Cannabis Singled Out for Cardiovascular Risk

 Not enough information here to tell me if this cannabis use is smoked or an edible. So without that this click-bait title tells us nothing!

For my next stroke I will use cannabis for recovery.

Didn't your competent? doctor prescribe marijuana years ago to help your stroke recovery?  Oh, you don't have a functioning stroke doctor, do you? 

• 13 reasons for marijuana (132 posts to April 2014)

• marijuana (150 posts to April 2011)

Cannabis Singled Out for Cardiovascular Risk

Findings independent of tobacco and e-cigarette use considered a "call to action"

by Nicole Lou, Senior Staff Writer, MedPage Today February 28, 2024

Cannabis use was independently linked to adverse cardiovascular outcomes in the general population even after accounting for tobacco cigarette and e-cigarette use, a large national study found.

Using data from the CDC's Behavioral Risk Factor Surveillance System (BRFSS), there was an increase in most incident cardiovascular disease events among adults using cannabis daily compared with non-users:

• Coronary heart disease: adjusted OR 1.16, 95% CI 0.98-1.38
• Myocardial infarction: adjusted OR 1.25, 95% CI 1.07-1.46
• Stroke: adjusted OR 1.42, 95% CI 1.20-1.68
• Composite of the three: adjusted OR 1.28, 95% CI 1.13-1.44

Evidence of an association between cannabis use and cardiovascular events persisted in non-tobacco smokers and younger people at risk of premature cardiovascular disease (men under 55 and women under 65), reported the study authors led by Abra Jeffers, PhD, a data analyst at Massachusetts General Hospital in Boston.

"We also accounted for number of days used per month as a continuous variable. This analysis is important, because it suggests that cannabis use alone may be a risk factor for adverse cardiovascular outcomes," Jeffers and team wrote in the Journal of the American Heart Associationopens in a new tab or window.

Of note, cannabis use has been rising while conventional tobacco use has decreased nationwide. According to the CDC, marijuana is the most commonly used federally illegal drug in the U.S., with 48.2 million people (or 18% of Americans) using it at least once in 2019.

"Despite common use, little is known about the risks of cannabis use and, in particular, the cardiovascular disease risks," said Jeffers in a press release from the American Heart Association (AHA). "Cannabis smoke is not all that different from tobacco smoke, except for the psychoactive drug: THC versus nicotine. Our study shows that smoking cannabis has significant cardiovascular risks, just like smoking tobacco."

The investigators noted that their study is consistent with older, smaller BRFSS studies supporting a relationship between cannabis and cardiovascular harms. Being three to 17 times larger, however, the present report had an adequate sample to show harms in the subgroup of tobacco and e-cigarette never-users.

"This is an important public health finding, particularly given our ongoing efforts to reduce the burden of heart disease in this country," said David Goff, MD, PhD, director of the National Heart, Lung, and Blood Institute's Division of Cardiovascular Sciences, in a statement.

Outside the CDC survey, other work has suggested that use of cannabis and other recreational substances is associated with early-onset atherosclerotic cardiovascular disease.

Yet cannabis is often undisclosed by patients. One French study showed that many recreational drug users with acute cardiovascular events landed in cardiac intensive care units without disclosing their drug use.

"As cannabis use continues to grow in legality and access across the U.S., practitioners and clinicians need to remember to assess cannabis use at each patient encounter in order to have a non-judgmental, shared decision conversation about potential cardiovascular risks and ways to reduce those risks," commented Robert Page II, PharmD, MSPH, of the University of Colorado School of Medicine in Aurora, in the AHA press release.

"The findings of this study have very important implications for population health and should be a call to action for all practitioners, as this study adds to the growing literature that cannabis use and cardiovascular disease may be a potentially hazardous combination," he added.

The population-based, cross-sectional study was based on data from the BRFSS covering 27 U.S. states and two territories. The analysis relied on data from the 2016 to 2020 telephone surveys, for which there were 434,104 respondents ages 18 to 74 years.

Overall, 55% of the respondents were ages 35-64, and 14.5% were ages 65-74; 51.1% were women, and 60.2% were white. The prevalence of daily and non-daily cannabis use was 4% and 7.1%, respectively.

Jeffers and colleagues acknowledged their reliance on self-reported cardiovascular conditions and cannabis use. Anonymous data also precluded linkage to mortality records for analysis.

Prospective cohort studies are needed to confirm their findings, they said.

• 

  Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was funded by grants from the National Heart, Lung, and Blood Institute and the National Cancer Institute.

Jeffers had no disclosures.

Primary Source

Journal of the American Heart Association

Source Reference: opens in a new tab or windowJeffers AM, et al "Association of cannabis use with cardiovascular outcomes among US adults" J Am Heart Assoc 2024; DOI: 10.1161/JAHA.123.030178.

Marijuana’s impact on cardiovascular risk uncertain

Insufficient evidence so more followup needed which will never occur. 

I'm not medically trained so I obviously don't know anything.  But I will do marijuana after my next stroke.

My 13 reasons for marijuana use post-stroke. 

Consuming Cannabis Could Slash Your Chances Of Blood Clots, Stroke: Study

https://www.mdlinx.com/internal-medicine/top-medical-news/article/2018/01/23/7501103/?

Reuters Health News

A systematic literature review found insufficient evidence to determine whether marijuana has any effect, positive or negative, on cardiovascular risk factors and outcomes, researchers say.
“The few studies that suggested a possible benefit were cross-sectional, and were contradicted by more robust longitudinal studies that reported potential harmful effects,” Dr. Divya Ravi of the Wright Center for Graduate Medical Education in Scranton, Pennsylvania, and Dr. Salomeh Keyhani of the University of California, San Francisco, told Reuters Health.
“With the recent change in policies, clinicians are more likely to encounter the effects of marijuana use, especially among middle-aged patient populations with existing comorbidities,” they said in a joint email. “At this juncture, we have little data on potential harms associated with use to inform the counseling of patients.”
The researchers analyzed data from English-language observational studies, of adults using any form of marijuana, that reported on vascular risk factors such as hyperglycemia, diabetes, dyslipidemia and obesity—or on cardiovascular outcomes and all-cause mortality. All had been published from January 1975 through September 2017.
As reported online January 22 in Annals of Internal Medicine, 13 studies examined associations between marijuana use and cardiovascular risk factors and 11 looked at clinical outcomes.
Six cross-sectional studies suggested a metabolic benefit from marijuana use, but the findings were not supported by prospective studies. Evidence was insufficient to detect an effect of marijuana on diabetes, dyslipidemia, acute myocardial infarction, stroke, or cardiovascular and all-cause mortality, according to the authors.
More recent long-term, prospective studies were limited by recall bias, inadequate exposure assessment, minimal marijuana exposure, and the use of mostly low-risk cohorts.
Drs. Ravi and Keyhani conclude, “There is a need to perform robust longitudinal studies that adequately characterize marijuana exposure, especially among an aging population.”
Dr. John Higgins, a sports cardiologist with McGovern Medical School at UTHealth in Houston, told Reuters Health, “The active ingredients of marijuana, cannabinoids, stimulate cannabinoid receptors CB1 and CB2, which are widely distributed in the cardiovascular system.”
“These receptors, when activated, can modulate the function of various cellular elements of the vessel wall, the immune system, and heart rate/blood pressure—and may contribute to the pathogenesis of atherosclerosis,” he said by email.
“In the short term,” he noted, “we know that marijuana does affect the senses and mood, impairs mental and physical functioning, and can result in psychiatric symptoms such as hallucinations, paranoia and delusions.”
“In addition,” he said, “high-risk behaviors have been associated with people under the influence of marijuana, which can have short- and long-term consequences to their health.”
“The associations of marijuana use with other drugs and dependencies/addictions (also) need to be clarified in order to learn the true effects of marijuana on the body systems,” he concluded.
Two cardiologists from Colorado, where recreational and medical marijuana use are legal, also commented by email. Dr. Larry Allen of UCHealth University of Colorado Hospital, Anschutz Medical Campus in Aurora, said the findings “are consistent with my reading of the literature and with my own experience in taking care of patients.”
“Those who use marijuana are not necessarily the same as those who do not, and thus observational comparisons and associations are highly problematic,” he stressed. “There are plenty of unfounded claims out there for both risk and benefit.”
Dr. Robert Page, Lead Cardiac Transplant Pharmacist at the University of Colorado, said, “Marijuana is not regulated, even in dispensaries, so home-grown products can contain pesticides and fungicides that could contribute to potential cardiovascular conditions.”
“It is just like herbal products,” he continued. The US FDA should do what was proposed due to the association of drinking energy drinks and cardiovascular events. Products were moved to the ‘food’ category for appropriate regulation under the Food, Drug, and Cosmetic Act.”
“However,” Dr. Page acknowledged, “this would warrant changing legislation, and moving marijuana from a schedule 1 drug so we can study the product.”
“We are back in the same situation that we were in the 1950s and ‘60s with cigarette smoking,” he concluded. “Policy makers need to consider well-designed cohort studies now if this question (about cardiovascular risk) is to be answered in the near future.”
Dr. Robert Kloner, Director of the Cardiovascular Research Institute at Huntington Medical Research Institutes in Pasadena, California, said in an email to Reuters Health, “Marijuana use is likely here to stay, and legalized increased use will continue. Just like alcohol, there may be both benefits and deleterious effects of the drug on the cardiovascular system.”
“We need to determine what factors may lead to benefits and what factors may lead to deleterious effects so that we can better educate subjects and patients who use marijuana,” he stressed. “I hope there is increased funding from states and the federal government to better understand the effect of marijuana on the cardiovascular system as well as other organ systems in the body.”

