Heart Health

Fat is not protective and HDL can be too high

Published 9.5.2017
Heart health and information about heart disease remains a topic of interest for me, even as I have less time to read and collect links as often. Still, the following are recent pieces I've come across and found worthy of highlighting.

Cardiovascular disease (CVD) is still underestimated as a risk for women.

Almost half of U.S. women (45%) didn't know that cardiovascular disease is the leading cause of death among women -- with younger patients, those with lower income or level of education, and Hispanic and African American women even more likely to be unaware, according to C. Noel Bairey Merz, MD, of Cedars-Sinai Heart Institute in L.A., and colleagues of the Women's Heart Alliance.

Their survey results, published in the Journal of the American College of Cardiology, revealed that even though 74% of women reported having at least one heart disease risk factor, only 16% had their risk addressed by their physician. Additionally, 45% said they have put off a doctor's appointment until losing weight.

Meanwhile, CVD is the first diagnosis that pops into doctors’ heads if the patient is male.

Low level ozone exposure might cause CVD- is there anything that doesn’t cause CVD?

The research is the first to show a positive association between low-level ozone exposure and the platelet activation biomarker soluble P-selectin (sCD62P), which is linked to increased cardiovascular disease risk, wrote Drew Day, PhD, of Duke University in Durham, N.C. and colleagues in JAMA Internal Medicine.

The study included 89 healthy adult participants living and working together at a work campus in Changsha City, China. The uniformity of their lifestyle patterns and their proximity provided a unique opportunity to monitor indoor and outdoor air pollution (ozone and particulate matter 2.5) exposures, the researchers noted. The longitudinal exposure analysis was conducted between December 2014 and January 2015.

Actually, this is part of the pollutants cause CVD hypothesis, and that’s because pollutants cause inflammation in the body.

Biomarkers indicative of inflammation and oxidative stress, arterial stiffness, blood pressure, thrombotic factors, and spirometry were measured over four sessions.

Many markers worsened with exposure, but spirometry (air capacity of the lungs) showed no association.

Everything causes heart disease, at least that’s how it feels occasionally.

Exposure to high levels of fine particulate matter found in air pollution was associated with an increase in stress hormones and negative metabolic changes in a randomized, double-blind, crossover study from China. But exposure to mechanically purified air appeared to lessen the negative effects.

The study included 55 healthy college students in Shanghai, China exposed to alternate treatments of real and sham air purification in random orders in their dormitory rooms.

Researcher Haidong Kan, MD, PhD, of Fudan University, Shanghai, and colleagues used state-of-the-art metabolomic profiling in the first-of-its-kind study to explore the biological mechanisms underlying the adverse health effects of fine particulate matter (PM2.5) exposure.In addition to metabolomics, the researchers also measured the impact of PM2.5 exposure on blood pressure, biomarkers of oxidative stress and inflammation in the controlled setting.

Excess weight affects heart health, which oughtn't be a controversial statement, but is for some people.

In yet another confirmation of the negative cardiometabolic impact of obesity, researchers detailed a causal effect for high body mass index (BMI) on heart and diabetes risks through Mendelian randomization (MR) analysis.

Another body blow to health at every size (HAE$).

Markers are not the be all and end all. If you’re overweight or obese, your risk of heart disease is higher, even if you’re metabolically healthy. Yes, you read that right. Even if you’re not obese, excess weight increase risk.

The pan-European prospective study reported a higher associated risk of CHD among people who were overweight (BMI ≥25 to <30) or with obesity (BMI ≥30), who were considered "metabolically healthy" (HR 1.26, 95% CI 1.14-1.40; HR 1.28, 1.03-1.58, P=0.02, respectively), according to a study led by Camille Lassale, PhD, of Imperial College London, and colleagues.

However, those were considered "metabolically unhealthy" carried a larger associated CHD risk, even if the person was of normal weight (BMI ≥18.5 to <25, HR 2.15, 95% CI 1.79-2.57, P<0.0001), they wrote in the European Heart Journal.

Similarly, metabolic syndrome (MetS) among overweight individuals was also tied to an increased CHD risk (HR 2.33, 95% CI 1.97-2.76), while people with obesity and MetS reported the largest risk (HR 2.54, 2.21-2.92).

Can your good cholesterol be too high? Yes, yes it can be. I’m glad to see this coverage and I hope this issue gets a bit more attention.

After adjusting for other factors, an HDL of 73 milligrams per deciliter in men and 93 in women was associated with the lowest all-cause mortality. Compared with that, men with HDL levels of 97 to 115 had a 36 percent increased risk for death, and twice the risk above 116. Women at greater than 135 had a 68 percent increased risk. (Only 2.3 percent of men had levels above 97, and 0.3 percent of women had levels above 135.)

The bias is that higher HDL is better, but as mine skyrocketed into the triple digits I became convinced that something was not right. It’s a marker, and changes in markers ought to be a red flag to medical professionals. And they usually are, but not HDL (at least not in my case).

In my most recent cholesterol screening, after being off the osteoporosis drug for more than a year, my HDL level fell from above the danger zone noted in the quote to merely higher than average. And I, for one, am thrilled. But because it’s still high none of the medical professionals that I see even commented on it. This is a market that has gyrated wildly over the past three years and the only person who seems to be tracking it is me.

A Nazi developed Cardiac catheterization. Although not a member of the Nazi party when he experimented on himself (which is why his work was ignored), Werner Forssmann became and remained a Nazi until the end of the war. The Nobel committee tried to whitewash that fact when his name was included on the 1956 Award for medicine, but it should not be.

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