Mild Cortisol Increases Affect Cardiovascular Changes Linked to Heart Disease in Cushing’s

Increases in cortisol secretion, even if mild, induce early heart and blood vessel changes that may increase the risk for cardiovascular disease, according to Italian researchers.

The findings continue to support the role of the hormone cortisol in heart disease, and demonstrate the need for carefully monitoring cardiovascular risk in patients with high levels of the hormone, including those with Cushing’s disease.

The study, “Cardiovascular features of possible autonomous cortisol secretion in patients with adrenal incidentalomas,” was published in the European Journal of Endocrinology.

While most patients with adrenal incidentalomas don’t have symptoms, nearly half have excess cortisol production. Adrenal incidentalomas are masses in the adrenal glands discovered only when a patient undergoes imaging tests for another unrelated condition.

These asymptomatic, mild cortisol-producing cases are defined as possible autonomous cortisol secretion (pACS), according to the European Society of Endocrinology Guidelines.

Excess production of the hormone, seen in Cushing’s disease patients, is associated with increased mortality, mainly due to heart diseases. Patients with asymptomatic adrenal adenomas and mild cortisol secretion also have more cardiovascular events and generally die sooner than those with normal cortisol levels.

But little is known about the causes behind cardiac and vessel damage in these patients.

To shed light on this matter, a research team at Sapienza University of Rome evaluated the cardiovascular status of patients with pACS. This allowed them to study the impact of cortisol in the heart and blood vessels without the interference of other hormone and metabolic imbalances seen in Cushing’s disease.

The ERGO trial (NCT02611258) included 71 patients. All had been diagnosed with adrenal incidentalomas, 34 of which were pACS with mildly increased levels of the hormone and 37 were defined as nonfunctioning adenoma (NFA) — adrenal masses with normal hormone levels.

The two groups were very similar, with no significant differences in metabolic and cardiovascular risk factors. Adrenal lesions in the pACS group, however, were significantly bigger, which was linked to cortisol levels.

Looking at the heart morphology, researchers found that pACS patients had a significantly higher left ventricular mass index (LVMI), which is a well-established predictive measure of adverse cardiovascular events.

Further analysis revealed that LVMI scores were associated with levels of the hormone, suggesting it has an “independent effect of cortisol on cardiac function,” the researchers wrote.

Slightly more than half of pACS patients (53%) also had a thicker left ventricle, a feature that was seen only in 13.5% of NFA patients. The performance of the left ventricle during diastole (muscle relaxation) was also affected in 82.3% of pACS patients, compared to 35.1% in those with NFA.

Patients with pACS also had less flexible arteries, which may contribute to the development of vascular diseases.

The results show that “mild autonomous cortisol secretion can sustain early cardiac and vascular remodeling” in patients who appear apparently healthy, the researchers said.

“The morphological and functional cardiovascular changes observed in pACS underline the need for further studies to correctly define the long-term management of this relatively common condition,” they added.

From https://cushingsdiseasenews.com/2018/03/13/cushings-disease-increased-cortisol-affects-cardiovascular-changes-heart-disease/

How women can spot heart attack warning signs

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According to the CDC, heart disease is the leading cause of death in the U.S. But shockingly, the World Health Organization says that 80 percent of heart disease is preventable. That’s right, 80 percent. The most common risk factors for heart disease are smoking, high cholesterol, high blood pressure, inactivity, obesity and diabetes. You can prevent heart disease by doing things like exercising, eating right and quitting smoking, but that’s for another article.

First, let’s talk a little science so you know why heart attacks happen. A heart attack happens when the blood flow that brings oxygen to the heart is severely reduced or stopped. This occurs because over time, the arteries that supply the heart with blood can slowly become thicker and harder from a buildup of fat, cholesterol and other substances. This process is known as atherosclerosis. If the plaque breaks open and a blood clot forms, it can block the blood flow in the vessel, causing a heart attack. Heart attacks are perhaps the most feared complication of heart disease, so it’s important to learn how to spot the signs. We’ve all seen the classic signs of a heart attack in movies. It can be dramatic and sudden, and can include:

