP, is 60 mg/dL or higher.

Why is having high HDL cholesterol is important?

At first, scientists believed that HDL was simply a garbage collector that picked up cholesterol from an artery’s walls and delivered it to the liver for disposal. That’s still considered the main role of HDL, but research is starting to suggest that HDL can help protect the heart in many ways:

  • Reverse cholesterol transport. HDL latches onto LDL embedded in an artery wall, lugs it back into the bloodstream, and carries it to the liver. The liver collects cholesterol from the HDL particles, packages it into bile salts and bile acids, and dumps it into the intestines for excretion.
  • Antioxidant activity. LDL cholesterol in the artery wall is bombarded by oxygen free radicals, which turns it into oxidized LDL cholesterol. Oxidized cholesterol is the stuff that’s actually responsible for arterial damage — and research shows that HDL can help protect LDL cholesterol from free radicals.
  • Anti-inflammatory action. HDL helps to quiet the inflammation of an atherosclerotic plaque. Elevated levels of C-reactive protein (CRP) reflect the inflammation of such a plaque and HDL may neutralize CRP’s tendency to perpetuate the inflammatory cycle.
  • Antithrombotic activity. Plaque rupture triggers the formation of an artery-blocking blood clot. By halting the flow of oxygen-rich blood, the clot kills heart muscle cells (heart attack) or brain cells (stroke). HDL reduces clot formation and accelerates the healing process that dissolves clots.
  • Endothelial function. Blood vessels plagued with atherosclerosis sustain other damage. In particular, the endothelial cells lining the arteries fail to produce normal amounts of nitric oxide, the chemical that allows arteries to dilate (widen) when tissues need more oxygen. HDL helps preserve nitric oxide production and protect endothelial function.

How much does HDL help?

The Framingham Heart Study was responsible for many landmark discoveries about HDL cholesterol, and the Physicians’ Health Study helped confirm that HDL was protective, reporting that various HDL subtypes are all helpful. Data continue to show that the good cholesterol is very good indeed.

  • Heart disease. Low HDL levels are associated with an increased risk of heart attacks, while high levels are protective. According to the Framingham Heart Study, cardiac risk rises sharply as HDL cholesterol levels fall below 40 milligrams per deciliter (mg/dL). In general, each 1 mg/dL rise in an HDL cholesterol level can be expected to cut cardiac risk by 2% to 3%.
  • Stroke. Strokes come in many forms, but the most common type, ischemic stroke, shares many risk factors with heart attack. High HDL cholesterol levels reduce the risk of stroke; in several studies, HDL cholesterol is a much better predictor of risk than LDL cholesterol, particularly in people older than 75.
  • Erectile dysfunction. Normal erections depend on many things, including healthy arteries that produce good amounts of nitric oxide. It’s no surprise, then, that the Massachusetts Male Aging Study found that 16% of men with low levels of HDL cholesterol had erectile dysfunction, but none of the men with the highest levels did.
  • Longevity. Several investigations suggest that high HDL levels are linked to longevity, particularly exceptional longevity. Other research links high levels of HDL cholesterol to preserved cognitive function in old age. More research is needed to learn if HDL deserves the credit or if other genetic factors are responsible.

Ways to raise your HDL

  • Exercise. Exercise is an important way to boost HDL levels. On average, sedentary people who start to exercise regularly can expect their HDL levels to rise by 3% to 20%. The benefit can occur with as little as one mile of walking or jogging a day, but the more you do, the better your result. Brisk walking for 40 minutes a day is a good target, but if you need more help, aim higher.
  • Watch your dietary fats. Saturated fat won’t affect your HDL cholesterol, but it will raise your LDL cholesterol. The latest American Heart Association (AHA) guidelines call for limiting saturated fat to less than 7% of your total daily calories. Reduce your intake of trans fats to less than 1% of your total daily calories. Trans fat lowers HDL cholesterol and raises LDL cholesterol, a double whammy to health. But unsaturated fats like virgin olive oil may boost HDL levels, and the omega 3 fats in fish, nuts, and canola oil may promote cardiac health even if they don’t affect your HDL reading.
  • Watch your carbs! Or at least the types of carbs you’re eating. Diets that provide large amounts of rapidly absorbed carbohydrates are clearly linked to low levels of HDL cholesterol. Avoid highly refined carbohydrates in favor of coarsely ground, whole grain, unrefined carbs like whole grain bread, oatmeal, and beans.
  • Alcohol. Moderate drinking will raise HDL levels by about 4 mg/dL, which should cut cardiac risk by about 10%. This translates to one to two drinks a day for men, and one drink a day for women. For this “prescription,” count 5 ounces of wine, 1½ ounces of liquor, or 12 ounces of beer as one drink.
  • Weight control. Obesity is linked to low HDL levels, but weight loss can help. Exercise and diet are the dynamic duo for weight loss, but shedding excess pounds will boost HDL levels over and above the independent effects of regular exercise and a healthful diet.

