TIME medicine

The Next Big Drug to Treat Heart Disease

The Food and Drug Administration may soon approve blockbuster drugs that can lower cholesterol better than anything on the market today. Here’s what you need to know about the heart disease game changers.

There’s a well accepted dogma in heart disease: too much cholesterol flowing through the blood vessels can jam up heart byways and lead to heart attacks, stroke and other problems. So lowering cholesterol, by eating fewer high-fat foods or taking advantage of drugs that can keep levels under control, can protect you against heart trouble.

A drug that promises to drop cholesterol levels to unprecedented levels—some say to as low as those found in infants—has to be a good thing. That’s what a Food and Drug Administration (FDA) advisory committee decided after reviewing data on the first candidate in a new class of heart drugs since the cholesterol-lowering statins emerged in the 1980s. The committee looked at studies involving alirocumab, developed by Sanofi and Regeneron Pharmaceuticals, and will do the same for a similar compound, evolocumab from Amgen, on Wednesday. Another drug, developed by Pfizer, is further behind the approval process. All three belong to a new class called PCSK9 inhibitors, which work by pumping out more LDL cholesterol receptors on liver cells; these can pull cholesterol out of the blood like sponges and keep vessels clear of the artery-clogging fats.

The committee voted 13-3 to recommend approval of alirocumab, determining that it was safe enough and provided significant enough benefits over existing therapies that it should be approved. The FDA usually follows its advisory committee recommendations, but isn’t bound by the advice.

The recommendation isn’t a surprise given the encouraging data so far on the drugs, but it is a bit unusual because there aren’t any long-term data yet on how patients taking these drugs fare. Normally, the FDA likes to see studies that follow people taking heart drugs, for example, for several years, and that demonstrate that they have fewer heart-related events and are less likely to die from heart problems than people not taking the medications. But the PCSK9 inhibitors have a unique advantage on this issue that may have helped them shortcut that process.

Some people are born with mutations that make them deficient in the PCSK9 enzyme, which tends to eat up and degrade LDL receptors. These individuals are blessed with low LDL levels throughout their lifetime and don’t seem to show any other adverse health effects. “These people are effectively experiencing the functional equivalent of taking one of these drugs for their entire life,” says Dr. Elliott Antman, professor of medicine at Brigham and Women’s Hospital and Harvard Medical School and president of the American Heart Association. “They almost never get vascular disease and tolerate their low levels of LDL very well. So they were the inspiration for developing drugs that inhibit PCSK9.”

Further studies of the drugs that mimicked the effect of the genetic mutation showed that almost everyone taking them enjoyed a drop in LDL cholesterol levels of up to 65%. Some people in the trials have seen their LDL levels go down to 25 mg/dL or below; in previous guidelines, heart experts advised people without a history of heart events to aim for LDL levels of 100 mg/dL or below and for heart attack patients to shoot even lower, for 70 mg/dL or less.

“These drugs are a big deal,” says Dr. Steven Nissen, chariman of cardiovascular medicine at Cleveland Clinic who is leading a study on the Amgen drug to see if it can not only lower cholesterol, but actually reverse existing plaques in the arteries. The dramatic effect that PCSK9 inhibitors have on cholesterol is making doctors also rethink how they treat heart disease. The latest guidelines from the American Heart Association and the American College of Cardiology did away with target cholesterol levels, and the new class of drugs may support that trend, pushing doctors to advise patients to go as low—meaning as close to zero cholesterol in their blood—as they can.

“I think right now that will scare most people,” says Dr. Seth Martin, assistant professor of medicine and cardiology at Johns Hopkins School of Medicine. “But the science supports that it’s safe.”

The FDA would still have to determine for which patients the drugs should be prescribed. Some panel members recommended that the first indication include only those with genetic conditions that make them more vulnerable to abnormally high cholesterol levels, or those who can’t tolerate statins. Because statins are generally effective, the new drugs may also be recommended as second line therapy, to be used only after patients have failed to respond to statins, Unlike statins, which remain the best-selling prescription drugs in the U.S., the PCSK9 inhibitors need to be self-injected, either every two weeks or once a month.

If approved, even for a limited group initially, the drugs are likely to make their way into the broader-based heart-disease patient population—and quickly. “I have patients keeping an eye on this, who said to me, ‘This sounds pretty good, how can I get some now?’” says Antman. “They asked me to give them a call if it gets approved.” Not all of them have a genetic predisposition to high cholesterol levels, but, Antman notes, “they are sophisticated patients and say ‘I’ve had a good response to statins, so if I took this on top of the statin, I could cut my current LDL in half. Doesn’t that mean good things for reduction of my risk?’ And the answer is yes, it does.”

