Showing posts with label cardio-vascular health. Show all posts
Showing posts with label cardio-vascular health. Show all posts

Is "Mini-Stroke" a Misleading Term?

Contributed by: Dennis Fortier, President, Medical Care Corporation

As our population simultaneously ages and becomes more obese, poor cardiovascular health has driven the incidence of certain medical conditions ever higher.  For example, general awareness and acceptance of transient ischemic attacks, alternatively known as TIA's and mini-strokes, has risen notably over the past two decades.

While awareness of medical conditions and the risks that cause them is generally a good thing,  a false comfort, based on a perception of "good medical outcomes", can be quite dangerous.

Sticking with the example of TIA's, the tone of much public discourse on such a clear symptom of severe cardiovascular disease, has been somewhat benign.  Because "mini-strokes" are common, and immediate outcomes are often fairly good, we may be developing a false notion that a mini-stroke is a minor occurrence.  On the contrary, a mini-stroke is a serious sign that immediate, medical attention is needed.

A recent study published in the journal Stroke showed that lingering disabilities, following a mini-stroke, are highly prevalent.  In fact, about 15% of patients who had a single TIA had lingering disabilities after three months and, for those who had a series of TIA's, more than half (53%) had lingering disabilities.

More importantly, TIA's are a major warning sign of an underlying problem that could lead to a much bigger stroke and major debilitation of the brain.  While the symptoms of a small stroke may fade quickly, immediate medical attention is still required.  Ignoring such events could lead to dire consequences including death.

The term "Mini-Stroke" may connote an insignificant event, but the evidence suggests that any stroke is serious, and the concept of "mini" might be misleading in terms of its health-related consequences. 

Smoking, Alzheimer's, and Dementia

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Smoking is clearly bad for your vascular health.  This has been well studied and consistently proven through decades of solid research.  Since one key function of the vascular system is to deliver oxygen rich blood to the the brain, it stands to reason that a compromised vascular system could negatively affect the brain.

Based on data from the Rotterdam Study published in Neurology, the hypothesis that smoking's impact on the vascular system is ultimately bad for the brain, is likely to be true.

Researchers analyzed data from 6,868 subjects aged 55 and older for an average of 7 years, all of whom were dementia free at the start of the study.  By comparing smoking habits, including number of packs per day and number of years smoked, to the eventual incidence of Alzheimer's disease and other causes of dementia, clear conclusions were drawn.  Those subjects who smoked in midlife were approximately 50% more likely to be diagnosed with Alzheimer's or to become demented from other causes later in life.

In a more recent study, researchers  looked at similar data from the Kaiser Permanente Medical Care Program of Northern California.  In this analysis, researchers studied midlife smoking habits and their correlation to Alzheimer's and/or vascular dementia in later life, across 21,123 subjects over a 23 year period.   They found that heavy smokers (2 packs/day) had about a 200% increase in risk for Alzheimer's and/or vascular dementia and that light smokers (half a pack/day) had about a 40% increase in risk.

The consistency of these findings should be noted,  especially given the large sample and long period of the second study.  It is safe to add "preserving the health of your brain" to the already long list of reasons why you should not smoke.

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A better understanding and more awareness of Alzheimer's related issues can impact personal health decisions and generate significant impact across a population of aging individuals. Please use the share button below to spread this educational message as widely as possible.

Smoking Increases Risk of Alzheimer's Disease and Vacular Dementia


Contributed by: Dennis Fortier, President, Medical Care Corporation
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Many of smoking's detrimental effects on long-term health have been well know for decades. Research has clearly shown that smoking can lead to lung cancer, emphysema, and heart disease. Now, based on research published this week in the Archives of Internal Medicine, we know that smoking can also dramatically increase risk for Alzheimer's disease and for vascular dementia.

In a study of more than 21 thousand subjects who were followed for an average of 23 years, Kaiser Permanente tracked smoking habits and incidence of dementia. The findings were clear:

Compared with non-smokers, those who smoked more than two packs of cigarettes a day in midlife had a "dramatic increase" in the incidence of dementia -- more than a 157 percent increased risk of developing Alzheimer's disease and a 172 percent increased risk of developing vascular dementia, Whitmer's team found.
- Lead Researcher, Rachel A. Whitmer

It should be noted that these heightened risks were demonstrated in middle-aged subjects (50-60 years old) who smoked more than 2 packs per day. Because data were not available across the full age spectrum, we cannot say with certainty if the same risks apply (or do not apply) to older or younger subjects. Those who smoke less than two packs per day did not have the same heightened risks.

