Wellness
4 Core factors to avoid a heart health syndrome
To avoid CKM syndrome, health experts suggest paying close attention to four of the American Heart Association’s Life’s Essential 8 – blood pressure, lipids, body weight and blood sugar level – which are core health factors that impact your metabolic health.
In the U.S., 1 in 3 adults is at risk for a newly recognized syndrome that comes from a combination of heart disease, kidney disease, type 2 diabetes and excess body weight. This cluster of conditions, called cardiovascular-kidney-metabolic (CKM) syndrome, is an example of how problems in one part of your body can affect other parts.
To avoid CKM syndrome, health experts suggest paying close attention to four of the American Heart Association’s Life’s Essential 8 – blood pressure, lipids, body weight and blood sugar level – which are core health factors that impact your metabolic health.
Good metabolic health means your body uses energy well and keeps these factors in a normal range. However, when numbers are off in one area, it can affect others, raising your risk for heart disease, stroke, kidney disease and diabetes.
Consider these tips from the American Heart Association to help keep your core health factors under control.
Blood Pressure
High blood pressure, also known as hypertension, happens when the force of your blood pushing against the walls of your blood vessels is too high. High blood pressure is a leading cause of heart disease, stroke and kidney disease.
Because high blood pressure doesn’t have symptoms, the only way to know you have it is to get your blood pressure checked. Healthy blood pressure is below 120/80. If your blood pressure is 130/80 or higher, talk to your doctor about checking your other core health factors.
Lifestyle changes can help reduce high blood pressure. One example is a Dietary Approaches to Stop Hypertension (DASH) eating pattern that’s low in fat and rich in fruits, vegetables, whole grains and low-fat dairy products. Losing 10 pounds and reducing alcohol consumption can also reduce blood pressure.
Cholesterol
Cholesterol is a waxy substance your liver makes then circulates in the blood where your body uses it to build cells and make vitamins and hormones. You may also get cholesterol from eating animal products. If there’s too much cholesterol circulating, your risk of type 2 diabetes, heart disease and stroke may increase.
For optimal CKM health, your LDL cholesterol should be below 100 and triglycerides below 150. Triglycerides are the most common type of fat in the body. If your triglyceride level is 135 or higher, talk to your doctor about decreasing your risk.
Losing body weight and increasing physical activity decrease triglyceride levels. In addition, DASH and Mediterranean (plant-based, high-fiber, low-fat) eating patterns support healthy LDL and triglyceride levels.
Body Weight
Healthy weight may be determined by body mass index (BMI), a number that represents your weight in relation to your height. Extra body fat can mean a higher risk for many health problems, including heart disease, stroke, high blood pressure, high cholesterol and diabetes.
CKM syndrome starts when BMI is 25 or higher and waist circumference is 88 centimeters or higher for women and 102 centimeters or higher for men. Aim for a BMI between 18.5-25.
To lose weight and keep it off, start by setting realistic goals. Understand how much and why you eat, manage portion sizes, make smart snack substitutions and be physically active.
Blood Sugar
High blood sugar can slowly damage the kidneys. In fact, diabetes is the leading cause of kidney disease, and it increases the risk of heart attack and stroke.
Blood sugar is measured in two ways: a fasting blood glucose test (short term blood sugar) and an A1C test (long term blood sugar control). A normal fasting blood glucose level is 70-99 and a normal A1C level is below 5.7%. Fasting blood glucose above 125 and A1C of 6.5% or higher means you have diabetes.
Habits that help you avoid high blood pressure, weight gain and high cholesterol also keep your blood sugar in check. These are especially important if you have a family history of diabetes.
Learn more about CKM syndrome and how to manage your risk at heart.org/CKMhealth.
Wellness
Dance effective in fighting against cognitive decline in Parkinson’s
Dance can be beneficial in halting the cognitive decline associated with Parkinson’s disease and, for some participants, they even showed signs of improvement.
A new study led by researchers at York University shows that dance can be beneficial in halting the cognitive decline associated with Parkinson’s disease and, for some participants, they even showed signs of improvement. Faculty of Health Associate Professor Joseph DeSouza, co-author of the study, says since cognition is nearly always expected to decline as the illness progresses and this was a multi-year study, the findings are quite remarkable.
“The classic progression of Parkinson’s disease is that cognition gets bad as well as motor symptoms, and some people already have significantly impaired cognition by the time they get to a diagnosis,” says DeSouza, who worked closely on the study with lead author Simran Rooprai, a second-year interdisciplinary master’s student at York. “So finding that no one in the dance group had further cognitive decline over six years, we think that’s pretty significant.”