Brain activity may be predictor of stress-related cardiovascular risk

So your doctor can now measure the effects of the doctor caused stress you are under because your doctor has no fucking clue how to get you 100% recovered. 
http://newsroom.heart.org/news/brain-activity-may-be-predictor-of-stress-related-cardiovascular-risk

American Heart Association Rapid Access Journal Report

August 23, 2017 Categories: Heart News

Study Highlights

• A pattern of brain activity that occurs during psychological stress may predict bodily reactions, such as surges in our blood pressure, that increase risk for cardiovascular disease.
• People who have exaggerated responses to stressors, like large rises in blood pressure or heart rate, are at greater risk of developing hypertension and premature death from cardiovascular disease, researchers say.

Embargoed until 3 p.m. CT / 4 p.m. ET Wednesday, Aug. 23, 2017
DALLAS, Aug. 23, 2017 — The brain may have a distinctive activity pattern during stressful events that predicts bodily reactions, such as rises in blood pressure that increase risk for cardiovascular disease, according to new proof-of-concept research in the Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.
The new research, the largest brain-imaging study of cardiovascular stress physiology to date, introduced a brain-based explanation of why stress might influence a person’s heart health. 
“Psychological stress can influence physical health and risk for heart disease, and there may be biological and brain-based explanations for this influence,” said Peter Gianaros, Ph.D., the study’s senior author and psychology professor at the University of Pittsburgh in Pennsylvania.
To help understand the brain-body link between stress and health, researchers conducted mental stress tests and monitored blood pressure and heart rates during an MRI procedure. The mental tests were designed to create a stressful experience by having research volunteers receive negative feedback while they were making time-pressured responses to computer challenges.
Research participants – 157 men and 153 women – were 30 to 51 years old and part of the Pittsburgh Imaging Project, an ongoing study of how the brain influences cardiovascular disease risk. As expected, the mental stress tests increased blood pressure and heart rate in most of the volunteers compared to a non-stress baseline period.
Using machine-learning, researchers determined that a specific brain activity pattern reliably predicted the size of the volunteers’ blood pressure and heart rate reactions to the mental stress tests.
The brain areas that were especially predictive of stress-related cardiovascular reactions included those that determine whether information from the environment is threatening and that control the heart and blood vessels through the autonomic nervous system.
The study was based on a group of middle-aged healthy adults at low levels of risk for heart disease, so the findings may not be applicable to patients with existing heart disease. Also, brain imaging does not allow researchers to draw conclusions about causality.
“This kind of work is proof-of-concept, but it does suggest that, in the future, brain imaging might be a useful tool to identify people who are at risk for heart disease or who might be more or less suited for different kinds of interventions, specifically those that might be aimed at reducing levels of stress,” Gianaros said. “It’s the people who show the largest stress-related cardiovascular responses who are at the greatest risk for poor cardiovascular health and understanding the brain mechanisms for this may help to reduce their risk.”
Co-authors are Lei Sheu, Ph.D.; Fatma Uyar, Ph.D.; Jayanth Koushik, B.S.; J. Richard Jennings, Ph.D.; Tor Wager, Ph.D.; Aarti Singh, Ph.D.; and Timothy Verstynen, Ph.D. Author disclosures are on the manuscript.
The National Institutes of Health and the National Science Foundation funded the study.
Additional Resources:

• Available multimedia is on the right column of the release link - http://newsroom.heart.org/news/brain-activity-may-be-predictor-of-stress-related-cardiovascular-risk?preview=80f5dbfe9f8cf0286f161417e2ca0dd9
• After Aug. 23, view the manuscript online.
• Follow AHA/ASA news on Twitter @HeartNews
• For updates and new science from JAHA, follow @JAHA_AHA

Associations between both lignan and yogurt consumption and cardiovascular risk parameters in an elderly population: Observations from a Cross-Sectional Approach in the PREDIMED Study

You need to ask your doctor, 'Just when the fuck will I get diet protocols written by your nutritionist?' 'Not generalities, specifics.'
1. Diet stroke prevention?
2. Diet stroke recovery?
3. Diet high blood pressure reduction?
4. Diet dementia prevention?
Or is this one of those dangerous tasks patients have to do on their own with no guidance?

 Associations between both lignan and yogurt consumption and cardiovascular risk parameters in an elderly population: Observations from a Cross-Sectional Approach in the PREDIMED Study

Journal of the Academy of Nutrition and Dietetics, 01/06/2017

Creus–Cuadros A, et al. – This research was done in order to assess a possible relationship between yogurt and lignans using biomarkers of cardiovascular disease risk in an elderly population. The results of this study showed that high lignan and yogurt consumption is correlated with a better cardiovascular risk parameters profile in an elderly Mediterranean population.

Methods

• The researchers directed a cross-sectional analysis of the relationship between baseline dietary information and cardiovascular risk parameters using food frequency questionnaires.
• They enlisted 7,169 Spanish participants of the PREDIMED (Prevención con Dieta Mediterránea) study (elderly men and women at high cardiovascular risk) from June 2003 to June 2009.
• After that, cardiovascular risk parameters, including cholesterol, triglycerides, glucose, body mass index, weight, waist circumference, and blood pressure were measured.
• Finally, general linear models were utilized to evaluate the relationship between categorical variables (yogurt, total dairy intake, lignans, and yogurt plus lignans) and cardiovascular risk parameters.

Results

• The results of this study showed that the consumption of either yogurt or lignans appears to beneficially effects on human health, but the consumption of both demonstrated greater improvement in some cardiovascular health parameters.
• It was observed in the findings that participants with a higher consumption of both yogurt and lignans indicated lower total cholesterol (estimated β-coefficients=-6.18; P=0.001) and low-density lipoprotein cholesterol levels (β=-4.92; P=0.005).
• Findings also revealed that participants with lower yogurt and lignan consumption had a higher body mass index (β=0.28; P=0.007) and weight (β=1.20; P=0.008).

