PreDisease.com Blog

A study by Canadian researchers illustrates the importance of monitoring bone density in patients who have decreased kidney function. Decreased bone density can predispose people to bone fractures, which can be deadly in the elderly population.

The study followed 635 people aged 50 and above for a total of five years. Kidney function and bone density were measured at the beginning and end of the study. Results showed that people with impaired kidney function lost bone density at a faster rate than those with healthy kidneys. Bone loss occurred even in those who had mild kidney impairment.

Many people with kidney disease are not aware they have a problem. Screening for kidney disease in older individuals might prevent bone loss from occurring, thus decreasing the risk of fractures and death in the older population. Screening for kidney disease could involve simple measures such as checking blood pressure and obtaining a serum creatinine level, GFR (glomerular filtration rate) and urine protein. These tests are often done yearly as part of an annual physical. People who have high blood pressure, diabetes and a family history of kidney disease are at increased risk for kidney disease.

Consider the following statistics: 1 in 3 women will die of heart disease, 450,000 women per year die from cardiovascular disease and only 1 in 5 women believe that heart disease is the biggest threat to their health.

Heart disease has been thought of as a disease affecting mostly men for so long that changing this perception is difficult. The fact is, heart disease now kills more women than men, but women often experience different symptoms than men and often develop heart disease later in life than do men. The rise in obesity, diabetes and the numbers of women who smoke are thought to be the reason for the changing demographics of heart disease.

Women’s symptoms of a heart attack are often different than the “classic” presentation. Men often experience crushing chest pain; women are more likely to complain of discomfort in an area other than their chest, such as the jaw, the abdomen and the arms. They may also complain of feeling exhausted and short of breath.

Women are also treated differently in hospital, according to some studies. They may be less likely to be put on aspirin therapy and to have their cholesterol as aggressively managed as men do. The good news is that women are surviving heart attacks in greater numbers. This may be a case of closing the barn door after the horse has escaped- women need to understand their personal risk factors for heart disease and seek counseling from their personal physicians on prevention strategies.

Source: Diagnosis dilemma: Women’s heart symptoms differ from men

Salt reduction is one of the ways that you can help prevent high blood pressure, one of the risks for heart disease and stroke. Cutting salt in your diet can help, but many people are unaware that only a small amount of their daily intake of salt comes from their salt shaker. Reducing the amount of salt you add to your food is important, but many of the foods we buy contain high amounts of sodium.

Your kidneys do a wonderful job of regulating the sodium in your body, which is needed for essential functions such as regulating fluid in your body, controlling muscle contractions and regulating nerve impulses. When you have too much sodium, your kidneys excrete sodium in your urine; your kidneys conserve sodium when you have too little in your body.

Many of the prepared and processed foods we buy already contain high amounts of sodium, and adding salt to these foods further increases their sodium content. In fact, about 77% of the sodium we consume comes from eating foods that already contain salt. It is important to be aware of foods that contain high levels of sodium if you are trying to control your salt intake. How much salt should you consume? The American Heart Association recommends limiting sodium intake to less than 1,500 milligrams per day. Reading food labels can help you become more aware of those foods that contain high amounts of sodium.

Source: http://www.americanheart.org/presenter.jhtml?identifier=4708

A new study has shown a definite link between women who have family members with type 2 diabetes and the risk of developing the disease themselves. Previous studies have also supported this hypothesis, but there is no clear genetic link identified.

In a study which spanned 20 years, 73, 227 women from the U.S. were followed to determine their risk of developing type 2 diabetes. Risk factors were taken into consideration, such as weight, height, BMI (body mass index) and lifestyle habits. After controlling for these variables, it was discovered that having a first-degree relative (parent or sibling) with the disease more than doubled the women’s’ risk of developing the disease themselves. Women who had family members with the condition were more prone to being overweight, and this factor accounts for approximately 20% of the heredity factor. Eating red meat and consuming alcoholic beverages and sweetened drinks were also considered to be factors in common. In all, 5,101 of the women developed type 2 diabetes during the course of the study.

Researchers came to the conclusion that being overweight and sharing these dietary habits partially explains the heredity factor in type 2 diabetes. The study was reported in the January issue ofDiabetes Care.

February is designated as American Heart Month, a good time to reflect on our own personal risks for heart disease and how best to prevent the development of heart disease. Although there are some risk factors you can’t change, such as your age, heredity and whether you are male or female, there are several areas that you can work on:

Quitting smoking- this is perhaps one of the best and most important things you can do to decrease your risk for heart disease. Smokers carry a two-to-fourfold risk of developing heart disease when compared to non-smokers.

Lose weight- being overweight forces your heart to work harder. Obesity also contributes to hypertension (high blood pressure) and diabetes. Losing weight, even a small amount, can help in the fight against heart disease.

Exercise- exercising can help you lose weight, avoid diabetes, lower your blood pressure and decrease your cholesterol. The more exercise you do, the healthier your heart will be! Regular, moderate physical activity has been proven to improve heart health, while a sedentary lifestyle is a known risk factor for the development of heart disease.

Watch your blood pressure- high blood pressure increases your risk for heart disease, especially when other risk factors are present, such as diabetes, obesity, and smoking. Monitor your blood pressure regularly, and intervene early.

