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Heart Attack Deaths Drop 90%, But Chronic Heart Disease Rising

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Heart Attack Deaths Plummet 90% in U.S., But Chronic Heart Disease is Surging

Table of Contents

Published: November 8, 2024 at 10:00 AM PST

By Dr. Michael Lee, World-Today-News.com




Washington D.C. – A groundbreaking new study reveals a dramatic 90% decrease in deaths from heart attacks in the United States since 1970, marking a monumental public health achievement. However, this victory is tempered by a concerning rise in deaths from other cardiovascular conditions, signaling a shift in the landscape of heart disease.

The research, published recently, attributes the decline in acute heart attack fatalities to decades of concerted efforts, including robust anti-smoking campaigns, advancements in emergency medical care, the widespread adoption of statin medications and stent procedures, and a heightened focus on rapid heart attack diagnosis and treatment. These interventions have demonstrably improved immediate survival rates.

Despite this progress,deaths related to arrhythmias have surged by over 400% as 1970. Fatalities stemming from heart failure have increased by nearly 150%,and heart disease linked to hypertension has doubled during the same period. experts attribute this trend to a growing emphasis on acute care while chronic disease management remains under-prioritized.

“We’ve become exceptionally skilled at rescuing individuals during a heart attack, but we are falling short in addressing the underlying chronic conditions that contribute to long-term cardiovascular health,” explains Dr. Dmitry Yaranov, an advanced heart failure cardiologist. “An aging population, coupled with the increasing prevalence of obesity, diabetes, and hypertension, is driving this shift. Long-term health requires sustained attention and access to care.”

The study underscores that while fewer people are succumbing to immediate heart attacks, a larger number are living with chronic cardiovascular diseases, ultimately leading to delayed mortality. This highlights the critical need for a paradigm shift towards proactive, lifelong prevention strategies.

The focus must extend beyond immediate intervention to encompass complete chronic disease management, including lifestyle modifications, regular monitoring, and personalized treatment plans. Addressing these factors is crucial to reversing the rising tide of chronic heart disease and ensuring sustained improvements in cardiovascular health.

Understanding the Evolution of Heart Disease

Cardiovascular disease has been the leading cause of death globally for decades. Historically, acute events like heart attacks were the primary drivers of mortality. However, advancements in medical technology and public health initiatives have significantly reduced the risk of dying from a heart attack in the immediate aftermath. This success story is built upon decades of research into risk factors,such as smoking,high cholesterol,and high blood pressure.

The rise in chronic heart conditions reflects a broader trend of increasing longevity and lifestyle-related diseases. As populations age, the cumulative effects of chronic conditions become more pronounced. Factors like obesity, diabetes, and sedentary lifestyles contribute to the development of heart failure, arrhythmias, and hypertension. These conditions often develop over years or decades, making early detection and proactive management essential.

Moreover, the increasing prevalence of these chronic conditions places a significant strain on healthcare systems. Effective management requires a multi-faceted approach, including preventative measures, early diagnosis, and ongoing care. Investment in public health initiatives, research, and access to affordable healthcare are crucial to addressing this growing challenge.

Frequently Asked Questions About Heart Disease Trends

What is causing the increase in deaths from heart failure?
The rise in heart failure deaths is linked to an aging population, increased rates of obesity, diabetes, and hypertension, and a relative lack of focus on long-

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Health

Cognitive Impact From Dementia Risk Factors Greater in Women

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Women’s Brain Health: Hidden Dementia Risks Revealed

New research highlights significant, yet often overlooked, lifestyle factors impacting cognitive decline in women.

New findings suggest that specific lifestyle choices and health conditions disproportionately affect women’s cognitive function, potentially increasing their risk for dementia. The study emphasizes the need for personalized health strategies tailored to both gender and age.

Unpacking Modifiable Risk Factors

Research presented at the Alzheimerโ€™s Association International Conference (AAIC) 2025 indicates that women face a higher prevalence of certain modifiable dementia risk factors compared to men. Six such factors were more common in women, while only three were more prevalent in men.

โ€œClinicians should familiarize themselves with the 14 identified modifiable risk factors, and if their patients have these risk factors, consider their sex and age, and try to target the behavior changes accordingly to minimize the impact on cognition and dementia risk,โ€ stated study author **Megan Fitzhugh**, PhD, assistant professor at the University of California San Diego.

Megan Fitzhugh, PhD

The study, which analyzed data from over 17,000 individuals, focused on risk factors identified by the Lancet Report on Dementia Prevention, which posits that approximately 45% of dementia risk is potentially modifiable.

