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AHA News: Women and Men Tolerate Heart Transplants Equally Well, But Men May Get Better Hearts

FRIDAY, Oct. 11, 2019 (American Heart Association News) — Women are just as likely as men to survive after a heart transplant despite often getting poorer-quality donor hearts, new research shows.

The findings, published this week in the American Heart Association journal Circulation: Heart Failure, sought to shed new light on what role, if any, gender plays in surviving a heart transplant. Past research on post-transplant survival rates and gender have told conflicting stories.

For the new study, researchers looked at data from 34,198 international heart transplant recipients from 2004 to 2014 and, after adjusting for recipient and donor factors, they found “no significant survival difference” between men and women.

“That’s a pretty novel finding,” said study author Dr. Yasbanoo Moayedi, a postdoctoral medical fellow at Stanford University in California. “We already know that women are hugely under-represented as recipients of heart transplants, but the striking thing about the new findings is there’s no difference in survival when matched to their male counterparts.”

The study also found women who get heart transplants appear to have lower-risk features than male recipients, with fewer instances of diabetes, high blood pressure, smoking, peripheral vascular disease and past cardiovascular surgery. Yet, women appear to receive higher-risk hearts than men.

“We need to better understand the matching of risk with recipient,” Moayedi said. “We hypothesize that women tend to deteriorate more acutely, and they’re sicker, so they take any heart that’s available.”

She said the findings suggest women with advanced heart failure need to be referred a bit earlier for transplant.

“One takeaway of the study is that maybe we’re missing the optimal window [for women],” she said. “Many factors may determine access to transplant, but gender should not be one of the them.”

The study was limited by its observational nature and its lack of data on waitlist mortalities, donor race and information about how sick patients where when they received a transplant.

Dr. Monica Colvin, a heart failure-transplant cardiologist who was not involved in the research, called it “a contemporary analysis” because it included newer devices and current medical therapy.

“There have been anecdotes of women having worse survival than men after heart transplant and studies have been conflicting,” said Colvin, director of the Heart Failure Network Strategy at the University of Michigan. “This study should dispel that myth and inform doctors that there really is no difference. We should not delay or defer referral for this lifesaving treatment based on concern for differential survival in women.”

An estimated 6.2 million U.S. adults have heart failure. In 2018, there were 3,408 heart transplants, according to the federal Organ Procurement and Transplantation Network.

Moayedi would like to see future studies explore why more women don’t undergo heart transplants and how a doctor’s gender might play into that decision.

“Is it that women don’t see themselves worthy enough for a heart transplant? As a patient, should I be more of an advocate for my symptoms? These things need to be looked at more systematically to learn how to best help the patient,” Moayedi said.

Colvin advises women with advanced heart failure to be seen at an advanced heart failure center “and seek out as much information as they can. It’s important to know what all your options are.”

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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How Pushups Can Help Men’s Hearts

man doing push ups

In a 10-year study published in February, researchers reported that men who can do 40 pushups have a whopping 96% lower risk of heart disease than guys who can’t muster 10. The average man in the study: Nearly 40 years old and overweight, but not obese. All 1,562 men were physically active firefighters rather than office workers. The study’s results strengthen the case that muscle-building promotes heart health.

“Resistance training is super important,” says Kaiser Permanente sports medicine specialist Robert E. Sallis, MD, who was not involved in the study. “It seems to have the same benefits as cardiovascular exercise.”

Can’t do 40 pushups? Don’t sweat it. In the study, even men who could do only 11 pushups dropped their risk of heart disease by 64%. The biggest difference, says Sallis, lies between those who do no exercise and those who at least do some: “Even if you can only do a little exercise, you get tremendous benefits.”

The study focused on pushups, but don’t limit yourself to that one exercise. Your workout should include a variety of movements that work as many muscles as you can. Sallis recommends weightlifting, situps, pullups, and interval training. “Your goal shouldn’t be simply to do more pushups in order to live longer,” he says. “It’s about your overall fitness.”