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Recreational, commuter biking linked to lower cardiovascular disease risk

Well shit, I biked to and from work 4 miles 9 months out of the year. I raced cars home, managed to have two accidents in those 25 years of biking. Didn't prevent plaque in my arteries. But I'm sure my cardiovascular fitness as a result of that allowed me to survive my stroke.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=169385&CultureCode=en

People who bike regularly, either for pleasure or as a way to commute, appear to have a lower risk of cardiovascular disease, according to two separate studies published simultaneously in the American Heart Association’s journal Circulation and Journal of the American Heart Association, the AHA/ASA’s Open Access Journal.
While structured cycling as part of a formal workout routine is already known to guard against cardiovascular illness, little is known about the effects of habitual biking done for leisure or as a way to commute. Together, the findings from the newly published studies suggest that leisure and commuter biking may be an important public health strategy in large-scale efforts to reduce cardiovascular risk.
In the Circulation study, 45,000 Danish adults (aged 50 to 65) who regularly biked for recreation or to commute had between 11 percent and 18 percent fewer heart attacks during a 20-year follow-up (1993-2013).
The analysis showed that as little as half an hour of biking per week provided some protection against coronary artery disease. Additionally, people who took up biking during the first five years the authors followed them had about a 25 percent lower risk of developing heart disease, compared with those who remained non-bikers in the subsequent 15-year period.
Researchers caution that their findings do not prove definitively that riding a bike for leisure or to and from work can prevent heart attacks. However, they say, the lower number of cardiovascular events observed among those who biked on a regular basis is a strong indicator that such activity can boost cardiovascular health.
“Finding time for exercise can be challenging for many people, so clinicians working in the field of cardiovascular risk prevention should consider promoting cycling as a mode of transportation,” said Anders Grøntved, M.Sc., M.P.H., Ph.D., senior study author and associate professor of physical activity epidemiology at the University of Southern Denmark.
Researchers also tracked participants’ overall exercise habits, activity levels and frequency of bicycle riding, along with heart disease risk factors, such as blood pressure, weight, cholesterol, smoking, diet and alcohol consumption. Participants were asked to provide information about cycling habits at the onset of the study and once more in five years.
In all, there were 2,892 heart attacks during the 20-year follow-up. Researchers estimate that more than 7 percent of all heart attacks could have been averted by taking up cycling and keeping it up on a regular basis.
“Because recreational and commuter biking is an easy way to make physical activity part of one’s routine in a non-structured and informal fashion, based on the results, public health authorities, governments and employers ought to consider initiatives that promote bicycle riding as a way to support large-scale cardiovascular disease prevention efforts,” said Kim Blond, M.Sc, lead author and research assistant at the University of Southern Denmark.
The Journal of the American Heart Association study revealed that middle-aged and older Swedish adults who biked to work were less likely than non-bikers to be obese, have high cholesterol, high blood pressure or pre-diabetes — all critical drivers of cardiovascular risk.
Researchers followed more than 20,000 people in their 40s, 50s and 60s over 10 years and monitored their commuting habits, weight, cholesterol levels, blood glucose and blood pressure.
At the beginning of the study, active commuters (biked to work) were 15 percent less likely to be obese, 13 percent less likely have high blood pressure, 15 percent less likely to have high cholesterol and 12 percent less likely to have pre-diabetes or diabetes, compared with passive commuters (used public transportation or drove to work).
During a follow-up exam 10 years later, the portion of study participants who switched from passive commuting to active commuting also had an improved risk profile. They were less likely to be obese, have diabetes, hypertension or elevated cholesterol, compared with non-bikers.
Collectively, at the 10-year follow-up, those who maintained biking or took up biking at some point had a 39-percent lower risk of obesity, 11 percent lower risk of high blood pressure, 20 percent lower risk of high cholesterol and 18 percent lower diabetes risk.
“We found active commuting, which has the additional advantages of being time-efficient, cheaper and environmentally friendly is also great for your health,” said Paul Franks, Ph.D., senior study author, professor in the Department of Clinical Sciences at Lund University in Sweden and guest professor at Umeå University in Sweden. “The multiple advantages of active commuting over structured exercise may help clinicians convey a message that many patients will embrace more readily than being told to join a gym, go for a jog or join a sports team.”
Researchers noted that there was no minimum amount of time or distance required to reduce one’s risk, even though people who biked longer or more often experienced small additional gains in risk reduction.
Because the study was observational, it is difficult to establish a cause-and-effect relationship between improved cardiovascular health and commuter biking, but the findings do indicate a strong cardio-protective effect from cycling.
Based on their findings, researchers also estimated that maintaining biking habits or switching from passive commuting to biking may have prevented 24 percent of obesity cases, 6 percent of hypertension diagnoses, 13 percent of high cholesterol diagnoses, and 11 percent of the cases of diabetes.
“The really good news here is that it’s never too late to benefit from an active lifestyle,” Franks said. “People who switched from passive to active commuting saw considerable gains in their cardiovascular health.”
Co-authors of the Circulation study are Kim Blond, M.Sc.; Martin Rasmussen, M.Sc.; Lars Østergaard, Ph.D.; Majken Jensen, PhD; Kim Overvad, MD, PhD; and Anne Tjønneland, MD, DMSc.
Co-authors of the JAHA study are Anders Grøntved, M.Sc., M.P.H., Ph.D.; Lars Østergaard, Ph.D.; Robert Koivula, M.Sc; Frida Renström, Ph.D; Ingegerd Johansson, D.D.Sc, Ph.D; Patrik Wennberg, M.D., Ph.D; and Göran Hallmans, M.D., Ph.D.
The Circulation study was funded by the Danish Cancer Society, the Lundbeck Foundation and the Danish Council for Independent Research.
The work described in the JAHA paper was funded by the Lundbeck Foundation, the Danish Council for Independent Research, the Novo Nordisk Foundation, the Swedish Research Council, the Swedish Heart-Lung Foundation and the European Research Council.
http://newsroom.heart.org/news/recreational-commuter-biking-linked-to-lower-cardiovascular-disease-risk?preview=145ce6d0890e1db0781a6cccc44c0b3d

• Full bibliographic informationJAHA:
  Bicycling to Work and Primordial Prevention of Cardiovascular Risk: A Cohort Study Among Swedish Men and Women
  Anders Grøntved, M.Sc., M.P.H., Ph.D.; Lars Østergaard, Ph.D.; Robert Koivula, M.Sc; Frida Renström, Ph.D; Ingegerd Johansson, D.D.Sc, Ph.D; Patrik Wennberg, M.D., Ph.D; and Göran Hallmans, M.D., Ph.D.
  (DOI: 10.1161/JAHA.116.004413)
  
  Circulation:
  Prospective Study of Bicycling and Risk of Coronary Heart Disease in Danish Men and Women
  Kim Blond, M.Sc.; Martin Rasmussen, M.Sc.; Lars Østergaard, Ph.D.; Majken Jensen, PhD; Kim Overvad, MD, PhD; and Anne Tjønneland, MD, DMSc.
  (DOI: 10.1161/CIRCULATIONAHA.116.024651)

Moderate physical activity linked with 50% reduction in cardiovascular death in over-65s