  • Chest pain in the center of your chest that can feel like squeezing, pressure or fullness and can radiate down the left arm or to other areas. The pain can come and go and lasts longer than a few minutes. It has often been described as “having an elephant sit on your chest” or “having your chest in a vise.”
  • Shortness of breath
  • Palpitations or heart racing
  • Sweating

The American Heart Association and a body of recent research suggest that this typical picture of a heart attack is more typical for men who experience symptoms. A report by BlueCross BlueShield revealed that while heart attacks are more common in men, women “who experience heart attacks have worse outcomes — they are more likely than men to die within one year of a heart attack, to have another heart attack within six years, and to be disabled because of heart failure within six years.” Women receive less aggressive treatment after a heart attack than men and often delay care longer than men. This is why it is especially important that women learn to identify signs of a heart attack. For women, the picture can be more insidious than the dramatic Hollywood heart attack. While chest pain is still a common symptom for women, many have atypical symptoms that can seem more like the flu than a heart attack. Some don’t even have chest pain. For women, signs of a heart attack can include more than the typical symptoms above, such as:

  • Unusual fatigue
  • Indigestion
  • Trouble sleeping
  • Pain in neck, jaw or back
  • Nausea
  • Vomiting
  • Stomach pain

There’s a story circulating in national news about a local woman who believed she was suffering symptoms of a viral illness. She wanted to sleep it off, but at the insistence of her husband, she went to the emergency room and discovered she was in the throes of a heart attack. These stories are common, so it’s important to listen to your body. If you don’t feel right, go in to the hospital and get checked out. If you do believe that you are suffering the symptoms of a heart attack call 911 immediately and, according to a suggestion by Harvard Medical School, chew a tablet of aspirin.

By 2020, the American Heart Association wants to improve the cardiovascular health of Americans by 20 percent and reduce death from cardiovascular disease by 20 percent. The key to this goal is education. Let’s all work together to spread awareness of the preventable nature of heart disease and the subtle signs of a heart attack.

From http://www.tennessean.com/story/life/entertainment/12th/2016/04/28/how-women-can-spot-heart-attack-warning-signs/83539580/

February is American Heart Month

February is American Heart Month. Learn about heart disease in women and what you can do to keep a healthy heart.

Get Informed: Facts on Women and Heart Disease

  • Heart disease is the leading cause of death for women in the United States.
  • Although heart disease is sometimes thought of as a “man’s disease,” around the same number of women and men die each year of heart disease in the United States.
  • Some conditions and lifestyle choices increase a person’s chance for heart disease, including diabetes, overweight and obesity, poor diet, physical inactivity, and excessive alcohol use.
  • High blood pressure, high LDL (low-density lipoprotein) cholesterol, and smoking are key risk factors for heart disease. LDL is  considered the “bad” cholesterol because having high levels can lead to buildup in your arteries and result in heart disease and stroke. Lowering your blood pressure and cholesterol and not smoking will reduce your chances for heart disease.

Symptoms

While some women have no symptoms of heart disease, others may experience heavy sharp chest pain or discomfort, pain in the neck/jaw/throat, or pain in the upper abdomen or back. Sometimes heart disease may be silent and not diagnosed until a woman has signs or symptoms including:

  • Heart Attack: Chest pain or discomfort, upper back pain, indigestion, heartburn, nausea/vomiting, extreme fatigue, upper body discomfort, and shortness of breath.
  • Arrhythmia: Fluttering feelings in the chest.
  • Heart Failure: Shortness of breath, fatigue, swelling of the feet/ankles/legs/abdomen.
  • Stroke: Sudden weakness, paralysis (inability to move) or numbness of the face/arms/legs, especially on one side of the body. Other symptoms may include confusion, trouble speaking or understanding speech, difficulty seeing in one or both eyes, shortness of breath, dizziness, loss of balance or coordination, loss of consciousness, or sudden and severe headache.
Stethoscope with plastic heartHealthy Hearts

Heart disease is largely preventable.
Listen to CDC’s Dr. Bowman discuss ways to prevent heart problems.
[00:04:06 minutes]

What You Can Do for Heart Health

You can lower your chance of heart disease and a heart attack by taking simple steps.

