Is Dozing During Daytime a Sign of Stroke or Even Heart Attack?

It is not uncommon to find people especially those older ones easily doze off during daytime. However, this may not be a healthy sign as this group of people is at high risk of getting stroke, as indicated by a study by United States researchers.

In the paper presented on February 21, 2008 at an American Stroke Association conference in New Orleans, researchers from Columbia University in New York reported that older people who easily doze off during the day have at least 4 times more likely to have a stroke. These people were also at a higher risk of heart attacks and other cardiovascular problems.

Even after the researchers took consideration for things like diabetes, hypertension (high blood pressure), obesity, physical activity and socioeconomic status, these people were much more likely to end up with stroke.

The study involved 2,153 adults with an average age of 73. The participants were mostly Hispanic men and women aged over 40 and lived in the same community in New York City. None of them had suffered a stroke.

It was found that those classified as doing 'some dozing' during the day had a risk of stroke that was 2.6 times greater for those with 'no dozing', and those who were in the 'significant dozing' group had a 4.5 times greater risk.

Questions on how often these participants dozed in specific situations such as watching TV, sitting quietly after a lunch without alcohol and stopping briefly in traffic while driving were asked. The findings shown that some 44 percent reported no dozing, 47 percent had some dozing and 9 percent reported significant dozing.

The researchers checked again after 2 and half years later to see how many of these participants had strokes or other vascular or heart disease problems like heart attack. 40 strokes and 127 other vascular or heart disease events were detected.

The researchers were not sure what causes the daytime sleepiness and whether this is related with sleep apnea. In fact, other studies have already found that people with sleep apnea who briefly stop breathing throughout the night are at high risk of stroke. Sleep apnea can cause daytime sleepiness too. They believe further investigation is necessary.

How Does Fat Accumulation Link to Diabetes?

Being overweight or obese, one is at risk of developing diabetes. Like it or not, he or she will have a much higher chance of getting heart disease and other medical conditions.

A recent study by researchers from Erasmus Medical Centre-Sophia, Children's Hospital, Rotterdam, the Netherlands argued that the amount of fat accumulation of people have as they grow into adulthood would affect their risk of developing Type-2 diabetes.

They found that fat mass of a person in adulthood was the only factor significantly related to insulin sensitivity. It has been known that reduced insulin sensitivity is a precursor to diabetes. As such, parents should be aware of the risk of fat accumulation in their children, independent of birth size or growth childhood.

There was research suggesting that low birth weight was linked to increased risk of Type-2 diabetes. Yet there were others proposing that the acceleration in growth in people who were born small but attain normal adult size has harmful effects on metabolism. Nevertheless, it is still not clear if people who are born small and catch up in body size or those remain small throughout their lifetime are at greater risk of getting Type-2 diabetes.

Insulin sensitivity of 136 young men and women were examined in the study. The participants consists of 4 groups: some were born small for gestational age and remained short as adults; some were born small but reached normal height in adulthood; some were of normal size at birth but grew up to be short adults; and some were born at normal size and remained normal size as adults.

At the end of the study, researchers discovered that fat mass in adulthood was the only measurement that showed a significant link with the insulin sensitivity. The group of men and women, who were born small but caught up in body size as adults, had significantly lower insulin sensitivity than the control group.

A so-called ‘fat accumulation hypothesis’ was then proposed in March 2008 by the researchers stating that ‘an increased accumulation of fat during childhood, independent of birth size, will result in reduced insulin sensitivity.’ They also believed growth acceleration in height and weight as such is not a problem as long as a normal amount of fat is accumulated.

In conclusion, the researchers urge all individuals, regardless of their size at birth, should try to achieve or maintain a normal fat mass for their body size.

Can Saliva Help Diagnose Heart Attack Faster?

When one is having a heart attack, timely treatment is very critical as this may decide whether he or she can survive. However, not all patients with syndromes like chest pain or cold sweat actually suffer heart attack. Likewise, many heart attack patients, especially women, show non-specific symptoms or have normal EKG readings. Therefore, timely diagnosis can be very difficult.

In April 2008, researchers from the University of Texas at Austin pointed out that a simple saliva test may one day be used to determine swiftly if a person is having heart attack because of the proteins found in the saliva. Such test can be used not only in ambulances but also in restaurants, drug stores and other places in the community.

A nano-bio-chip sensor was developed by the researchers. It is biochemically programmed to detect sets of proteins in saliva, which could determine if a person is currently having a heart attack or is at high risk of having a heart attack in the near future.

What the potential victim needs to do is to spit into a tube and the saliva is then transferred to credit-card-sized lab card, which holds the nano-bio-chip containing a standard battery of cardiac biomarkers. Then, the card is inserted into an analyzer to determine the patient's heart status in as little as 15 minutes.

