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From the Townsend Letter
April 2011

Anti-Aging Medicine
Women Take Heart: An Anti-Aging Approach to Heart Disease
by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO

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The US Centers for Disease Control and Prevention reports that heart disease is the #1 leading cause of death among women, as one-third of American women aged 20-plus have hypertension. The National Women's Health Information Center explains: "Among all U.S. women who die each year, one in four dies of heart disease. In 2004, nearly 60 percent more women died of cardiovascular disease (both heart disease and stroke) than from all cancers combined."

While aging increases the odds of a woman's getting heart disease, experts urge that women of all ages should be concerned about heart disease. The American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net), the world's largest nonprofit scientific society comprising 24,000 physicians, health practitioners, and scientists from 110 nations dedicated to improving your life and enhancing your lifespan, supports efforts to place women's health as a top public health priority. In this column, we share recent medical headlines relating to women's health, and encourage our readers to embrace the principles of the Anti-Aging Lifestyle, involving diet, exercise, and healthful habits, to both improve their quality of life and achieve optimal health and well-being.

Centers for Disease Control and Prevention. Women's health [online document]. http://www.cdc.gov/nchs/fastats/womens_health.htm. Accessed 7 January 2011.
National Women's Health Information Center. Heart disease: frequently asked questions [online document]. http://www.womenshealth.gov/faq/heart-disease.cfm. accessed 7 January 2011.

Magnesium May Reduce Risks of Sudden Heart Failure
Among women, increased intakes of magnesium-rich foods may reduce the risk of sudden cardiac death. Stephanie Chiuve and colleagues from Harvard Medical School (Massachusetts, USA) studied data collected from 88,375 women participating in the Nurses' Health Study. During 26 years of follow-up, a total of 505 cases of sudden or arrhythmic death were documented, and subsequent analysis of the role of magnesium was performed from 99 cases of sudden cardiac death and 291 women who did not die. After adjusting for confounding factors, the researchers observed that the highest intakes and the highest blood levels of magnesium were associated with significant decreases in the risk of sudden cardiac death, as compared with the lowest average intakes and blood levels. Specifically, the highest dietary intakes of the mineral were associated with a 37% reduction in the risk of sudden cardiac death, and the team found that every 0.25 milligram per deciliter increase in blood levels of magnesium associated with a 41% reduction in the risk of sudden cardiac death. Writing, "In this prospective cohort of women, higher plasma concentrations and dietary magnesium intakes were associated with lower risks of [sudden cardiac death]," the researchers conclude: "If the observed association is causal, interventions directed at increasing dietary or plasma magnesium might lower the risk of [sudden cardiac death]."

Chiuve SE, Korngold EC, Januzzi JL, Gantzer ML, Albert CM. Plasma and dietary magnesium and risk of sudden cardiac death in women.
Am J Clin Nutr. Epub November 24, 2010.

Women with Stressful Jobs at Increased Risk of Heart Disease   
Women experiencing high job strain are at 40% increased risk of cardiovascular disease. Michelle A. Albert and colleagues from Brigham and Woman's Hospital (Massachusetts, USA) analyzed job strain in 17,415 healthy women, average age 57 years, who participated in the Women's Health Study. The subjects provided information on heart disease risk factors, job strain, and job insecurity, and were followed for more than 10 years to track the development of cardiovascular disease. Women who reported having high job strain were at 40% increased risk of heart attacks, ischemic strokes, coronary artery bypass surgery or balloon angioplasty, and death. The increased risk of heart attack was about 88%, while the risk of bypass surgery or invasive procedure was about 43%. As well, job insecurity – fear of losing one's job – was associated with risk factors for high blood pressure, increased cholesterol, and excess body weight. The researchers urge: "With the increase in dual career and childrearing responsibilities for women, these data emphasize the importance of assessing job stress in [cardiovascular disease] prevention efforts among working women."

Slopen N, Glynn RJ, Buring J, Albert MA. Job strain, job insecurity, and incident cardiovascular disease in the Women's Health Study [abstract 18520].
Circulation. 23 November 2010;122:A18520.

Multivitamin May Ward Off Risks of Heart Attack    
A Swedish study reveals that women who take a daily multivitamin may be at a reduced risk for heart attack. Susanne Rautiainen and colleagues from Karolinska Institutet (Sweden) assessed the relationship between multivitamin use and myocardial infarction in a population of over 30,000 Swedish women aged 49 to 83 years. Among those women with no history of cardiovascular disease, the daily use of multivitamins alone (as compared with no use of supplements at all) was associated with a 27 % lower risk of myocardial infarction. Additionally, women using multivitamins in combination with other supplements were at a 30% lower risk of myocardial infarction. The team concludes: "The use of multivitamins was inversely associated with [myocardial infarction], especially long-term use among women with no [cardiovascular disease]."

