Where You Live May Just Determine Your Blood Pressure Level!

If you live in a neighborhood where harmony exists, you will tend to be happy most of the time. On the other hand, if your neighborhood is one in which frequent collision between residents persists, I am sure you can hardly have good mood. Nevertheless, do you know that the state of your neighborhood will also determine the level of your blood pressure?

A study published in journal “Epidemiology” in July 2008 indicated that people who lived in neighborhoods with less crime, better grocery stores, a closer sense of community and more opportunities for exercise, would have a lower risk of high blood pressure, irrespective of the income and education level. Therefore, the researchers from the University of Michigan School of Public Health in Ann Arbor suggest that building better neighborhoods might also improve residents’ cardiovascular health. High blood pressure is known to be a risk factor for heart disease.

In area where walking in streets is safe and with recreational facilities and better access to healthy foods, people can exercise and maintain a healthy diet easier. In addition, stress may play a role because if people find their living conditions hard to relax and recover from daily stresses from work or elsewhere, their blood pressure might well be affected.

A large survey of cardiovascular health on 2,612 adults ages 45 to 85, lived either in New York City, Baltimore or Forsyth County in North Carolina, was used as the basis for the findings. In the survey, conditions in the mile surrounding the participants’ home, including things like whether they felt safe, whether nearby markets had a good selection of fruits and vegetables, and whether it was easy to walk in the neighborhood were asked.
The participants were also questioned about their neighborhood’s 'social cohesion', including if their neighbors were generally friendly and willing to help each other.

People who lived in the most walkable neighborhoods were found to be about one quarter less likely to have high blood pressure than those in the least pedestrian-friendly neighborhoods. Similar differences were also revealed when neighborhood safety, availability of healthy foods and social cohesion were being looked into. However, when participants' race and ethnicity were factored in, the links did diminish.

In conclusion, the researchers suggest that the characteristics of the neighborhood do play some role in the risk of high blood pressure. This also means that policies, which could improve communities (from fewer crime to more parks and better food choices), might just help improve people’s health.

Perhaps, you may want to access the state of your neighborhood should you intend to locate a new house in future.

Would Gastric Bypass Help Achieve Diabetes Remission?

Gastric bypass surgery is a procedure, which involves sectioning off a small portion of the stomach, to create a pouch to limit the amount of food for a person to take. Meanwhile, the surgeon will add a bypass to reroute food past the rest of the stomach and part of the small intestine so that calorie and nutrient absorption could be limited.

Previous studies had shown that such procedure could actually control Type-2 diabetes that is commonly associated with obesity. In the past, it has been thought that the surgery creates hormonal changes that help improvement in diabetes control.

However, the surgeons at Duke University Medical Center in Durham, North Carolina, showed in their latest study that while gastric bypass could cause important metabolic effects that rapidly improve Type-2 diabetes, the key is still the amount of weight patients lose in the first 6 months after surgery. The findings of the study were presented in the month of June 2008 at the annual meeting of American Society for Metabolic and Bariatric Surgery in Washington, DC.

The team studied 71 morbidly obese patients with severe diabetes, which were prescribed with high doses of insulin and oral medications for controlling their blood sugar levels. The purpose of the study was to find out factors that differentiate patients who go into remission from those who do not. “The amount of weight loss by the patient” was identified as the most important factor.

All patients were found to have a better diabetes control as evidenced by better long-term blood sugar levels and lesser medication. Yet, only 48 percent of the patients went into complete remission. According to the researchers, the hormonal effects of gastric bypass surgery are still important but the weight loss in the first 3 weeks to 6 months appears to be a critical factor in diabetes remission.

Morbidly obese patients usually lose about 10 percent of their body weight within 3 weeks of surgery and they can take less medication within the first day or two. This could be an effect on gut hormones, with dramatic improvements in insulin resistance, as explained by the researchers. Nevertheless, greater amount lost at a faster pace seems to improve the chance that patients will remain in remission.

In conclusion, the researchers believed that if the weight-loss effect of surgery could be enhanced by adding medications or rigorous behavior change, it is possible to do better than a 50 percent remission rate.

Is Finland Spared From Obesity Epidemic?

The number of people with overweight and obesity has been increasing at a horrible rate. For example, two-thirds of people in the United States are overweight. Even in Finland, every 1 in 5 adults is considered overweight.

