Diabetes Or Hypertension Link To Higher Sleep Apnea Risk

Obstructive sleep apnea (OSA) is a condition in which breathing repeatedly stops and starts during sleep. It is a potentially serious disorder since people with OSA are at risk of developing cardiovascular disease if it is not appropriately treated. During OSA, the sudden decline in blood oxygen levels would raise the blood pressure and strain the cardiovascular system. Besides cardiovascular disease, people with OSA can also have other complications including daytime fatigue and eye problems.

During the 27th Annual Meeting of the Associated Professional Sleep Societies, LLC (APSS) held between June 1 and 5, 2013 at the Baltimore Convention Center, the American Academy of Sleep Medicine (AASM) is advising people with Type-2 diabetes or hypertension to be evaluated for sleep apnea by a board-certified sleep medicine physician.

Patients suffering from Type-2 diabetes and hypertension are at much higher risk for OSA, as shown by overwhelming clinical evidence, Research also indicated that treating OSA could help manage these 2 disorders, including improved insulin sensitivity, blood pressure and cholesterol.

As revealed by Centers for Disease Control and Prevention (CDC), 25.6 million Americans aged 20 years or older suffer from diabetes. 90 to 95 percent of these patients are Type-2 diabetics. 7 in 10 people with Type-2 diabetes also have OSA, and it was found that the severity of the sleep disorder directly affects the glucose control.

Treating sleep apnea in diabetics could not only lower their nighttime glucose levels and insulin sensitivity but also provide them with benefits of improved sleep unrelated to diabetes, including better alertness during the day and improved memory as well as cognitive function.

According to a recent study by the University of Chicago, continuous positive airway pressure (CPAP) treatment of sleep apnea might have an effect comparable to prescribed oral diabetes medications.

In the study, average 24-hour glucose levels were reduced and post-breakfast glucose response was improved in Type-2 diabetics with OSA, with just one week of optimal CPAP. CPAP therapy also reduced dawn phenomenon, an early-morning surge in blood sugar in people with Type-2 diabetes, by 45 percent.

About 67 million Americans have hypertension, or 1 in every 3 adults. 30 to 40 percent of these patients also have sleep apnea. Approximately 80 percent of those who do not respond to hypertensive drugs have sleep apnea.

The nighttime and daytime blood pressure will decline with appropriate sleep apnea treatment. For patients with moderate to severe sleep apnea, the treatment would give them the greatest improvement. Reducing blood pressure would naturally lower the risk of cardiovascular disease and improve the overall health.

Less Salt More Potassium For Stroke Prevention!

About 98 percent of Americans consume an average 3436 milligrams of salt (sodium) daily, which is more than twice the recommended amount for a healthy diet, according to American Heart Association (AHA).

Higher intake of sodium is tied to a higher risk of developing hypertension (high blood pressure) that would eventually lead to heart disease and stroke, as suggested by many studies. However, little is known about that lower potassium consumption could also lead to high blood pressure.

Several studies published on April 4, 2013 in the ‘British Medical Journal’ (BMJ reported that less salt and more potassium in a person's diet could lower blood pressure and hence the risk of stroke. In the first study, researchers from the Queen Mary University of London and Affiliated Hospital of LuZhou Medical College, China argued that while the current recommendations to lower salt intake from 9-12 to 5-6 grams per day will have a major effect on blood pressure, a further reduction of 3 grams per day will have a greater effect and should become the long-term objective for population salt intake.

Using data collected from 34 trials consisting of 3230 participants, researchers examined people with hypertension and those with normal blood pressure. The results showed that notable decreases in blood pressure in both groups after 4 or more weeks of modest salt intake. The change in the diet did lower their risk of heart attack, heart failure as well as stroke.

The second study by a group of scientists from Britain, Germany and Switzerland found that lower salt intake reduced blood pressure yet had no negative impact on hormone levels, blood lipids, or kidney function, as shown by high quality evidence. A total of 56 reports were analyzed, 37 of which were of high quality. A reduction in sodium intake could lower blood pressure in kids, as demonstrated by moderate quality evidence.

Lower sodium intake was also linked to a reduced risk of stroke and fatal coronary heart disease in adults. The totality of evidence suggested that most people will likely benefit from lowering sodium intake.

