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Mental health conditions may affect blood pressure, heart rate

Mental health conditions may affect blood pressure, heart rate

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Psychological health and fitness ailments might interfere with blood strain and heart fee, a new research finds. Vladimir Tsarkov/Stocksy
  • Aside from influencing psychological nicely-currently being, mental health ailments can also interfere with the body’s autonomic features, generating physiological complications.
  • Preceding reports have found that folks with mental well being conditions frequently experience diminished coronary heart price variation (HRV), which can show a inadequate anxiety reaction.
  • A new systematic critique attracts a link between mental disease and broadly fluctuating blood tension, which can guide to cardiovascular disease.

A new review has located that people with mental wellness ailments these as depression or nervousness may be additional prone to experience cardiovascular problems.

Scientists at the rear of this systematic overview, printed in the journal BioMedical Engineering, noticed that psychological wellbeing problems might have an effect on autonomic capabilities, which may possibly induce blood pressure to greatly fluctuate.

“We know that people today with psychological health and fitness issues have [an] improved possibility of cardiovascular events and organ injury,” Dr. Renly Lim, one of the researchers behind the study and a exploration fellow at the University of South Australia, explained to Professional medical Information Right now.

Research so far on the connection in between blood pressure variability (BPV) and psychological ailment has been minimal. This is vital as BPV has been associated with coronary ailment.

“We also know that men and women with greater blood pressure variation have bigger cardiovascular threat. Our analyze now helps make the relationship concerning mental health and fitness troubles with blood force and coronary heart rate,” said Dr. Lim.

The analyze adds to present investigate setting up a url concerning psychological wellness and physical perfectly-getting.

The autonomic anxious system (ANS) is a elaborate community of cells that regulate involuntary physiologic processes like maintaining a constant inside temperature, regulating respiration patterns, retaining blood tension continual, and moderating the coronary heart fee.

Autonomic dysfunction is related with an increased threat of cardiovascular illness.

Doctors evaluate coronary heart rate variability (HRV), which is controlled by the ANS, to see the period in time involving heartbeats. Acquiring a constantly altering coronary heart level has been joined with possessing a nutritious regulatory procedure.

Correspondingly, a selection of scientific studies have noted an affiliation concerning lessened HRV and despair and anxiousness conditions — which includes generalized panic problem, social anxiousness dysfunction, panic problem, and post-traumatic strain condition.

For their evaluate, the scientists searched four digital databases for scientific tests investigating BPV in people with mental ailment who did not have hypertension. They found 12 scientific tests that met the conditions.

Of the 12 scientific studies, 7 calculated ultrashort time period BPV (beat-to-defeat blood stress measurement above seconds to minutes), three calculated short-time period BPV (blood strain fluctuations that take place more than a 24-hour time interval), and two calculated lengthy-phrase BPV (fluctuations that take place more than days, months, or even a long time).

Five of the scientific tests assessed BPV in grownups aged 55 and more mature when the remaining scientific tests assessed BPV in adults among the ages of 18 and 46.

Persons with despair or nervousness experienced substantial BPV in the studies that measured small-time period BPV. The studies measuring ultra-shorter-time period BPV also found a considerable affiliation involving BPV and mental disease.

The two research that calculated extensive-phrase BPV experienced combined results, that means the affiliation involving psychological health situations and lengthy-term BPV is much less clear.

The researchers from the University of South Australia and a number of universities in Malaysia publish that early therapeutic intervention for psychological health issues “may prevent disorders related with autonomic dysregulation and minimize the chance of unfavorable cardiac outcomes.”

Dr. Richard Wright, a cardiologist at Providence Saint John’s Health and fitness Heart, instructed MNT that the systematic assessment illustrates how mental ailment, “at least in theory”, can make sufferers “more vulnerable to owning cardiac problems that we normally only assume would be attributable to atherosclerosis, and hypertension, aged age, [etc.].”

“I think which is the principal importance of this form of an investigation: to position out that there are bodily ramifications of these emotional issues,” he said.

