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Joe Burrow: Bengals quarterback says team has ‘mixed’ feelings about playing next game

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CNN
 — 

Cincinnati Bengals quarterback Joe Burrow says he “probably wants to play” his team’s next game but also understands that others don’t in the aftermath of Damar Hamlin’s collapse on Monday.

Buffalo Bills safety Hamlin suffered a cardiac arrest when playing against the Bengals, an incident which left players from both teams visibly distressed and led to the game’s postponement.

While the world waits anxiously for more updates on Hamlin’s condition, the NFL announced Wednesday that the Bengals’ game against the Baltimore Ravens is still scheduled for 1 p.m. ET in Cincinnati on Sunday.

“We haven’t had that discussion as a team,” Burrow told reporters when asked if the team felt comfortable playing at the weekend.

“There’s definitely some side discussions about that, but that’s not where we’re at right now. So we’ve got a game to play on Sunday.”

Hamlin’s heartbeat was restored on the field as staff tended to him, the Bills have said, before he was taken to the University of Cincinnati Medical Center.

Hamlin remains under intensive care, though he has been showing “signs of improvement” his team said in a statement Wednesday.

It is still unclear what led to the cardiac arrest. CNN has requested comment from the hospital system, which is not releasing information about Hamlin or providing interviews with his medical staff.

Burrow, who was on the field when Hamlin collapsed, says there is no consensus within his team regarding fulfilling their next fixture.

“We have not been asked that,” added Burrow when asked if the players had been consulted about playing.

“I’m sure if you polled the locker room there would be mixed votes on that. Personally, I think playing is going to be tough, but there’s people that want to play, too, and there’s people that don’t.

“Personally, I probably want to play. I think getting back to as normal as you can as fast as you can is personally how I kind of deal with these kinds of things. But like I said, everyone has a different way of dealing with it.”

Burrow added that the team has been preparing as usual for Sunday’s game but that it remains “a scary, emotional time” for everyone involved.

“Unfortunate as it is, we got a game to play on Sunday,” he said.

“It’s our job to get out there and execute and play the game the way that we need to play it to go and win. It is what it is.

“We’ve had discussions as a team about what happened and about where we’re at going forward and that’s where we’re at.”

– Source:
CNN
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If you don’t know how to perform CPR, watch this

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Damar Hamlin update: As the Bills player remains in critical condition, Colts’ Rodney Thomas II details his bedside hospital visit

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CNN
 — 

As Buffalo Bills player Damar Hamlin remains in critical condition after suffering a mid-game cardiac arrest, his childhood friend and high school teammate, Indianapolis Colts safety Rodney Thomas II, says there is “no doubt in my mind” that Hamlin will recover.

Thomas drove directly to the hospital where Hamlin was being treated Monday night, where he said Hamlin lay sedated after being rushed from the field during the Bills’ game against the Cincinnati Bengals.

“I know he could hear me,” Thomas said while speaking to reporters Wednesday. He said he was able to be in the room with Hamlin and hold his hand. “Even if he couldn’t hear me, it didn’t matter. I said what I had to say.”

The pair, who became close friends while teammates at their Pittsburgh high school, spoke daily and had talked earlier Monday before Hamlin’s collapse.

“It calmed me way down,” Thomas said of seeing his friend. “It made the trip home a lot easier. I could go home and know he’s gonna be straight. I got him. We all got him. Everybody’s behind him.”

Hamlin remains under intensive care at the University of Cincinnati Medical Center following his collapse during the first quarter of Monday night’s game, though he has been showing “signs of improvement” his team said in a statement Wednesday.

His heartbeat was restored on the field, the Bills have said, before he was carried from the stadium in an ambulance while stunned and visibly emotional players and fans looked on. Hamlin is on a ventilator and was “flipped over on his stomach” in the hospital to help relieve some of the strain on his lungs, his uncle Dorrian Glenn told CNN Tuesday.

Since his hospitalization, Hamlin has received a nationwide outpouring of support from fans and players across the sports world, including more than $7 million donated to his foundation’s toy drive GoFundMe as of Thursday morning. Several athletes have donned Hamlin’s number, 3, or his jersey while teams across the league have honored him through jumbotron messages and light displays at their stadiums.

The Bills-Bengals game was postponed after Hamlin’s collapse with the Bengals leading 7-3. The NFL is discussing how to handle the incomplete game – which will not be continued this week – but has yet to announce a strategy.

Initially regarded as an important late-season matchup with significant playoff implications, the showdown averaged 21.1 million viewers on ESPN during gameplay, according to Nielsen ratings. After Hamlin’s collapse, viewers grew to a historic 23.9 million, making the telecast the most watched “Monday Night Football” in ESPN history.

It is still unclear what caused Hamlin’s cardiac arrest, but NFL chief medical officer Dr. Allen Sills said the league will investigate what could have led to the player’s collapse during the game.

Any time a player is evacuated from the field, the NFL and its medical experts perform a detailed review of what happened, Sills explained on a call with reporters Wednesday. They also examine the role protective equipment may have played, he said.

In some cases, Sills said, the medical team will not be able to determine what caused the problem.

The doctor also addressed theories that the cardiac arrest could have been caused by commotio cordis, which occurs when severe trauma to the chest disrupts the heart’s electrical charge, causing dangerous fibrillations.

“You have to have the right type of blow hitting at the right spot on the chest with the right amount of force at just the right time in that cardiac cycle. So a lot of things have to line up for that to happen,” he said, emphasizing that while it is possible, investigators will consider all options.