If the FDA does decide to approve alirocumab and other PCSK9 inhibitors, the agency will likely require the manufacturers to keep registries of patients using the drugs and monitor any side effects or other adverse events that may arise.

TIME Research

This Is the Healthiest Month to Be Born In, According to Science

A new study identified 55 diseases associated with birth month

Read an interview with the study’s author.

Your birthday may be more important than you think when it comes your health.

Scientists at Columbia University used an algorithm to identify “significant associations” between the time a year a person is born and 55 diseases, including ADHD, asthma and heart disease. The new study, which was published in the Journal of American Medical Informatics Association, concludes that people born in May have the lowest overall risk for disease, while people born in October have the highest.

Though previous research had explored the connection between disease risk and birth season, this study confirmed 39 associations as well as laid out 16 new ones. Researchers looked at more than 1,600 diseases and 1.7 million patients treated in New York between 1985 and 2013 to identify the months most associated with asthma (October and July babies), ADHD (November babies, matching a Swedish study), and nine kinds of heart disease. They plan to replicate the study in other locations, to better identify the environmental factors contributing to such disparities.

“It’s important not to get overly nervous about these results because even though we found significant associations the overall disease risk is not that great,” said Nicholas Tatonetti, the study’s senior author and an assistant professor at Columbia University Medical Center. “The risk related to birth month is relatively minor when compared to more influential variables like diet and exercise.”

For more on the study, read an interview with Columbia’s Tatonetti here.

TIME medicine

Memory Loss Not Caused By Cholesterol Drugs After All

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Chris Gallagher—Getty Images/Photo Researchers RM

Some cholesterol-lowering drugs, called statins, could contribute to short-term memory lapses, but new data suggest that risk may not be real

About 25 million Americans currently take a drug to lower their cholesterol, so it’s no surprise that the most popular among them, statins, consistently top the list of best-selling prescription medications. But recent studies hinting that they were associated with memory problems have led some patients to shy away from them.

According to the latest data, though, there’s probably no need to avoid taking statins for this reason if a doctor prescribes them to protect against heart disease. In a report published in JAMA Internal Medicine, Dr. Brian Strom, chancellor of biomedical and health sciences at Rutgers University, and his colleagues say that while statins may contribute to short term memory issues, these tend to resolve over the long term and that such memory problems are not unique to the statins.

MORE: Who Really Needs To Take a Statin?

Previous studies had reported a possible connection between statins and memory loss, but those studies compared statin users to non-statin users. In his study, Strom included another group for comparison: people prescribed cholesterol-lowering drugs that were not statins. Among a large group of 482,543 statin users, 26,484 users of non-statin cholesterol-lowering drugs and 482,543 controls who weren’t on any drugs, Strom and his team found that both cholesterol-lowering drug groups showed short-term memory problems in the first 30 days after they started taking their medications compared to the controls. For statin users, the increased odds of memory lapses was four-fold, and for the other drug group, nearly the same, at 3.6-fold.

Because both groups taking drugs showed similar memory effects, Strom says that it’s unlikely that statins are uniquely to blame for the short-term cognitive issues. And because statins and the other cholesterol-lowering drugs work in vastly different ways, it’s also unlikely that the effect can be blamed on the drugs themselves. Strom proposes that the groups’ short-term memory issues, which were recorded by doctors in the patients’ medical records, is more likely the result of these patients simply being more aware of and sensitive to any changes in their functions after starting a new medication. In other words, people may have been having memory issues before they started their medications, and the problems might have occurred if they had not started taking them, but the symptoms became more noticeable because the users were more attuned to changes after filling their new prescription. The control group might have been experiencing similar memory issues but didn’t report them to their doctors; therefore, the issues might not have been recorded. “People on new medicines are more likely to notice a problem, more likely to blame problems on the drug and more likely to go back to the doctor and report these problems,” Strom says.

MORE: Statins May Seriously Increase Diabetes Risk

While it’s possible that the drug-taking group is also at higher risk to begin with for memory-related problems, since they have more potentially vessel-blocking cholesterol in their blood that can also impede blood flow to the brain, the results remained strong even after the group adjusted for risk factors such as diabetes and other blood-related conditions.