Dr. Wright said supplemental investigation on what to do about the association amongst psychological health and cardiovascular well being would be valuable for healthcare practitioners.

“If you’re chronically depressed and you have these troubles wherever the autonomic nervous process is messed up, do you get superior if your melancholy goes away?” he requested.

Specifically, he explained would like to see studies on no matter if BPV variability decreases with psychological wellness treatment plans like converse treatment, meditation, or medicine.

Dr. Cristen Wathen, an assistant professor in the counseling office at Palo Alto College, wasn’t astonished by the conclusions the scientists drew from their systematic assessment.

“When we are regularly in long-term strain, which is standard of people who have been identified with [anxiety and depression], then our bodies are releasing strain hormones, cortisol, epinephrine,” she told MNT.

“If we’re in that regular state of long-term pressure [due to anxiety and depression], then that’s going to relate to our actual physical wellness.”
— Dr. Cristen Wathen

Dr. Wathen stated she would have appreciated to have noticed extra in-depth perception into the analyze participants’ races and socioeconomic statuses.

“There’s so a great deal which is relevant to poverty, oppression, trauma, like generational trauma, and access to healthcare, that also can guide to much more experiences of chronic pressure,” she pointed out.

Dr. Lim said the research bundled in the systematic overview most likely did not include things like data about the participants’ race or socioeconomic status both. She agreed that it would be helpful to know that data.

“It is a little something truly worth investigating, considering race and socioeconomic status do influence a lot of wellbeing disorders,” she reported.

Even with out that facts, nonetheless, Dr. Wathen felt the examine highlighted a weakness of the American healthcare process.

“It speaks to the require for there to be much more integrated treatment and coordination involving psychological health gurus and health care specialists because of how similar our actual physical wellness and our mental health is,” she explained.

Dr. Lim hopes the evaluation will crank out higher consciousness amid well being practitioners of the health and fitness complications that can go together with mental ailment.

“I consider the information listed here is to fork out a lot more notice to the physical impacts of mental ailment. So, when a person is diagnosed with mental wellness difficulties, it’ll be significant to also display screen for any abnormalities in blood stress and coronary heart fee.”
— Dr. Renly Lim

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Mild COVID-19 may affect heart health in younger adults

Mild COVID-19 may affect heart health in younger adults

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New investigate emphasizes the cardiovascular effect of COVID-19 on youthful adults. Image credit score: Vachira Vachira/NurPhoto by means of Getty Illustrations or photos.
  • A study of young Brazilian grown ups finds that even a mild-to-moderate situation of COVID-19 can unbalance the autonomic anxious process, probably major to cardiovascular challenges that grow to be apparent afterwards in everyday living.
  • COVID-19’s effect on the autonomic nervous technique tends to make feeling looking at how many organs and devices it seems to affect.
  • Holding a healthy physique mass index (BMI) and sustaining a physically active life-style could minimize the imbalance.

The autonomic anxious program (ANS) is responsible for keeping different overall body procedures in harmony. These procedures contain respiratory, heart price, and blood stress.

A new review from São Paulo State University (UNESP) in Brazil, which labored with a cohort of younger older people, found that COVID-19, even in gentle-to-average circumstances, can disrupt the autonomous anxious system’s essential balancing act.

COVID-19 might as a result quietly induce cardiovascular complications that do not make by themselves recognized right until later on in lifestyle.

COVID-19 has shown a perplexing capability to have an effect on many organ techniques, and the suggests by which this takes place is not but entirely recognized. If the virus damages the success of the ANS, which is associated in the management of various units, at the very least a partial explanation may be at hand.

Research co-creator Prof. Fábio Santos de Lira of UNESP discussed for Health-related News Today:

“The autonomic nervous method controls the coronary heart rate — the sympathetic anxious system activity maintains a bigger heart fee, and parasympathetic exercise cuts down coronary heart amount. This ailment can favor, later on, a coronary heart dysfunction, [such] as arrhythmia.”