As well as knowing your risk factors for heart disease, it is important to know the signs of a heart attack, the most obvious of which is chest pain or discomfort. Pain or discomfort may come and go, or may be constant. It may be centered in the mid-sternum and may feel like squeezing, pressure, or tightness. You may also feel light-headed, nauseous, and may feel short of breath.

A study published in the New England Journal of Medicine showed that increasing Medicare co-payments resulted in fewer doctor visits and more frequent and lengthy hospitalizations among seniors.

In tough economic times, insurance companies may see the benefit in raising co-payments to help defer rising costs, but this strategy is likely to backfire on them, as evidenced by this study. The study included almost 900,000 seniors enrolled in 36 different Medicare plans. The results? Those seniors who saw a raise in their co-pay rates saw a doctor less often and were hospitalized more often and for longer periods of time. Good medicine? This would not seem to be the case. The populations most affected by a rise in co-payments were those who could least afford it- those living in low-income neighborhoods and those who already had diagnosed health problems, such as diabetes, hypertension and heart disease.

The study illustrated what many intuitively know: raising co-payments leads to less preventative care, which means sicker patients who need to be cared for at a higher cost, not to mention an increase in patient dissatisfaction.

Source: Increased Ambulatory Care Copayments and Hospitalizations among the Elderly

Meridia, a popular weight loss drug, must now come with a stronger warning on its label, following the results of the Scout trial, a study of 10,000 individuals taking Meridia (sibutramine) to manage their weight. The participants of the study all had type 2 diabetes or cardiovascular disease. The results of the Scout trial showed an increase in the risk of myocardial infarction (heart attack), stroke, and other cardiovascular problems.

Following the release of the results of the trial, Europe has banned the sales of medication containing sibutramine, including Meridia, one of the most popular. In the US, however, it has only been recommended that the drug be labeled with the stronger warning. Patients who have a history of the following conditions should not take Meridia or any other drugs containing sibutramine:

• Previous heart attack
• Previous stroke
• Heart arrhythmia
• Coronary artery disease
• Peripheral artery disease
• Uncontrolled hypertension (high blood pressure)

Meridia is prescribed for patients with a BMI of 30 or more, or a BMI of 27 with risk factors for cardiovascular disease.

Source: Europe Bans Meridia Diet Pill; FDA Strengthens Warning

More and more studies are pointing to the fact that vitamin D is important in disease prevention. Scientists studied the genetic material of 617 people stored in a DNA data bank. They divided the people into three groups: those who were healthy, those who had hypertension, and those who had both hypertension and CHF (congestive heart failure).

What they discovered is that those who suffered from both conditions, high blood pressure and congestive heart failure, had an abnormality in the CYP27B1 gene. This gene is associated with a reduction in the rate at which the body converts vitamin D which has been stored into active vitamin D that the body can readily use. Researchers point out that this means that, in future, they may be able to screen people for this an abnormality in this gene earlier. Knowing that someone has this gene may mean that that person requires more vitamin D from their diet and more daily exposure to UVB rays present in sunlight, although researchers point out that more studies will need to be done to confirm their findings.

Vitamin D has been researched extensively in recent times, and is thought to have a protective effect against certain cancers, autoimmune disorders, insulin sensitivity, depression and hypertension.

Source: American Heart Association (2008). Lack Of Vitamin D May Increase Heart Disease Risk. ScienceDaily.

Women who are an unhealthy weight during pregnancy may be putting themselves and their unborn babies at risk. More than half of non-pregnant women of childbearing age are considered overweight or obese. Gaining too much weight during pregnancy can lead to complications for both mother and baby.

Complications for babies can include neural tube defects, such as spina bifida, heart defects and the risk of having more than one health problem at birth, or multiple anomalies. In addition, babies born to overweight mothers are more likely to be obese when they grow up.

For overweight pregnant mothers, health risks can run the gamut from high blood pressure to preeclampsia, increasing the risk of a cesarean birth, the necessity of inducing labor, and hemorrhage. In addition, being overweight or obese during pregnancy increases the risk of gestational diabetes. Having diabetes during pregnancy is one of the risk factors for the development of type 2 diabetes later on.

There is a definite relationship between obesity in pregnancy and obesity in the offspring of overweight women. By entering pregnancy at a healthy weight, women can reduce the risk of their children becoming obese, lowering their future risk of diseases related to obesity, such as heart disease and diabetes.

Source: Overweight Pregnant Women May Be Putting Their Infants At Risk

Most of us associate high cholesterol levels with advancing age. Cholesterol is something you are not supposed to have to worry about until middle to late adulthood. This is not necessarily the case: a new study has shown that many teens have high cholesterol levels, predisposing them to the risk of heart disease at a younger age.

A study of 3,125 teens found that an astonishing 20% of the subjects, aged 12 to 19, had abnormally high lipid or cholesterol levels. Males were affected more often than females. In some cases high levels correlated with the teen being overweight, but even some of the normal-weight teens (14.2%) had unhealthy levels. Being overweight would likely lead to screening of cholesterol and lipid levels for some of the teens, but those of normal weight would likely not be tested on a routine basis.

The study pointed to the need for health care professionals and parents to be aware of the risks of these high levels, and to encourage teens to modify their risk factors early. Exercising and weight reduction, as well as watching their diet, should be counseled. For teens who have a positive family history of heart disease, this may be even more important.

Source: Prevalence of Abnormal Lipid Levels Among Youths — United States, 1999—2006 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5902a1.htm