Air pollution increases risk of heart disease by lowering the good cholesterol

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Air pollution is a reality today and has been a subject of much discussion recently. Several studies have demonstrated the association of poor air quality with diseases such as respiratory and heart diseases, global warming making it a major public health problem of concern.

Yet another new study reported in the journal Arteriosclerosis, Thrombosis, and Vascular Biology has highlighted the increased risk of cardiovascular diseases due to traffic-related air pollution and proposed an explanation for the relationship between air pollution and cardiovascular disease.

The study says that traffic-related air pollution may increase risk of developing heart diseases via its effects on the good high-density lipoprotein cholesterol (HDL-C).

The study involving more than 6000 middle-aged and older adults in the United States found that people who live in areas with high levels of air pollution, especially traffic-related air pollution, have lower levels of the good HDL-C. Over a period of one year, those with higher exposure to black carbon, emitted from vehicles, had considerably lower levels of HDL-C compared to those with lower exposure to black carbon. Higher particulate matter exposure over three months was associated with a lower HDL particle number. Compared to men, women had much lower levels of HDL-C.

Keep your total cholesterol lower than 160mg/dL. HDL is good cholesterol, keep it more than 40mg/dL. LDL is bad cholesterol and should be kept as low as possible; keep it lower than 80 mg/dL. A 1% rise in bad cholesterol increases the chances of heart attack by 2% and 1% reduction in good HDL-C reduces the chances of heart attack by 3%.

(Source: AHA news release, April 13, 2017)

Dr KK Aggarwal
National President IMA & HCFI

Sedentary time associated with higher waist circumference & increased cardiovascular risk

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The negative health effects of a sedentary lifestyle are well known. Yet another study has shown a sedentary lifestyle to be associated with increased risk of heart disease.

In a new study from UK published January 31, 2017 in the International Journal of Obesity led by Dr William Tigbe from Warwick Medical School, University of Warwick, workers who had desk jobs were found to have higher waist circumference and increased risk of heart disease.

The study included 111 healthy non-smoking postal workers from Glasgow and randomized them into two groups: 55 were office workers and 56 walked/delivered post. The waist circumference was 2 cm higher in those who had desk jobs; 97 cm vs 94 cm, respectively. The risk of heart diseases was also higher in the workers who had desk jobs. 2.2% compared to 1.6% over 10 years. With each extra hour of sitting from five hours a day, the LDL ‘bad’ cholesterol increased and HDL ‘good’ cholesterol reduced.

The various health benefits of walking are well recognized. It has been shown in a study published earlier this year in the American Journal of Epidemiology that lack of exercise affects the human body right up to the cellular level. Elderly women who sit for more than 10 hours a day with low physical activity had cells that were biologically older by eight years compared to women who are more active.

Hence, physical activity is recommended for all ages.

Getting people to move more is a key strategy for reducing the burden of NCDs, as outlined in WHO’s Global Action Plan for the Prevention and Control of NCDs 2013-2020. The plan calls for a 10% relative reduction in insufficient physical activity by the year 2025 to achieve the Sustainable Development Goals (SDGs).

White collar workers or people who have desk jobs spend most of their working hours sitting in chairs. Interventions that encourage walking and physical activity in the workplace are needed to counter the negative health effects of sedentary behavior.

The IMA initiative ‘Move, Move and Move’ is a campaign to increase awareness about the benefits of physical activity and to encourage people to be more active at work and cut down on sedentary time.

(Source: Medical News Today)

Dr KK Aggarwal
National President IMA & HCFI

A new risk assessment tool for heart disease

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A special report from the American Heart Association (AHA) and American College of Cardiology (ACC) published November 4, 2016 in the journal Circulation and in the November 2016 issue of the Journal of American College of Cardiology describes a new risk assessment tool for atherosclerotic cardiovascular disease (ASCVD) – The Million Hearts Longitudinal ASCVD Risk Assessment Tool.

The Million Hearts Tool is an extension of the ASCVD Pooled Cohort Equation first published in the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk and is designed to help predict the 10-year risk of developing atherosclerotic cardiovascular disease (ASVCD) and how that risk may change over time as preventive treatments are initiated.

The tool can be used in 3 steps:
• Estimating the baseline 10-year risk for ASCVD
• Considering the potential benefits of risk-reducing therapies for a given patient in the context of a patient-clinician discussion and shared decision-making;
• Assessing the updated ASCVD risk based on the response to therapy.

The Million Hearts® Initiative, developed by the United States Department of Health and Human Services (HHS) and supported by the ACC and AHA, aims to prevent 1 million heart attacks and strokes by 2017 through the management of the “ABCS”—aspirin therapy, blood pressure control, cholesterol management and smoking cessation.

(Source: Circulation, Journal of American College of Cardiology, AHA/ACC News release)

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