As we know, when one is overweight or obese, he or she is subject to a much higher rate of developing heart disease, diabetes, high blood pressure, cancer, and many other complications. Therefore, obesity epidemic will definitely put tremendous pressure on the governments in terms of medical cost to deal with diseases associated with overweight or obesity.

A recent study found that women in Finland weigh on average almost 1 kilo (approximately 2.2 pounds) more than in 2002 yet obesity remains primarily a problem for male. The researchers from Finland's National Public Health Institute reported on July 21, 2008 that people in Finland are getting fatter at a steady rate for decades and this is obvious among young adults.

The report showed that during the past 5 years, men in Finland have gained an average of 500 grams (1.1 pound), whereas women have gained 900 grams (1.98 pounds). Interestingly, the weight index is the lowest among those people in the most educated group. Data also showed that 1 in 2 Finnish women are of normal weight, as compared to only 1 in 3 men.

According to the researchers, the increasing rate of obesity may well be attributed to the fact that people in Finland eat better quality food in large quantity yet exercise less. Meanwhile, Finns also smoke less than they did 5 years ago.

In fact, the problem in high blood pressure had been decreasing since 1972, but the decline had come to a halt due to the change to rising alcohol consumption. Since 2005, alcohol abuse has been the leading cause of death among Finnish males aged between 15 and 64.

Is Reducing Diabetes Risk That Hard for Men?

As we know, people with diabetes are exposed to a higher risk of developing heart disease and other medical complications, regardless of whether their diabetes is of Type-1 or Type-2.

For Type-2 diabetics, whether they are male or female, losing weight through diet and exercise are one of the alternatives that might just lower their risk of getting it. Nevertheless, men may have to work harder in order to have the same benefit.

Researchers at the University of Colorado Health Sciences Center in Aurora studied more than 1,100 adults at risk of Type-2 diabetes and found that those who aggressively perform calorie-cutting and exercise did lower their risk of getting diabetes over the next year. However, although men lost more weight and exercised more than women did, their diabetes risk was not greatly reduced by doing so. These findings were published in July 2008 in the Journal “Diabetes Care”.

In the study, participants were randomly assigned to either an intensive program of lifestyle changes or standard lifestyle advice. People in the former group had to lose 7 percent of their body weight by cutting calories and fat from their diet and exercising for at least 2.5 hours per week. Both men and women were 58 percent less likely to develop diabetes over the next year when they were put in the intensive group.

According to the researchers’ observation, men generally exercised more and were more successful at losing weight: 47 percent reached the 7-percent target compared with 37 percent in women. It is known that weight loss can actually be translated into a reduction in triglycerides (a kind of blood fat) and hence blood sugar could be better controlled. For male participants, the decrease in these 2 factors was greater than the female participants.

Interestingly, there was in fact no additional benefit for men when it was related to diabetes risk. The rates of return to normal glucose tolerance levels and the development of diabetes did not differ very much for both sexes.

One possible reason for such phenomenon is perhaps men had more diabetes risk factors to begin with. Therefore, the researchers suggested carrying out further studies to discover whether and how various diabetes prevention tactics would affect men and women differently.

Are Heart Tests Necessary for All Athletes?

The collapse of athletes during or after the match is not uncommon. For instance, in 2007, Sevilla footballer Antonio Puerta died 3 days after collapsing during a Primera Liga match, and in 2003, Cameroon's Marc-Vivien Foe died during a Confederations Cup match.

Figures revealed by the Italian researchers from the Institute of Sports Medicine at the University of Florence, show that one young athlete dies every 3 days from an unrecognized heart disease in the United States alone. Therefore, the researchers recommend mandatory heart screenings for all athletes as this could detect potentially fatal problems and save lives.

Their paper published on July 4, 2008 in the British Medical Journal indicated that exercise electrocardiograms could identify cardiac abnormalities among people who seek to take part in competitive sports. In their opinion, a family history and physical examination may miss many undiagnosed heart problems

The study analyzed data from more than 30,000 heart screenings over a period of 5 years (between 2002 and 2006). It was found that 1,459 people showed some form of heart problem during an exercise electrocardiogram and 348 people had abnormal results during their resting electrocardiogram. Only 159 of these people had serious conditions that prevent them from competing. Yet, only 6 of these athletes would have been identified through a family history and physical examination.