Researchers from Britain and Switzerland examined data in the third study on potassium intake and health from 33 reports consisting of 128,644 healthy volunteers. The high quality evidence showed that higher potassium intake reduced blood pressure in people with hypertension but had no adverse effect on hormone levels, kidney function, or blood lipids in adults. Meanwhile, moderate quality evidence also indicated that higher potassium intake was linked to a 24 percent lower risk of stroke.

Link Between Restaurant Meal And Weight Gain

Since 1980, the number of obese American adults has doubled to more than 78 million, according to an estimate made by the Centers for Disease Control and Prevention (CDC). People who are obese are more likely to develop chronic diseases such as heart disease and diabetes. Meanwhile, obesity costs the American economy an estimated $147 billion a year in medical expenses and lost productivity.

Unhealthy diet and sedentary have been accused to be 2 of the important factors that cause the obesity epidemic. Fast food consumption is definitely linked to disease risk. However, the disease-promoting potential of meals from sit-down restaurants has not given enough attention.

A study conducted by researchers from the University of Toronto found that a single meal at a North American restaurant might contain more than half the calories an average person needs for the entire day. The findings were published in the ‘Journal Of The American Medical Association’ (JAMA).

Hundreds of meals at 19 sit-down chain restaurants were sampled and it was found that average breakfast, lunch and dinner meals each contained 1128 calories, or 56 percent of the daily 2000-calorie recommendation.

Salt, fat, saturated fat and cholesterol levels were also found to be extremely high in these meals, which contained 2269 milligrams of salt or 151 percent of the daily-recommended amount for most adults (1500 milligrams), 89 percent of the daily value for fat, 83 percent of the daily value for saturated fat, and 60 percent of the daily value for cholesterol.

In another paper also published in JAMA, researchers from Tufts University focused on dishes available at 33 small independent and small chain restaurants in the Boston area, and samples were taken from Mexican, American, Chinese, Italian, Japanese, Thai, Indian, Greek and Vietnamese restaurants.

Their findings showed that, on average, these meals contained 1,327 calories, which significantly exceeds the estimated energy needs of an individual adult at a single meal. Meanwhile, the researchers discovered that more than 75 percent of the meals contained at least 1000 calories and nearly 8 percent of meals contained 2000 calories. And surprisingly, they also found that calorie content was nearly 50 percent greater than that of popular meals from the largest national chain restaurants.

Italian meals had the highest average calories per meal (1,755), followed by American (1,494 calories) and Chinese (1,474 calories). Vietnamese meals had the least number of calories on average (922), and Japanese meals had the second lowest (1,027).

Obese Men Likely Hyperactive During Childhood!

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders for kids aged between 3 and 17. It can sometimes continue through adolescence and adulthood. The average age of onset is 7 years old.

The Centers for Disease Control and Prevention (CDC) in the United States revealed that nearly 7 percent of children and teenagers have been diagnosed with ADHD and boys are more than twice as likely to have such disorder as girls are.

Obese men are likely hyperactive during their childhood, according to a recent study. Researchers from New York University found that boys who were diagnosed with ADHD in elementary school were more likely to grow up to be obese adults than those who do not have the condition.

Their findings, which were published on May 20, 2013 in ‘Pediatrics’, indicated that participants with a history of ADHD were 8.6 kilos heavier than those without ADHD after surveying 2 groups of 41-year-old men.

Data was drawn from 207 white boys with ADHD at around 8 years old. They were followed as they grew up. Another group of teenage boys without ADHD were added to the study10 years later. These boys were similar to the original participants.

At the age of 41, 111 men from each group were still in the study and were asked to report their weight. It was found that men with a history of ADHD weighed 96.6 kilos on average and 41.4 percent of them were obese. In comparison, men without ADHD weighed 88 kilos on average and 21.6 percent of them were obese.

Some of the common symptoms of ADHD, such as lack of impulse control, difficulty paying attention and poor planning skills, can lead to unhealthy food choices and irregular eating patterns that continue into adulthood. These behaviors could be responsible for the weigh gain.

While the findings were based on male participants, the researchers suspected that the results could well hold true for women.

It is hoped that the new findings will prompt parents to help their children, especially boys, develop healthy eating habits, and they should pay special attention to the change in weight over time.

Being a global health concern, obesity is the culprit for many chronic diseases including Type-2 diabetes, high blood pressure, heart disease and stroke.

Smoking Ban Saves Life!