What’s more, Strom and his team also looked at users who might have been prescribed statins, stopped taking them because they were uncomfortable with the short-term memory issues, and then were prescribed them again at a later time. These patients did not report memory problems at the same rate, suggesting that the effect has less to do with the drugs themselves than with a hyper-vigilance for any changes associated with new drugs—the second time around, the drugs weren’t novel any more. “If the memory problems were real, we would expect that those who took statins for the second time would develop memory problems again,” he says. “The fact that we saw this as a problem so infrequently in this group suggests that it was more because the statins were a new drug the first time around.”

Based on the results, Strom says he informs his own patients that for some, statins may be linked to a short-term memory issue but that these tend to disappear over the long term. He also warns that even the short-term problems may not be a true effect of the drugs but rather a misinterpretation of the studies. “People should not steer away from statins because of a fear of short-term memory problems,” he says, “because they probably are not real.”

TIME Heart Disease

Cancer Is Now the Number 1 Killer of Men in the UK

TIME.com stock photos Health First Aid Kit Gloves
Elizabeth Renstrom for TIME

Women are still more likely to die of heart disease than cancer

A new report shows that in the U.K., cancer has surpassed cardiovascular disease as the most common cause of death, but only among men.

The research published in The BMJ looked at the national data on both cancer and heart disease in countries in the U.K. from 2012 to 2013. Among men, fewer were dying of heart-related disease like high blood pressure and stroke than they have been in the past. Thirty-two percent of deaths among men were cancer-related and 29% were from heart disease. For women, 27% of deaths were from cancer and 28% from heart disease.

Overall, in 2012 the researchers reported that the proportion of deaths from cancer was 29% and cardiovascular disease related-deaths came out to 28%. England had the lowest rate of heart conditions and Scotland had the highest.

It’s unclear what precisely is responsible for the drop in heart-related disease, but it’s known that in some cases, heart disease is preventable with lifestyle changes.

TIME Heart Disease

How Much Alcohol Is Too Much? A New Study Has Answers

Alcohol, at least in moderation, can help the heart, but too much can be toxic. The latest study tells you where to draw the line

For decades, there’s been a steady line of literature welcomed by anyone who enjoys a regular drink or two: that moderate drinking can actually protect you from having a heart attack by keeping your vessels clear and relatively plaque-free. But there’s another set of data that shows too much alcohol can start to poison the heart. So where does the line between good-for-you and bad-for-you lie?

Researchers led by Dr. Scott Solomon, professor of medicine at Harvard Medical School and director of non-invasive cardiology at Brigham and Women’s Hospital, and his colleagues provide some clues Tuesday in their latest report in the journal Circulation: Cardiovascular Imaging. The scientists combed through data collected from 4,466 elderly people about their alcohol consumption. They also agreed to echocardiograms of their hearts. Solomon wanted to see if there were any changes in the structure of the heart that had anything to do with how much the volunteers reported they drank each week.

MORE: Should Alcohol Be Forced to List Calories?

The not-so-good news: The more the participants drank, the more likely they showed abnormal changes in their heart structure and function. In men, the changes started accumulating after more than two drinks per day, or 14 or more drinks a week. In these men, the pumping chambers of their hearts increased slightly compared to those in non drinkers, a sign that the heart had to work harder to pump the same amount of blood, which can cause it enlarge and weaken. In women, these changes appeared when women drank much less, just above the one drink a day. In addition, among the women who imbibed more than a drink a day, the scientists found slight drops in heart function compared to women who drank less.

“A little bit of alcohol may be beneficial, but too much is clearly going to be toxic,” says Solomon. “Once you get beyond two drinks a day in men, you get into the realm where you start to see subtle evidence of cardiotoxic effects on the heart that might over the long term lead to problems. And that threshold might be lower in women.”

The study provides valuable information about how alcohol affects the heart, and how much alcohol exposure can trigger changes to the heart’s structure and more importantly, how it functions. But where the tipping point lies with each individual between the benefits and harms of a having a few drinks isn’t clear yet. More studies investigating which genetic factors may predispose people, and in particular women, to the toxic effects of alcohol will need to done before more refined advice about how much is too much can be discussed.

Those investigations might start with potential differences in the way men and women process alcohol. The effects Solomon and his team saw remained strong even after they adjusted for body mass index, and other studies have hinted, for example, that the different hormone environments in men and women might be responsible for the increased vulnerability of women’s heart tissues to the toxic effects of alcohol.

Future work may also delve deeper into the question of how long people drink; like any exposure, the effects of alcohol may also be cumulative. Because the participants in the study were relatively elderly, with an average age of 76, their heart changes reflected decades of exposure to alcohol but it’s not clear whether there is a threshold for when the harmful effects dominate over the potentially beneficial ones.

