Before ordering Oxiline’s Pressure X Pro, I measured my arm, as well as my husband’s, to ensure I ordered the correct cuff size. Oxiline’s online checkout process is quick and simple to use. I chose the free expedited shipping (three to four business days) option. My order shipped two days after the order was placed and was delivered three days later with no issues. Altogether, the process from order placement to delivery took five days. It took approximately 10 minutes to read the manual and prepare the monitor for use. The device came with batteries, which helped expedite set up, and illustrations for proper cuff placement are located directly on the cuff itself. With the click of one button, the device starts taking blood pressure measurements. The blood pressure monitor syncs each measurement with the app seamlessly, but it’s important the user profile of the person taking the measurement is selected in the app prior to starting the measurement. Otherwise, the reading is logged under the last selected user’s profile. There’s also an option to delete a reading. My husband, who tracks his blood pressure daily, was very impressed by the tracking features of the app. His previous blood pressure monitor didn’t have smart features, so he manually logged his measurements in a document. The graphics in the Oxiline app made it easier to visualize where his readings fell on a blood pressure chart. Although I have not had any issues or complications throughout my experience with Oxiline, many online reviews express complaints. Reviews found on the Better Business Bureau (BBB) website state that orders weren’t shipped within the specified shipment window and that items were often backordered. One BBB reviewer notes a poor experience with the company, citing backorders and difficulty with refunds specifically. “Really bad online experience with Oxiline. I strongly advise the consumer to find another company. They say same-day shipping, but you will come to learn they don’t even have the item in stock.” Many reviews expressed similar experiences with the company. Overall, I was impressed by my personal experience with the Oxiline Pressure X Pro blood pressure monitor. Delivery was quick, the device was easy to use, and readings were consistent. I highly recommend creating an account and using the app to log data, as it’s convenient to have all your blood pressure readings in one place. Although my experience with Oxiline has been without issues, I would also consider others’ experiences before recommending or purchasing from the company again. Hospital-Grade Accuracy For Your Home Oxiline blood pressure monitors enable you to view, store and share all of your data with smartphone connectivity.
Credit: Pixabay/CC0 Public Domain Debra Stewart walked toward a horse paddock with a bag of carrots in hand. Whisper, a splashed chocolate and white paint horse, met her at the fence. Flies shrilled as they bounced off Whisper’s body and her hooves plopped in ground softened by an overnight rain. But Whisper’s thick, forced cough made the most pronounced sound. “C’mon, c’mon,” Stewart said, gently encouraging Whisper to step free of mud as she crunched on carrots in between coughs. Whisper had moved to Debra’s property a few miles south of Fayetteville from another county in 2017. After arriving, the horse developed heaves—a common, allergic, respiratory horse disease characterized by chronic cough, nasal discharge and respiratory difficulty. That was the same year news broke that a factory near her Gray’s Creek neighborhood for decades had released a family of industrial chemicals known as PFAS that polluted river water and drinking wells. Experts can’t confirm that Whisper’s cough is tied to PFAS exposure on Stewart’s property. But in a recent study prompted by concerned community members, North Carolina State University researchers detected the industrial compounds in dogs and horses, including Whisper, in Gray’s Creek. The wind-broke horse Whisper’s condition is most similar to asthma in humans. Horses with it are often described as being “wind-broke.” Six months after Whisper arrived in Gray’s Creek, Stewart noticed the horse had developed a cough. “She was completely fine before I brought her down to this area,” said Stewart in an interview at her home, “My vet said she had environmental allergies—but her cough is year round.” Gray’s Creek sits a few miles north of the Fayetteville Works Facility. The North Carolina Department of Environmental Quality has stated the plant may have started releasing PFAS into