This is a fascinating and important area of medical research that moves beyond the traditional risk factors for heart disease.
Here’s a breakdown of what that link means, the science behind it, and what it implies for the future.
The Core Finding: It’s Not Just About Cholesterol and Blood Pressure
For decades, the primary focus for heart attack (myocardial infarction) risk has been on factors like:
High Cholesterol
High Blood Pressure
Smoking
Diabetes
Obesity
Family History
The new research suggests that chronic inflammation caused by bacterial infections may be a significant, independent trigger for the events that lead to a heart attack.
How Could Bacteria Cause a Heart Attack?
The connection isn’t that bacteria directly “eat” the heart. Instead, it’s a more indirect process related to atherosclerosis (the hardening and narrowing of arteries due to plaque buildup).
The Inflammatory Spark: Bacteria from chronic, often low-grade infections (like gum disease or respiratory infections) can enter the bloodstream. The body’s immune system responds by sending inflammatory cells to fight them.
Plaque Vulnerability: This systemic inflammation doesn’t just target the bacteria. It can also make the fatty plaques in your arteries (atherosclerotic plaques) unstable and “vulnerable.” Inflammation weakens the fibrous cap that covers a plaque, making it more likely to rupture.
The Final Clot: When a vulnerable plaque ruptures, its contents spill into the artery. The body mistakes this as an injury and forms a blood clot (thrombus) to seal it. If this clot is large enough, it can completely block the coronary artery, cutting off blood flow to the heart muscle and causing a heart attack.
Key Bacterial Suspects
Research has pointed to several specific bacteria as potential culprits:
Porphyromonas gingivalis: This is a primary bacterium associated with periodontitis (severe gum disease). There is a very strong and well-documented link between gum health and heart health. The theory is that bleeding gums provide an easy entry point for these bacteria into the bloodstream.
Streptococcus pneumoniae: The common bacteria that causes pneumonia, sinusitis, and other respiratory infections. Studies have shown it can invade heart tissue and directly promote clot formation.
Chlamydia pneumoniae: This respiratory pathogen has been found embedded within atherosclerotic plaques themselves, suggesting it may play a direct role in plaque development and instability.
Helicobacter pylori: Known for causing stomach ulcers, this bacteria is also linked to systemic inflammation that could contribute to cardiovascular risk.
What Does This Mean for You? Key Takeaways
Oral Hygiene is Heart Hygiene: This is the biggest practical takeaway. The link between gum disease and heart disease is powerful. Brushing, flossing, and regular dental check-ups are not just about saving your teeth—they could be vital for protecting your heart.
Don’t Ignore Chronic Infections: Persistent low-grade infections (like gum disease, respiratory issues, or others) should be taken seriously and treated promptly, as they may be contributing to systemic inflammation.
It’s a “Trigger,” Not a Solo Cause: It’s crucial to understand that bacterial infection is likely a trigger that acts on top of existing risk factors. Someone with clean arteries is unlikely to have a heart attack from a bacterial infection alone. But for someone with significant plaque buildup, a bacterial infection could be the final straw.
Antibiotics Aren’t the Answer (Yet): Large clinical trials using broad-spectrum antibiotics to prevent heart attacks have largely failed. This suggests the relationship is more complex than a simple infection that can be “cured” with a short course of antibiotics. It may be related to the body’s inflammatory response rather than the bacteria themselves.
The Future of Treatment and Prevention
This research opens up new avenues for medicine:
Vaccines: Developing vaccines against specific bacteria like S. pneumoniae could have the dual benefit of preventing infections and reducing heart attack risk.
Anti-inflammatory Therapies: It strengthens the rationale for using targeted anti-inflammatory drugs for heart disease prevention.
Novel Diagnostics: In the future, testing for certain bacterial markers or specific inflammatory signals might help identify individuals at very high risk for a heart attack.
In conclusion, the study is correct. While traditional risk factors remain critically important, the role of chronic bacterial infections and the inflammation they cause is a significant and evolving piece of the heart disease puzzle. Maintaining good overall health, with a special emphasis on oral hygiene, is a powerful step you can take to mitigate this newly understood risk.
The potential for potassium supplements to lower heart failure risk is primarily linked to its critical role in regulating blood pressure and maintaining normal electrical function in the heart. However, it’s crucial to understand that this relationship is a “Goldilocks” scenario—not too little, not too much, but just the right amount.
Here’s a breakdown of the mechanisms by which adequate potassium intake might help lower the risk of heart failure:
1. Lowering Blood Pressure (The Most Significant Factor)
High blood pressure (hypertension) is the number one risk factor for developing heart failure. It forces the heart to work much harder to pump blood, which, over time, causes the heart muscle to thicken and stiffen (a condition called left ventricular hypertrophy) and eventually weakens it.
How Potassium Works: Potassium helps lower blood pressure through two main actions:
Counteracting Sodium: Potassium promotes the excretion of sodium through the urine. Sodium holds onto water in the body, increasing blood volume and, consequently, blood pressure. By helping the body get rid of sodium, potassium reduces blood volume and eases the pressure on blood vessel walls.
Vasodilation: Potassium helps the walls of the blood vessels relax and widen (dilate). This reduces resistance to blood flow, making it easier for the heart to pump and lowering blood pressure.
By effectively managing blood pressure, adequate potassium intake directly addresses the primary driver of heart failure risk.
The heart’s rhythm is controlled by a delicate and continuous electrical impulse. Potassium is one of the key electrolytes (along with sodium, calcium, and magnesium) that governs this electrical activity.