Among about 6 million deaths caused by smoking annually, more than 5 million are smokers while more than 600,000 are non-smokers being exposed to second-hand smoke. This is the statistics released by the World Health Organization (WHO). The annual number of death could rise to more than 8 million by 2030.

Smoking can cause not only cancer but also many other chronic diseases including heart disease, stroke and peripheral vascular disease. It will also raise the cost of health care and hinder economic development. Hence, many countries have implemented control to curb the number of smokers.

In July 2013, researchers from Georgetown University Medical Center in Washington and associates published a paper in the Bulletin of the World Health Organization reporting that the tobacco control measures implemented in 41 countries including Pakistan, Argentina and Italy between 2007 and 2010 will prevent some 7.4 million premature deaths by 2050.

These countries represented nearly one billion people or one-seventh of the world’s population in 2008. The total number of smokers in those countries was nearly 290 million in 2007.

Tobacco control measures, which include higher taxes on tobacco products, bans on adverts and controls on lighting up in public, were on track to persuade an estimated 15 million people not to smoke. Wider use of the controls could also lead to lower health care costs and higher birth weights for babies.

Increasing taxes and banning smoking in offices, restaurants and other public places were the most effective measures. The first method would prevent 3.5 million smoking related deaths, while the second would prevent 2.5 million.

A sharp drop in smoking rates was seen in Turkey as a result of control measures: from 47.9 percent in 2008 to 41.5 percent in 2012. The implemented measures include raising taxes on tobacco products to 75 percent of the final retail price, smoke-free air policies, warnings on cigarette packages, bans on advertising, promotion and sponsorship, and offering treatments to kick the habit.

Another study, conducted by a team of scientists based in the United States, Britain and India, revealed that banning smoking in the workplace and levying a tobacco tax could prevent more than 9 million deaths from cardiovascular disease in India over the next decade.

Smoking is blamed for the deaths of 1 in 5 men in India. The deaths from cardiovascular disease linked to tobacco use are projected to increase by 12 percent over the next 10 years. Their findings, which were published in ‘PLoS Medicine’, confirmed that smoke-free laws and increased tobacco taxes were the single 2 most effective measures. These 2 measures alone would reduce heart attack deaths by 6 million and stroke deaths by 3.7 million (a total of 9.7 million) over the next 10 years.

Sugary Drinks Linked To Higher Diabetes Risk!

According to the World Health Organization (WHO), more than 310 million people worldwide have Type-2 diabetes. In the United Kingdom, about 2.9 million people are affected by it.

Type-2 diabetes, the most common form of diabetes, is a long-term condition characterized by insulin resistance, which means the body does not use insulin properly. Patients with Type-2 diabetes will have high blood sugar. Long term complications from high blood sugar can include heart disease, kidney failure, stroke, blindness and even limb amputations.

Researchers from various institutions in Europe found that drinking just a can of sugar-laced soda drink a day increases the risk of developing diabetes by more than a fifth. The results were published in July 2013 in ‘Diabetologia’, the journal of the European Association for the Study of Diabetes.

In order to find out whether a link between sugary drinks and diabetes risk also existed in Europe, the researchers used data including 12,403 Type-2 diabetics and a random population of 16,154 people identified within EPIC (European Prospective Investigation into Cancer and Nutrition). These participants, who came from Britain, Germany, Denmark, Italy, Spain, Sweden, France, Italy, and Netherlands, were questioned about their diet, including how many sugary and artificially sweetened soft drinks and juices they drank each day. 

It was found that every extra 340 ml serving of sugar-sweetened drink increases the risk of diabetes by 22 percent, compared with drinking just 1 can a month or less. The risk was lowered to 18 percent after taking into account people’s total calorie intake and body-mass index (BMI), a measurement of body fat based on height and weight. But consumption of pure or diluted fruit juice was found not significantly linked to diabetes risk.

Consumption of sugary drinks increases the risk of developing diabetes beyond the effect on body weight, the researchers warned, people can be thin yet still develop diabetes.

Results of this study were similar to previous research showing that North Americans who consume sugary beverages have a 25 percent increased risk of diabetes. While an association between consumption of sugary drinks and higher risk of Type-2 diabetes was found, the study did not prove a cause-and-effect relationship.

Surge in diabetes cases are caused by unhealthy lifestyle. The International Diabetes Federation forecast that the number of diabetics worldwide will almost double to an estimated 552 million by 2030.

