Tag: Heart attack

Diet soda: Bad for your health and your weight
According to the experts, diet soda is bad for your health and your weight, Peri Ormont Blumberg reports for Time Magazine. Notwithstanding, many Americans live on diet sodas. By so doing, they often mistakenly think they are keeping their weight down and promoting good health.

According to recent research, however, diet drinks lead to all kinds of diseases, including cancer, mood disorders, fatty liver development and diabetes. There’s only observational studies to support these findings, which means the researchers can’t link cause and effect for sure. But, there’s mountains of long-term studies showing a correlation between drinking diet soda and poor health outcomes.
- Type 2 diabetes strongly linked to consumption of diet soda: Many researchers find this connection. Here’s a recent study of 106,000 people.
- Diet soda strongly linked to obesity. This meta-analysis of 11 studies found a significant association between artificially sweetened soda consumption and obesity.
- Diet soda linked to heart conditions: People who drink more than two quarts of diet soda a week have a 20 percent higher likelihood of poor heart health, including heart attacks, heart disease and stroke. Here’s a recent study.
- Diet soda linked to cancer. Here’s a meta-analysis. Other research has found potential links from diet soda to cancers including colon, uterine, kidney, and pancreatic, though it’s not clear whether obesity or diet soda is causing the cancer.
No one can pinpoint why the link between diet soda and poor heart health. It could be most pronounced in people who don’t exercise, smoke, drink alcohol, and otherwise don’t take care of themselves.

Diet soda is linked to cancer: The World Health Organization believes that aspartame, a key ingredient in some diet sodas, could be carcinogenic. Some research has shown links between diet soda and colon, pancreatic, and kidney cancer. But, the World Health Organization somehow also found that it’s safe for people who weigh around 150 pounds to drink eight cans of diet soda with aspartame a day!!!! You wonder whether it is being sincere or is worried about a lawsuit from the diet soda manufacturers.

Diet soda is linked to weight gain: Some researchers suggest that, because diet soda tends to be sweeter than sugar, it could change the way people experience tastes. As a result, it could make people feel hungrier, causing them to consume more calories and to gain weight. People should not think that drinking diet soda helps with weight loss.

Should you drink diet soda? No. It is far better to drink water than diet soda. And, if you need your soda to be sweet, drink soda water with a bit of honey or juice in it. That said, some researchers believe that if you must drink prepackaged soda, diet soda could be preferable to sugary soda and alcohol for your health and your teeth. We know how harmful sugar can be; but, for some reason, we are not as clear about the harms of artificial sweeteners.

Tricks to limit your diet soda intake:
- Take a sip and pour the rest down the drain.
- Think of it like candy, not like an alternative to water when you sit down to a meal.
- Drink seltzer water with some fruit juice or honey added.
Here’s more from Just Care:
April 17, 2024
Have A-fib? Here’s what you can do
More than two million adults in the US have atrial-fibrillation or A-fib, according to the National Institute on Health. Scientific American pegs the number of people with A-fib much higher at one in three adults over 40, likely because it is believed that many people have A-fib and do not know it. But, it’s important to know because A-fib can kill you if you don’t ensure it’s in check, causing strokes, heart attacks, blood clots and dementia.

What is A-fib? Simply put, A-fib is an irregular fast heartbeat that can lead to chest pain, lightheadedness and shortness of breath. Consequently, your lower heart chambers do not pump enough blood to your lungs and body. A-fib can affect your quality of life. But, many people have A-fib and don’t even realize it because it can pass quickly

What causes A-fib? Your atria–which is in your heart’s upper chambers–have electrical signals that do not function properly. Consequently, your heart does not have a regular beat, your blood pools instead of pumping to your heart’s lower chambers.

How to treat A-fib? There are lots of things you can do to treat A-fib and minimize its risks. You can take medication or get a cardioversion that essentially directs your heart back to a normal beat. Pulsed field ablation is another treatment.

Why is treating A-fib quickly important? Early diagnosis and treatment of A-fib improves health. Returning your heartbeat to a normal rhythm as soon as possible changes the way A-fib progresses.

What to do if you have A-fib? Eat healthy, don’t smoke, and cut back on alcohol. The sooner you change these behaviors the better. There are also medications that can slow heart rate and control your heart’s rhythm. Here are the latest guidelines.

If you’re able to splurge, an Apple Watch can identify any irregularities in your heartbeat.

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February 21, 2024
For people with heart disease, polypills save lives
Heart disease is the number one killer. But, people who take their heart medicines are likely to thrive and survive. How to improve medication compliance? The New York Times reports that a polypill for people with heart disease, one pill containing three drugs instead of three separate pills, saves lives.

