Nov
01
2008

Low Testosterone And Heart Disease

More men than women seem to be affected by cardiovascular illness, and the reasons have been manifold. At one time work stress was cited for the prevalence of heart disease in men. Other lifestyle factors, lack of exercise, being overweight, poor dietary choices and smoking have been found to play significant roles. The risk for cardiovascular disease increases with age, as does the likelihood for hypertension, elevated cholesterol levels and glucose intolerance.

Some attention has been paid to the fact that hormones can also play a role, and research has now shown that testosterone has some direct cardiovascular effects. Testosterone has been found to dilate blood vessels. The effect can be likened to the calcium channel blocker Nifedipine. It has also been substantiated that males with coronary artery disease and heart failure tend to have low levels of testosterone. If testosterone deficient men receive replacement therapy, vasodilatation (dilation of blood vessels) has been demonstrated in males who have received testosterone replacement for a few months. Male hormone replacement therapy has also been found to relieve the symptoms of angina in patients with heart failure. The question, how testosterone fits into the concept of disease prevention, comes up in this context. Researchers have found enough evidence that a low testosterone blood level has an independent association with accelerated atherosclerosis (hardening of arteries).

Low Testosterone And Heart Disease

Testosterone in men prevents heart disease

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding is the fact that this condition is reversible by replacement of testosterone. Male hormone therapy has received a lot of bad press in the case of overtreatment with androgens to achieve muscle growth in body building. However, in this case there was no testosterone deficiency and athletes and their coaches were using doses that were too high. This type of administration entails grave health risks and has nothing to do with good medicine. In case of hormone deficiency replacement the normal body function of a younger male is restored with bioidentical testosterone, which can be a tool to better health for the aging male. Anti-aging physicians are very familiar with this treatment modality.

More on the heart vessel protecting effect of bio-identical hormones:

http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Journal of Men’s Health – Volume 5, Issue Suppl (September 2008)

Last updated Nov. 6, 2014

Oct
01
2008

Lifestyle Can Be A Killer For Middle Age Women

Generally it is assumed that persons in their thirties and forties should be in their prime, and health concerns are cropping up in the higher middle age or only in old age.
Also, women were thought to generally enjoy better health and life expectancy, but the large Nurses’ Health Study on 77,782 women in the age group of 34 to 59 years shows other aspects.
Even in females who had no heart problems and no cancer at the onset of the study, lifestyle choices can make it or break it. At the end of the study that spanned 24 years, it became obvious that a total of 28% of all the mortalities could be attributed to smoking. If risky lifestyle choices were combined in the form of smoking, being overweight, having a lack of physical activity and a qualitatively poor diet, this number jumped to 55%. Alcohol intake did not change this estimate significantly.

Lifestyle Can Be A Killer For Middle Age Women

Lifestyle Can Be A Killer For Middle Age Women

It is obvious that for the benefit of better health and less mortality in middle age women, diet, exercise, a healthy body weight and eradicating smoking are key factors.

Reference: BMJ 2008;337:a1440

Comment on Nov. 18, 2012: So how many years longer will a woman live, if she quits at age 30? The Million Women Study found out that she will live 10 years longer than the control group of smoking women (see link). Nothing has changed since 2008. Lifestyle issues remain at the forefront.

Last edited December 3, 2012

Sep
01
2008

Runners Live Healthier Lives

It has been known for some time that exercise is healthy for you. But how do runners do on the long-term? This has been investigated in a recent study spanning 21 years from 1984 to 2003 published in the August edition of the Archives of Internal Medicine. 538 members 50 years or older of a nationwide running club were compared to a sample of 423 healthy controls. In the beginning of the study the members (all males) were 50 years or older. Disability levels were assessed with a health questionnaire and classified into a scale from 0 (no disability) to 3 (unable to perform). Death rates were also determined.The results showed that disability scores were always lower in runners (0.17) than in controls that did not run (0.36), which translated into 39% less disability. In 2003 the death rate was 34% in the controls, but only 15% in the runner group, in other words a 38% better survival of runners compared to the controls. In 2005 a further follow-up showed that the survival curve was still increasing for the runners who had now entered their eighties.

