Elderly men with high blood pressure lower death risk with moderate fitness

Elderly men with high blood pressure can lower their risk of death with even moderate levels of fitness, according to new research in the American Heart Association's journal Hypertension.

"This level of fitness is achievable by most elderly individuals engaging in a brisk walk of 20 to 40 minutes, most days of the week," said Charles Faselis, M.D., lead author of the study and chief and professor of medicine at George Washington University in Washington, D.C.

For the study, researchers assessed the fitness status of 2,153 men, aged 70 years and older with high blood pressure by a standard treadmill exercise test. Researchers applied the international units used to measure fitness, called metabolic equivalents (METs), to determine the men's peak fitness levels. A MET is equal to the amount of oxygen the body uses per kilogram of body weight per minute. One MET is the amount of energy expended at rest; anything above that represents work.

Researchers categorized the men as very low fitness, low fitness, moderate fitness, and high fitness.

"To put this in perspective, the peak MET level of a sedentary 50-year-old is about five to six METs," said Peter Kokkinos, Ph.D., senior author and professor at Veterans Affairs Medical Center, Georgetown University School of Medicine and George Washington University School of Medicine and Health Sciences.

"For a moderately fit individual, it's about seven to nine METS, and for a highly fit person, it's 10 to 12 METs. Still, marathon runners, cyclists and other long distance athletes often have MET levels of 20 or higher."

After an average follow-up of nine years, researchers found that the risk of death was 11 percent lower for every one-MET increase in exercise capacity.

"Although this does not sound like a big drop in the death rate, the impact of it is revealed when we compared low-, moderate- and high-fit individuals to the least fit, who achieved less or equal to four METs," Kokkinos said.

Compared to least-fit men (up to 4 peak METs):

    * Those in the low-fit category (4.1 to 6 peak METs) had an 18 percent lower risk of death.

    * Moderately-fit men (6.1 to 8 peak METs) had a 36 percent lower risk of death.

    * High-fit men with peak METs of more than 8 reduced the risk of death by 48 percent.

"For every 100 people who died in the least-fit category, 82 died in the low-fit, 64 in the moderate-fit and 52 in the high-fit categories," Kokkinos said. "The death rate is cut in half for those in the highest fitness category."

Resveratrol in red wine, chocolate, grapes not associated with improved health

A study of Italians who consume a diet rich in resveratrol — the compound found in red wine, dark chocolate and berries — finds they live no longer than and are just as likely to develop cardiovascular disease or cancer as those who eat or drink smaller amounts of the antioxidant.

"The story of resveratrol turns out to be another case where you get a lot of hype about health benefits that doesn't stand the test of time," says Richard D. Semba, M.D., M.P.H., a professor of ophthalmology at the Johns Hopkins University School of Medicine and leader of the study described May 12 in JAMA Internal Medicine. "The thinking was that certain foods are good for you because they contain resveratrol. We didn't find that at all."

Despite the negative results, Semba says, studies have shown that consumption of red wine, dark chocolate and berries does reduce inflammation in some people and still appears to protect the heart. "It's just that the benefits, if they are there, must come from other polyphenols or substances found in those foodstuffs," he says. "These are complex foods, and all we really know from our study is that the benefits are probably not due to resveratrol."

The new study did not include people taking resveratrol supplements, though few studies thus far have found benefits associated with them.

Semba is part of an international team of researchers that for 15 years has studied the effects of aging in a group of people who live in the Chianti region of Italy. For the current study, the researchers analyzed 24 hours of urine samples from 783 people over the age of 65 for metabolites of resveratrol. After accounting for such factors as age and gender, the people with the highest concentration of resveratrol metabolites were no less likely to have died of any cause than those with no resveratrol found in their urine. The concentration of resveratrol was not associated with inflammatory markers, cardiovascular disease or cancer rates.

Semba and his colleagues used advanced mass spectrometry to analyze the urine samples.

The study participants make up a random group of people living in Tuscany where supplement use is uncommon and consumption of red wine — a specialty of the region — is the norm. The study participants were not on any prescribed diet.

Resveratrol is also found in relatively large amounts in grapes, peanuts and certain Asiatic plant roots. Excitement over its health benefits followed studies documenting anti-inflammatory effects in lower organisms and increased lifespan in mice fed a high-calorie diet rich in the compound.

The so-called "French paradox," in which a low incidence of coronary heart disease occurs in the presence of a high dietary intake of cholesterol and saturated fat in France, has been attributed to the regular consumption of resveratrol and other polyphenols found in red wine.