Stable Electrical Activity: Potassium is essential for “repolarizing” the heart muscle cells after they contract, resetting them for the next beat. This ensures a stable, regular heartbeat.
The Danger of Imbalance:
Low Potassium (Hypokalemia): Can cause the heart to beat abnormally, leading to arrhythmias like atrial fibrillation or even more dangerous ventricular arrhythmias. These irregular rhythms can reduce the heart’s pumping efficiency and are a known cause and consequence of heart failure.
High Potassium (Hyperkalemia): Can be equally dangerous, slowing the heart rate to a point where it can become life-threatening.
Maintaining a normal potassium level is therefore critical for preventing arrhythmias that can both trigger and worsen heart failure.
3. Reducing Vascular Stiffness and Protecting Blood Vessels
Over time, high blood pressure and other factors can cause blood vessels to become stiff and less elastic. This stiffness forces the heart to pump against greater resistance.
Potassium’s Role: Studies suggest that adequate potassium helps protect the endothelial lining of blood vessels (the inner layer) and reduces vascular stiffness. More flexible arteries mean less workload for the heart.
4. Counteracting Negative Effects of a High-Sodium Diet
The modern Western diet is notoriously high in sodium and often low in potassium. This imbalance disrupts the natural sodium-potassium pump in our cells, which is crucial for nerve function, muscle contraction, and fluid balance. By increasing potassium intake, we help restore this balance and mitigate the damaging effects of excess sodium on the cardiovascular system.
Crucial Caveats and Warnings
While the science supporting adequate dietary potassium is strong, the idea of taking potassium supplements requires extreme caution.
“Food First” is the Rule: The benefits are most clearly seen from getting potassium from a diet rich in fruits, vegetables, beans, and nuts. Excellent sources include:
Leafy greens (spinach, kale)
Potatoes and sweet potatoes
Bananas, oranges, and avocados
Tomatoes and tomato products
Beans and lentils
Coconut water
Supplements Can Be Dangerous: Over-the-counter potassium supplements are typically limited to 99 mg per dose (a fraction of the recommended 3,400-4,700 mg daily intake for adults) for a reason.
Kidney Function is Key: Healthy kidneys are excellent at removing excess potassium from the blood. However, in people with kidney disease or those taking certain medications (like some drugs for heart failure and high blood pressure, including ACE inhibitors, ARBs, and some diuretics), potassium can build up to dangerously high levels (hyperkalemia), which can cause fatal cardiac arrest.
Never Self-Prescribe: You should never take potassium supplements without a doctor’s supervision and a confirmed deficiency. A doctor will prescribe a supplement (often a higher-dose prescription form) only if blood tests show it’s necessary and will monitor your blood levels regularly.
Summary
Potassium might help lower heart failure risk primarily by:
Lowering blood pressure (the biggest factor).
Stabilizing the heart’s electrical rhythm to prevent arrhythmias.
Protecting blood vessels from stiffness.
The take-home message is not to run out and buy supplements, but to focus on eating a diet rich in potassium-filled whole foods. If you are concerned about your heart failure risk or your potassium levels, the safest and most effective step is to consult your doctor for personalized advice.
You’ve hit on a very important and nuanced point in cardiology. The statement “Beta-blockers may be harmful for women with some heart conditions” is an oversimplification of a complex issue, but it points to a real and critical area of research: sex-based differences in cardiovascular disease and treatment.
Let’s break down what this means, separating fact from fiction.
The Core of the Issue: Not “Harmful” but “Potentially Less Effective or Different Risk-Benefit”
For the vast majority of heart conditions (like coronary artery disease, heart attack, heart failure), beta-blockers are lifesaving for both men and women. The benefits are well-proven.
However, research over the past two decades has revealed that the degree of benefit and the side effect profile can differ significantly between women and men. The idea of “harm” primarily comes from two areas:
Increased Side Effects: Women consistently report a higher incidence and severity of side effects from beta-blockers.
Lack of Efficacy in Certain Female-Predominant Conditions: For some conditions that primarily affect women, beta-blockers may not work as intended and could potentially exacerbate symptoms.
1. Increased Side Effects in Women
Women are more likely to experience side effects from beta-blockers, often at the same doses prescribed to men. This is due to well-documented pharmacokinetic and pharmacodynamic differences:
Body Size and Composition: Women generally have lower body weight, less muscle mass, and a higher percentage of body fat, which can affect drug distribution.
Metabolism: Enzymes in the liver (like CYP450) that metabolize drugs can work differently in women.
Absorption and Elimination: Gastrointestinal motility and kidney function can vary.
Common side effects that are more frequent or severe in women include:
Bradycardia (excessively slow heart rate)
Hypotension (low blood pressure)
Fatigue and Depression
Cold hands and feet (due to peripheral vasoconstriction)
The “Harm” Here: If side effects are severe enough, they can lead to poor quality of life and, crucially, non-adherence to medication. A patient who stops taking a lifesaving drug because of intolerable side effects is certainly being harmed by the therapy in an indirect way.
2. Specific Heart Conditions Where Beta-Blockers Are Questioned for Women
This is where the “harm” concept becomes more direct.
A. Coronary Microvascular Dysfunction (CMD)
What it is: A condition where the tiny blood vessels (microvasculature) in the heart don’t function properly, causing chest pain (angina). It is much more common in women, especially after menopause.
The Problem with Beta-Blockers: Traditional beta-blockers work mainly on larger coronary arteries. In CMD, the problem is in the microvessels. Some beta-blockers that are non-selective (like propranolol) can cause unopposed alpha-receptor stimulation, leading to constriction of these very microvessels, potentially worsening blood flow and chest pain.
