Aug
01
2004

Uric Acid Blood Test Predicts Future Health Problems

By | Arthritis, Heart Disease, Stroke

A 12 year prospective, well controlled follow-up study from Finland determined that uric acid blood tests are not only useful in following patients with gout or kidney stones, but are also predictive for future health problems including death. Dr. Leo K. Niskanen from Kuopio University in Finland and colleagues followed 1,423 middle-aged Finnish men who at the beginning of the study were free from cancer, heart disease, strokes and diabetes. After about 12 years the researchers found that 157 men had died, 55 from heart disease or strokes. When men with elevated uric acid levels were classified into low, medium and high levels, an interesting observation was made when subclasses were compared with each other. Those men in the upper range of uric acid levels had a risk of more than 2.5-fold to die from a heart attack or stroke when compared to men with uric acid levels in the lower range. Also, men in the higher range were 1.7-fold more at risk to die from any cause than men in the lower range of uric acid levels.

Dr. Niskanen said that uric acid simply seems to be another good marker for spotting troubles in health. The mechanism of this connection is not known at this point in time, but the test is easy to do and is very useful in screening a middle aged population.

Risk of Developing a Heart Attack or Stroke with Elevated Uric Acid Blood Test

Uric Acid Blood Test Predicts Future Health Problems1

Uric Acid Blood Test Predicts Future Health Problems

 

 

 

 

 

 

 

 

 

Other investigators in the past have also observed a similar association, but this seems to be the first longterm and prospective study.

More info on:

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

2. strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/

3. Gout: https://nethealthbook.com/gout/

Reference: Arch Intern Med 2004;164:1546-1551

Last edited October 26, 2014

Aug
01
2004

Birth Control Pill Increases Strokes And Heart Attacks

By | Heart Disease, Hormones, Stroke, Women’s Diseases

At the recent 86th Annual Meeting of the Endocrine Society in New Orleans/Louisiana a Canadian delegation presented data from a meta-analysis of 14 trials regarding side effects of the birth control pill (BCP) when taken on a prolonged basis. The researchers were interested to know the risk of heart attacks or strokes that would be associated with the prolonged use of the low dose estrogen BCP. All of the studies between 1980 and October of 2002 were examined and 14 independent studies qualified for the meta-analysis. The strength of such a meta-analysis lies in the pooling of data and the fact that the data is derived from a much larger patient population, which generally makes the results more reliable. Dr. J. Baillargeon from the Centre Hospitalier Universitaire in Sherbrooke, Quebec/Canada, stated that they found a 1.85-fold risk for developing heart attacks with longterm use of the BCP and at the same time there was a risk of 2.54-fold of hemorrhagic strokes with longterm use of the low-dose BCP.

I have depicted these findings below in graph form where the risk is readily seen when compared to women who did not use any birth control pills. In discussions following this presentation the authors explained that with short-term use of the BCP using the modern low dose formulations heart attacks and strokes would likely not be noticeable.

Birth Control Pill Increases Strokes And Heart Attacks

Birth Control Pill Increases Strokes And Heart Attacks

But women should know that long-term use does have this risk. These decisions of whether to take the BCP and for how long needs to be discussed with the treating physician also in the view that other risks such as high blood pressure, diabetes or the metabolic syndrome would be added risks where heart attacks and strokes can occur more frequently. In these conditions the BCP likely should be avoided.

Risk of Developing Heart Attack or Stroke after Longterm Use of The Birth Control Pill
 Birth Control Pill Increases Strokes And Heart Attacks1

 

 

 

 

 

 

 

 

 

Dr. Ricardo Azziz, chairman of obstetrics and gynecology at the Cedars-Sinai Medical Centre in Los Angeles, California, stated that these findings from this meta-analysis would be very important because it was based on such a large data base and was measuring the effect of the BCP over a long period of time. He stressed that the benefits of any medication must always be weighed against the risks by the treating physician. In diabetic patients on the BCP, for instance, the benefits likely outweigh the risks as the metabolism is stabilized through an improved insulin sensitivity, improved managability of the diabetes and avoidance of the high risk pregnancies in diabetics.