Sills attributed the “transformational response” of medical personnel when Hamlin collapsed to the “60-minute meeting” that is held among medical teams and NFL officials before every game. During the meeting, teams identify the location of medical equipment and nearby medical centers, and establish a chain of command in case of an emergency, including cardiac arrest, among other things.

Hamlin’s collapse is the latest in a string of recent tragedies that have struck the community of Buffalo and and its beloved football team, including a racist mass shooting and a historic blizzard that left at least 41 people dead in Erie County, New York.

A high-ranking official within the Bills organization told CNN’s Coy Wire that they broke down in tears after day and night-long meetings on Tuesday, sobbing because of the heaviness of the situation.

The series of difficult blows to Buffalo have emotionally piled up within the organization, the source said, adding that through it all, the team has tried to be a source of strength for the city, the source tells Wire.

The source pointed to the performance of Buffalo Sabres hockey forward Tage Thompson on Tuesday night as a “glimmer of hope” at a time when the team needs inspiration.

Hamlin’s jersey number, 3, was a recurring motif throughout the game, played on January 3. Thompson’s three goals during overtime brought the Sabres a win. It was Thompson’s third hat trick of the season and his third goal came fortuitously in the third minute of overtime.

The Sabres also wore “Love for 3” t-shirts honoring Hamlin before the game.



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Damar Hamlin shows ‘signs of improvement’ while still in ICU in critical condition, Bills say, after mid-game cardiac arrest

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Cincinnati
CNN
 — 

After suffering a cardiac arrest during a game on Monday, Buffalo Bills safety Damar Hamlin remains in critical condition in intensive care, with “signs of improvement” noted over the past day, his team tweeted early Wednesday afternoon, while uneasy supporters across the nation awaited word of his fate.

“He is expected to remain under intensive care as his health care team continues to monitor and treat him,” the Bills said.

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Hamlin, 24, had still been sedated on a ventilator as doctors worked toward getting him to breathe on his own, his uncle Dorrian Glenn told CNN on Tuesday, after Hamlin’s collapse on the field the prior night halted the Bills game against the Cincinnati Bengals, stunning a packed stadium that only moments earlier had been rippling with excitement ahead of Hamlin’s tackle of a Bengals wide receiver.

Hamlin’s heartbeat was restored on the field as staff tended to him, the Bills have said, before he was taken to the University of Cincinnati Medical Center, where he was still being treated Wednesday. Hamlin was resuscitated only once, a family spokesman clarified Wednesday, not twice, as his uncle told CNN on Tuesday.

“My nephew basically died on the field and they brought him back to life,” Glenn said Tuesday.

It is still unclear what led to the cardiac arrest. CNN has requested comment from the hospital system, which is not releasing information about Hamlin or providing interviews with his medical staff.

Hamlin is on a ventilator to relieve some of the strain on his lungs, which have been damaged, according to Glenn. The doctors told Glenn his nephew has also been “flipped over on his stomach” in the hospital to help with the blood on his lungs, he said, adding, “It seems like he’s trending upwards in a positive way.”

Hamlin’s cardiac arrest came as the NFL is under scrutiny for how it protects players in an inherently violent game. Hamlin collapsed shortly after a collision in which Higgins tried to power past Hamlin, who’d approached for a tackle, with about six minutes remaining in the first quarter of Monday’s game. Hamlin still twisted Higgins to the ground and stood up – but within seconds fell and lay motionless.

Monday’s contest was postponed with the Bengals leading 7-3, and will not be resumed this week, and no decision has been made on whether to ever continue it, the NFL said Tuesday.

On-field injuries are not uncommon in the league, which often resumes play even after severe cases. Many current and former players strongly have supported the game’s postponement, saying Hamlin’s cardiac arrest felt especially disturbing as medical personnel fought to save his life while fans and players looked on.

As Hamlin was treated on the field, some players fell to their knees, sent up a prayer or were openly weeping and embracing one another. Bills offensive tackle Dion Dawkins realized the gravity of his teammate’s condition when Hamlin stayed on the ground as more and more medical staff were called over, he said.

“In that moment, you’re just thinking like, ‘What can I do? What can we do?’ And it just immediately breaks you down into prayer,” Dawkins told CNN’s Wolf Blitzer on Tuesday. “Whether you’re a believer or not, only a higher power can really take control of what is next. And our people that help also assisted that higher power.”

The incident marks the latest in a series of tragic blows for the Buffalo community, which in the past few months has endured a racist mass shooting and a historic blizzard that left at least 41 people dead in Erie County, New York. “It has been, you know, just (a) constant beating for Buffalo,” Dawkins said.

A swell of support has surrounded Hamlin and his family as messages of prayers and well wishes have flooded in from star athletes, fans and national leaders. A fundraiser that Hamlin previously had started for his Chasing M’s Foundation toy drive has raised more than $6 million since his hospitalization.

At a prayer service for the player Tuesday night, community members described the heartbreak of watching “one of our own” endure such a crisis.

“All you can do right now is pray for Damar: the man, not the football player, not the Buffalo Bill, but the person,” the city’s poet laureate Jillian Hanesworth said. “He has to pull through.”

Cardiac arrest results from electrical disturbances that cause the heart to suddenly stop beating properly, and death can occur quickly if help isn’t rendered immediately. It is not the same as a heart attack or heart failure.