Runners Live Healthier Lives

Runners Live Healthier Lives

The authors of this study pointed out that length of life, health status and disability status can all be significantly improved with regular moderate exercise such as running. Other studies have suggested this as well, but none has followed this up over such a long period (21 years). Increasing healthy lifestyle behaviors will also reduce health care costs and prevent disabilities from chronic diseases.

Choose your fitness activity as reviewed here: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Arch Intern Med. 2008;168:1638-1646

Last edited November 5, 2014

Jul
01
2008

Have A Cup Of Coffee And Decrease Your Death Risk

Coffee can be good for you, and this is one of the items, which even tastes good! There are some exceptions as discussed in previous articles: more than 2 cups per day can increase the risk for miscarriages in pregnant women. People who are anxious or nervous can find that coffee will aggravate anxiety. Patients with rheumatoid arthritis should also not indulge in the flavorful brew.

Aside from these exceptions researchers have found that coffee consumption can be beneficial. A recent study using the data from 41,736 male and 86,214 female subjects has evaluated data over a follow- up time of 18 years in the male group and 24 years in the female group. The risk of all-cause mortality decreased significantly with increasing coffee consumption in the male as well as in the female group.

Men had a relative risk reduction of 20% as compared to their counterparts with the lowest level of coffee consumption. Women with intermediate to high consumption had a relative risk reduction of 10% to 30 % as compared to the group that drank less than 1 cup of coffee per day.

Have A Cup Of Coffee And Decrease Your Death Risk

Have A Cup Of Coffee And Decrease Your Death Risk

The limit of the study in this case was the self-reported nature of coffee consumption, but the researchers feel that the modest benefit of reduction of all-cause and CVD death warrants further investigation.

Reference: June 17, 2008 Annals of Internal Medicine

Last edited December 4, 2012

Jul
01
2008

Chronic Kidney Disease Kills

Chronic kidney disease (CKD) has been on the rise for several years and is responsible for premature deaths all over the world. Many different kidney diseases (glomerulonephritis, pyelonephritis, diabetic nephropathy, hypertensive nephropathy etc.) will lead to end stage kidney disease, called chronic kidney disease, and this in turn would require dialysis treatment or a kidney transplant. Often these patients will die prematurely.

Dr. Chi-Pang Wen and collegues from the National Health Research Institutes, Taiwan, have followed a total of 462,293 people with all stages of CKD since 1994. At the end of 2006 there were 14,436 deaths in this population. The two best screening tests to predict deterioration of kidney disease were the flow rate of fluid through the kidneys (medically termed “glomerular filtration rate”) and protein tests of urine. The glomerular filtration rate should stay constant and above a certain cut-off point, and protein should not leak into urine. When the medical researchers started to analyze the results of this study, they found that CKD was affecting about 12% of the general population (the figures are very similar to the US). The patients with CKD had an 83% higher general mortality and had a 100% higher mortality from cardiovascular diseases.

Chronic Kidney Disease Kills

Chronic Kidney Disease Kills

After a 13 year observation period with a median follow-up of 7.5 years 10.3% of the deaths in the entire population were due to CKD. In the low socioeconomic status group this figure was 17.5%. About 40% of the deaths from CKD occurred before the age of 60. Those in the study who had been taking Chinese medicines had a 20% increased risk to develop CKD.

In most countries around the world regular yearly screening of glomerular filtration rates and testing for protein leakage into urine is not done on a large scale. But this is the only way to prevent early kidney disease from developing into chronic kidney disease. Once early kidney disease has been identified, preventative measures like salt restriction, treating diabetes and treating unrecognized high blood pressure etc. can be implemented. In many cases this will prevent the need for dialysis, kidney transplants and death from chronic kidney disease.

More information about pyelonephritis, one of the possible causes of kidney failure: http://nethealthbook.com/infectious-disease/urinary-tract-infection/pyelonephritis/

Reference: Lancet ( 2008), vol. 371, page 2173 to 2182 (June 28, 2008)

Last edited November 4, 2014

May
01
2008

Glucose and Colorectal Cancer Are No Sweet Deal

It has been noted in various publications that insulin resistance carries a host of health risks: aside from type 2 diabetes, there is cardiovascular disease. Also high insulin levels are associated with growth hormone like substances in the body. These substances are contributing to the development of some cancers.