Current Thinking: Cardiologists are now more cautious. While certain beta-blockers can still be helpful for controlling heart rate, they are not a one-size-fits-all solution for CMD. Other medications like calcium channel blockers (e.g., verapamil) or ranolazine are often preferred or used in combination.
B. Takotsubo Cardiomyopathy (“Broken Heart Syndrome”)
What it is: A temporary weakening of the heart muscle, often triggered by extreme stress. It overwhelmingly affects postmenopausal women.
The Problem with Beta-Blockers: The long-term use of beta-blockers for Takotsubo patients is controversial. Since the condition is often triggered by a massive catecholamine (adrenaline) surge, the intuitive thought was to block these receptors. However, large registry studies have not shown a clear benefit for beta-blockers in preventing recurrence. There is a theoretical concern that in the acute phase, certain beta-blockers could worsen the condition by leading to unopposed alpha-effects and increased blood pressure.
C. Heart Failure with Preserved Ejection Fraction (HFpEF)
What it is: A type of heart failure where the heart pumps normally but is too stiff to fill properly with blood. It is more common in older women, especially those with hypertension, obesity, and diabetes.
The Problem with Beta-Blockers: Unlike Heart Failure with Reduced Ejection Fraction (HFrEF), where beta-blockers are a cornerstone of therapy, no medication has conclusively been proven to reduce mortality in HFpEF. Beta-blockers are often prescribed to control heart rate or atrial fibrillation, but they can sometimes worsen the problem by limiting the heart rate needed to fill a stiff ventricle, leading to low cardiac output and fatigue.
The Bigger Picture: The Historical Lack of Women in Clinical Trials
A major reason these differences are only now being understood is that for decades, cardiovascular clinical trials predominantly enrolled middle-aged men. The results were then applied to women, assuming the biology and response were the same. We now know this is not the case.
Conclusion and Key Takeaway
It is inaccurate and dangerous to say that women with heart conditions should avoid beta-blockers. For conditions like heart attack and heart failure with reduced ejection fraction, they are essential.
However, the correct, modern interpretation is:
Cardiovascular treatment must be personalized, and biological sex is a critical factor in that personalization. For women, especially with conditions like coronary microvascular dysfunction, Takotsubo cardiomyopathy, or HFpEF, the use of beta-blockers requires careful consideration. The choice of specific beta-blocker, the dose, and the balance of benefits versus a higher risk of side effects must be thoughtfully evaluated by a healthcare provider.
If you are a woman prescribed a beta-blocker, the most important thing is to:
Take it as prescribed unless your doctor tells you otherwise.
Report any side effects to your doctor promptly. Do not just stop taking the medication.
Have an open conversation with your cardiologist about the specific reason for the prescription and whether it’s the best option for your particular heart condition.
Disclaimer:This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider for diagnosis and treatment decisions tailored to your individual health needs.
A plant compound found in nuts, vegetables, and fruits that may lower the risk of diabetes and heart disease is polyphenols. Among these, flavonoids (a subclass of polyphenols) are particularly well-studied for their health benefits.
Key Polyphenols and Their Sources:
Flavonoids
Found in: Berries, apples, citrus fruits, tea, dark chocolate, onions, and red wine.
Benefits: Improve insulin sensitivity, reduce inflammation, and support cardiovascular health.
Resveratrol
Found in: Grapes, red wine, peanuts, and berries.
Benefits: May improve blood sugar control and reduce heart disease risk by improving endothelial function.
Lignans
Found in: Flaxseeds, sesame seeds, whole grains, and nuts.
Benefits: Linked to better glycemic control and reduced LDL cholesterol.
Ellagic Acid
Found in: Pomegranates, strawberries, walnuts, and raspberries.
Benefits: Antioxidant and anti-inflammatory effects that may protect against metabolic syndrome.
How They Help:
Improve Insulin Sensitivity: Polyphenols can enhance glucose metabolism by activating AMPK (an enzyme that regulates energy balance).
Reduce Inflammation: They lower oxidative stress and inflammatory markers like CRP and TNF-α.
Support Heart Health: Improve endothelial function, reduce blood pressure, and lower LDL cholesterol.
Evidence:
A 2020 study in Nutrients found that high polyphenol intake was associated with a 30% lower risk of type 2 diabetes.
Research in The American Journal of Clinical Nutrition showed that flavonoids reduced heart disease risk by 20% in high consumers.
Practical Tips:
Eat a variety of colorful fruits and vegetables daily.
Include nuts (like almonds and walnuts) and seeds (flaxseeds, chia) in your diet.
Opt for dark chocolate (70%+ cocoa) and green tea for extra polyphenols.
Yes, omega-6 fatty acids found in nuts, vegetable oils (like soybean, sunflower, and corn oil), and seeds can help lower the risk of heart disease and may have a modest benefit for diabetes risk when consumed in moderation as part of a balanced diet. However, the relationship is nuanced and depends on overall dietary context.
Heart Disease Benefits:
LDL Cholesterol Reduction: Omega-6s (especially linoleic acid) help lower LDL (“bad”) cholesterol when they replace saturated fats in the diet.
Anti-inflammatory Effects (in balance with omega-3s): While omega-6s are precursors to some pro-inflammatory molecules, they also have anti-inflammatory effects when not consumed in excess. The key is maintaining a healthy omega-6 to omega-3 ratio (ideally around 4:1 or lower).