the environment as early as the 1980s. In 2017, Stewart started attending local forums about PFAS polluting the Cape Fear River area. She was concerned that animals, as well as people, were exposed and raised that alarm to state regulators, Cumberland County commissioners and staff with Chemours, which now operates the factory. In 2018, Stewart had to euthanize a pig named Wilbur after he developed a massive testicular tumor. Like Whisper, Wilbur drank well water contaminated with PFAS on Stewart’s property. Mike Watters, a local advocate pushing for protections from pollution released by Fayetteville Works Facility, introduced Stewart to Scott Belcher, a North Carolina State environmental science professor. Belcher and his team had detected PFAS in the blood of many animal species in the Cape Fear River Basin. Dogs and horses were of particular interest because they share environments with people, including drinking water sources. Something in the water PFAS are tough, human-made compounds that can accumulate in people’s bodies. Some have been linked to health problems, from decreased fertility in women and developmental delays in children to behavioral changes and increased cholesterol levels, according to the state Department of Health and Human Services. When researchers collected blood samples from 1,020 people in the Cape Fear River Basin from 2020 to 2021, they detected four types of PFAS compounds in nearly every person. But two types recorded in people living near or downstream of the Chemours factory were distinctive, according to researchers. They were either produced at or a byproduct of what was produced at the factory. Belcher’s previous studies revealed elevated levels of contaminants in fish and alligators in the Cape Fear River Basin when compared to the same animals in different regions of the state. In Gray’s Creek, Belcher’s team analyzed the blood of 31 dogs and 32 horses. They detected clear differences in PFAS exposure in animals with different drinking water sources. Fluoroethers, a type of PFAS associated with Fayetteville Works were found only in dogs given well water. A different suite of chemicals were detected in dogs given bottled water, said Belcher. Dogs who drank well water had higher concentrations of two PFAS types—PFOS and PFHxS—as compared to dogs given bottled water. These PFAS are known to contaminate the plants and animals near the Cape Fear River watershed, according to the study. The horses, which all lived outdoors, drank well water and had a lower average concentration of PFAS than dogs. Belcher and his team found higher total PFAS concentrations in dogs living indoors, which could be due to their contact with tainted water, house dust or PFAS-treated materials, according to the study. Out of the 20 types of PFAS the researchers were looking for, 12 were found in more than half of the animals. When analyzing the dogs and horses blood, they also saw proteins and other biomarkers associated with changed liver and kidney function—two major biological effects that have been associated with PFAS exposure in people, said Belcher. PFAS tend to stick to blood proteins, and since a lot of blood flows through the kidneys and liver, they can accumulate in these organs at high levels, presenting the most opportunity to have toxic effects, explained Belcher. How animals can signal exposure risks in people The study proves that dogs and horses could signal potential PFAS exposure risks in people and the environment, said Belcher. The median concentrations of two kinds of PFAS—PFOS and PFHxS—in dogs consuming well water was similar to the concentrations found in children residing in Wilmington, North Carolina, according to the study. Dogs, who live closer to the ground, could potentially indicate PFAS exposure risks in children and babies, who crawl on the floor and are more sensitive to chemical exposures than adults, said Belcher. The type of PFAS detected in horses have also been consistently detected in humans and animals in the Cape Fear River Basin, according to the study. While the researchers can’t make direct correlations between health effects in the Gray’s Creek animals with PFAS contamination, Belcher said they’re coming closer to understanding how much PFAS is in their environment. 2023 The Charlotte Observer. Distributed by Tribune Content Agency, LLC. Citation: PFAS detected in blood of horses and dogs too near factory in eastern North Carolina
