JustCare

Tag: Heart disease

  • Why do Americans die younger than people in other wealthy nations?

    Why do Americans die younger than people in other wealthy nations?

    Americans have shorter life expectancies than people in other wealthy nations, even though we spend more on health care than other nations. The Peterson-KFF Health System Tracker looks at why it is that Americans die younger than people outside the US.

    KFF studied mortality rates in the US as well as Austria, Belgium, Canada, France, Germany, Japan, Netherlands, Sweden, Switzerland and the United Kingdom. Americans have a premature death rate of 408 deaths for 100,000 people under 70. The other countries had 228 premature deaths, close to half as many as people in the US.

    Unlike other wealthy nations, which have seen a reduction in the number of their premature deaths, the US has faced an uptick since 2010. Americans had a similar life expectancy as people in peer nations 45 years ago. We saw some increase in life expectancy with scientific advancements, but other countries saw greater increases in life expectancy by 1990. Moreover, peer countries did not see as great a reduction in life expectancy from COVID-19 as the US.

    Heart disease and cancer are the two leading causes of death in each of the countries studied, particularly for older adults. New medicines have reduced the number of premature deaths from heart disease. But, since 2010, Americans have seen an increase in premature deaths from heart disease, while other countries have seen a decrease.

    Americans suffer more from heart disease, chronic respiratory diseases, and chronic kidney diseases, which are collectively responsible for about 105 of the 408 premature deaths. COVID-19 was responsible for 64 of the 408 premature deaths in the US, and substance abuse was responsible for 29 of the premature deaths.

    Today twice as many Americans die of heart disease before the age of 70 than people in peer countries, likely because of more substance abuse and obesity in the US. Moreover, people with chronic heart conditions need ongoing medical care to remain healthy. But, Americans face much larger barriers to care than people in other countries.

    Cancer death rates declined by 40 percent in the US since 1988 for people under 70. And, the US cancer death rates remain comparable to those in peer countries over the last 40 years. Older Americans are less likely to die of cancer than people in peer nations. Some believe that’s because more Americans have died prematurely of other conditions than people in peer nations.

    Younger Americans suffer more from chronic conditions, substance abuse, injuries and communicable diseases than people in peer nations. Fifteen to 49 year olds in the US suffer two and half times more premature deaths than 15-49 year olds in peer nations. The premature death rate for this population in the US has not changed much in the last 45 years. In peer nations, it has dropped by half!

    The US has also seen higher numbers of childhood deaths than other wealthy nations. Over the last 45 years, the number of deaths of 0 to 14 year olds in the US has declined some, but it’s still higher than peer nations, 20 more deaths per 100,000 American kids. Some attribute this difference to racial disparities leading to worse health of babies at birth, more of whom are born premature or with congenital birth defects. In addition, three to four times more American kids died from killings, travel fatalities (we drive bigger cars and have less public transportation) and choking.

    Thankfully, medical advances have reduced death rates a lot. Many fewer people die of neonatal conditions, birth defects and HIV/AIDS. Deaths resulting from heart conditions also have dropped considerably. And, because fewer people smoke, fewer people are dying of cancer and heart disease. But, we are the richest country in the world, and there’s no excuse for our continuing to have shorter life expectancies than people in ever other wealthy country.

    Here’s more from Just Care:

  • Over 65? Eat more salmon and less cheese!

    Over 65? Eat more salmon and less cheese!

    As you age, you want more high-quality fatty proteins in your diet, Leigh Weingus reports for The Huffington Post. These proteins reduce inflammation and promote brain health. Eating more salmon should help a lot.

    Of course, different foods deliver different health benefits. Some foods boost energy levels. Some prevent disease, often caused by inflammation. But eating too much saturated fat is linked to heart disease and high LDL cholesterol. It also reduces your fiber intake which can lead to constipation.