56 people who had a heart attack and 59 healthy controls who did not were involved in a study. It was found that the test could actually distinguish heart attack patients from controls, with about the same diagnostic accuracy as that of standard blood tests.

In fact, there were about one third of the patients showing silent heart attack symptoms on EKG. These patients were required to admit to the emergency department to have blood test for enzymes that are indicative of a heart attack. The results of the test could be known after an hour to an hour and a half.

The saliva test could be used together with the EKG. This would help diagnosing those heart attacks that are silent on EKG. Meanwhile, larger and more refined studies on the saliva test have been planned.

Can Peer Pressure Prevent Youngsters From Smoking?

Being bad for our health, smoking has been accused as the culprit that causes heart disease, osteoporosis, stroke, and lung cancers. According to the World Health Organization (WHO), smoking kills about 4 million people every year, and some health experts even estimate the deaths from smoking worldwide would exceed 10 million by 2020.

A 2006 study indicated that 9.5 percent of worldwide students aged between 13 and 15 smoke cigarettes and those from European countries accounted for the highest rate at 19.1 percent.

As compared to using traditional posters, advertisements and comic strips to tell young people about the harmful effects of smoking, British researchers found that enrolling an influential student to convey the anti-smoking message to their schoolmates could be a feasible way of getting youngsters to stay away from smoking.

Researchers from the University of Bristol, western England, and Cardiff University in Wales carried out a project known as ASSIST to cover 59 schools in western England and Wales, involving 11,000 students aged between 12 and 13. Their findings were published on May 10, 2008 in the British journal The Lancet.

The researchers implemented the peer-pressure project, known as ASSIST in 30 schools while asked the remaining 29 schools to carry out their normal anti-smoking education to act as control group.

The students were first asked to nominate influential schoolmates in their year group. These individuals were then invited to a recruitment meeting where the researchers explained the purpose of being a 'peer supporter.'

After getting consent from their parents, these peer supporters participated in a 2-day training session held outside the school. The risks of smoking and the economic benefits of stopping were made known to them. Meanwhile, they were also taught the skills in communication, conflict negotiation and resolution and understanding self-esteem.

The training continued and was beefed up in 4 school-based sessions. Over the following 10 weeks, the 'peer supporters' began to interact with and disseminate the benefits of not smoking to the peers in their year group.

Students in schools where the ASSIST program was tried were 25 percent less likely to engage in regular smoking immediately after the intervention, as compared with the control group. However, the success rate gradually lowered over time, and the reduction was 15 percent after 2 years.

The ASSIST program was said to be popular among students and staffs in the schools where it was tried and the researchers pointed out that their results did support a shift in thinking on how to tackle smoking. For the past, anti-smoking campaigns have been targeted at cessation rather than prevention, and have been focused mainly on adults instead of youngsters.

Are People With Restless Leg Syndrome At Higher Risk of Heart Disease?

When a person has a strong, irresistible urge to move the legs that is often associated with an itching, tugging or gnawing feeling, he or she is said to have Restless Leg Syndrome (or in short, RLS).

When resting, the syndrome tends to worsen and this could cause a person difficult to fall or stay asleep. About 5 percent to 10 percent of adults have RLS, and some 80 percent of sufferers move their legs periodically during sleep.

A study, which was conducted by Harvard Medical School and Brigham & Women's Hospital in Boston, revealed that people with RLS were twice as likely to have a heart disease or stroke and those having severe syndromes were at higher risk. In fact, the association of RLS with heart disease and stroke was strongest in those people having RLS symptoms at least 16 times per month. The finding was published on December 31, 2007 in Neurology, the medical journal of the American Academy of Neurology.

3,433 men and women were enrolled in a sleep study with an average age of 68, and a detailed questionnaire indicated that nearly 7 percent of women and 3 percent of men in the study had RLS.

The researchers found that people with RLS were more than twice as likely to have heart disease or stroke, even after making adjustment for several risk factors such as diabetes, high blood pressure, high cholesterol levels, obesity and smoking.

While the results do not directly show that RTS can cause heart disease or stroke, the researchers argued that the periodic leg movements associated with RLS could well be a contributing factor.

According to the researchers, most people with RLS can have between 200 and 300 periodic leg movements per night of sleep. These leg movements are associated with substantial acute increases in both blood pressure and heart rate that may produce cardiovascular or cerebrovascular disease over the long term. Moreover, sleep deprivation may also be linked to heart disease.

Incidentally, the research, which confirms several smaller studies, was also supported by the National Heart, Lung and Blood Institute.

Depression Could Be Bad for Heart Attack Patients!

As defined by Merriam-Webster Dictionary, depression is a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies.

It is unavoidable that people would occasionally suffer certain degree of depression no matter how optimistic they are. Nevertheless, persistent depression could be bad for the body even for healthy persons, not to mention those already have heart disease.

