Diabetes – Heart Health

 

The INTERHEART study, funded by the Canadian Institutes of Health Research, shows that the risk of heart attack crosses geographic boundaries and correlates strongly to the so-called Western diet that favors salty snacks and fried foods, and to a lesser extent, meat. The risk, spread over five continents, is 30% higher for those who eat a Western diet, the study shows, than for those who adhere to a “prudent diet,” or one rich in fruits and vegetables. An Oriental diet, which is high in tofu and other soy products, doesn’t seem to lower or raise heart attack risk overall, according to the study. Researchers out of McMaster University in Ontario, Canada, examined dietary trends among more than 16,000 participants in 52 countries who were recruited between 1999 and 2003. One-third of the participants, or 5,761 people, were interviewed after having a single heart attack; the remaining 10,646 had no known heart disease, including angina, and did not suffer from diabetes, hypertension, or high cholesterol. The mean age of participants was between 53 and 57 years old. The study categorized eating patterns as Western, Oriental, and prudent. Participants answered written questions and were interviewed by medical personnel about their consumption of 19 food categories, including leafy greens, pickled foods, dairy products, and desserts. All answers were scored according to dietary risk. The study accounted for other risk factors like smoking, body mass index, age, physical activity, sex, and geographical region in assessing overall heart attack risk. It did not track long-term changes in regional eating habits and their link with health problems. Researchers concluded that the higher the regular intake of fried and salty foods, the higher the risk of heart attack regardless of which region of the world one resides in; prudent dietary habits carried the lowest risk. An Oriental diet seemed to be protective against heart attack in some regions of the world, but was not the best hedge overall, perhaps because of the high salt content of soy and other sauces common in the dining choices.  “The objective of this study was to understand the modifiable risk factors of heart attacks at a global level,” says Salim Yusuf, DPhil, the study’s senior author. “This study indicates that the same relationships that are observed in Western countries exist in different regions of the world.” Yusuf is a professor of medicine at McMaster University and is director of the Population Health Research Institute at Hamilton Health Sciences in Ontario, Canada. The study acknowledges that serving sizes and preparation technique (the type of fat used in cooking, for example) could play a role in increasing heart attack risk in participants adhering to a Western diet.  http://www.webmd.com/heart-disease/news/20081020/western-diet-is-a-global-heart-risk

 

Oct. 27, 2008 — A review of 40 clinical drug trials failed to produce reliable conclusions about the effects of oral diabetes medicines on cardiovascular health, despite controversy over the drug Avandia. However, researchers at the Johns Hopkins Bloomberg School of Public Health did find that metformin seemed to be associated with a decrease in heart disease and heart-related deaths Despite a finding that the drug trials, most of them short-term, were not comprehensive enough to yield the best data, researchers point to metformin as a drug that is “moderately protective” and Avandia as “possibly harmful.” The earlier analysis of the effect of diabetes drugs on cardiovascular health, reported in TheNew England Journal of Medicine in 2007, showed that Avandia, which works well to reduce blood sugar, was associated with a higher risk of heart attack. However, researchers in that case also acknowledged that their conclusions were limited by a lack of access to original clinical data. http://www.webmd.com/heart-disease/news/20081027/do-diabetes-drugs-affect-heart-health

– It may be possible for people with type 2 diabetes to reverse a heart threat without surgery, a new study shows. The study included 358 people with type 2 diabetes who took stress tests to check their heart’s health. The stress tests showed that a fifth of the patients had silent myocardial ischemia. Translation: Those patients had no heart disease symptoms, but their heart muscle didn’t get enough oxygen during the stress test. Heart muscle needs oxygen, which it gets from blood. Blood flow to the heart muscle suffers if the coronary arteries narrow. Ischemia (and possibly a heart attack) can be the result. The patients and their doctors were free to pick any ischemia treatment. None of the patients got surgery, but they tended to start taking at least one of the following medications:
Aspirin
Statin drugs, which lower LDL (“bad”) cholesterol
ACE inhibitors, which lower blood pressure

Three years after their initial stress test, the patients repeated the stress test. The researchers expected that the patients’ ischemia would have worsened. But they were wrong. Of the 71 patients who had ischemia at the study’s start, 56 patients (79%) no longer had ischemia three years later. That finding was “striking and unexpected,” write Yale University’s Frans Wackers, MD, and colleagues. The researchers aren’t sure that the medications reversed ischemia. For instance, the study doesn’t show whether the patients also got serious about their diet and exercise after learning they had silent cardiac ischemia, or which medications helped most. The surprising results deserve further research, Wackers and colleagues conclude.
http://www.webmd.com/heart-disease/news/20071026/diabetes-heart-help-without-surgery

 

Potassium and Your Heart

Potassium is a simple mineral with a crucial job: helping your heart beat. A hundred thousand times a day, potassium helps trigger your heart’s squeeze of blood through your body. If you have high blood pressure, heart failure, or heart rhythm problems, getting enough potassium is especially important. And although potassium and cholesterol aren’t directly related, eating a potassium-rich diet just might lower your cholesterol, too.