The sympathetic nervous technique is liable for the body’s reaction to anxiety, threat, and extreme work. In the circumstance of the coronary heart, it pushes the heart price upwards. This boost is held down to satisfactory boundaries by the parasympathetic anxious process that manages everyday bodily capabilities, this sort of as digestion, resting, recharging.

The research also discovered that sustaining a wholesome BMI and a physically energetic lifestyle seems to assist retain the ANS in suitable equilibrium, suggesting that even further investigation should really appear into mitigating the long lasting stressing consequences of COVID-19.

Brazil has the second-greatest amount of COVID-19 fatalities, and other analysis has connected this to higher being overweight prices.

The new examine seems in MDPI.

The cross-sectional, observational research took area in the town of Presidente Prudent, a local community with some 232,000 inhabitants, which experienced 39,049 scenarios of COVID-19 by February 2022, and 982 fatalities.

The researchers recruited male and female individuals aged 20 to 40 who had examined beneficial for COVID-19 through a PCR take a look at within just 15 to 180 days in advance of the evaluation started.

Following excluding people today with chronic non-communicable illnesses, a record of using tobacco, drug use, and having anti-inflammatory prescription drugs or antibiotics acknowledged to influence the ANS, the closing cohort consisted of nine women and 11 adult males.

To evaluate the working of their ANS, scientists calculated the participants’ coronary heart rate variability (HRV), a measurement of the variation of time amongst each individual heartbeat.

Professor de Lira discussed that the “simplest type of assessing this circuit is by coronary heart fee variability, wherever the observe captures the details and we can observe it in software.”

If the HRV is far too significant, the ANS is not functioning easily, with the sympathetic and parasympathetic sides at odds with just about every other.

The researchers identified that even with gentle-to-moderate bouts of COVID-19, sympathetic action amplified whilst parasympathetic exercise diminished.

The reduction of parasympathetic activity was primarily pronounced in persons with overweight or weight problems.

The info also implied that primary a physically energetic way of living left an individual’s ANS in greater equilibrium. On the other hand, the analyze authors counsel that training may possibly truly be a confounding component because “the variations noticed in HRV could be generally modulated by degrees of actual physical activity and not by the presence of article-COVID-19.”

In the analyze paper, the authors go on to warning that: “It is regarded that workout encourages positive diversifications in HRV parameters in both handle subjects and people struggling from a wide variety of diseases. Equally, equally exercising training and actual physical exercise patterns strengthen heart charge variability parameters, the autonomic profile, and arterial compliance, as nicely as the baroreflex sensitivity in HIV+ sufferers, highlighting the influence of way of life habits to modulate ANS in viral ailments.”

Prof. de Lira proposed committing to a healthy life style to offset the impression of COVID-19.

“Excess adipose tissue is related to numerous ailments, in addition to weight problems, these as style 2 diabetic issues, dyslipidemia, fatty liver, cancer, kidney failure, among the other folks,” he spelled out. “In the same sense, the sedentary way of life favors the gain of system body fat, which will set off or worsen being overweight.“

“Thus, it is exceptionally vital to preserve physique excess weight, primarily reduced human body fat — very little as well athletic — [with] BMI ranges involving 18-24.99, as perfectly as maintaining a physical activity plan, this sort of as strolling, biking, swimming, functioning, go walking to the bakery. This lifestyle will add protection from the penalties of COVID-19,” he encouraged.

For reside updates on the most up-to-date developments relating to COVID-19, simply click listed here.

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How does COVID-19 affect the brain?

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A recent article in the journal Science outlines what we know about the neurological consequences of SARS-CoV-2 infection. NICOLAS TUCAT/AFP via Getty Images
  • Neurologic complications from COVID-19 are common and can range from decreased mental clarity to stroke.
  • A recent perspective article outlines what we know about these complications so far.
  • The authors explain how prior assumptions that the virus directly affected brain cells have been disproven.
  • Instead, nervous system injury is likely a result of severe inflammation and neurovascular injury.
  • Neurologic insults from SARS-CoV-2 infection could increase the incidence and severity of neurodegenerative diseases, such as Alzheimer’s and Parkinson’s disease, in future generations.