When the heart is not beating well, fluid can sometimes back up into the lungs and make it hard for medical staff to oxygenate the patient, CNN Chief Medical Correspondent Dr. Sanjay Gupta explained. So, they flip the person on their stomach into a prone position to make breathing easier.

The prone position “is used only when it is very difficult to oxygenate, or move gases in and out through the lungs,” which can happen when fluid backs up in the lungs because the heart isn’t functioning well, Dr. Jonathan Reiner, a cardiologist and director of the cardiac catheterization laboratory at George Washington University Hospital, said Tuesday.

It sounded Tuesday evening like Hamlin still was having a significant amount of cardiac dysfunction and his heart not pumping enough blood, Gupta told CNN’s Anderson Cooper at the time. A treatment option would be to decrease the body’s demand for oxygenated blood, he said.

“So, you want to improve the amount of circulation, but in the interim, you can also decrease the demand by sedating somebody, by keeping them on a breathing machine,” he said. “Sometimes they’ll even use cooling agents, hypothermia it’s called, to basically almost put the body in more of a hibernation-like state so it’s not demanding as much oxygenated blood. That’s part of the reason he would be on a breathing machine as well.”

Hamlin was resuscitated just once after his collapse, his family’s spokesperson said Wednesday. Glenn, the player’s uncle, misspoke when he told CNN and ESPN the prior day that Hamlin had been resuscitated twice, spokesperson Jordon Rooney said.

“There’s a lot of medical jargon, a lot of things being said, so Damar’s only been resuscitated once,” Rooney, Hamlin’s friend and marketing representative, said Wednesday, speaking on behalf of the family.

“His uncle’s incredibly supportive of his of his nephew. … I think that, you know, he just wanted to do his part to share some good news, and I think just misspoke,” Rooney said.

The family has said it is grateful for all the support it has received, including from the hospital, fans and the NFL community.

“(They are) incredibly thankful of everything that has been out there, all of the support that they’ve gotten. It’s made this just a little bit easier for them,” Rooney said Wednesday. “They’re very grateful people, and it’s meant a lot to them.”

Higgins, the receiver involved in the collision that preceded Hamlin’s collapse, has reached out to Hamlin’s family and been supportive, Rooney said.

Several star athletes – including tennis player Coco Gauff, the NFL’s JJ Watt and NBA legend LeBron James – have applauded the NFL’s decision to postpone the game and have emphasized the importance of Hamlin’s safe recovery over the game’s outcome

Former NFL player Donté Stallworth said the league’s decision to postpone the game wouldn’t have happened years ago. “Five, 10 years ago, the game probably would have resumed,” he told CNN’s Jim Sciutto on Tuesday.

“I don’t know if you can make the game any much safer,” he said. “This is a brutal sport. I think people forget that. They look at players more as commodities sometimes, especially with fantasy football.

“Sometimes we forget the human side, that these players are actually human beings and they have families and they have wives and kids,” he added, pointing out that Hamlin’s “mother was there witnessing this with her own eyes.”

Dawkins was relieved and grateful that his team did not have to continue playing, he said.

“The fact that we did not have to go back out there on that field and play just shows that there is care, and that’s all we can ever ask for is that we get treated as people,” he said. “Because most people just treat us as athletes, as superstars, and some people like celebrities, but in that moment they treated us like people.”

Bills players and staff are still processing Monday night’s events, a source within the team told CNN’s Coy Wire on Tuesday.

The continued shock of Hamlin’s hospitalization – on top of the city’s mass shooting in May, deadly December blizzard, having a home game in November moved to Detroit and getting stuck in Chicago during the holidays – has been heavy on everyone associated with the club, the source said.

“Everyone is exhausted,” the source told Wire, adding that the team’s flight back to New York didn’t land until 3:30 a.m. ET on Tuesday.

This story has been updated to reflect the number of times Hamlin was resuscitated based on information from a family spokesperson and his uncle.



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Hydration linked with lower disease risk, study finds

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CNN
 — 

You may know that being adequately hydrated is important for day-to-day bodily functions such as regulating temperature and maintaining skin health.

But drinking enough water is also associated with a significantly lower risk of developing chronic diseases, dying early or being biologically older than your chronological age, according to a National Institutes of Health study published Monday in the journal eBioMedicine.

“The results suggest that proper hydration may slow down aging and prolong a disease-free life,” said study author Natalia Dmitrieva, a researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung and Blood Institute, a division of NIH, in a news release.

Learning what preventive measures can slow down the aging process is “a major challenge of preventive medicine,” the authors said in the study. That’s because an epidemic of “age-dependent chronic diseases” is emerging as the world’s population rapidly ages. And extending a healthy life span can help improve quality of life and decrease health care costs more than just treating diseases can.

The authors thought optimal hydration might slow down the aging process, based on previous similar research in mice. In those studies, lifelong water restriction increased the serum sodium of mice by 5 millimoles per liter and shortened their life span by six months, which equals about 15 years of human life, according to the new study. Serum sodium can be measured in the blood and increases when we drink less fluids.

Using health data collected over 30 years from 11,255 Black and White adults from the Atherosclerosis Risk in Communities study, or ARIC, the research team found adults with serum sodium levels at the higher end of the normal range — which is 135 to 146 milliequivalents per liter (mEq/L) — had worse health outcomes than those at the lower end of the range. Data collection began in 1987 when participants were in their 40s or 50s, and the average age of participants at the final assessment during the study period was 76.

