Tag Archives: health

Patient Outcomes Significantly Improved By L-Carnitine Following Heart Attack

Posted on by MaryO
myocardial infarction - Myokardinfarkt - scheme

myocardial infarction – scheme (Photo credit: Wikipedia)

L-carnitine significantly improves cardiac health in patients after a heart attack, say a multicenter team of investigators in a study published in Mayo Clinic Proceedings. Their findings, based on analysis of key controlled trials, associate L-carnitine with significant reduction in death from all causes and a highly significant reduction in ventricular arrhythmias and anginal attacks following a heart attack, compared with placebo or control.

Heart disease is the leading cause of death in the United States. Although many of the therapies developed in recent decades have markedly improved life expectancy, adverse cardiovascular events such as ventricular arrhythmias and angina attacks still occur frequently after an acute myocardial infarction (heart attack).

It is known that during ischemic events L-carnitine levels are depleted. Investigators sought to determine the effects of targeting cardiac metabolic pathways using L-carnitine to improve free fatty acid levels and glucose oxidation in these patients. By performing a systematic review and meta-analysis of the available studies published over several decades, they looked at the role of L-carnitine compared with placebo or control in patients experiencing an acute myocardial infarction.

L-carnitine is a trimethylamine which occurs in high amounts in red meat and is found in certain other foods, and is also widely available as an over-the-counter nutritional supplement which is claimed to improve energy, weight loss, and athletic performance. Its potential role in treating heart disease was first reported in the late 1970s.

A comprehensive literature search yielded 153 studies, 13, published from 1989-2007, were deemed eligible. All the trials were comparison trials of L-carnitine compared with placebo or control in the setting of acute myocardial infarction.

This systematic review of the 13 controlled trials in 3,629 patients, involving 250 deaths, 220 cases of new heart failure, and 38 recurrent heart attacks, found that L-carnitine was associated with:

  • Significant 27% reduction in all-cause mortality (number needed to treat 38)
  • Highly significant 65% reduction in ventricular arrhythmias (number needed to treat 4)
  • Significant 40% reduction in the development of angina (number needed to treat 3)
  • Reduction in infarct size

There were numerically fewer myocardial reinfarctions and heart failure cases associated with L-carnitine, but this did not reach statistical significance.

First author James J. DiNicolantonio, PharmD, Wegmans Pharmacy, Ithaca, NY, observes, “Although therapies for acute coronary syndrome (ACS), including percutaneous coronary intervention, dual antiplatelet therapy, b-blockers (BBs), statins, angiotensin-converting enzyme inhibitors (ACEIs), omega-3 fatty acids, and cardiac rehabilitation, have markedly improved clinical outcomes, adverse cardiovascular (CV) events still occur too frequently after ACS. One promising therapy for improving cardiac health involves using L-carnitine to improve free fatty acid levels and glucose oxidation.”

“The potential mechanisms responsible for the observed beneficial impact of L-carnitine in acute myocardial infarction are likely multifactorial and may, in part, be conferred through the ability of L-carnitine to improve mitochondrial energy metabolism in the heart by facilitating the transport of long-chain fatty acids from the cytosol to the mitochondrial matrix, where b-oxidation occurs, removing toxic fatty acid intermediates, reducing ischemia induced by long-chain fatty acid concentrations, and replenishing depleted carnitine concentrations seen in ischemic, infarcted, and failing myocardium,” says DiNicolantonio.

L-carnitine is proven to be safe and is readily available over the counter. The investigators agree that the overall results of this meta-analysis support the potential use of L-carnitine in acute myocardial infarction and possibly in secondary coronary prevention and treatment, including angina. They advocate for a larger randomized, multicenter trial to be performed to confirm these results in the modern era of routine revascularization and other intensive medical therapies following acute myocardial infarction. But, says DiNicolantonio, “L-carnitine therapy can already be considered in selected patients with high-risk or persistent angina after acute myocardial infarction who cannot tolerate treatment with ACE inhibitors or beta blockers, considering its low cost and excellent safety profile.”