Early in the pandemic, researchers observed that people recovering from COVID-19 were not returning to their pre-illness state of health — this is now commonly known as “Long COVID.”

Among the myriad persistent symptoms, many people experience headaches, memory issues, and cognitive deterioration.

Researchers from Northwestern University in Chicago, IL, were the first to report that even non-hospitalized people with COVID-19 demonstrated significant cognitive dysfunction that persisted well beyond 6 weeks from the acute infection.

In the journal Science, Dr. Serena Spudich and Dr. Avindra Nath review our current understanding of the neurologic consequences of COVID-19.

Building on clinical observations, autopsy, and laboratory findings, the authors propose theories of causality about how COVID-19 may result in long-term neurologic symptoms.

Neurologic complications of COVID-19 include:

  • loss of smell (anosmia)
  • stroke
  • delirium — a mental state characterized by an inability to rest, illusions, and incoherent thought and speech patterns
  • encephalopathy — a temporary or permanent state of altered brain function
  • psychiatric symptoms
  • peripheral neuropathy — a condition where nerve damage alters the communication between the central nervous system and the rest of the body

The authors acknowledge that the mechanisms by which COVID-19 can wreak havoc on the human nervous system are not well understood.

Cerebrovascular complications, such as a stroke, can occur early in the infection — even before the respiratory effects of the disease. Central inflammatory conditions and peripheral nerve symptoms occur later, typically 2 weeks after the acute infection.

These disparate timelines suggest that the cause of these neurologic symptoms may differ. Studying the cerebrospinal fluid (CSF) offers clues as to underlying mechanisms for neurologic damage in people with COVID-19.

CSF is a fluid that surrounds the spinal cord and brain.

Scientists have observed increases in certain immune-related compounds in the CSF, including:

  • Interleukin-1 (IL-1) and IL-2 proteins, which are inflammatory cytokines produced by the body.
  • Expression of genes controlled by interferon, an infection-fighting protein present during viral infections.
  • Activated T-cells and natural killer cells, which combat viral antigens.
  • Markers that indicate the presence of monocytes — large white cells that fight infection.
  • Breakdown proteins suggesting nerve damage.

Conversely, researchers have not found evidence that the SARS-CoV-2 virus directly impacts the nervous system. For instance, research has shown that the following factors are reduced or absent in people with a SARS-CoV-2 infection:

  • Cells that cause inflammation are not found clustered around the brain, which normally occurs in cases of viral encephalitis — a swelling of the brain.
  • The CNS does not contain viral RNA.
  • Limited presence of SARS-CoV-2 nucleic acid or viral protein in the brain cells of people who died from COVID-19.

When asked about the lack of virus in the CSF and brain cells, Dr. Santosh Kensari, chair, and professor of translational neurosciences and neurotherapeutics at St. Johns’ Cancer Institute in Santa Monica, CA, commented:

“If the virus isn’t there, it’s not directly [causing] the problem — that would be encephalitis — but the viruses can cause systemic problems, like the inflammation that [can] affect every organ system, including the brain — its an indirect effect.”

Adding and subtracting the positive and negative findings helped the authors of the perspective article to formulate a theory regarding the cause of nervous system consequences of SARS-CoV-2 infection.

They do not rule out that the virus may transiently infect the brain very early in infection. However, the authors ultimately conclude that inflammation and widespread vascular dysfunction may be the vector of neurologic damage in people with COVID-19.

Compared with people with influenza, individuals with COVID-19 exhibit an increased risk of stroke. When scientists studied the blood of people who experienced a stroke, they found elevated blood markers of vascular inflammation, tissue death, and thrombosis, which are clots that obstruct blood flow.

Radiologic testing also provides evidence of injury in people who experienced COVID-19. MRIs confirm microvascular damage and brain atrophy, or shrinkage. Positron emission tomography confirms decreased metabolic activity in the brains of people diagnosed with Long COVID.

