Yo-yo dieting may raise women's heart disease risk

Yo-yo dieting-weight cycling, or the cyclical loss and gain of weight- can make it harder for women to control a variety of heart disease risk factors, according to a research.

The study found in case of women losing at least 10 pounds and regaining the weight within a year could be detrimental to heart health.

Besides achieving a healthy weight, maintaining a consistent body weight is important for lowering heart disease risks.

Earlier research showed similar results in men, with those who weight-cycled having twice the risk of cardiovascular death in middle age.

Achieving a healthy weight is generally recommended as heart healthy but maintaining weight loss is difficult and fluctuations in weight may make it harder to achieve ideal cardiovascular health, said a Prof.

For the study, the team examined 485 women ( average age 37 years, average body mass index 26, in the overweight range.

Women reported how many times ( other than during pregnancies) they had lost at least 10 pounds only to regain the weight within a year.

Most women ( 73 %) reported at least one episode of yo-yo weight loss, with a range of zero- 20 episodes.

They were assessed according to cardiologist's measure- of how well people control major heart disease risk factors, including body mass index, cholesterol, blood pressure, blood sugar, smoking, physical activity and diet.

The more episodes of weight cycling women reported, the poorer they scored in the measurement chart according to researchers.

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Yo-yo dieting -- weight cycling, or the cyclical loss and gain of weight -- can make it harder for women to control a variety of heart disease risk factors, according to a research. The study found in case of women losing at least 10 pounds and regaining the weight within a year could be detrimental to heart heath. Besides achieving a healthy weight, maintaining a consistent body weight is important for lowering heart disease risks. Earlier research showed similar results in men, with those who weight-cycled having twice the risk of cardiovascular death in middle age.

https://www.thehansindia.com/life-style/yo-yo-dieting-may-raise-womens-heart-disease-risk-511062

Aggressive lowering of BP may up risk of CHD in diabetes

Aggressive lowering of blood pressure may be associated with increased risk of coronary heart disease (CHD) in black or white patients with diabetes, according to research.

The scientists conducted a prospective cohort study from 2000 to 2009 involving 17,536 African-American and 12,618 Caucasian patients with diabetes. The association of blood pressure with CHD risk was analyzed.

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Cholesterol-Lowering Vaccine May Immunise People Against Heart Disease

What is the main cause for human suffering and deaths worldwide? Until recently, it used to be infectious diseases. But in the last 15 years or so, heart disease has taken the helm, becoming responsible for a quarter of deaths each year,

There are many approaches to prevent diseases. Among them, the use of effective vaccines is popular, effective and desirable. Vaccination is the administration of antigenic material to induce an individual’s immune system to develop antibodies to a pathogen. It is a time-tested technique a and long-lasting method to prevent infectious diseases. A vaccine against cardiovascular disease has not been not available until now – although that may soon change. 

A study published recnetly has become the first of its kind to show that it is possible to immunise genetically modified mice with a molecule that causes the body to produce antibodies against PCSK9 (proprotein covertase subtilisin/kexin type 9), an enzyme that plays a pivotal role in preventing the clearance of low density lipoprotein (“bad”) cholesterol from the blood.

This enzyme binds to the low-density lipoprotein receptor and enhances its degradation. This leads to the reduced clearance of low-density lipoprotein (LDL) and a higher risk of atherosclerosis, a disease in which plaque builds up inside the arteries.

In the present study, researchers evaluated a vaccine, dubbed AT04A anti-PCSK9, for its therapeutic potential to ameliorate or even prevent coronary heart disease in the APOE*3Leiden.CETP mouse model. These are genetically modified mice for human-like lipid metabolism. Their response to lipid-lowering and high-density lipoprotein increasing interventions is similar to that of humans.

Impressive results in mice
According to a press release , “At present, drugs such as statins can be used to lower LDL cholesterol, but they have to be taken on a daily basis and although they are generally well-tolerated they can cause adverse side effects in some people. The most recently approved cholesterol-lowering compounds are monoclonal antibodies targeting PCSK9, which are highly effective, but their effect is short-lived, resulting in frequent reapplication and high costs.”

Researchers fed the vaccine-treated mice with a fatty Western diet for 18 weeks. They then monitored the antibody titres, plasma lipids and inflammatory markers by advanced, analytical procedures. They found that AT04A vaccine induces an effective immune response against PCSK9 in APOE*3Leiden.CETP mice, leading to a significant reduction of plasma lipids, systemic and vascular inflammation and atherosclerotic lesions in the aorta, the main artery.

They concluded that the vaccine might represent an effective approach for the treatment and even prevention of cardiovascular disease. But will it also be economic, as they claim? There is little doubt that the cost of the vaccine is bound to be prohibitive to the many who will need it. For example, a treatment regimen involving either alirocumab and evolocumab, both inhibitors of the PCSK9 enzyme, has been estimated to cost very high, which most patients won't be able to afford.