Adults with levels above 142 mEq/L had a 10% to 15% higher chance of being biologically older than their chronological age compared with participants in the 137 to 142 mEq/L range. The participants with higher faster-aging risk also had a 64% higher risk for developing chronic diseases such as heart failure, stroke, atrial fibrillation, peripheral artery disease, chronic lung disease, diabetes and dementia.

And people with levels above 144 mEq/L had a 50% higher risk of being biologically older and a 21% higher risk of dying early. Adults with serum sodium levels between 138 and 140 mEq/L, on the other hand, had the lowest risk of developing chronic disease. The study didn’t have information on how much water participants drank.

“This study adds observational evidence that reinforces the potential long-term benefits of improved hydration on reductions in long-term health outcomes, including mortality,” said Dr. Howard Sesso, an associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital in Boston, via email. Sesso was not involved in the study.

However, “it would have been nice to combine their definition of hydration, based on serum sodium levels only, with actual fluid intake data from the ARIC cohort,” Sesso added.

Biological age was determined by biomarkers that measure the performance of different organ systems and processes, including cardiovascular, renal (relating to the kidneys), respiratory, metabolic, immune and inflammatory biomarkers.

High serum sodium levels weren’t the only factor associated with disease, early death and faster aging risk — risk was also higher among people with low serum sodium levels.

This finding is consistent with previous reports of increased mortality and cardiovascular disease in people with low regular sodium levels, which has been attributed to diseases causing electrolyte issues, the authors said.

The study analyzed participants over a long period of time, but the findings don’t prove a causal relationship between serum sodium levels and these health outcomes, the authors said. Further studies are needed, they added, but the findings can help doctors identify and guide patients at risk.

“People whose serum sodium is 142 mEq/L or higher would benefit from evaluation of their fluid intake,” Dmitrieva said.

Sesso noted that the study did not strongly address accelerated aging, “which is a complicated concept that we are just starting to understand.”

“Two key reasons underlie this,” Sesso said. The study authors “relied on a combination of 15 measures for accelerated aging, but this is one of many definitions out there for which there is no consensus. Second, their data on hydration and accelerated aging were a ‘snapshot’ in time, so we have no way to understand cause and effect.”

About half of people worldwide don’t meet recommendations for daily total water intake, according to several studies the authors of the new research cited.

“On the global level, this can have a big impact,” Dmitrieva said in a news release. “Decreased body water content is the most common factor that increases serum sodium, which is why the results suggest that staying well hydrated may slow down the aging process and prevent or delay chronic disease.”

Our serum sodium levels are influenced by liquid intake from water, other liquids, and fruits and vegetables with high water content.

“The most impressive finding is that this risk (for chronic diseases and aging) is apparent even in individuals who have serum sodium levels that are on the upper end of the ‘normal range,’” said Dr. Richard Johnson, professor at the University of Colorado School of Medicine, via email. He was not involved in the study.

“This challenges the question of what is really normal, and supports the concept that as a population we are probably not drinking enough water.”

More than 50% of your body is made of water, which is also needed for multiple functions, including digesting food, creating hormones and neurotransmitters, and delivering oxygen throughout your body, according to the Cleveland Clinic.

The National Academy of Medicine (formerly known as the Institute of Medicine) recommends women consume 2.7 liters (91 ounces) of fluids daily, and that men have 3.7 liters (125 ounces) daily. This recommendation includes all fluids and water-rich foods such as fruits, vegetables and soups. Since the average water intake ratio of fluids to foods is around 80:20, that amounts to a daily amount of 9 cups for women and 12 ½ cups for men.

People with health conditions should talk with their doctor about how much fluid intake is right for them.

“The goal is to ensure patients are taking in enough fluids, while assessing factors, like medications, that may lead to fluid loss,” said study coauthor Dr. Manfred Boehm, director of the Laboratory of Cardiovascular Regenerative Medicine, in a news release. “Doctors may also need to defer to a patient’s current treatment plan, such as limiting fluid intake for heart failure.”

If you’re having trouble staying hydrated, you might need help working the habit into your usual routine. Try leaving a glass of water at your bedside to drink when you wake up, or drink water while your morning coffee is brewing. Anchor your hydration habit to a location you’re in a few times per day, behavioral science expert Dr. B.J. Fogg, founder and director of the Stanford University Behavior Design Lab, previously told CNN.

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Study suggests that HDL or ‘good’ cholesterol is less beneficial than previously thought, especially for Black adults

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CNN
 — 

High-density lipoprotein, or HDL, cholesterol – often referred to as the “good” cholesterol – may not be as useful in predicting the risk of heart disease and protecting against it as previously thought, according to new researched funded by the National Institutes of Health.

A study from the 1970s found that high levels of HDL cholesterol concentration were associated with low coronary heart disease risk, a link that has since been widely accepted and used in heart disease risk assessments. However, only White Americans were included in that study.

Now, research published Monday in the Journal of the American College of Cardiology found that low levels of HDL cholesterol were associated with higher risk of heart attack among White adults, but the same was not true among Black adults. Also, higher levels of HDL cholesterol were not found to reduce the risk of cardiovascular disease for either group.

“It’s been well accepted that low HDL cholesterol levels are detrimental, regardless of race. Our research tested those assumptions,” said Nathalie Pamir, a senior author of the study and an associate professor of medicine at the Knight Cardiovascular Institute at Oregon Health & Science University, Portland, in a news release. “It could mean that in the future, we don’t get a pat on the back by our doctors for having higher HDL cholesterol levels.”