Blood Pressure & Vascular Health: Some studies suggest omega-6s support healthy blood vessel function.
Diabetes Risk:
Some research links higher omega-6 intake (especially from plant sources) to improved insulin sensitivity and lower type 2 diabetes risk, possibly due to reduced inflammation and better lipid metabolism. However, evidence is less consistent than for heart disease.
Caveats:
Source Matters: Omega-6s from whole foods (nuts, seeds) are more beneficial than from processed oils in fried or ultra-processed foods.
Balance with Omega-3s: Excessive omega-6 intake without enough omega-3s (from fish, flaxseeds, walnuts) could promote inflammation in some individuals.
Avoid Overprocessing: Heating vegetable oils at high temps (e.g., deep frying) can oxidize fats, potentially harming health.
Replacing saturated fats (like butter, fatty meats) with omega-6-rich plant oils and nuts is linked to better heart health and possibly reduced diabetes risk. However, focus on whole-food sources and maintain a balanced diet with adequate omega-3s.
Among all the substances found in our bodies, cholesterol is arguably the most well-known. Even though everyone is familiar with this fatty substance, there is a lot of misinformation about it. We shed some light on cholesterol in this article.
Since cholesterol is a necessary part of animal cell membranes, all animal cells synthesize it. Despite its unfavorable reputation, cholesterol is necessary for life. On the other hand, high blood levels of it raise the risk of cardiovascular disease. Plaques containing cholesterol and other materials, like fat and calcium, accumulate on the artery walls. This causes the blood vessels to narrow over time, which can result in complications like heart attacks and strokes.
The Centers for Disease Control and Prevention (CDC) estimate that 13% of Americans who were 20 years of age or older had high cholesterol in 2015–2016. According to estimates from the World Health Organization (WHO), elevated cholesterol levels cause 26 million deaths annually. It is not surprising that there is a lot of false information regarding cholesterol given its prevalence. So, to help us separate fact from fiction.
All cholesterol is bad As indicated in the introduction, cholesterol is an essential part of membranes found in cells. In addition to playing a structural role in membranes, it is essential for the synthesis of bile acid, vitamin D, and steroid hormones. Therefore, even though high cholesterol raises the risk of disease, without cholesterol, life would not be possible.
Cholesterol is not harmful. In today’s modern world, an innocent bystander is being mistreated. Because our bodies were not made to survive in an environment where food was abundant, excess cholesterol will be stored in our bodies. And our blood vessels are frequently that deposit center, which is when it becomes harmful to us. In addition to its physiological roles, cholesterol’s mode of transportation influences whether or not it is harmful to health.
Lipoproteins are molecules made of protein and fat that transport cholesterol throughout the body. There are two primary methods of this transport. From the liver, low-density lipoprotein (LDL) transports cholesterol to cells, where it is utilized in a variety of functions. Because elevated blood levels of LDL cholesterol raise the risk of cardiovascular disease, people sometimes refer to LDL cholesterol as bad cholesterol. Since high-density lipoprotein (HDL) returns cholesterol to the liver, it is frequently referred to as good cholesterol. Once there, the body expels cholesterol, lowering the risk of cardiovascular disease.
I am a healthy weight, so I can’t have high cholesterol Yes, you can, as Dr. Greenfield says. In actuality, our genetic makeup and the food we eat determine our cholesterol balance. For instance, a person may have a genetic predisposition to process cholesterol inefficiently from birth. He clarified that it has been dubbed familial hypercholesterolemia and that its frequency may be as high as 1 in 200 due to its genetic nature. Your genetic metabolism and the ratio of calories burned to calories consumed play a bigger role in weight. Dr. Paz agreed: Your cholesterol can be abnormal even if you have a healthy weight. The foods you eat, how much alcohol you drink, how much you smoke, and how often you exercise all have an effect on your cholesterol.
Furthermore, as Dr. Lajoie informed us, some overweight individuals may not have high cholesterol, while others who maintain a healthy weight may. She clarified that a person’s diet, exercise, sleep patterns, thyroid function, medications, and genetics all influence their cholesterol levels. She went on, Your age and your genetics are two more factors that can contribute to high cholesterol but that you cannot modify.
I would have symptoms if I had high cholesterol This is an additional myth. According to Dr. Paz, high cholesterol typically doesn’t cause any symptoms. For this reason, it is advised to have blood tests regularly to check for high cholesterol. Your unique risk factors dictate when you should begin screening and how often.
When excessive cholesterol accumulation causes heart and blood vessel damage and blockage, the only symptoms that cholesterol can be linked to are the late symptoms. Angina (chest pain), a heart attack, or even abrupt death result from this. Dr. Lajoie reaffirmed that elevated cholesterol causes silent plaque accumulation in arteries, which worsens over time and can result in heart attacks or strokes.
If I eat lots of cholesterol, I will have high cholesterol levels This subject is a little trickier to understand than one might think. According to Dr. Lajoie, cholesterol levels are not always directly correlated with the amount of cholesterol one consumes. Even if a person doesn’t consume much cholesterol, eating sugars or simple carbs can raise their blood pressure. She added, Compared to sedentary people, those who exercise are less likely to see elevations in cholesterol from eating cholesterol.
Our cholesterol levels will almost certainly rise if we eat more cholesterol. He gave the following explanation for this: You buy red meat, cheeses, and eggs at the grocery store, but you don’t go buy a package of cholesterol. Red meat has cholesterol and saturated fat. Since cholesterol is derived from animals, eating foods high in saturated fat will raise cholesterol overall as well as the bad, or LDL, cholesterol, which is then deposited in the arterial walls of our blood vessels.