At least this one actually defined moderate exercise so you could actually use this information. Maybe not so useful, previous CVD events were excluded from the research. I was doing high intensity exercise but still had a stroke.  A great stroke association would complete this research with prior stroke patients. But that followup won't happen ever.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=167333&CultureCode=en
Moderate physical activity is associated with a greater than 50% reduction in cardiovascular death in over-65s, according to research presented at ESC Congress 2016 today.1 The 12 year study in nearly 2500 adults aged 65 to 74 years found that moderate physical activity reduced the risk of an acute cardiovascular event by more than 30%. High levels of physical activity led to greater risk reductions.
“The role of physical activity in preventing cardiovascular disease (CVD) in people of working age is well established,” said Professor Riitta Antikainen, professor of geriatrics at the University of Oulu, Finland. “But relatively little is known about the effect of regular physical activity on CVD risk in older people.”
The present study assessed the association between leisure time physical activity and CVD risk and mortality in 2456 men and women aged 65 to 74 years who were enrolled into the National FINRISK Study between 1997 and 2007.
Baseline data collection included self-administered questionnaires on physical activity and other health related behaviour, clinical measurements (blood pressure, weight and height), and laboratory measurements including serum cholesterol. Participants were followed up until the end of 2013. Deaths were recorded from the National Causes of Death Register and incident CVD events (coronary heart disease and stroke) were collected from the National Hospital Discharge register.
The researchers classified self-reported physical activity as:
·       Low: reading, watching TV or working in the household without much physical activity.
·       Moderate: walking, cycling or practising other forms of light exercise (fishing, gardening, hunting) at least four hours per week.
·       High: recreational sports (for example running, jogging, skiing, gymnastics, swimming, ball games or heavy gardening) or intense training or sports competitions at least three hours a week.
During a median follow-up of 11.8 years, 197 participants died from CVD and 416 had a first CVD event.
When the researchers assessed the link between physical activity and outcome they adjusted for other cardiovascular risk factors (blood pressure, smoking and cholesterol) and social factors (marital status and education). To minimise reverse causality, where worse health leads to less physical activity, patients with coronary heart disease, heart failure, cancer, or prior stroke at baseline were excluded from the analysis.
The investigators found that moderate and high leisure time physical activity were associated with a 31% and 45% reduced risk of an acute CVD event, respectively (figure 1). Moderate and high leisure time physical activity were associated with a 54% and 66% reduction in CVD mortality.
Professor Antikainen said: “Our study provides further evidence that older adults who are physically active have a lower risk of coronary heart disease, stroke, and death from cardiovascular disease. The protective effect of leisure time physical activity is dose dependent – in other words, the more you do, the better. Activity is protective even if you have other risk factors for cardiovascular disease such as high cholesterol.” 
She concluded: “Physical exercise may become more challenging with ageing. However, it is important for older people to still get enough safe physical activity to stay healthy after their transition to retirement.”
Figure 1. Relative risk of cardiovascular disease events and death according to physical activity level
Full bibliographic information1Professor Riitta Liisa Antikainen will present the abstract “Leisure time physical activity reduces the risk of cardiovascular death and an acute CVD event also among older adults” during:
• The press conference “The cardiovascular risks of modern life” on 27 August at 12:30 to 13:30
• The session “One to ten in exercise, physical activity and cardiology” on 27 August at 13:30 to 15:00 in Agora 1 – Poster Area

The role of dietary phenolic compounds in cardiovascular diseases

Your doctor and nutritionist should be deciding how much folate you should have. Like maybe creating a stroke diet protocol?
http://www.uef.fi/en/web/nutritionepidemiologists/other-research-topics
We are a group of nutrition researchers from the University of Eastern Finland (UEF), Kuopio Campus. The main field of our research is epidemiological research, but we also do clinical trials.
With approximately 14 000 students and 3000 members of staff, the University of Eastern Finland is one of the largest universities in Finland. Its four faculties offer teaching in more than 100 major subjects.
The UEF is an international, research-intensive university and has campuses in Joensuu, Kuopio and Savonlinna. The campus of Kuopio specializes in health sciences and it is also the only place in Finland where one can study clinical nutrition and become a certified clinical nutritionist.
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During the last years, elevated plasma total homocysteine (tHcy) has been one of the most studied risk factors for heart diseases.
Homocysteine (Hcy) is a sulphur-containing amino acid, which is formed from the essential amino acid methionine. Defects in intracellular Hcy metabolism lead to the elevation of plasma tHcy. These metabolic defects can have a genetic or a nutritional background, i.e. an inadequate intake of folate or vitamin B6 or B12 that serve as cofactors or substrates to the enzymes involved in the Hcy metabolism. Approximately two thirds of the cases with elevated tHcy levels have been estimated to be due to low or moderate concentrations of these vitamins, of which folate is considered the most important. Few previous epidemiological studies have addressed the link between folate and the risk of cardiovascular diseases (CVD). In some studies, subjects with lower circulating folate concentrations or lower dietary intake of folic acid have had higher risk of coronary events compared with others, although not all studies have found this association.
Although it has been supposed that elevated plasma tHcy concentration is a risk factor for CVD, the risk-increasing mechanisms are still poorly understood. It has been proposed that high plasma tHcy concentration alters the anticoagulant properties of endothelial cells to a procoagulant phenotype, causes dysfunction of the vascular endothelium or enhances lipid peroxidation.

Gene-nutrient interactions, folate and paraoxonase (PON)

The human serum paraoxonase/arylesterase (PON) is an antioxidative enzyme in HDL, which eliminates radicals in the circulation and protects against coronary diseases. PON has been suggested to account for an important part of the antioxidative property of HDL, and it has been shown that PON protects LDL against oxidation. Its activity is modulated by two common amino acid polymorphisms at positions 192 (Gln Q > Arg R) and 55 (Met M > Leu L) in the paraoxonase gene PON1. A lowered PON activity has been reported also in patients with atherosclerotic heart disease. Low PON activity or polymorphisms in PON1 gene that are associated with paraoxonase levels in serum are also associated with CHD in some prospective studies.

In human plasma Hcy exists in various forms: less than 1% is in the reduced (sulfhydryl) form, remaining part is oxidized and exists as various disulphides, such as Hcy thiolactone. Hcy thiolactone is formed in all cell types in a human and because inadvertent reactions of thiolactone with proteins are potentially harmful, the ability to detoxify Hcy thiolactone is essential for biological integrity.

Dr. Jakubowski reported that the enzyme Hcy thiolactonase, which hydrolyzes Hcy thiolactone to Hcy, could be in fact paraoxonase. If it is so, paraoxonase can hydrolyze Hcy thiolactone back to Hcy and Hcy may be then converted either back to methionine (by reaction which needs folate and vitamin B12 as co-factors), or condensed with serine to form cystathionine in a reaction that is dependent on vitamin B6 (transsulphuration pathway). In light of Dr Jakubowski's study, it is possible that folic acid supplementation or high folate intake decreases plasma tHcy (and plasma Hcy-thiolactone levels) and affects serum PON activity by this mechanism.

Gene-nutrient interactions, folate, homocysteine and COMT

Catechol-O-methyltransferase (COMT) is an enzyme that has a crucial role in dopamine inactivation. A common functional polymorphism (Val108Met) in the COMT gene is associated with a three- to four-fold variation in enzyme activity. The low activity genotype has been associated with alcoholism and some other psychiatric disorders, such as bipolar disorder and schizophrenia. COMT also catalyzes the O-methylation of various compounds, like catechol estrogens and dietary polyphenols, and is closely involved to homocysteine metabolism. Therefore we wanted to test the hypothesis that the functional polymorphism in COMT gene could modify the coronary event risk by increasing effect of serum tHcy. Our manuscript "Interaction of serum total homocysteine and folate concentration and the catechol-O-methyltransferase (COMT) gene with risk of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study" is now submitted.

Our earlier results and research interests

We have shown in our Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study that high serum concentration and dietary intake of folate is associated with significantly lower risk of acute coronary events, but in a nested case-control setting of this same cohort elevated plasma tHcy concentration is not associated with elevated risk of coronary events. In KIHD Study low folate intake is also significantly related to increased CVD and overall mortality (in a Cox' proportional hazards' model adjusted for age, examination years, serum LDL and HDL cholesterol, diabetes, systolic blood pressure and BMI, men in the highest fifth of folate intake had a relative risk of CVD death of 0.50 (95% CI 0.27 to 0.92), the risk of CHD death of 0.54 (95% CI 0.26 to 1.13), and death due to any cause of 0.63 (95% CI 0.47 to 0.86), when compared with men in the lowest fifth of folate intake).In a cross sectional analysis of Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) Study we have shown that high plasma tHcy levels are associated with enhanced in vivo lipid peroxidation in men, as measured by plasma F2-isoprostane concentrations. We have also shown in supplementation study of 40 men that dietary folic acid enhances serum PON activity.Sari Voutilainen's present research interest in homocysteine-folate metabolism is to study association between folate and homocysteine with PON enzyme activity, PON genes and CVD risk. Genes available for these analyses three mutations in PON1 genes and one in PON2 gene. Material available for these analyses is KIHD Study 4-year visit cohort, n=1038 men.