Signal of PFS Improvement in SIENDO for Selinexor-Treated Patients was Observed Only in Subgroup Who are TP53 Wild-Type with a Median Progression-Free Survival of 27.4 Months Median PFS Not Reached for Selinexor-Treated Patients Who are TP53 Wild-Type MSS (pMMR) Updated Analysis Provides Further Rationale for XPORT-EC-042, the Ongoing Pivotal Phase 3 Study (NCT05611931) Evaluating Selinexor as Maintenance Therapy in TP53 Wild-Type Endometrial Cancer NEWTON, Mass., July 25, 2023 /PRNewswire/ — Karyopharm Therapeutics Inc. (Nasdaq: KPTI), a commercial-stage pharmaceutical company pioneering novel cancer therapies, today announced the presentation of updated exploratory subgroup analyses from the SIENDO study (NCT03555422) in patients with advanced or recurrent TP53 wild-type endometrial cancer at the virtual American Society of Clinical Oncology (ASCO) Plenary Series. Currently, there are no specific targeted therapies available for patients with TP53 wild-type endometrial cancer. Advanced and recurrent endometrial cancer is associated with a poor prognosis, including limited disease control for patients who relapse after first-line systemic treatment.1 TP53 wild-type is found in approximately 50% of advanced/recurrent tumors in patients with endometrial cancer.2,3 TP53 wild-type is observed in both MSS (pMMR) and MSI-H (dMMR) populations. Recently there has been progress in potential treatment options in the MSI-H (dMMR) subgroup with new targeted treatments. However, a large unmet need continues to exist for MSS (pMMR), which comprises approximately 70% of all endometrial cancer patients and of that population, approximately 70% are TP53 wild-type. The primary analysis of the Phase 3 SIENDO study of selinexor maintenance therapy in advanced or recurrent endometrial cancer showed improvements in median progression-free survival (PFS) for the intent-to-treat (ITT) population but were not clinically meaningful. However, an exploratory analysis of a pre-specified subgroup of patients with TP53 wild-type endometrial cancer showed a promising efficacy signal. In the SIENDO study, 263 patients were randomly assigned, with 174 patients allocated to the selinexor arm and 89 patients to the placebo arm. One hundred and thirteen patients with TP53 wild-type endometrial cancer were randomized to receive selinexor (n=77) vs placebo (n=36) as maintenance therapy. As of the March 30, 2023 data cut-off date, and a median duration of follow-up of 25.3 months, selinexor-treated patients with TP53 wild-type endometrial cancer had a median PFS of 27.4 months compared to 5.2 months for patients with TP53 wild-type endometrial cancer receiving placebo. Additionally, median PFS was not reached for selinexor-treated TP53 wild-type MSS (pMMR) endometrial cancer patients compared to 4.9 months for TP53 wild-type MSS (pMMR) endometrial cancer patients treated with placebo. No new safety signals were identified as of the last data cut-off date on March 30, 2023. The most common adverse events (AEs) in TP53 wild-type patients were nausea (91%), vomiting (61%) and diarrhea (40%), the majority of which were grades 1-2. The most common reported grade 3-4 treatment-emergent AEs (TEAEs) included neutropenia (18%), nausea (12%), and thrombocytopenia (9%). TEAEs leading to discontinuations were reported in 16% of patients. The SIENDO exploratory subgroup data provides further rationale for the ongoing pivotal Phase 3 study (XPORT-EC-042; NCT05611931) of selinexor as a maintenance therapy following systemic therapy in patients with TP53 wild-type advanced or recurrent endometrial cancer with the strongest signal in TP53 wild-type, MSS (pMMR). Karyopharm is currently enrolling patients in the pivotal Phase 3 study of selinexor as a maintenance therapy following systemic therapy in patients with TP53 wild-type advanced or recurrent endometrial cancer (XPORT-EC-042; NCT05611931) to better understand the exploratory subgroup analysis. This trial includes a companion diagnostic tool under development by Foundation Medicine, Inc. Karyopharm entered into a global collaboration with Foundation Medicine, Inc. to develop FoundationOne®CDx, a tissue-based comprehensive genomic profiling test to identify and enroll patients whose tumors are TP53 wild-type. “The updated results from SIENDO suggest that selinexor may have the potential to prolong systemic therapy response in patients whose disease is TP53 wild-type. Particularly encouraging are the data observed in the subgroup of patients whose disease are both TP53 wild-type and MSS,” said Reshma Rangwala, MD, PhD, Chief Medical Officer of Karyopharm. “We are encouraged by the updated results from this