While we have long known about the many risks that smoking poses to our physical health, the evidence that it could also impair our cognitive health has been historically, less substantial. This well designed study on a large sample population and a long follow-up period draws a highly valid and important conclusion.

It's another good reason to quit. More importantly, it's another good reason not to start.
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A better understanding and more awareness of Alzheimer's related issues can impact personal health decisions and generate significant impact across a population of aging individuals. Please use the share buttons below to spread this educational message as widely as possible.

The Global Cost of Dementia


Contributed by: Dennis Fortier, President, Medical Care Corporation
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With each new study, the numbers get bigger and scarier. The latest report, The Global Economic Impact of Dementia, released by the non-profit group Alzheimer's Disease International, is no exception. The full report can be downloaded here.

At a top line level, the report estimated the annual cost of care for demented patients at over $600B or about 1% of the world's gross domestic product. Astoundingly, that figure is dwarfed by the projected rise in costs over the next decades. In fact, the report estimates that costs could reach nearly $2 trillion by the year 2050. A good summary of these findings are published online by Time.

While a cure is the goal that everyone seeks, a cold economic look at the disease makes it clear that the crippling expense of care comes primarily from patients in the moderate to severely demented stages of illness, when they cannot administer their own lives. While delaying progression to those stages might seem to be an uninspiring health care goal, it is a very attractive economic goal.

To that end, earlier intervention and robust treatment, including a balanced diet, physical exercise, pharmaceutical therapy, and tight control of diabetes and any present cardiovascular risks, should be a high priority in the primary care setting.

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A better understanding and more awareness of Alzheimer's related issues can impact personal health decisions and generate significant impact across a population of aging individuals. Please use the share button below to spread this educational message as widely as possible.

The Unseen Side Effects of a Healthy Heart


Contributed by: Dennis Fortier, President, Medical Care Corporation
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Do you know the chances of surviving a heart attack? According to WebMD, they’re actually pretty good at about 85%.

That doesn’t mean that anyone wants to test the statistics personally nor does “survival” guarantee a high quality of life thereafter. But it may be true that as public awareness grows about heart attack victims who fully recover and live well, the prospect of heart failure becomes less of a deterrent from an unhealthy life style.

In fact, WebMD also notes that survival has become more likely despite the fact that heart attack victims are in generally worse cardio-vascular health (more high blood pressure and diabetes) than in the past. This suggests that the better survival rate is due to better medical techniques, not to a general trend toward improved vascular health.

Healthy Hearts Maintain Healthy Brains
Importantly, there are other, less obvious but perhaps more compelling reasons to care for your heart. Mainly, good vascular health is extremely important to maintaining a healthy brain. While most of us accept the fact that our tennis serve will likely slow as we age, few are so willing to accept the prospect of diminishing cognitive capacity. The good news is that cognitive decline is far from inevitable and we probably don’t need to accept it.

So how does one take good care of their heart and reap the brain related benefits? What exactly should one do? The answer is to focus on managing those risks that are known to be associated with poor heart health.

These risks include monitoring and controlling blood pressure, cholesterol, and body mass. Making the heart work extra hard to pump blood through the body is a strain that, when considered cumulatively across many years, can greatly increase the likelihood of emergent problems. The primary behaviors one should adopt are well known and should not come as a surprise; they are sensible diet and regular physical exercise.

In terms of diet, there are many helpful resources available including a very good one at the Mayo Clinic. In general, one should be sure to get the necessary proteins, vitamins, and minerals while avoiding high calorie foods containing unhealthy amounts of saturated and trans fats.

Regarding physical exercise, it needn’t be overly rigorous as much as it should be regular. Walking may be the most under-rated form of exercise but its benefits to the heart and brain are well documented. Starting each day with a 30-40 minute walk at a pace slightly faster than leisurely is easy on muscles and joints but beneficially demanding on the heart and lungs.

The Unseen Side Effects
The unseen but well established side effects of taking care of one’s heart include a healthier brain and better cognition. Evidence has been pouring in for the last year that these benefits may be much greater than many of us initially understood. In the last few months alone, our knowledge of the link between vascular health and cognitive health has increased significantly.

