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It’s time to rethink heart health

On average, someone dies from cardiovascular disease (CVD) every 36 seconds, approximately 2,380 deaths each day, according to the American Heart Association. Each day, 405 deaths occur as the result of strokes, an average of one death every 3:33.

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On average, someone dies from cardiovascular disease (CVD) every 36 seconds, approximately 2,380 deaths each day, according to the American Heart Association. Each day, 405 deaths occur as the result of strokes, an average of one death every 3:33. More people die annually from CVD than from any other cause including cancer, COPD, diabetes, lung infections and the flu, according to the American Heart Association (AHA) 2021 Heart Disease and Stroke Statistics.

Consider these steps to #RethinkCVRisk to change the course of the disease and your life.

Understand Your Risk

COVID-19 has shown that those with underlying CVD face an especially high risk of serious COVID-19-related illness or even death, according to the Centers for Disease Control and Prevention (CDC). Regardless of whether you’ve received your COVID-19 vaccination, now is a good time to discuss your risk for heart disease with your doctor.

How Cardiovascular Disease Develops

Risk factors for CVD include high cholesterol, high triglycerides, diabetes and high blood pressure. Other factors that contribute to risk are family history, prior cardiovascular (CV) events, smoking, being overweight or obese and unhealthy diet and exercise habits. Over time, these risk factors can lead to injury of the blood vessel lining, causing inflammation, which can then trigger plaque growth. Plaque grows at different rates and in different arteries in the body for everyone and is often a slow, gradual process without symptoms.

As plaque buildup continues, the risk of suffering a CV event – such as heart attack or stroke – increases. If plaque ruptures, the body will try to repair the injury, potentially causing a blockage to form, and when an artery becomes fully blocked, blood flow is restricted. Blocked blood flow to the heart causes a heart attack while blocked blood flow to the brain causes a stroke.

Managing Risk Factors

The most effective way to prevent CVD is to understand and address risk factors. Triglycerides play an important role in heart health. Triglycerides store unused calories to give your body energy and are the most common type of fat in the body. They come from foods you eat such as butter, oils and other fats, as well as carbohydrates, sugars and alcohol. Your diet, lack of exercise, medical conditions, certain drugs and genetics can all cause high triglycerides.

In the past, medicines used to lower triglycerides, like fenofibrates and niacin, were commonly prescribed to help manage CV risk along with statins. However, clinical studies failed to show benefits and both the U.S. Food and Drug Administration (FDA) and American Diabetes Association discourage combining niacin and fenofibrates with statins.

Some turn to dietary supplement fish oil to help manage CV risk. However, supplements contain only 30% of the omega-3 fatty acids EPA and DHA (docosahexaenoic acid) with the majority of the product consisting of non-omega-3 ingredients, including saturated fats. Some data suggests certain ingredients in dietary supplement fish oils, such as DHA and saturated fats, may raise bad cholesterol.

While high triglycerides are an indicator of CV risk, lowering them won’t necessarily reduce your risk. However, addressing the underlying causes of high triglycerides can help, according to the AHA.

Treatment Options

With ongoing research, new standards-of-care are emerging. High cholesterol is a key CV risk factor with statins currently the first-line therapy for lowering cholesterol. Statins, diet and exercise can lower your CV risk by about 25-35%, but, for many people, controlled cholesterol doesn’t eliminate CV risk. This residual risk, or “persistent CV risk,” puts millions of patients at risk and has been the focus of therapeutic development for many years.

Talk with your doctor about FDA-approved options that can help further reduce your heart risk if you already take statins.

Truths and Falsehoods About Heart Disease Risk

1. Statins reduce your chance of experiencing a CV event by up to 90%.

False. Statins, diet and exercise can lower your risk by about 25-35%, but for many patients, controlled cholesterol doesn’t eliminate CV risk. This residual risk, or “persistent CV risk,” puts millions of patients at risk and has been the focus of therapeutic development for many years.

2. Managing high triglycerides along with taking statins is enough to reduce your risk.

False. High triglycerides are a CV risk factor but lowering them won’t necessarily reduce your risk. For example, earlier generation medicines prescribed to lower triglycerides, like fenofibrates and niacin, failed to show clinical benefit when used with statins to reduce CV risk. In fact, the FDA withdrew approval for fenofibrates and niacin in combination with statins because they add potential risk with no proven benefit to heart health.

3. Fish oil supplements are a proven way to get protection from a CV event.

False. Fish oil supplements are not FDA-approved medicines intended to treat or prevent a medical condition. Despite multiple clinical studies, these products have not been proven, to reduce CV risk on top of current medical therapies including statins.

4. Having a first CV event, such as a heart attack or stroke, puts you at greater risk to suffer another.

True. Having a CV event makes you more likely to suffer another. That’s why it’s important to protect against a first CV event or future events. To closely monitor your heart health, stay in close contact with your doctor and reduce your risk by keeping up with your medications, exercising and sticking to a healthy diet.