In fact, Canadian researchers from McGill University, Montreal, Quebec found that persistent depression would mean worse physical health a year after heart attack or acute coronary syndrome (ACS).

In an attempt to investigate whether symptoms of depression during and after hospitalization for ACS would affect the health status, they studied 425 patients using Beck Depression Inventory (BDI).

BDI, which was created by Dr. Aaron T. Beck in 1961, was revised in 1978 as the BDI-1A, and subsequently published in 1996 as BDI-II. Being a 21-question multiple-choice self-report inventory, it is regarded as one of the most widely used instruments for measuring the severity of depression.

Based on a Beck Depression Inventory (BDI) score of 10 or higher, 123 patients (28.9 percent) had at least mild symptoms of depression during their stay in the hospital and 102 patients (24 percent) had at least mild symptoms of depression a year later.

For patients with signs of depression in the hospital, significantly poorer physical health status 12 months after ACS had been predicted, as compared with patients who had a Beck Depression Inventory score below 10.

Persistent symptoms of depression significantly predicted worse physical health at 12 months after ACS compared with physical health before ACS. However, new depressive symptoms showed only a non-significant trend to predict worse physical health.

Meanwhile, the study also showed that patients with fleeting symptoms of depression did not have a higher risk of poor physical health outcomes 12 months after ACS.

Based on their findings, researchers urge doctors to assess symptoms of depression, not only at the time of the acute ACS hospitalization, but also during the subsequent follow-up visits.

Anger and Stress Can Be Deadly for People With Heart Disease!

According to the American College of Cardiology, there are more than 400,000 sudden cardiac deaths in the United States every year. Previous studies also showed that earthquakes, war or even the loss of a World Cup soccer match could raise rates of death from sudden cardiac arrest. Sudden cardiac arrest is a condition in which the heart stops circulating blood.

Recently, a study by Yale University in New Haven, Connecticut indicated that anger and other strong emotions could trigger potentially deadly heart rhythms in certain people with heart disease. The paper was published on February 23, 2009 in the Journal of the American College of Cardiology.

62 patients with heart disease were studied by the researchers. They were equipped with implantable heart defibrillators or ICDs (implantable cardioverter-defibrillator), which are devices that deliver an electrical shock to restore a normal heartbeat when dangerous heart rhythms or arrhythmias are detected.

The patients were asked to recount a recent angry episode so that the research team could perform a so-called T-Wave Alternans test to measure electrical instability in the heart. By specifically asking questions to get people to relive the angry episode, the researchers found in the lab setting that anger did increase the electrical instability in these patients.

These patients were then followed for 3 years. The study found that people who had the highest anger-induced electrical instability were 10 times more likely to have an arrhythmia in follow-up.

The researchers suggested that anger could be deadly for people who are already vulnerable to this type of disturbance in the heart. However, how anger and stress might affect people with normal hearts is likely very different from how it might affect the heart with structural abnormalities. Therefore, they cautioned that people should not simply extrapolate their results to normal people.

Meanwhile, a study has been conducted by the same researchers to see if anger management classes can actually help reduce the risk of arrhythmia for patients who are at risk.

Heart Attack Symptoms in Women Can Appear Differently!

Instead of having chest pain, a 70 year-old woman was overwhelmed by dizziness before breaking out into a cold sweat. She alerted her son and immediately she was admitted to the hospital. Yes, she had a heart attack.

While pain, tightness or discomfort in the chest is commonly experienced by most heart attack patients, women may get symptoms quite different from these. For example, dizziness, nausea and even indigestion-like discomfort. It was estimated that about one-third of patients, who are elderly and female, might experience atypical symptoms during a heart attack.

A possible explanation is that most women suffer from heart attacks at an older age than men do. The physiology of ageing could make the chest pain in these women not as intense as that in younger patients. Therefore, other atypical symptoms may be predominant during an attack. Too often, these symptoms can be ignored or just go unrecognized. Studies have shown that up to one third of the heart attacks can go unrecognized in women, comparing to one quarter in men.

Central chest pain lasting more than 20 to 30 minutes is considered as one of the major criteria for heart attack diagnosis. Doctors might not consider a heart attack as the diagnosis if there are other symptoms presented. Moreover, a heart attack could frequently be confused with indigestion or an anxiety attack.

If a person already has some known risk factors for heart disease such as diabetes, hypertension (high blood pressure), high cholesterol or smoking, and feels persistently unwell with the symptoms indicated above, he or she should see a doctor at once for a more detailed evaluation. In fact, a simple ECG or EKG (electrocardiogram) can always diagnose a heart attack even if the symptoms are non-specific.

Although heart attacks do occur suddenly without any obvious preceding symptoms, some patients may notice increasing frequency or severity of certain symptoms. For instance, some might have chest pains on exertion or even at rest, while others might feel more breathless than usual when doing their normal daily activities.