Women with Gout at Increased Heart Risk

Although gout is characterised as a disease of old colonels who have drunk too much port, the reality is it can affect men and women who may never have had a drink in their lives. It is often genetically inherited and although more common in older men and women after the menopause, the most vulnerable group are usually men over 30.

Now equality has caught up and although it is known that gout increases the risk of a heart attack in men what has just been revealed is that women with gout are at greater risk of a heart attack than the men are.

This research (I know, all research to be taken with a pinch of metaphorical, not actual, salt) was recently published in the Annals of Rheumatic Diseases and based on a study of more than 9500 gout patients and 48, 000 people without the disease, aged 65 and older in British Columbia, Canada.

The study took place over 7 years and tracked cardiovascular health and they found that compared with women who did not have gout, those who did were 39% more likely to have a heart attack of any kind and 41% more likely to have a non-fatal heart attack. The surprise in the study was that the risks were significantly higher among the women than among the men as men with gout were only 11% more likely than those without the disease to have a fatal or non-fatal heart attack.

Gout is common and caused by inflammation in the joints as a result of excess uric acid deposits, that are a feature of western diets. Factors that can produce gout include other forms of arthritis obesity, weight gain, high alcohol intake, high blood pressure, poorly functioning kidneys and certain drugs.

If you are wondering if you have it, then look for redness, pain and inflammation of the joints, particularly toes and fingers. Natural remedies suggested to help with gout include dietary help by avoiding alcohol and organ meats, particularly liver, tart cherry juice, celery seed, apple cider vinegar and yoga.

Hard to die from a heart attack today

I have always thought that you have to a touch arrogant to be a consultant, and proof is in this week from Barcelona where the European Society of Cardiology have been meeting. Their President, Roberto Ferrari MD, claimed that adults today can expect to live 10 years longer than the average adult 30 to 40 years ago. Nothing too surprising about that, but he has set the cat among the pigeons by claiming that most of that extra decade resulted from advances in cardiovascular medicine, especially the treatment of heart attacks. Fine if he had left it there, but he went on to say “In cardiology, we have contributed seven of those 10 years of life, while oncologists have contributed 2.4 months,” and we are awaiting a response from the various Cancer Societies in Europe and the USA on that one.

However it might reassure you to know that he is confident that “it is difficult to die from a heart attack today.” Let’s hope his own heart is a strong one or he might keel over from the adverse publicity if he ever did have a heart attack!

Statins update

A new trial has shown that taking an omega-3 fish oil capsule outperforms a statin drug in reducing mortality and hospital admissions for chronic heart failure.

The results of the recent Italian study were given at the European Society of Cardiology meeting and published online by The Lancet on 31 August 2008. The patients on omega-3 supplements showed a lowered risk of mortality compared to those heart failure patients who received 10 mg/day of a potent statin drug and others given a placebo. The patients given the statin showed no benefit and in fact had the same outcome as taking the placebo.

What this study suggests is that a daily intake of omega-3 fatty acid supplement for close to four years may provide a slight reduction in mortality or hospitalizations for patients with chronic heart failure and that treatment with statins does not appear to be beneficial in patients with chronic heart failure. The American College of Cardiology has predicted that the results would soon be rapidly incorporated into their guidelines on heart failure. This is the second trial to demonstrate benefit for omega-3 in cardiovascular disease: the first trial found that omega-3 reduced the risk of major cardiovascular events following a heart attack whereas the second appears to lower the risk of mortality from heart disease.

If you are concerned about your risk for heart disease and want to take preventive measures, the suggested supplemental daily dose of omega-3 is equivalent to a gram day, taken for at least four years continuously – or seriously increase your intake of sardines and other oily fish!

Statins – Saint or sinner?

Many of you will have heard of Patrick Holford, the UK’s leading nutrition expert, and I have known him for many years. Indeed I edited his Optimum Nutrition magazine for a while and always find what he has to say of interest.

The topic of statins has come up a lot recently, particularly when I have been giving talks on natural health, and there seems to be a lot of confusion. This is not surprising because every year there is always a ‘new’ wonder thing that will help us stay health without much willpower on our part, but will bring fairly large profits to the people manufacturing it.