Homocysteine and other CVD risk factors

High circulating Hcy concentrations may increase the risk of CVD when present with other CVD risk factors. For example, there is some evidence that in hypercholesterolemic patients the risk of an atherosclerotic event was about three times higher in patients with high plasma tHcy concentrations compared to those with low tHcy concentrations. Another study done in subjects with elevated LDL cholesterol concentrations suggests that even mildly increased plasma tHcy levels are of crucial importance for deterioration of endothelial function. Increased risk of mortality in the subjects with both elevated cholesterol and tHcy concentrations may at least partly be explained by deterioration of endothelial function.Similar findings to those found in hypercholesterolemic patients have also been reported in case of increased plasma fibrinogen levels or in smokers. The increased risk with increased fibrinogen and tHcy concentrations could be explained by their complementary roles in the platelet activation-aggregation cascade. Fibrinogen represents a major step in platelet aggregation while homocysteine impairs nitric oxide production and also contributes to the generation of oxidized species. In some studies smoking has been shown to increase plasma tHcy concentrations, but in the KIHD study population this is not seen. Smokers have an increased risk of vascular disease in general and according to some recent research the risk is greatly increased in the presence of a raised plasma tHcy concentration when compared with non-smokers.

Homocysteine and methionine

Currently Jyrki Virtanen is studying the effects of high plasma tHcy concentration on CVD risk in men of the KIHD study, who also have other CVD risk factors. These include smoking, high serum total and LDL cholesterol and apo-B apolipoprotein concentrations and high plasma fibrinogen concentration. Preliminary results would seem to indicate that although tHcy alone is not a risk factor for CVD in this study population, it may increase the risk when present with above mentioned risk factors.
Since Hcy is formed from an essential dietary amino acid methionine, high intakes of methionine increase the plasma tHcy concentrations. This happens because the capacity of the transsulfuration pathway is exceeded and Hcy is excreted from cells. Elevation of plasma tHcy occurs, for example, in the oral methionine loading test, in which a large dose of methionine (0.1 g/kg body weight of L-methionine) is ingested to diagnose hyperhomocysteinemia. It could be speculated that a long-term high methionine intake from diet could lead to modest but chronic plasma tHcy concentrations, which in turn could increase the risk of CVD.

Homocysteine and stroke

Although high plasma tHcy has been suggested to be a risk factor for CVD, its role as a risk factor for stroke is more controversial. Although most case-control studies suggest it to be a risk factor for stroke, the results from prospective studies are conflicting. Two recent meta-analyses, however, have concluded that Hcy might increase the risk of stroke. The mechanisms through which Hcy could cause stroke are its hypercoagulative effects in ischemic stroke and promotion of plaque rupture in hemorrhagic stroke. Jyrki Virtanen's next paper will concern the role of high plasma tHcy concentration in the risk of overall and ischaemic stroke in the KIHD study population.

Conclusion

Although folate or folic acid intake could lower the risk of CVD through reducing plasma tHcy concentrations, elevated homocysteine may also be only a marker for low folate and/or vitamin B6 status or an indicator of an unhealthy lifestyle rather than a causal risk factor per se. Ongoing intervention trials will indicate whether homocysteine-lowering through vitamin supplementation prevents heart diseases, or are the measured circulating high homocysteine and low folate levels just markers of unhealthy lifestyle.

 

 

 

 

 

More information about our studies: sari.voutilainen at uef.fi, jyrki.virtanen at uef.fi

Our publications:

Voutilainen Sari et al: Functional COMT Val158Met Polymorphism, Risk of Acute Coronary Events and Serum Homocysteine: The Kuopio Ischaemic Heart Disease Risk Factor Study. PLoS ONE 2007 Jan 31;2:e181.

Virtanen J et al. High dietary methionine intake increases the risk of acute coronary events in middle-aged men. Nutr Metab Cardiovasc Dis 2006;16:113-20.
Virtanen J et al. Serum homocysteine, folate and risk of stroke: Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Eur J Cardiovasc Prev Rehabil 2005;4:369-75.
Voutilainen S, Virtanen JK, Rissanen TH, Alfthan G, Laukkanen J, Nyyssonen K, Mursu J, Valkonen VP, Tuomainen TP, Kaplan GA, Salonen JT. Serum folate and homocysteine and the incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2004;80(2):317-23.
Voutilainen S, Rissanen T, Virtanen J, Lakka TA, Salonen JTS. Low folate intakes are associated with an excess risk of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Circulation 2001;103:2674-2680.
Voutilainen S, Lakka TA, Porkkala-Sarataho E, Kaplan GA, Salonen JT. Low serum folate levels are associated with an excess risk of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:242-248.  
Voutilainen S, Lakka TA, Hämelahti P, lehtimäki T, Poulsen HE, Salonen JT. Plasma total homocysteine concentration and the risk of acute coronary events: the Kuopio Ischemic Heart Disease Risk factor Study. Journal of Internal Medicine 2000;248:217-222.
Voutilainen S, Morrow J, Roberts J, Alfthan G, Nyyssönen K, Salonen J. Correlation between Plasma Total Homocysteine Concentration and Plasma F2-Isoprostane in 100 men in Eastern Finland. Arteriosclerosis, Thrombosis and Vascular Biology 1999;19:1263-1266.  
Voutilainen S, Alfthan G, Nyyssönen K, Salonen R, Salonen JT. Association Between Elevated Plasma Homocysteine and Increased Carotid Artery wall Thickness in Men. Annals of Medicine 1998;30:300-306.
Voutilainen S, Rissanen T, Seppänen K, Porkkala-Sarataho E, Kaikkonen J, Tuomainen T-P, Virtanen J, Lehtimäki T, Malin R, Penttilä I, Kaplan GA, Salonen JT. Folic acid increases serum paraoxonase activity: evidence from a double blind oral supplementation trial in men. Current Topics in Nutraceutical Research 2003;1:175-182.

CardioBrief: Women With Migraine Face Increased CV Risk

But no explanation why. More research needed that will not occur in any reasonable amount of time. We need strong stroke leadership and a strategy, but have neither.
http://www.medpagetoday.com/Cardiology/CardioBrief/58237?xid=nl_mpt_DHE_2016-06-01&eun=g424561d0r

Women who have migraine headaches have a significantly increased risk of cardiovascular disease, according to new results from a large observational study published in The BMJ.
Earlier studies have established a strong link between migraine and stroke, which the new study now extends to other types of cardiovascular disease. However, the clinical implications are uncertain since there is no definite mechanism to explain the association.
Researchers analyzed data from more than 115,000 women followed for more than 20 years in the Nurses' Health Study II. More than 17,000 participants reported a migraine diagnosis. Women who had migraines were more likely to have other risk factors for cardiovascular disease, including hypertension, hypercholesterolemia, family history, obesity, and history of smoking.
After adjusting for the known risk factors, women with migraine had a significantly elevated risk for developing major cardiovascular disease (hazard ratio 1.50, 95% CI 1.33-1.69). The greatest increase in risk was for stroke (HR 1.62) and for angina/coronary revascularizations (HR 1.73).
The findings were consistent and robust across multiple analyses. But the authors acknowledged that, as with any observational study, cause and effect could not be demonstrated and that residual confounding factors might offer "a potential alternative explanation."
The chief weakness in the link between migraine and cardiovascular disease is the lack of "clear mechanisms ... that could explain the increased risk of cardiovascular disease," write the authors. There is also no evidence looking at "whether prevention of migraine attacks reduces these risks."
In an accompanying editorial, Rebecca Burch, MD, of Harvard Medical School, and Melissa Rayhill, MD, of SUNY Buffalo, wrote that "it is time to add migraine to the list of early life medical conditions that are markers for later life cardiovascular risk." But, they warned, "the magnitude of the risk should not be over-emphasized," because the increased risk "is small at the level of the individual patient but still important at a population level because migraine is so prevalent."
Burch and Rayhill also warned against any attempt to use the association to influence treatment. Without better evidence, they wrote, "migraine is probably best thought of as a situation in which the medical urge to 'do something' (beyond currently recommended assessments for cardiac risk and advocating a healthy lifestyle) should be resisted."
Burch affirmed her position in an email interview. "There is currently no evidence to recommend any changes in how physicians manage cardiovascular risk in patients with a history of migraine. If a patient has a history of migraine, it might remind the physician of the importance of assessing cardiovascular risk in that patient. Once the risk has been assessed, however, management would be the same: treatment of hypertension and hyperlipidemia, recommending regular exercise, etc."
The first author of the study, Tobias Kurth, MD, of the Harvard T.H. Chan School of Public Health, agreed with the editorialists and said that physicians "cannot really make any inference of treatment" based on the association in the study. "Physicians may want to discuss vascular risk with patients and reduce the risk by addressing known vascular risk factors (i.e., where we know that intervention helps)."