These findings may seem to contradict those reported in a study published earlier this month in Nature Medicine by Robert A. Koeth and others (Koeth, R. A. et al. Nature Med.*), which demonstrated that metabolism by intestinal microbiota of dietary L-carnitine produced trimethylamine N-oxide (TMAO) and accelerated atherosclerosis in mice. They also noted that omnivorous human subjects produced more TMAO than did vegans or vegetarians following ingestion of L-carnitine, and suggested a possible direct link between L-carnitine, gut bacteria, TMAO, and atherosclerosis and risk of ischemic heart disease.

“The Nature Medicine paper is of interest,” agrees senior investigator Carl J. Lavie, M.D.,FACC,FACP,FCCP, Medical Director of the Cardiac Rehabilitation and Prevention Center at the John Ochsner Heart and Vascular Institute at the University of Queensland School of Medicine in New Orleans, “but the main study reported there was in animals, and unlike our study, lacks hard outcomes.” He also notes that “there are various forms of ‘carnitine’ and our relatively large meta-analysis specifically tested L-carnitine on hard outcomes in humans who had already experienced acute myocardial infarction.”

from Sciences, E. (2013, April 16). “Patient Outcomes Significantly Improved By L-Carnitine Following Heart Attack.” Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/259096.php.

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Cushing’s syndrome increased risk for coronary arterial atherosclerosis

Posted on by MaryO

cushings-ladyNeary NM. J Clin Endocrinol Metab. 2013;doi:10.1210/jc.2012-3754.

In a recent study supported by the NIH, researchers determined that patients with Cushing’s syndrome have a greater risk for developing coronary arterial atherosclerosis, increasing their rate of cardiovascular morbidity. These findings were published in the Journal of Clinical Endocrinology & Metabolism.

The researchers conducted a prospective case-control study of 15 consecutive patients with adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome who were matched with 15 controls (aged 32 to 66 years) with at least one risk factor for cardiac disease (ie, diabetes, hypertension, hyperlipidemia, family history of early-onset coronary artery disease and previous or current smoking).

Researchers used a multidetector CT (MDCT) coronary angiogram scan to measure calcified and noncalcified coronary plaque volume and Agatston scores. Additional variables included fasting lipids, BP, history of hypertension or diabetes and 24-hour urine free cortisol excretion.

According to data, patients with Cushing’s syndrome had significantly greater noncalcified plaque volume and Agatston scores compared with controls (noncalcified plaque volume median [interquartile ranges]: 49.5 vs. 17.9,P<.001; Agatston score: 70.6 vs. 0, P<.05).

Patients with Cushing’s syndrome also demonstrated higher systolic (143 mm Hg) and diastolic (86 mm Hg) BP compared with controls (systolic: 134 mm Hg, diastolic: 76 mm Hg).

The limitations of the study include the small cohort of patients and potential selection bias due to ectopic ACTH secretion. However, the researchers wrote that these findings demonstrate a significant difference between the two groups included in the study.

“Overall, the findings point to the possible causes of cardiovascular morbidity in patients treated with exogenous steroids and indicate the need for further studies of that population,” they wrote.