Results from a randomized controlled trial of more than 2,000 people reported in the New England Journal of Medicine found that people with heart disease who were prescribed a polypill were much more likely to take their heart drugs and reduce their likelihood of heart issues than people who were prescribed multiple pills. The polypill makes it easy to comply. One pill, once a day.

People on the polypill also were significantly less likely to die as a result of their heart disease. In addition, the researchers report that the polypill ensures that physicians prescribe all the appropriate medicines rather than prescribing fewer medicines than appropriate.

What’s in a polypill for people with heart disease? Blood-pressure medicine, aspirin and a drug that lowers cholesterol, reducing the likelihood of a blood clot.

Polypills have been around for a long time because they help ensure compliance but also because drug companies can patent the combination drug and charge a fortune for it. Polypills can cost a lot more than the cost of buying the drugs separately. (The heart medicines are all generic and cost very little.) Unfortunately, insurers might not cover polypills when they cost a lot, and it’s hard to argue that they should.

Does the FDA have to approve polypills? The answer is yes. So, they can be patented, driving up their cost.

Who were the trial participants? People who had lived through a heart attack in the past six months. They were all 65 or over. The vast majority had high blood pressure, more than half smoked at some point and almost three in five had diabetes.

The value of the polypill was in adherence to the medication. Though, it’s noteworthy that the difference was 70.6 percent of polypill users adhered compared to 62.7 percent of those taking multiple medicines.

What was the difference in health outcomes between polypill users and people who took individual drugs? About 3 percent fewer people taking a polypill experience a stroke or heart attack, died of a heart issue or needed care to address a blocked artery over three years than people taking multiple medicines, 9.5 percent v. 12.7. Of note though, death rates were the same for both groups. People in the polypill group had fewer heart deaths but had deaths from other causes.

Here’s more from Just Care:
September 5, 2022
Women beware! You could have heart disease and not know it
Anahad O’Connor writes for the New York Times about heart disease in women. Women, more than men, often have heart disease, but they downplay or ignore the symptoms, which puts them at higher risk of heart attack. Do you have heart disease and not know it?

Heart disease kills more Americans than any other condition, nearly 700,000 people a year. About 400,000 of them are women. Also, more women appear to be getting heart disease than ever before.

A lot of women end up dying because they do not recognize heart attack symptoms, which can include everything from chest pain, fatigue, dizziness, jaw pain, and nausea to indigestion. Women tend to have milder heart attack symptoms than men.

Women often wait too long to get needed care and don’t get the health care they need. And, health care providers tend not to diagnose and treat them. Consequently, women are more likely to die of heart disease than men.

Women typically have heart attacks at around age 69. Men tend to have them earlier, at around age 61

What should you do to protect yourself if you are not feeling well? If you are not feeling well and there’s any chance it could be a heart attack, make sure that your treating physician or the physician at the hospital takes an EKG. You want to rule out a heart attack as quickly as possible.

What are the most common symptoms of a heart attack in women? Unlike most men, women with a heart attack might not experience chest pain, the largest heart attack symptom. Instead, women might find themselves short of breath, fatigued or experiencing cold sweats. They might also suffer from jaw and back pain.

Doctors tend not to recognize symptoms of a heart attack in women. Women with heart attacks who do not experience chest pain are more likely to die. They and their physicians are less likely to diagnose their condition. But, even with chest pains, women are more likely to die than men.

Women who experience chest pains are not likely to be diagnosed with heart attacks as quickly as men either. Many physicians are inclined to see the symptoms in women as mental. But, physicians tend to see the symptoms in men as heart disease.

Not surprisingly, physicians are even less likely to recognize chest pain symptoms in women of color as a heart attack. One study found that women waited about 11 minutes longer to get treatment than men, with women of color waiting even longer. Fewer women with chest pains are admitted to hospital than men. Also, health care providers tend to spend less time evaluating women and tend to provide women with EKGs less frequently than men.

Here’s more from Just Care:
May 18, 2022
Daily use of baby aspirin can present greater risks than benefits
For quite some time now, older adults with certain health conditions have been told to take a daily dose of baby aspirin in order to ward off heart disease. A panel of independent experts at the US Preventive Services Task Force now recommends against this treatment, finding that daily use of baby aspirin generally presents greater risks than benefits for people over 60.