High nut consumption linked with reduction in CHD risk among women

Not enough information to help you, no amounts or type of nuts.
http://www.healio.com/cardiology/chd-prevention/news/online/%7Bd30f8dc3-9476-4768-9c0c-47e3df511345%7D/high-nut-consumption-linked-with-reduction-in-chd-risk-among-women?utm_source=maestro&utm_medium=email&utm_campaign=cardiology%20news
In an analysis of the Women’s Health Study, increased consumption of nuts was associated with reduced risk for CHD.

However, analysis yielded no relationship between nut consumption and CVD mortality in women.
Previous epidemiological studies have suggested that high nut consumption could protect against CHD due to positive effects on serum lipids, according to the study background.
“The study suggests that nut consumption is not associated with [CV] mortality in apparently healthy women,” Tasnim Imran, MD, from the division of aging, department of medicine, Brigham and Women’s Hospital, Boston Veterans Affairs Healthcare System and Harvard Medical School, and colleagues wrote in an abstract. “However, our secondary analysis is consistent with a lower risk for CHD with nut consumption in women.”
Imran and colleagues analyzed 39,167 participants from the Women’s Health Study (mean age, 55 years) with no CVD at baseline to determine the relationships between nut consumption and CVD mortality and CHD.
Participants reported nut consumption in a food-frequency questionnaire at baseline. CVD deaths and CHD incidence were attained through a follow-up questionnaire and medical records. Mean follow-up was 18.9 years. The results were presented at the National Lipid Association Scientific Sessions.
During the study period, 959 CVD deaths and 1,774 CHD events occurred.
When the researchers adjusted for age, alcohol use, smoking, physical activity, family history of premature MI in a parent and postmenopausal status, there was no significant relationship between nut consumption at CVD death (HR for nut consumption one to three times per month = 0.96; 95% CI, 0.81-1.13; HR for nut consumption once per week = 0.94; 95% CI, 0.78-1.2; HR for nut consumption at least twice per week = 0.9; 95% CI, 0.74-1.1) compared with women who did not consume nuts (P for linear trend = .25).
A secondary analysis showed that nut consumption was inversely associated with occurrence of CHD events. Compared with women who did not consume nuts, women consuming nuts one to three times per month (HR = 0.96; 95% CI, 0.85-1.09), women consuming nuts once per week (HR = 0.93; 95% CI, 0.81-1.06) and women consuming nuts at least twice per week (HR = 0.86; 95% CI, 0.74-0.99) had reduced risk for CHD, although it was only significant for the highest-consumption group (P for trend = .037).
Adjustment for dietary variables did not change the results.
This abstract won the second-place Young Investigator Award at the NLA Scientific Sessions. – by Dave Quaile
Reference:
Imran T, et al. Abstract 123. Presented at: National Lipid Association Scientific Sessions; May 19-22, 2016; New Orleans.
Disclosure: Imran reports no relevant financial disclosures.

Benefits of calcium supplements in preventing broken bones may be cancelled out by increased stroke risk

Be careful out there.
Have your doctor compare and contrast these pros and cons. Hopefully your doctor already knows about these research trials, but I highly doubt it. If not they should be fired.

Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline but causing falls

 

Scientists Pinpoint What Level of Vitamin D Promotes Heart Health

 

Low vitamin D predicts more severe strokes, poor health post-stroke

 

Effects of vitamin D supplementation on neuroplasticity in older adults: a double-blinded, placebo-controlled randomised trial

 

More Evidence That Vitamin D Protects Against Alzheimer’s - 

 

Vitamin D Blog: A Bedroom Boost

 

The Vitamin Which May Reduce Risk of Alzheimer’s and Dementia

 

Vitamin D, Omega-3 May Help Clear Amyloid Plaques Found in Alzheimer's

 

Low-Dose Vitamin D Prevents Muscular Atrophy and Reduces Falls and Hip Fractures in Women after Stroke

 

More Evidence That Vitamin D Protects Against Alzheimer’s - 

 

Warning: Vitamin D supplements may do more cognitive harm than good

 

New meta-analysis suggests "threshold" effect for vitamin D and CVD

 

If your doctor sees calcium, he knows you have heart disease

 

Vascular events in healthy older women receiving calcium supplementation

 

Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis

 

 The latest here:

Benefits of calcium supplements in preventing broken bones may be cancelled out by increased stroke risk

Taking calcium and vitamin D can help prevent broken bones in older women. However, this benefit may be cancelled out by an increased risk of heart attack and stroke.
With the highest reported risk of hip fractures in the word, Norway has good reason to consider the benefits and risks of calcium supplements. The challenge is that too little calcium and vitamin D in your diet leads to an increased risk of osteoporosis and broken bones, which taking supplements has been shown to help prevent.
However, some studies have also shown that taking supplemental calcium may also increase your risk of heart attack and stroke.
"We conclude that the moderate effect of supplemental calcium and vitamin D on the risk of fractures is not large enough to outweigh the potential increased risk of cardiovascular disease, specifically in women who are at a low risk of bone fracture," said Gunhild Hagen, a PhD candidate at the Norwegian University of Science and Technology's (NTNU) Department of Public Heath and General Practice who was first author of an article recently published in Osteoporosis International.
Analytical model of health effects
Researchers at NTNU and the University of Oslo used an advanced analytical model to investigate the total health effect of taking a combined calcium and vitamin D supplement, compared to taking no supplements, based on a group of healthy women aged 65 with a BMI of 24 kg/m2.
"Our analysis shows that if 100 000 65-year-old women take 1000 mg calcium every day, 5890 hip fractures and 3820 other fractures would be prevented. On the other hand, as many as 5917 heart attacks and 4373 strokes could be caused. So for women of this age, the risks outweigh the benefits," the authors of the study wrote in an article in Aftenposten, one of Norway's national newspapers.
Recent studies of the effect of calcium supplementation on the risks of heart attack and stroke differ in their conclusions, so the researchers used three different scenarios based on results from previous studies.

The high-risk model predicted that more than 10 000 heart attacks and strokes would be caused by supplemental calcium and vitamin D in a group of 100 000 65-year-old women, whereas the medium-risk model predicted about 5000.
Both models showed that the number of years of high-quality life lost by taking calcium was higher than the number of years of high-quality life saved by preventing broken bones.
Benefits are nullified
The study also investigated the cost-effectiveness of offering 65-year-old women supplemental calcium and vitamin D, assuming that the women were at low risk of cardiovascular problems. In this case, the authors concluded that providing supplements is cost-effective and good for public health, given that the benefits outweigh the risks.
If the supplement increases the risk of heart attack and stroke, however, both the savings and the public health benefits are lost.
Hagen says one possible solution is to prescribe medicines that help prevent osteoporosis along with vitamin supplements.
"If we provide a preventative osteoporosis medication in addition to a supplement, it will increase the effect of preventing bone fractures, and have a positive risk/gain ratio, resulting in reduced costs," says Hagen.
Don't know if calcium increases risk of heat disease
The researchers point out that it isn't possible to conclude that calcium increases risk of cardiovascular disease, and that the analysis needs to be seen in light of this uncertainty.
At the same time, their models are simplifications that can't replace studies done on actual people.
"We don't know for sure if calcium has this negative effect, but to be careful, we should choose to give another treatment to help prevent broken bones in older women," says Hagen.