Everyone should aim for the same cholesterol targets Dismissed! According to Dr. Paz, your target cholesterol level depends on your risk of heart attack and stroke, which is determined by factors like age and high blood pressure, as well as whether you have a history of these conditions. That is untrue, according to cholesterol guidelines released by the National Lipid Association, the American College of Cardiology, and the American Heart Association (AHA). He went on to say that the LDL cholesterol, or bad cholesterol, should be less than 100 milligrams per deciliter (mg/dl) for those of us who have not experienced any cardiovascular issues. However, the LDL cholesterol target should be less than 70 mg/dl, if not lower, if you have a history of heart attacks, strokes, or other arterial vascular diseases, and especially if you have diabetes.
Only men need to worry about cholesterol levels Despite being a persistent myth, this is untrue. Dr. Paz clarified: The CDC reports that between 2015 and 2018, the incidence of elevated total cholesterol in the U.S. adult population was 11.4 percent. In comparison to women, men were more likely than women to have high total cholesterol (10.5% versus 12.1%). Dr. Greenfield concurred that heart disease is an equal opportunity employer. He clarified that women start to accelerate their risk of heart disease and develop the same risk as men after losing the protective effects of estrogens. In actuality, more female heart attacks than male heart attacks are reported each year because women typically develop heart disease later in life and live longer. He also informed us that women are far more likely to die from heart disease than from breast cancer and that when they do suffer a heart attack, their prognosis is typically worse.
There’s nothing I can do about my cholesterol level Fortunately, this is not accurate. Dr. Paz states that in addition to taking cholesterol-lowering drugs, you can lower your cholesterol by eating a healthy weight, exercising, quitting smoking, and consuming moderate amounts of alcohol. Dr. Greenfield concurred that there is a lot that can be done with an abnormally high cholesterol level. The first steps are always diet and exercise, and they are still very important. Statins are safe and highly effective at lowering cholesterol. The more recent statins have been around since 1987 and are thought to be safer, more effective, and have fewer side effects. And science is still coming up with new ideas. According to Dr. Greenfield, more recent injectable PCSK-9 inhibitors have also been demonstrated to significantly reduce cholesterol to previously unheard-of levels.
I take statins, so I can eat what I want Dr. Greenfield started, Wouldn’t that be nice if it were true, but it’s not. You will put on weight if you overindulge in food and calories. Excessive weight gain, particularly around the abdomen, can lead to the development of metabolic syndrome, a prediabetic state. He went on: Statins do not help people lose weight. It is your responsibility to treat your body with respect, which includes what you eat, and your job to lower the bad LDL cholesterol.
I’m under 40, so I don’t need to have my cholesterol checked Dr. Paz clarified that many, advise screening for elevated cholesterol as early as age 20, despite some disagreement regarding the optimal age to begin. Dr. Greenfield agreed the longer blood in your blood vessels has an excessively high cholesterol content, the higher your chance of developing cardiovascular disease in later life. According to the recommendations, a person’s first cholesterol test should be taken when they are a teenager, and if there is a strong family history, it should be taken earlier. He informed us that people with homozygous familial hypercholesterolemia should have their cholesterol checked starting at age 2.
Dr. Greenfield summarized her remarks as follows: I encourage my patients to ask questions and to do research on their medical conditions. But please be advised that a good portion of the polluted content is inaccurate and deceptive. He went on to visit reliable websites and trust the research presented by individuals who have devoted their lives to the treatment of heart disease.. Furthermore, anything that seems too good to be true or nonsensical is most likely not. Handle your body with reverence, not as if it were a theme park!
In this part of our series on medical myths, we explore common misconceptions regarding stroke. We address a number of common misconceptions, including whether a stroke is a heart condition and what to know about ministrokes and paralysis.
The Centers for Disease Control and Prevention (CDC) estimates that 610,000 Americans have their first stroke out of the over 795,000 who experience one each year in the United States. With 11 percent of deaths worldwide in 2019, stroke was the second most common cause of death. Stroke comes in three primary forms. The first type of stroke is the most prevalent, making up 87% of cases. It happens when an artery supplying the brain with oxygen loses its ability to carry blood. The second type of stroke is known as a hemorrhagic stroke, which is brought on by a brain artery burst that subsequently injures nearby tissues.
A transient ischemic attack (TIA), referred to as a ministroke, is the third stroke category. It occurs when there is a brief interruption in blood supply to the brain, usually lasting no longer than five minutes. Despite being extremely common, stroke is frequently misinterpreted. We consulted with Dr. Rafael Alexander Ortiz, chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital, to clear up misconceptions and deepen our understanding of the subject.
Stroke is a problem of the heart Strokes occur in the brain, not the heart, although cardiovascular risk factors are linked to stroke risk. Dr. Ortiz told MNT that some people believe that heart problems are the cause of stroke. That’s not correct. A stroke is not a heart issue; rather, it is a brain issue brought on by an obstruction or rupture of cerebral arteries or veins. Heart attacks, which are brought on by a blockage in the blood supply to the heart rather than the brain, are sometimes confused with strokes.
Stroke is not preventable According to Dr. Ortiz, the most prevalent risk factors [for stroke] are high blood pressure, smoking, high cholesterol, obesity, diabetes, head or neck trauma, and cardiac arrhythmias. A lot of these risk factors are modifiable through lifestyle choices. Regular exercise and a balanced diet help lower risk factors like diabetes, high blood pressure, obesity, and obesity. Stress and alcohol use are two more risk factors. A person’s chance of stroke may be decreased by making efforts to lessen or eliminate these lifestyle factors.