More info on:

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

Strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/

Reference: The Medical Post, Vol.40, July 20, 2004, page 20

Comments on Nov. 6, 2012: What was not discussed by these experts is the fact that the BCP contains a mix of two artificial hormones (estrogen and progesterone equivalents) that the body’s estrogen and progesterone hormone receptors cannot recognize. Bio-identical estrogen and progesterone creams on the other hand would be recognized by these receptors, but nobody has researched their use for BCP purposes, only for post-menopausal hormone replacement.

Last edited Oct. 26, 2014

Aug
01
2004

Too Much Fat Fuels Metabolic Syndrome

By | Heart Disease, High Blood Pressure, Hormones, Nutrition, Obesity

In a review article for physicians from the St. Michael’s Hospital of the University of Toronto (see reference below) Dr. Monge outlined some of the newer human research where links were found between the lining of the blood vessels and the hormones produced by fat cells that lead to the complications of the metabolic syndrome. In obese people there is a cluster of conditions such as high blood pressure, high blood sugar, high cholesterol, lipid abnormalities and high insulin levels, which is known as “metabolic syndrome”. Another name that was used for this condition in the 1990’s was “syndrome of insulin resistance”.

Dr. Monge pointed out that blood vessel health depends on the fine balance between two opposing forces. On the one hand there is a system that leads to blood vessel spasm, blood clotting, growth promoting, inflammation causing and oxidizing. On the other hand there is a system that is responsible for blood vessel relaxation, growth inhibition, blood clot dissolving, inhibiting inflammation and antioxidant activity. Complex changes occur in our metabolism when we put on pounds and accumulate too much fat. It is important to realize that fat is not just sitting there, but is composed of highly active fat cells that respond to insulin and growth factors and in turn produce a number of hormones and factors that affect the cells that are lining the blood vessels. Inflammatory cytokines are produced by fat cells that attack the blood vessels by producing atheromatous plaques, causing them to accumulate fat again and help in the processes that lead to rupture of the plaques.

Too Much Fat Fuels Metabolic Syndrome

Too Much Fat Fuels Metabolic Syndrome

The end result is that the deadly interplay between the fat cells and the endothelial cells lining the blood vessels tips the balance between the two systems mentioned above to the point where heart attacks and strokes suddenly occur.

There are two complex pathways that are involved in this process and that are linked to what was stated above. One crucial aspect of this involves nitric oxide, a small molecule that is normally produced by the endothelial lining cells and that is needed for normal circulation of the heart muscle, skeletal muscles and internal organs. This protective system is where much of the derangement of normal metabolism occurs with regard to the metabolic syndrome.

Dr. Monge pointed out that with these newer insights into the complex metabolic changes associated with the metabolic syndrome in obese people, there will be very practical results in the near future. Anti-inflammatory medications are already being utilized and some of the anti-diabetic medications have been shown to reduce the risk of heart attacks. It is hoped that sensitive tests will be developed to measure the hidden endothelial dysfunction at a time when preventative steps are still effective or early intervention can be done.

More info on the metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: Metabolic Syndrome Rounds (April 2004): J.C. Monge “Endothelial Dysfunction and the metabolic syndrome”

Last edited Oct. 26, 2014

Aug
01
2004

Citrus Fruit Peel Lowering Cholesterol

By | Anti-aging medicine, Heart Disease, Nutrition

New research from London/Ontario in cooperation with the U.S. Department of Agriculature has shown that in hamsters cholesterol can be reduced by about 35% through a diet that contains compounds derived from orange peel.

A development company (KGH Syndergize, London/Ont.) under the lead researcher, Dr. Elzbieta Kurowska (PhD), has identified the active compounds in the peels of oranges or tangerines that are having cholesterol lowering properties. They are a group of substances known under the name of “polymethoxylated flavones” (PMFs) and have the advantage that they have no side-effects. They are naturally occuring and have been part of the food chain that our bodies are used to.

The research results were recently published in the Journal of Agricultural and Food Chemistry, which is a peer-reviewed journal of the American Chemical Society.