Rautiainen S, Akesson A, Levitan EB, Morgenstern R, Mittleman MA, Wolk A. Multivitamin use and the risk of myocardial infarction: a population-based cohort of Swedish women.
Am J Clin Nutr. Sept. 22, 2010.

Routine Dental Visits Help Lower Cardiovascular Disease  
Women who receive routine dental care services reduce their risk of heart attacks, stroke, and other cardiovascular diseases by at least one-third. Timothy Brown and colleagues from University of California, Berkeley, School of Public Health (USA) analyzed data collected from nearly 7000 men and women, aged 44 to 88 years, enrolled in the Health and Retirement Study, comparing those who visited the dentist during the previous two years with those who did not. Employing statistical analytics to assess for causality, the researchers found that for women, general dental care leads to fewer heart attacks, strokes, and other adverse cardiovascular outcomes in a causal way, with "women who receive dental care [reducing] their risk of future [cardiovascular disease] events by at least one-third."

Brown TT, Cruz ED, Brown SS. The effect of dental care on cardiovascular disease outcomes: an application of instrumental variables in the presence of heterogeneity and self-selection.
Health Econ. 29 September 2010.

Healthy Proteins Lower Heart Disease Risk   
Women who substitute fish, poultry, low-fat dairy products, and nuts in place of red meat significantly reduce their risks of heart disease. Adam M. Bernstein and colleagues from Harvard School of Public Health (Massachusetts, USA) studied data collected on 84,136 women, aged 30 to 55 years, enrolled in the Nurses' Health Study. The team examined the medical history and lifestyles of these women, including dietary habits, and tracked the incidence of nonfatal heart attack and fatal coronary heart disease, for a 26-year follow-up period. The researchers found that women who consumed two servings per day of red meat, as compared with those who had a half a serving per day, were at a 30% higher risk of developing coronary heart disease. The data also showed that eating more servings of poultry, fish, and nuts was significantly associated with a decreased risk of coronary heart disease. Compared with one serving each day of red meat, women who substituted other protein-rich foods experienced significantly lower risk of coronary heart disease:
•    30% lower risk with one serving each day of nuts
•    24% lower risk with one serving each day of fish
•    19% lower risk with one serving each day of poultry
•    13% lower risk with one serving each day of low-fat dairy products

Urging that substitutions for red meat result in important health benefits, the team concludes: "These data suggest that high red meat intake increases risk of [coronary heart disease] and that [coronary heart disease] risk may be reduced importantly by shifting sources of protein in the US diet."

Bernstein AM, Sun Q, Hu FB, et al. Major dietary protein sources and risk of coronary heart disease in women.
Circulation. Aug 2010.

Physical Activity Promotes Cardiometabolic Fitness
While sedentary time has become part of the Western lifestyle, sitting for prolonged periods worsens key cardiometabolic risk factors. Genevieve Healy and colleagues from the University of Queensland (Australia) analyzed data collected on 4757 American men and women, mean age 46.5 years, enrolled in a three-year period in the US National Health and Nutrition Examination Survey (NHANES). Study subjects wore an accelerometer on the hip to record the amount of time spent standing or sitting still or being active, with sedentary time defined as any period when the accelerometer read fewer than 100 counts per minute. On average, the participants wore the accelerometer for 14.6 hours a day, of which 8.44 hours was sedentary time that was broken up an average of 92.5 times a day, with a mean break duration of about four minutes.

After adjusting for confounding factors, the team found that increases in sedentary time were associated with worsening trends in several cardiometabolic markers, most notably waist circumference, HDL cholesterol, C-reactive protein, fasting triglycerides, insulin, and measures of insulin resistance. In contrast, periodically standing up and moving about for as little as a minute was associated with beneficial changes in waist circumference and C-reactive protein. Explaining, "These are the first population-representative findings on the deleterious associations of prolonged sedentary time with cardio-metabolic and inflammatory biomarkers," the researchers conclude: "The findings suggest that clinical communications and preventive health messages on reducing and breaking up sedentary time may be beneficial for cardiovascular disease risk."

Healy GN, Matthews CE, Dunstan DW, Winkler EAH, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06.
Eur Heart J. January 11, 2011;doi:10.1093/eurheartj/ehq451.

To stay updated on the latest breakthroughs in natural approaches to promote women's health, visit the World Health Network (www.worldhealth.net), the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, your weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.

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