TIME Research

Having Good Neighbors Could Reduce Heart Attacks in the Over-50s

Medical Check-up
A patient has a medical check-up in Lille's Institut Pasteur (IPL) in France. BSIP/UIG—Getty Images

A study finds that participants who rate their communities the highest have an almost 70% reduced risk of heart attack

A new study by researchers from the University of Michigan appears to suggest that close community ties reduce heart-attack risk for people over 50.

Researchers say previous data shows that some aspects of a person’s neighborhood — such as the amount of violence and the prevalence of fast-food restaurants — can elevate heart-attack risk, but this is the first study that reveals the cardiovascular benefits of “neighborhood social cohesion,” reports AFP.

The research, which was published in the Journal of Epidemiology and Community Health on Tuesday, monitored the cardiovascular health of 5,276 participants who were over the age of 50 and had never had a heart attack.

The participants, who were mostly married women with an average age of 70, were involved in an ongoing Health and Retirement Study in the U.S. Beginning in 2006, participants were asked to rate, on a seven-point scale, whether their neighbors were trustworthy, reliable and friendly, and if they felt connected to their community. During the study, 148 of the participants had a heart attack.

Although data was adjusted to account for variables such as age, race and income, the four-year study revealed that every mark-up in neighborhood cohesion on the scale led to a 17% reduction in the odds of heart disease, according to the Health Medicine Network. The study’s co-author Eric Kim told AFP that those who gave a full score out of seven had a 67% reduced risk of heart attack.

Researchers admitted, however, that the study had limitations, like a lack of access to the participants’ family histories of cardiovascular disease. “This is an observational study, so no definitive conclusions can be drawn about cause and effect,” researchers emphasized.

MONEY

6 Surprising Reasons Eating Right Pays Off

French Fry Packaging with rolled up dollar bills
Saying no to the fries is a smart money choice. Mike Kemp—Getty Images

You know a better diet will make you fitter and healthier. What you may not realize is that replacing fries with a salad can help your finances too.

Eating healthy can make you look and feel better, but it can also be great for your wallet. Whether by reducing medical costs or helping you earn more, a healthy diet has benefits beyond a slimmer waistline. Consider these ways your diet can improve your finances:

1. You’ll Lower the Likelihood of Needing to Take a Sick Day

Fruits and vegetables contain vitamins and minerals that help boost your immune system so it can better fight off viruses and bacterial infections. Staying healthy during flu season means you can go to work and get that paycheck (or promotion), and you won’t have to spend money on meds and extra doctor’s visits.

Not only does consuming a lot of produce increase your immunity in the short term, but it also helps prevent disease in the long run. Notably, eating more vegetables reduces the risk of heart disease, which afflicts about a third of all adults and costs about $444 billion a year to treat in the U.S., according to the Centers for Disease Control and Prevention.

2. You Can Stay More Productive

Not much is better for your finances than making more money, and one way to do that is to work harder. According to 2012 research conducted at Brigham Young University, eating healthy can help you do that. The researchers evaluated 19,800 employees at three large companies and found that eating well every day may lower your risk of productivity loss by 66%. They also found that exercise lowered the risk of lost productivity by 50%, and getting five fruit and vegetable servings lowered the risk by 39%. (Other research has found that frequent exercise is connected to higher pay.)

3. You Can Take Fewer Pills

Disease costs a lot of money in terms of doctor’s visits, procedures, surgeries, and medical devices, but a large chunk of medical spending goes toward prescriptions that could be discontinued. In fact, three of the top five most commonly prescribed medications in the U.S. are for preventable heart conditions, adding up to more than 160 million scripts per year. Keeping your heart healthy and your weight down through diet will help reduce the need for these medications and the monthly expense that goes along with them.

4. You’ll Steer Clear of Complications

When you’re unhealthy or obese, you’re more likely to have complications with an existing condition. For example, obesity decreases lung performance and is thought to exacerbate asthma symptoms. But foods rich in antioxidants and omega-3 fatty acids can increase lung performance. In addition, high blood pressure and diabetes can complicate your pregnancy, according to the CDC, and those costs can add up. Eating a healthy diet and keeping a normal body weight can help you avoid these problems.