Cynical? Maybe, but when you have written about health for as long as I have you see the cycle of celebration, doubt, debunking and then quietly disappearing for many so called ‘miracle’ cures.

New health guidelines issued recently say all adults aged 40 to 75 should be assessed for risks, including smoking, weight and blood pressure and those with at least a 20 per cent increased chance of a heart attack over the next 10 years should be offered treatment, usually statins. Patrick Holford takes a different view and completely disagrees with the routine prescribing of these drugs. I think what he has to say is important so I am quoting him directly here, and leaving you to make up your own mind.

“Statins work by blocking the production of cholesterol, which is a perfectly normal substance, and in the process, stops the body producing Co-Q10, a vital heart nutrient, causing harmful side effects. This was confirmed in research published last month in the journal Nature. As a consequence, statins are far from harmless.

The notion that cholesterol is linked with heart disease goes back over fifty years, along with the idea of bringing cholesterol levels down with a low fat diet to protect the heart. But both of these ideas have been strongly challenged. For example, plenty of studies show that only 50% of people who develop heart problems have high cholesterol, while a study in the BMJ in 2001 found no link between changing fat in the diet and heart disease.

The best known side-effect of statins involves muscles problems. The probable reason for this is that they stop the production of Co-Q10 which is found in all cells (especially those of the heart muscle) and is vital to energy production. In one study of 14 healthy people, 10 developed heart rhythm abnormalities when given statins. This, say some researchers, could explain the muscle weakness and also the memory loss some people experience.

Some practitioners recommend that anyone taking statins should also supplement with Co-Q10 and a warning on statin packets is now mandatory in Canada, saying that CoQ10 reduction ‘could lead to impaired cardiac function’.

In fact the closer you look, the more questionable the benefits become. You might assume that taking prophylactic statins would mean that you would live longer overall. But that isn’t what the studies show. The total number of heart attacks drops slightly but then the risk of dying from other things goes up slightly, so overall life expectancy stays the same.

How can you avoid statins? By doing everything you can to keep your heart healthy. You do that by the well- known – but little enough practiced – regime of eating well with plenty of fruit, vegetables and wholegrains in your everyday diet. Make sure you also include foods that are high in heart-protective Vitamin E, such as beans, olive oil and eggs and reduce the amount of sugary foods, refined carbohydrates and keep your stress levels as low as you can.

Instead of an expensive drug, try lowering your cholesterol levels and heart disease risk by raising your ‘good’ HDL cholesterol and lowering ‘bad’ LDL cholesterol. A simple, inexpensive way to do that is take a supplement of niacin (vitamin B3), and to further help prevent cardiovascular disease it is suggested that you include a CoQ10 supplement of around 90mg a day. The COQ10 will also help those who are already on statin drugs and wish to stay on them.

If you would like to know more about Patrick Holford’s work, his new book ‘Food is Better Medicine Than Drugs’ would be a good place to start. You can read about it here: Food Is Better Medicine Than Drugs: Your Prescription for Drug-free Health

Heart attack risk linked to bodys fat distribution

The link between heart attack risk and being overweight is well-established, but now it seems that it is not so much how much extra weight you are carrying, but where it is on the body that increases the risk factor. Two studies, one in the US at the Medical College of Wisconsin and another at Tel-Aviv University in Israel indicate if extra weight is all carried on the stomach and abdomen then you need to take action. In the two separate studies 20,000 subjects had their body mass index (BMI) compared to their waist measurement in relation to cardiovascular disease risk factors. The bigger the waist, the risk of high blood pressure, high cholesterol and high glucose levels were found to be significantly stronger than the link between those same factors and BMI.

The leader of the Israeli study, Dr David Tanne, pointed out that excessive abdominal fat also raises the risk of other factors associated with metabolic syndrome, such as type 2 diabetes. Their research also found that during a 23-year follow up period that those subjects with excessive abdominal fat were one and a half times more likely to suffer a stroke compared to subjects with the lowest abdominal fat.

What can you do?
Whether you can’t see your feet when looking down, or are just a little soft around the waist, it pays to take preventive action. Heart disease and stroke risk are not to be taken lightly and although regular exercise is certainly essential there is another factor that might help.