The researchers used data from thousands of people who were enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Participants were at least 45 years old when they enrolled in the program between 2003 and 2007, and their health was analyzed over an average of 10 years.

The researchers found that high levels of low-density lipoprotein (LDL) cholesterol and triglycerides “modestly” predicted heart disease risk among both Black and White adults.

But they suggest that more work is needed to understand what’s driving the racial differences in the link between HDL and heart disease risk.

And in the meantime, current clinical assessments for heart disease risk “may misclassify risk in Black adults, potentially hindering optimal cardiovascular disease prevention and management programs for this group,” they wrote.

CNN Medical Correspondent Dr. Tara Narula, associate director of the Lenox Hill Women’s Heart Program, said the study “highlights the very important need for more race- and ethnic-specific research and that there is not a one-size-fits-all approach. Additionally, this research emphasizes the continued need to educate that high levels of HDL are not a free pass and focus must be placed on controlling elevated LDL and other known markers of increased cardiovascular risk. “

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Don’t bother with dietary supplements for heart health, study says

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CNN
 — 

Six supplements that people commonly take for heart health don’t help lower “bad” cholesterol or improve cardiovascular health, according to a study published Sunday, but statins did.

Some people believe that common dietary supplements – fish oil, garlic, cinnamon, turmeric, plant sterols and red yeast rice – will lower their “bad” cholesterol. “Bad” cholesterol, known in the medical community as low-density lipoproteins or LDL, can cause the buildup of fatty deposits in the arteries. The fatty deposits can block the flow of oxygen and blood that the heart needs to work and the blockage can lead to a heart attack or stroke.

For this study, which was presented at the American Heart Association’s Scientific Sessions 2022 and simultaneously published in the Journal of the American College of Cardiology, researchers compared the impact of these particular supplements to the impact of a low dose of a statin – a cholesterol-lowering medication – or a placebo, which does nothing.

Researchers made this comparison in a randomized, single-blind clinical trial that involved 190 adults with no prior history of cardiovascular disease. Study participants were ages 40 to 75, and different groups got a low-dose statin called rosuvastatin, a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols or red yeast rice for 28 days.

The statin had the greatest impact and significantly lowered LDL compared with the supplements and placebo.

The average LDL reduction after 28 days on a statin was nearly 40%. The statin also had the added benefit on total cholesterol, which dropped on average by 24%, and on blood triglycerides, which dropped 19%.

None of the people who took the supplements saw any significant decrease in LDL cholesterol, total cholesterol or blood triglycerides, and their results were similar to those of people who took a placebo. While there were similar adverse events in all the groups, there were a numerically higher number of problems among those who took the plant sterols or red yeast rice.

“We designed this study because many of us have had the same experience of trying to recommend evidence-based therapies that reduce cardiovascular risks to patients and then having them say ‘no thanks, I’ll just try this supplement,’ ” said study co-author Dr. Karol Watson, professor of medicine/cardiology and co-director, UCLA Program in Preventive Cardiology. “We wanted to design a very rigid, randomized, controlled trial study to prove what we already knew and show it in a rigorous way.”

Dr. Steven Nissen, a cardiologist and researcher at the Cleveland Clinic and a co-author on the study, said that patients often don’t know that dietary supplements aren’t tested in clinical trials. He calls these supplements “21st century snake oil.”

In the United States, the Dietary Supplement and Health Education Act of 1994 sharply limited the US Food and Drug Administration’s ability to regulate supplements. Unlike pharmaceutical products that have to be proven safe and effective for their intended use before a company can market them, the FDA doesn’t have to approve dietary supplements before they can be sold. It is only after they are on the market and are proven to be unsafe that the FDA can step in to regulate them.

“Patients believe studies have been done and that they are as effective as statins and can save them because they’re natural, but natural doesn’t mean safe and it doesn’t mean they’re effective,” Nissen said.

The study was funded via an unrestricted grant from AstraZeneca, which makes rosuvastatin. The company did not have any input on the methodology, data analysis and discussion of the clinical implications, according to the study.

The researchers acknowledged some limitations, including the study’s small sample size, and that its 28-study period might not capture the effect of supplements when used for a longer duration.

In a statement on Sunday, the Council for Responsible Nutrition, a trade association for the dietary supplement industry, said “supplements are not intended to replace medications or other medical treatments.”

“Dietary supplements are not intended to be quick fixes and their effects may not be revealed during the course of a study that only spans four weeks,” Andrea Wong, the group’s senior vice president for scientific and regulatory affairs, said in a statement.

Dr. James Cireddu, an invasive cardiologist and medical director of University Hospitals Harrington Heart & Vascular Institute at University Hospitals Bedford Medical Center, said the work is going to be helpful.

“They did a nice job collecting data and looking at the outcomes,” said Cireddu, who did not work on the study. “It will probably resonate with patients. I get asked about supplements all the time. I think this does a nice job of providing evidence.”

Dr. Amit Khera, chair of the AHA Scientific Sessions programming committee, did not work on the research, but said he thought this was an important study to include in the presentations this year.

“I take care of patients every day with these exact questions. Patients always ask about the supplements in lieu of or in addition to statins,” said Khera, who is a professor and director of preventive cardiology at UT Southwestern Medical Center. “I think if you have high quality evidence and a well done study it is really critical to help inform patients about the value, or in this case the lack of value, for some of these supplements for cholesterol lowering.”

Statins have been around for more than 30 years and they’ve been studied in over 170,000 people, he said. Consistently, studies show that statins lower risk.

