Obesity contributes to cardiovascular risk no matter where a person carries the weight, concluded researchers after looking at outcomes for nearly a quarter-million people worldwide.
Body mass index, (BMI) waist circumference, and waist-to-hip ratio do not predict cardiovascular disease risk any better when physicians recorded systolic blood pressure, history of diabetes and cholesterol levels, researchers reported in The Lancet.
The research group used individual records from 58 prospective studies with at least one year of follow up. In each study, participants were not selected on the basis of having previous vascular disease. Each study provided baseline for weight, height, and waist and hip circumference. Cause-specific mortality or vascular morbidity were recorded according to well defined criteria.
Individual records included 221,934 people in 17 countries. In people with BMI of 20 kg/m2 or higher, hazard ratios for cardiovascular disease were 1.23 (95 percent CI, 1.17 to 1.29) with BMI, 1.27 (95 percent CI, 1.20 to 1.33) with waist circumference, and 1.25 (95 percent CI, 1.19 to 1.31) with waist-to-hip ratio, after adjustment for age, sex, and smoking status. After adjusting for baseline systolic blood pressure, history of diabetes, and total and HDL cholesterol, corresponding hazard rations were 1.07 (95 percent CI, 1.03 to 1.11) with BMI, 1.10 (95 percent CI, 1.05 to 1.14) with waist circumference, and 1.12 (95 percent CI, 1.08 to 1.15) with waist-to-hip ratio.
BMI, waist circumference, or waist-to-hip ratio did not importantly improve risk discrimination or predicted 10-year risk, and the findings remained the same when adiposity — the carrying of adipose tissue (fat) — measures were considered. Read more »
*This blog post was originally published at ACP Internist*
Heart disease and February: What relationship could be more cozy? From the scary risks of shoveling snow (yep, you could die, so be sure to lift a little at a time), Mercedes-sponsored red dress parades and government-sponsored National Wear Red Day®, to tips for identifying heart attacks in women (men, you need a different month I guess), February has all the important stories to improve your awareness. Such a polite term “awareness.”
But I wonder, now that the Internet is upon us and people are seeing their insurance rates and co-pays skyrocket, if maybe we’re shooting ourselves in the foot with all this heart-month marketing hype. People are sick and tired of testing “just to be sure.” It’s starting to directly cost them a fortune, and people are frustrated at having to pay a fortune for healthcare, let alone heart care.
I know, I know — I should be at the forefront of working with patients to stomp out heart disease. And goodness, people DO need to be attuned to diet, exercise, and weight loss. But the reality is, if we’re giving you the 10 latest tips on how to detect a heart attack, we’re probably a bit too late.
That’s the problem with all these press releases: While there’s a need to raise “awareness” of heart health, there’s also a very real need for people to take us — heart disease professionals — seriously to help cut costs in healthcare here. The last thing our healthcare system needs is more frivolous testing. Yet this is exactly what all this marketing does for our healthcare system — and it helps those with the largest PR budgets most of all. Read more »
*This blog post was originally published at Dr. Wes*
“This job is killing me” is not a statement of jest. It is a desperate plea of outright sincerity.
Stress, anxiety, depression — all have been associated with an increased risk of cardiovascular disease and mortality. But can interventions to help people cope with stress positively affect longevity and decrease risk of dying? The results of a new study in the Archives of Internal Medicine would imply the answer is an encouraging “yes.”
Constructively dealing with stress is easier said than done, but it would seem logical that if we can reduce our psychological and social stressors we might live longer and delay the inevitable wear and tear on our vessels. This study proved that one such intervention, cognitive behavioral therapy (CBT) for patients who suffered a first heart attack, lowered the risk of fatal and nonfatal recurrent cardiovascular disease events by 41 percent over eight years. Nonfatal heart attacks were almost cut in half. Excitement may be dampened by the fact that all-cause mortality did not statistically differ between the intervention and control groups, but did trend towards an improvement in the eight years of follow up.
Definitely less suffering. Maybe less deaths.
The authors state that psychosocial stressors have been shown to account for an astounding 30 percent of the attributable risk of having a heart attack. Chronic stressors include low socioeconomic status, low social support, marital problems, and work distress. Emotional factors also correlated with cardiovascular disease include major depression, hostility, anger, and anxiety. Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
I’ve been waiting for this soup for weeks. Eleven weeks, to be exact. That’s how long I was enrolled in a research diet study, and unable to eat anything other than the food they provided me, which was nowhere near as delicious as this soup.
The study is designed to compare the effects of three different diets — the American Diet, the Mediterrnean Diet, and a high-protein diet — on weight loss and cardiovascular disease risk.
I randomized to the American Diet, meaning that Thursday’s lunch was a slice of pizza with potato chips and an afternoon snack of Oreos and chocolate pudding, Saturday’s lunch was hamburger and fries, and the most veggies I ever saw at one sitting was a measly stalk of broccoli.
Despite this, I lost 30 pounds over the 11 weeks of the study, primarily because my caloric intake was only 1,200 calories per day, carefully calculated based on my basal metabolic rate. Read more »
*This blog post was originally published at The Blog that Ate Manhattan*