The animal and cell line experiments showed that the liver cell metabolism of cholesterol is changed so that bad cholesterol (LDL cholesterol) is lowered, but the good cholesterol (HDL cholesterol) is unaffected. When hamsters were fed a diet with 1% PMFs their LDL blood levels were lowered by 32% to 40%.

Citrus Fruit Peel Lowering Cholesterol

Citrus Fruit Peel Lowering Cholesterol

The experiments were so successful that there is now a human trial on the way where the longterm effects of PMFs on LDL levels is being followed. Dr. Kurowska cautioned that drinking orange or tangerine juice would be having many beneficial health effects. But in order to get the cholesterol lowering effect that you can achieve with the citrus peel PMF supplement you would have to consume about 20 cups of orange or tangerine juice every day.

Reference: The Medical Post, Vpl. 40 (June 22, 2004): page 18

Last edited December 8, 2012

Jul
01
2004

Gene Therapy Can Repair Blood Vessels

By | Heart Disease

When the first attempt of gene therapy were made, a concoction of LDL- receptor genes was infused into the portal vein of patients with a family trait of high cholesterol levels. This was back in 1989, and the results at that point were not encouraging.
In the meantime advances have been made in genetic research. Dr. Duncan Stewart of the cardiology department of St. Michael’s Hospital in Toronto who is considered by many as the guru of cardiac gene therapy, reports that we are now “at a crucial stage of the field”. He cautions, that having the gene on hand is only part of the answer. For good results it is also important to understand how the delivery system to the diseased organ works.

Gene therapy stands out from other treatment options, because instead of drugs, DNA is provided. DNA itself is not the therapeutic agent. It penetrates the cells where it sets up shop and produces proteins, which are needed for therapy. In the case of heart disease, where heart vessels are blocked or have been damaged, the idea is to send specific DNA sequences to the heart cells and stimulate the production of growth factors. These growth factors would trigger new heart vessels to grow and take over for damaged or blocked vessels. This is not just a dream of a research team: a gene therapy trial – the only one of its kind in Canada – is on its way under the leadership of Dr. Stewart. This ambitious project was launched in 2002. In seven sites across Canada 110 patients with heart disease are receiving the vascular endothelial growth factor gene (VEGF for short). The gene is being directly injected into the areas of the heart where blood vessels have become diseased or blocked. The placement is measured with a mapping system known as NOGA. At the end of the year the study enrolment will be finished. Patients will be followed up for results 6 months later. This therapy promises long lasting effects, but it  still has a long way to go.

Gene Therapy Can Repair Blood Vessels

Gene Therapy Can Repair Blood Vessels

Dr. Robert Hegele from the Blackburn Cardiovascular Genetic Laboratory at the University of Western Ontario is credited with uncovering eight genes for human disease (four of them are related to cardiovascular illness) and 80 mutations in other genes that are contributing to premature heart disease and diabetes. Dr. Hegel’s interest is to discover the villains that predispose people to illness, but at the same time he cautions that genes are not everything. Being genetically susceptible does not necessarily foretell one’s destiny when it comes to developing heart disease. Dr. Hegele emphasizes that the longer he works in the genetic field, the more he respects environment and lifestyle and finds that most people can even overturn genetic susceptibility and he leaves us with the final remark: “Tell your patients to stay away from tobacco, eat wisely and get that needed exercise.”

More info on arteriosclerosis (hardening of the arteries): http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Reference: The Medical Post June 29, 2004 (Vol. 40, No.26): page 35

Comment (July 9, 2012): Note that this trial failed to show effectiveness as indicated in the paper below. So, eat wisely, exercise and don’t smoke.

VEGF gene therapy fails to improve perfusion of ischemic myocardium in patients with advanced coronary disease: results of the NORTHERN trial. Stewart DJ, Kutryk MJ, Fitchett D, Freeman M, Camack N, Su Y, Della Siega A, Bilodeau L, Burton JR, Proulx G, Radhakrishnan S; NORTHERN Trial Investigators. Mol Ther. 2009 Jun;17(6):1109-15. Epub 2009 Apr 7.