“The good news, we know statins work,” Khera said. “That does not mean they’re perfect. That doesn’t mean everyone needs one, but for those at higher risk, we know they work and that’s well proven. If you’re going to do something different you have to make sure it works.”

With supplements, he said he often sees misinformation online.

“I think that people are always looking for something ‘natural’ but you know there’s a lot of issues with that terminology and most important we should ask do they work? That’s what this study does,” Khera adds. “It’s important to ask, are you taking something that is proven, and if you’re doing that and it’s not, is that in lieu of proven treatment. It’s a real concern.”

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Heart failure: Black patients less likely to get devices and transplants they need, study finds

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CNN
 — 

There’s growing evidence that Black heart failure patients are less likely to get advanced therapies than White patients.

A study published Wednesday in the journal Circulation: Heart Failure finds that among a group of adults with heart failure, White people were twice as likely as Black people to receive a heart transplant or a ventricular assist device, a mechanical heart pump often used for patients with end-stage heart failure.

“The totality of the evidence suggests that we as heart failure providers are perpetuating current inequities,” Dr. Thomas Cascino, the study’s first author and a clinical instructor in the Division of Cardiovascular Disease at the University of Michigan at Ann Arbor, said in a news release. “However, recognizing disparities isn’t enough. As physicians and health care providers, we must find ways to create equitable change.”

The researchers analyzed data on 377 adults being treated for heart failure in the United States, among whom 27% identified as Black, between July 2015 and June 2016.

The data showed that a heart transplantation or a ventricular assist device was performed in 11% of the Black patients compared with 22% of the White patients, although death rates were similar in both: 18% in Black patients and 13% in White patients.

The researchers noted that patients’ preferences for ventricular assist devices, heart transplantation or other therapies did not affect the results.

“This residual inequity may be a consequence of structural racism and discrimination or provider bias impacting decision-making,” the researchers wrote.

Experts in the field say the findings offer confirmation of what doctors have been seeing for years.

“I cannot say I’m surprised,” said Dr. Jaimin Trivedi, an associate professor at the University of Louisville School of Medicine who has studied racial disparities among heart patients. He was not involved in the new research.

Trivedi’s recommendation for getting cardiovascular care is to be engaged in your own health journey. Your family or loved ones should be closely involved, too.

The new findings were also not a surprise to Dr. Dave Montgomery, a cardiologist at Piedmont Healthcare in Atlanta.

“The study confirms what has been known for too long, which is that Black heart failure patients have worse outcomes, and that part of the reason for the worse outcomes is a gradient in the quality of care they are offered,” said Montgomery, who also was not involved in the new research.

“While I am not surprised to see the results of this study, I am encouraged by the new information that it provides. These data refute the idea that disparate heart failure outcomes have to do with things like the personal preferences of the patient,” he said. “The problem is not indistinct and unapproachable, as we may have believed in the past. Instead, it shows the distinct inroad to better care for all.”

People should be educated on how to advocate for themselves and ask for options, such as the ventricular assist device, that they might not know about, said Dr. Bessie Young, an adjunct professor in health systems and population health at the University of Washington.

“There’s just difficulty for certain groups of people to get some of these really life-saving procedures and transplants, and there has to be sort of systemic changes made as to who the gatekeepers are for these devices and how people think about how patients get these devices,” Young said.

Young, a health equities researcher who was not involved in the study, believes that it shows that the disparity is caused by social determinants such as education and access, rather than biological determinants.

As for the study’s implications for health care providers, she said, “there should be equity among people who get these resources, because they’re so limited. And that’s where you have to make sure that people are looking at how they’re assessing people to get a device or transplant, making sure that they’re using some sort of equity lens to do that.”

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Health

Drink these types of coffee to live longer, study says

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CNN
 — 

Drinking two to three cups a day of most types of coffee may protect you from cardiovascular disease and an early death, a new study found.

“The results suggest that mild to moderate intake of ground, instant and decaffeinated coffee should be considered part of a healthy lifestyle,” said study author Peter Kistler, head of clinical electrophysiology research at the Baker Heart and Diabetes Institute and head of electrophysiology at Alfred Hospital in Melbourne.

Researchers found “significant reductions” in the risk for coronary heart disease, congestive heart failure and stroke for all three types of coffee. However, only ground and instant coffee with caffeine reduced the risk for an irregular heartbeat called arrhythmia. Decaffeinated coffee did not lower that risk, according to the study published Wednesday in the European Journal of Preventive Cardiology.

Prior studies have also found moderate amounts of black coffee — between 3 and 5 cups daily — has been shown to lower the risk of heart disease, as well as Alzheimer’s, Parkinson’s, type 2 diabetes, liver disease and prostate cancer.

“This manuscript adds to the body of evidence from observational trials associating moderate coffee consumption with cardioprotection, which looks promising,” said Charlotte Mills, a lecturer in nutritional sciences at the University of Reading in the UK, in a statement.

However, this study, like many in the past, was only observational in nature and therefore cannot prove a direct cause and effect, added Mills, who was not involved in the study.

“Does coffee make you healthy or do inherently healthier people consume coffee?” she asked. “Randomized controlled trials are needed to prove the relationship between coffee and cardiovascular health.”

The study used data from the UK Biobank, a research database which contained coffee consumption preferences on nearly 450,000 adults who were free of arrhythmia or other cardiovascular disease at the start of the study. They were divided into four groups: those who enjoyed caffeinated ground coffee, those who chose decaffeinated coffee, those who preferred caffeinated instant coffee, and those who did not drink coffee at all.