study as it further strengthens the rationale for our ongoing EC-042 Phase 3 study.” “Treatment options for women with advanced or recurrent endometrial cancer are rapidly evolving with the identification of molecular subgroups. Limited options, however, still persist among certain subgroups, including patients with mismatch repair-proficient disease (pMMR), who comprise about 70% of endometrial cancers,” said Dr. Ignace Vergote, principal investigator and gynecologist oncologist, ENGOT and the Belgium and Luxembourg Gynaecological Oncology Group (BGOG), University of Leuven, Leuven Cancer Institute, Leuven, Belgium. “TP53 is a well-recognized molecular marker in endometrial cancer. About 50% of patients with advanced, recurrent endometrial cancer have disease identified as TP53 wild-type and about 70% of those further classified as a pMMR. The EC-042 study is designed to show that inhibition of XPO1 with selinexor may provide a potential new therapeutic option for these patients.” “The long-term follow-up in the TP53 wild-type subgroup from the SIENDO trial is extremely encouraging and suggests that TP53 status could be an important biomarker that can identify patients who benefit from XPO1 inhibition with selinexor,” said Dr. Brian Slomovitz, Director of Gynecologic Oncology and Co-Chair of the Cancer Research Committee at Mount Sinai Medical Center, and Uterine Cancer Trial Advisor for GOG Partners, Inc. “Given the unmet need that remains for patients whose disease is pMMR as well as the encouraging exploratory data in the subgroup of patients who are classified as TP53 wild-type and pMMR, a potential new paradigm for both the diagnosis and treatment of women with endometrial cancer may be identified. I look forward to the ongoing progress of EC-042 to further explore this hypothesis.” ASCO Plenary Series ProgramTitle: Long-term follow up of selinexor maintenance in patients with TP53wt advanced or recurrent endometrial cancer: A pre-specified subgroup analysis from the phase 3 ENGOT-EN5/GOG-3055/SIENDO study.Presenter: Brian Slomovitz, MD, Mount Sinai Medical CenterSession Date and Time: Tuesday July 25, 2023, 3:00pm – 4:00pm (ET)This livestream event presented by ASCO is free to register at:https://old-prod.asco.org/meetings-education/monthly-plenary-series/program About the EC-042 StudyEC-042 (XPORT-EC-042; NCT05611931) is a global, Phase
From Indiana Regional Medical Center (IRMC) The American Heart Association presents the Get With The Guidelines awards for proven dedication to best practices and life-saving care Indiana Regional Medical Center (IRMC) has received two American Heart Association Get With The Guidelines achievement awards for demonstrating commitment to following up-to-date, research-based guidelines for the treatment of stroke, ultimately leading to more lives saved, shorter recovery times and fewer readmissions to the hospital. Every 40 seconds, someone in the U.S. has a stroke or heart attack, and heart disease and stroke are the No. 1 and No. 5 causes of death in the United States, respectively. Studies show patients can recover better when providers consistently follow treatment guidelines. Get With The Guidelines put the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping ensure patient care is aligned with the latest evidence- and research-based guidelines. As a participant in Get With The Guidelines program, Indiana Regional Medical Center qualified for the awards by demonstrating how their organization has committed to improving quality care. “IRMC is committed to improving care by adhering to the latest treatment guidelines and streamlining processes to ensure timely and proper care for strokes,” noted Steve Wolfe, IRMC President & CEO. “The Get With The Guidelines programs make it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which helps us ensure more people in the communities we serve are able to experience longer, healthier lives.” This year, IRMC’s Primary Stroke Center received these achievement awards:• Stroke Silver Plus with Target: Type 2 Diabetes Honor Roll “We are pleased to recognize IRMC for its commitment to caring for those in their community who need cardiovascular care,” said John Warner, M.D., FAHA, past president of the American Heart Association and CEO of The Ohio State University Wexner Medical Center. “Hospitals that follow the American Heart Association’s quality improvement protocols often see improved patient outcomes, fewer readmissions and lower mortality rates – a win for health care systems, families and communities.” .