Disclosure: The researchers report no relevant financial disclosures.

~~~~~~~~~~~~~~

PERSPECTIVE

Alice C. Levine, MD Alice C. Levine

  • It has long been recognized that endogenous hypercortisolism (Cushing’s syndrome) and administration of supraphysiologic doses of glucocorticoids are associated with increased mortality, primarily due to cardiovascular disease. Excess glucocorticoids induce all of the features of the metabolic syndrome including obesity with central weight gain, hypertension, impaired glucose tolerance/diabetes mellitus and dyslipidemia, all of which increase cardiovascular risk. In this small but well-designed study, the authors attempt to determine whether excess glucocorticoids have a direct adverse effect on the coronary vasculature. Utilizing multidetector computerized tomographic (MDCT) coronary angiography, a validated noninvasive method of assessing calcified and noncalcified coronary plaques, they compared measurements of coronary plaques (Agatston score) in 15 patients with ACTH-dependent Cushing’s syndrome (CS) vs. 15 age-, sex- and body weight-matched controls with at least one risk factor for cardiac disease. They found significantly greater coronary calcifications and noncalcified coronary plaque volumes in patients with active or previous hypercortisolism.There are obvious limitations to the study; most notably the small sample size, the predominance of patients with CS due to ectopic ACTH (14/15) and significantly more hypertension in the CS vs. the control group. However, other than the HTN, the groups were well-matched and there was no statistical difference in the Framingham risk scores between groups. This is the first study to demonstrate direct effects of CS on coronary plaque burden.The findings, while unsurprising, underscore several important features of CS which endocrinologists need to consider. Firstly, as there were no statistical differences in plaque burden in patients with CS who were eucortisolemic (4/15) vs. those who were hypercortisolemic (11/15) at the time of study, the effects of CS on the coronary vasculature may persist even after biochemical cure. Many previous studies in larger cohorts have similarly demonstrated that the adverse effects of high glucocorticoids on cardiovascular, metabolic, psychiatric and neurocognitive function may be only partially reversible with disease remission. Secondly, even adjusting for all the confounding variables, hypercortisolism seems to be an independent risk factor for the development of coronary artery disease. The possible mechanisms underlying this observation are discussed and include increases in prothrombotic factors, circulating levels of vascular endothelial growth factor (VEGF) and angiogenesis. It is also plausible that cortisol increases atherosclerosis through the mineralocorticoid rather than the glucocorticoid receptor, suggesting the possibility of treating this particular deleterious effect of hypercortisolism with a mineralocorticoid-receptor blocker such as spironolactone.

    Within the CS group, no significant correlations were observed between the coronary plaque volumes and the duration of CS or urinary free cortisol (UFC) either at presentation or at the time of MDCT. Although this lack of correlation may also be attributable to the small sample size, it is well known that the onset of Cushing’s syndrome is often insidious and it is impossible to pinpoint the exact duration of the abnormality in most patients. This study’s finding of direct, adverse and possibly irreversible effects of hypercortisolism on the coronary vasculature should make endocrinologists even more vigilant in diagnosing and treating the disease as early as possible in its course.

    • Alice C. Levine, MD
    • Professor of medicine, division of endocrinology, diabetes and bone diseases
      Co-Director of The Adrenal Center
      Icahn School of Medicine
      Mount Sinai, New York, NY
  • Disclosures: Levine reports no relevant financial disclosures.

From Healio.com

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Wednesday, Nine Weeks Post-Op

Posted on by MaryO

day-late

Running Late!  The Nine Week Anniversary was 2 days ago.  I got so tired singing  Holy Thursday, Good Friday and three Easter Services that I’ve just been resting up for a few days.

It also turned out that our son came home Thursday night, after rehab, after that service so my energy has been really sapped.

DH is still doing well, the rehab continues and he’s done 5 as of today.  We also signed up for our first patient meeting next Tuesday and a class on Cardiac Valve Surgery later this month.

So…we have rehab Wednesday and Thursday this week, Mended Hearts on Saturday, Monday rehab, Tuesday patient meeting, Wednesday and Thursday rehab…

Soon we’ll be experts!

Because DS was here, we ate some foods that I doubt are on the new diet.  I hope that there are no setbacks because of this.

Yesterday was one of those busy days.  A friend happened to call on Monday while we were driving back from rehab and DH took the call since I was driving.  As a result, DH, DS, my mom and I all went out with the friend in the afternoon.  In the morning, I had a staff meeting for work.  Our son decided that it was closer for him to take the train back to NYC from our friend’s, so we swung by the train station on the way home.

A tiring, but fun, day.  Our friend also has stairs up to her house, so it was one of the first times DH climbed a lot of them.