After an average of 12.5 years, researchers looked at medical and death records for reports of arrhythmia, cardiovascular disease, stroke and death. After adjusting for age, diabetes, ethnicity, high blood pressure, obesity, obstructive sleep apnea, sex, smoking status, and tea and alcohol consumption, researchers found all types of coffee were linked with a reduction in death from any cause.

The fact that both caffeinated and decaffeinated coffee was beneficial “might suggest that it is not simply the caffeine which could potentially explain any associated reduction in risk,” said Duane Mellor, a registered dietitian and senior teaching fellow at Aston University Medical School in Birmingham in the UK, in a statement. He was not involved in the study.

“Caffeine is the most well-known constituent in coffee, but the beverage contains more than 100 biologically active components,” said Kistler, who holds joint appointments as professor of medicine at the University of Melbourne and Monash University.

“It is likely that the non-caffeinated compounds were responsible for the positive relationships observed between coffee drinking, cardiovascular disease and survival,” Kistler said.

Drinking two to three cups of coffee a day was linked to the largest reduction in early death, compared to people who drank no coffee, according to the statement. Ground coffee consumption lowered the risk of death by 27%, followed by 14% for decaffeinated, and 11% for instant caffeinated coffee.

The link between coffee and a lowered risk for heart disease and stroke was not as robust: Drinking two to three cups a day of ground coffee lowered risk by 20%, while the same amount of decaf coffee reduced risk by 6% and instant by 9%.

The data changed when it came to coffee’s impact on irregular heartbeat: Four to five cups a day of caffeinated ground coffee lowered risk by 17% while two to three cups a day of instant coffee reduced the likelihood of arrhythmia by 12%, the statement said.

A limitation of the study was that coffee consumption was self-reported at a single point in time, said Annette Creedon, a nutritional scientist and manager at the British Nutrition Foundation, which is partially funded by food producers, retailers and food service companies.

“This study had a median follow-up period of 12.5 years during which many aspects of the participants diet and lifestyle may have changed,” said Creedon in a statement. She was not part of the research.

In addition, coffee can produce negative side effects in some people, she added. People with sleep issues or uncontrolled diabetes, for example, should check with a doctor before adding caffeine to their diets.

These negative side effects “can be particularly relevant to individuals who are sensitive to the effects of caffeine,” Creedon said. “Hence, the findings of this study do not indicate that people should start drinking coffee if they do not already drink it or that they should increase their consumption.”

Most studies are focused on the health benefits of black coffee, and do not take into account the extra sugars, creams, milks and processed additives that many people use in coffee.

“A simple cup of coffee perhaps with a little milk is very different to a large latte flavoured with a syrup and added cream,” Mellor said.

In addition, how coffee is brewed can also affect its benefits for health. Filtered coffee catches a compound called cafestol that exists in the oily part of coffee. Cafestol can increase bad cholesterol or LDL (low-density lipoproteins).

However, using a French press, Turkish coffee maker or boiling coffee (as is often done in Scandinavian countries), does not remove cafestol.

And, finally, coffee’s benefits do not apply to children – even adolescents should not drink colas, coffees, energy drinks or other beverages with any amount of caffeine, according to the American Academy of Pediatrics.

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Health

Night owls have higher risk of diabetes, heart disease, study says

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“Insulin tells the muscles to be a sponge and absorb the glucose in the blood,” said senior study author Steven Malin, an associate professor in the department of kinesiology and health at Rutgers University in New Jersey.

“Think about it like water from a water faucet: You turn the water on and a drop touches the sponge and is immediately absorbed,” Malin said. “But if you’re not exercising, engaging those muscles, it’s like if that sponge was to sit for a couple days and get rock hard. A drop of water isn’t going to make it soft again.”

If sleep chronotype is affecting how our bodies use insulin and impacting metabolism, then being a night owl might be useful in predicting a person’s risk for heart disease and type 2 diabetes, Malin added.

“The study adds to what we know,” said Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine in Chicago, who was not involved with the research.

“There is good evidence that being a late sleeper has been linked to a higher risk for metabolic and cardiovascular disease,” said Zee, who is also a professor of neurology. “Several mechanisms have been proposed: sleep loss, circadian misalignment, eating later in the day and being exposed to less morning light and more evening light, which have all been shown to affect insulin sensitivity.”

Body clock and chronotype

All humans have a circadian rhythm — an internal 24-hour body clock that regulates the release of the hormone melatonin to promote sleep and ceases production so that we wake. Our body clock also directs when we get hungry, when we feel most sluggish, and when we feel peppy enough to exercise, among many other bodily functions.

Traditionally, sunrise and nightfall regulated the human sleep-wake cycle. Daylight enters the eyes, travels to the brain and sets off a signal that suppresses melatonin production. When the sun goes down, the body clock turns melatonin production back on, and a few hours later sleep arrives.

Your personal sleep chronotype, thought to be inherited, may alter that natural rhythm. If you’re an innate early bird, your circadian rhythm releases melatonin much earlier than the norm, energizing you to become most active in the morning. In night owls, however, the internal body clock secretes melatonin much later, making early mornings sluggish and pushing peak activity and alertness later into the afternoon and evening.

Sleep chronotype can have profound effects on productivity, school performance, social functioning and lifestyle habits, experts say. Early birds tend to perform better in school, and are more active throughout the day, which may partly explain why studies have found they have less risk of cardiovascular disease, Malin said.
Evening types may take more risks, use more tobacco, alcohol and caffeine, and are more likely to skip breakfast and eat more later in the day. In addition, research suggests “later cronotypes have higher body fat located more in the stomach or abdominal region, an area which many health professionals believe to be worse for our health,” Malin said.

