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Higher risk of heart failure: Urban vs Rural area.

Higher risk of heart failure: Urban vs Rural area.

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According to an observational study, American people who live in rural locations are 19% more likely overall to get heart failure than those who reside in metropolitan areas.

American black men who live in rural areas are 34% more likely than their urban counterparts to experience heart failure. Compared to Black women in rural regions, Black women in urban areas had an 18% higher risk.

Also, compared to white women living in urban settings, white women in rural regions had a 22% higher risk of heart failure.

According to the U.S. Department of Agriculture, approximately 46 million Americans, or 14% of the population, resided in rural regions in 2020.

In the 1980s, the number of deaths per 100,000 people in rural and urban areas was roughly similar, but by 2016, there were 135 more deaths per 100,000 people in rural areas than in urban ones, according to a 2019 study.

According to the US Centres for Disease Control and Prevention, people who live in rural areas have a higher risk of dying from heart disease, cancer, accidental injury, chronic lower respiratory disease, and stroke than people who live in urban areas.

As per a sizable observational study conducted by scientists at the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health, and the Vanderbilt University Medical Centre in Tennessee, Americans who live in rural areas are 19% more likely overall to develop heart failure than those who live in urban areas.

Researchers acknowledged that this study is the first to examine the relationship between rural American life and heart failure cases that are newly diagnosed.

Study of heart failure in rural vs. urban areas

More than 2,700 persons in 12 states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia) provided data that was collected over a 13-year period.

The information was obtained from The Southern Community Cohort Study, a National Cancer Institute-funded long-term health study of persons in the Southeast of the United States.

“At the end of the study period, the researchers found that living in rural America was associated with an increased risk of heart failure among both women and Black men, even after adjustment for other cardiovascular risk factors and socioeconomic status,” a news release for the study stated.

The National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health (NIH), provided the majority of the funding for the study. The research results, which were developed in association with Nashville, Tennessee’s Vanderbilt University Medical Centre, were released in JAMA Cardiology.

Conduction of Rural heart disease study

The Southern Community Cohort Study (SCCS) included 27,115 persons who were the subject of the study.

Participants from Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia were among the first to be enrolled in the study by its researchers, which got underway in 2002.

Approximately 86% of those people were chosen from community health centers that offer medical care to underserved groups.

A little over 20% of the SCCS participants who were chosen for the study were residents of rural areas. This study only included participants who identified as Black or non-Hispanic White because, as the researchers explain in their publication, there were insufficient numbers of participants from other racial and ethnic groups.

Approximately 69% of the chosen individuals were Black. Participants’ ages ranged from 24 to 54. Only those participants were chosen for the trial who did not initially report having heart failure.

According to research, participants from rural areas had somewhat higher body mass indices and rates of hypertension, diabetes, cardiovascular disease, and hyperlipidemia than those from urban areas.

Both stroke and depression rates were lower among rural inhabitants than among their urban counterparts. Diet and exercise habits were comparable between the two populations. In addition to being more likely to be married and have less formal schooling, individuals from rural areas were also less likely to now smoke.

Greatest risk is for Rural Black men

Participants experienced 7,542 occurrences of heart failure between the study’s beginning and a median 13-year follow-up.

When the heart is unable to adequately pump blood throughout the body, heart failure results. Shortness of breath when performing daily tasks or difficulty breathing while lying down are symptoms.

1,865 of the heart failure incidents involved rural individuals, whereas 5,677 were city dwellers.

After accounting for variables like age, sex, and race as well as cardiovascular risk factors, health behaviors, and socioeconomic factors in their analysis, the researchers concluded that adults who live in rural areas have an overall higher risk of developing heart failure than their counterparts in urban areas of 19%.

Black men from rural areas had the highest risk of heart failure. Compared to their urban counterparts, this group had a 34% higher chance of developing heart failure.

Women were likewise more vulnerable. Rural Black and White women had an 18% and 22% higher risk of heart failure than women who lived in metropolitan areas.