5. You’ll Age Better

When most people think of retirement planning, they think of 401(k)s and IRAs. That’s a great start, but if there’s anything that can deplete your retirement funds, it’s unplanned medical costs. Studies conducted over the past 20 years show that plant-based and Mediterranean diets increase longevity and health, helping you work longer (if you want), save more toward retirement, and hopefully spend less on health care later.

More recently, researchers in Rome and the Washington University School of Medicine jointly published a paper that concluded that calorie restriction may be the best way to prevent disease and lengthen lifespan—even for people at a normal weight. The paper, published in 2011, took into account studies on rodents and humans. More human studies are needed, but the paper provided a basis for in-depth trials to come.

6. Your Insurer May Reward You

Employers and insurers are doing what they can to get you to eat right and work out (and need less high-cost medical care). That can mean discounts on the food you should be eating. The health-care network Harvard Pilgrim rewards workers for buying healthy food (up to $20 a month) and recently announced that it would roll out the program to other employers. Blue Cross Blue Shield offers Jenny Craig discounts, and Humana gives members a 10% discount on healthy groceries purchased at Wal-Mart.

Read more from NerdWallet Health, a website that empowers consumers to find high quality, affordable health care, and insurance.

 

TIME Aging

Gains in Life Expectancy in the U.S. May Be Slipping

Nearly four in five Americans over age 67 have multiple chronic medical conditions

The more chronic medical conditions you have, the shorter your life will be, say researchers from Johns Hopkins Bloomberg School of Public Health.

In the study, published in the journal Medical Care, the team found that nearly four in five Americans over the age of 67 have multiple chronic conditions such as heart disease, hypertension and diabetes.

Obesity may be driving much of this trend, and may responsible for slowing recent gains in life expectancy. Life expectancy has been growing at about .1 years per year in the U.S., (that’s slower than rates in other developed countries).

The study used the Medicare 5 percent sample, a nationally representative group of 1.4 million Medicare beneficiaries, which included data on 21 chronic conditions. On average, life expectancy decreased by 1.8 years with each additional chronic condition among older Americans.

“When you’re getting sicker and sicker, the body’s ability to handle illness deteriorates and that compounds,” says senior study author Gerard Anderson, a professor in the Department of Health Policy and Management at Johns Hopkins. “Once you have multiple conditions, your life expectancy becomes much shorter.”

For example, he says, a 75-year-old woman with no chronic medical conditions would likely live to at least 92 years old, or another 17.3 years. However, a 75-year-old woman with five chronic conditions will likely only live another 12 more years, and a woman of the same age with 10 chronic conditions would only live to about 80 years old. According to the data, women fare better than men and white people live longer than black people even with the burden of additional health conditions.

The type of chronic disease older people develop also seems to affect their life expectancy. A 67-year-old diagnosed with Alzheimer’s will only live an additional 12 years, while someone with a heart condition can expect another 21.2 years. But once people develop more than one chronic condition, the specific illnesses no longer matter.

“There are interaction effects among the diseases that result in decreases in life expectancy. Any condition on its own has a particular effect. When you have heart disease plus cancer, that has a particular affect, and then those start to accumulate,” says lead study author Eva DuGoff.

The findings may be important for calculating health costs in coming years, especially for Social Security and Medicare programs. Currently, 60% of people over age 67 have three chronic medical conditions that require medical care — a significant increase from previous years when individuals didn’t live long with chronic conditions.

“In some ways we’re a victim of our own success. As we’re living longer and our health system has gotten better, no longer are people dying of heart disease at age 50 so now they’re dying of heart disease later when they have other things like cancer as well,” says DuGoff. Whatever gains improved health care has provided may be eroded by the effect of these accumulating chronic conditions. “We need to reorient our healthcare system to care for chronic conditions. If we don’t reorientate ourselves in that way, the impact of chronic conditions on life expectancy could be extremely negative.”

