Why people with Type 1 diabetes have a greater risk for heart diseases; preventive measures

Cardiovascular events are becoming more common, occuring at a younger age than usual - equally both in males and females. But people with Type 1 diabetes mellitus (T1DM) have a higher risk of developing heart disease than the general population, although the reason behind this hasn’t been clearly understood. In fact, people with both types of diabetes - Type 1 and Type 2 - have a higher risk for heart disease, perhaps, just for different reasons.

The Pittsburgh Epidemiology of Diabetes Complications (EDC) study showed that the incidence of major coronary artery disease (CAD) events in young adults (aged 28-38 years) with Type 1 diabetes mellitus was 0.98 per cent per and surpassed 3 per cent per year after age 55 years, making it the leading cause of death in that population. Patients with Type 1 diabetes can prevent or reduce their risk of developing an immune reaction to their own body, one that specifically attacks the heart, by keeping their condition under control through a combination of medication and lifestyle changes.
The link between CVD and Type 1 diabetes

The main risk factors responsible for cardiovascular disease in Type 1 diabetes are hypertension, cigarette smoking, obesity, lipid levels, inflammation, microalbuminuria, and poor glycemic control. According to Dr M Sai Sudhakar, Director - Cath lab, Chief Interventional Cardiologist and Chief Cardiac Transplant Physician at Gleneagles Global Hospitals, Lakdi ka Pul, Hyderabad, there are several potential explanations why patients with Type 1 diabetes have a greater risk for CVD. A scientific statement from the American Heart Association and American Diabetes Association explained how type 1 diabetes mellitus increases your risk for CVD. Here's how:
 
Genetic polymorphisms appear to influence the progression and prognosis of CVD in Type 1 diabetes mellitus.
 
People exposed to higher blood sugar levels were more likely to develop an autoimmune response to the heart proteins linked to later development of heart disease, including heart attack and death.
 
Abnormal vascular findings associated with atherosclerosis are seen in patients with T1DM. 

Endothelial function alters even at a very early stage of type 1 diabetes mellitus. Atherosclerosis - When plaque clogs your arteries - in the setting of Type 1 diabetes mellitus is characterised by more severe stenoses, more extensive multiple vessels and more distal coronary findings than in patients without the disease.
 
Neuropathy in Type 1 diabetes mellitus can cause abnormalities in the response of coronary vasculature to sympathetic stimulation, which may manifest as resting tachycardia or bradycardia, exercise intolerance, orthostatic hypotension, loss of the nocturnal decline in BP, or silent myocardial ischemia on cardiac testing. These abnormalities can result in delayed presentation of CVD.
 
Inflammation operates in T1DM via multiple mechanisms, which may include hyperglycemia and hypoglycemia, excess adiposity or altered body fat distribution, thrombosis, and adipokines.

Prevention

The good news is, there are many things you can do to reduce your risk of developing heart disease or having a heart attack. These include:

Risk modifications such as avoidance of smoking, maintenance of a normal weight, and consumption of a balanced diet replete in fruits and vegetables and enriched in whole grains, but low in saturated fat and sodium are generally recommended.
 
Aggressive diabetes and lipid management is of utmost importance. A lower BP goal of <130 appropriate="" be="" br="" in="" individuals.="" may="" mmhg="" younger=""> 
All patients with Type 1 diabetes mellitus and hypertension or albuminuria are usually advised to take an angiotensin-converting enzyme (ACE) inhibitor -- a class of medication used to treat certain heart and kidney conditions. If an ACE inhibitor is not tolerated, an angiotensin II receptor blocker (ARB) may have similar efficacy.
 
People suffering from diabetes are vulnerable to heart ailments, which may trigger a stroke unless the patient adopts a healthy lifestyle. It is essential for diabetic patients to maintain their cholesterol level at the prescribed limit, regular physical activity, and reduce their body weight in addition to taking the right medication.

Following the right preventive methods and appropriate treatment may help reduce the risk of heart complications and improve the life expectancy in patients with diabetes.

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Grana Padano: The Hard Cheese Good Health Story

Cheese is certainly delicious, but you might be surprised to learn that eating it regularly can also be beneficial to your health. Recent research seems to suggest that there is, at least, one Italian cheese that can protect your heart. What great news this is for us cheese lovers!

 

The study showed that people with high blood pressure saw their systolic blood pressure improve by 7 to 8 millimeters of mercury (mm Hg) and their diastolic blood pressure by 5 to 7 mm Hg, after they had eaten a single ounce of the renowned Italian cheese Grana Padano per day for two months.