For more information about CVD and what you can do, look for #RethinkCVRisk on social media or visit truetoyourheart.com.

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Gene therapy has potential to cure thalassemia patients from blood disorder

Thalassemia is a blood disorder that affects the body’s ability to produce red blood cells, and hemoglobin, the protein that carries oxygen in red blood cells. Even with blood transfusion and appropriate iron chelation therapy; patients can develop iron overload, with potential to damage the liver, heart, and endocrine system.

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Gene therapy could pave the way for patients with the inherited blood disorder thalassemia to stop or significantly reduce blood transfusions and transform their daily lives, says an expert at a top American hospital, Cleveland Clinic.

Dr. Rabi Hanna, a pediatric hematologist-oncologist, said: “Thalassemia is a disease that can be cured, with gene therapy as a novel step that uses the patients’ own hematopoietic stem cells to produce healthier red blood cells and fix their blood disorder. Thalassemia patients who have received gene therapy have either eliminated or significantly reduced the amount of blood transfusions needed to manage their condition. With gene therapy, we can remove the challenges that thalassemia patients face to give them the courage to pursue their goals and dreams, whether in education, careers, or families.”

Thalassemia is a blood disorder that affects the body’s ability to produce red blood cells, and hemoglobin, the protein that carries oxygen in red blood cells. Even with blood transfusion and appropriate iron chelation therapy; patients can develop iron overload, with potential to damage the liver, heart, and endocrine system.

There are two type of thalassemia, alpha and beta, depending on the defects that can occur in the protein chains that make up hemoglobin. Patients with alpha thalassemia tend to be silent carriers without symptoms, while patients with beta thalassemia major will have major symptoms early after birth and require frequent red blood transfusions. Moderate and severe thalassemia cases are usually diagnosed with early childhood blood tests. Married couples can also have genetic tests that can predict the risk of thalassemia and related blood disorders.

Worldwide, there are 270 million carriers with abnormal hemoglobin and thalassemia, with 300,000-400,000 babies born with serious hemoglobin disorders annually, according to the US National Institute of Health. It is estimated that 90 percent of those births are in low- or middle-income countries, especially in the Middle East, South and Southeast Asia, the Mediterranean, Africa, and the South Pacific. Recognizing this, International Thalassemia Day’s theme for 2021 is “Addressing Health Inequalities Across the Global Thalassemia Community.”

In contrast to time-consuming, life-long blood transfusions, gene therapy could be a one-time therapy and provide a potential cure. Despite that, the allogeneic bone marrow transplant is currently the only available option with the potential to correct the genetic deficiency in Transfusion-dependent Thalassemia (TDT), but it has possible complications such as graft failure, graft-versus-host disease (GvHD), and opportunistic infections, particularly in patients who undergo non-sibling matched allogeneic HSCT. Gene therapy, in contrast, uses the patient’s own cells and eliminates the risk of GVHD.

The challenge in Dr. Hann’s opinion is how we can make this therapy available worldwide, especially in developing countries, where most of the patients are, globally.

The European Medicines Agency has given conditional marketing authorization to one form of genetically modified products for beta-thalassemia. In the United States, there are currently clinical trials for gene therapy, and this therapy is under review by Food and Drug Administration – which experts hope could lead to authorization later in 2021.

In recent phase 1-2 studies of gene therapy for 22 patients, all of them had reduced or eliminated the need for long-term red blood cell transfusions. Of the 13 alpha-thalassemia patients, 12 stopped receiving red blood cell transfusions. For the nine beta-thalassemia patients, three stopped red blood cell transfusions, and the remaining six patients saw their median annualized transfusion volume decrease by 73 percent.

“While gene therapy is a promising cure for transfusion-dependent thalassemia, many patients do not know the whole process – including chemotherapy to get rid of the old bone marrow and create space for the new modified stem cells. This will currently require admission to hospital for four to 6 weeks until new the stem cells are working and able to produce white blood cells, platelets and healthier red blood cells,” added Dr. Hanna. “We are hopeful that in the future we can target the bone marrow more selectively using reduced intensity chemotherapy or other medication to avoid the acute and long-term toxicity associated with high doses of chemotherapy.”

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Asthma both under-diagnosed and misdiagnosed

Proper medical diagnosis of asthma could mean that about one-third of people assumed to suffer from the disease could be weaned off long-term medications, impacting millions of people worldwide, says an expert at a top American hospital, Cleveland Clinic.

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Proper medical diagnosis of asthma could mean that about one-third of people assumed to suffer from the disease could be weaned off long-term medications, impacting millions of people worldwide, says an expert at a top American hospital, Cleveland Clinic.

Dr. Joe Zein, who specializes in pulmonary medicine at Cleveland Clinic, said: “Asthma impacts millions of people, and proper diagnoses and treatment are vital to treat asthma early before any damage occurs to the airway. Studies show that one-third of patients thought to have asthma are misdiagnosed by doctors, and 15% of asthma patients taking medication long term do not have an objective diagnosis. Proper diagnosis can ensure that patients receive the right treatment, reduce triggers, and lead healthier lives.”