For example, a study at UCLA showed a strong link between obesity and brain shrinkage, a study published in the journal Neurology showed that high blood pressure is associated with memory loss, and Kaiser Permanente published that even borderline high-cholesterol increases the risk for dementia.

There is no doubt that keeping an oxygen-rich supply of blood flowing freely to the brain is key to maintaining good intellectual health and to aging with cognitive vitality. You can accomplish this through all of the well-established approaches to vascular health that we’ve all been hearing about for decades. The good news is that everything you can do to keep your heart healthy will also benefit your brain.

The purpose of this blog is to spread useful information as broadly as possible. If you found this article worthwhile, please share it with your online networks using the share button below.

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This article was featured by Life Line Screening.

Life Line Screening, in business since 1993, is the nation's leading
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Starting Fresh in the New Year


Contributed by: Dennis Fortier, President, Medical Care Corporation
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It is that season when it is enjoyable, and in some ways instructive, to pause and reflect on the passing of another year. It is also an excellent time for setting priorities and establishing habits that we will be happy to reflect upon twelve months from now. With that in mind, this article suggests 5 simple practices with clear “brain health” benefits that you may wish to consider as you embark on a fresh new year.

To be sure, there are higher ideals than those I have listed here, toward which we could all strive. However, my intention is to provide readers with some ideas that are relatively easy to pursue but can still yield important benefits; the goal is to offer maximal return for minimal effort and sacrifice.

With that said, here are five considerations for starting fresh in 2010:

1. Improve Cardio-Vascular Health

This suggestion is not new but deserves repeating because it has been proven beyond a doubt that good cardio-vascular health leads to better over all health and lower risks for heart disease, diabetes, and Alzheimer’s disease. What is new is certain evidence about how easy it may be to start moving the needle in the right direction.

Improving cardio fitness need not involve strenuous exercise and really doesn’t even require that you sweat. Walking is one of the overall best and most underrated forms of exercise and can often be incorporated into daily errands. Also, don’t think that because walking is easier than running or swimming that you must do it longer to gain a benefit; a daily 30-minute walk is immensely beneficial to a person with no current routine of physical exercise. Especially if the walk can be augmented with a few trips up and down the stairs in lieu of the usual elevator ride.

In terms of staying motivated to maintain a routine of physical exercise, try to find a quantitative measure that will reveal your progress and keep you looking for more gains. In the past, much emphasis has been placed on body weight, a measure that is easy to obtain but can be difficult to improve. As an alternative, check your pulse rate at the end of your work out and track it for one month of daily walks; you might be surprised to see it fall. When you consider how many beats of your heart you can save over the course of a year by keeping your heart rate low, it can be very motivating.

Also, whether or not you suffer from high blood pressure or high cholesterol, be sure to get these measures from your physician during your next check-up and keep track of them as you exercise. Even something as simple as a daily walk is good for your brain and can produce meaningful improvements in both of these bio-markers as you gain better fitness.

2. Reduce Stress

This suggestion might top the all time list of things that are easy to suggest but difficult to achieve. However, it turns out that for many of us, a high percentage of the daily stresses we encounter are self-inflicted. That’s right; choices we make and attitudes we willingly assume end up creating stress that we could otherwise avoid.

Reducing stress is important because we know how detrimental stress can be to our health. Real physical processes are triggered by emotional reactions to stress and, as far as our science can tell, none of those processes are beneficial while all have harmful side effects.

Here is a simple suggestion for reducing stress that, although it won’t work for all of you, must be tried by the rest of you before you can fully believe its effects. Put simply, you should make a conscious decision to drive with patience and courtesy. Look for other drivers trying to cut traffic and motion them in. Don’t speed up to close the gap when another car wishes to enter your lane; slow down and allow them in. Embrace yellow lights for the opportunity they foretell to pause for a moment – this is certainly less stressful than treating them as a threat to your rapid progress. Don’t tailgate or change lanes incessantly seeking opportunities to move one car length closer to the front of the crawling traffic; it is just not worth it. Instead, accept the pace, listen to some music, and keep an eye out for other drivers who might benefit from your courteous cooperation.