Stroke does not run in families A person’s risk of stroke is increased by single-gene diseases like sickle cell disease. The risk of stroke may also be indirectly increased by genetic factors, such as an increased propensity for high blood pressure and other cardiovascular risk factors. Unhealthy lifestyle choices are likely to raise the risk of stroke in family members since families frequently share environments and lifestyles, particularly when combined with genetic risk factors.
Stroke symptoms are hard to recognize The most common symptoms for stroke form the acronym F.A.S.T. F: face dropping, when one side of the face becomes numb and produces an uneven smile A: arm weakness, when one arm becomes weak or numb and, when raised, drifts slowly downward S: speech difficulty, or slurred speech T: time to call 911 Other symptoms of stroke include: The symptoms may include numbness or weakness in one or both eyes; confusion; trouble speaking or understanding speech; difficulty walking, including dizziness, loss of balance, and coordination; and severe headaches without a known cause.
Stroke cannot be treated Dr. Ortiz clarified that there is a false belief that strokes are incurable and untreatable. Many stroke patients can have their symptoms reversed by emergency treatment with a clot-busting drug injection, minimally invasive mechanical thrombectomy for clot removal, or surgery, he noted. This is especially true if the patient arrives at the hospital early enough for the therapy (within minutes or hours since the onset of the symptoms). The chance of a positive result decreases with the duration of the symptoms. As a result, it’s imperative that at the first sign of a stroke, ie. He went on, “If you’re having problems speaking, double vision, paralysis, numbness, etc., call 911 to send an ambulance to the closest hospital.”. Additionally, studies reveal that people who visit within three hours of the onset of symptoms usually experience less disability three months later than people who arrive later.
Stroke occurs only in the elderly One major risk factor for stroke is age. After age 55, the risk of stroke doubles every ten years. Strokes, however, can happen at any age. According to a study that looked at medical data, 34% of stroke hospitalizations in 2009 involved people under the age of 65. According to a 2013 review, young adults and adolescents account for 15% of all ischemic stroke cases. The most prevalent co-existing conditions in this age group, according to the researchers, were lipid disorders, obesity, diabetes, hypertension, and tobacco use all stroke risk factors.
All strokes have symptoms Not every stroke has symptoms, and some studies indicate that strokes without symptoms occur far more frequently than strokes with symptoms. According to one study, of the approximately 11 million strokes that occurred in 1998, 770,000 had symptoms, while nearly 11 million did not. Evidence of these so-called silent strokes appears on MRI scans as white spots from scarred tissue following a blockage or ruptured blood vessel. When patients undergo MRI scans for symptoms like headaches, cognitive problems, or dizziness, silent strokes are frequently discovered. Even though they don’t have any symptoms, they should be treated in the same way as strokes that do. People who have silent strokes are more vulnerable to dementia, cognitive decline, and subsequent symptomatic strokes.
A ministroke is not so risky According to Dr. Ortiz, the term “ministroke” has been misused because some people believe it to refer to small, low-risk strokes. That is untrue because a ministroke is actually a transient ischemic attack (TIA). This is not a minor stroke; rather, it is a warning sign that a major stroke could happen. He continued, “Any acute stroke symptom, whether temporary or persistent, requires emergency workup and management to prevent a devastating large stroke.
Stroke always causes paralysis A stroke is one of the most common causes of permanent disability; however, not all stroke victims will become paralyzed or weak. Studies reveal that more than half of stroke survivors 65 and older have decreased mobility as a result of their stroke. However, many variables, including the location and extent of brain tissue damage, affect how a stroke affects a person in the long run. For instance, harm to the left brain will impact the right side of the body and vice versa. Effects of a stroke that happens on the left side of the brain might include memory loss, speech and language difficulties, paralysis on the right side of the body, and slow, cautious behavior. Paralysis may also happen, but on the left side of the body, if it impacts the right side of the brain. Other side effects could be memory loss, rapid and curious behavior, vision issues, or both.
Stroke recovery happens fast After a stroke, recovery may take several months or even years. Many, though, might not fully recover. According to the American Stroke Association, of those who survive a stroke, 10% will recover almost completely, 10% will need care in a long-term facility or nursing home, 25% will recover with minor impairments, and 40% will experience moderate to severe impairments. Research indicates that there may be a critical window of 2-3 months following the onset of the stroke, during which intensive motor rehabilitation is more likely to result in recovery. During this time, some people might also be able to recover on their own. Although they are likely to occur much more slowly, improvements are still possible after this window and the 6-month point.
Because it lowers the risk of DNA damage and chronic degenerative disorders, a diet high in magnesium is beneficial for human health according to a recent Australian study. Researchers at the University of South Australia examined blood samples from 172 middle-aged adults. They discovered a significant correlation between elevated levels of the genotoxic amino acid homocysteine and low magnesium levels. Because of the harm this toxic combination causes to the body’s genes, individuals are more vulnerable to diabetes, gastrointestinal disorders, cancers, Alzheimer’s and Parkinson’s disease, and other illnesses. Foods high in magnesium, such as whole grains, dark green leafy vegetables, nuts, beans, and dark chocolate, support the body’s ability to create energy, maintain healthy teeth and bones, control blood pressure and sugar levels, and support the healthy operation of the heart, muscles, and kidneys.