Cognitive Impact Varies by Sex and Age

Investigators observed that the cognitive impact of some risk factors was more pronounced in women. Notably, hearing loss and diabetes appeared to have a greater detrimental effect on women’s cognitive performance than on men’s.

For instance, diabetes showed a significant dip in cognitive scores for women, while its impact on men’s cognition was relatively minimal. Similarly, poor sleep, elevated BMI, hypertension, vision loss, lower education levels, and hearing loss were found to negatively impact cognitive function more in women.

โ€œThe way I think about age in this study is itโ€™s telling us when, potentially, we should be targeting these risk factors,โ€ **Fitzhugh** added, suggesting that interventions should be time-sensitive.

Targeted Interventions for Women

Hearing loss, identified as a major modifiable risk factor, proved particularly impactful for women. Despite its higher prevalence in men, its effect on cognitive function was more severe in women. This highlights a critical need for proactive hearing health management in women.

โ€œMaybe we should be targeting women with hearing loss in middle to older age, making sure they get hearing aids,โ€ **Fitzhugh** suggested. Her research also indicated that women with hearing loss have a heightened dementia risk compared to men with the same condition.

Age-Specific Vulnerabilities

The study also revealed age-related variations in risk factor impact. For women, hearing loss had the greatest cognitive effect during middle to older age. Poor sleep was significant only in middle age, a period often coinciding with menopause.

Interestingly, among men, only smoking demonstrated a notable increase in cognitive impact, and this was specifically observed in the older age group.

Expert Commentary on Brain Health Strategies

Commenting on the findings, **Liisa Galea**, PhD, a leading researcher in women’s mental health, noted the surprising association between more modifiable factors and cognition in females. โ€œClearly these factors are important for everyone, but we need more targeted messaging to women across the lifespan about the importance of these variables for their brain health,โ€ she said.

The implications of this research are significant for public health initiatives. For example, the Centers for Disease Control and Prevention (CDC) reports that individuals who are physically active tend to have better cognitive function as they age, underscoring the importance of addressing sedentary lifestyles, particularly in at-risk populations (CDC).

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Health

Preeclampsia: New Biomarkers and Risk Assessment Advancements

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Here are a few options for rewriting the provided text, focusing on different aspects and tones:

Option 1 (Concise and Action-Oriented):

Improving Preeclampsia Diagnosis and Management with PlGF Testing

Dr. John Kingdom highlights the significant role of placental growth factor (PlGF) testing in managing preeclampsia and related conditions. In high-risk pregnancies, real-time PlGF testing aids in diagnosing post-viability issues like fetal growth restriction. For those on aspirin prophylaxis from 12 weeks, a 16-week PlGF test combined with placental ultrasound can guide management, offering reassurance with normal results or prompting further intervention when levels are low.

Kingdom also advocates for PlGF testing in low-risk pregnancies, citing a decade-old UK study that demonstrated its ability to improve preterm preeclampsia identification when used with clinical risk assessment. His recent Mount Sinai Hospital study of over 9000 unselected patients found that a low PlGF level (<100 pg/mL) at 24-28 weeks was associated with a nearly 80-fold increased risk of preterm birth. He emphasizes that plgf testing is practical, cost-effective, and easily integrated into existing gestational diabetes screening. Future directions in Preeclampsia Prevention:

Experts anticipate that improved risk assessment will lead to greater adherence to aspirin prophylaxis and a broader adoption of evidence-based nonpharmacologic interventions. Research is also ongoing into other potential prophylactic agents like heparin, metformin, and statins, as aspirin alone only prevents a portion of the disease.

Studies suggest higher aspirin doses may be slightly more effective and equally safe. Metformin has shown promise in prolonging pregnancies in early-onset preeclampsia, while low-molecular-weight heparin may improve vascular health and boost plgf production. Statins,particularly pravastatin,are also being investigated for their potential to prevent preeclampsia in specific patient subgroups.

Option 2 (More Explanatory and Detailed):

PlGF Testing: A Key Tool for Preeclampsia Prediction and Management, Say experts

Dr. John Kingdom, MD, emphasizes the utility of placental growth factor (PlGF) testing in optimizing the care of pregnant individuals. For high-risk patients, real-time PlGF testing is instrumental in diagnosing conditions that arise after fetal viability, such as fetal growth restriction. Moreover, in high-risk individuals who begin aspirin prophylaxis at 12 weeks to prevent preeclampsia, a PlGF test at 16 weeks, coupled with placental ultrasound, can inform management decisions. “A normal result provides reassurance, while a low level prompts consideration of adjunctive therapies,” Dr. Kingdom explained.