This evidence, coupled with the system-wide vascular dysfunction seen in people with severe COVID-19, points to vascular injury as a potential cause of stroke, brain, and nerve injury.

The authors conclude that SARS-CoV-2 is absent and markers of inflammation and vascular dysfunction are increased in the brains of people with COVID-19. So, the effects of COVID-19 are likely the result of an intersection of disease-causing mechanisms:

  • Generalized neuroinflammation supported by the presence of immune cells, cytokines, antibodies, and activated microglia, which are specialized neuron damage-fighting cells.
  • Damage to the cells lining the brain’s blood vessels (endothelium).
  • Elevated levels of blood-clotting proteins.
  • Individual susceptibility, including genetics, preexisting health conditions, and immune strength.

For MNT, Dr. Santosh Kensari addressed why some people might be more susceptible to neuropsychiatric complications from COVID-19 infection.

“I don’t think we know fully, but I suspect it is a variety of factors,” he explained. He believes these probably include the severity of COVID-19 and other cardiovascular risk factors, such as type 2 diabetes.

“My philosophy in medicine has completely changed. For example, inflammation is probably 90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of aging. Cancer, dementia, all are due to immune function. COVID-19 is making all these things worse because it is driving inflammation.”

– Dr. Santosh Kensari

While laboratory and radiologic evidence support their theories, there is only conjecture on the exact mechanisms at this time.

The authors note that people living with Long COVID may have long lasting immune activation, persistent autoimmune disturbance, or ongoing damage to the endothelium.

Medical experts around the world are worried about the long-term prognosis for people recovering from COVID-19.

From a neurologic standpoint, Dr. Spudich and Dr. Nath are concerned that the neuroinflammation and neuronal injury caused by acute SARS-CoV-2 infection may “accelerate or trigger future development of neurodegenerative diseases, such as Alzheimer’s or Parkinson’s disease.”

And they feel that the neurodevelopmental influences of SARS-CoV-2 infection on children remain unknown.

For MNT, Dr. Santosh Kensari added:

“Chronic inflammation has many causes, including diabetes, obesity, and nutrition. These are a predisposition to autoimmune disorders, and they cause and accelerate the risk of brain-related disorders.”

Given the number of individuals who have experienced COVID-19, the researchers note that the neurologic consequences of COVID-19 represent a global public health problem.

In response to this challenge, the National Institute of Health has established a COVID-19 NeuroDataBank and NeuroBioBank to allow doctors to report and quantify neurologic events from COVID-19.

Drs. Spudich and Nath recommend that rigorous study and interventional trials are needed to dissect why some patients have an acute neurologic illness and others develop chronic disease late in their illness. They propose that understanding the immune dysregulation in individuals with Long COVID holds promise for treatment and long-term management.

For live updates on the latest developments regarding COVID-19, click here.

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Can body fat affect brain aging?

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A current study investigates no matter whether body excess fat may possibly affect cognitive overall performance. BSIP/UIG Via Getty Visuals
  • Being overweight and overweight enhance the chance of numerous health and fitness conditions.
  • A new examine from Canada has identified that surplus overall body pounds might also affect cognitive function, with inflammation maybe actively playing a purpose.
  • Persons with excess fatty tissue gained decreased scores for processing speed in cognitive exams.
  • Bodily training, which raises blood move to the brain, may perhaps aid limit cognitive impairment even in these with a superior physique mass index (BMI).

It is broadly recognised that extra physique weight is involved with lots of wellness disorders. Now, scientists have uncovered an association among adiposity — obtaining way too a lot fatty tissue in the human body — and cognitive impairment.

At the commence of a new review, which appears in JAMA Community Open up, Canadian scientists identified the adiposity of a lot more than 9,000 individuals. They calculated both of those complete entire body body fat and visceral adipose tissue (VAT) — the excess fat that predominantly sits all around organs in the stomach cavity.

Former studies have affiliated VAT, or visceral unwanted fat, with enhanced morbidity and a better mortality danger. Visceral excess fat raises the danger of several conditions, this kind of as:

This most recent review implies that excessive extra fat could have psychological as nicely as actual physical results.

All contributors undertook two cognitive tests — the Electronic Symbol Substitution Test (DSST) and the Montreal Cognitive Assessment (MoCA) — to evaluate a selection of cognitive functions.

The scientists altered the scores for cardiovascular risk factors, academic degree, and MRI-detected vascular brain injuries, which is identified to be linked with cognitive impairment.

The scientists discovered that bigger total body extra fat and better VAT have been both equally noticeably connected with reduced DSST and MoCA scores. The association was larger on the DSST, which assesses processing velocity, than on the MoCA, which is a multidimensional cognitive examination.

Compared with all those in the lowest quartile (25{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) of adiposity, the efficiency of all those in the optimum quartile was equal to an supplemental 3 yrs of cognitive aging.

These outcomes are not unforeseen, as Dr. Anton Porsteinsson, professor and director of the Alzheimer’s Sickness Care, Analysis and Education Method (Advert-Treatment) at the University of Rochester Healthcare Heart, informed Health care Information Right now:

“It is well-identified that increased adiposity and body fats are linked with increased cardiovascular threat factors and that these are connected with increased danger of cognitive drop. This cross-sectional research observed that extra adiposity was a risk issue for reduced cognitive scores, unbiased of cardiovascular possibility aspects, instructional stage, and MRI-detected vascular brain damage.”

This review reinforces conclusions from a prior analyze of more mature grownups in Dublin, which located an affiliation among adiposity, notably central adiposity, and reduced cognitive operate.

This review can not verify a causative link among adiposity and cognitive impairment, as Dr. Eamon Laird, a senior study fellow at Trinity University Dublin in Ireland, pointed out to MNT:

“It is cross-sectional, and it can be difficult to tease out the associations and detect if visceral adiposity is causative and not just correlated with lowered cognitive scores. But the association is clear.”

The researchers controlled for cardiovascular risk and vascular mind damage, both of those of which investigate has revealed to induce cognitive impairment. So, what else may possibly be dependable for the website link?

The authors counsel that irritation could play a role in cognitive impairment in individuals with over weight or being overweight. Just one current examine involving a lot more than 15,000 people discovered large concentrations of plasma C-reactive protein, an inflammatory marker, in those people with a superior BMI and a superior midsection-hip ratio.

Dr. Porsteinsson agreed with this recommendation, stating, “Systemic swelling and glucose intolerance arise as guide suspects.”

Dr. Laird also supports inflammation getting a role. He said, “Pro-inflammatory cytokines from adipose tissue could also perhaps be contributing to tissue damage by way of swelling.”

There are also other prospective mechanisms. For case in point, “Adiposity can generally go hand in hand with other serious conditions, these types of as hypertension, which could be a individual mechanism,” Dr. Laird explained to MNT.

“Obesity could be linked with lowered blood movement to the mind, which may possibly enhance the threat of vascular microcellular injury, which could direct to [a] reduction in cognitive exam rating,” he additional. In yet another analyze, which Dr. Laird co-authored, scientists uncovered that a 1-centimeter raise in midsection measurement gave the exact same reduction in blood circulation as 1 calendar year of growing older.

This examine confirms former findings that obese and being overweight are involved with cognitive impairment, so what can people do to enable battle this?

Dr. Porsteinsson recommended numerous measures that may well aid: “Weight loss, exercising (the two aerobic and resistance teaching), handle of diabetic issues/glucose intolerance, or speed of processing cognitive schooling are a number of that appear to brain.”

Citing research findings that those with a large BMI or higher waistline-hip ratio who did little physical activity had substantially lower cerebral blood movement, Dr. Laird additional:

“Since physical exercise could likely average weight problems/blood circulation associations, this [increasing physical activity] may well be a price powerful and rather easy way to assistance mitigate the damaging influence of obesity.”

“There are nevertheless several unanswered issues right here, such as why a job of processing velocity (DSST) is additional impacted than a multidimensional cognitive test, so this research begs for more study.”

