Heart attack: Use of amino acid supplement

Use of amino acid supplement following a heart attack provides no benefit, may be harmful

Use of the amino acid supplement L-arginine following a heart attack does not improve certain cardiac functions and measurements and may be associated with an increased risk of death, according to a study in the January 4 issue of JAMA.

L-arginine is a widely available dietary supplement and is publicized as having benefits for patients with hypertension, angina, heart failure and sexual dysfunction, according to background information in the article. Prior studies suggest that L-arginine has the potential to reduce vascular (blood vessel) stiffness.

Steven P. Schulman, M.D., of Johns Hopkins Medical Institutions, Baltimore, and colleagues conducted the Vascular Interaction with Age in Myocardial Infarction (VINTAGE MI) clinical trial to test whether administering L-arginine to patients following a first ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram following a heart attack) over a 6-month period would decrease vascular stiffness and improve ejection fraction (a measure of how much blood the left ventricle of the heart pumps out with each contraction).

The randomized, double-blind, placebo-controlled trial included 153 STEMI patients; 77 were 60 years or older. Participants were enrolled from February 2002 to June 2004. Patients were randomly assigned to receive L-arginine (goal dose of 3 g three times a day) or matching placebo for six months.

The researchers found: "The VINTAGE MI study demonstrated that 6 months of L-arginine added to standard postinfarct medications did not reduce noninvasive measures of vascular stiffness, improve ejection fraction, or improve clinical outcomes. To the contrary, we noted a possible increased risk of death in older patients after infarction while taking L-arginine compared with those taking a placebo, leading to the early termination of the study. These findings have broad public health implications given the increasing availability and use of L-arginine in patients with and without established cardiovascular diseases."

Death occurred in 6 patients (8.6 percent) in the L-arginine group died during the 6-month study period vs. none in the placebo group.

"In conclusion, L-arginine therapy should not be given to patients following a myocardial infarction. It neither alters noninvasive measures of vascular stiffness nor improves left ventricular function. L-arginine therapy in older patients with diffuse atherosclerosis may worsen clinical outcomes," the authors write.

JAMA and Archives Journals

Transcendental Meditation and heart disease

Transcendental Meditation reduce risk factors for heart disease

The Transcendental Meditation (TM) program has been shown to significantly reduce risk factors for heart disease, including hypertension, high cholesterol, anxiety, hostility, and smoking.

In a randomized study published in the journal of the American Heart Association, individuals with mild hypertension experienced significant reductions in systolic and diastolic blood pressure over a 3-month period after learning the TM technique.

These reductions in blood pressure were substantially greater than those experienced by individuals in two control groups-a "usual-care" group that received training in improved diet and exercise and a group practicing muscle relaxation.

The TM technique produced reductions in blood pressure equivalent to those produced by anti-hypertensive drugs but without their adverse side effects.

A related study of health insurance data over a five-year period found that individuals regularly practicing the TM technique required 87% less hospitalization for heart disease than the norm.

Hypertension, 26: 820-827, 1995.
Psychosomatic Medicine 49: 493-507, 1987.

Stroke ischaemic

Stroke caused by blood clots or other obstructions - ischaemic stroke - accounts for 80% of all cases.

A blockage is called a cerebral thrombus or cerebral embolism and can be caused by atherosclerosis - hardening of the arteries.
In both types of stroke - those caused by blood clots and those caused by burst blood vessels - blood supply to the brain is interrupted, depriving the cells of oxygen and other nutrients. The cells are then damaged or die.
Mini-strokes, or transient ischaemic attacks (TIAs), may be a warning sign of an imminent full-blown stroke.

Embolic
In an embolic stroke, a blood clot - or embolus - forms somewhere in the body, usually the heart, and travels through the bloodstream to the brain.
Once in the brain, the clot eventually travels to a blood vessel small enough to block its passage. The clot lodges there, blocking the blood vessel and causing a stroke.

Thrombotic
In the other form of blood-clot stroke, blood flow is impaired because of a blockage to one or more of the arteries supplying blood to the brain - a thrombus.
The process leading to this blockage is known as thrombosis and strokes caused in this way are called thrombotic strokes.
In atrial fibrillation, where the two upper chambers of the heart - the atria - quiver instead of beating properly, blood is not properly pumped out of the heart. As a result it may form clots and if the clot becomes lodged in an artery in the brain, a stroke may result.
The American Heart Association says arond 15% of strokes are caused in this way.
Blood clot strokes can also happen as the result of unhealthy blood vessels clogged with a build up of fatty deposits and cholesterol.
The body regards these build ups as multiple, tiny and repeated injuries to the blood vessel wall and reacts as it would to bleeding from a wound, by forming clots.