Fat or carbs?

Researchers classified 51 adults without heart disease or diabetes into morning or evening chronotypes, based on their natural sleep and wake preferences. During the study, the participants ate a controlled diet and fasted overnight while their activity levels were monitored for a week.

The research team determined each person’s body mass, body composition and fitness level, and measured levels of insulin sensitivity. In addition, researchers looked at how each person’s metabolism obtained most of their energy, either via fat or carbohydrates.

“Fat metabolism is important because we think if you can burn fat for energy that’s going to help the muscle pick up the glucose in a more enduring fashion,” Malin said.

Burning fat can promote endurance and more physical and mental activity throughout the day. Carbohydrates, on the other hand, are what the body uses for intense physical activity. Carbs are burned more quickly, which is why many athletes carb-load in advance of a race or marathon.

Results of the test showed early birds used more fat for energy at both rest and during exercise than night owls in the study, who used more carbohydrates as a source of fuel.

There is a need for more research, Malin said, to confirm the findings and determine if the metabolic differences are due to the chronotype or a potential misalignment between a night owl’s natural preference and the need to wake early due to the hours set by society for work and school.

People who are continuously out of synch with their innate body clock are said to be in “social jet lag.”

“This extends beyond just diabetes or just heart disease,” Malin said. “It may point to a bigger societal issue. How are we helping people who may be in misalignment? Are we as a society forcing people to behave in ways that might actually be putting them at risk?

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Health

Walking briskly reduces risk for cancer, heart disease, early death, study says

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Health benefits rose with every step, the study found, but peaked at 10,000 steps — after that the effects faded. Counting steps may be especially important for people who do unstructured, unplanned physical activity such as house work, gardening and dog walks.

“Notably, we detected an association between incidental steps (steps taken to go about daily life) and a lower risk of both cancer and heart disease,” noted study coauthor Borja del Pozo Cruz, an adjunct associate professor at the University of Southern Denmark in Odense, Denmark, and senior researcher in health sciences for the University of Cadiz in Spain.

“By and large, I think the study is well done and it certainly continues to add to the foundation of knowledge that tells us exercise is good stuff,” said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado. He was not involved in the research.

“Physical activity is just absolutely magnificent,” Freeman said. “And when if you blend that with eating a more plant-based diet, de-stressing, sleeping enough and connecting with others — that’s your magic recipe. It’s the fountain of youth, if you will.”

Walking helps dementia too

Del Pozo Cruz and his team recently published a similar study that found walking 10,000 steps a day lowered risk for dementia by 50%. Risk decreased by 25% with as few as 3,800 steps a day, according to the previous study.

However, if walking occurred at a brisk pace of 112 steps a minute for 30 minutes, it maximized risk reduction, leading to a 62% reduction in dementia risk. The 30 minutes of fast-paced walking didn’t have to occur all at once, either — it could be spread out over the day.

“Our take is that intensity of stepping matters — over and above volume,” said del Pozo Cruz via email.

The new study, published Monday in the journal JAMA Internal Medicine, followed 78,500 people between the ages of 40 and 79 from England, Scotland and Wales who wore wrist step counters for 24 hours a day over a seven day stretch.

After counting each person’s total number of steps each day, researchers placed them into two categories: Fewer than 40 steps per minute — which is more of an amble, like when you’re walking from room to room — and more than 40 steps per minute, or so-called “purposeful” walking.

A third category was created for peak performers — those who took the most steps per minute within 30 minutes over the course of a day (although, again, those 30 minutes did not have to occur in sequence).

About seven years later, researchers compared that data to medical records and found people who took the most steps per minute — in this case, approximately 80 steps per minute — showed the biggest reduction in risk for cancer, heart disease and early death from any cause.

Researchers found the association between peak 30-minute steps and risk reduction to be dependent on the disease studied.

“We observed a 62% reduction for dementia: This figure was almost 80% for CVD mortality and incidence and much less (approx. 20%) for cancer,” del Pozo Cruz said via email.

“This may be related with specific pathways by which physical activity is beneficial,” he said. “It pushes the body in general: can generate more muscle, a bigger heart and a better fitness, all of which are known protective factors for cardiovascular disease and cancer, and other health issues too.”

Get breathless

What’s the takeaway? You don’t have to fixate on the numbers of steps (unless you really want to), Freeman said.

“Does every step count? Absolutely. And we know that brisk walking each day brings on extra benefits in terms of blood pressure reduction and cardiovascular training and so forth,” said Freeman, who was the founding chair of the American College of Cardiology’s Nutrition & Lifestyle workgroup.

“But the truth is, the same goal has always applied: Challenge yourself at whatever fitness level you’re at. Obviously check with your doctor first, but your goal is to become breathless for 30 minutes each day.”

What is breathlessness as it applies to exercise? It’s not gasping and panting so hard you can barely breathe. Instead, breathlessness is when you are walking with someone, they talk to you, and you have a bit of trouble talking back, Freeman said.

“Spend 30 minutes being breathless at whatever pace you’re at, and then keep challenging yourself to be slightly unsatisfied at your current level so you can get better and better,” Freeman said.

Being more physically active often jumpstarts other healthy habits, such as an improved diet, and discourages unhealthy ones, such as smoking, he added.

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