There is other extensive medical literature stating that glucose (=sugar) and refined carbohydrate (cookies, cakes, French fries, doughnuts, bread, rice, potatoes)  intake lead to chronic inflammation in blood vessels throughout the body, but also to a weakening of the immune system. This explains why such varied diseases as high blood pressure, hardening of arteries with resulting strokes and heart attacks, diabetes, asthma and cancer are caused by the same chronic inflammation that in turn is brought on by our eating habits of a refined diet consumed by most industrialized nations. This blog deals only with cancer of the colon and cancer of the rectum as a result of  chronic inflammation.

Researchers from Minnesota and Maryland examined 375 individuals with recurrent polyps (=adenomas) and the identical number without recurrent adenomas. They followed the course of the patients for 4 years. In their study they looked at fasting serum. Patients who were found to have the highest levels of both insulin and glucose in their serum were at an approximately 50% higher risk of colorectal cancer recurrence. The strongest risk factors were elevated glucose levels.

Glucose and Colorectal Cancer Are No Sweet Deal

Glucose and Colorectal Cancer Are No Sweet Deal

The individuals with the highest glucose levels also tended to be slightly older, have a higher waist to hip ratio and a higher body mass index. These results do point out the necessity of keeping a close tab on glycemic control in person with a history of colorectal polyps. It also is evident that consuming foods with a low to medium glycemic index will help to reduce the risk for colonic cancers.

More information about:

1. Colon cancer: http://nethealthbook.com/cancer-overview/colon-cancer/

2. Sugar causes cancer: https://www.askdrray.com/sugar-as-a-cause-of-cancer/

Reference: The Medical Post, April 1, 2008, page 21

Last edited November 3, 2014

Apr
01
2008

High Blood Pressure Decreases Cognitive Function

It is known that high blood pressure that is left untreated gives rise to a host of health problems, some of which are heart attacks and strokes. It is not surprising to Dr. Jose Luchsinger of Columbia University Medical Center in New York that high blood pressure (hypertension) can be related to all kinds of cognitive impairment, which is connected to vascular damage in the brain. A cohort study which was published in the December issue of Archives of Neurology included 918 subjects age 65 or older with no history of mild cognitive impairment (MCI) or dementia at baseline. All participants underwent neurophysical and medical testing every 1 ½ years for more than 4 ½ years. The majority of the individuals had high blood pressure. During the course of the study 334 of the participants developed MCI. 174 cases had impairment in domains such as language and executive function or visual-spatial elements were impaired. 160 individuals had amnestic MCI (affecting memory), which is thought to have the strongest link to Alzheimer’s disease.

High Blood Pressure Decreases Cognitive Function

High Blood Pressure Decreases Cognitive Function

The study showed that hypertension played a significant role in the higher risk of developing any form of cognitive impairment. Detection of hypertension and proper treatment will not only protect against strokes, but certainly also extend its benefits to cognitive function.

More information how strict blood pressure control prevents trouble: http://nethealthbook.com/news/stroke-risk-present-even-borderline-high-blood-pressure/

Reference: The Medical Post, February 5, 2008, page 65 and Dec.2007 issue of Archives of Neurology

Last edited November 3, 2014

Mar
01
2008

The Culprits For Periodontal Disease

When people think of hazards to dental health, the first thought will be about tooth decay, lack of brushing and flossing and eating candies and other sugar-laden foods. Periodontal disease is often neglected, and yet it is just as threatening to teeth and gums. Destructive periodontal disease will lead to loss of the supporting tissues of the teeth and as a result, there will be loose or shifting teeth and ultimately tooth loss. Generally these findings were seen in older population groups. It was thought that the disease would rarely occur in patients younger than 35 years of age and the theory was that dental plaque was the likely cause. Lifestyle choices were not thought to play a large role. Recent findings told a different story. A cohort study consisting of 903 participants examined self-reported tobacco and marijuana smoking and dental examinations were also done. The authors of the study found that tobacco smoking as well as cannabis (marijuana) smoking was linked with a higher incidence of destructive periodontal disease before the age of 32 years.