TIME Heart Disease

Mississippi Men Learn About Heart Disease — At the Barber

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John Sigler—Getty Images

Barbershops may be the new doctor's office, at least in Mississippi where African American men are learning about high blood pressure...while they get their hair cut

Barber shops and hair salons are great community hubs where residents gather for both grooming and gossip. So public health experts in the Mississippi Delta have decided to exploit these social meccas to connect with groups that don’t often see health care providers, including African American men.

Heart disease and stroke, for example, disproportionately affect this population of men, partly due to genetics, and partly due to lifestyle behaviors. But in places like the Mississippi Delta region, these men also do not get regular heart disease screenings. They do, however, go to barbershops for trims and to catch up on community news. So the Centers for Disease Control and Prevention (CDC) is funding a barbershop initiative called Brothers (Barbers Reaching Out to Help Educate Routine Screenings) located throughout the Mississippi Delta, where heart disease and stroke are the second and fourth leading causes of death in black men.

The Mississippi Department of Health spent a year recruiting and training barber shop workers on how to read a blood pressure screening, and discuss risk factors. During appointments, barbers talk to their clients about heart health, take their blood pressure, and refer them to a physician if they need further counseling. Recruitment was, and continues to be a challenge since some of the barbers were on board with the benefits of educating their clients, but worried about whether the program would hurt their business.

So far, thought, the barbers are being pretty persuasive. The project, which involves 14 barbershops that have so far served 686 men, just released its first set of data. Only 35% of the customers said that they had a doctor and 57% did not have health insurance. Among the men who received blood pressure readings, 48.5% had prehypertension, and 36.4% had high blood pressure. The findings, published in the journal Preventing Chronic Disease, shows that the program provides care to men who need it, as well as gives public health care workers a better idea of how prevalent heart disease is in the region, and how many patients are in need of medical care. The next step for the researchers is to create a community health worker network that could introduce these men to the health care system and help them navigate more regular screenings and better treatment of their condition.

Shifting health care from the clinic to the community isn’t a new idea; in some areas, health screenings and education are conducted in churches. But the faithful are a select group, and the study’s lead author says it’s important to bring services to hard-to-reach populations, such as young black men, to where they are. “We realized in our standard community health screenings–which were happening in churches–that we were not reaching adult black men,” says lead study author Vincent Mendy, an epidemiologist at the Mississippi State Department of Health. “We think the best way to reach them is through barbershops.” The program is part of a partnership between the CDC and the Mississippi State Department of Health, and is funded through September 2015.

Mendy is hopeful that the program will reach more men and bring them into treatment, since a similar 2011 initiative in Texas, funded by the National Institutes of Health, found that barbers helped to lower blood pressure in a population of African American men by 20%. Based on this growing body of research, the CDC is considering relying on community health workers to help improve the health of minority groups that have a disproportionate risk of disease and death in the U.S. — but are often outside of the health care system. Barbershops aren’t clinics, but they do seem to be a good place to get health messages across.

TIME sexual abuse

Childhood Sexual Abuse Raises Heart Disease Risk In Adulthood

Researchers link early sexual abuse to greater risk of developing blocked heart arteries

Sexual and physical abuse during childhood can have long term effects on both mental and physical health, and previous studies have linked childhood sexual abuse to a greater risk of heart attack and other heart events—but it has been unclear exactly why. New research published Thursday in the journal Stroke adds to the case, showing thatwhether or not women had other risk factors for heart problems, a history of childhood sexual abuse remained a strong potential contributor to their atherosclerosis.

“What was a surprise was that when we controlled for [heart disease] risk factors, such as smoking and obesity, the association didn’t go away. We just couldn’t get rid of the association,” says Rebecca Thurston, director of the Womens’ Biobehavioral Health Laboratory at the University of Pittsburgh, who led the research with a team of colleagues.

