Heart Beat October 2013 Issue

Heart Beat: October 2013

Though type 2 (or “adult onset”) diabetes is usually the type of blood glucose management challenge most often associated with cardiovascular disease, a new study finds that coronary artery calcification (CAC) is accelerated in individuals with type 1 diabetes (formerly known as “juvenile diabetes”), even without the presence of diabetic kidney disease. The study, published earlier this year in Diabetes Care, found that CAC progression is significantly higher in patients with type 1 diabetes than those without. Coronary arteries aren’t supposed to have calcium, so calcium buildup in those blood vessels could be a sign of coronary artery disease. Researchers note that patients with kidney disease face higher cardiovascular risks, and that individuals with type 1 diabetes are more likely to develop renal complications. And since these findings suggest that heart risks are elevated even without the presence of kidney disease, it’s especially important that type 1 diabetes patients be particularly vigilant about managing their diabetes and taking steps to keep their kidneys healthy. In addition to diabetes control, manageable risk factors for kidney disease include controlling hypertension and smoking cessation.

Men who skip breakfast on a regular basis face a 27 percent higher risk of heart attack or death from coronary arter disease than those who are more consistent about eating their morning meal. That’s according to a 16-year study published in the American Heart Association journal Circulation. There are several theories to explain why skipping breakfast presents such a risk. Researchers suggested, for example, that going longer without new calorie sources puts greater long-term stress on the body, which can, in turn, lead to higher levels of fasting insulin, triglycerides and LDL (“bad”) cholesterol. Researchers found that the men who skipped breakfast tended to be smokers, had lower levels of physical activity, and drank more alcohol, though even when such factors were accounted for in the study, men who skipped breakfast still had higher heart health risks than those who didn’t skip breakfast.

Resistant hypertension is a condition officially defined as having blood pressure that is above elevated treatment goals even when an individual is taking at least three antihypertensive medications (including one diuretic). But a new study, published in Circulation, suggests that as many as 15 percent of patients with treatment-resistant hypertension may be in that condition because they aren’t receiving optimal antihypertensive therapy. Researchers suggest that a drug’s dosage may be insufficient, or that a patient isn’t adhering strictly to his or her medication regimen, and those issues may be keeping an individual from achieving controlled blood pressure. Researchers also noted that, in addition to making sure patients are compliant with their medication use, physicians should take greater efforts to diagnose other underlying causes of their patients’ resistant hypertension.

While several studies have shown the heart-health benefits of coffee consumption, new research suggests there may be such a thing as “too much” coffee. A new analysis from the Aerobics Center Longitudinal Study found that drinking more than 28 cups of coffee a week is associated with an increase in all-cause mortality. Men who drank more than four cups of coffee per day, on average, had a 21 percent increased risk of all-cause mortality, while the risks for women who consumed that much coffee were lower. Interestingly, there was no association between heavy coffee consumption and cardiovascular mortality. Researchers acknowledged there are still many unanswered questions, and there may be other factors contributing to the health risks in this analysis. However, they do note that a cup of coffee is considered an 8-ounce cup, so four cups of coffee a day is only 32 ounces.


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