Last edited Oct. 26, 2014

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May
01
2004

Chronic Inflammation Causes Cancer, Heart Attacks And More

By | Anti-aging medicine, Arthritis, Cancer, Heart Disease, Obesity

When the Time Magazine devotes 7 full pages in the March 22, 2004 issue to the topic of inflammation as the source of most of the diseases of the Western World, you know that something important is happening in medicine. Christine Gorman and Alice Park have summarized some of the groundbreaking research of the past few years in this article. I will report about this article here, but also include direct links regarding some of the relevant research the authors have mentioned including some of the key links regarding the metabolic syndrome, which was not mentioned in the article.

Since the beginning of the obesity wave in North America it has become obvious that a cluster of diseases such as heart attacks, strokes, Alzheimer disease, cancer of the colon, multiple sclerosis, arthritis and others have also become more frequent. Dr. Paul Ridker, a cardiologist at Brigham and Women’s Hospital, was one of the pioneers of investigating inflammation as a possible cause and the common denominator of these diverse illnesses. He noticed that certain patients got heart attacks although their blood LDL cholesterol levels (the “bad” cholesterol) were normal. The theory at that time was that all patients who would develop heart attacks would come from a high-risk group of patients with elevated LDL cholesterol. The problem was that 50% of patients with heart attacks had normal LDL cholesterol levels. Dr. Ridker suspected that the C-reactive protein (CRP), which is found to be elevated in the blood of rheumatoid patients, would be somehow involved in the disease process of hardening of the arteries before a heart attack would occur. CRP is produced by the liver cells and by the lining cells of arteries in response to a general inflammatory reaction in the body. Examples of this would be rheumatoid arthritis patients and patients with autoimmune diseases, where CRP levels can be readily measured with a blood test. Dr. Ridker found that there was a very good correlation between the CRP level and the degree of inflammation as well as the risk for developing heart attacks and strokes. Further investigation by others confirmed that CRP levels were perhaps more important than LDL levels in predicting impending heart attacks. This is so, because CRP is the body’s substance in the blood stream that would be responsible for breaking up LDL containing deposits (plaques) in the walls of the arteries, which leads to heart attacks in the heart and to strokes in the brain.

Chronic Inflammation Causes Cancer, Heart Attacks And More

Chronic Inflammation Causes Cancer, Heart Attacks And More

Other investigators found that CRP was only one link in a complex chain of events that includes inflammatory substances (cytokines) from the fat cells as well as insulin and insulin-like growth factors from the metabolic syndrome. Leptins are also a factor as has been discussed under this link.
Dr. Steve Shoelsen from the Joslin Diabetes Center in Boston has developed a mouse model for the metabolic syndrome. These mice will produce huge amounts of inflammatory substances in their fatty tissue in response to any inflammatory process that is started in them. Anti-inflammatory drugs such as the statins or metformin, it is hoped, will be shown conclusively to dampen the inflammatory process and prevent heart attacks, strokes and diabetes as well as cancer, Alzheimers disease and arthritis. Heart disease has already been shown to be improved by anti-inflammatory drugs. Asthma is an inflammatory disease of the small bronchial tubes, which can be stabilized with the anti-inflammatory drug Avastin.

What can we do as consumers to prevent some of those life-threatening diseases? By reducing our weight through calorie restriction on a low-glycemic diet we can help to reduce the insulin-like hormone substances of the fatty tissue. Regular exercise of at least 30 minutes of a brisk walk daily or the equivalent of other sports activities will half our risk for colon cancer and many other cancers. A diet rich in fruits and vegetables as well as fish and fish oils will reduce the amount of free radicals in our system cutting down on the circulating inflammatory substances. This prolongs life, prevents all of the major diseases of modern civilization and leads to longevity as the study of the Okinawa diet has shown.

Based on an article in the Time Magazine, March 22, 2004 edition, page 54 to 60.