Abstract Background Nonhygienic products for managing menstruation are reported to cause reproductive tract infections. Menstrual cups are a potential solution. We assessed whether menstrual cups would reduce bacterial vaginosis (BV), vaginal microbiome (VMB), and sexually transmitted infections (STIs) as studies have not evaluated this. Methods and findings A cluster randomized controlled trial was performed in 96 Kenyan secondary schools, randomized (1:1:1:1) to control, menstrual cup, cash transfer, or menstrual cup plus cash transfer. This substudy assessing the impact of menstrual cups on BV, VMB, and STIs, included 6 schools from the control (3) and menstrual cup only (3) groups, both receiving BV and STI testing and treatment at each visit. Self-collected vaginal swabs were used to measure VMB (16S rRNA gene amplicon sequencing), BV (Nugent score), and STIs. STIs were a composite of Chlamydia trachomatis and Neisseria gonorrhoeae (nucleic acid amplification test) and Trichomonas vaginalis (rapid immunochromatographic assay). Participants were not masked and were followed for 30 months. The primary outcome was diagnosis of BV; secondary outcomes were VMB and STIs. Intention-to-treat blinded analyses used mixed effects generalized linear regressions, with random effects term for school. The study was conducted between May 2, 2018, and February 7, 2021. A total of 436 participants were included: 213 cup, 223 control. There were 289 BV diagnoses: 162 among control participants and 127 among intervention participants (odds ratio 0.76 [95% CI 0.59 to 0.98]; p = 0.038). The occurrence of Lactobacillus crispatus–dominated VMB was higher among cup group participants (odds ratio 1.37 [95% CI 1.06 to 1.75]), as was the mean relative abundance of L. crispatus (3.95% [95% CI 1.92 to 5.99]). There was no effect of intervention on STIs (relative risk 0.82 [95% CI 0.50 to 1.35]). The primary limitations of this study were insufficient power for subgroup analyses, and generalizability of findings to nonschool and other global settings. Conclusions Menstrual cups with BV and STI testing and treatment benefitted adolescent schoolgirls through lower occurrence of BV and higher L. crispatus compared with only BV and STI testing and treatment during the 30 months of a cluster randomized menstrual cup intervention. Author summary Why was this study done? Many girls in low- and middle-income countries are unable to adequately manage their menses and can suffer reproductive tract infections resulting from use of inappropriate materials. Reusable menstrual cups are medical grade silicone bell-shaped chambers that are inserted into the vagina to capture menstrual blood. Menstrual cups are safe and have not been associated with changes in vaginal pH or microflora. It is not known whether menstrual cups could lead to improvements in reproductive tract health. What did the researchers do and find? We assessed the impact of menstrual cups on the vaginal microbiome (VMB), bacterial vaginosis (BV), and sexually transmitted infections (STIs) in 436 secondary schoolgirls in western Kenya. During the 30-month cluster randomized controlled trial, BV and VMB composition were assessed every 6 months, and STIs (gonorrhea, chlamydia, and trichomoniasis) were assessed annually, with testing and treatment for BV and STIs for intervention and control participants regardless of symptoms. Among the intervention group, in crude analyses, the occurrence of BV was 24% lower than control participants, while the proportion of Lactobacillus crispatus–dominated community state type was 37% higher. What do these findings mean? Other studies have found that menstrual cups are a safe and cost-effective tool for menstrual hygiene management. These results provide evidence they can promote an optimal VMB and reduce BV for adolescent girls. Further research should investigate the constitution of the VMB and incidence of BV and STIs in different age groups and populations