If you are not aggressive driver and cannot benefit from that tip, perhaps you can benefit from becoming a less aggressive “parker”. When visiting an establishment with a large parking lot, rather than seeking the spot nearest to the entrance, subjecting yourself to the anxiety of passing up a mediocre spot for the possibility of finding a better one, all the while monitoring the flow of motorists who might be competing for the best spot, try driving to the far end of the lot and parking in the open expanse of remote spots. It is a stress-free approach with the added benefit of a short cardio workout as you walk to your final destination.

While this might seem silly, it’s a step toward avoiding self-inflicted stress that just might carry over into other realms of your life as well. Get the right attitude, reduce your stress, and enjoy a healthier brain and body.

3. Stay Socially Active

While most of us are not in danger of becoming accidental hermits, making new friends and interacting socially are activities that have been documented to decline as we age. We are most prolifically social as young students, followed by fairly intense socialization in adulthood when our children are students, and we tend to be least active when we are older and our children have grown and moved on.

Much research on the benefits of intellectual stimulation, the act of using our brains in challenging ways, has shown a positive correlation with maintained cognitive health. I will write more on that below but will make a separate point here. Meeting people, learning about them, interacting and cooperating with groups, and cultivating relationships are all activities that require deep and comprehensive cognitive activity. In socializing, especially with persons we are still getting to know, we use memory, verbal skills, and judgment along with a poorly understood melding of emotions and executive function. In the opinion of many scientists, socializing may be the best mental activity we have.

Two great ideas for remaining socially active are club membership and volunteering. While you may or may not have interests that lend themselves easily to club membership, a regular card game or social activity with a committed group brings the same benefits. As for volunteering, hospitals, churches, and many non-profit organizations are begging for help in nearly every community. Incidentally, one of the most meaningful gifts you can offer through volunteering is friendship and interaction with a lonely, usually elder, person. Doing so will yield a double benefit because every interaction will be a work-out for both of your brains, not to mention the good it will do for your hearts.

4. Eat Well

You had to know this one was coming. As I did with the section on cardio-vascular fitness, I will try to present this in a new perspective that might be easier to embrace than those perspectives you have heard in the past.

Here is my fresh take on eating well. You needn’t necessarily deny yourself the junk food you’ve grown to love nor worry too much about your daily intake of calories. You do need, however, to worry about getting proper nutrition first. While consuming empty calories is harmful because it leads to weight gain and poor vascular health, the more damaging impact is that it strips away your appetite and prevents consumption of necessary vitamins and nutrients. A fresh approach to diet in the new year might be to focus first on what you should eat and set, as a second goal, the elimination of foods that you should not.

The good news is that the diet shown to produce the best vascular health was also shown this year to also promote the best cognitive health. One should be sure to consume a diet rich in cruciferous and green leafy vegetables, nuts, fish, and tomatoes and low in red meat and high-fat dairy products. Ideally, you will eventually adopt a diet whereby you take in what you need and avoid what you do not, but an easy place to start is to ensure that you get enough fruits and vegetables prior to filling up on junk; this will offer the best opportunity to keep your brain functioning at a high level in the new year.

5. Seek Intellectual Stimulation

If you have pondered the health of your brain at all, you have likely read or heard about the importance of ongoing intellectual stimulation. While it is not yet completely understood, it does appear that active brains decline more slowly with age than those that are relatively unchallenged.

A potential red herring in the discussion is the value of crossword puzzles, sudoku, and the like. Yes, they are mentally challenging activities but they may not produce the rich neural rewards that other activities, such as socializing, might yield. The key seems to be related to the concept of “learning”. If you don’t know the rules of crossword or sudoku then these may be great activities for your brain. However, if you know how the games are played, then merely working through new forms of each puzzle requires no new learning and may offer few benefits to brain health.

Among the most challenging yet rewarding intellectual activities that you pursue are learning to play a musical instrument and learning to speak a foreign language. Both of these have become much easier in the digital age with the advent of tools and software to aid in the learning process. While this might seem counter-intuitive it is actually quite well-grounded. With better tools, the learning becomes easier so the process yields faster proficiency and remains interesting through time. Despite the ease, the learning is real and the brain builds new circuits in accordance with the new learning. The whole process can be great fun, deeply rewarding, and very good for your brain.

So there you have 5 good suggestions to start fresh in the new year and keep your brain healthy in the process. Work on that cardio-vascular fitness, reduce your stress, stay socially active, eat well, and challenge your brain with new learning. If you do so, you can expect that twelve months from now you can look back with clarity and reflect on a year when you made a worthy commitment to the health of your brain.