Incidentally, Italy is the only country where these tests are mandatory. The tests will cost 40 euro and is recommended by the researchers as mandatory in other countries.

The issue of pre-screening programs using electrocardiograms has been controversial. In fact, the American Heart Association had reaffirmed in 2007 their recommendation against universal use of electrocardiography, citing cost, low prevalence of disease and a high false positive rate. On the other hand, the European Society of Cardiology, International Olympic Committee and other sports league do endorse the screenings on grounds on grounds basis as some studies have found them effective.

A detailed personal and family history and physical examination will detect some athletes with underlying heart disease, but the addition of screening process using electrocardiograms will detect more athletes with silent cardiovascular disorders at risk of sudden death, as indicated by some health experts.

People Are Abandoning Their Healthy Diet!

Mediterranean diet, with its emphasis on fresh fruits and vegetables, has followers all over the world. It has been recommended and praised by health experts as one healthy diet that will keep people from being overweight, healthy and long living. As we know, overweight is a risk factor for many diseases like heart disease, diabetes, hypertension (high blood pressure), etc.

However, it seems that its popularity was dropping lately in some Mediterranean countries including Greece, Italy, Portugal and Spain. Instead, the people in these regions are now in favor of food that has too much fat, salt and sugar. This is the latest warning issued by the Food and Agricultural Organization (FAO), a United Nation body on July 29, 2008.

Growing affluence had altered the way people eat in Southern Europe, North Africa and the Near East. They had switched from their traditional diet, which is light on animal products to more meat and fatty foods. In other words, what they are eating now is just too fat, too salty and too sweet.

Because of higher calorie intake and less physical activities, the people in Greece have now the highest average body mass index and highest prevalence of overweight and obesity among the EU (European Union) member countries. In fact, 3 quarters of the Greek population are overweight or obese. Meanwhile, there is more than half of Italian, Spanish and Portuguese populations are overweight.

In the Near North-East Africa region, there is a significant increase in the overall calories and glycemic load of the diets as well. In general, people with a high glycemic index are prone to get health problems such as heart disease and diabetes.

According to the survey conducted on the 15 EU nations, citizens across the EU were generally ignoring the recommendations made by both the FAO and the WHO (World Health Organization) regarding the calorie intake. Statistics showed that the calorie intake for people in Greece, Italy, Spain, Portugal, Cyprus and Malta have increased by 30 percent.

Higher income is probably the only reason for people to change their eating habits. Things like development of supermarkets, working women having less time to cook and families eating out more often in fast food restaurants could also contribute to the change in eating habit. More importantly, the lifestyles of these people, who are consuming more calories, have become more sedentary as they exercise less.

Why Are Weight Gain For Type-1 Diabetics Not Big Deal?

Diabetics, who can be classified as Type-1 or Type-2, have high levels of sugar in their blood. For Type-2 diabetics, weight gain can be very bad for them. It is believed that this kind of diabetes is driven by rising rates of obesity and sedentary lifestyles.

On the other hand, Type-1 diabetes, previous known as juvenile diabetes, is an autoimmune disease, in which the body mistakenly destroys cells in the pancreas that make insulin.

The function of insulin is to convert sugar, or glucose, into energy. The excess sugar in the blood will damage organs including the eyes, kidneys and heart for both types of diabetes. Diabetics are at high risk of developing heart disease, kidney failure and blindness.

A recent study by the researchers at the University of Pittsburgh indicated that people who gained weight over time were less likely to die than others studied, while those classified as underweight were facing greatest risk for death. Even obese or overweight Type-1 diabetics were less likely to die.

The researchers tracked 655 patients with Type-1 diabetes for 20 years and found that those people who gained the most weight over time seemed to have lower mortality than those who gained less weight or lost weight. According to the researchers’ interpretation, Type-1 diabetics are often underweight. If they were able to gain weight, it means that they may also able to control their disease better. The findings were presented at a meeting of the American Diabetes Association in San Francisco during June 2008.

When statistically accounted for waist circumference (a risk factor for death), the researchers also discovered that overweight or obese patients were less likely to die when compared with patients with a normal weight.