The symptoms of stroke:
1. Sudden numbness or weakness of the face, arm or leg, particularly if it is on one side of the body
2. Sudden confusion, trouble speaking or understanding. Sudden difficulty with walking, dizziness, loss of balance or co-ordination
3. Sudden trouble seeing in one or both eyes
4. Sudden severe headache with no known cause

Anyone identifying themselves or friends or family as having a stroke should call emergency services, not a GP, as any delay reduces the chance of a full recovery.
The speed of treatment after a stroke is extremely important as the longer the brain cells are deprived of oxygen, the more damage they will suffer.

Treatment
Clot-busting drugs can be used in the first minutes or hours - up to a maximum of three hours - after an ischaemic stroke to dissolve the clot.
After this time aspirin, which is not as powerful, may be given.
Survival rates are better for patients in specialist stroke units, because of the expert nature of staff and early use of rehabilitation, but such units are not always available. Rehabilitation programmes will be given to most stroke patients to help them recover lost mobility and speech.

http://news.bbc.co.uk

10 ways for the health of your heart

10 ways to take control of your heart health
Take action!

1. Exercise. Make exercise a regular part of your life. Each day, enjoy at least 30 minutes of physical activity that raises your heart beat. Recommended activities include brisk walking, gardening, dancing and such sports as tennis and basketball.

2. Drink lots of water - at least six glasses per day.

3. Eat healthfully. Eat plenty of fresh fruit and vegetables as well as a variety of whole grains.

4. Watch your cholesterol. Choose foods containing unsaturated or monosaturated fats. Avoid foods containing saturated fats, trans fats and cholesterol. Eat fewer fried foods. Eat lean meat and fish.

5. Reduce your salt intake. It can help to reduce your blood pressure.

6. Stop smoking. Tobacco smoking is a major risk factor for cardiovascular disease.

7. Maintain a healthy weight. By avoiding obesity and overweight, you’ll reduce your risk of heart disease, stroke and diabetes.

8. Stay on track. If you miss some exercise or eat an unhealthful meal, just get back on track!

9. Monitor your progress. Keep track of your achievements and reward yourself each time you reach a goal.

10. Check up. Ask your healthcare provider to test your blood pressure, cholesterol and glucose levels. Let him or her help you get them where they need to be.

Cardiovascular disease: Eating less salt

Eating less salt can cut cardiovascular disease risk by a quarter and fatal heart disease by a fifth, work shows

The ideal daily intake of salt is no more than six grams and ministers want everyone to achieve this by 2010.
Experts already know that too much salt can raise blood pressure and high blood pressure increases the risk of heart attack and stroke. The British Medical Journal study now gives the evidence behind this link and quantifies how much harm salt can do.

People who significantly cut back on the amount of salt in their diet reduced their chances of developing cardiovascular disease by 25% over the following 10 to 15 years. And their risk of dying from cardiovascular disease went down by 20%.
All of the 3,126 people studied by the US team from Boston had had high-normal blood pressure, or "pre-hypertension". In the trials, participants reduced their salt (sodium) intake by about 25% - 35%, from about 10g to around 7g.
And those who cut back tended to stick to a lower salt diet in the long term, the researchers from Brigham and Women's Hospital found.
Professor Graham MacGregor, a consultant in cardiovascular medicine at London's St George's hospital and chairman of the Consensus Action Group on Salt, said: "This is a very important study. "It shows that if people reduce their salt intake it will reduce the number of people suffering from heart attacks, strokes and heart failure. We did not have that type of evidence before.

"And we are only talking about quite small reductions in salt intake to have a big effect on risk."
Three-quarters of the salt we eat is already in the food we buy. The average daily consumption in the UK is 9g.
Professor MacGregor said the 6g target was achievable for most people if they were careful about the food they chose to eat. He said the onus was on food manufacturers to limit the amount of salt in products.
Sodium is usually listed in the nutritional information on food labels, and multiplying this value by 2.5 will give the salt content.
The Food Standards Agency said it would continue its work in encouraging industry to offer consumers healthier choices.
Ellen Mason, cardiac nurse at the British Heart Foundation, advised: "By simply checking the labels and switching to a lower salt option, you'll be doing your heart a favour."
The Salt Manufacturers Association said the evidence did not prove that salt reduction would have any significant health benefits for the majority of people. It conceded that individuals with high blood pressure might be advised to restrict their intake.

RECOMMENDED SALT LIMITS

1 to 3 years - 2 g salt a day (0.8g sodium)
4 to 6 years - 3g salt a day (1.2g sodium)
7 to 10 years - 5g salt a day (2g sodium)
11 and over - 6g salt a day (2.5g sodium)

Source: Food Standards Agency

http://news.bbc.co.uk/2/hi/health/6570933.stm