Potassium: Abundant and invisible

Potassium exists in abundance in soil and seawater. A healthy amount of potassium is essential to all plant and animal life. A critical electrolyte, potassium allows our muscles to move, our nerves to fire and our kidneys to filter blood. The right balance of potassium literally allows the heart to beat. Most people get plenty of potassium just by eating a normal American diet. The main source of potassium in our food is fruits and vegetables. Dairy products, whole grains, meat, and fish also provide potassium.

Excellent sources of potassium include:

• potatoes
• tomatoes
• avocados
• fresh fruits (bananas, oranges, and strawberries)
• orange juice
• dried fruits (raisins, apricots, prunes, and dates)
• spinach
• beans and peas

Eating a diet rich in fruits and vegetables is the best way to get enough potassium. You’ll also get the other benefits of a high fruits-and-veggies diet. Those include:

• reduction of heart disease risk
• lower cancer risk
• lower risk for obesity

Potassium and your heart

In healthy amounts, potassium is a heart-friendly mineral. Potassium doesn’t treat or prevent heart disease. Numerous studies show, though, that getting enough potassium has heart-healthy benefits in several important ways.

Potassium and high blood pressure

In one major study of people with high blood pressure, taking potassium supplements reduced systolic blood pressure (the top number) by about 8 points. But you don’t have to pop potassium pills to get the heart-healthy benefits. A diet high in fruits and vegetables (good sources of potassium) and fat-free or low-fat dairy foods can help lower systolic blood pressure by more than 10 points in people with hypertension.

Potassium and high cholesterol

A direct link between potassium and cholesterol hasn’t been established. But it’s interesting that many diets proven to lower cholesterol are also high in potassium. If you have abnormal cholesterol levels, you’re at higher than average risk for heart disease. The same goes for anyone with any of the other risk factors for atherosclerosis:

• smoking
• high blood pressure
• age over 55 for men or 65 for women
• lack of exercise
• obesity

Taking potassium isn’t known to reduce the risk of heart attacks. But by making sure you’re taking in enough potassium, you’ll probably end up eating more fruits and vegetables. A healthy diet — high in fruits and veggies and low in saturated fat and cholesterol — can help cholesterol levels and reduce the risk of heart disease

Potassium and abnormal heart rhythms (arrhythmias)

For people with abnormal heart rhythms, potassium may be even more important. Potassium is hiding inside every heartbeat. Each heart muscle needs just the right potassium balance in order to contract in a coordinated fashion.

People who’ve had abnormal heart rhythms — arrhythmias or dysrhythmias — are at risk for an uncoordinated heart rhythm. Some abnormal heart rhythms include:

• atrial fibrillation
• atrial flutter
• ventricular tachycardia
• ventricular fibrillation
• supraventricular tachycardia
• Wolf-Parkinson-White syndrome

People with a history of arrhythmias should see a doctor on a regular basis. A periodic potassium check might be part of your routine doctor’s visits.

Potassium and heart failure

For many people with heart failure (also called congestive heart failure), getting enough potassium is especially important. Some diuretics — water pills — for heart failure can cause you to lose potassium in the urine. Potassium supplements or a potassium-rich diet can put it back. Ask your doctor before starting a potassium supplement on your own because it may not be necessary.

Potassium: How much?

When it comes to potassium, it is possible to have too much of a good thing. Healthy people shouldn’t have any problems from eating a high-potassium diet or taking potassium supplements as directed. But people with kidney problems or certain other conditions such as the following need to be cautious about potassium intake:

• acute renal failure
• chronic kidney disease or dialysis dependence
• use of medications that increase potassium levels, including spironolactone (Aldactone), triamterene, or trimethoprim/sulfamethoxazole (Bactrim)

How much potassium should you be eating? The easiest thing to do is to increase the amount of high-potassium fruits and vegetables in your diet. You’ll be getting plenty of potassium — with no calculator required.

If you really feel like counting, the USDA recommends 4,700 milligrams of potassium per day. You can find the potassium content in foods on their package labels or from the USDA Web site: www.nal.usda.gov.

http://www.webmd.com/heart-disease/potassium-and-your-heart