Perhaps, based on the findings, the concerns on growing rates of obesity will have to be looked differently for Type-1 diabetics than for the general population. However, people should not take the results of this study as excuse for them to go out, eat, and put on weight.

Don't Ignore Snoring, It May Trigger Heart Attack!

When a person snores during the sleep, there is a possibility that he or she has a sleep disorder called as obstructive sleep apnea (OSA). Technically, an apnea occurs when there is a cessation of breathing for at least 10 seconds.

OSA is one in which tissues in the back of the throat temporarily collapse during sleep causing a series of interrupted breathing. Patients with OSA have extreme daytime sleepiness. OSA is usually associated with obese men and women. These people have thicker necks because of fat deposition that narrows the upper airway and aggravate obstructive apnea.

In fact, the blood pressure, nerve, and hormonal changes caused by OSA may raise the risk of heart attack during the night, as revealed by a new research. The findings of the study, carried out by researchers from Mayo Clinic in Rochester, Minnesota, were published in the Journal of the American College of Cardiology in July 2008.

OSA causes some changes in the body that may lead to blockage of the coronary arteries and heart attack. It is suspected that a peak of heart attack symptoms would be expected during the night.

92 heart attack patients were studied and documented at the time their chest pain began. They were then asked to undergo sleep tests 2 to 3 weeks after their heart attack. It was found that 70 percent (64) of the patients were diagnosed with OSA. Patients with and without OSA were generally similar in terms of their health background and current medications.

The researchers found that from midnight to 6am, the frequency of heart attack was higher in OSA patients. Meanwhile, it was higher in patients without OSA from 6am to noon. Furthermore, patients with OSA were 6 times more likely to have a heart attack at night in comparison with those without OSA.

The findings suggest that nighttime heart attacks may be the cause of the increased likelihood of nighttime sudden death that has been reported in OSA patients. Therefore, it is recommended that patients with a heart attack at night should be evaluated for OSA.

Is Distance Running A Dangerous Sport?

Taking part in a marathon is not easy and definitely not suitable for everyone because one needs to run for a distance of about 42 km. In October 2007, a 35-year-old police officer running in the Chicago Marathon collapsed and died. In Singapore, a 25-year-old army captain also died after finishing a half marathon in August 2007.

Does this mean that marathon is a dangerous sport? Before drawing any conclusion, let us hear what the experts have said about marathon.

In fact, statistics showed that sudden death during running a marathon is very rare. In Singapore, there is only one death in every 15,000 to 18,000 healthy runners each year. The more common one are ailments such as musculoskeletal and heat injuries, according to experts.

People with uncontrolled hypertension and ischemic heart disease should not take part in marathons. This is because unforeseen stresses from heat, dehydration and physical or psychological pressures could well strain the cardiovascular system. People suspected of other medical conditions should get a pre-race screen.

Once results of screening confirm one’s fitness for running marathon, he or she should then undergo adequate training. The runner should at least have completed a distance run of 30 to 32 km at some point during the training for a marathon. The purpose is to allow acclimatization to weather, testing the type of clothing need, knowing energy and fluid needs, and gauging body's limits.

Running for 42 km straight is very likely to wear out the body. The human body begins to experience fatigue as soon as the carbohydrate stores are depleted. Therefore, a high-carbohydrate meal should be taken before the big race to provided sufficient fluid and energy for a run. Meanwhile, do not try new food just before a race as this could cause gastrointestinal discomfort. Instead, opt for safe food choices such as bananas or power bars.

During the run, the runner should monitor his or her physical state because the day's temperature and humidity could also affect the body adversely. Under the hot weather, blood is diverted to the skin for heat dissipation. This, coupled with fluid loss from sweating, will affect the body's ability to deliver oxygen and energy to the muscles. Such disturbance of the body’s heat regulation would trigger the occurrence of heat stroke. The result could be fatal if multiple organ complications emerge.

Hence, the runner should be aware of such as high internal temperatures and significant changes in one's mental state. In addition, unusual chest pains or palpitations, disorientation or confusion could also indicate cardiac-related conditions and other injuries.

If runners could observe points mentioned above, they might minimize their risk of having fatal consequence during the marathon event.

Can B Vitamins Really Reduce Heart Risk for Women?

It is believed that a high level of homocysteine in the bloodstream could damage arteries and it has been linked to blood clots, strokes and heart attacks.