 

Background: The "French Paradox" of a low incidence of coronary heart disease despite a diet high in cholesterol and saturated fat in France has been attributed to the regular intake of red wine, in particular, to resveratrol and other polyphenols contained in wine. Some preliminary evidence also suggests that resveratrol may have anti-inflammatory effects, prevent cancer, and decrease blood vessel stiffness.

How the Study Was Conducted: The participants (a sample of 783 men and women 65 years or older) were part of the Aging in the Chianti Region study from 1998 to 2009 in two Italian villages. The authors sought to determine if resveratrol levels achieved through diet were associated with inflammation, cancer, cardiovascular disease, and death. Levels were measured using 24 hour urine collections to look for breakdown products of resveratrol.

Results: During nine years of follow-up, 268 participants (34.3 percent) died; of the 639 participants free of cardiovascular disease at enrollment, 174 (27.2 percent) developed cardiovascular disease during the follow-up; and of the 734 participants who were free of cancer at enrollment, 34 (4.6 percent) developed cancer during the follow-up. Urine resveratrol metabolite levels were not associated with death, inflammation, cardiovascular disease or cancer.

Discussion: "In conclusion, this prospective study of nearly 800 older community-dwelling adults shows no association between urinary resveratrol metabolites and longevity. This study suggests that dietary resveratrol from Western diets in community-dwelling older adults does not have a substantial influence on inflammation, cardiovascular disease, cancer, or longevity."

Having a Sense of Purpose May Add Years to Your Life

Feeling that you have a sense of purpose in life may help you live longer, no matter what your age, according to research published in Psychological Science, a journal of the Association for Psychological Science.

The research has clear implications for promoting positive aging and adult development, says lead researcher Patrick Hill of Carleton University in Canada:

“Our findings point to the fact that finding a direction for life, and setting overarching goals for what you want to achieve can help you actually live longer, regardless of when you find your purpose,” says Hill. “So the earlier someone comes to a direction for life, the earlier these protective effects may be able to occur.”

This is an image of a sunrise over a road in the countryside.Previous studies have suggested that finding a purpose in life lowers risk of mortality above and beyond other factors that are known to predict longevity.

But, Hill points out, almost no research examined whether the benefits of purpose vary over time, such as across different developmental periods or after important life transitions.

Hill and colleague Nicholas Turiano of the University of Rochester Medical Center decided to explore this question, taking advantage of the nationally representative data available from the Midlife in the United States (MIDUS) study.

The researchers looked at data from over 6000 participants, focusing on their self-reported purpose in life (e.g., “Some people wander aimlessly through life, but I am not one of them”) and other psychosocial variables that gauged their positive relations with others and their experience of positive and negative emotions.

Over the 14-year follow-up period represented in the MIDUS data, 569 of the participants had died (about 9% of the sample). Those who had died had reported lower purpose in life and fewer positive relations than did survivors.

Greater purpose in life consistently predicted lower mortality risk across the lifespan, showing the same benefit for younger, middle-aged, and older participants across the follow-up period.

This consistency came as a surprise to the researchers:

“There are a lot of reasons to believe that being purposeful might help protect older adults more so than younger ones,” says Hill. “For instance, adults might need a sense of direction more, after they have left the workplace and lost that source for organizing their daily events. In addition, older adults are more likely to face mortality risks than younger adults.”

“To show that purpose predicts longer lives for younger and older adults alike is pretty interesting, and underscores the power of the construct,” he explains.

Purpose had similar benefits for adults regardless of retirement status, a known mortality risk factor. And the longevity benefits of purpose in life held even after other indicators of psychological well-being, such as positive relations and positive emotions, were taken into account.

“These findings suggest that there’s something unique about finding a purpose that seems to be leading to greater longevity,” says Hill.

The researchers are currently investigating whether having a purpose might lead people to adopt healthier lifestyles, thereby boosting longevity.

Hill and Turiano are also interested in examining whether their findings hold for outcomes other than mortality.

“In so doing, we can better understand the value of finding a purpose throughout the lifespan, and whether it provides different benefits for different people,” Hill concludes.

Frequent arguments may boost the risk of death from any cause in middle age

 

Frequent arguments with partners, relatives, or neighbours may boost the risk of death from any cause in middle age, suggests research published online in the Journal of Epidemiology & Community Health. 

 

Men and those not in work seemed to be the most vulnerable, the findings indicate.

 

The evidence suggests that supportive social networks and strong relationships are good for general health and wellbeing, but the authors wanted to find out if the stressors inherent in family relationships and friendships had any impact on the risk of death from any cause.

 

They therefore quizzed almost 10,000 men and women aged 36 to 52 about their everyday social relationships. All the participants were already taking part in the Danish Longitudinal Study on Work, Unemployment and Health.