    The benefits of an anti-inflammatory diet: Experts advise to eat an anti-inflammatory diet, as we get older, in order to stay in good physical and mental health. Including a fatty fish in your diet, such as salmon, at least twice each week, will help your muscles and strength. It will also increase your omega-3 consumption, promote brain health, and reduce inflammation.

    Eat protein-rich foods and foods with antioxidants: If you don’t like salmon, chicken or duck without the skin, eggs and tofu are also rich in protein. And, kale and spinach are good antioxidants, as are pomegranates. They also provide folic acid, niacin and other B vitamins that help to promote healthy brains.

    As for dairy products: Experts are now thinking you need less cheese and other dairy products than previously advised and possibly none at all, reports Andrea Petersen for the Wall Street Journal. There’s a new-found link between dairy products and cardiovascular disease as well as some cancers, including prostate cancer. But, some experts disagree, claiming that dairy products reduce the risk of heart disease and colon cancer.

    And, the jury’s still out as to the value of drinking fat-free milk over whole milk or two percent milk. Whatever you do, the new thinking is that one serving of dairy products a day is all you need. Dairy is primarily good for calcium, and you can get your calcium from other foods, such as tofu, edamame, kale and bok choy.

    If possible, avoid ultra-processed foods and supplements. Food that is fresh and not ultra-processed offers nutrients that are far easier to absorb into your body.

    Here’s more from Just Care:

  • New guidelines on alcohol consumption is likely to expose its many risks

    New guidelines on alcohol consumption is likely to expose its many risks

    I’ve written about the risks of consuming alcohol several times now. Despite the fact that we have been told for decades that a little bit of alcohol can lower the risk of heart disease, there is mounting evidence that you’re better off staying away from alcohol altogether. Isabelle Cueto reports for StatNews on past government alcohol consumption guidelines tainted by the influence of the alcohol industry and new independent guidelines to be released next year.

    Bottom line, the people preparing the research findings on alcohol consumption in the 1990’s were allowed to design the studies, collect the evidence and disseminate the results, allowing for alcohol-industry bias. Now, the guidelines are being updated. And, notwithstanding claims of fewer heart attacks among French people than Americans because they drank wine every day—broadcast on 60 Minutes in the 1990’s—it appears that the research was flawed; the alcohol industry was involved.

    The earlier research did not take account of the people who did not drink because of an illness and other considerations. There was no reason to connect alcohol consumption with better health.

    Cueto explains the tight link between politics and money, which affected the guidelines on alcohol consumption. Congress had created an independent advisory committee in the 1990’s as a result of questions about the alcohol guidelines in the 1980’s. But, it appears that the committee was far from independent. Members had ties to different food industries.

    As recently as 2020, a scientific panel tried to recommend limiting sugar and alcohol intake and federal officials wouldn’t allow it. The US Department of Health and Human Services and the US Department of Agriculture share responsibility for overseeing the recommendations on an alternating basis.

    This time, a new set of committees are overseeing the process, doing independent reviews. Their results will be released in 2025. The belief among independent experts is that the committee members looking at the evidence will recognize the risk of certain cancers and other chronic diseases from any amount of alcohol consumption and likely recommend against consuming any alcohol.

    Here’s more from Just Care:

  • Would you want to know the “age” of your heart?

    Would you want to know the “age” of your heart?

    Alex Janin writes for the Wall Street Journal on how, before long, you might be able protect yourself from some serious health conditions by knowing the “age” of your organs. Would you want to know the “age” of your heart?

    Did you know that while you might be 65 based on your birthday, your pancreas could be 70 and your heart 55?  Apparently, researchers say that we can have an organ that is considerably older than our actual age. If so, that could increase our odds of getting certain diseases.

    If you heart or artery or brain or pancreas are “older” than you are, you have a higher risk of dying sooner. So, if you knew your heart were older, theoretically you might be able to act in ways that reduce your chances of heart disease. Similarly, if your brain were older, theoretically you might be able to act in ways that reduce your chances of dementia.