“What is clear is that at more than two drinks a day is the point at which we start to think we are beyond the safe level for men, and with women, it’s likely to be even lower than that,” says Solomon.

TIME Obesity

‘Thrifty’ Metabolisms May Make It Harder to Lose Weight

File photo dated Thursday October 16, 2014. of a young girl using a set of weighing scales as slimmers should forget what they have been told about avoiding rapid weight loss in favour of slow but sure dieting, according to new research.
Chris Radburn—PA Wire/Press Association Images File photo dated Thursday October 16, 2014. of a young girl using a set of weighing scales as slimmers should forget what they have been told about avoiding rapid weight loss in favour of slow but sure dieting, according to new research.

The study marks the first time lab results have confirmed the widely held belief

Losing those love handles may be easier for some people than for others, says a new study that confirmed the theory that physiology plays a role in a person’s ability to lose weight.

According to a press release, researchers at the Phoenix Epidemiology and Clinical Research Branch studied the metabolisms of 12 obese men and women undergoing a six-week 50% calorie-reduction experiment. After measuring participants’ energy expenditure after a day of fasting and then re-examining them during the caloric-reduction period, researchers found that the slower the metabolism works during a diet, the less weight the person loses.

Coining the terms “thrifty” vs. “spendthrift” metabolisms, the experiment marks first time lab results have confirmed a widely held belief that a speedy metabolism plays a role in weight loss.

“While behavioral factors such as adherence to diet affect weight loss to an extent, our study suggests we should consider a larger picture that includes individual physiology — and that weight loss is one situation where being thrifty doesn’t pay,” said lead author Dr. Susanne Votruba, Ph.D.

Researchers have yet to figure out if the differences in metabolic speeds are innate traits or develop over time. Also, the study was only focused on weight loss, and the team does not know if the body’s response to caloric reduction can be used to prevent weight gain.

Over one-third of Americans are obese, and it leads to some of the most common forms of preventable deaths in the country.

TIME Diet/Nutrition

This Diet Is Better for Your Brain Than Low-Fat

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Rita Maas—Getty Images

Simply adding more olive oil and nuts to your diet may help prevent memory problems and loss of cognitive skills that come with old age

You’ve heard a million times that the modern Mediterranean diet is good for you. Now there’s stronger evidence the diet may be good for your brain, too.

In a study published in JAMA Internal Medicine, Dr. Emilio Ros from the Hospital Clinic in Barcelona, Spain and his colleagues conducted a study of 447 men and women aged 55 to 80 years to see whether changing their diet could affect their performance on cognitive tests. The volunteers were healthy but at higher risk of developing heart-related problems; some smoked or had hypertension, for instance, others had a family history of heart issues. Everyone in the study was randomly assigned to eat, for about four years, a Mediterranean diet supplemented with 1 liter of extra virgin olive oil a week, a Mediterranean diet enhanced with 30 grams of nuts a day, or a low-fat diet. The researchers performed a series of brain functioning tests on the participants at the start of the study and then at the end of the study.

MORE: Here’s Another Reason to Try the Mediterranean Diet

Both Mediterranean diet groups showed improvements compared to the low-fat diet group; those consuming more olive oil showed better memory scores at the end of the study while those eating more nuts showed improvements in executive function skills. The low-fat diet group, on the other hand, showed declines in many of the cognitive measures.

“It’s never too late to change your dietary patterns to improve your health,” says Ros. “This surprised even myself.” The results, he says, are especially encouraging since the people in the study were at higher risk of developing cognitive problems because of their heart-related risk factors, which can also impair cognitive function by increasing risk of stroke and compromising blood flow to the brain. “If you intervene with a healthy dietary pattern in people who are at risk of cognitive failure, even in people who still haven’t had any memory complaints or loss of cognitive function, you can prevent cognitive deterioration,” he says.

MORE: This Diet Has Been Linked to a Longer Life—Again

The findings support a growing body of evidence that connects the Mediterranean diet, which is high in antioxidant-rich foods like rich vegetables and fats, and improved brain function. Because researchers now believe that the brain is damaged by free radicals produced by stress, a diet that is rich in antioxidants may help to counter that harm. A previous study involving the same group of participants found similar brain benefits of olive oil and nuts, but that trial did not follow volunteers over time to measure the change associated with the dietary change.