The Culprits For Periodontal Disease

The Culprits For Periodontal Disease

In comparison to this dental plaque was not contributing to a higher incidence of periodontal disease in this younger age group. Another risk for destructive periodontal disease in the youngest age group (as young as 12 to 18 years of age) was impaired glucose intolerance (a condition leading to diabetes). Due to those findings it is obvious that brushing and flossing are not the only weapons against periodontal disease. Healthy eating habits and cessation of smoking are equally important for dental health. This is particularly important as heart disease, which is also an inflammatory condition is closely linked to inflammatory disease of the gums and you likely have heard that heart attacks can be prevented by brushing and flossing teeth.

More information about periodontal disease: http://nethealthbook.com/dentistry/periodontitis/

Reference: Journal of American Medical Association 2008; 299(5): pages 574-575

Last edited November 3, 2014

Mar
01
2008

High Death Rate In India Due To Smoking

Dr. Prabhat Jha of the Centre for Global Health Research, Toronto has published research regarding the risk of mortality associated withs smoking in India, involving data from 1.1 million Indian homes. Data of deceased individuals, all of them in the age group between 30 and 69 years of age, showed that 37% of the men and 5% of the women had been smokers, and smoking doubled the risk for both sexes due to medical causes. Smoking did not only rate as a risk for lung and respiratory cancers but also for tuberculosis, vascular and respiratory disease. Smoking as a causal relationship was estimated to be responsible for 1 in 5 deaths in men and 1 in 20 deaths in women. With the population growth in India the number of death in the age group of 30 to 69 related to smoking is estimated to increase by 3% per year. Currently available data suggests that the rate of smoking is high especially among men in India. Data from other nations show, that smoking bans in public places are effective in turning these statistics around. Italy used to be one of the European nations, where smoking in public was common and as a result the exposure to second hand cigarette smoke was not only an inconvenience but a serious health risk. Cardiovascular events like heart attacks showed a decrease among men and women in Italy after the smoking ban in public places was put into effect in 2005. The findings were related to the improved indoor air quality.

High Death Rate In India Due To Smoking

High Death Rate In India Due To Smoking

There was an increase of sales in stop smoking aids like nicotine replacement products. Sales of cigarettes showed a decrease. Giulia Cesaroni from a local health unit in Rome remarked that even a small reduction in the incidence of cardiovascular disease can have enormous public health implications, as coronary artery disease is the leading cause of deaths in Italy. Compared to before the ban heart attack rates of middle aged (35- to 64-years) Italians dropped by 11%, 65- to 74-year-olds had a reduction of 8%, but those in the 75-84 year age group showed no benefit (as coronary artery disease in them likely was irreversible).

More information about:

1. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

2. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

3. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

References: The Indian data based on www.nejm.org (February 13, 2008); the Italian study was published in Circulation 2008 (Feb. 11)

Last edited November 3, 2014

Sep
01
2007

Weight Loss Surgery Reduces Mortality

Excessive bodyweight contributes to a host of illnesses. Diets and lifestyle changes, physical activity and exercise programs can contribute to successful weight loss, but for a group of patients morbid obesity remains a significant problem. Weight loss surgery, also known as bariatric surgery has been on the increase.

Opinions about the usefulness of bariatric surgery have been divided. Often it was seen as a heroic effort with lots of risks and questionable benefits. In some procedures patients did not show significant weight loss, and there were some doubts whether the risk of surgery was worth taking.

Dr. Lars Sjoestroem of Gothenburg University has a detailed study on 4,047 Swedish patients with obesity, of which 2,010 underwent bariatric surgery, while 2,037 received non-surgical treatment. The two groups were compared for overall mortality after 11 years. The non-surgical control group lost little or no weight. The bariatric surgery patients did better. The most successful group was the one which received gastric bypass surgery with a weight loss of 25%. Vertical-based gastroplasty patients lost 16% of their weight, and those who underwent gastric banding lost 14% of their weight over 10 years.

Weight Loss Surgery Reduces Mortality

Gastric bypass surgery

At follow up the overall mortality was significantly decreased in the group that underwent surgery. Death risk from disease which is associated with obesity, such as coronary artery disease was significantly decreased by 56%. The risk of death from diabetes was decreased by 92% and the risk of death from cancer also showed a reduction of 60%.

US data show similar results of a decrease in long-term mortality in obese patients who underwent bariatric surgery and lost weight.

More information on weight loss: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/weight-loss/

Reference: August 23, 2007 issue of The New England Journal of Medicine.

Last edited November 3, 2014