    To be clear, it’s still not possible to know the age of your various organs. It takes identifying the proteins in different organs and then using blood samples to determine the level of these proteins, which are different as you age. And, the science is not definitive at this point.

    Moreover, even if it were possible to determine people’s organ ages, the next question becomes what to do about older organs. And, that’s not always clear. What we do know is that it’s not unusual for people to have organs that are “older” than their chronological age. About one in five people apparently do.

    Here’s more from Just Care:

  • What’s your cholesterol level?

    What’s your cholesterol level?

    More than 25 percent (86 million) of Americans have high cholesterol. Another 33 percent (120 million) do not know their cholesterol level. But, if you want to reduce your risk of plaque in your arteries and heart disease, as well as protect your health overall, you want your cholesterol levels under control, writes Knvul Sheikh for the New York Times.

    What is cholesterol? Cholesterol is a waxy “lipid,” or fat that your liver produces for good health. Among other things, it creates cell membranes and hormones. But, if the amount of cholesterol is not right, it can cause health problems.

    Can you have good cholesterol or is it all bad? You have two types of cholesterol, “good” cholesterol and “bad” cholesterol. If your LDL or “bad” cholesterol is high, it can cause health problems. If your HDL is high, it can reduce your risk of health problems.

    What causes high LDL cholesterol levels? If you eat too much meat and dairy products, you can create too much cholesterol. Your genes can also contribute to high LDL cholesterol levels.

    What’s the danger of high cholesterol levels? Too much cholesterol can cause heart attacks and stroke. And, you might not know you are at risk because you are not likely to have symptoms.

    When should you check your cholesterol levels? By the time you have Medicare, you should have regular cholesterol checks. But, as early as your 20’s, it’s good to check your cholesterol levels every several years. And, if you have a family history of heart attacks and stroke, you might want to get more frequent checks. Talk to your doctor.

    Your cholesterol levels will likely rise as you get older. For women, they rise after menopause.

    What should you be tracking? Track your LDL, which is the “bad” cholesterol. It should not go above 100 mg/dL and should be as low as possible.  If you have diabetes, you should keep it below 70. Your HDL, the “good” cholesterol, brings the cholesterol you don’t need back to your liver from your arteries, so you can discharge it. You want your HDL to be greater than 40 mg/dL and ideally above 60.

    How can you lower your LDL cholesterol level? Exercise more, eat healthy and avoid alcohol. Eat more whole grains, vegetables, fruits, seeds and legumes–“soluble fibers.” Eating avocados, nuts and fatty fish can also help. Don’t eat butter, cheese and red meat or ultraprocessed foods.

    Should you take drugs to lower your cholesterol? Sometimes. Especially if you’ve had a heart attack or a stroke or your LDL is high or your arteries are severely blocked.

    Here’s more from Just Care:

  • Heart disease is on the rise, especially for people over 65

    Heart disease is on the rise, especially for people over 65

    Cardiovascular disease, which includes heart disease and coronary artery disease kills more than 800,000 people each year. It’s the number one killer for people over 65. And, Judith Graham reports for Kaiser Health News that it is not going away soon.

    People with cardiovascular disease have blocked arteries. Blocked arteries can lead to stroke, heart attacks and other heart failure. People with high blood pressure, people who are overweight, people with diabetes, people with high cholesterol, and people who don’t exercise are most likely to end up with heart disease.

    More than four in five people who die of coronary artery disease are over 65. Death rates were down in the first decade of this century. People smoked less and new treatments helped. But, beginning in 2o11, deaths were on the rise again. And, Covid-19 also contributed to more deaths because it worsened people’s heart conditions and people were less inclined to seek medical care.

    Cardiovascular disease is one powerful example of health inequities in the US. Black and Hispanic Americans are more likely to be diagnosed with cardiovascular disease than other individuals. Black men are at the greatest risk of getting cardiovascular disease. Their plight will only worsen without better education, more prevention efforts and treatments.