People at high risk of a heart attack or stroke are generally better off not starting a daily regimen of baby or low-dose aspirin (81-100 milligrams), according to the recommendations of the US Preventive Services Task Force “USPSTF.” Apparently, the side effects of daily low-dose aspirin intake are more grave than originally understood. Internal bleeding is more likely than heart attack prevention. Moreover, aspirin use has never reduced the risk of death from heart disease.

The expert panel also does not recommend taking baby aspirin daily for the prevention of colorectal cancer any longer. One recent study found that taking aspirin nearly doubled the number of colorectal cancer deaths after five years. But, aspirin has been found to reduce the risk of polyp growth in the colon as well as the risk that polyps will become cancerous.

The panel believes that, for people over 60, daily intake of low-dose aspirin can lead to a higher risk of internal bleeding that can be life-threatening. Aspirin reduces the formation of blood clots, which can block arteries.

Aspirin increases the likelihood of bleeding in the brain and digestive tract, especially for older people. For this reason, the panel discourages older adults from starting a daily aspirin regimen.

The recommendations do not apply to people already taking daily aspirin or to people who have had a heart attack. The panel recommends that these people should speak to their doctor regarding the best course of action.

Here’s more from Just Care:
October 20, 2021
Coronavirus: It’s causing heart problems
You’ve likely heard repeatedly that the novel coronavirus can cause people to have difficulty breathing and can lead to respiratory illness. What you might not know is that the novel coronavirus can also cause heart problems and cardiac arrest. Kaiser News reports on one study that found that COVID-19 caused heart damage in as many as one in five people.

Heart specialists who have studied the data believe that COVID-19 can infect your heart muscle. It might attach to receptors in heart muscle much as it attaches to receptors in lungs. In fact, it can cause cardiac damage or heart failure in people who have no respiratory issues. In many cases it presents as if people are having a heart attack.

People with heart conditions need to be especially careful of getting COVID-19, as the risk of death from cardiac damage is high. But, even people who do not have heart disease might end up with heart damage as a result of COVID-19. And, the risk of harm from the virus for them is high. It’s not known whether people who end up with cardiac issues as a result of COVID-19 are simply genetically predisposed to this outcome or have more exposure to the virus than other people.

It’s also still unclear whether COVID-19 is directly causing heart problems or whether it indirectly affects people’s hearts. Being seriously sick or getting medical care for any health condition, even hip surgery, can damage people’s hearts. For example, pneumonia will cause people’s hearts to stop if they are unable to get enough oxygen into their systems. Or, it can cause inflammation, which in turn leads to heart attacks or weakening of heart muscles and heart failure.

A heart biopsy can determine whether the heart muscle has the virus. But, that’s an invasive procedure. It’s unnecessary for the patient. And, it’s risky for doctors to perform in the face of the coronavirus pandemic, with limited PPE. So, it’s not possible to know the full extent to which the virus is infecting people’s heart muscle.

Here’s more from Just Care:
April 7, 2020
If you have heart disease, drug therapy may be as good as bypass surgery or a stent
Carolyn Johnson reports for The Washington Post on a new large federal study which finds that people with heart disease may do as well with drug therapy and lifestyle changes as with a stent. As previous studies have found, doctors too often perform unnecessary bypass surgery.

It is common for doctors to do bypass surgery or to use stents to open up blocked coronary arteries in patients. More than 30,000 heart disease patients have stents implanted each year. But, this invasive procedure often does nothing more to decrease the risk of heart attacks or death than drug therapy.

Indeed, even patients with very blocked arteries did as well with drug therapy as with stents. Bypass surgery and stents were found to be beneficial only in some cases of patients with chronic chest pain or angina. For patients who are not experiencing chest pain, these invasive procedures are generally unwarranted.

According to Gina Kolata at The New York Times, the study looked at 5,179 patients over three and a half years, most of whom had experienced chest pain. It specifically did not assess the value of bypass surgery on patients who have heart attacks or blocked left main coronary arteries. In those two cases, using stents can save people’s lives.

Some doctors still disagree with the findings. They argue that the study did not look at the benefits of stents for people with particular risk factors. They further argue that newer stents release drugs that reduce the likelihood that arteries will close after surgery. And, in this study, attention was paid to ensuring patients adhered to their drug treatment plan, which is not feasible in normal situations.

Of course, drug therapy only works if patients comply with the treatment plan. Usually, the treatment includes cholesterol-lowering drugs, such as statins, blood pressure medicines and aspirin. Still, even patients with stents must take strong drugs that prevent clotting for as long as 12 months; one in three of them experience chest pain again within six months of getting a stent, requiring yet another stent.

