Frequent exercise is robustly associated with a decrease in cardiovascular mortality as well as the risk of developing cardiovascular disease. Physically active individuals have lower blood pressure, higher insulin sensitivity, and a more favorable plasma lipoprotein profile. Animal models of exercise show that repeated physical activity suppresses atherogenesis and increases the availability of vasodilatory mediators such as nitric oxide.
Exercise has also been found to have beneficial effects on the heart. Acutely, exercise increases cardiac output and blood pressure, but individuals adapted to exercise show lower resting heart rate and cardiac hypertrophy.
“It’s extremely important we as health care professionals address diabetes, poor sleep and poor sleep hygiene, and obesity as they are modifiable risk factors for cardiovascular disease,” says Nishant P. Shah, MD, FACC, a preventive cardiologist at Duke Heart Center, Duke University School of Medicine, in Durham, NC.
Obesity, diabetes and sleep-disordered breathing (SDB) are considered to be extant and growing public health crises. A wealth of information links these conditions to each other and to increased morbidity, reduced quality of life and death. While managing these conditions that often occur together may be challenging for patients and clinicians, successfully addressing them represents a real opportunity to reduce cardiovascular disease and prevent cardiovascular events.
Our new position paper with @worldheartfed summarises the relationship between obesity and cardiovascular disease (#CVD) mortality.
World Obesity Federation (January 2023) – The ongoing obesity epidemic represents a global public health crisis that contributes to poor health outcomes, reduced quality of life, and >2.8 million deaths each year. Obesity is relapsing, progressive, and heterogeneous. It is considered a chronic disease by the World Obesity Federation (WOF) and a chronic condition by the World Heart Federation (WHF).
People living with overweight/obesity are at greater risk for cardiovascular (CV) morbidity and mortality. Increased adiposity (body fat), particularly visceral/abdominal fat, is linked to CV risk and CV disease (CVD) via multiple direct and indirect pathophysiological mechanisms. The development of CVD is driven, in part, by obesity-related metabolic, endocrinologic, immunologic, structural, humoral, haemodynamic, and functional alterations.
Centers for Disease Control and Prevention (CDC) – The body is complicated! While organs in your body each have a specific job to do to keep you healthy, they still rely on each other to function well. When one organ isn’t working the way it should, it can put stress on other organs, causing them to stop working properly as well.
The relationship between chronic kidney disease (CKD), diabetes, and heart disease is one example of the ways our organs are connected.
The body uses a hormone called insulin to get blood sugar into the body’s cells to be used as energy. If someone has diabetes, their pancreas either doesn’t make enough insulin or can’t use the insulin it makes as well as it should.
If someone has CKD, their kidneys are not able to filter out toxins and waste from their blood as well as they should.
Heart disease refers to several types of heart conditions. The most common condition, coronary artery disease, leads to changes in blood flow to the heart, which can cause a heart attack.
Make the Connection
So how are these three conditions connected? Risk factors for each condition are similar and include high blood sugar, high blood pressure, family history, obesity, unhealthy diet, and physical inactivity.
High blood sugar can slowly damage the kidneys, and, over time, they can stop filtering blood as well as they should, leading to CKD. Approximately 1 in 3 adults with diabetes has CKD.
When the kidneys don’t work well, more stress is put on the heart. When someone has CKD, their heart needs to pump harder to get blood to the kidneys. This can lead to heart disease, the leading cause of death in the United States. Change in blood pressure is also a CKD complication that can lead to heart disease.
Luckily, preventing or managing one condition can help you prevent and manage the others and lower the risk for more complications.
In December 2020, a week before cardiologist Stuart Katz was scheduled to receive his first COVID-19 vaccine, he came down with a fever. He spent the next two weeks wracked with a cough, body aches and chills. After months of helping others to weather the pandemic, Katz, who works at New York University, was having his own first-hand experience of COVID-19.