“We addressed, as much as we could, things that we thought could be playing a role in our observation,” Roger stated. We anticipated that we would discover such a difference, but we did not anticipate the size of the difference we discovered.

Racial and gender biases play?

The fact that Black men and women had a higher chance of developing heart failure in rural locations wasn’t surprising to Keisha Ray, an assistant professor of bioethics and medical humanities at McGovern Medical School at UTHealth Houston in Texas.

“It is consistent with what health disparities scholars have consistently maintained—discrimination like racism and sexism touches all parts of Black people’s and women’s lives,” she said. “Racism also affects people’s access to the resources they need for good heart health, such as access to wholesome foods, leisure activities, adequate housing and income, and access to preventive healthcare.”

Because of chauvinism, health professionals frequently fail to take women seriously, Ray continued.

She stated that “women are frequently not believed when they complain of illness or their poor health is downplayed and dismissed.” This might delay the delivery of care that could save their lives.

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Higher magnesium intake linked to lower dementia risk.

Higher magnesium intake linked to lower dementia risk.

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Researchers looked into the effects of magnesium consumption on dementia risk variables. They discovered that a higher magnesium intake is associated with a lower risk of dementia. The findings need to be confirmed by other research.

Globally, 57.4 million people suffered from dementia in 2019. This number is projected to increase to 152.8 million by 2050.

Many researchers focus on preventative measures, such as diet, as there is presently no cure for dementia. According to certain research, consuming magnesium supplements may lower the chance of developing dementia and improve cognitive performance.

Reports

According to one study that tracked 1,000 middle-aged adults for 17 years, those who consumed the most magnesium had a 37% lower risk of developing dementia than those who consumed the least.

Further investigation on the relationship between magnesium and cognitive function may help develop dementia prevention measures.

Several studies looked into how long-term magnesium intake impacts dementia risk. They discovered that improved brain health—especially in women—is associated with higher magnesium intake.

The National Capital Poison Center’s Dr. Kelly Johnson-Arbor, a medical toxicologist, co-medical director, and interim executive director who was not involved in the study, said, “Although more research is needed on this subject, the results of this study suggest that higher magnesium intake is associated with improved brain health and may conceivably also be linked to preserved mental function and a reduced or delayed risk of developing dementia.”

Published in the European Journal of Nutrition was the study. Further investigation on the relationship between magnesium and cognitive function may help develop dementia prevention measures.

Several studies looked into how long-term magnesium intake impacts dementia risk. They discovered that improved brain health—especially in women—is associated with higher magnesium intake.

The National Capital Poison Center’s Dr. Kelly Johnson-Arbor, a medical toxicologist, co-medical director, and interim executive director who was not involved in the study, said, “Although more research is needed on this subject, the results of this study suggest that higher magnesium intake is associated with improved brain health and may conceivably also be linked to preserved mental function and a reduced or delayed risk of developing dementia.”

Published in the European Journal of Nutrition was the study.

350 vs. 550 mg of magnesium daily

The researchers used 6,001 people’ medical records from the UK Biobank, aged 40 to 73, for the study. Measurements of blood pressure, an MRI scan, and dietary magnesium consumption over a 24-hour period five times during a 16-month period were all included in the data.

Almost 95% of individuals maintained consistent magnesium intake throughout the research period. Yet, some people over time increased their intake while others decreased it.

Finally, they discovered that, in MRI scans, increased dietary magnesium intake was associated with larger brain volumes and smaller white matter lesions (WML), both of which are signs of dementia.

Also, they discovered that magnesium intake exceeding 550 mg per day is associated with a brain age by 55 years old that is roughly one year younger than intake of 350 mg per day, which is close to the daily recommended amount.

They pointed out that this indicates a 41% increase in magnesium intake could enhance brain health, maintain cognitive function, and reduce the incidence of dementia.