He also asserts that PlGF testing can predict preeclampsia in patients without pre-existing high-risk factors.A study conducted over a decade ago in the UK indicated that plasma PlGF levels at 14-16 weeks gestation, when combined with clinical risk assessment, improved the identification of preterm preeclampsia in nulliparous women compared to clinical risk factors alone.

In a recent prospective cohort study led by Dr. Kingdom at Mount Sinai Hospital, Toronto, over 9000 unselected, predominantly low-risk patients were evaluated. The findings revealed that a low PlGF level (<100 pg/mL) detected during routine gestational diabetes screening (24-28 weeks) was associated with a significant 79.4-fold increased risk for preterm birth. Dr. Kingdom stressed the need for high precision,practicality,and widespread implementation in preeclampsia screening,noting that PlGF testing in mid-pregnancy is "cheap,easily interpreted,unimodalโ€ฆand can be tagged onto current diabetes screening." Advancing Preeclampsia Prevention: Future Therapies and Actions

Experts believe that as risk assessment becomes more precise, adherence to aspirin prophylaxis recommendations will rise, alongside a greater appreciation for evidence-based nonpharmacologic interventions.However, there is also hope for more data on the potential prophylactic benefits of other agents, including heparin, metformin, and statins. Dr. Bernstein commented,”Even when used in the right patient,aspirin prevents only a portion of disease.”

Ongoing research is exploring optimal aspirin regimens, with data suggesting that higher doses may offer slightly greater effectiveness with comparable safety. Dr. Kingdom noted that metformin has demonstrated in at least one randomized controlled trial the ability to prolong pregnancy by at least 10 days in patients diagnosed with early-onset preeclampsia.

Low-molecular-weight heparin, which can enhance vascular health through nonanticoagulant mechanisms, “has been shown to boost the production of PlGF by placental tissues and by the endothelial cells,” he added.

Dr. McElrath expressed interest in research investigating the role of statins in preeclampsia prevention, particularly the efficacy of pravastatin. He anticipates that further study may identify “specific subgroups who will benefit [most].”

Option 3 (Focus on the “Why” and Impact):

Unlocking Better Preeclampsia Outcomes: The Power of PlGF Testing and Emerging Therapies

Dr. John Kingdom,

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Health

Microbiome Rhythm and Metabolic Health

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Gut Microbes Show How Eating Times Boost Metabolism

New Research Reveals Timing Your Meals Aligns Gut Bacteria for Better Health

When you eat could be as crucial as what you eat for metabolic well-being. Scientists are uncovering how synchronizing meal times with your gut microbes’ daily activity can offer significant health advantages.

Unlocking Microbial Rhythms

Researchers at UC San Diego have pioneered methods to observe real-time changes within the gut microbiome. Their goal was to determine if aligning eating schedules with peak microbial activity, a practice known as time-restricted feeding (TRF), could improve metabolic health.

Amir Zarrinpar, MD, PhD, a gastroenterologist and associate professor at UC San Diego School of Medicine, explained the study’s focus: Microbial rhythms are daily fluctuations in the composition and function of microbes living in our gut. Much like how our bodies follow an internal clock (circadian rhythm), gut microbes also have their own rhythms, adjusting their activities based on the time of day and when we eat.

The team specifically investigated whether TRF could counteract the negative metabolic effects commonly associated with high-fat diets.

Advancing Gut Science with Metatranscriptomics

A significant leap in this research was the adoption of metatranscriptomics. This advanced technique allows scientists to capture real-time microbial activity by analyzing RNA transcripts, offering a dynamic view of what microbes are doing, unlike older metagenomics methods that only identified potential capabilities.

Zarrinpar elaborated on the technology’s impact: It helps us understand not just which microbes are present, but specifically what they are doing at any given moment. In contrast, metagenomics looks only at microbial DNA, which provides information about what microbes are potentially capable of doing, but doesnโ€™t tell us if those genes are actively expressed.

The instability of RNA previously made widespread metatranscriptomic analysis challenging. However, improved bioinformatics tools and decreasing sequencing costs are now making this powerful technology more accessible for in-depth research into microbial gene expression.

Key Findings: TRF Offers Metabolic Protection

In a study involving three groups of miceโ€”one on an unrestricted high-fat diet, another on an 8-hour TRF high-fat diet, and a control group on a standard dietโ€”compelling results emerged after eight weeks.

Mice consuming a high-fat diet without time restrictions exhibited metabolic dysfunction. This was linked to disrupted circadian and microbial rhythms, leading to increased daytime eatingโ€”a period when mice typically rest. This misalignment can negatively impact metabolism and overall health.

