For Your Heart, Watch the Summertime Heat

When summer arrives, you may wonder how to stay cool as temperatures rise. Dehydration, heat exhaustion, and heatstroke can be a concern for people with heart trouble?especially heart failure. That?s because your heart may have difficulty pumping blood to your skin, where heat is released. Your medication may make it harder to sweat, too. Sweating also helps you cool off.

Seek out the cool

The best way to cool off is to get to an air-conditioned environment. If your home is not air-conditioned, head to the mall, library, or movie theater.

Try these tips, too:

• Plan activities for early morning or late evening.

• Shower, bathe, or sponge yourself off with cool water.

• Wear loose, lightweight, light-colored clothes.

Stay hydrated

If you?ve been sweating, your body probably needs more fluid. Experts usually suggest drinking electrolyte drinks or freezer pops in warm weather. But some people with heart problems need to limit their fluid intake. So be sure to check with your health care provider about whether it is safe for you to drink more fluids when it's hot out.

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Abnormal Heart Rhythm Linked to Alzheimer's

FRIDAY, April 16 (HealthDay News) -- People with atrial fibrillation, a form of abnormal heart rhythm, are more likely than others to develop dementia, including Alzheimer's disease, a new study finds.

The presence of atrial fibrillation also predicted higher death rates in dementia patients, especially among younger patients in the group studied, meaning under the age of 70.

"This leaves us with the finding that atrial fibrillation, independent of everything else, is a risk factor [for dementia]," said Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. "This is adding one more brick in the road toward understanding that cardiovascular disease is a major risk factor for dementia."

"Alzheimer's disease, in particular, is one where we don't quite understand the risk factors and what causes it, so studies [like this] that try to investigate the causative effect will help us understand that and ultimately design therapies and approaches to prevent or minimize disease," added Dr. Jared Bunch, lead author of a study appearing in the April edition of the HeartRhythm Journal and a cardiologist/ electrophysiologist with Intermountain Medical Center in Murray, Utah.

This study, however, was not specifically set up to establish a direct cause-and-effect relationship.

The authors looked at 37,025 patients without atrial fibrillation or dementia, aged 60 to 90, over a five-year period.

Individuals who developed atrial fibrillation had a higher risk of all types of dementia, even when other risk factors were taken into account. Alzheimer's disease is by far the most common form of dementia.

More surprising was that those in the younger group -- under age 70 -- who had atrial fibrillation had the highest risk of developing dementia, even though dementia is normally associated with aging. People in this group were also at a 38 percent higher risk of dying.

Among the 764 patients who developed both conditions, diagnosis of atrial fibrillation usually happened first, followed by a diagnosis of dementia. Sometimes the diagnoses occurred simultaneously, the researchers noted.

The authors hypothesized that both atrial fibrillation and dementia may arise from the same risk factors, such as hypertension. Another possibility is that atrial fibrillation increases inflammation, and dementia has been shown to be higher in people with signs of systemic inflammation. Investigating whether treatment of hypertension and/or inflammation in AF patients might help curb the risk of dementia is an area of future study, the researchers added.

"From a public health perspective, the best thing we can do to decrease the coming epidemic of Alzheimer's disease is to do a much better, more aggressive job of helping people with heart disease," Kennedy said. "That means diet and exercise, of course -- everyone knows that. We need to look at obstacles that people encounter beyond their own behavior, obstacles we put up environmentally in the workplace, in the school, that keep people from having better diet and exercise. A heart-healthy diet and lifestyle are really the best means we have available to prevent dementia."

About 2.2 million Americans have atrial fibrillation, while an estimated 5.5 million suffer from Alzheimer's.

More information

The American Heart Association has more on atrial fibrillation.

SOURCES: Jared Bunch, M.D., cardiologist and electrophysiologist, Intermountain Medical Center, Murray, Utah; Gary Kennedy, M.D., director, geriatric psychiatry, Montefiore Medical Center, New York City; April 2010 Heart Rhythm Journal

Air Pollution May Raise Blood Pressure

MONDAY, Sept. 14 (HealthDay News) -- Breathing polluted air for even two hours can boost blood pressure, potentially raising the risk of cardiovascular disease in those exposed to smog, a new study suggests.

Although the increase may not mean much for healthy people, "this small increase may actually be able to a trigger a heart attack or stroke," study author Dr. Robert D. Brook, an assistant professor of medicine at the University of Michigan, said in a university news release.

An estimated nearly one in three Americans suffer from high blood pressure, meaning the heart is straining to push blood through the circulatory system.

In the study, which appears in a recent issue of Hypertension, researchers tested 83 people as they breathed levels of air pollution similar to those in an urban city near a roadway.

"We looked at their blood vessels and then their responses before and after breathing high levels of air pollution," study co-author Robert Bard, a University of Michigan clinic research coordinator, said in a news release.

The air pollution caused diastolic pressure -- the lower number in a blood pressure reading -- to rise within two hours. Blood vessels were impaired for as long as 24 hours.

Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function.

"If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity," Brook said.

More information

Learn more about blood pressure from the American Heart Association.

SOURCE: University of Michigan, news release, September 2009

Celiac Disease Can Harm Digestion

Suppose you or a friend has frequent abdominal distress, bloating and other symptoms that seem to puzzle doctors.