The people in the study who did not eat the semi-fat hard, parmesan-like cheese, but rather a fake-dairy version of it, saw no improvement in their blood pressure.

Lead study author found that Grana Padano contains two compounds that can relax your blood vessels, leading to a lowering of your blood pressure. These are known as isoleucine-proline-proline (IPP) and valine-proline-proline (VPP).

IPP and VPP function like common blood pressure ACE inhibitors (e.g. Lotensin or Capoten), which stop our bodies producing angiotensin II, an active hormone that increases blood pressure by constricting blood vessels.

Although this study is exciting, both for the health news and for the excuse to eat cheese, Dr. sounds a note of caution. He says that because cheeses contain lots of salt and fat, they can really boost your calorie count if you’re not careful. For this reason, he recommends substituting an ounce of Grana Padano cheese for every dairy serving you normally eat per day.

It's not clear at this stage whether similar cheeses, such as the similar Parmigiano Reggiano, offer the same health benefits. Yet, future studies are likely to be started to explore and resolve the question.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                    PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/                                                                                                                                                FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                                                       https:// kneereplacement-stickclub.blogspot.com/                                                                                                                     FOR CROCHET DESIGNS                                                                                                   

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Checking a Cough is Essential

Most people assume that coughing is associated with a lung or an airway problem. But, an unusual suspect may actually be the heart. It isn't unusual for people who have heart failure to experience significant coughing. In fact, a cough may indicate an important sign that heart failure treatment is inadequate, or, possibly, treatment may be causing problems. 

1. Heart Failure
Heart failure does not mean that the heart just stops, that is cardiac arrest. Rather, it means that the heart's pumping ability has been impaired to the extent that the heart is not always able to keep up with the demands of the body. Heart failure can cause a number of cardiac disorders, including coronary artery disease, hypertension, hypertrophic cardiomyopathy, diastolic dysfunction, and heart valve disease, among several others. Heart failure is a common disorder, with over a million people each year being hospitalized in the world.
A common problem with heart failure is that due to the heart's inefficient pumping ability, blood returning to the heart from the lungs tends to back up, producing pulmonary congestion, which is why people with heart failure are often said to have 'congestive heart failure.'
Consequently, with pulmonary congestion, fluid, and a little blood, can leak into the alveoli (air sacs) of the lungs. This lung fluid is what's largely responsible for the dyspnea (a feeling one cannot breathe properly) commonly experienced by people with heart failure because coughing is the body's way of clearing the airway and bronchial passages. Thus, it makes sense that a cough can also result from pulmonary congestion. 
2. Cardiac Cough
Coughing caused solely by heart failure can take several forms. A wet cough produces frothy sputum that may be tinged pink with blood, tends to be quite common with heart failure. Heavy wheezing and labored breathing may also accompany spells of coughing, along with a bubbling feeling in the chest, or even a whistling sound from the lungs.
Coughing symptoms like this usually are a sign that heart failure has become substantially worse, and such a cough is usually accompanied by a general flare-up of heart failure symptoms. These symptoms are likely to include dyspnea, orthopnea (shortness of breath when lying down), edema (swelling), and paroxysmal nocturnal dyspnea - waking up from sleep in the middle of the night, gasping and coughing. However, people who have this severe form of cardiac cough are generally sick enough to seek medical help without much prompting. 
A cardiac cough can take a much less severe form. Some people with heart failure will develop an annoying, more chronic, drier cough that may produce a small amount of white or pink frothy mucus. People who have this less severe form may assume it to be due to some other cause, and thus may fail to seek medical assistance. In doing so, however, the symptoms of heart failure are likely to become substantially worse. So anyone who has been told they have heart failure should not ignore the onset of a cough even if they consider it to be mild. 

3. Medication-Related Cough
Coughing is also a common effect of a class of medication that is often prescribed to those who have been diagnosed with heart failure: angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are helpful for heart failure because they dilate the arteries, thus making it easier for the heart to pump blood. These drugs, however, produce a cough in about 4% of people who do take them.
The cough they experience is generally a dry hacking cough which does not produce sputum. Reports suggest that non-steroidal anti-inflammatory drugs (NSAIDs) may improve a cough caused by ACE inhibitors, but, in the large majority of people who have this problem, the drug must be discontinued, primarily because the ACE inhibitor can be switched to an angiotensin II receptor blocker (ARB), which has many of the same advantages as the ACE inhibitor, but which causes coughing less frequently. A change in medication can help relieve a dry, hacking cough due to ACE inhibitors.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                
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Cardiomyopathy

Cardiomyopathy is a progressive disease of the myocardium, the heart muscle. The condition is either confined to the heart or is part of generalised systemic disorders. They often lead to cardiovascular death or progressive heart failure-related disability.