    In many instances, individuals are not personally responsible for cardiovascular disease. Stressors, including systemic racism, can contribute to high blood pressure and other conditions that increase people’s risk of heart disease.

    Treatments are available for cardiovascular disease.  But, people need to have primary care doctors who screen them for cardiovascular disease and help treat underlying conditions.

    What can you do to lower your risk of cardiovascular disease?

    • Don’t smoke
    • Ask your doctor to check your blood pressure and A1C levels
    • Eat less salt and more fruits, vegetables and whole grains
    • Exercise, build muscle and maintain a good weight
    • Reduce stress
    • Control diabetes

    Here’s more from Just Care:

  • For people with heart disease, polypills save lives

    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:

  • Eating avocados offers so many health benefits

    Eating avocados offers so many health benefits

    If you’re looking to switch up your diet to eat healthy and want to continue to enjoy the foods you eat, consider eating lots of avocados. Some experts call avocados a superfood because they offer so many health benefits. And, they are so delish! What more can you ask for?

    The benefits of eating an avocado a day appear to have no bounds. Eating avocados provides you with more than 20 essential vitamins and minerals, including vitamins B6, C, E and K. Avocados also are a great source of folate, potassium, magnesium, niacin and riboflavin.

    There’s more. Avocados can be good for your eyes, providing you with beta carotene and lutein. These nutrients, in turn, have been shown to reduce people’s risk of macular degeneration and vision loss.

    Avocados also give you omega-3 fatty acids, which have been found to reduce heart disease and stroke, and lots of monounsaturated fats, which are good for your heart. Avocados can lower people’s blood pressure and bad cholesterol, LDL They can also boost people’s good cholesterol, HDL

    Avocados could help you lose weight, even though a single avocado has around 227 calories. The healthy fat in avocados keeps you feeling full much longer than other far less nutritious and equally caloric foods. Moreover, avocados’ fat and antioxidants reduce inflammation and help with weight management. One study found that women who ate one Hass avocado a day had less belly fat than women who ate the same number of calories but no avocado.

    Avocados could do wonders for your skin. A UCLA study found that people who ate one avocado a day had improved skin elasticity and firmness.

    Here’s more from Just Care:

  • Women beware! You could have heart disease and not know it

    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:

  • What counts as enough exercise?

    What counts as enough exercise?

    Not too long ago, experts agreed that people needed about 20 minutes of moderate exercise a day or 150 minutes a week to live longer and stay healthy. And, if you exercise intensely, 10 minutes a day could be enough. Gretchen Reynolds reports for the New York Times on the latest thinking on when to exercise, what counts as moderate or intense exercise, how much exercise is needed in one session and more.

    No question that exercise improves your health and well-being. Exercise is good for the body, the mind and the soul. And, a little can go a long way.

    Experts appear to assume that daily exercise is asking too much. Instead, they look for 3o minutes of exercise five times each week. They say that this simple task reduces the risk of premature death and disease, including stroke, diabetes, cancer and heart attack.

    The goal of moderate exercise is to increase your heart rate and feel a little bit out of breath. You can do that six times a day for five minutes a time, three times a day for ten minutes, twice a day for 15 minutes, or once a day for 30 minutes. It doesn’t matter. Even 15 two-minute walks each day is good.

    Packing the 15o minutes into the weekend is also helpful in terms of extending your life expectancy relative to people who never exercise. But, it’s not ideal to sit still all week and exercise only on Saturdays and Sundays.

    The benefits of doing some exercise each day include better control of your blood-sugar and better mental health. Moreover, exercising daily lowers your risk of hurting yourself as a result of exercise. Ideally, you want to be taking around 8,000 steps a day.

    To maintain your weight as you age, you need to exercise even more. One study found that an hour a day of moderate exercise is needed.

    Here’s more from Just Care: