Heart Health

Pomegranate proves potent in metabolic health management

A comprehensive study featured in Nutrients journal has cast a spotlight on pomegranate (Punica granatum l., PG) and its polyphenolic compounds, scrutinising their potential to modulate metabolic irregularities. Historically embraced for its therapeutic properties against bacterial infections, diabetes, and various metabolic syndromes, pomegranate’s efficacy is being re-evaluated amidst concerns over the side effects of conventional pharmacological treatments.

The review delves into pomegranate’s pharmacokinetic profiles, safety, and bioavailability, particularly focusing on its capacity to combat metabolic disorders such as type 2 diabetes, obesity, dyslipidemia, and cardiovascular diseases. It outlines how PG’s consumption could attenuate insulin resistance, inflammatory cytokines, redox gene expression, blood pressure elevation, vascular damage, and lipoprotein oxidation.

In animal models, pomegranate seed oil has been found to reduce fat mass and enhance insulin sensitivity, corroborating previous research indicating significant reductions in lipid levels. The study further explains how enzymes and nuclear receptors involved in lipid metabolism are positively influenced by PG’s floral components.

Despite some contradictory findings regarding PG’s impact on food intake and weight gain, the review suggests genetic differences may account for varied physiological reactions to phytochemicals. PG polyphenols are also being explored for their anti-diabetic properties through diverse mechanisms, including modulation of PPAR-γ activity and adiponectin gene expression.

The review also evaluates the pharmacodynamics and safety of PG’s ellagitannin compounds, noting individual differences in urolithin production and absorption, which are influenced by factors such as gut microbiota composition and pH. Although high doses of PG have shown cellular and nuclear alterations in toxicological studies, conventional uses of PG and its compounds appear safe, with adverse effects only predicted at dosages exceeding those traditionally used in ethnomedicine.

In conclusion, the research indicates that PG could play a beneficial role in preventing metabolic disorders. However, the outcomes of clinical and pharmacokinetic studies remain variable, attributed to factors like plant part selection, cultivar differences, environmental conditions, bioavailability, organ accessibility, and individual genetic profiles. Despite these discrepancies, the therapeutic potential of PG in addressing components of metabolic syndrome highlights the need for integrated treatment strategies.

New study finds obesity in pregnancy raises risk of future heart disease

The link between maternal obesity and the long-term risk of cardiovascular disease has been further solidified by new research findings. A study led by Northwestern University in the United States has shone a light on the significant health risks faced by women who enter pregnancy with obesity.

The research team discovered that women with obesity before conception are more susceptible to complications during pregnancy than their counterparts with healthier pre-pregnancy weights. These complications include conditions like pre-eclampsia and gestational diabetes, which have previously been associated with an increased risk of heart disease later in life.

The study’s principal investigator, Dr. Sadiya Khan, emphasised that while these pregnancy-related issues can indeed signal future cardiovascular problems, they are not the underlying cause of heart disease. Instead, they merely highlight pre-existing risk factors that become apparent during the metabolic and physical demands of pregnancy.

To reach these conclusions, the researchers analysed health data from 4,216 women who were giving birth for the first time. They observed that those with higher body mass indices (BMIs) in the first trimester had an elevated risk of developing hypertensive disorders during pregnancy than those with BMIs within the normal range.

Dr. Khan explained that the study approached pregnancy as a ‘natural stress test’ for the heart, which could expose pre-existing health concerns. The implications of these findings underscore the importance of addressing pre-pregnancy obesity with proactive health interventions rather than waiting for cardiovascular events to occur.

The research team is advocating for healthcare providers to emphasise the importance of a nutritious diet and regular physical activity during prenatal visits. While weight loss is not recommended during pregnancy, guidance and support for maintaining an appropriate weight gain during this period are crucial.

The study also presented quantitative insights, revealing that among the participants, 4% had gestational diabetes and 15% encountered complications due to high blood pressure.

These findings, which align with prior research advocating for weight management during pregnancy through diet and exercise, have been published in the journal Circulation Research, providing valuable insights for expectant mothers and healthcare professionals alike.

Obesity-linked heart deaths triple in 20 years

Recent research disclosed a concerning surge in the number of US adults succumbing to heart disease where obesity was cited as a pivotal contributing factor, exhibiting a threefold rise between 1999 and 2020. This alarming revelation was documented in a study published in the Journal of the American Heart Association, leveraging data encapsulated in the comprehensive database curated by the Centers for Disease Control and Prevention (CDC).

Analysing death certificates facilitated a granular examination of the escalation in obesity-correlated cardiac deaths over the span of two decades. The researchers pinpointed a total of 281,135 heart disease fatalities attributed to obesity during the period under scrutiny. This translated to a tripling of the death rate, spiralling from a rate of 2.2 per 100,000 individuals to a significant 6.6 deaths per 100,000 populace, thereby showcasing a worrying trend in health outcomes related to obesity.

Ironically, this spike unfolded amidst a nearly 18 percent decrement in overall heart disease mortalities from 1999 to 2020, pointing towards a deep-seated issue relating specifically to obesity-linked cardiac ailments.

The racial and gender disparities were stark, with the black populace shouldering a higher mortality rate compared to other racial cohorts. Moreover, a gendered analysis revealed a preponderance of these deaths amongst males, albeit black females demonstrated a marginally elevated mortality rate relative to their male counterparts.

Obesity, delineated as a profound risk catalyst for heart disease, presently afflicts approximately 115 million individuals in the US, encompassing around 42% of the adult demographic and 20% of the juvenile population, as per CDC statistics. A decade-long observation underscores a rise by nearly 10% in adult obesity, illuminating the swelling magnitude of this health crisis.

Medical professionals accentuate the multifaceted pathways through which obesity can foster heart disease, encompassing the enhancement of blood pressure levels, fostering a surge in detrimental cholesterol whilst diminishing beneficial cholesterol levels, amplifying diabetes susceptibility, and facilitating the accrual of fatty substances within arterial structures.

The in-depth study unearthed that the primary culprits behind obesity-associated heart disease fatalities within the scrutinised period were ischemic heart disease — characterised by artery narrowing — accompanied by heightened blood pressure. This dual identification not only underscores the critical role of cardiovascular health monitoring in obesity management but also necessitates intensified focus on preventive measures to curb the steady increase in obesity-related cardiac deaths.

The findings evoke an urgent call for bolstered interventions targeting obesity prevention and management, steering individuals towards healthier lifestyles to avert the onset of associated cardiac complications. The study stands as a testament to the urgent necessity for a comprehensive approach in mitigating obesity-related health ramifications, fostering a society armed with the knowledge and resources to combat this escalating health concern effectively.

Digital health applications: A game-changer in post-hospitalisation heart failure care

According to a study published in the International Journal of Cardiology, the use of electronic health services via health applications after heart failure (HF) hospitalisation notably enhances patient outcomes and reduces mortality risk.

The research team aimed to scrutinise the effectiveness of digital health interventions (DHI) in comparison to conventional care for patients who had previously been hospitalised due to HF. To do this, they performed a retrospective study involving ten randomised controlled trials listed on databases such as MEDLINE, Cochrane, OVID, CINHAL, and ERIC. The trials studied the effects of DHI on patients with HF. The sample size comprised 7204 patients, predominantly men, with an average age of 65.7 years. These patients were followed for nearly 16 months, with all-cause death being the primary outcome measured.

Upon comparing the group utilising DHI with the standard care group, researchers discovered a reduction in all-cause mortality (8.5% vs. 10.2%; risk ratio [RR], 0.80; 95% CI, 0.66-0.96; P =.02) as well as cardiovascular mortality (7.3% vs. 9.6%; RR, 0.76; 95% CI, 0.62-0.94; P =.01). However, the study found no significant difference in HF-related hospitalisations (23.4% vs. 26.2%; RR, 0.82; 95% CI, 0.66-1.02; P =.07) and all-cause hospitalisations (48.3% vs. 49.9%; RR, 0.89; 95% CI, 0.77-1.03; P =.11).

Further, the DHI group experienced fewer lost days due to HF-related hospitalisations when compared with the standard care group (mean difference [MD], -1.77; 95% CI, -3.06 to -0.48; P =.01; I2 = 51). However, the number of days lost to all-cause hospitalisations was similar in both groups (MD, -0.76; 95% CI, -3.07 to -1.55; P =.52; I2 = 69).

The study had certain limitations, including reliance on study-level data rather than individual patient data, the meta-analysis research design, variability in certain study endpoints, and a lack of representation of women in the study group.

The authors of the study concluded, “This meta-analysis of randomised controlled trials supports a reduction in all-cause and cardiovascular mortality, with less total time spent in HF hospitalisations when DHI is employed in patients with prior HF hospitalisations.” They further highlighted the need for more extensive studies to examine different types of DHI and assess their cost-effectiveness in managing HF.

Common painkillers linked with heart failure in people with type 2 diabetes

A recent study published in the Journal of the American College of Cardiology suggests that the use of common pain medications such as Advil or Motrin (ibuprofen) may increase the risk of heart failure in people with type 2 diabetes. The study found that NSAIDs (nonsteroidal anti-inflammatory drugs) may lead to first-time hospitalisation for heart failure in patients with type 2 diabetes. This is noteworthy, as these individuals are already known to face an elevated risk of heart failure.

The Danish study included more than 330,000 individuals with type 2 diabetes, of whom 1 in 6 filled at least one NSAID prescription within a year. During a follow-up of almost six years, more than 23,000 subjects were hospitalised with heart failure for the first time, and NSAID use was associated with a 40 percent higher relative risk of first-time heart failure hospitalisation. Ibuprofen and diclofenac were found to increase the risk of heart failure hospitalisation, but not celecoxib and naproxen. There was no association of NSAID use and increased risk in people with well-controlled diabetes. Strong associations were found in people aged 65 and older, while no association was found in those younger than 65. The strongest association was found in very infrequent or new users of NSAIDs. The study highlights the need for education in patients with cardiac risk factors, such as diabetes, on the dangers of over-the-counter medications.