A study in the Journal of American Medicine (JAMA) found that 33% of randomly tested asthma patients could be safely weaned off their medications, and did not need long-term inhaled steroids.

Asthma is one of the world’s major chronic diseases, impacting more than 339 million people globally, and the most common, non-communicable disease among children, according to the World Health Organization. At the same time, studies have found that asthma is under-diagnosed and under-treated.

Commenting on World Asthma Day 2021’s theme of “Uncovering Asthma Misconceptions,” Dr. Zein emphasized that while some people assume otherwise, asthma tests are often quick and easy. Common diagnostic methods include a spirometry test that measures the airflow through the lungs, and a methacholine challenge test that evaluates how reactive lungs are to changes in the environment. Healthcare practitioners may also request chest x-rays, and blood, skin, or allergy tests.

Asthma patients can suffer from chest tightness, pain, or pressure; coughing; and shortness of breath or wheezing. An asthma attack restricts airflow due to tightened and inflamed airways, and mucus clogs.

Treatment can include anti-inflammatory medicines that make it easier for air to enter and exit the lungs, bronchodilators that relax the airway muscles, or biologic therapies that target specific molecules.

Asthma, which has both genetic and environmental causes, has a wide range of triggers – especially in people’s own homes and neighborhoods. The most common asthma triggers are dust mites, pet dander, pollen and ragweed, pests such as cockroaches and mice, and mold. Tobacco smoke from the patient themselves or from secondhand smoke, air pollution, and exercise can also all trigger asthma attacks.

“People with asthma may not want to get rid of their pets, especially cats or dogs,” added Dr. Zein. “If asthma patients have to keep their pets in the house, they should keep pets outside of the bedroom, and replace any thick carpets with tile or hardwood to reduce pet dander. Asthma patients should also wash their bedding with hot water, vacuum often to remove dust, and put in de-humidifiers in any damp areas of the house.”

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Does listening to calming music at bedtime actually help you sleep?

Listening to calming music at bedtime improved sleep quality in older adults, and calming music was much better at improving sleep quality than rhythmic music.

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A new study published in the Journal of the American Geriatrics Society has found that listening to music can help older adults sleep better.

Researchers from the National Cheng Kung University Hospital in Taiwan combined the results of past studies to understand the effect that listening to music can have on the quality of older adults’ sleep. Their work suggests that:

  • Older adults (ages 60 and up) living at home sleep better when they listen to music for 30 minutes to one hour at bedtime.
  • Calm music improves older adults’ sleep quality better than rhythmic music does.
  • Older adults should listen to music for more than four weeks to see the most benefit from listening to music.

Why Older Adults Have Trouble Getting a Good Night’s Sleep

As we age, our sleep cycles change and make a good night’s sleep harder to achieve. What does it really mean to get a good night’s sleep? If you wake up rested and ready to start your day, you probably slept deeply the night before. But if you’re tired during the day, need coffee to keep you going, or wake up several times during the night, you may not be getting the deep sleep you need. According to the National Institute on Aging, older adults need seven to nine hours of sleep each night.

But studies have shown that 40 to 70 percent of older adults have sleep problems and over 40 percent have insomnia, meaning they wake up often during the night or too early in the morning. Sleep problems can make you feel irritable and depressed, can cause memory problems, and can even lead to falls or accidents.

How the Researchers Studied the Effect of Music on Older Adults’ Quality of Sleep

For their study, the researchers searched for past studies that tested the effect of listening to music on older adults with sleep problems who live at home. They looked at five studies with 288 participants. Half of these people listened to music; the other half got the usual or no treatment for their sleep problems. People who were treated with music listened to either calming or rhythmic music for 30 minutes to one hour, over a period ranging from two days to three months. (Calming music has slow tempo of 60 to 80 beats per minute and a smooth melody, while rhythmic music is faster and louder.) All participants answered questions about how well they thought they were sleeping. Each participant ended up with a score between 0 and 21 for the quality of their sleep.

The researchers looked at the difference in average scores for:

  • people who listened to music compared to people who did not listen to music;
  • people who listened to calm music compared to people who listened to rhythmic music;
  • and people who listened to music for less than four weeks compared to people who listened to music for more than four weeks.

What the Researchers Learned

Listening to calming music at bedtime improved sleep quality in older adults, and calming music was much better at improving sleep quality than rhythmic music. The researchers said that calming music may improve sleep by slowing your heart rate and breathing, and lowering your blood pressure. This, in turn helps lower your levels of stress and anxiety.

Researchers also learned that listening to music for longer than four weeks is better at improving sleep quality than listening to music for a shorter length of time.

What this Study Means for You

If you’re having trouble sleeping, listening to music can be a safe, effective, and easy way to help you fall and stay asleep. It may also reduce your need for medication to help you sleep.

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