MORE: Mediterranean Diet Better Than Low-Fat Diet in Keeping Aging Brains Sharp

While these results are promising, Ros says that more work is needed to confirm them; the current study is relatively small and did not find, for example, a strong correlation between the Mediterranean diet and the rate of mild cognitive impairment, a measure of cognitive decline that often precedes conditions like Alzheimer’s. “I think these results contribute to our understanding of healthy aging,” he says. “With a change in lifestyle as simple making some healthy choices in your food, it can make a difference.”

TIME medicine

Hormone Treatments Raise Cancer Risk Even After They’re Stopped

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Estrogen and progestin therapy to treat menopause has led to controversial and confusing recommendations. But in the latest and longest term look at the data, experts say the risks of the hormones may last long after women stop taking them

Researchers admit that when it comes to hormone therapy — estrogen and progestin — to treat the symptoms of menopause for women, they don’t have a lot of consistent or convincing answers. They thought the medications could not only help menopause symptoms but also protect against heart disease, although some studies showed the added hormones could also raise risk of breast cancer. The resulting advice to women seeking answers about whether hormone therapy is for them has been anything but satisfying.

Now the scientists involved in the first large trial of hormone therapy, the Women’s Health Initiative (WHI), have continued to study those women who participated in the 1990s and found some surprising results. Reporting in the journal JAMA Oncology, they say that the risk of breast cancer for women taking the combination of estrogen and progestin remains the same seven to eight years after they stop the drugs than while they were taking them.

MORE: Hormone Replacement Therapy After Menopause: What Women Need to Know

The estrogen helps to maintain levels of that hormone as natural amounts start to drop during menopause, and the progestin protects the uterus from potential tumors arising from excess amounts of estrogen. They also found that for the quarter or so post-menopausal women who have had a hysterectomy, and can take estrogen alone, the hormone can lower their risk of breast cancer.

The WHI was created to study the health effects of hormone therapy on the millions of women taking them. Some small studies had suggested that the hormones could protect women from heart disease; women tend to have heart attacks about a decade or so later than men on average, and researchers believed some of that protection came from estrogen. But doctors were concerned about the known connection between estrogen and breast cancer, since during puberty estrogen contributes to breast tissue growth, and wanted to understand how the benefits for the heart matched up against the risks to the breast, so they enrolled more than 26,600 women aged 50 to 79 years in the WHI.

MORE: Estrogen After Menopause Lowers Breast Cancer Risk for Some Women

They intended to study them until 2005, but in 2002, they stopped the trial when it became clear that there was a group of women experiencing higher heart disease rates. It turned out that these were the women taking hormones, either the combination or estrogen alone.

MORE: The Truth About Hormones

The results completely changed menopause treatment, and led to a precipitous drop in the use of the medications; in the U.S., where about 40% of women turned to the hormones, only 15% did after most experts agreed that they should only be used in the short term, for about a year or so during and just after menopause. The assumption was that the benefits in lowering breast cancer risk would be similar — if women stopped taking the hormones, then their risk would decline.

That seemed to be true, at least for the first year or so after discontinuing the therapy. But in 2013, Dr. Rowan Chlebowski, an oncologist at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, and one of the initial investigators on WHI, reported that the benefit didn’t hold for long. He found that if women who had previously been on estrogen and progestin therapy were studied for more than eight years, their risk of breast cancer started climbing back up, to levels that were on par with when they were taking the medications.

That finding, however, contradicted other results from studies. And to make matters more confusing, the women who had had a hysterectomy, and no longer had a uterus so could take estrogen alone, did not seem to experience the same increased risk of breast cancer. All of this data prompted Chlebowski to do a more detailed analysis of the WHI data on women who agreed to continue to participate years after they stopped taking the hormone therapy.

MORE: Making Sense of Hormone Therapy After Menopause

In the current study, it’s clear that the combination of estrogen and progestin increases breast cancer risk, he says. The drop in risk that occurs immediately after the therapy is stopped is likely due to the changing hormone environment. Any small or emerging tumors that were already present before hormone treatment started may eventually start growing again years later.

For women who have had a hysterectomy, taking estrogen alone does not increase breast cancer risk and may, according to the latest results, even provide some protection against the disease.

“It looks like hormones have longer term lingering effects,” says Chlebowski. “For estrogen and progestin together, we see an increase in risk even years after you stop. But for estrogen alone, it looks like the hormone may be more favorable in reducing breast cancer risk than we thought before. The estrogen alone findings are now quite compelling that we may had to call lit risk reduction.”