Heart Disease Prevention With Pets!

Pets have been thought to be human’s best friends. For nearly 25 years, researchers have shown that living with pets can provide certain health benefits to the pet owners.

For instance, pets can help lessen anxiety, reduce stress, depression and loneliness. Several studies also reported that heart attack patients who have pets survive longer than those without, and male pet owners have less sign of heart disease than non-owners.

A scientific statements written by American Heart Association (AHA) indicated that owning a pet, particularly dog, might help decrease a person's heart disease risk and is associated with lower levels of obesity, blood pressure and cholesterol.

The statement was published online on May 9, 2013 in journal ‘Circulation’, after reviewing previous studies of the influence of pets. The researchers also pointed out that of all pets, dogs appear most likely to positively influence the level of human physical activity.

Dog owners engage in more physical activity and walking, and are more likely to achieve the recommended level of physical activity than non-owners of dogs. An online survey of 5,253 Japanese adults, quoted in the statement, revealed that dog owners engaged in significantly more walking and physical activity than non-owners, and were 54 percent more likely to achieve the recommended level of physical activity.

While there is a substantial body of data suggesting pet ownership is linked to a reduction in cardiovascular disease risk factors and increased survival in individuals with established cardiovascular disease, these studies could not prove owning a pet can directly cause a reduction in heart disease risk.

Hence, people should not simply adopt, rescue or buy a pet solely for the purpose of reducing cardiovascular disease. The researchers stressed that further research, including better quality studies, should be carried out to more definitively find out whether the act of adopting or acquiring a pet could lead to a lower risk in getting cardiovascular disease in those with pre-existing disease.

According to the American Pet Product Association 2011-2012 National Pet Owners Survey, about 78.2 million people in the United States own a dog and 86.4 million have a cat. However, based on the report by the Centers for Disease Control and Prevention (CDC), pet owners are still just as likely to be overweight as people without pets.

Heart disease prevention cannot be achieved by just owning a pet. It is possible that taking care of a pet requires its owner to get more exercise that can lower stress, weight and blood pressure, and benefits the heart. If a pet owner still sits on the couch and eats whatever they want, and smoke and does not control the blood pressure, then there is no benefit at all.

Is Blood Pressure Higher At Night?

High blood pressure, also known as hypertension, is a major risk factor for heart disease and stroke. It is a cause of chronic kidney disease, too. Affecting over 12 million people in the United Kingdom, hypertension is the single most important preventable cause of premature death.

While it is possible to improve blood pressure control by dietary and lifestyle changes, medication is often needed for patients for whom lifestyle changes are insufficient or ineffective. Meanwhile, regular blood pressure monitoring is also paramount for effective blood pressure control.

Nighttime blood pressure has been thought to be a strong predictor of both heart disease and stroke and previous studies had indicated that blood pressure measured over the arm falls at night during sleep.

However, the new data collected by researchers from University College London (UCL) using the new technology showed that the nighttime decline in blood pressure might be less extensive than previously thought. The findings were published in the June 2013’s issue of the journal ‘Hypertension’.

With the support by the National Institute for Health Research (NIHR), they developed a portable wrist watch-based device together with a Singaporean technology company (Healthstats International). The device contains a sensor in the strap that detects the pulse wave at the wrist, rather than measuring the pressure directly. By mathematically modeling the pulse wave, pressure at the aortic root (close to the heart) could be measured accurately over a full 24-hour period, without disturbing the person being monitored.

Patterns of brachial blood pressures (in the arm) and central aortic pressures (where blood exits the heart) were measured at the same time. Though similarities in the circadian rhythms of brachial and central aortic pressures were found, there was a significantly reduced nighttime dip in central aortic pressure relative to the corresponding nighttime dip in brachial pressure. The pressures by the heart do not dip as much during sleep as previously thought based on conventional pressure measurements taken from the arm.

The findings suggested that nocturnal aortic pressures are disproportionately higher than brachial pressures during sleep. Such information is very useful for professionals who are investigating the damage in the brain and heart caused by high blood pressure, and can have significant implications for the evaluation of future therapies. This would probably change the way high blood pressure is measured and treated.

Since the new developed watch can be worn continuously, it is possible for the health experts to program the device to sample the pulse wave day and night, and obtain measurements of the aortic pressure over a 24-hour period.