 

The researchers focused particularly on who, among partners, children, other relatives, friends and neighbours, made excess demands, prompted worries, or was a source of conflict, and how often these arose. They also considered whether having a job made any difference.

 

The health of the study participants was tracked from 2000 to the end of 2011, using data from the Danish Cause of Death Registry.

 

Between 2000 and 2011, 196 women (4%) and 226 men (6%) died. Almost half the deaths were from cancer, while heart disease/stroke, liver disease, and accidents and suicide made up the rest.

 

Around one in 10 study participants said that their partner or children were a frequent or constant source of excess demands and worries; around one in 20 (6%) and a further 2% claimed this for relatives and friends, respectively.

 

Similarly, 6% had frequent arguments with their partner or children, 2% with other relatives, and 1% with friends or neighbours.

 

After taking account of a range of influential factors, including gender, marital status, long term conditions, depressive symptoms, available emotional support, and social class, as defined by job title, the analysis indicated that frequent worries or demands generated by partners and/or children were linked to a 50%-100% increased risk of death from all causes.

 

But constant arguing seemed to be the most harmful for health. 

 

Frequent arguments/conflicts with anyone in the social circle - ranging from partners and relatives to friends and neighbours - were associated with a doubling to tripling in the risk of death from any cause compared with participants who said these incidents were rare.

 

Being out of work seemed to amplify the negative impact of social relationship stressors. Those who were unemployed were at significantly greater risk of death from any cause than those who were exposed to similar stressors but had a job.

 

And men seemed to be particularly vulnerable to the worries and demands generated by their female partners, with a higher risk of death than that normally associated with being a man or with this particular relationship stressor.

 

The authors accept that personality may have a role in how people perceive, generate, and respond to stress, and so may influence an individual’s risk of an early death.

 

But they conclude that skills in conflict management may help to curb premature deaths associated with social relationship stressors.

 

Click here for full study.

Fruits and Veggies May Lower Stroke Risk

Regularly eating fruits and vegetables may reduce your stroke risk, according to a new review of worldwide research.

Stroke risk declined by 32 percent for every 200 grams of fruit consumed each day, and by 11 percent for every 200 grams of daily vegetables, according to the findings published in the journal Stroke.

"Improving diet and lifestyle is critical for heart and stroke risk reduction in the general population," senior study author Dr. Yan Qu, director of the intensive care unit at Qingdao Municipal Hospital in China, said in a news release provided by the American Heart Association.

"In particular, a diet rich in fruits and vegetables is highly recommended because it meets micronutrient and macronutrient and fiber requirements without adding substantially to overall energy requirements," Qu added.

Stroke is the fourth leading cause of death in the United States and a major cause of disability. In China, stroke is the leading cause of death.

Boosting people's consumption of fruits and vegetables up to 600 grams a day could cut the rate of ischemic stroke (caused by a blood clot) by 19 percent worldwide, according to the World Health Organization.

Investigators analyzed 20 studies over the last 19 years that included more than 760,00 people and were conducted in the United States, Asia and Europe.

The lower risk was seen in strokes caused by a blood clot (ischemic) or bleeding (hemorrhagic) and was consistent among men and women and people of different ages.

Because of the way the study was designed, it can't show that fruits and vegetables are the cause of the decline in strokes, only that there is an association between frequent produce consumption and a lower risk of stroke.

Eating plenty of fruits and vegetables has also been linked to lower blood pressure, improved blood vessel function, as well as beneficial effects on body fat, waist size, cholesterol and inflammation, according to the review authors.

Exercise Crucial for Women's Heart Health After 30, Study Finds

Staying physically active is far more likely to determine a woman's future risk of heart disease than any other well-known factor, including smoking, obesity and high blood pressure, a new study reports.

Looking across the lifespan of Australian women using data on more than 32,000 of them, University of Queensland researchers found that physical inactivity served as the leading risk factor for heart disease at every age from the early 30s to late 80s.

"We have to get everyone to move more," said lead author Wendy Brown, director of the university's Center for Research on Exercise, Physical Activity and Health. "From about age 30, physical activity levels decline. We need to do everything we can to prevent this."

Even though this study was conducted in Australia, American women should figure that physical inactivity will affect their risk of heart disease in much the same way, said Dr. Michael Scott Emery, co-chair of the American College of Cardiology's Sports and Exercise Cardiology Council.

"They're both very developed countries, and developed countries tend to have the same general themes of health issues," said Emery, a cardiologist in Greenville, S.C.

The study measured the top four risk factors for heart disease in Australia -- excess weight, smoking, high blood pressure and physical inactivity. Together, the factors account for more than half the heart disease across the globe, the researchers said in background information.