MORE: Viewpoint: Why a Mandatory Child Abuse Reporting Law Could Backfire

More than 1,000 middle-aged women of various ethnic backgrounds from across the U.S. had yearly clinical exams beginning in 1996 for 12 years. At the end of the study, they also answered questions about sexual and physical abuse and had an ultrasound of their carotid arteries. About a quarter of the women reported being sexually abused as a child, and a similar percentage reported the experience as an adult.

When Thurston compared the women’s answers to their ultrasound, she found that those who reported childhood sexual abuse showed higher rates of plaque buildup in their arteries. They also had hearts and vessels that looked about two to three years older than those of women who hadn’t been abused.

MORE: Psychological Abuse: More Common, as Harmful as Other Child Maltreatment

Thurston’s findings suggest that whether or not the women had other risk factors for heart problems, their history of childhood sexual abuse remained a strong potential contributor to their atherosclerosis.

Thurston plans to continue the work by studying women who have had heart events – in this study, only women without heart disease were included – to see if the correlation still holds. She also wants to better understand how the early abuse affects women in later life. There is some evidence that traumatic experiences may change the stress response system in lasting, and possibly permanent ways.

While none of the women had signs of heart disease at the start of the study, Thurston says the results hint that physicians should be considering childhood experience, particularly traumatic ones, as part of comprehensive heart care for women. If the results are validated, then they might lead to ways of intervening with stress reduction or other psychological techniques to hopefully slow down the hardening of the arteries and lower their risk of heart disease.

TIME Heart Disease

A Common Cholesterol Drug’s Safety Is In Question

New studies suggest Niacin doesn't help, but harms users

Two new studies suggest significant dangers from the common cholesterol drug niacin, and some doctors say the risks are not worth it.

One of the studies published in New England Journal of Medicine looked at extended-release niacin, and the other study looked at the combination of extended-release niacin and another drug, laropiprant, that makes it more effective. Neither found significant benefits, and both found high risk for adverse side effects in the gastrointestinal and musculoskeletal systems like bleeding, diarrhea and even gout. The niacin-laropiprant study found a 9% increase in death risk.

In a corresponding editorial, “Niacin and HDL Cholesterol — Time to Face Facts,” Dr. Donald Lloyd-Jones of Northwestern University in Chicago writes, “on the basis of the weight of available evidence showing net clinical harm, niacin must be considered to have an unacceptable toxicity profile for the majority of patients, and it should not be used routinely.” He notes that niacin may still have a role for patients at a very high risk for cardiovascular disease who do not tolerate statins.

It’s been thought in the past that niacin, a type of B vitamin, are a viable alternative or complement to statins. But the NEJM studies show that not only does niacin not work as well as statins, but it has some serious side effects. The researchers found that people taking niacin had about the same rates of disease as people on placebos, suggesting that the drug is not as effective as it’s thought to be.

Though many people will likely remain on niacin, members of the medical community caution people on the drugs, warning they should talk to their doctors about whether or not they should continue.

TIME Obesity

The Question of Healthy Obesity Continues

Is the obesity paradox real?

In a new review published in the journal Mayo Clinic Proceedings, researchers looked at 36 studies and found that among people with coronary artery disease, those with a high BMI had the lowest cardiovascular mortality risk compared to people with a normal weight.

The researchers say it’s further evidence of an obesity paradox, where being overweight or obese actually protects people from heart-related death.

Now, there are a few things to point out before we accept headlines like “Yes, Healthy Obesity Exists.” For one, the study population already had heart disease, and being obese puts people at a greater risk for heart-related ailments like stroke and high blood pressure. Second, it’s possible that the reasons the obese people had better outcomes was because they are more likely to be prescribed heart medications like statins compared to the normal population. It’s also possible that there is some sort of protective benefit from body fat that makes obese people less likely to have the worst effects from heart disease.

But doctors are not quick to conclude that being obese can protect your health. After all, the new study was looking at people who were already sick. But many in the medical community will agree that there are other factors critical to health that have nothing to do with the number on the scale, and that ultimately, concentrating on a person’s lifestyle behaviors over their size is a good strategy.

Read more of our coverage on the obesity paradox here.

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