Conversely, mice on the high-fat diet within the TRF window were protected from adverse effects such as increased body fat, inflammation, and insulin resistance. They also showed improved glucose regulation and a partial restoration of daily microbial rhythms.

Engineering a Solution: The Power of Bile Salt Hydrolase

The study identified bile salt hydrolase (BSH), an enzyme crucial for lipid and glucose metabolism, as a pivotal factor in the observed metabolic improvements. Specifically, the gut microbe *Dubosiella newyorkensis* showed enhanced BSH gene expression during daytime feeding in the TRF group.

To test this, researchers engineered a benign gut bacterium to continuously express a BSH variant from *Dubosiella newyorkensis*. Mice receiving this engineered bacterium demonstrated increased lean muscle mass, reduced body fat, lower insulin levels, and better blood glucose control, mirroring benefits seen with TRF.

It is still early to know the full clinical potential of this new BSH-expressing engineered native bacterium. However, our long-term goal is to develop a therapeutic that can be administered as a single dose, stably colonize the gut, and provide long-lasting metabolic benefits. stated Zarrinpar, highlighting the potential for a one-time therapeutic intervention.

Expert Perspectives and Future Directions

Mitchell Roslin, MD, FACS, chief director of bariatric and metabolic surgery at Lenox Hill Hospital, who was not involved in the study, commented on the findings: Using enzymes or medications that work in the GI tract without absorption into the body is very interesting and has great potential. It is an early but exciting prospect.

However, Dr. Roslin also raised important questions: I think we are still trying to understand whether the difference in microbiomes is the cause or effect/association. Is the microbiome the difference or is a different microbiome representative of a diet that has more fiber and less processed foods? He also noted that translating findings from mice to humans can be speculative.

This research underscores the intricate link between host circadian rhythms and microbial functions, impacting host metabolism. The development of engineered bacteria offers a promising avenue for future targeted therapies against metabolic disorders, potentially offering benefits similar to dietary timing strategies.

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Health

Supreme Court Backs Free Preventive Care Access

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

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Supreme Court Preserves Affordable care Act Mandate for Preventive Services

Table of Contents

In a 6-3 decision announced Friday, the US Supreme Court upheld a key provision of the Affordable Care Act (ACA), ensuring that health insurers must continue to cover preventive medical tests and treatments without requiring copays. This ruling preserves access to vital healthcare services for millions of Americans, although some concerns remain regarding the influence of the Health and Human Services (HHS) Secretary over the panel that determines which services are covered.

supreme Court Ruling: A Win for Preventive Care

The decision thwarts a challenge to the ACA mandate, which has been instrumental in expanding access to preventive services across the nation. The case originated from a complaint by braidwood Management, a Texas-based company with Christian ownership, which sought to exclude coverage for pre-exposure prophylaxis (PrEP) for HIV prevention, citing religious objections. The ACA requires coverage without cost-sharing for preventive services receiving an “A” or “B” rating from the US Preventive Services Task Force (USPSTF) (USPSTF).

Did You Know? The ACA mandate has lead to a meaningful increase in the utilization of preventive services, particularly among previously uninsured populations.

Impact on Healthcare Access

The mandate covers over 40 tests and treatments with “A” and “B” ratings from the USPSTF.These include screenings for various cancers and diabetes, nicotine replacement therapy for smoking cessation, statins for reducing heart disease and stroke risk, and physical therapy to prevent falls in older adults. According to the American Cancer Society, early detection through regular screenings significantly improves survival rates for many types of cancer (american Cancer Society).

Major medical groups,including the American Medical Association,the American Academy of Family Physicians,and the American cancer Society,lauded the supreme Court’s decision. These organizations had previously filed a brief arguing that the mandate enabled nearly 152 million Americans to access preventive services without cost-sharing in 2020.They warned that reducing coverage would lead to poorer patient outcomes, preventable deaths, and higher long-term medical costs.

Concerns Regarding HHS Secretary’s Authority

While celebrating the ruling, some advocates voiced concerns about the HHS Secretary’s influence over the USPSTF.Anthony Wright, executive director of families USA, noted that the decision reaffirms the HHS Secretary’s ability to control the membership and recommendations of the USPSTF. This raises concerns about potential political interference in the determination of covered preventive services.

Pro Tip: Stay informed about changes to preventive service coverage by regularly checking the USPSTF website and consulting with your healthcare provider.

USPSTF’s Role and Authority

Justice Kavanaugh addressed concerns that the USPSTF wields unchecked power, clarifying that the HHS Secretary can remove task force members and directly review or block their recommendations. This oversight ensures that the USPSTF’s recommendations are subject to executive branch review and accountability.