The results should stress the importance of defining what menopausal symptoms are, and how much they interfere with women’s daily lives. Most health groups now recommend short term hormone therapy, but it’s clear that the risks of breast cancer remain even after exposure. So doctors and patients need to weigh the relief of symptoms against the unhealthy legacy of taking these medications. “There is a little more risk than we thought with estrogen and progestin,” says Chlebowski. “But it’s always difficult to figure out how to categorize that risk. It’s different for each woman.”

TIME Heart Disease

What Divorce Does to Women’s Heart Health

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Getty Images

When it comes to the fallout from a divorce, one spouse is harmed more by it’s biological and psychological effects on the heart

Dissolving a marriage is hard on everyone, but researchers say the psychological stress of a divorce can have serious physical effects on the heart, especially for women.

Women who divorced at least once were 24% more likely to experience a heart attack compared to women who remained married, and those divorcing two or more times saw their risk jump to 77%. In the study published in the journal Circulation: Cardiovascular Quality and Outcomes, Matthew Dupre of Duke University and his colleagues found that men weren’t at similar risk. Men only saw their heart attack chances go up if they divorced two or more times compared to men who didn’t split with their spouses. If men remarried, their heart risk did not go up, while for women who remarried, their chances of having a heart attack remained slightly higher, at 35%, than that of divorced women.

MORE: Divorce More Likely When Wife Falls Ill

These findings remained strong even after Dupre’s team adjusted for other potential contributors to heart attack, including age, social factors such as changes in occupation and job status and health insurance coverage, and physiological factors including body mass index, hypertension and diabetes. Previous studies have found links between divorce or widowhood and heart disease that were explained, at least in part, by changes in people’s access to health care and their ability to keep up healthy eating and exercise habits.

But these are the first results from tracking people over a longer period of time—18 years—to capture the cumulative effects of changes in marital status, says Dupre. “We looked at lifetime exposure to not only current marital status, but how many times someone has been divorced in the past. What we found was that repeated exposure to divorce put men and women, but particularly women, at higher risk of having a heart attack compared to those who were married.”

MORE: Study: Marriage is Good For The Heart

And it wasn’t simply changes in health insurance coverage or financial status resulting from the divorce that explained the higher heart risk. Even after Dupre’s group accounted for these, the relationship held. While he admits that the trial did not investigate exactly how divorce is seeding more heart attacks, other studies hint at a possible explanation. Dramatic life changes such as divorce, which signal an end to not only a significant relationship but potentially to stable financial and social circumstances as well, can lead to spikes in the stress hormone cortisol, which in turn can push blood pressure, cholesterol and blood sugar to unhealthy heights.

The long term scope of the study revealed the impact that social and life events can have on the physical functioning of the body. “The health consequences of social stresses are real,” says Dupre. For women, the 77% higher risk of heart attack connected to multiple divorces was on par with well-established factors such as hypertension (which boosts risk by 73%) and diabetes (which elevates heart problems by 81%).

MORE: Do Married People Really Live Longer?

That’s doesn’t mean, of course, that women should avoid getting divorced to save their hearts. “Another way to put it is to say that women who are stably married are at an increased advantage of preventing heart attacks than women who may have had to go through transitions where they weren’t,” says Dupre.

It also makes a good case for doctors including discussion about potential stressors, including lifestyle and social circumstances, in their health assessment of patients. Recognizing that divorce may be a life event that can contribute to higher heart attack risk, for example, they can monitor patients experiencing divorce more carefully, and be alert to the first signs of potential problems with cholesterol, blood pressure or blood sugar. “Understanding all of the factors that lead to a physiological response are equally important,” says Dupre. And potentially life saving.

TIME

Shorter People More at Risk From Heart Disease Says Study

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Roy Hsu—Getty Images/Uppercut Short business man standing next to tall man

"If you're 6ft 1in, you still need to stop smoking"

A study of nearly 200,000 men and women found that shorter people have a higher risk of heart disease than their taller counterparts.

Every 2.5 inches up reduce the risk of heart disease by 13.5 percent, according to the study published in the New England Journal of Medicine on Wednesday.

Scientists have long considered there to be a link between height and heart health, but the latest research found that genes controlling height were directly linked to heart disease risks.

To be sure, height is only one of many factors that affect the level of risk.

“In the context of major risk factors this is small – smoking increases the risk by 200-300% – but it is not trivial,” Nilesh Samani, a professor of cardiology at the University of Leicester and lead author of the study, told the BBC News website. “If you’re 6ft 1in, you still need to stop smoking.”

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