In church on Sunday, someone prayed for another who had had surgery before DH’s and wasn’t doing well yet.  It makes me very thankful for how well things are working out here.

 

 

 

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Cardiac Rehabilitation Starts Today!

Posted on by MaryO

cardiac-rehab

DH finally starts his cardiac rehab today, just over 8 weeks after his triple bypass.

Cardiac rehabilitation (rehab) teaches you how to be more active and make lifestyle changes that can lead to a stronger heart and better health. Cardiac rehab can help you feel better and reduce your risk of future heart problems.

In cardiac rehab, you work with a team of health professionals. Often the team includes a doctor, a nurse specialist, a dietitian, an exercise therapist, and a physical therapist. The team designs a program just for you, based on your health and goals. Then they give you support to help you succeed.

If you have had a heart attack, you may be afraid to exercise. Or if you have never exercised, you may not know how to get started. Your cardiac rehab team will help you start slowly and work up to a level that is good for your heart.

Many hospitals and rehab centers offer cardiac rehab programs. You may be part of a cardiac rehab group, but each person will follow his or her own plan.

Who should take part in cardiac rehab?

Doctors often prescribe cardiac rehab for people who have had a heart attack or bypass surgery. But people with many types of heart or blood vessel disease can benefit from cardiac rehab. Rehab might help you if you have:

  • Heart failure.
  • Peripheral artery disease (PAD).
  • Had or plan to have a heart transplant.
  • Had angioplasty to open a coronary artery.
  • Had another type of heart surgery, such as valve replacement.

Often people are not given the chance to try cardiac rehab. Or they may start a program but drop out. This is especially true of women and older adults. And that’s not good news, because they can get the same benefits as younger people. If your doctor suggests cardiac rehab, stay with it so you can get the best results.

Medicare will pay for cardiac rehab for people with certain heart problems. Many insurance companies also provide coverage. Check with your insurance company or your hospital to see if you will be covered.

What happens in cardiac rehab?

In cardiac rehab, you will learn how to:

  • Manage your heart disease and problems such as high blood pressure and high cholesterol.
  • Exercise safely.
  • Eat a heart-healthy diet.
  • Quit smoking.
  • Reduce stress and depression.
  • Get back to work sooner and safely.

Exercise is a big part of cardiac rehab. So before you get started, you will have a full checkup, which may include tests such as an electrocardiogram (EKG or ECG) and a “stress test” (exercise electrocardiogram). These tests show how well your heart is working. They will help your team design an exercise program that is safe for you.

At first your rehab team will keep a close watch on how exercise affects your heart. As you get stronger, you will learn how to check your own heart rate when you exercise. By the end of rehab, you will be ready to continue an exercise program on your own.

What are the benefits of cardiac rehab?

Starting cardiac rehab after a heart attack can lower your chance of dying from heart disease and can help you stay out of the hospital. It may reduce your need for medicine.

Cardiac rehab may also help you to:

  • Have better overall health.
  • Lose weight or keep weight off.
  • Feel less depressed and more hopeful.
  • Have more energy and feel better about yourself.

Changing old habits is hard. But in cardiac rehab, you get the support of experts who can help you make new healthy habits. And meeting other people who are in cardiac rehab can help you know that you’re not alone.

Adapted from CardioSmart.org

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Monday – Eight Weeks Post-Op

Posted on by MaryO

Monday

I’m happy to report that life continues to return to normal.

I was out walking the dog this morning, and it was snowy again.  The sidewalk was very slippery and it reminded me of that Monday two months ago when I was out with her and slipped and fell.  My shin still hurts a bit from that day.

DH has been out to several meetings and has won a court case – all without driving himself.  He’s still having to “pay” for a lot of activity by napping later.

He’s able to easily put on sweaters now that go over his head.

Tomorrow is our first rehab appointment.  We’re both looking forward to that for different reasons.  I’m eager to get my life back on a schedule.  He’s looking forward to being able to drive and become stronger.

We’re still mostly vegetarian.  I hope to get some food/cooking advice at the rehab meeting tomorrow.

DH went to church again yesterday for Palm Sunday, then we went out for breakfast again.  He’s found a healthy meal at a local restaurant without too much prodding.

He’s busy trying to find a timeshare in Japan that we could trade for although it will be a while before we could consider that kind of travel.

On the 20th, I had to make a very difficult decision.  There’s a Cushing’s Conference in Las Vegas next month.  I already had plane tickets but hadn’t registered for the conference or a hotel room.  I decided that I didn’t feel comfortable leaving DH alone for 5 days with a dog he couldn’t walk or a car he might not be able to drive.  I’m also just afraid to be away that long, just in case…