A low magnesium intake (less than 300 mg per day), according to UniSA molecular biologist Dr. Permal Deo, can raise the risk of many diseases; however, its function in preventing DNA damage in humans has not yet been thoroughly investigated. According to co-author Professor Michael Fenech, a persistent magnesium deficiency is likely to impair the body’s capacity to generate energy and power cells, hastening the aging process of tissue and increasing the risk of developing some diseases at an earlier age. The fourth most common mineral in the human body is magnesium. It is needed as a co-factor by over 600 enzymes and as a trigger for nearly 200 vital bodily functions. Finding the ideal magnesium dietary intake—whether from food or supplements and how it might affect the development or course of cancer and other chronic illnesses are the next steps, according to Prof. Fenech.
Even after controlling for age and gender, our research revealed a clear link between elevated DNA damage and blood magnesium levels below 18 mg/L. Measurements of blood levels of magnesium, homocysteine (Hcy), folate, and vitamin B12 revealed a positive correlation between magnesium and vitamin B12 and an inverse relationship between magnesium and Hcy.
This suggests that homocysteine toxicity, which is exacerbated in cases of folate and vitamin B12 deficiency, increases the levels of magnesium in the blood to dangerous levels. Symptoms of magnesium deficiency include tremors, twitches, and cramping in the muscles. In severe cases, a deficiency may even result in convulsions or seizures. Researchers think that these symptoms are brought on by increased calcium entry into nerve cells, which causes the muscle nerves to become overexcited or hyper-stimulated.
Numerous symptoms, such as hypocalcemia, hypokalaemia, and cardiac and neurological problems, can be brought on by magnesium deficiency. The body uses magnesium for numerous functions in every organ and cell, and a chronic low magnesium state has been linked to some chronic diseases, such as diabetes, hypertension, coronary heart disease, and osteoporosis. We frequently hear less about magnesium and more about other electrolytes like calcium, potassium, and sodium.
However, magnesium, like these other electrolytes, is essential to our metabolism and general well-being. It is particularly crucial for the heart’s electrical conduction system and nervous system. Hypomagnesemia, or low or inadequate magnesium levels, can result in some issues. Certain ones are more severe than others. We’ll talk about this condition’s symptoms, causes, diagnosis, and treatment here. Different body parts may experience a variety of symptoms due to low magnesium levels. Numerous symptoms are related to issues with electrical conduction in the heart and nervous system.
Hypomagnesemia can cause a variety of symptoms, such as weakness, exhaustion, tremors or twitches in the muscles, cramping in the heart, palpitations or arrhythmias, numbness, seizures, confusion, or mood swings. Low magnesium is frequently linked to low levels of other crucial electrolytes. Particularly common are low calcium and potassium levels. This is because there are common causes for low levels of these electrolytes. Magnesium is necessary for every organ in the body, but it is especially important for the heart, muscles, and kidneys. It also plays a role in the synthesis of bones and teeth. Many processes in the body require magnesium. This encompasses the bodily chemical and physical processes known as metabolism that transform or utilize energy. Low magnesium can cause symptoms to appear when the body’s magnesium levels fall below normal.
Many people, especially those who should limit their intake due to heart health concerns, consume more sodium than is advised daily. This is supported by a recent study that discovered individuals with cardiovascular disease (CVD) were ingesting more than twice as much sodium per day 1,500 mg—as is advised. The study participants consumed an average of 3,096 mg of sodium daily, with 89% consuming more than the recommended amount. The results will be presented from April 6–8 at the Annual Scientific Session of the American College of Cardiology. The findings are still pending publication in a peer-reviewed journal.
The American Heart Association (AHA) advises adults without a history of heart disease or those not suspected of being at risk to consume no more than 2,300 mg of sodium daily. This is roughly the same as one teaspoon of table salt. This study’s average heart disease patient was over 1,000 mg above that threshold. 3,170 participants in the NHANES study conducted by the Centers for Disease Control provided data for the study. Men and women with a diagnosis of cardiovascular disease who were older than 20 were included in this sample. White people 65 years of age or older with less education than a high school diploma made up the bulk of this group. With an average daily calorie intake of 1,862, males, who made up slightly more than half of the subjects (56.4%), were overweight. Although it’s commonly believed that having fewer food options leads to excessive sodium consumption, this study challenges that theory.
Those with a college degree or above and those at the higher end of the income spectrum consumed the most sodium. The unexpected findings may have been influenced by the fact that people with greater incomes and educational backgrounds may have been more accurate in disclosing their sodium consumption, according to the study’s authors. Sodium chloride is the chemical name for table salt. In trace amounts, sodium, a naturally occurring mineral, is essential to human health. According to cardiologist Jayne Morgan, MD, clinical director at Piedmont Healthcare Corporation in Atlanta, GA, sodium helps to balance the water in your body. It even helps to maintain the healthy operation of nerves and muscles.
Your body’s blood volume rises as a result of salt. High blood pressure is the result of this. Due to the increased cardiac workload caused by the elevated blood pressure, you may eventually develop heart disease. Atherosclerosis and the hardening and stiffening of the arteries have long been associated with excess sodium, according to Dr. Morgan. Numerous studies have examined the reasons behind the widespread desire for salt.
According to registered dietitian nutritionist Michelle Routhenstein, MNT, “the consistent overconsumption of sodium across the socioeconomic spectrum suggests that factors beyond just access to resources may influence sodium intake.”. Routhenstein did not work on the project. According to Routhenstein, this might imply the marketing and general availability of processed foods that are easily accessed and high in sodium, cultural eating habits that value salty foods, and a lack of knowledge or instruction regarding the health risks connected to consuming excessive amounts of sodium.