Nonetheless, the results of using the vaccine were very impressive. Also according to the release, “The AT04A vaccine, when injected under the skin in mice … reduced the total amount of cholesterol by 53%, shrank atherosclerotic damage to blood vessels by 64% and reduced biological markers of blood vessel inflammation by 21-28%, compared to unvaccinated mice.” It added that the antibodies introduced by the vaccine had “remained functional over the whole study period” and that “concentrations were still high at the end of the study.”

“If these findings translate successfully into humans, this could mean that, as the induced antibodies persist for months after a vaccination, we could develop a long-lasting therapy that, after the first vaccination, just needs an annual booster,” the release quotes one of the study’s authors  as saying. “This would result in an effective and more convenient treatment for patients, as well as higher patient compliance.”

He also told this correspondent that that they were currently performing a phase-one clinical trial to immunise people, and that the final results will become available in early 2018.

Potential side effects
He explained, “The way that AT04A is administered is comparable to a vaccine. However, the difference between a conventional vaccine and our approach is that a vaccine induces antibodies that are specific to bacterial or viral proteins that are foreign to the body – pathogens – whereas AT04A induces antibodies against a target protein that is produced by the body: endogenous proteins. Thus it is really an immunotherapeutic approach rather than a vaccine approach.”

He clarified that they hope to sell their drug commercially by 2023-2025 depending on the market and the geography.

Will potential side effects of the vaccine, such as type 2 diabetes, have to be considered before submitting the vaccine for approval? “Although it has been published that LDL lowering by either statins or PCSK9 blockers might be associated with a small increased risk in new-onset of diabetes, the impact of these drugs on glycemic control parameters in patients with diabetes mellitus still remains unclear,” he answered. “However, upcoming clinical studies using AT04 have to prove safety of this immunotherapeutic drug also in terms of new-onset of diabetes.”

The phase one trial underway with humans – which he mentioned earlier – commenced in 2015. In the trial, AT04A and another molecule, AT06A, were given to 72 healthy people to assess their safety and activity. 

A professor of clinical and experimental medicine and  an associate professor of medicine  wrote in an editorial accompanying the mice study that the results appeared “promising”. However, they cautioned, “Safety, the response in humans and the very important but unknown long-term immune effects need to be very carefully addressed during the course of clinical development.”

They also noted that reductions in total cholesterol via statins and other drugs have been associated with an increase in new onset diabetes. “Therefore, potential safety concern for long-term lowering of LDL cholesterol with a vaccine directed against PCSK9 is the potential for an increased risk of new onset diabetes. In the short term, the LDL cholesterol lowering effect of statins and PCS9 inhibitors appears to far outweigh the risks of new onset diabetes,” they concluded.

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BP medications after stroke not beneficial

Lowering blood pressure during the first 48 hours after a stroke does not reduce the likelihood of death or major disability, claims research.

Blood pressure often is elevated following a stroke.

"In most cases, treatment is unnecessary because the blood pressure declines naturally over time and lowering blood pressure may be contra-indicated," warned stroke specialist.

It is important not to overtreat and cause low blood pressure, because the most important objective is to maintain adequate blood flow to the brain, Dr. advised.

Lowering blood pressure has been shown to reduce the risk of stroke. The study investigated whether there also would be a benefit to lowering blood pressure immediately after a stroke.

The study included more than 4,000 stroke patients in 26 hospitals across China who were randomly assigned to receive blood pressure medications or to discontinue blood pressure medications.

At 14 days or hospital discharge, there were no statistically significant differences between the groups in mortality or disability, said the study.

It involved patients who had suffered ischemic strokes, which account for about 85 per cent of all strokes.

Such strokes are caused by blood clots that block blood flow to a part of the brain.

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Walking in the woods can keep heart disease at bay

Nature's own stress buster! A simple walk in the woods can boost heart health by lowering stress and blood pressure levels. Nature has beneficial effects that help us cope with stress at work, according to new research. The study highlights the power of the 'great outdoors' to improve both physiological and psychological well being. "The value of nature has long been considered to be advantageous to human health. Early examples of this come in the form of urban parks established by wealthy philanthropists during the 19th century, and in the gardens incorporated into hospital designs," she said. "Our research supports this, demonstrating an association between improved health outcomes and engagement with surrounding 'green space'," she said.

A series of five studies were set up by the researchers to explore the physiological and psychological benefits of nature, and the response to stress during and after viewing nature in simulated and real environments. Individual perceptions of green space surrounding home and work environments were examined, as well as how individuals interact with green space and its impact on their health. One specific study measured how a group of people recovered from a stressful task after they had viewed slides showing scenes of nature. Results showed that recovery from the stressful task was improved compared to when the scenes were of unpleasant built-up environments, according to a statement.

In a separate study, a walk in "green" environments at lunch time enhanced restorative sleep the following night. Furthermore, if individuals walked regularly in a "green" environment, they showed significantly lower levels of blood pressure and perceived stress after just eight weeks. "It's widely accepted that nature is good for us, but we're still trying to delve into what it does for us and why," she concluded . "However, our research has shown that 'green' environments can be an effective stress buster. If we can encourage more people to enjoy the great outdoors it may help increase their levels of physical activity and, therefore, could also be a powerful tool to help fight the growing incidence of cardiovascular disease," she said.

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