using menstrual cups. Citation: Mehta SD, Zulaika G, Agingu W, Nyothach E, Bhaumik R, Green SJ, et al. (2023) Analysis of bacterial vaginosis, the vaginal microbiome, and sexually transmitted infections following the provision of menstrual cups in Kenyan schools: Results of a nested study within a cluster randomized controlled trial. PLoS Med 20(7): e1004258. https://doi.org/10.1371/journal.pmed.1004258 Academic Editor: Sarah J. Stock, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, UNITED KINGDOM Received: November 4, 2022; Accepted: June 7, 2023; Published: July 25, 2023 Copyright: © 2023 Mehta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: Raw sequence data (FASTQ files) were deposited in the National Center for Biotechnology Information (NCBI) Sequence Read Archive (SRA), under BioProject identifier PRJNA746243. This study was conducted with approval from the Kenya Medical Research Institute (KEMRI) Scientific and Ethics Review Unit (SERU), which requires that data be released from any KEMRI-based Kenyan studies (including de-identified data) only after their written approval for additional analyses. In accordance, data for this study will be available upon request, after obtaining written approval for the proposed analysis from the KEMRI SERU. Their application forms and guidelines can be accessed at https://www.kemri.org/seru-overview. To request these data, please contact the KEMRI SERU at [email protected]. Funding: This study was supported by the National Institutes of Health Eunice Shriver National Institute of Child Health and Human Development (R01-HD093780 to SDM), and the Joint Global Health Trials Initiative (UK-Medical Research Council/ Department for International Development/ Wellcome Trust/Department of Health and Social Care; MR/N006046/1 to PPH). The funders had no role in the design of the study, the collection, analysis, and interpretation of data, or in writing the manuscript. Competing interests: The authors have declared that no competing interests exist. Abbreviations: BIOM, biological observation matrix; BV, bacterial vaginosis; CaCHe, Cups and Community Health; CCT, conditional cash transfer; COVID-19, Coronavirus Disease 2019; CST, community state type; CT, Chlamydia trachomatis; GLMM, generalized linear mixed model; GRC, Genome Research Core; HDSS, health and demographic surveillance system; ITT, intention to treat; MHM, menstrual hygiene management; NG, Neisseria gonorrhoeae; OR, odds ratio; RR, relative risk; SES, socioeconomic status; SSA, sub-Saharan Africa; STI, sexually transmitted infection; TV, Trichomonas vaginalis; VALENCIA, VAginaL community state typE Nearest CentroId classifier; VMB, vaginal microbiome; WASH, water,
100 Pints: Mocksville man’s first blood donation was made to get out of work Published 1:58 pm Tuesday, July 25, 2023 Bruce Henry, accompanied by wife Joyce, prepares to give his 100th pint of blood at the Red Cross Blood Drive. – Photo by Mike Barnhardt By Mike Barnhardt Enterprise Record Henry Bruce remembers that day in the U.S. Army many years ago. “A guy came around with a clipboard. He was looking for volunteers, and said you would get the rest of the day off.” Bruce didn’t even have to know the cause. His hand went immediately in the air to volunteer. It was his first time donating blood. Last week, the Mocksville man, 83, donated his 100th pint of life-saving blood. “It just seems like the right thing to do,” he said. “It doesn’t take long and you always feel good afterward. I donate whenever I’m able and thinking about it.” It likely won’t be his last time to donate, either. He’s in good health, and his doctor, Dr. Melanie Seagle, smiled and gave him permission to donate blood until hs is 100. Bruce and his wife of 62 years, Joyce, moved to Mocksville some 17 years ago from Florida, and haven’t regretted it. “We like it here,” she said. Their family – four sons, 15 grandchildren and 11 great-grandchildren – are scattered across the country.