This is a powerful illustration of how common the Western diet is and how much people crave salt and “flavor.”. It also illustrates how simple and readily available sodium is in a lot of grocery items, even when purchasing ‘healthy’ alternatives. According to her, the Food and Drug Administration (FDA) could establish a uniform food rating system that would enable everyone to know where a given food choice falls on a health spectrum. At that point, the customer can make an informed choice. The first step in lowering sodium consumption is to monitor your salt intake, but it can be challenging to determine how much sodium you’re really taking in.
Sodium is used in many food products for purposes other than just adding flavor. It has multiple uses, including baking, thickening, curing meat, retaining moisture, and serving as a preservative. A lot of sodium-rich foods don’t even taste salty. According to Routhenstein, people may unintentionally consume excessive amounts of sodium if they don’t actively read food labels and pay attention to sodium levels. Before even thinking about using a salt shaker, people might not be aware of how much sodium is in their food, according to Routhenstein. For instance, the recommended sodium intake for people with heart disease can be exceeded by the 2,000 mg or more found in a typical restaurant meal.
Using fresh ingredients when cooking at home, selecting low-sodium options, incorporating herbs and spices for flavor, reading labels, and being aware of hidden sodium in processed foods are all good ways to reduce your intake of sodium through diet. While eating out, people can choose heart-healthier, lower-sodium options by asking for dressings and sauces to be served on the side, choosing grilled or steamed food over fried, and asking for meals to be prepared without added salt. While [you’re] still enjoying delicious meals, these small changes can make a big difference in your overall sodium intake reduction. Routhenstein offered a variety of flavor-retaining salt substitutes, such as a small amount of lemon or grapefruit juice added to recipes.
Citrus fruits’ tart flavor can fool the palate into thinking food has more salt than it actually does, keeping food tasty even when it contains less sodium. Furthermore, Routhenstein promoted spiciness; add hot sauce or chili peppers to your food based on your personal preferences. You could also use a shaker of your favorite powder, like oregano or garlic powder, in place of the tabletop salt shaker (not garlic salt, which contains sodium). Seasonings such as Dijon mustard, whole grain mustard, or dry mustard powder can give dressings, marinades, and sauces tang and depth. According to Routhenstein, adding mustard to rubs, sandwich spreads, and vinaigrettes provides a tasty variation without using a lot of sodium.
The semaglutide drug Wegovy was approved by the FDA on March 8 to help lower the risk of heart attack, stroke, and cardiovascular death in adults with heart disease who are obese or overweight. According to the indication, semaglutide should be used in conjunction with a lower-calorie diet and more exercise. The Food and Drug Administration (FDA) first authorized semaglutide in 2017 for the treatment of type 2 diabetes in adults. The FDA approved Novo Nordisk’s semaglutide drug Wegovy in 2021 for the treatment of obesity and overweight adults who also have at least one weight-related condition.
Medication classified as glucagon-like peptide-1 (GLP-1) receptor agonists includes semaglutide, which was first created to treat type 2 diabetes. Since then, the use of GLP-1 medications to treat weight loss has skyrocketed. Researchers have looked into the effects of semaglutide on cardiovascular health in recent years. For example, a 2021 study discovered a link between semaglutide and anti-atherosclerotic benefits. According to a 2023 study, semaglutide may help adults with obesity who do not have diabetes by improving cardiometabolic risk factors and lowering the usage of high blood pressure and high cholesterol medications.
This class of medications may help lower blood pressure and cholesterol, two risk factors for cardiovascular disease, by promoting weight loss and weight control. By addressing one component of the metabolic syndrome, you can also improve the other heart disease risk factors, which will ultimately lead to better cardiovascular outcomes. The short answer is that everything is interconnected, and managing weight and blood sugar levels is a major factor in many cases of heart disease. Based on the findings of the SELECT cardiovascular outcomes clinical trial, the FDA has granted a new approval. According to the study, adults with established cardiovascular disease who are overweight or obese and take Wegovy have a 20 percent lower risk of major adverse cardiovascular events, such as cardiovascular death, non-fatal heart attack, or non-fatal stroke. Furthermore, the trial discovered that, in comparison to individuals who took a placebo, semaglutide use decreased a person’s risk of dying from cardiovascular disease by 15% and death from all causes by 19%.
It is well known that obesity raises the risk of cardiovascular disease on its own. Additionally, patients can lower that risk by losing weight. This study was intriguing because it suggests that these weight-loss drugs have an impact beyond only assisting patients in losing weight. Regretfully, they were unable to address that in this study; however, further research in that field is required. Despite all of our efforts over the past few decades, cardiovascular disease continues to be the leading cause of death worldwide. As a result, we need to keep looking for new strategies to lower the morbidity and mortality rate from this illness. Heart failure and advanced vascular disease, for example, carry a higher death risk than many types of cancer. Cardiovascular disease is a public health emergency, especially when it is linked to obesity. As such, any safe treatment that lowers the risk of death or complications will be highly sought after. When it comes to treating these ailments, there is still a great deal we don’t know.
The way semaglutide medications function is by mimicking the body’s natural release of the GLP-1 hormone during meals by the gastrointestinal tract. This hormone lowers blood sugar levels by instructing the body to produce more insulin. Semaglutide is a prescription drug that is administered intravenously by the patient. It works by increasing the amount of insulin produced by the pancreas and lowering the amount of glucagon produced by the liver. These drugs directly lessen appetite and cravings by acting on the hypothalamus, a region of the brain.