Sallis says that men often become discouraged when their exercise routine does not lead to weight loss: “They think their program’s not working, but that’s wrong.” He says that fitness — or your capacity for exercise — is a much better indicator of your health than weight, at least up to a point.

“All of the data tells us that if you can be active and do those pushups or other exercises, the weight doesn’t matter unless you’re morbidly obese,” says Sallis.

New to exercise? Start slow and ramp up. Sallis recommends daily brisk walks at first, building up to 150 minutes per week, or 30 minutes a day.

“Try 10 minutes a day at first,” he says. “If that’s all you can do, I’ll take it. Even low doses of exercise provide benefits.”

And if you don’t like pushups? That’s OK. Do something else. “I don’t necessarily want people to do more pushups,” says Sallis. “I want them to be more fit. Do whatever you want to do — you’ve got a large menu.”

Continued

Questions for Your Doctor

Should I avoid some types of exercise?

Some conditions will make certain exercises a bad choice. For example, shoulder arthritis may make pushups impossible. Try other bodyweight exercises.

Do I need to be evaluated before I exercise?

Most people don’t need a doctor’s permission to start moderate exercise, like a walking program, but if you have heart disease, diabetes, or other chronic health problems, check in with your doctor.

What health red flags should I watch for?

See your doctor if you feel any chest pains while working out or if you have excessive shortness of breath. Knee pain also should not be ignored.

Do my medications mix well with exercise?

Some blood pressure medications affect your heart rate, cause shortness of breath and dizziness, and make you more likely to get dehydrated. Review your prescription drugs with your doctor when starting to exercise.

Find more articles, browse back issues, and read the current issue of WebMD Magazine.

Sources

SOURCES:

Robert E. Sallis, MD, Kaiser Permanente sports medicine specialist.

American Council on Exercise: “Common Medications and Their Effects on Exercise Response.”

Mayo Clinic: “Exercise: When to check with your doctor first.”

JAMA Network Open: “Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men.”

© 2019 WebMD, LLC. All rights reserved.

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Smoking Around Expectant Moms Can Harm Babies’ Hearts

SUNDAY, March 24, 2019 — Fathers-to-be who expose their pregnant partners to secondhand smoke put their babies at risk of heart defects, researchers warn.

For the new study, investigators in China reviewed 125 studies that included a total of nearly 9 million prospective parents and more than 137,000 babies with congenital heart defects.

All types of parental smoking were linked to an increased risk of these birth defects, the analysis found. Compared to no smoking exposure, the increased risk was 124 percent for women exposed to secondhand smoke while pregnant, 74 percent for men smoking, and 25 percent for women smoking.

“Fathers are a large source of secondhand smoke for pregnant women, which appears to be even more harmful to unborn children than women smoking themselves,” said study author Jiabi Qin of Central South University in Changsha, China.

“Fathers-to-be should quit smoking,” Qin said in a news release from the European Society of Cardiology.

The overall risk with all types of parental smoking was greater when the analysis was restricted to Asian groups, the study authors noted.

Women’s exposure to secondhand smoke was dangerous throughout pregnancy — and even before, according to the report. While those who smoked before getting pregnant had no added risk, those who smoked during pregnancy were more apt to give birth to a child with a heart defect.

Specifically, smoking while pregnant was associated with a 27 percent higher risk for the newborn to have a hole in the wall between the heart’s upper chambers (atrial septal defect), and a 43 percent higher risk of an abnormality in which the smooth flow of blood through the heart is blocked (right ventricular outflow tract obstruction).

Congenital heart defects are the leading cause of stillbirth. These birth defects also affect eight in 1,000 babies born worldwide. Though treatments have improved, the effects last a lifetime.

Qin said women should stop smoking before trying to conceive and should avoid smokers, too. Employers can help by ensuring workplaces are smoke-free.