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Truvian presents data for its desktop blood-testing device in a field still in Theranos’s shadow
SAN DIEGO — Truvian Health, a San Diego blood diagnostics company, shared data on Tuesday showing that its benchtop instrument’s results are largely consistent with those generated by large central laboratories. But while the results lend support for the company’s vision of decentralized and widely available clinical testing, they also resurface questions about the value of an approach widely associated with the now defunct and notorious Bay Area startup Theranos. In a multisite study, the company tested nearly 240 blood samples from healthy donors and chronic disease patients for dozens of blood-based measurements commonly ordered by doctors, from cholesterol to blood sugar to blood cell counts. Results from Truvian’s benchtop analytical instrument, with few exceptions, closely matched readings from devices used in large central labs and made by Swiss pharma giant Roche and Japanese firm Sysmex. advertisement The findings were presented at the annual meeting of the American Association for Clinical Chemistry, recently rebranded as the Association for Diagnostics & Laboratory Medicine. It’s the first time Truvian has shared clinical data on its product, though they have not been published in a peer-reviewed journal. The company, which is planning additional validation studies, expects to submit for Food and Drug Administration approval of its device by the third quarter of 2024. Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED
image: Arterial stiffness may cause premature cardiac damage in youth, but decreasing blood pressure and insulin resistance may reduce this effect by fifty percent. view more Credit: Andrew Agbaje. Arterial stiffness is a novel cause of premature heart damage among adolescents, according to a new follow-up study. The study was conducted in collaboration between Texas Children’s Hospital and Baylor College of Medicine in the US, the University of Bristol in the UK, the University of Exeter in the UK, and the University of Eastern Finland, and the results were published in Atherosclerosis. Left ventricular hypertrophy and left diastolic dysfunction are measures of structural and functional heart damage, which have been associated with an increased risk of cardiovascular-related death in adults. These cardiac measures are also used in the paediatric population as indicators of premature heart damage. Arterial stiffness estimated from carotid-femoral pulse wave velocity has been discovered as a novel cause of increased blood pressure, insulin resistance, and metabolic syndrome in adolescents and young adults. It was also recently shown that increased blood pressure in adolescence may cause premature heart damage, but it is not known whether arterial stiffness could independently cause structural and functional damage to the heart. The current study was conducted among 1,856 adolescents of whom 1,011 were female. The adolescents were 17 years old at baseline, and they were followed up for 7 years until young adulthood at age 24 years. Arterial stiffness, carotid intima-media thickness, and evidence of heart damage were assessed at baseline and follow-up. Signs of heart structure damage are left ventricular hypertrophy and high relative wall thickness, whereas signs of heart function damage are left ventricular diastolic dysfunction and increased left ventricular filling pressure. During the 7-year follow-up period, the prevalence of heart structural damage among adolescents doubled. With extensive control for fat mass, muscle mass, glucose, insulin, blood pressure, lipids, smoking status, sedentary time, physical activity, socio-economic status, and family history of cardiovascular disease, and using adults’ cut points for diagnosing heart damage, it was observed that adolescents in the highest tertile category of arterial stiffness and carotid intima-media thickness had a 23 – 27% increased risk of progressively worsening structural heart damage. Only arterial stiffness appears to independently cause both structural and functional heart damage, whereas increased carotid wall thickness does not seem to have a causal role. Increased carotid wall thickness is an early indicator of atherosclerosis, whereas increased arterial stiffness describes arteriosclerosis. The study further reported that arterial stiffness caused heart damage by increasing blood pressure and insulin resistance. The increase in blood pressure explained 34% of the heart damage caused by arterial stiffness. Moreover, insulin resistance explained 15% of the heart damage caused by arterial stiffness. “We are seeing for the first time that arterial stiffness is a novel cause of several diseases such as hypertension, insulin resistance, metabolic syndrome, and heart damage in