9 ways to protect your heart from diabetes

Diabetes and heart disease often go hand in hand. Here’s how you can uncouple them.

Diabetes and heart disease were once thought to be entirely unrelated disorders. New thinking suggests that they may actually spring from the same underlying cause — chronic, systemwide inflammation — or at least be influenced by it. This intertwining is a bad thing, since developing diabetes usually means developing heart disease as well. It also has a silver lining: Protecting yourself against one of these chronic conditions works against the other, too.

More than one million Americans are diagnosed with type 2 diabetes each year. Traditionally, up to 80% of people with diabetes develop some form of cardiovascular disease, from heart attack and stroke to peripheral artery disease and heart failure.

The connection between the two diseases isn’t ironclad. The American Heart Association and the American Diabetes Association have joined forces to fight both heart disease and diabetes. Their latest effort focuses on helping people with diabetes whose hearts seem healthy keep them that way.

As you scan the tips below, remember that almost every recommendation is good for diabetes as well as heart disease.

1. Know your risk

Goal: Knowledge is power. Calculate your risk of heart disease, or ask your doctor to do it.
Getting there: The Framingham calculator is a general heart disease–risk estimator. Specific ones for people with diabetes have been developed by two diabetes groups.

2. Exercise

Goal: Aim for at least 150 minutes a week of moderate exercise (like walking) or 90 minutes of vigorous exercise.
Getting there: If you do just one thing on this list, choose exercise. It is a key to controlling blood sugar, strengthens the heart and lungs, improves blood pressure, corrects out-of-whack cholesterol, and has other beneficial effects.

3. Control your weight

Goal: If your weight is in the healthy range, work to keep it there. If you are overweight, try to lose 5% to 7% of your weight over the next 12 months. (That’s about a pound a month for someone weighing 200 pounds.)
Getting there: Cutting out just one 12-ounce can of sugared soda a day (150 calories) is enough to help you lose a pound a month. You can easily double that by burning more calories with exercise.

4. Improve your diet

Goals:

  • Cut back on unhealthy fats: Lower saturated fat to under 7% of calories (about 17 grams), and keep trans fat intake as close to zero as possible.
  • Add more unsaturated fats from fish, grains, and vegetable oils.
  • Include at least 30 grams of fiber a day.
  • Watch the salt — reduce your intake to under 2,500 milligrams a day.
  • Choose whole grains and other slowly digested carbohydrates.

Getting there: The foods you eat can help you control blood sugar and protect your arteries. The main strategy is to get more fruits, vegetables, beans, whole grains, fish, and vegetable oils (especially olive oil), and less fast food, salty or fried food, and rapidly digested carbohydrates. There is no one-size-fits-all “diabetes diet.” The American Diabetes Association released a comprehensive set of nutrition recommendations in January 2007. But rather than trying to wade through these, ask your doctor to refer you to a nutritionist.

5. Lower your blood pressure

Goal: A healthy blood pressure is 120/80 or below. If you have high blood pressure, aim for a systolic pressure of 130 or lower and a diastolic pressure of 80 or lower.
Getting there: Measure your blood pressure often; home monitors are a good investment. If it is above the goal, try exercise, the DASH diet, and, if needed, weight loss, smoking cessation, or medications.

6. Control your cholesterol

Goal: Aim for and LDL under 100 mg/dL, an HDL above 40 mg/dL, and triglycerides under 150 mg/dL.
Getting there: A healthful diet and exercise can do a lot to reverse risky lipid levels. A cholesterol-lowering statin can help protect against heart attack and stroke even when LDL levels are near the recommended goal. Niacin or a fibrate can improve HDL and triglyceride levels.