  • Eat a healthy diet with fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products. Choose foods low in saturated fats, cholesterol, salt (sodium), and added sugars.
  • Exercise regularly. Adults needs 2 hours and 30 minutes (or 150 minutes total) of exercise each week. You can spread your activity out during the week, and can break it up into smaller chunks of time during the day.
  • Be smokefree. If you are ready to quit, call 1-800-QUIT-NOW (1-800-784-8669) or 1-855-DÉJELO-YA (1-855-335-3569 for Spanish speakers) for free resources, including free quit coaching, a free quit plan, free educational materials, and referrals to other resources where you live.
  • Limit alcohol use, which can lead to long-term health problems, including heart disease and cancer. If you do choose to drink, do so in moderation, which is no more than one drink a day for women. Do not drink at all if you are pregnant.
  • Know your family history. There may be factors that could increase your risk for heart disease and stroke.
  • Manage any medical condition you might have. Learn the ABCS of heart health. Keep them in mind every day and especially when you talk to your health provider:
    • Appropriate aspirin therapy for those who need it
    • Blood pressure control
    • Cholesterol management
    • Smoking cessation

From http://www.cdc.gov/features/wearred/index.html

Are Exercise Recommendations Really Enough to Protect the Heart?

When it comes to preventing heart failure, even the recommended amounts may not be enough, finds a new study

Being inactive is solidly linked to heart problems like heart attack and stroke, and exercise can help lower risk factors—such as high blood pressure and narrowed blood vessels—that are connected to those heart events.

But when it comes to another type of heart condition, heart failure, the effect of physical activity isn’t as clear. If coronary heart disease can be traced to more physical issues, such as blocked arteries or excessive pressure from blood pumping around the body, heart failure is more of a body-wide problem affecting not just the heart but almost every tissue.

In heart failure, the heart gradually loses its ability to effectively pump oxygen-rich blood to the rest of the body, and it can’t keep up with supplying muscles and cells with what they need to function properly. 5.1 million people in U.S. have heart failure.

Source: Are Exercise Recommendations Really Enough to Protect the Heart? | TIME

Don’t Ignore These Early Signs Of Heart Disease In Men | Michael Lazar

Early Signs Of Heart Disease In Men

While many men may be unaware that they suffer from heart disease until a major incident, like a heart attack, occurs, there are several red flags that you should be aware of to better detect problems with the heart during the earliest and most treatable phases, explains WebMD.

The early stages of heart disease may have come-and-go symptoms that include:

Out of breath after moderate exercise, like climbing stairs.

A feeling of achiness or squeezing in the chest that can last 30 minutes or longer.

Pain in the upper extremities that can’t be explained.

Sometimes heart disease is caused by blood vessels. Key early signs include:

Chest pain

Shortened breath

Pain or tingling in the upper extremities

These symptoms could mean that your blood vessels have narrowed and are constricted. This can sometimes be caused by the build-up of plaque, which forces the heart to work harder to pump blood.

via Don’t Ignore These Early Signs Of Heart Disease In Men | Michael Lazar.

Enzyme that triggers muscle wasting could be key to REVERSING signs of ageing

The effects can be devastating for patients who can develop features such as muscle wasting and weakness, weight gain, thinning of the bones, diabetes, high blood pressure and heart disease.

Dr Hassan-Smith said: ‘Looking at this particular enzyme seemed like an intriguing way forward.

‘We knew how it works in relation to Cushing’s Syndrome, which is characterised by similar symptoms, and thought it would be worthwhile applying what we knew to the ageing population.’

via Enzyme that triggers muscle wasting could be key to REVERSING signs of ageing | Daily Mail Online | CushieBlog.

Snow shoveling: How to avoid a heart attack – WTOP

“Shoveling snow can, in fact, precipitate a heart attack, and it does for thousands of Americans every year,” says Dr. Warren Levy, chief medical officer of Virginia Heart, one of the largest cardiology practices in the region.

He says shoveling snow involves a level of exertion that most of us just are not used to and don’t do on a daily basis.

“It is the same sort of trouble people get into [when they] have never exercised and decide to suddenly train for a marathon,” Levy explained.

People most likely to have problems while shoveling snow are those already diagnosed with heart disease, or who have significant risk factors, such as high blood pressure, obesity, diabetes, cigarette smoking, a strong family history or a sedentary lifestyle.

Read more at Snow shoveling: How to avoid a heart attack – WTOP.