Canadian researchers reported in a study published last year in the Journal of Nutrition that having a higher intake of protein might help. Like the other researchers they were also measuring their subjects to assess waist-hip ratio (WHR). The result was that those with the highest waist-hip ratio, indicating excessive abdominal fat, were found to have the lowest intake of protein.

Why would protein have this effect?
A fatty acid called conjugated linoleic acid (CLA) might provide the answer. CLA is most abundant in protein-rich dietary sources such as meat and dairy products. It’s also available in supplement form, and studies have shown that CLA supplements may help reduce body fat mass, but as always take the simplest route first and look at your diet before taking supplements, and then only on the advice of your doctor.

Women smokers at greater risk for heart attacks

Traditionally women have enjoyed a natural shield against a major cardiac event such as a heart attack. Being a woman has ensured a huge nine year barrier before women become more prone to heart disease, but now a new finding has been reported by the American Heart Association. A study of more than 7,000 men and women undertaken at Johns Hopkins University in Baltimore has found that women who smoke eliminate that beneficial barrier and their risk of a heart attack is exactly the same as a man’s.

In real terms, this means that up to now, women who do not smoke would not normally present with heart problems until on average around the age of 71 but women smokers are being seen with heart problems at around the age of 62. That is a loss of nine years, but if you need an even greater incentive to give up – or persuade the woman in your life to do so = then the researchers also found that if a woman quits smoking for at least six months, her risk factors for heart attacks reverts to average.

Interestingly, the analysis of men showed virtually the same, although men only lost 3.8 years because of smoking. Men who didn’t smoke tended to show up with a heart attack at age 61; men who smoked showed up at the emergency room when they were 57.

A final cheery note from the director of the New York University Women’s Health Program. “Smoking among women causes heart attacks, lung disease, and wrinkles so this study is just another reason for women to quit or never start. It takes nine years off your life.”

Natural ways to control high blood pressure

As there are 16 million people in the UK with high blood pressure (hypertension), and of those nearly a third are not aware that they have the condition, it is obviously an issue that needs to be addressed. High blood pressure is defined as being at a level consistently at or above 140mmHg and/or 90mmHg and it is a both a preventable and manageable condition. You would think that as it is the direct cause of half of all strokes and heart attacks in the UK that those who have it would be regularly monitoring it, but sadly only 10% of those diagnosed with the condition have their blood pressure controlled to target levels.

Yet there is something that is so incredibly simple, that everyone can do, at no cost and no risk that will naturally help control high blood pressure. Hypertension results from the balance between two factors: how hard the heart is pumping (cardiac output) and how easily plasma can diffuse out of your capillaries (peripheral resistance) and most people with high blood pressure have a normal cardiac output but increased peripheral resistance. That resistance means you are more at risk of heart attacks and strokes and the most likely cause is dehydration.When you are dehydrated the level of blood in your body falls but the body has it’s own incredibly clever regulatory system where it prioritises the maintenance of your essential organs and shuts down blood supplies to the capillaries of non-essential areas like the muscle and skin. The effect of this is to increase your peripheral resistance and also to increase the production of histamine, a hormone-like substance, and this causes your blood vessels to narrow and this in turn further increases blood pressure. This can be also exacerbated by the fact that many treatments for hypertension include the taking of diuretics and this again reduces the amount of fluid in the body.

The remedy? Drink at least two litres of plain, still, water every day – not tea, coffee, soft drinks as a substitute but pure unadulterated water. Often the easiest way to measure is to have a full bottle by the kettle and make sure it is empty by the time you have that bedtime drink – or even earlier for preference so you aren’t then getting up too often in the night.

If you want to try and control your blood pressure without drugs, then one of the most effective supplements is Co-enzyme Q10. This is a substance which is produced naturally in the body and taking it has lowered blood pressure as effectively as prescription medications in a number of patients. Unlike some of the drugs, it’s only side effects are the good ones of lowering cholesterol and preventing diabetes and gum disease and the recommended dose for supplementation is normally between 60-120mg a day, but always start on the lower amount first and in consultation with a natural practitioner.