Part of the reason that the stents may not have any better results than drugs is that artery blockages can present themselves in multiple places. Some plaque that narrows the artery may never lead to a heart attack and other plaque could. Yet, it is not possible to know which plaques are potentially lethal.

People who take prescription drugs instead of getting a stent or bypass surgery have the benefit of a treatment for all their coronary arteries, not simply an isolated area. If chest pain persists, then a stent or bypass may be warranted to ease the pain. Moreover, patients who take drugs instead of undergoing an invasive procedure take fewer drugs than patients who undergo invasive procedures.

There remains a strong difference of opinion among doctors about the value of stents relative to drug therapy. But, the evidence is strong that stents and bypass surgery are unnecessary and unhelpful in many cases. One takeaway from the study is that patients with blocked arteries who are not feeling chest pain do not put themselves at any risk if they opt for drug treatment. They can decide to undergo an invasive procedure if they later experience chest pain.

Here’s more from Just Care:
December 3, 2019
John Oliver: Racism and sexism in medicine
Most Americans respect doctors. Still, racism and sexism in medicine is not uncommon. John Oliver explores this topic in Last Week Tonight.

Biases in medicine, as in every profession, abound. In medicine, however, biases, can have a tremendous impact on health outcomes. Oliver reports that women and people of color often have a very different relationship to our health care system than white men. “People have biases, and doctors are people. And they may have come up in a system that intentionally, or not, has often discounted the experiences of a major portion of the population.”

Sexism in medicine is real. Women have challenges getting needed health care. One study shows that if you are a woman, you are less likely to get a referral for a knee replacement. Another study shows that women over 50 who are critically ill are less likely to receive life-saving interventions than men. Still another shows that women who go to the ER with terrible stomach pain are less likely to receive pain medicine than men. A woman’s pain may be dismissed as emotional imbalance.

Some doctors do not appreciate that women may experience different symptoms from men for a particular condition. For example, women’s heart attack symptoms are different from men’s. Because some doctors are unaware, women who come to the hospital with heart attack symptoms are far more likely to be misdiagnosed than men. One study found they were seven times more likely to be misdiagnosed than men.

At the systemic level, doctors literally may know less about women’s bodies than they do about men’s bodies. Women’s bodies have not been studied as extensively as men’s; for decades women could not participate in research trials. Instead, researchers simply assumed that women’s bodies were fundamentally the same as men’s bodies, notwithstanding hormonal differences.

Racism in medicine is also severe. Just look at life expectancy differences between black men and white men. By one estimate, because of racial disparities in health care, there are 83,570 unnecessary deaths of black men each year.

There is tremendous misinformation about African Americans when it comes to health care. Oliver reports that studies show that some doctors believe there are biological differences between African Americans and white Americans, including with regard to skin, blood, and nerve endings. One in four doctor residents think black people have thicker skin than white people.

Many studies show that black Americans have less chance of getting the care they need than white Americans for hip fractures, prostate cancer and pneumonia, among other conditions. One study showed that blacks were 34 percent less likely to be prescribed opioids for pain than whites.

Racism and sexism in medicine contribute to poor health outcomes. Also, poor treatment of women and people of color can lead women and people of color to forsake needed treatment.

Oliver recommends that doctors and medical students should get bias training. We also need more diversity in the medical field. Patients need to advocate for themselves. How? Wanda Sykes, a guest on Oliver’s show, suggests that you bring a white man to the hospital or doctor’s office with you. And, ask the white man to repeat everything you say. That just might get your voice heard!

Here’s more from Just Care:
August 27, 2019
After a heart attack, multiple drugs can affect quality of life
Elderly nursing home patients prescribed a multitude of medications following a heart attack may live longer compared to those given just one prescription drug, but it can come at a cost: It may negatively impact their quality of life.

Researchers examined claims data from nearly 4,800 nursing home residents, most of whom were white women with an average age of 84. The study looked at deaths, hospitalizations and decreased ability to manage daily activities after the residents were prescribed one of four kinds of medications after leaving the hospital following a heart attack. Those medications were beta blockers, blood thinners, blood pressure drugs and statins.

Results, published in Circulation: Cardiovascular Quality and Outcomes, showed that residents prescribed three or four medications after hospital discharge were less likely to die within 90 days compared with those prescribed just one medication. The death risk between those taking one or two prescription drugs did not differ.

Additional analysis found that, with the exception of blood thinners, greater prescription drug use was associated with a 30% increase in functional decline.