Here is a chapter on arteriosclerosis from the Net Health Book, which explains inflammatory changes of the arterial wall:

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

Last edited October 26, 2014

May
01
2004

Sugar And Starchy Foods Cause Colorectal Cancer

By | Cancer, Heart Disease, Nutrition

A study from the Harvard University involving 38,000 women and having been started in 1993 has surprised the researchers. They wanted to find out whether there were certain foods that may cause colon and rectal cancer. So they administered a “food-frequency” questionnaire with 131 questions to women 45 years or older who entered into the study. Such factors as low-dose aspirin, vitamin E and beta-carotene were included in the questionnaire as was the exact food composition for the year prior to enrolment into the study.

A sugar load (glycemic load) was calculated. This way the impact of various sugar and starch containing foods could be assessed and compared among different subgroups regarding the later development of cancer in the colon and rectum.
When Dr. Susan Higginbotham and Dr. Simin Liu analyzed the diets of the 174 patients who did develop cancer (26 rectal cancers, 148 colon cancers) they found that the women with the highest sugar and starch load were 3 times more likely to develop cancer than the controls with a low glycemic load. High glycemic load foods are candy, cakes, cookies; any other refined flour products including white bread, pasta, French fries and baked potatoes. Together with other literature in this field the authors of this study concluded that the high glycemic food load leads to increased insulin levels in the blood as well as insulin-like growth factors. This in turn leads to cell division in normal and cancerous cells including the lining of the colon and rectum. In addition it is known that the C-reactive protein promotes an inflammatory response that will lead to heart attacks and to cancer.

Sugar And Starchy Foods Cause Colorectal Cancer

Sugar And Starchy Foods Cause Colorectal Cancer

Dr. Bob Bruce from the University of Toronto has shown in his research on colon cancer that insulin and related factors are important in the promotion of this cancer. He commented regarding the Harvard study reviewed here that more research is required before the exact cause of cancer of the colon and rectum would be understood. This knowledge is required before more effective preventative measures can be found other than a simple reduction of sugar and starch in the foods we eat.

Based on the Feb.4 edition of the Journal of the National Cancer Institute (U.S.) and the National Review of Medicine (Canada) March 15, 2004.

More info about Colorectal cancer can be found through this link.

Last edited October 26, 2014

May
01
2004

Age-Related Macular Degeneration Can Be Postponed

By | Anti-aging medicine, Diabetes, Eye Diseases, Heart Disease, Stroke

In a well-controlled study that was published earlier in 2004 Dr. Johanna M. Seddon

has shown that age-related blindness (AMD) is caused from an inflammation in the blood vessels, which is associated with an elevated blood marker, called C-reactive protein (CRP). The authors of this study also showed that the dry form of AMD would tend to deteriorate with age and/or from smoking cigarettes into the more serious wet form, a common cause of blindness.

The inflammatory component of cardiovascular disease is known to be controlled by the use of aspirin (ASA) or the statins, medication that is known to lower the bad LDL cholesterol. It is with this background that the author of the study that I am reviewing here, Dr. Jacque L. Duncan from the University of California at San Francisco, has examined the effects of ASA and of statins on AMD. 326 patients with AMD (204 with dry AMD, 104 with wet AMD from blood vessels forming underneath the retina and 18 with geographic atrophy) were followed between January 1990 and March 2003. Patients were at least 60 years old or older and followed at the San Francisco VA Hospital Eye Clinic.
Dr. Duncan found that patients with blindness due to wet AMD used ASA or statins significantly less than patients with stable AMD. Moreover, he found that patients who had AMD and took statins were 49% less likely to develop wet AMD and if they took ASA the were 37% less likely to develop wet AMD.

Age-Related Macular Degeneration Can Be Postponed

Age-Related Macular Degeneration Can Be Postponed

The study also suggests that there is a link between the inflammatory process that leads to heart attacks and strokes on the one hand and the further deterioration to blindness when dry AMD is not treated on the other hand. The notion that inflammation is the missing link in both of these processes is a relatively new finding.

More information about Macular Degeneration here.

Based on article by Dr. Jacque L. Duncan in the American Journal of Ophthalmology 2004;137: 615-624.

