MELBOURNE, Australia — From someone experiencing chest pain after a breakup, to a married couple dying within minutes of each other, there are many real examples of what doctors call broken heart syndrome. While the emotional scars are a separate issue, there may finally be a way to prevent lasting physical injury. Researchers in Australia say, for the first time, scientists have uncovered a drug that can literally mend a broken heart.
A team from Monash University find Suberanilohydroxamic acid (SAHA) can significantly improve cardiac health due to this condition. In their study, researchers used SAHA to target genes affected by a “broken heart” — or Takotsubo cardiomyopathy.
Although many may think broken heart syndrome is just a saying, doctors know it to be a very real ailment. Patients suffer a weakening of the left ventricle, the heart’s main pumping chamber. Stressful emotional triggers, usually following a traumatic event like the death of a loved one, often cause this problem. Researchers add broken heart syndrome can mimic a heart attack, causing chest pain, shortness of breath, and an irregular heartbeat.
How does SAHA heal the heart?
Suberanilohydroxamic acid is currently serving as a cancer treatment, with the U.S. Food and Drug Administration approving its use. The drug works on the heart by protecting certain genes and the acetylation/deacetylation (Ac/Dc) index in particular. This is a vitally important process which regulates gene expression in humans.
“We show for the first time a drug that shows preventative and therapeutic benefit is important to a healthy heart. The drug not only slows cardiac injury, but also reverses, the damage caused to the stressed heart,” says study leader Professor Sam El-Osta from Monash Central Clinical School in a university release.
Mostly women suffer from this mysterious condition
The study finds, in western nations, broken heart syndrome almost exclusively affects women, especially after menopause. In fact, researchers say up to eight percent of women believed to be having a heart attack may actually be dealing with Takotsubo cardiomyopathy.
While the symptoms are similar, the exact cause of the physical pain of a broken heart is still a mystery. Doctors believe a surge of stress hormones flood the heart during a traumatic event. This may cause changes in the heart muscles and blood vessels which prevent the left ventricle from working properly. The result is the heavy, achy feeling people get in the chest that can be mistaken for a heart attack.
The good news is most people recover from broken heart syndrome within two months. The bad news, unfortunately, is that some patients may suffer from heart failure due to their extreme trauma. Although death from a broken heart is rare, researchers say 20 percent of patients experience some degree of heart failure. Until now, there has been no standard treatment to alleviate this condition.
“This pre-clinical study describes a new standard in preventative and therapeutic potential using a cardioprotective drug that targets genes in the heart,” Professor El-Osta concludes.
“The team is committed to the research of women’s health recognizing the uneven sex prevalence of almost 9:1 (female to male). Based on these promising results we are focused on the continued development of compounds like SAHA to improve cardiac benefit and healthier life.”
Cholesterol-lowering statin drugs, already one of the most popular medications worldwide, may become even more widely used as evidence grows of their safety and value to the elderly and their potential benefits beyond the heart and blood vessels.
Among the latest are reports of the ability of several leading statins to reduce deaths from common cancers and blunt the decline of memory with age. Perhaps such reports will persuade a reluctant 65-year-old friend who has diabetes, and others like him, that taking the statin his doctor strongly advised is a smart choice.
In addition to accumulating evidence that the benefits of statins far outweigh possible risks for the vast majority of people for whom they are now recommended, nearly all statins on the market are now available as inexpensive generics.
Full disclosure: I have a strong family history of heart disease and have been taking a statin — atorvastatin, originally marketed as Lipitor — for many years after dietary changes failed to control a steadily rising blood level of artery-damaging LDL-cholesterol. My prescription is now fully covered by my Medicare Part D insurance with no co-pay.
But cost of a medication is not the only consideration for a drug that can be lifesaving for many people. The primary indication for taking a statin is to reduce the risk of a heart attack or stroke by lowering serum LDL-cholesterol and, in some cases, also triglycerides, both of which can damage coronary arteries when levels rise above normal.
Statins offer further cardiovascular protection by stabilizing the fatty deposits in arteries called plaque that can break loose, block a major artery and cause a heart attack or stroke.
Current guidelines typically recommend statin therapy for:
People over 40 with diabetes and an LDL-cholesterol level above 70 milligrams per deciliter;
People over 21 with an LDL-cholesterol level of 190 or higher (despite dietary changes to minimize saturated fats and achieve a normal body weight).
Currently, more than 60 percent of older people in the United States who, like me, have high cholesterol take a statin to help prevent a heart attack or stroke.
Still, there’s been a long-simmering debate as to whether statins are advisable for people over 75, even though the risk of suffering life-threatening cardiovascular disease rises precipitously with age. Concerns have been raised about side effects associated with statins, potential adverse effects of the drugs on other ailments common in the elderly and possible harmful interactions with the many other medications they often take.
Writing in the Harvard Health Blog last October, Dr. Dara K. Lee Lewis noted, “The paradox that we face is that as our patients age, they are at increased risk for heart attacks and strokes, and yet they also become more sensitive to medication side effects, so it is a tricky balance.”
Statins can sometimes cause blood sugar abnormalities, resulting in a diagnosis of pre-diabetes or diabetes, and possible toxic effects on the liver that necessitate periodic blood tests for liver enzymes. A very small percentage of people prescribed a statin develop debilitating muscle pain. An elderly friend developed statin-induced nightmares. There have also been reports suggesting statin-associated memory problems and cognitive decline, already a common concern as people age.
But likely the biggest deterrent was the existence of meager evidence for the role statins might play for older people at risk of cardiovascular disease. As is true in most drug trials on new medications, relatively few people over 75 were included in early studies that assessed the benefits and risks of statins.