These diseases have many causes, signs and symptoms and treatments. The heart muscle either becomes enlarged, thick or rigid in cardiomyopathy. In rare cases, the muscle tissue is replaced with a scar tissue.

The main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy and arrhythmogenic right ventricular dysplasia.

Some other types of cardiomyopathy are called ‘unclassified cardiomyopathy’ and ‘stress-induced cardiomyopathy’, also known as broken heart syndrome.

Cardiomyopathy can be inherited i.e. a family history of cardiomyopathy, sudden cardiac arrest, or heart failure. Four in ten cardiomyopathies – a major cause of sudden cardiac death and heart failure in young people – are genetic, according to a study published today.

Often, the cause isn’t known and it can affect all ages and certain age groups are more likely to have certain types of cardiomyopathy, according to a Consultant Interventional Cardiologist.
  
Symptoms
People with cardiomyopathy never have signs or symptoms in the early stages of the disease. It usually occurs later as the heart weakens.

“The cardiac expression of these genetic diseases starts early in some patients,” said the first author of the study. “In others it is delayed for many decades – longer than previously thought.”

Symptoms such as – shortness of breath, fatigue, and light-headedness or dizziness, edema or swelling in the ankles, feet, legs, abdomen, and veins in the neck, fainting attacks during physical activity, arrhythmias (irregular heartbeats), chest pain, especially after physical exertion or heavy meals.

Medication
People with cardiomyopathy condition are prescribed medicines such as ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers to lower the blood pressure. Beta blockers, calcium channel blockers, and digoxin help in decreasing the heart rate.

An antiarrhythmic drug helps to keep the heart beating with a normal rhythm. Diuretics are used to remove excess fluid and sodium from the body. Anticoagulants – “blood thinners” helps to prevent blood clots. Blood thinners are often used to prevent blood clots from forming in people who have dilated cardiomyopathy.

Treatment
With proper lifestyle modification, one can lower the risk for diseases or conditions that may lead to or complicate cardiomyopathy. A healthy diet and physical activities are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and grains.
It is suggested to consume foods that are low in saturated fat, trans fat, and cholesterol. Salt intake should be reduced. Smoking and consumption of alcohol and illegal drugs should be avoided. Having a good sleep and rest will help in reducing stress.
It is also important to note that one should take proper measures to treat conditions such as diabetes and high blood pressure.

Treatment
People with cardiomyopathy should get medical advice before performing any kind of physical activities. Implanted devices mentioned below helps the heart work better. The goal of treatment is to help your heart be as efficient as possible and to prevent further damage and loss of function.

Pacemaker, a small device that’s placed under the skin helps to control arrhythmias. It uses electrical pulses to prompt the heart to beat at a normal rate.

Cardiac resynchronization therapy (CRT) device coordinates contractions between the heart’s left and right ventricles.

A left ventricular assist device (LVAD) helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant.

An implantable cardioverter defibrillator (ICD) helps control life-threatening arrhythmias that may lead to a sudden cardiac arrest.

This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat.

Heart Transplant is considered as a last resort treatment for people whose condition has become so severe that all treatments have failed. 

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                      PS- THOSE INTERESTED IN RECIPES ARE FREE TO VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/   
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Some Simple Ways To Lower Blood Pressure

Snack on yoghurt
Snacking with yoghurt can trim your risk of high blood pressure by 31%. Swapping some of your daily calories with one 6-ounce cup of low-fat yoghurt  without increasing the number of calories you eat in a day, can lead to a lower risk of high blood pressure, according to new research . The researchers found those who ate yoghurt daily saw the biggest reduction in their risk of high blood pressure.  You'll feel full after eating one six-ounce cup, making it easier to miss salty or sweet snacks to maintain a healthy weight.



Eat More Legumes
Eating one cup of cooked beans, chickpeas, and lentils and other legumes can reduce the risk of heart disease and improve control of blood pressure, according to a study . They can slash your risk for type 2 diabetes, as they're rich in fibre. In the study, beans and other legumes shaved 4.5 points off participants' systolic blood pressure number (that's the top number) and cut the chance of heart disease by about 1%. 