They also discovered that post-menopausal women compared to pre-menopausal women had higher levels of neuroprotective magnesium intake than men. However, they pointed out that bigger brain sizes in women were associated with lower magnesium intake over time.

Most correlations between blood pressure measurements and magnesium consumption were insignificant.

How magnesium lowers dementia risk?

According to Dr. Howard Pratt, D.O., psychiatrist and Mental Health Medical Director at Community Health of South Florida, Inc., who was not involved in the study, magnesium is known to be a neuroprotector and to have favourable effects on blood pressure.

“High blood pressure is a documented dementia risk factor in and of itself. The study later showed a decrease in white matter lesions in medium to early old age, indicating that increasing dietary magnesium consumption can have beneficial benefits on cardiovascular health,” he noted.

Magnesium, according to Dr. Johnson-Arbor, may aid in reducing inflammation.

Chronic medical disorders that lead to magnesium deficiency are more likely to occur as we age, including renal disease and vitamin D deficiency. Several studies have suggested that magnesium may be implicated in the development of dementia and other neurologic diseases because magnesium deficiency may result in reduced cellular communications and increased inflammation inside the brain,” stated Dr. Johnson-Arbor.

Magnesium’s effects on women’s health

The University of California, Irvine, Program in Public Health’s Dr. Bruce Albala, an environmental and occupational health professor who was also not involved in the study, is trying to figure out what might be to blame for the enhanced effects of magnesium on post-menopausal women.

The authors suggest that the older women’s lower levels of chronic inflammation may have been a result of their higher magnesium consumption. At this time, these findings should be treated with caution, especially for the smaller magnesium dietary subgroups, the author advised.

The fact that oestrogen is a vasodilator, which means that it can assist lower blood pressure, is one of the interesting things about it. Post-menopausal women’s lower oestrogen levels can actually lead to greater blood pressure.

Study restrictions

Dr. Albala cited a number of the study’s limitations. The individuals’ average age was 55, thus it is unknown whether magnesium is beneficial later in life because the researchers did not include a follow-up MRI scan.

More than 95% of the subjects had steady magnesium intake during a 16-month period, he continued, therefore there was no information available on how variations in magnesium intake over time increase the risk of dementia.

He added that the amount of magnesium consumed is not always related to the body’s actual amounts of the mineral or how it affects tissues like the brain. Dr. Pratt stated that rather than making dementia diagnosis, the study looked into risk factors.

The fact that a person can have numerous dementia risk factors but not actually get the disease restricts this study. Also, there are limits in our knowledge of the timing and scope of magnesium’s neuroprotective effects on the brain, the author pointed out.

Dr. Johnson-Arbor continued, “Although the study authors considered elements like triglyceride levels, tobacco use history, history of diabetes, physical activity, and alcohol intake when they created their analysis, they did not collect data on other conditions—such as other cancer, kidney disease, or other neurologic conditions—that may have affected the findings in this study.

Magnesium to ward off dementia

Board-certified emergency medicine specialist Dr. Naomi Jean-Baptiste was not involved in the study. She advised people to avoid consuming too much magnesium.

“Like all nutrients in the body, magnesium has a recommended range and too much of it might be bad for you. Magnesium excess can result in mortality due to muscle weakness, exhaustion, low blood pressure, and dyspnea. Hence, before include additional magnesium in your diet, use caution and see your doctor, advised Dr. Naomi Jean-Baptiste.

Dr. Jason Krellman is an assistant professor of neuropsychology at Columbia University Medical Center and a neuropsychologist who was not engaged in the study.

“Further research is required to investigate the possible neurological and cognitive benefits of a magnesium-rich diet utilising carefully controlled, experimental circumstances and a study design that tracks people’s neurocognitive health over time,” he said.

However, the study’s encouraging results show that there are a number of dementia risk factors that people can identify and minimise through healthy lifestyle choices, such as heart-healthy eating habits, aerobic exercise as tolerated, and engaging in enjoyable cognitive and socially stimulating activities.

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