“Doctors and primary health care professionals need to do more to publicize and educate prospective parents about the potential hazards of smoking for their unborn child,” Qin concluded.

The study was published March 24 in the European Journal of Preventive Cardiology.

More information

The March of Dimes has more on smoking and pregnancy.

© 2019 HealthDay. All rights reserved.

Posted: March 2019

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Walnuts, Almonds Help Hearts in Type 2 Diabetes

By Serena Gordon

HealthDay Reporter

TUESDAY, Feb. 19, 2019 (HealthDay News) — If you have type 2 diabetes and you want to do your heart a favor, a new study suggests you should let your diet get a little nutty.

Folks with type 2 diabetes who ate five or more servings of certain kinds of nuts weekly dropped their odds of heart disease by about 20 percent, compared to people who ate less than a serving a month. A serving in the study was defined as one ounce.

Noshing five or more weekly servings of nuts also appears to lower the risk of premature death from heart disease or any other cause by about one-third for people with type 2 diabetes.

Not all nuts are created equal, however. Nuts grown on trees seemed to provide more heart-health benefits than peanuts, which grow underground.

Tree nuts include walnuts, almonds, cashews, Brazil nuts, pistachios, pecans, macadamias, hazelnuts and pine nuts.

“Our findings suggest that nut consumption, especially tree nuts, is beneficial for the prevention of cardiovascular disease [heart disease and stroke] and premature deaths among individuals with diabetes,” said study author Gang Liu. He’s a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health, in Boston.

The study was funded by the U.S. National Institutes of Health.

What is it about nuts that makes them so heart-healthy for people with diabetes?

Liu said that nuts seem to help control blood sugar, blood pressure and cholesterol. Eating nuts also appears to help dampen inflammation and improve blood vessel health.

The current study focused on people with type 2 diabetes, and Liu said there isn’t yet enough research to know if nuts would provide the same benefit to people with type 1 diabetes.

However, when asked if people without diabetes might see heart benefits from nuts, he said, “Based on our findings and existing evidence, I would say that nuts are beneficial for people with and without diabetes.”

Heart specialist Dr. Terrence Sacchi agreed that nuts can be beneficial. “This observational study provides more evidence that certain types of nuts perhaps have some effect on diabetes and heart disease,” Sacchi said. He’s the chief of cardiology at NewYork-Presbyterian Brooklyn Methodist Hospital in New York City.

Continued

But Sacchi added a few caveats. “Nuts are good in moderation, but you can’t be eating 18 handfuls of nuts. A serving is a handful. Nuts contain a lot of fat; it’s good fat, but gaining weight would counteract any benefit,” he explained.

Sacchi also pointed out that it’s important to limit the salt in nuts, because excess salt can increase your heart disease and stroke risk. He said the best type of nuts are raw, unsalted nuts.

The study included diet and health information from more than 16,000 people before and after they were diagnosed with type 2 diabetes. The study covered about two decades. Because it was an observational study, it cannot prove cause and effect.

During the study period, more than 3,000 people developed heart disease or stroke. More than 5,600 of the study volunteers died. Of those, nearly 1,700 died from heart disease or stroke.

The researchers found that when people ate more nuts after a diabetes diagnosis, they lowered their risk of heart disease or stroke more than 10 percent. Eating more nuts was also tied to about a 25 percent reduction in premature death from heart disease or another cause.

Each additional serving of nuts was linked to a 3 percent decreased risk of heart disease and stroke, as well as a 6 percent drop in the risk of dying of cardiovascular disease.

The study findings were published online Feb. 19 in the journal Circulation Research.

WebMD News from HealthDay

Sources

SOURCES: Gang Liu, Ph.D., research associate, department of nutrition, Harvard T.H. Chan School of Public Health, Boston; Terrence Sacchi, M.D., chief of cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, New York City; Feb. 19, 2019Circulation Research, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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