The latest reports, however, are highly reassuring. One followed more than 120,000 French men and women ages 75 to 79 who had been taking statins for up to four years. Among the 10 percent who stopped taking the drug, the risk of being admitted to a hospital for a cardiovascular event was 25 to 30 percent greater than for those who continued taking a statin.
Another study in Israel, published last year in the Journal of the American Geriatrics Society, involved nearly 20,000 older adults followed for 10 years. Among those who stayed on statin therapy, the chance of dying from any cause was 34 percent lower than among those who failed to adhere to a prescribed statin. The benefits were not reduced for those older than 75 and applied to women and men alike.
This year a study published in JAMA by a team headed by Dr. Ariela R. Orkaby of the VA Boston Healthcare System found that among 326,981 United States veterans whose average age was 81, the initiation of statin use was associated with 25 percent fewer deaths over all and 20 percent fewer cardiovascular deaths during a follow-up of nearly seven years.
However, none of these studies represent “gold standard” research. The results of two such studies, the Staree trial and the Preventable trial, both randomized controlled clinical trials of statin therapy to prevent cardiovascular events in the elderly, have not yet been published. Both will also assess effects on cognition.
Meanwhile, a report last year from Australia published in the Journal of the American College of Cardiology found no difference over a six-year period in the rate of decline in memory or cognitive status between statin users and those who had never taken the drugs. In fact, among those who started a statin during the study, the rate of memory decline was blunted. Another observational study by a Swedish team published in Nature found beneficial effects on reaction time and fluid intelligence among statin takers over 65.
Finally, there are several reports that a major class of statins called lipophilic (including atorvastatin, simvastatin, lovastatin and fluvastatin) may have anticancer effects. One study of nearly 2,000 survivors of early-stage breast cancer found a decreased five-year recurrence rate in women who started a statin within three years of diagnosis.
In a report presented in June to a virtual meeting of the American Association for Cancer Research, Dr. Kala Visvanathan of Johns Hopkins Medicine in Baltimore described a 40 percent reduction in deaths from ovarian cancer among more than 10,000 patients who had used statins either before or after their diagnosis. The patients who benefited in this observational study had the most common and aggressive form of ovarian cancer.
Dr. Visvanathan explained that statins inhibit an enzyme in a chemical pathway involved in the growth and proliferation of tumors. At a press briefing, Dr. Antoni Ribas, president of the association, said that if the finding is confirmed in a randomized clinical trial, “this would be a great outcome.”
A single exercise session that ups your heart rate can lower blood pressure, improve sleep, reduce anxiety and improve insulin sensitivity on the day you do it.
The big benefits such as lowering your risk of many chronic diseases and cancers start adding up within days or weeks of starting regular physical activity. The current guidelines are:
Move more, sit less. Some physical activity is better than none.
Spread aerobic activity through the week. Aim for at least 2.5 -5 hours of moderate intensity or 1.25 – 2.5 hours of vigorous intensity.
Strength train at least twice a week. Your bones, joints and muscles need love!
Add balance training as you get older. Yoga, tai chi and other activities help prevent falls.
Anyone with chronic conditions should be as physically active as
their abilities and conditions allow.
Pregnant? Stay moderately active, per your doctor’s advice.
What’s moderate vs. what’s vigorous? Per the guidelines, moderate activity means you’re breathing hard and can hold a conversation, but you can’t sing. (OK, some of us can’t sing no matter what.) “Vigorous” means you can’t get more than a couple of words out without a breath.
Exercise with others and live longer! A recent Mayo Clinic study of more than 8500 participants found that playing team and partner sports added years to their lives vs exercising alone:
Tennis: +9.7 yrs
Badminton +6.2 yrs (I am not making this up)
Soccer +4.7 yrs
Jogging +3.2 yrs
Gym +1.5 yrs
Group exercise classes or clubs also boost longevity
I have high-ish cholesterol (controlled by medication); as a result, I tend to avoid eating eggs. But a little research has revealed that they’re more good than bad for our health.
While it’s true that chicken eggs are high in cholesterol, their effect on blood cholesterol is minimal when compared with the effect of trans fats and saturated fats; i.e., skip the bacon/ham/sausage/frying in butter part. Instead, opt for poached eggs or make your omelet with one egg white + one whole egg and cook it in olive oil.
According to experts, most healthy people can eat up to seven eggs a week with no increase in their risk of heart disease, and some scientists don’t see a problem with eating as many as three a day. (The main problem would probably be how boring that would be!)
Eggs consistently raise HDL (“healthy”) cholesterol. For 70% of people, there is no increase in total or LDL (“lousy”) cholesterol, though some people may experience a mild increase in a benign subtype of LDL.
As a good source of inexpensive, low-calorie, high quality protein, eggs are hard to beat (pun intended). More than half their protein is found in the egg white, along with vitamin B2 and lower amounts of fat than the yolk.
Along with beneficial fat, they also contain biotin and vitamin B12 (great for skin, hair and nails), plus vitamin A and lutein, which support eye health. Some stats:
Vitamin A: 6% of the RDA.
Folate: 5% of the RDA.
Vitamin B5: 7% of the RDA.
Vitamin B12: 9% of the RDA.
Vitamin B2: 15% of the RDA.
Phosphorus: 9% of the RDA.
Selenium: 22% of the RDA.
Eggs also contain decent amounts of vitamin D, vitamin E, vitamin K, vitamin B6, calcium, and minerals such as iron, copper and zinc (which supports a healthy immune system).
Virtually all egg yolks contain omega-3 fats. And of course, egg whites contain no cholesterol.
I’m pretty sure there are health benefits associated with an accompanying mimosa, too, aren’t you?!