The Rise of Early-Onset Cancers

The ACA mandate has also played a crucial role in promoting cancer screening among younger individuals,which is increasingly important given the rising incidence of certain cancers in people under 50.Research from the National Institutes of Health (NIH) indicates that the incidence of 14 cancer types has increased in this age group between 2010 and 2019 (NIH). Removing financial barriers to screening is essential for encouraging healthy individuals to undergo tests that can detect cancer early, improving their chances of accomplished treatment.

key Preventive Services Covered Under the ACA Mandate
Service Benefit
Cancer Screenings (e.g., mammograms, colonoscopies) Early detection and improved survival rates
Diabetes Screenings Early diagnosis and management of diabetes
Nicotine Patches Support for smoking cessation
Statin Medications Reduced risk of heart disease and stroke
Physical Therapy Prevention of falls in older adults
HIV Prevention (PrEP) Reduced risk of HIV infection

Evergreen Insights: the Enduring Importance of preventive Care

Preventive care is a cornerstone of public health, focusing on proactive measures to maintain health and prevent disease rather than treating illnesses after they occur. The ACA’s mandate for no-copay preventive services has significantly expanded access to these vital services, particularly for underserved populations. By removing financial barriers, the mandate encourages individuals to seek regular check-ups, screenings, and vaccinations, leading to earlier detection of health issues and improved health outcomes.

The ancient trend in healthcare has shifted from a reactive approach to a more proactive and preventive model. This shift is driven by growing evidence that preventive measures are cost-effective and can significantly reduce the burden of chronic diseases. The ACA mandate reflects this trend,recognizing that investing in preventive care is an investment in the long-term health and well-being of the population.

Frequently Asked Questions About Preventive Care and the ACA

What is considered preventive care?

preventive care includes services such as vaccinations,screenings,and check-ups that help prevent illnesses or detect them early when they

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Health

Heart Risk Tool: Ethnic Patterns Revealed

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

New Equations Accurately Predict Heart Disease Risk Across Diverse Populations, Study Finds

TOPLINE: Groundbreaking research from the American Heart Association reveals that the Predicting Risk of Cardiovascular Disease Events (PREVENT) equations effectively identify heart problem risk in a large, ethnically diverse group of over 361,000 patients. The study, spanning 8.1 years, tracked 22,648 cardiovascular events and demonstrated consistent performance across various ethnic subgroups.

Why This Matters: Accurate risk assessment is crucial for preventative care.These findings suggest a more equitable tool for identifying individuals who would benefit from early intervention to reduce their risk of heart disease – a leading cause of death [[2]].

The Study: Researchers analyzed data from 361,778 primary care patients (aged 30-79) within the Sutter Health system in Northern California (2010-2023). Participants needed at least two primary care visits and had to have baseline data including cholesterol levels, blood pressure, BMI, kidney function, diabetes status, and smoking history, all while being free of existing cardiovascular disease. Researchers tracked incidents of total cardiovascular disease (CVD), atherosclerotic CVD, and heart failure.Key Findings:

Strong Performance Across Groups: The PREVENT equations showed a C statistic (a measure of accuracy) ranging from 0.79 to 0.85 for total CVD among Asian populations, varying by specific Asian ethnicity (Filipino to Asian Indian). Hispanic subgroups consistently scored between 0.80 and 0.82.
 Outperformed Existing Models: PREVENT equations were more accurate than previously used models (pooled cohort equations) in predicting atherosclerotic CVD across all racial and ethnic groups.
Minor Variations: Small differences were observed in performance for atherosclerotic CVD and heart failure among different racial and ethnic groups.
 Calibration Insights: The equations tended to slightly overestimate CVD risk for Asian populations but accurately predicted risk for Hispanic individuals.

In Detail: The study highlighted that the PREVENT equations performed well, mirroring results from the original equation advancement and validation. Notably,the equations showed slightly better discrimination of CVD events for Asian and Hispanic participants compared to Black or White participants.

What This Means For You: This research supports the use of PREVENT equations as a valuable tool for healthcare providers to assess cardiovascular risk in a diverse patient population. Early and accurate risk assessment allows for proactive lifestyle changes and medical interventions to prevent heart disease, including addressing risk factors like coronary artery disease and heart valve disease [[1]].

Sources: american Heart Association’s Predicting Risk of Cardiovascular Disease Events (PREVENT) equations.

CTA: Talk to your doctor about your heart health and whether a cardiovascular risk assessment is right for you. Learn more about preventing heart disease at Mayo Clinic

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