Today, experts believe those doctors should consider celiac disease. Also known as celiac sprue, this illness can cause a range of symptoms and problems. Among them: diarrhea, constipation, bloating, abdominal pain, fatigue, irritability, infertility in women, depression and anemia.

"This is a misunderstood disease people may have fleetingly heard about and that the medical community in the United States is also less aware of," says Ciaran P. Kelly, M.D., associate professor of medicine at Harvard Medical School.

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The culprit in celiac disease is gluten, a protein found in many grains, including wheat, rye and barley. When a person with celiac disease eats gluten, the immune system responds by damaging the villi, the absorptive surface of the small intestine. This damage makes it difficult for the body to absorb nutrients the way it should.

"These foods are plentiful in our diet and often are also used as fillers in sauces and in other foods where one might not expect to find them," Dr. Kelly says. "The challenge for the celiac patient is to learn which foods can cause trouble."

In the past, U.S. doctors did not often look for celiac disease. They thought it occurred in just one of 4,000 people. "In Europe, it's a far more common diagnosis," Dr. Kelly says. But many Americans have European ancestors -- and celiac disease tends to run in families. "It stands to reason there would be more of it here," Dr. Kelly says. "The latest thinking is that celiac disease occurs in between one in 150 to one in 200 Americans."

About 10 percent of the first-degree relatives of a person with celiac disease will also have the disease. A first-degree relative is a parent, sibling or child.

Celiac disease can be triggered by surgery, pregnancy, childbirth, a viral infection or severe emotional stress, the NIDDK says.

Symptoms

Symptoms occur at different times in different people. Sometimes they appear in childhood, but for other people, the symptoms appear when they are adults. Symptoms aren't always in the digestive system, the NIDDK says. Although chronic diarrhea and recurrent abdominal pain are symptoms, irritability and depression also can be symptoms.

Other symptoms, from the NIDDK:

• Recurring abdominal bloating

• Weight loss

• Pale, foul-smelling stool

• Unexplained anemia

• Gas

• Bone pain

• Behavior changes

• Muscle cramps

• Fatigue

• Delayed growth

• Failure to thrive (infants)

• Pain in joints

• Seizures

• Tingling numbness in legs

• Pale sores inside the mouth

• Painful skin rash

• Tooth discoloration

• Missed menstrual periods

Diagnosis

Doctors may have difficulty diagnosing celiac disease because its symptoms are similar to other diseases, the NIDDK says. Diseases that share symptoms with celiac disease include irritable bowel syndrome, Crohn's disease, ulcerative colitis, diverticulosis, chronic fatigue syndrome and depression.

Recent research has found that people with celiac disease have higher than normal levels of antibodies to endomysium and tissue transglutaminase. Tests can be given to measure these antibody levels. If the tests and symptoms indicate celiac disease, the doctor may confirm the diagnosis with a biopsy of the small intestine, to check for villi damage.

Early diagnosis is important. The longer a person goes undiagnosed and untreated, the greater the chance of developing malnutrition and other complications, the NIDDK says.

Treatment

Gluten does not harm the bowels of those who do not have celiac disease. But if you have the disease, Dr. Kelly says, there's only one treatment: Avoid gluten for life.

For most people, following this diet will halt the symptoms, heal existing villi damage and prevent further damage, the NIDDK says. The improvement begins almost immediately -- within days of starting the diet. The small intestine is usually completely healed, with the villi intact and working normally, in three to six months. (The healing process may take up to two years for older adults.)

A gluten-free diet bans all foods that contain wheat, rye and barley. Most grains, pastas, cereals and many processed foods fall into that category. A person with celiac disease can eat breads and pastas made with potato, rice, soy or bean flour, however, the NIDDK says. Gluten-free foods also are available from specialty food manufacturers. Other foods that are fine to include are meat, rice, fruits and vegetables.

"It's very important to read labels very carefully and to read between the lines when it comes to fillers used in food," says Dr. Kelly. "I advise patients to read the website of the Celiac Sprue Association or call them for more information about specific food." Patients can also see a nutritionist who knows about celiac.

1 in 4 Americans Under 65 Lacks Dental Insurance

WEDNESDAY, June 9 (HealthDay News) -- About three-quarters (73 percent) of Americans under the age of 65 years had some type of dental coverage in 2008, but about 45 million had no coverage, according to a new report from the U.S. National Center for Health Statistics.

"A primary indicator of access to dental care in the United States is dental insurance. Previous studies have shown that persons with private dental insurance have more dental visits in the previous year than persons without private dental insurance," wrote Barbara Bloom and Robin A. Cohen of the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics, Division of Health Interview Statistics.

The complete report, Dental Insurance for Persons Under Age 65 Years with Private Health Insurance: United States, 2008, was released online June 9.

Among the other findings from the survey:

• About 80 percent of people with employer-based private health insurance had dental coverage, compared with about 30 percent of those with directly purchased insurance.

• Blacks were more likely to have dental insurance than whites, Asians or Hispanics.

• About 40 percent of those with less than a high school education had no dental insurance of any kind.

• The higher a person's income, the more likely they were to have dental insurance.

More information

The U.S. National Institute of Dental and Craniofacial Research offers tips on low-cost dental care.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, June 9, 2010