The study, published in the Journal of Alzheimer’s Disease, looked at 43 participants from a group with Parkinson’s participating in the Sharing Dance Parkinson’s program at the National Ballet of Canada and the Dance for Parkinson’s Disease program through Trinity St. Paul’s Church, both located in Toronto, and a reference group of 28 people with Parkinson’s who were sedentary and not engaged in any physical activity.
Dance classes would begin with a seated warm-up, followed by “barre” exercises, and sessions ended with floorwork dances. One group was also taught a specific choreography in preparation for an upcoming performance.
The researchers found that the cognitive scores for the dance group had improved compared to the reference group, where they saw no changes, or a slight decline.
Rooprai says the research shows that dance could help with cognitive preservation, or perhaps even improvement in those with Parkinson’s.
“We can’t really fix the brain, but we’re trying to show that with dance, maybe we can delay the onset of further cognitive decline,” says Rooprai.
While Parkinson’ disease is most closely associated with the characteristic tremors of the disease, it is also associated with cognitive decline, with four out of five people with the illness eventually experiencing severe cognition problems as the disease progresses.
Earlier research led by DeSouza at York that he worked on with fellow author and former York PhD student Karolina Bearss, now a professor at Algoma University, has shown the benefits of dance for depression and motor symptoms of the illness, suggesting the benefits of dance are widespread.
“Dance engages many parts of the brain,” says Rooprai. “While dancing, you’re listening to music, learning new steps, remembering the different sequences, and you’re engaging with other dancers so you’re aware of your surroundings. Dance is physical, mental, and social all at once.”
DeSouza and Rooprai are working on a follow-up study in collaboration with the Baycrest Academy for Research and Education, where they will look at how working memory is affected for people with Parkinson’s taking weekly dance classes.
“Given how dance has so many different positive impacts on cognition, we expect to see improvements,” says DeSouza.
Wellness
Regular exercise ‘rewires’ heart-control nerves differently on left and right side, study finds
Frequent exercise doesn’t just strengthen the heart – it also changes the nerves that control it.
Frequent exercise doesn’t just strengthen the heart – it also changes the nerves that control it, according to new research which could guide more targeted and effective care for common heart problems.
The study, led by the University of Bristol (UK), shows for the first time that moderate aerobic training reshapes nerves that drive the heart, and affects them on each side of the heart differently. The research is published in the journal Autonomic Neuroscience.
Findings highlighting this marked left-right split could ultimately be used to treat more effectively a range of conditions, including irregular heartbeats, chest pain, angina pain, and ‘broken-heart’ syndrome.
Study lead author Dr Augusto Coppi, Senior Lecturer in Veterinary Anatomy at the University of Bristol, said: “The discovery points to a previously hidden left–right pattern in the body’s ‘autopilot’ system that helps run the heart.
“These nerve clusters act like the heart’s dimmer switch and we’ve shown that regular, moderate exercise remodels that switch in a side-specific way. This could help explain why some treatments work better on one side than the other and, in future, help doctors target therapies more precisely and effectively.”
The research, in collaboration with the University College London (UCL) in the UK and the University of São Paulo (USP) and Federal University of São Paulo (UNIFESP) in Brazil, used advanced 3D quantitative imaging analysis methods called stereology. Findings showed that trained rats over a 10-week period had around four times more nerves – called neurons – in the cardiovascular cluster on the right-hand side of the body than the left compared to untrained rats. Conversely, the neurons on the left nearly doubled in size while those on the right slightly shrunk.
Dr Coppi explained: “Irregular heart rhythms, known as arrhythmias, stress-induced ‘broken‑heart’ syndrome, and certain types of chest pain are often treated by dialling down overactive stellate ganglia – the paired small nerve hubs in the lower neck/upper chest area that send ‘go faster’ signals to the heart.
“By mapping how exercise changes these ganglia on each side, the study offers clues that could one day fine‑tune procedures like nerve blocks or denervation to the side most likely to help. The findings are early-stage and in rats, so clinical studies would need to follow.”
The researchers are now planning studies to link these structural changes to how the heart actually behaves at rest and during exercise. They will then look for the same left–right pattern in other animal models and in people using non‑invasive markers. This will help ascertain whether targeting one side of the nerve cluster could make treatments such as stellate nerve blocks or denervation more effective for arrhythmias, stress‑induced ‘broken‑heart’ syndrome, and difficult‑to‑treat angina.