Homocysteine is a chemical compound, which is produced naturally by the body. In rare cases, some children may have levels that are out of control, and will be given heavy doses of folic acid and Vitamins B6 and B12 to break it down. Previous research has already shown that level of homocysteine will rise when one of these vitamins is insufficient. However, it is unclear if lowering elevated homocysteine levels in the “general population” will actually prevent heart disease.

A recent study by researchers from Brigham and Women's Hospital and Harvard Medical School in Boston showed that giving folic acid and B Vitamins supplements fails to protect women from heart disease. The findings, published on May 6, 2008 in the Journal of the American Medical Association, questioned whether addressing a marker for heart disease (in this case, homocysteine) can really prevent heart attacks or strokes.

The study followed female patients of age 42 or older for more than 7 years. These women, either were at risk for heart disease, or had already experienced heart problems. On a daily basis, 2.5 milligrams of folic acid, 50 milligrams of Vitamin B6, and 1 milligram of vitamin B12 were given to half the 5,442 participants, while a placebo was distributed to the rest.

During the 7-year study, it was observed that though no harm came from the B vitamins, the homocysteine levels fell by nearly one-fifth in the first group, yet there was no noticeable difference in the incidence of heart problems or heart-related deaths, as compared with the placebo group.

It is reported that large-scale studies examining homocysteine and the impact on heart disease are under way in Europe.

In the United States and Canada, folic acid has been added by law to white floor and grain products since the late 1990s. However, European flour is not routinely supplemented. Therefore, it is expected people in Europe will have homocysteine levels are likely higher and the impact of lowering them may be better seen.

Until further data become available, it is perhaps best to base on the available evidence. One should not forget that experimental and observational data do not always translate into therapeutic benefits.

Defibrillators May Save Lives In Public Places!

Every year, some 300,000 Americans die from sudden cardiac arrest, which should be differentiated from heart attack. In fact, a heart attack may actually cause sudden cardiac death either during the first few hours of the heart attack or up to many years after the attack.

We can consider sudden cardiac death as an electrical malfunction while heart attack as one that is caused by blocked arteries (plumbing malfunction). Sudden cardiac arrest is a potentially deadly event, in which heart stops contracting and fails to pump blood properly.

When such event occurs in public places like airport or shopping mall, any bystanders could save the life of the victim using automatic external defibrillator (AED). A study conducted by researchers at Johns Hopkins University in Baltimore reported that bystanders using battery-operated defibrillators might be saving more than 500 lives every year in the United States and Canada. The findings were presented at an American Heart Association meeting in Orlando, Florida, on November 5, 2008.

The automatic defibrillators are of laptop size and are portable. They come with full set of instructions so that even the untrained bystanders could be guided through the rescue process. The defibrillator analyzes the person's heart rhythm and delivers a shock when necessary through the electrodes placed on the victim’s chest.

In the study, the researchers analyzed patient records from more than 10,600 incidents of cardiac arrest called into 911 emergency telephone lines in the 11 cities in the United States and Canada.

It is found that bystanders administered CPR (cardiopulmonary resuscitation) in nearly 30 percent of the cases, while in 2.4 percent of the cases, bystanders offered CPR together with automated defibrillator. There was only 259 patients had been offered an AED by a bystander. Their survival is very good. If patients needed a shock and device shocked them, their survival rate is 36 percent, as compared to the overall rate of 7 percent.

Since the AEDs are available in public places, where people could get them fast in case of emergency, the survival rates with a defibrillator are about 2.5 times better than with the help of CPR alone.

The study advocates wider use of AEDs as the cost is considerably affordable. According to the researchers, for example, putting in AEDs in a building with 1,000 people will cost US$3,000, which is less than the price of a cup of latte.

Be Active to Stay Healthy and Biologically Younger!

It is not uncommon nowadays to find that most people, irrespective of their ages, are not keen to exercise or just keep themselves active. Why does such phenomenon prevail?

People’s favorite activities, such as watching round-the-clock television programs, surfing Internet, electronic games, do refrain them from moving away from the sofas or chairs. Such unhealthy lifestyle could even cause many of them become overweight or obese if they also eat whatever they like.

In fact, physically active people do not just look better, they too appear to be biologically younger, according to a study published on January 28, 2008 in the Journal of the American Medical Association's Archives of Internal Medicine.