the young population. Among adults, arterial stiffness is currently being established as a cause of type 2 diabetes. We discovered that approximately 50% of the deleterious role of arterial stiffness in causing heart damage is enhanced by the mechanism of increased blood pressure and insulin resistance. Thus, preventing and lowering blood pressure and insulin resistance may potentially diminish the negative impact of arterial stiffness on the heart, by up to half,” says Andrew Agbaje, a physician and clinical epidemiologist at the University of Eastern Finland. “Experimental and clinical intervention studies are urgently needed on comprehensive approaches to treating and reversing arterial stiffness from adolescence. At least, targeting blood pressure and insulin resistance leaves the problem half-solved,” Agbaje continues. Dr Agbaje’s research group (urFIT-child) is supported by research grants from Jenny and Antti Wihuri Foundation, the Finnish Cultural Foundation Central Fund, the Finnish Cultural Foundation North Savo Regional Fund, the Orion Research Foundation, the Aarne Koskelo Foundation, the Antti and Tyyne Soininen Foundation, the Paulo Foundation, the Yrjö Jahnsson Foundation, the Paavo Nurmi Foundation, the Finnish Foundation for Cardiovascular Research, Ida Montin Foundation, Eino Räsänen Fund, Matti and Vappu Maukonen Fund, and the Foundation for Pediatric Research. Journal Atherosclerosis Article Title Arterial Stiffness but not Carotid Intima-Media Thickness Progression Precede Premature Structural and Functional Cardiac Damage in Youth: A 7-Year Temporal and Mediation Longitudinal Study. Article Publication Date 3-Aug-2023 Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
DEAR DR. ROACH: My mom had a throat and palate infection that was treated in 2017, and about two weeks later, she had a heart attack. In 2023, she had pneumonia, and was briefly hospitalized and treated, but again about two weeks later, she had another heart attack. We asked her cardiologist if there is a relationship between either the infections themselves or the treatment of infections and heart attacks, but he was not aware of any. This seems too unlikely to be a coincidence. What is your experience on this? — A.C.S. ANSWER: A heart attack happens when the demand for blood from the heart is greater than the ability of the blood vessels can provide. In practice, this almost always means that there are blockages in the blood vessels. However, an increase in the workload of the heart, such as strenuous exercise or an infection (fever tends to increase heart rate, and the blood flow from the heart usually increases with serious infection), can be what leads a person to have a heart attack. It’s possible that this is what happened with your mom. The timing of two weeks after the event is longer than expected, but it’s possible. Whether from chronic infection or inflammatory conditions like rheumatoid arthritis, inflammation in the blood increases the risk of heart disease in the long term, so if there is a connection, and it’s not just coincidental, that would be the most likely cause. DEAR DR. ROACH: You wrote about the dangers of testosterone replacement in men over 70 in your column a few months ago. Could you please describe the dangers of this again? My husband is 73 and injects testosterone every 10 days or so. He’s not feeling too well overall, but he doesn’t know why. He’s been to the cardiologist, but the studies came back fine. He says he feels nerves in his stomach and a bit of shortness of breath. He’s also tired and without much energy. — E.D. ANSWER: There are clear dangers with excess testosterone use, especially in older men. Some men use very high doses of testosterone or other androgens for muscle building, and this can cause heart damage, blood clots and stroke. I strongly do not recommend doing this, but it is generally used illicitly. By contrast, for men in whom testosterone therapy is given appropriately, the dangers are quite small, and in most men, the benefits outweigh the risks. Men should have a clear reason to receive testosterone therapy, such as having low bone density, low libido, loss of body hair, or development of breast tissue, in addition to repeatedly low testosterone levels (including a level taken between 8 a.m. and 10 a.m. when testosterone levels are highest). In these men, the goal is to stabilize the testosterone level, and the risks of the catastrophic outcomes listed above appear to be very small, or even zero. Testosterone levels should also be measured during therapy. I can’t speculate on the cause behind your husband’s symptoms. Nonspecific symptoms, such as low energy, can be caused by low testosterone, but unless there are more specific symptoms of low testosterone, I generally do not recommend testosterone replacement. Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].