Half of women with heart failure get the wrong treatment
January 6, 2020
Science Daily/The University of Bergen
More women than men die of heart failure. The reason is that only 50 per cent of the heart failure cases among women are caused by having a heart attack, which can be treated with modern methods.
For the other 50 per cent of women experiencing heart failure the cause is generally related to having untreated high blood pressure levels over time, which leads to progressive stiffening of the heart. There is no effective treatment for this kind of heart failure yet.
"Men and women have different biologies and this results in different types of the same heart diseases. It is about time to recognise these differences," says Professor Eva Gerdts, Department of Clinical Science, University of Bergen.
"Another important point concerning how to avoid heart disease is to ask about what the national health service is doing on this issue. Heart disease remains among the most common cause of death and reduced quality of life in women. Medically speaking, we still do not know what the best treatment for heart- attack or -failure is in many women. It is an unacceptable situation," Gerdts claims.
Gerdts has recently published an invited review paper in Naturetogether with Professor Vera Regitz-Zagrosek ved Charité Universitätsmedizin.
The researchers have compared common risk factors for heart disease and how these affect men and women differently. They have, among other things, focused on the sex differences in the effect of obesity, high blood pressure and diabetes.
Women gain more weight
According to The World Health Organization (WHO) 11 per cent women and 15 per cent men are obese (BMI over 30 kg/ m2) globally. In Norway one in five adults are obese.
"If we see this from a life span perspective, we can see that obesity increases with age, and that this trend is greater for women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease," Gerdts points out.
According to Gerdts, obesity also increases the risk of diabetes 2. A woman with diabetes has a much higher relative risk of heart complications and death than a man.
"We know that women with diabetes 2 are usually obese and some of this fat is stored in the heart, which makes it more vulnerable for disease."
Oestrogen influence heart risk
Gerdts explains that many of the differences between woman and men when it comes to heart disease are connected to the sex hormone, oestrogen. The hormone prevents the formation of connective tissue in the heart, which makes it harder for the heart to pump. In men the effects are the opposite.
"We see that obese men store oestrogen in their fat cells in the abdomen, which has a bad effect on the heart."
After menopause, women lose the oestrogen advantage. Their arteries becomes stiffer and more vulnerable for disease. We see this in the fact that for persons under 60, high blood pressure is most common amongst men. For persons over 60, it is the opposite.
"We think that this is part of the explanation for why high blood pressure seems to indicate higher risk of heart disease amongst women."
Women smoke more
In addition, smoking is also a part of the risk scenario for women. During the past decades, more women have started smoking than men.
"Many women start smoking to reduce their appetite and to control their weight. However, this is not a good choice from a health perspective."
"For women, the effects of risk factors such as smoking, obesity and high blood pressure increase after menopause," says Eva Gerdts.
https://www.sciencedaily.com/releases/2020/01/200106103444.htm
Even in young children: Higher weight = higher blood pressure
June 13, 2019
Science Daily/European Society of Cardiology
Overweight four-year-olds have a doubled risk of high blood pressure by age six, raising the hazard of future heart attack and stroke. That's the finding of a study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
"The myth that excess weight in children has no consequences hampers the prevention and control of this health problem," said study author Dr Iñaki Galán, of Carlos III Health Institute, Madrid, Spain. "Parents need to be more physically active with young children and provide a healthy diet. Women should shed extra pounds before becoming pregnant, avoid gaining excess weight during pregnancy, and quit smoking, as these are all established risk factors for childhood obesity."
According to the World Health Organization, childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and the prevalence has increased at an alarming rate. In 2016, more than 41 million children under the age of five were overweight.
This study, based on the ELOIN cohort, examined the link between excess weight and high blood pressure in 1,796 four-year-olds who were followed up two years later. Blood pressure was measured at both time points, as was body mass index (BMI in kg/m2) and waist circumference.
Compared to children maintaining a healthy weight between ages four and six, those with new or persistent excess weight according to BMI had 2.49 and 2.54 higher risks of high blood pressure, respectively. In those with new or persistent abdominal obesity, the risks for high blood pressure were 2.81 and 3.42 greater, respectively. Children who lost weight did not have an increased risk of high blood pressure. The findings applied to all children regardless of sex or socioeconomic status.
"There is a chain of risk, whereby overweight and obesity lead to high blood pressure, which heightens the chance of cardiovascular disease if allowed to track into adulthood," said Dr Galán. "But the results show that children who return to a normal weight also regain a healthy blood pressure."
The best way to maintain a healthy weight and lose excess kilos is to exercise and eat a healthy diet, said Dr Galán. In addition to the central role of parents, the school curriculum needs to include three to four hours of physical activity every week. Teachers should supervise activities during breaks, while schools can offer games and sports after classes and provide nutritionally balanced meals and snacks.
Doctors should routinely assess BMI and waist circumference at early ages, added Dr Galán. "Some paediatricians think the harms of overweight and obesity begin in adolescence but our study shows they are mistaken," he said. "We need to detect excess weight as soon as possible so the damaging impact on blood pressure can be reversed."
Overweight children should have their blood pressure measured. Three consecutive elevated readings constitute high blood pressure. In young children, the most common cause is excess weight, but doctors will rule out other reasons such as heart defects, kidney disease, genetic conditions, and hormonal disorders. If the cause is overweight, more activity and dietary improvements will be advised. If lifestyle changes don't help, blood pressure lowering medication may be prescribed.
Dr Galán noted that overweight in children is most accurately assessed using both BMI and waist circumference. In the study, using either measurement alone would have missed 15% to 20% of cases.
https://www.sciencedaily.com/releases/2019/06/190613095224.htm