Dr Coppi added: “Understanding these left-right differences could help us personalise treatments for heart rhythm disorders and angina. Our next step is to test how these structural changes map onto function and whether similar patterns appear in larger animals and humans.”
Wellness
Walking further and faster linked to reduced risk of heart attacks, heart failure, stroke in people with high blood pressure
Compared to a daily step count of 2,300 steps, every extra 1,000 steps was linked to a 17% reduction in the risk of developing a major adverse cardiovascular event (MACE), up to 10,000 steps. Additional steps above 10,000 were associated with a lower risk of stroke.
Analysis of over 36,000 people with high blood pressure has shown that taking more steps, even below the recommended daily target of 10,000 steps, and walking faster, is associated with a significant reduction in the risk of major problems of the heart and blood vessels.
The study, published in the European Journal of Preventive Cardiology, found that compared to a daily step count of 2,300 steps, every extra 1,000 steps was linked to a 17% reduction in the risk of developing a major adverse cardiovascular event (MACE), up to 10,000 steps. Additional steps above 10,000 were associated with a lower risk of stroke.
Approximately 1.28 billion people worldwide are living with high blood pressure, and it places them at increased risk of heart disease (49% increase), stroke (62% increase) and heart failure (77-89% increase). Until now, it has been unclear how much people with high blood pressure need to increase their physical activity in order to see a reduction in their risk of MACE.
Professor Emmanuel Stamatakis, Director of the Mackenzie Wearables Research Hub at the University of Sydney, Australia, who supervised the study, said: “This study is one of the first to demonstrate a dose-response relationship between daily step count and major problems of the heart and blood vessels. In a nutshell, we found that, if you live with high blood pressure, the more you walk with greater intensity, the lower your risk for future serious cardiovascular events.
“These findings support the message that any amount of physical activity is beneficial, even below the widely recommended daily target of 10,000 steps.”
The study analysed data obtained from 32,192 people who had enrolled in a sub-study of the UK Biobank study. They had been diagnosed with high blood pressure and agreed to wear an accelerometer on their wrist for seven consecutive days to measure how far and how fast they walked. Data from the accelerometers was collected between 2013 and 2015. The average age was 64 and the participants were followed up for nearly eight years, providing the researchers with data for 283,001 person-years. During this time 1,935 cases of heart problems or stroke occurred.
In addition to a 17% reduction in overall risk for every extra 1,000 steps a day, the researchers found a 22% reduction in heart failure, 9% reduction in risk of heart attack, and 24% reduction in risk of stroke. This means that every increase of 1,000 steps a day was associated with:
- an average reduction in the absolute risk of MACE of 31.5 events per 10,000 person-years
- an average reduction in the absolute risk of 7.2 heart failure events per 10,000 person-years
- an average reduction in the absolute risk of 9.9 myocardial infarctions (heart attacks) per 10,000 person-years
- an average reduction in the absolute risk of 10.4 strokes per 10,000 person-years.
The average (mean) intensity of the 30 minutes of fastest walking per day was 80 steps a minute and this was associated with a 30% reduced risk of MACE. There was no evidence of harm in people whose 30 minutes of fastest walking or running was over 130 steps a minute.
The researchers found similar results when they looked at 37,350 people without high blood pressure. Every 1,000-step increase in daily step count led to an average lower risk of MACE, heart failure, myocardial infarctions and stroke of 20.2%, 23.2%, 17.9%, and 24.6%, respectively.
Prof. Stamatakis said: “Our findings offer patients accessible and measurable targets for heart health, even below 10,000 steps daily. Clinicians should promote physical activity as standard care, especially in patients with high blood pressure. Our results can inform new, tailored public health recommendations for these patients. Future recommendations on walking in people with high blood pressure could consider promoting higher stepping intensity.”
Strengths of the study include the large number of patients, the use of accelerometers to provide detailed information on numbers of steps and speed, and the use of data from national records in England, Wales and Scotland on deaths and causes of death.
Limitations include the fact that physical activity was measured only when people first joined the study and did not include any subsequent changes in behaviour. In addition, the researchers point out that their findings can show only that there is an association between walking further and faster and better health outcomes, not that it causes these better outcomes. However, they conducted extensive analyses to minimise the risk of what is called ‘reverse causation’ (in which, in this case, health problems could be causing both a reduction in physical activity and an increase in heart disease events). Most UK Biobank participants are White, are less likely to be obese, to smoke or drink alcohol, and to be better educated, and so they may not be representative of the general UK population.
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