Hopefully, next week’s update will have more good news to report.

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Common Foods Loaded with Excess Sodium

Posted on by MaryO
salty6

The Salty Six

 

 

Eating too many salty foods can create all sorts of health problems, including high blood pressure. But did you know a lot of common foods are packed with excess sodium? It’s not just the french fries and potato chips you need to be careful with.

That’s why the American Heart Association/American Stroke Association is increasing awareness of sodium and the “Salty Six” – common foods that may be loaded with excess sodium that can increase your risk for heart disease and stroke.

Sodium overload is a major health problem in the United States. The average American consumes about 3,400 milligrams of sodium a day – more than twice the 1,500 milligrams recommended by the American Heart Association/American Stroke Association. That’s in large part because of our food supply; more than 75 percent of our sodium consumption comes from processed and restaurant foods.

heart-checkBe sure to keep in mind that different brands and restaurant preparation of the same foods may have different sodium levels. The American Heart Association’s Heart-Check mark—whether in the grocery store or restaurant helps shoppers see through the clutter on grocery store shelves to find foods that help you build a heart-healthy diet.

Sodium doesn’t just affect your heart health, but your physical appearance as well. Excess sodium consumption may make your face feel puffy, give you bags under your eyes, increase swelling in your fingers and make your jeans look, and feel, tighter. In fact, from an American Heart Association/American Stroke Association consumer poll, 75 percent of respondents stated that their pants feeling too tight is their least favorite effect of bloating which may be associated with excess sodium consumption.

As you gear up for your next grocery store run or order from the menu, keep the Salty Six in mind. All you need to do to make a heart-healthy choice is to look for the Heart-Check mark. Another helpful tool is the Nutrition Facts label on the package and calorie labeling in restaurants, which together with the Heart-Check mark helps you make wise choices for the foods you and your family eat. Make the effort to choose products that contain less sodium. It’s worth it!

Here’s a quick look at the Salty Six, the top sources for sodium in today’s diet (download the infographic as a pdf)

Article from http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Salty-Six_UCM_446090_Article.jsp

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Warning Signs of Heart Disease & Heart Attack

Posted on by MaryO
An example of a heart attack, which can occur ...

An example of a heart attack, which can occur after the use of a performance-enhancing drug. (Photo credit: Wikipedia)

 

Preventing Heart Disease and Heart Attack Educational Video. U.S. Department of Health and Human Services
National Institutes of Health; National Heart, Lung, and Blood Institute; Act in Time to Heart Attack Signs; Item #56-042N, September 2001;

 

The dramatic, moving stories of three heart attack survivors and their families illustrate the importance of heeding heart attack warning signs and seeking medical care quickly. They vividly convey how a real heart attack may differ from the stereotypical “movie heart attack” and how getting immediate treatment can save lives. The warm and sympathetic narration by an emergency department physician explains what a heart attack is, the treatments that can save lives if given quickly, why many heart attack victims delay seeking care, and how to make a heart attack survival plan. Useful for health fairs, medical waiting rooms, community groups, and home viewing.

 

Producer: National Institutes of Health; Keywords: hhs.gov; public_safety; Creative Commons license: Public Domain.

 

Heart Attack Warning Signs. A heart attack is a frightening event, and you probably don’t want to think about it. But, if you learn the signs of a heart attack and what steps to take, you can save a life–maybe your own. What are the signs of a heart attack? Many people think a heart attack is sudden and intense, like a “movie” heart attack, where a person clutches his or her chest and falls over. The truth is that many heart attacks start slowly, as a mild pain or discomfort. If you feel such a symptom, you may not be sure what’s wrong. Your symptoms may even come and go. Even those who have had a heart attack may not recognize their symptoms, because the next attack can have entirely different ones. Women may not think they’re at risk of having a heart attack–but they are.

 

Learn more about women and heart attack. It’s vital that everyone learn the warning signs of a heart attack. These are: Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain. Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach. Shortness of breath. Often comes along with chest discomfort. But it also can occur before chest discomfort. Other symptoms. May include breaking out in a cold sweat, nausea, or light-headedness. Learn the signs–but also remember: Even if you’re not sure it’s a heart attack, you should still have it checked out. Fast action can save lives-maybe your own.

 