Source:

The Norwegian University of Science and Technology (NTNU)

Benefits of calcium supplements/vitamin D may be outweighed by cardiovascular risks

Have your doctor compare and contrast these pros and cons. Hopefully your doctor already knows about these research trials, but I highly doubt it. If not they should be fired.

Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline but causing falls

 

Scientists Pinpoint What Level of Vitamin D Promotes Heart Health

 

Low vitamin D predicts more severe strokes, poor health post-stroke

 

Effects of vitamin D supplementation on neuroplasticity in older adults: a double-blinded, placebo-controlled randomised trial

 

More Evidence That Vitamin D Protects Against Alzheimer’s - 

 

Vitamin D Blog: A Bedroom Boost

 

The Vitamin Which May Reduce Risk of Alzheimer’s and Dementia

 

Vitamin D, Omega-3 May Help Clear Amyloid Plaques Found in Alzheimer's

 

Low-Dose Vitamin D Prevents Muscular Atrophy and Reduces Falls and Hip Fractures in Women after Stroke

 

More Evidence That Vitamin D Protects Against Alzheimer’s - 

 

Warning: Vitamin D supplements may do more cognitive harm than good

 

New meta-analysis suggests "threshold" effect for vitamin D and CVD

 

If your doctor sees calcium, he knows you have heart disease

 

Vascular events in healthy older women receiving calcium supplementation

 

Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis

 

 The latest here:

Benefits of calcium supplements/vitamin D may be outweighed by cardiovascular risks

Taking calcium and vitamin D can help prevent broken bones in older women. However, this benefit may be cancelled out by an increased risk of heart attack and stroke.
With the highest reported risk of hip fractures in the word, Norway has good reason to consider the benefits and risks of calcium supplements. The challenge is that too little calcium and vitamin D in your diet leads to an increased risk of osteoporosis and broken bones, which taking supplements has been shown to help prevent.
However, some studies have also shown that taking supplemental calcium may also increase your risk of heart attack and stroke.
"We conclude that the moderate effect of supplemental calcium and vitamin D on the risk of fractures is not large enough to outweigh the potential increased risk of cardiovascular disease, specifically in women who are at a low risk of bone fracture," said Gunhild Hagen, a PhD candidate at the Norwegian University of Science and Technology's (NTNU) Department of Public Heath and General Practice who was first author of an article recently published in Osteoporosis International.
Analytical model of health effects
Researchers at NTNU and the University of Oslo used an advanced analytical model to investigate the total health effect of taking a combined calcium and vitamin D supplement, compared to taking no supplements, based on a group of healthy women aged 65 with a BMI of 24 kg/m2.
"Our analysis shows that if 100 000 65-year-old women take 1000 mg calcium every day, 5890 hip fractures and 3820 other fractures would be prevented. On the other hand, as many as 5917 heart attacks and 4373 strokes could be caused. So for women of this age, the risks outweigh the benefits," the authors of the study wrote in an article in Aftenposten, one of Norway's national newspapers.
Recent studies of the effect of calcium supplementation on the risks of heart attack and stroke differ in their conclusions, so the researchers used three different scenarios based on results from previous studies.
The high-risk model predicted that more than 10 000 heart attacks and strokes would be caused by supplemental calcium and vitamin D in a group of 100 000 65-year-old women, whereas the medium-risk model predicted about 5000.
Both models showed that the number of years of high-quality life lost by taking calcium was higher than the number of years of high-quality life saved by preventing broken bones.
Benefits are nullified
The study also investigated the cost-effectiveness of offering 65-year-old women supplemental calcium and vitamin D, assuming that the women were at low risk of cardiovascular problems. In this case, the authors concluded that providing supplements is cost-effective and good for public health, given that the benefits outweigh the risks.
If the supplement increases the risk of heart attack and stroke, however, both the savings and the public health benefits are lost.
Hagen says one possible solution is to prescribe medicines that help prevent osteoporosis along with vitamin supplements.
"If we provide a preventative osteoporosis medication in addition to a supplement, it will increase the effect of preventing bone fractures, and have a positive risk/gain ratio, resulting in reduced costs," says Hagen.
Don't know if calcium increases risk of heat disease
The researchers point out that it isn't possible to conclude that calcium increases risk of cardiovascular disease, and that the analysis needs to be seen in light of this uncertainty.
At the same time, their models are simplifications that can't replace studies done on actual people.
"We don't know for sure if calcium has this negative effect, but to be careful, we should choose to give another treatment to help prevent broken bones in older women," says Hagen.
Reference:
The predicted lifetime costs and health consequences of calcium and Vitamin D supplementation for fracture prevention--the impact of cardiovascular effects. Published in Osteoporosis International, 4 February 2016 (online) Hagen, G., Wisløff, T., & Kristiansen, I. S. (2016).
http://gemini.no/en/2016/05/calcium-supplements-can-increase-risk-of-heart-attack-stroke/

• Full bibliographic informationHagen, G., Wisløff, T., & Kristiansen, I. S. (2016). The predicted lifetime costs and health consequences of calcium and vitamin D supplementation for fracture prevention--the impact of cardiovascular effects. Osteoporosis International, 1-10, 4 February 2016 (online). DOI 10.1007/s00198-016-3495-9

Diet drink consumption and the risk of cardiovascular events: a report from the Women's Health Initiative

Another risk factor for stroke. Take care.
http://www.ncbi.nlm.nih.gov/pubmed/25515135

Vyas A¹, Rubenstein L, Robinson J, Seguin RA, Vitolins MZ, Kazlauskaite R, Shikany JM, Johnson KC, Snetselaar L, Wallace R.

Author information

Abstract

BACKGROUND:

Data are limited regarding the influence of diet drink consumption on cardiovascular disease (CVD) outcomes.

OBJECTIVE:

We aimed to evaluate the relationship between diet drink intake and cardiovascular events.

DESIGN:

We conducted a retrospective cohort study, utilizing data from the national, multicenter Women's Health Initiative Observational Study (WHI OS), recruiting subjects from 1993 to 1998.

PATIENTS:

Post-menopausal women with available diet drink intake data, without pre-existing CVD and who survived ≥ 60 days were included in the study.

MAIN MEAURES:

A composite of incident coronary heart disease, heart failure, myocardial infarction, coronary revascularization procedure, ischemic stroke, peripheral arterial disease and CVD death was used as the primary outcome. CVD death and all-cause mortality were secondary outcomes. Adjusted Cox proportional hazards models were used to compare primary and secondary outcomes across diet drink intake strata.

KEY RESULTS:

In all, 59,614 women, mean age 62.8 years, were included for analysis. In unadjusted analysis over a follow-up of 8.7 ± 2.7 years, the primary outcome occurred in 8.5 % of the women consuming ≥ 2 diet drinks/day, compared to 6.9 %, 6.8 % and 7.2 % in the 5-7/week, 1-4/week and 0-3/month groups, respectively. After controlling for other CVD risk factors, women who consumed ≥ 2 drinks/day had a higher adjusted risk of CVD events (HR 1.3, 95 % CI 1.1-1.5), CVD mortality (HR 1.5, 95 % CI 1.03-2.3) and overall mortality (HR 1.3, 95 % CI 1.04-1.5) compared to the reference group (0-3 drinks/month).

CONCLUSIONS:

This analysis demonstrates an association between high diet drink intake and CVD outcomes and mortality in post-menopausal women in the WHI OS.

Comment in

• Capsule commentary on Vyas et al., Diet drink consumption and the risk of cardiovascular events: a report from the Women's Health Initiative. [J Gen Intern Med. 2015]

PMID:

25515135

[PubMed - in process]

PMCID:

PMC4371001

[Available on 2016-04-01]

Changes in Diet Quality Scores and Risk of Cardiovascular Disease Among US Men and Women.

You're going to have an even harder time convincing your doctor you know how to handle this.
http://www.ncbi.nlm.nih.gov/pubmed/26644246

Sotos-Prieto M¹, Bhupathiraju SN¹, Mattei J¹, Fung TT¹, Li Y¹, Pan A¹, Willett WC¹, Rimm EB¹, Hu FB².