 Use More Of Sesame Oil Combined with Other Oils
Vegetables are great as a side dish or snack, but not in your oil. Instead of cooking with vegetable oil, use a blend of sesame and rice bran oil . Not only is that blend effective at reducing total cholesterol and LDL cholesterol because it’s lower in saturated fats, according to a study, a sesame and rice bran blend does wonders for your blood pressure, too. People who used about 2 Tbsp of a blend of sesame and rice bran oil a day (to cook with, in salad dressings, etc.) saw systolic blood pressure drop an average 16 points, their diastolic drop an average 12 points. Their total cholesterol also dipped 18%


Go for gazpacho, i.e., A cold soup with tomatoes, cucumbers, garlic etc.
A 6- to 8-ounce bowl of the tasty cold soup that features tomatoes, cucumbers, garlic, and olive oil was found to trim nearly 2 points off systolic and 2.6 points off diastolic blood pressure, according to new research. A team of  researchers studied the blood pressure of thousands of gazpacho guzzlers and suspect that specific polyphenols, a set of compound chemicals and antioxidants, in the soup's ingredients are able to tame blood pressure.Don't like cold soup when it's chilly out? then use the ingredients in your favourite gazpacho recipe to whip up salsa for a healthy snack.

Go For hot cocoa at breakfast
 Start your day with a nod to your sweet tooth and fill your mug with 2 to 3 Tbsp of cocoa powder and 8 ounces of low-fat milk. The cocoa powder can cut 2 to 3 points off your blood pressure. Turns out the flavonols  natural plant compounds in cocoa, help your blood vessels function better. More productive blood vessels means there's less strain on your heart as it pumps blood throughout your body—and blood pressure that doesn't sky-rocket out of control.


Sip Cranberry, the antioxidant-rich juice
Wet your thirst with a tangy, tart glass of low-calorie unsweetened cranberry juice and lower both your systolic and diastolic blood pressure by 3 points, according to new research.  Although scientists aren't sure of the definite link, the study credits the antioxidants in the berries with the ability to help temper blood pressure. Cranberries can also help stave off UTIs and all types of urinary infections.

Develop a passion for purple
Add a pop of colour to your plate with purple potatoes, and watch your diastolic blood pressure drop by 4.3% and systolic pressure dip 3.5% . And no need to worry that this starchy veggie will crush your diet. The researchers found eating about 1.5 to 2 cups (about 300 calories) of microwaved purple potatoes twice a day did not cause weight gain. The study says purple potatoes are thought to spark effects in the body similar to the way ACE-inhibitor medications, a mainstay for treating high blood pressure, manage blood pressure. 

Kick the salt habit
A diet of more than 2,200 mg of sodium a day may damage blood vessels, increasing the risk of developing high blood pressure by 21 to 32%, according to research . Consuming more than 2,200 mg of salt a day may be the cause of 20 to 40% of all cases of high blood pressure.


Toast With  a glass Of Non-Alcoholic Red Wine
Toast the day with a glass of non-alcoholic red wine and cut about 6 points off your systolic and 2 points from your diastolic blood pressure. You could also reduce the risk of heart disease by 14% and stroke by as much as 20%, according to new research.

Just be sure to stick to non-alcoholic red wine, which the new study says is the best bet if you want to tame your blood pressure. The study says alcohol weakens wine's ability to lower blood pressure. But the polyphenols credited with reducing blood pressure are well preserved in non-alcoholic red wine. 

Pomegranates
Before you hit the gym or treadmill, snack on pomegranate seeds. Packed with vitamin C and antioxidants, pomegranates are good at helping you maintain a healthy blood pressure during exercise, according to researchers. That's because low levels of antioxidants in your body can trigger a spike in blood pressure, but the antioxidants found in pomegranates lessen the increase in blood pressure, leading to a healthier workout and ability to sustain intensity of activity to burn more calories. 

SOME BLOOD PRESSURE TABLETS CAN CAUSE APPENDICITIS

Intake of blood pressure pills could increase the risk of potentially deadly appendicitis by up to 63 per cent, a new study has found.

Types of blood pressure pill like ACE inhibitors and ARBs raised the risk considerably in millions of people.

The two types can cause swelling in the bowel which inflames the appendix - a vestigial finger-like pouch connected to the large intestine.

When this occurs, it must be removed within hours or a deadly infection can set in. 

Researchers discovered ACEs and ARBs appeared to increase the chance of appendix trouble by 36 to 63 per cent. Generic drug names for ACEs include ramipril, lisinopril and perindopril.

ARBs include telmisartan, losartan and candesartan, the paper reported.

None of the other blood pressure tablets, like beta-blockers or calcium-channel blockers, had the same effect.

The National Health Service (NHS) in UK issues more than 50 million prescriptions for the pills each year. The drugs work by keeping the arteries open, boosting blood flow.

It’s vital  for people continue to take their medication and discuss their individual risk, if any, with their doctor.