After you learn more about heart attack, try a brief quiz to see if you know what to do if you or someone else has warning signs. How do you survive a heart attack? Fast action is your best weapon against a heart attack. Why? Because clot-busting drugs and other artery-opening treatments can stop a heart attack in its tracks. They can prevent or limit damage to the heart–but they need to be given immediately after symptoms begin. The sooner they are started, the more good they will do–and the greater the chances are for survival and a full recovery. To be most effective, they need to be given ideally within 1 hour of the start of heart attack symptoms. You can reduce your risk of having a heart attack—even if you already have coronary heart disease (CHD) or have had a previous heart attack. The key is to take steps to prevent or control your heart disease risk factors.

 

Six Key Steps To Reduce Heart Attack Risk; Taking these steps will reduce your risk of having a heart attack: Stop smoking; Lower high blood pressure; Reduce high blood cholesterol; Aim for a healthy weight; Be physically active each day. Manage diabetes.

 

 

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Monday – Seven Weeks Post-Op

Posted on by MaryO

Things are really getting more normal here as time goes on.  7 weeks ago, I never would have imagined it.

DH still can’t drive but he asked to borrow my car one day last week and I said NO.  Soon, though.

He’s able to put sweaters over his head now, a big improvement from a few weeks ago when he was cutting t-shirts in half and wearing 2, or using a safety pin to hold everything together.

Next Tuesday, March 26, he’ll go for his first cardiac rehab.  I don’t know if they schedule the “real” ones then, but this is more of an intake meeting and a test to see where he before he can get started.

I’ve started resuming my regular activities – on Saturday, I went to a 5-hour with no problem and I wasn’t spending my time worrying, either, although some mornings when he wakes up late, I’ll go check to be sure he’s breathing.


One thing I’ve done as part of our more healthy eating – I bought a soymilk maker.  I had one in my cart on amazon.com for a while, watching the price.  Then, one day, they didn’t offer it anymore.  I kept searching on amazon for several days and the next version became available.  I put that in my cart and watched.  On Wednesday, the price dropped to $119 – $20 less than the first one I’d wanted.  I jumped on that and ordered it Wednesday.  Thursday, it went back up to $139 so I played that right!

The soymilk maker arrived on Saturday and I made almond milk first.  Today, I have soybeans soaking right now and will make the first batch of soymilk in about an hour.

Bob's Red Mill

Bob’s Red Mill (Photo credit: Wikipedia)

I just went on amazon to get a link to the one I got and found the price back to $119!  It comes with a small bag of Laura soybeans to get you started but I’d already ordered Bob’s Red Mill.

Yesterday, I was singing in the choir at church and DH decided to go along.  Before church, so many of the choir members and others went over to give him a big hug and say how well he looked.  During prayer request time, he stood up to thank the church for their prayers and folks started clapping.

After church, we decided to stop for breakfast in a newesh restaurant in the neighborhood.  While waiting in line, some neighbors also arrived.  They said they hadn’t seen either of us for a while.  I mentioned DH’s heart attack and it turned out that other man had had one too, about 15 years ago.  They had lots to talk about.  The other guy did a kind of at-home chelation which sounded a bit odd but it worked for him to remove calcium deposits.  It didn’t sound like anything I’d want to try!

This morning I was teaching piano and one of my students is the associate pastor of my church.  He said how powerful that DH stood up yesterday and demonstrated the power of prayer.

Not much else here – everything’s pretty normal except for not driving or walking the dog but those things will come.

Hooray!

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It’s Pretty But…

Posted on by MaryO

snowstorm

 

 

No shoveling here!  We’ll tough it out somehow.

From Shoveling snow can be hard on the heart

Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.

What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snow blower can do the same thing. Cold weather is another contributor because it can boost blood pressure, interrupt blood flow to part of the heart, and make blood more likely to form clots.

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The Mixed Blessing of Heart Surgery

Posted on by MaryO
Three coronary artery bypass grafts, a LIMA to...

Three coronary artery bypass grafts, a LIMA to LAD and two saphenous vein grafts – one to the right coronary artery (RCA) system and one to the obtuse marginal (OM) system. (Photo credit: Wikipedia)

Angioplasty and heart bypass surgery are giants among medical procedures in America. They are performed more than a million times each year and together drive a $100-billion industry. But an article in the recent issue of Harvard Magazine explores a frightening truth: There’s no evidence that they improve life expectancy by even a single day. – See more at:

The mixed blessing of heart surgery.