Author information

Abstract

BACKGROUND:

Adherence to several diet quality scores, including the Alternative Healthy Eating Index, Alternative Mediterranean Diet score, and Dietary Approach to Stop Hypertension, has been associated with lower risk of cardiovascular disease (CVD), but little is known about how changes in these scores over time influence subsequent CVD risk.

METHODS AND RESULTS:

We analyzed the association between 4-year changes in the 3 diet quality scores (Alternative Healthy Eating Index, Alternative Mediterranean Diet score, and Dietary Approach to Stop Hypertension) and subsequent cardiovascular disease (CVD) risk among 29 343 men in the Health Professionals Follow-up Study and 51 195 women in the Nurses' Health Study (1986-2010). During 1 394 702 person-years of follow-up, we documented 11 793 CVD cases. Compared with participants whose diet quality remained relatively stable in each 4-year period, those with the greatest improvement in diet quality scores had a 7% to 8% lower CVD risk in the subsequent 4-year period (pooled hazard ratio, 0.92 [95% confidence interval (CI), 0.87-0.99] for the Alternative Healthy Eating Index; 0.93 [95% CI, 0.85-1.02] for the Alternative Mediterranean Diet score; and 0.93 [95% CI, 0.87-0.99] for the Dietary Approach to Stop Hypertension; all P for trend <0.05). In the long term, increasing the diet scores from baseline to the first 4-year follow-up was associated with lower CVD risk during the next 20 years (7% [95% CI, 1-12] for the Alternative Healthy Eating Index, and 9% [95% CI, 3-14] for the Alternative Mediterranean Diet score). A decrease in diet quality scores was associated with significantly elevated risk of CVD in subsequent time periods.

CONCLUSIONS:

Improving adherence to diet quality scores over time is associated with significantly lower CVD risk in both the short term and long term.

Consuming tree nuts may reduce risk of cardiovascular disease, new study finds

This is useless because there is no specific definition of the amount or when these walnuts should be consumed. As a result your doctor and nutritionist will do nothing with this. You're screwed. Or are almonds better? A great stroke association would do research to answer this simple question. But since we don't have one we will never know which is better.

New research shows almonds reduce the risk of heart disease

Consuming tree nuts may reduce risk of cardiovascular disease, new study finds

A new study published in the American Journal of Clinical Nutrition found that consuming tree nuts, such as walnuts, may lower the risk of cardiovascular disease. After conducting a systematic review and meta-analysis of 61 controlled trials, one of the authors, Michael Falk, PhD, Life Sciences Research Organization, found that consuming tree nuts lowers total cholesterol, triglycerides, LDL cholesterol, and ApoB, the primary protein found in LDL cholesterol. These are key factors that are used to evaluate a person's risk of cardiovascular disease. Walnuts were investigated in 21 of the 61 trials, more than any other nut reviewed in this study.
"Our study results further support the growing body of research that tree nuts, such as walnuts, can reduce the risk of cardiovascular diseases," said Dr. Falk. "Tree nuts contain important nutrients such as unsaturated fats, protein, vitamins and minerals. Walnuts are the only nut that provide a significant amount (2.5 grams per one ounce serving) of alpha-linolenic acid (ALA), the plant-based form of omega-3s."

Beyond finding that tree nuts lower total cholesterol, triglycerides, LDL cholesterol and ApoB, researchers also found that consuming at least two servings (two ounces) per day of tree nuts, such as walnuts, has stronger effects on total cholesterol and LDL. Additionally, results showed that tree nut consumption may be particularly important for lowering the risk of heart disease in individuals with type 2 diabetes.
Of 1,301 articles surveyed, 61 trials met eligibility criteria for this systematic review and meta-analysis, totaling 2,582 unique participants. Trials directly provided nuts to the intervention group rather than relying solely on dietary advice to consume nuts. The dose of nuts varied from 5 to 100g/day and most participants followed their typical diet.
More than two decades of research has shown that walnuts may help lower cardiovascular risk factors by decreasing LDL (bad) cholesterol by 9-16% and diastolic blood pressure by 2-3 mmHg, as well as reducing total cholesterol, raising HDL cholesterol, reducing inflammation as measured by C-reactive protein, and improving arterial function. These factors are major contributors to heart disease risk, and reducing them is a critical step toward a healthier heart. In addition to providing omega-3s, walnuts also deliver a convenient source of fiber (2 grams per ounce) and protein (4 grams per ounce).

Can Natural Remedies Jeopardize Cardiovascular Health?

Natural does not mean safe. Arsenic is natural, so are these;

Cute Killers: 16 Unassuming-but-Lethal Poison Plants

 http://www.alphagalileo.org/ViewItem.aspx?ItemId=158560&CultureCode=en

Chinese physicians report on a case of potentially lethal cardiovascular symptoms induced by a traditional Chinese medicine component (aconitine), in the Canadian Journal of Cardiology
Chinese physicians report on the case of a woman who presented with aconitine-induced cardiovascular symptoms. Their report, published in the Canadian Journal of Cardiology, warns that the use of this natural ingredient may lead to severe poisoning.
A 45-year-old Chinese woman was diagnosed with a severe heart-rhythm disorder, bidirectional ventricular tachycardia (BVT), associated with aconitine poisoning. BVT is a rare form of tachycardia (characterized by a resting heart rate over 100 beats per minute) and a distinct pattern of ECG waves on presentation.
The patient’s husband reported that she had drunk about 50 milliliters of a medicinal liquid about 30 minutes before she developed a sudden drop in blood pressure and then lost consciousness. The woman had no history of previous heart-rhythm problems and there was no family history of unexpected sudden death or fatal accidents. On examination she had a heart rate of 150 beats per minute and her blood pressure was 50/30. Her skin was cool, moist, and cyanotic. Treatment with the antiarrhythmic agents amiodarone, metoprolol, lidocaine, and potassium chloride was ineffective. An abdominal ultrasound showed marked gastric retention. A gastric tube was used to suction out the contents of her stomach. After two hours, the patient’s BVT ceased and her circulation improved.
Investigation revealed that the patient’s blood was positive for aconitine, a substance produced by the Aconitum plant, also known as devil’s helmet or monkshood. Although well-known for its highly toxic properties, aconitine is the primary ingredient of the traditional Chinese medicine known as Fuzi, a remedy made from the processed lateral roots of Aconitum carmichaeli Debx. It is widely distributed in the southwest provinces of China and is used in small doses for its anti-inflammatory and pain-relieving effects.
“Management of potentially lethal ventricular tachyarrhythmia associated with aconitine poisoning presents a therapeutic challenge. In a previously published case, amiodarone was effective in suppressing the BVT. However, in our patient, both lidocaine and amiodarone were ineffective,” explained lead author Zhong Yi, MD, PhD, of the Aerospace Center Hospital, Beijing, People’s Republic of China.
“The public should be warned of the risk of severe poisoning that can accompany traditional Chinese medicinal usage of Fuzi,” Dr. Yi concluded.
Commenting on the report, P. Timothy Pollak, MD, PhD, FRCPC, of the Department of Medicine at the University of Calgary, Alberta, cautioned that “not all products of Mother Nature are free of harm. This case report reminds us that aconitine is not the only naturally derived substance that can cause potentially lethal ventricular tachyarrhythmias, including BVT. The report also demonstrates the human tendency to think that if a little is good, more must be better.”
Dr. Pollak advises clinicians to be aware of what their patients are taking and be prepared to discuss alternative remedies, at least at a basic level. “Dodging the discussion can only lend credibility to any patient suspicions that as a practitioner of Western medicine, you have been denied the secrets of alternative remedies or are hiding them for ulterior motives. This report serves as a timely illustration that alternative remedies do have implications for the practice of cardiology that cannot be ignored.”
Full bibliographic information“An Unusual Etiology for Bidirectional Ventricular Tachycardia,” by Yun-Tao Zhao, MD, PhD, Lei Wang, MD, and Zhong Yi, MD, PhD (DOI: http://dx.doi.org/10.1016/j.cjca.2015.06.024).