The researchers used data drawn from more than 32,000 participants in the Australian Longitudinal Study on Women's Health. Since 1996, this study has been keeping tabs on the long-term health of women born during specific generational periods, including 1921 to 1926, 1946 to 1951, and 1973 to 1978.

They analyzed how the women's health would improve if each specific risk factor vanished -- for example, if no one ever smoked or everyone had an ideal body weight.

Younger women were more likely to smoke, they found, which drove heart disease risk up by 59 percent and made smoking the most important contributor to heart disease among the youngest adults.

But smoking rates fell from 28 percent in women between the ages of 22 and 27 to 5 percent in women 73 to 78 years old, while physical inactivity and high blood pressure increased steadily across all women's lifespans from ages 22 to 90.

In findings published May 8, 2014 in the online British Journal of Sports Medicine, the researchers concluded that from age 30 until the late 80s, low physical activity levels were responsible for higher levels of heart disease risk than any other risk factor. Remaining inactive raised women's risk of heart disease an average of 33 percent for middle-aged women and 24 percent for older women, they determined.

If every woman between the ages of 30 and 90 were able to reach the recommended weekly exercise quota -- 150 minutes of at least moderate-intensity physical activity -- then the lives of more than 2,000 middle-aged and older women could be saved each year in Australia alone, the researchers concluded.

That recommended weekly exercise quota is the same for both the United States and Australia.

Brown noted that the type of exercise doesn't necessarily matter, as long as a woman becomes more physically active.

"Aerobic exercise and activity is very important for cardiovascular and metabolic health, and strength training is very important for musculoskeletal health that maintains the ability to conduct activities of daily living in older age," she said. "So both are important."

Physical activity tends to play a key role in heart health because it affects so many other risk factors, said Dr. Nieca Goldberg, a cardiologist and medical director of the Women's Heart Program at NYU Langone Medical Center in New York City. For example, exercise helps lower blood pressure, reduce body fat and improve blood sugar levels.

"If you want to do one thing to prevent heart disease, you should exercise," Goldberg added. "We need people to become more active again, and the way you can do that is to make it part of your life, like brushing your teeth."

Shorter Men Live Longer

Short height and long life have a direct connection in Japanese men, according to new research based on the Kuakini Honolulu Heart Program (HHP) and the Kuakini Honolulu-Asia Aging Study (HAAS).

"We split people into two groups – those that were 5-foot-2 and shorter, and 5-4 and taller," said Dr. Bradley Willcox, one of the investigators for the study and a Professor in the University of Hawai`i (UH) John A. Burns School of Medicine's Department of Geriatric Medicine. "The folks that were 5-2 and shorter lived the longest. The range was seen all the way across from being 5-foot tall to 6-foot tall. The taller you got, the shorter you lived."

Researchers at the Kuakini Medical Center, the UH John A. Burns School of Medicine and U.S. Veterans Affairs worked on the study, which was recently published in PLOS ONE, a peer-reviewed medical journal.

The researchers showed that shorter men were more likely to have a protective form of the longevity gene, FOXO3, leading to smaller body size during early development and a longer lifespan. Shorter men were also more likely to have lower blood insulin levels and less cancer.

"This study shows for the first time, that body size is linked to this gene," said Dr. Willcox. "We knew that in animal models of aging. We did not know that in humans. We have the same or a slightly different version in mice, roundworms, flies, even yeast has a version of this gene, and it's important in longevity across all these species."

Dr. Willcox noted that there is no specific height or age range that should be targeted as a cut-off in the study, in part because "no matter how tall you are, you can still live a healthy lifestyle" to offset having a typical FOXO3 genotype rather than the longevity-enhancing form of the FOXO3 gene.

The Kuakini HHP started in 1965 with 8,006 American men of Japanese ancestry born between the years 1900 and 1919. The lifestyles and health conditions of these men were closely followed and studied by the researchers through the years. The Kuakini HHP is the only longitudinal study of Japanese-American men that has included epidemiological and clinical data of the cohorts for almost 50 years. From a worldwide perspective, it is the only research program that maintains a comprehensive, longitudinal database of demographic, lifestyle and medical information, as well as biological specimens collected, from such a large cohort of aging men.

"One of the reasons why Honolulu is perfect for this kind of study is that we have the longest-lived state in the country, combined with a population that has remained, for the most part, in Hawaii. This has helped us maintain one of the longest-running, largest studies of aging men in the world, in the Kuakini Honolulu Heart Program," Dr. Willcox said.

Approximately 1,200 men from the study lived into their 90s and 100s, and approximately 250 of those men are still alive today.