“Since using more medications may interfere with older adults’ ability to do their daily activities, more medications should not be taken by older adults who wish to maintain their independence and daily functioning rather than live longer,” lead author Andrew R. Zullo, PharmD, PhD, an assistant professor at the Brown University School of Public Health, said in a statement. “Using more medications after a heart attack does not simply improve all health outcomes.”

This article originally appeared in Medshadow.org

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April 16, 2019
A psychiatrist’s reflections on grief
In the spring of 2014, I lost my “memere” (the French Canadian term for grandmother). While I had lost grandparents before and have since, my memere’s passing was particularly painful for me. From my earliest memories, she was a constant source of love, support, and joy. She was like a second mother, from taking care of me when I was home from school for a couple weeks with the Chicken Pox, to helping me navigate the choppy social waters of adolescence, to the countless times her quick wit made me laugh. As painful as her death was, it also somehow felt “normal.” She lived to her late seventies, and while I would have wanted her to live longer, I had the sense that she lived a long, rich life. Because she had found out she was dying of pancreatic cancer while still feeling relatively well, I had the opportunity to say goodbye. And I spent the days following her passing with family, celebrating her life and cherishing her memory.

Five months later, my father died suddenly of a heart attack at sixty-one years old. Only catastrophic metaphors seem to work here: it was like being hit by a Mack truck of grief. For all we knew before he died, he was perfectly healthy, with a stellar visit with his primary care physician only weeks prior and very few risk factors for heart disease (e.g., he wasn’t a smoker, obese, or diabetic). His relatively young age and seemingly good health made his sudden death stunning and tragic. I immediately thought about everything he would never get the chance to experience (retirement with my mother, his grandson’s birth, a new home on the coast of Maine). To make matters even worse, he died on his thirty-fifth wedding anniversary. My mother found an un-signed card. (I could go on, but I won’t . . . )

I still wince remembering the details of that day (a psychiatrist would call this a traumatic memory), and the following days and weeks were a blur of blinding shock and grief, during which I sometimes felt like I was underwater emotionally, desperate to catch a breath but unable to surface. It was nothing less than a physical experience, and a deeply alienating one that no one could understand or ease. I hurt for my father, thinking about all the life he was so abruptly deprived. I hurt for myself, in a desperate state of disbelief about the reality that I would never see him again. Most of all, I hurt for my dear mother, who had lost her mother and her life companion in the span of five months. Seeing her in her own place of anguish and wrenching grief, where I could neither reach nor comfort her, was the worst part.

How does one get through this? While grief is a universal human experience, every individual’s suffering is unique and in certain ways incomparable. However, I feel that my own experience five years ago, combined with my training as a psychiatrist, might benefit others. Take it one day at a time; recovering from grief is not a race. Realize that life will never go back to “the way it was before” your loss, so your goal should be to – slowly and carefully – find a “new normal.” You will never stop missing your loved one or hurting over their loss, but trust (even when you can’t imagine it) that your day-to-day experience will get easier. I still think of my father every day, but memories of him are no longer always accompanied by pangs of sadness that take my breath away. And while I don’t believe that trauma makes anyone stronger, healing is possible, and you may even find that you grow in ways that you never would have otherwise.

Take care of yourself, by doing all the things that you don’t want to do. Eat even though you have no appetite. Go to bed early or sleep in. Exercise even if you have no energy. Avoid turning to alcohol or drugs to temporarily numb the pain (they will likely make you feel worse). Do things that you enjoy and find meaningful, even if nothing brings you pleasure and everything seems meaningless. Even though you can’t concentrate, read books about other people’s grief, or books that have nothing to do with loss whatsoever. Interact with friends and family even though you feel like isolating. Let people know how they can help you (otherwise, you will drown in floral arrangements and baked ziti). For instance, you may need help with funeral arrangements, more time off or a lighter load at work for a while, or a few shoulders to cry on. Ask for what you need.

Finally, reach out for more formal help if you’re struggling to feel better and move forward after a month or two. Grief counseling could help, either in a group or one-on-one. And if your grief prevents you from functioning for what feels like a long time or is accompanied by serious symptoms like thoughts of suicide or crippling anxiety, be sure to let your health care provider know. These are signs that you might need mental health treatment to cope with your loss, and the sooner you start it, the better.

Grief is part of the human experience. Everyone who experiences the joy of loving will experience the pain of losing. But even when you’re suffering so much that you can’t imagine going on, it is important to remember that healing is possible, and that you can and will move forward without your loved one, but with their memory and legacy. After all, wouldn’t they want it that way, and isn’t this one of the reasons you loved them so much?

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April 16, 2019