7. Quit smoking

Goal: If you smoke, try to stop. Avoid secondhand smoke whenever possible.
Getting there: The most effective quitting strategy includes talk therapy plus nicotine replacement therapy along with drugs such as bupropion (generic, Wellbutrin, Zyban) or varenicline (Chantix).

8. Control your blood sugar

Goal: Aim for hemoglobin A1c to be at least under 7% and, ideally, as close to 6% as possible without causing bouts of low blood sugar.
Getting there: Managing carbohydrate intake and switching to whole grains can help ease the blood sugar roller coaster. Exercise is vitally important. Use medications such as metformin, thiazolidinediones, and insulin as needed.

9. Prevent clots

Goal: Take a low-dose aspirin (75–162 milligrams) every day unless your doctor tells you not to.
Getting there: Aspirin prevents platelets from latching onto each other, an early step in clot formation. Preventing clots helps prevent heart attack and stroke.

For more information on controlling diabetes, order the Special Health Report, Healthy Eating for Type 2 Diabetes, at www.health.harvard.edu/HED.

Risk of stroke doubles with type 2 diabetes

Extracted from the following the University of Alberta’s new research that recently appeared in the American Heart Association’s Stroke journal :-

1. Individuals diagnosed with Type 2 diabetes are at double the risk of having a stroke compared to those without diabetes

2. Compared to persons from the general population of a similar age, the relative risk for stroke was much greater in younger persons with diabetes than for older persons.

3. it is possible that physicians are under-treating stroke risks because of a prevailing attitude among physicians and patients that the cardiovascular complications of diabetes occur long after diagnosis rather than in the first five years.

Increase in obesity and diabetes but decrease in deaths from Coronary Heart Disease (CHD) 

Epidemiologists at the University of Liverpool and the Heart of Mersey have found that approximately half the recent fall in coronary heart disease deaths in the US is due to positive life style changes and a further half to medical therapies.

The team found that a decrease in smoking, cholesterol, blood pressure and physical inactivity contributed to the fall in deaths from coronary heart disease, yet this decrease could have been substantially more had it not been for the increases in obesity and diabetes cases.

Coronary heart disease (CHD) death rates in the US almost halved between 1980 and 2000. To understand how this fall occurred scientists combined information on medical treatments with national changes in the levels of major risk factors, such as smoking and high cholesterol. The UK has seen similar falls in heart disease, but this fall is mainly attributed to healthier diets rather than medication.

From 1980 to 2000, the US death rates for CHD fell from 543 to 267 per 100,000 population among men and from 263 to 134 per 100,000 population among women. Overall there were 341, 745 fewer CHD deaths in 2000 than in 1980.

The team found that this decrease was attributed to reductions in risk factors such as total cholesterol, systolic blood pressure, smoking and physical inactivity. However, they found that this reduction could have been 15% more had it not been for an increase in obesity and diabetes. Approximately half the fall in CHD deaths was also attributed to medical treatments, including medications for heart failure and emergency treatments for heart attacks and angina.

Professor Simon Capewell, from the University of Liverpool’s Division of Public Health and Trustee at CHD prevention charity, Heart of Mersey, said: “Using a sophisticated computer model called IMPACT we were able to combine and analyse data on the uptake and effectiveness of specific cardiac treatments and changes in risk factors among adults aged 25 to 84 years in the US. Data included results from trials, official statistics and national surveys.

We found that CHD death rates halved, and 47% of the fall was attributed to medical treatments and approximately 44% to changes in risk factors. Prevalence of smoking, for example had fallen by 12%. Decreases in physical inactivity however, were offset by increases in body mass index and diabetes.

Robin Ireland, Chief Executive at Heart of Mersey, added: “We have recently seen similar falls in heart disease here in the UK. These changes mainly reflect healthier diets, not tablets. However the increase in obesity and diabetes are a wakeup call. They reflect the increasing consumption of large helpings of junk food. We need legislation to encourage food manufacturers and supermarkets to provide healthier food options.

Source:  News release issued by University of Liverpool.