Researchers from King's College London examined 2,401 Caucasian twins and found that those reported having an active lifestyle had biological markers that appeared to be as much as 10 years younger, comparing with their more sedentary twins.

Health experts always urge people to stay active because a sedentary lifestyle does raise the risk of aging-related disease like heart disease, diabetes, and high blood pressure, and premature death. In other words, inactivity may lower life expectancy not only by predisposing to aging-related diseases but also because it may influence the aging process itself.

The twins participated in the study were asked to fill out a questionnaire on physical activity level, smoking habits and socioeconomic status. Their blood samples were also taken. DNA was extracted from the white blood cells to examine the chromosomes in order to determine the length of a generic sequence called telomeres.

The length of telomeres decreased with age, with an average loss of 21 structural units per year. It is believed telomeres play an important role in the ageing process. Moreover, these telomeres were significantly shorter in the men and women who were less physically active in their leisure time. Such a relationship remained significant even after the adjustment for body mass index, smoking, socioeconomic status and physical activity at work.

The mean difference between the most active subjects, who averaged 199 minutes of physical activity per week, and least active ones who averaged 16 minutes of activity per week, was 200 nucleotides. This implies that the most active subjects had telomeres the same length as sedentary individuals up to 10 years younger. Similar results were also found when comparing twins with different levels of physical activity.

The researchers suggested that inflammation and damage caused to cells by exposure to oxygen are the likely mechanisms by which sedentary lifestyles shorten telomeres. Meanwhile, physical activity can also reduce psychological stress, which has also been linked to telomere length.

Sticking to the United States guidelines of 30 minutes of moderate-intensity physical activity at least 5 days a week can have significant health benefits.

What Is The Chance of Surviving Sudden Cardiac Arrest Outside Hospital?

There is no doubt that time is very critical if a person is to survive sudden cardiac arrest (heart attack). According to the American Heart Association, the chance of survival from sudden cardiac arrest decreases by 7 to 10 percent with every passing minute.

The average survival rate in Singapore for people who suffer from heart attack outside hospital is rather poor: between 1.5 percent and 3 percent. This is because of the small number of people here who are trained in CPR (Cardiopulmonary Resuscitation) and the limited effectiveness of performing CPR.

CPR is a technique that involves mouth-to-mouth rescue breathing and chest compressions. It helps artificially circulate oxygen-rich blood for the victims, keeping their brain and vital organs alive. In most cases of sudden cardiac arrest, the heart can also have an irregular rhythm, which can be corrected using an automated external defibrillator (AED).

AED is a portable computerized machine delivers an electric shock to re-establish normal heartbeats. Being easy to use, AED can allow non-medically trained people help save lives. The people who use it just need to follow the step-by-step instructions from the machine via voice prompt. In Singapore, AEDs have been installed at sports centers, stadiums and swimming pools, as well as major public places such as hotels and shopping centers.

The American Journal of Sports Medicine revealed that around 1 to 5 sudden cardiac deaths occur each year for every 1 million athletes below the age of 35. People with the age below 35 years old having sudden cardiac arrest are usually the result of coronary artery disease. Sudden cardiac arrest victims who are below 35 years old are due to a genetic disorder known as hypertrophic cardiomyopathy (HCM), an abnormal thickening of the heart muscle.

People with this type of disorder are predisposed to abnormal heart rhythms, which can be triggered during vigorous exercise. Though most of the reports of athletes dying from sudden cardiac arrest were men, this does not rule out women.

In fact, HCM could happen equally in both sexes. One possible reason for more reported cases of cardiac arrest in men is that men are more likely to engage in vigorous and competitive sports. In comparison, women's level of participation in intensive sports is much lower than that of men. That is why women are less exposed to exercise-induced cardiac arrest.

Recognizing the warning signs of a possible heart condition is very important. Those who get palpitations, breathlessness or dizziness, and those who have a family history of heart problems should consult their doctor.

Unfortunately, identifying athletes who are vulnerable to the condition is not so easy. Some heart problems cannot be detected in tests, and screening for rare congenital conditions can be expensive, too.

Nevertheless, people who want to engage in vigorous physical activity, such as marathons or hiking expeditions, are still urged to go for a thorough screening.