On Christmas Day, Katz’s acute illness finally subsided. But many symptoms lingered, including some related to the organ he’s built his career around: the heart. Walking up two flights of stairs would leave him breathless, with his heart racing at 120 beats per minute. Over the next several months, he began to feel better, and he’s now back to his normal routine of walking and cycling. But reports about COVID-19’s effects on the cardiovascular system have made him concerned about his long-term health. “I say to myself, ‘Well, is it really over?’” Katz says.
In one study1 this year, researchers used records from the US Department of Veterans Affairs (VA) to estimate how often COVID-19 leads to cardiovascular problems. They found that people who had had the disease faced substantially increased risks for 20 cardiovascular conditions — including potentially catastrophic problems such as heart attacks and strokes — in the year after infection with the coronavirus SARS-CoV-2. Researchers say that these complications can happen even in people who seem to have completely recovered from a mild infection.
Some smaller studies have mirrored these findings, but others find lower rates of complications. With millions or perhaps even billions of people having been infected with SARS-CoV-2, clinicians are wondering whether the pandemic will be followed by a cardiovascular aftershock. Meanwhile, researchers are trying to understand who is most at risk of these heart-related problems, how long the risk persists and what causes these symptoms.
The routine mammograms women receive to check for breast cancer may also offer clues to their risk for heart disease, new research suggests.
White spots or lines visible on mammograms indicate a buildup of calcium in breast arteries. This breast arterial calcification is different from coronary artery calcification, which is known to be a marker for higher cardiovascular risk. For the study, researchers followed 5,059 postmenopausal women (ages 60 to 79) for six and a half years. They found that those with breast arterial calcification were 51% more likely to develop heart disease or have a stroke than those without calcification. The study was published March 15, 2022, in Circulation: Cardiovascular Imaging.
Vulnerability to heart disease can be projected before symptoms occur, Mayo Clinic discovered in preclinical research. This proof-of-concept study revealed that heart muscle changes indicate who is vulnerable to disease later in life. These changes can be detected from blood samples through comprehensive protein and metabolite profiling. This exploratory mapping, conducted in the Marriott Family Comprehensive Cardiac Regenerative Program within Mayo Clinic’s Center for Regenerative Medicine, is published in Scientific Reports.
“The team implemented state-of-the-art technologies to predict who is vulnerable and who is protected from heart disease,” says Andre Terzic, M.D., Ph.D., a Mayo Clinic cardiologist and the senior author. “In this era of post-genomic medicine, the acquired foundational knowledge provides guidance for development of curative solutions targeted to correct the disease-causing maladaptation.” Dr. Terzic is the Marriott Family Director, Comprehensive Cardiac Regenerative Medicine, for the Center for Regenerative Medicine and the Marriott Family Professor of Cardiovascular Research.
Transcatheter valvular repair and implantation has become increasingly common for treating patients diagnosed with valvular heart diseases.
0:00 This video summarizes the three transcatheter valvular therapies currently in use in the United States: transcatheter aortic valve implantation (TAVI), transcatheter valve-in-valve procedures, and transcatheter edge-to-edge mitral valve repair.
0:47 Transcatheter aortic valve replacement (TAVI) for patients with severe aortic stenosis regardless of surgical risk 2:47 Transcatheter valve-in-valve procedures for patients with bioprosthetic valve failure
3:35 Transcatheter mitral valve repair for high surgical risk degenerative mitral regurgitation and for severe functional mitral regurgitation regardless of surgical risk.
Good oral health leads to benefits beyond a healthy mouth
People today want to be more in control of their own health and are more attuned to getting the support and information they need online, from apps, and from connected products. Yet there are gaps in both their knowledge and daily commitment to good oral hygiene, and they need help along the way. Depending on lifestage, patient’s oral health concerns can evolve from plaque removal and aesthetics to larger concerns around gum health and disease. Too often, by the time they begin thinking about gum health, it’s too late. Multiple studies have revealed linkages between periodontal diseases and certain systemic diseases, such as diabetes, heart disease and kidney disease .
Prevention is key. Along with professional deep cleaning, good daily brushing and interdental cleaning are critical. It’s also important for patients to have regular conversations with their dentist about oral health issues and the linkage to their overall health.