Last edited October 26, 2014

May
01
2004

Physicians Use New Technology (GCFP) To Study Blood Flow

By | Health, Heart Disease

Researchers at the Duke University Medical Center have developed a new non-invasive method of visualizing blood flow through blood vessels of patients. It is a modification of the well-known MRI scan technology where a magnetic field realigns the center of hydrogen atoms (protons) during the time of the examination and the differences of the tissue and fluid qualities are reflected in the images created by this technology. This new application depicting moving blood in blood vessels is called “global coherent free procession” (GCFP).

The principle is that the investigator can focus on an area of a blood vessel upstream of the area to be examined and tag a portion of the blood flowing through with an energy pulse. As the blood continues to flow through the area of interest, the protons give off the energy again without any changes to the body fluids or the blood cells and the MRI scanner picks up the images of the blood flow through the blood vessel.
The advantage of this technique is that it is done without any catheters (it is non-invasive), there is no need for any contrast material to be injected and there are no X-rays needed. At the present time this is the only diagnostic technology available for examining a patient’s blood flow through the heart and its vessels in real time, which is very valuable for physicians (cardiologists).
Here is a link to the Duke University publication

Physicians Use New Technology (GCFP) To Study Blood Flow

Physicians Use New Technology (GCFP) To Study Blood Flow

Based on an article in the April 13, 2004 issue of The Medical Post , Vol.40, No. 15, p.5.

PS. When checked on Nov. 5, 2012 this procedure has not been widely accepted in medical circles. It seems to be still more of a research tool.

Last edited December 8, 2012

Mar
01
2004

Ankle Blood Pressure Reveals Diabetic Problems

By | Diabetes, Heart Disease, High Blood Pressure, Prevention, Stroke

One of the complications of diabetes is that ity leads to clogged arteries from peripheral artery disease and this can lead to heart attacks, strokes and circulation problems in the legs.

Recommendations were recently given to physicians in the December edition of the medical journal Diabetes Care that circulation problems in diabetics need to be monitored more stringently to avoid needless amputations.

Medically these circulation problems that affect mainly lower legs and feet are known as “peripheral vascular disease” (or PVD for short). PVD can be detected by the physician checking for ankle pulses. Another valuable and very simple test is to measure the blood pressure in the arm and at each ankle (using the stethoscope just under the inside (medial) ankle bone. If there is a major discrepancy between the arm and ankle blood pressure or if the ankle pulse is missing, this would be a sign of possible PVD. With a diabetic patient it would still be important to get the hemoglobin A1C under control through exercise, a low glycemic diet and possibly anti-diabetic medication. But the patient likely would have to be referred to a cardiovascular surgeon for further testing in order to find out whether there would be hardening of the arteries with circulation problems in the lower leg, the ankle or foot.

Ankle Blood Pressure Reveals Diabetic Problems

Ankle Blood Pressure Reveals Diabetic Problems

Dr. Peter Sheehan, the director of the Diabetes Foot & Ankle Center at the New York University school of medicine, stated that many patients and doctors overlook how frequent this condition is. About 33% of diabetic patients who are older than 50 years have PVD, but only a fraction know about it until it is too late. Once a patient has PVD in one of the legs there is a 4-fold risk of getting a heart attack or a stroke, because the hardening of the arteries is happening simultaneously in all of the body’s arteries. If the blood pressure is normal at the ankle, Dr. Sheehan recommends to check it again in 5 years.

Who should have the blood pressure check at the ankle? Here is a table that summarizes Dr. Sheehan’s recommendations.

Which diabetic needs the ankle blood pressure check?
High risk group: Remarks or more detail:
Anyone with leg PVD* symptoms legs tired or hurting when walking
Young diabetics
with other risks		 smoking, high blood pressure, high cholesterol, diabetes present for more than 10 years are such risk factors
diabetics 50 years of age and over particularly when the hemoblobin A1C is high and other risk factors are present
*PVD = peripheral vascular disease

Why is it so important to screen for circulation problems in the lower legs? Because this is the area where diabetics tend to get problems that often result in amputations of a foot or lower leg below the knee. With early detection of these problems and intervention by a cardiovascular surgeon often disastrous outcomes can be avoided.

More info is available at:

Diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

High blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

Last edited October 26, 2014