– Dr. Anton Porsteinsson

In summary, sustaining a reasonable weight could advantage the brain as very well as the system.

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How does heart health affect brain health?

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Updated data from the American Heart Association (AHA) emphasize the crucial link between heart and brain health. Image credit: Hiroshi Watanabe/Getty Images.
  • The 2022 Update of the AHA’s Heart Disease and Stroke Statistics emphasizes the bidirectional relationship between brain and heart health.
  • Globally, the number of dementia cases and deaths has increased alarmingly over the past 3 decades, more than heart disease.
  • Modifying risk factors for cardiovascular disease, such as smoking, diabetes, high blood pressure, obesity, and high cholesterol, may promote healthy aging and prevent cognitive decline.

Current evidence suggests a robust connection between brain health and cardiovascular health. Damage to the heart and blood vessels can increase a person’s risk of stroke and dementia.

A stroke occurs when a clot blocks blood flow or when a blood vessel ruptures in the brain. Strokes cause the death of brain tissue, sometimes resulting in a decline in memory and profound disability.

Additionally, the cumulative effect of multiple small silent strokes — which health experts call ministrokes — can cause vascular dementia. Dementia can have a detrimental impact on memory, cognitive functioning, and personality.

The AHA and the National Institutes of Health (NIH) update vital heart disease and stroke statistics annually. Their joint report highlights data related to important modifiable risk factors affecting cardiovascular health and outcomes associated with the quality of care, procedures, and economic costs for cardiovascular-related conditions.

The AHA Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee recently published “The Heart Disease and Stroke Statistics — 2022 Update: A Report From the American Heart Association” in the AHA’s peer-reviewed journal Circulation.

According to 2020 Global Burden of Disease (GBD) study data, the number of people worldwide with Alzheimer’s disease and related dementias increased at a greater rate than that of people with ischemic heart disease (IHD). From 1990 to 2020, the prevalence of Alzheimer’s disease and related dementias increased about 144{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} globally, compared with 120{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} for IHD.

The study reports more dramatic differences in Alzheimer’s disease and related dementias death rates during the same time frame, with an approximately 185{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increase in Alzheimer’s disease and related dementias deaths and a 66{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increase in IHD-related deaths.

A systematic analysis of the 2017 GBD study — the most recent data available — reports that 2.9 million people in the United States had an Alzheimer’s disease or Alzheimer’s disease and related dementias diagnosis.

It is the fourth most prevalent neurological disorder in the U.S., as well as the leading cause of death from neurological disease, surpassing stroke.

There is also a significant economic burden associated with Alzheimer’s disease and related dementias. Between 1996 and 2016, U.S. spending on dementias increased twofold, from about $39 billion to $79 billion.

Dr. Mitchell Elkind, the immediate past president of the AHA, a professor of neurology and epidemiology at Columbia University Vagelos College of Physicians and Surgeons, and attending neurologist at New York-Presbyterian/Columbia University Irving Medical Center in New York, spoke with Medical News Today about the new updates.

“Heart disease and brain disease share many of the same risk factors. Cardiovascular disease risk factors, or the health behaviors and conditions that can lead to heart attacks, include high blood pressure, diabetes, smoking, high cholesterol, and obesity,” he explained.

“For some time, we have known that these same risk factors also lead to strokes, which are injuries to the brain caused by blood vessel — i.e., vascular — disorders. What clinicians, epidemiologists, and other scientists have more recently found is that these same risk factors also contribute to other manifestations of brain disease, such as cognitive decline and dementia, that had not previously been recognized as [a] vascular disorder.”

– Dr. Mitchell Elkind

The 2022 Update highlights the effects of cardiovascular disease risk factors on cognitive dysfunction or dementia development.

In brief, a meta-analysis of 139 studies demonstrated that people with high blood pressure midlife were 55{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} more likely to develop impaired global cognition and about 20{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} more likely to experience impaired executive function, dementia, or Alzheimer’s disease.

Another meta-analysis of four studies found that people with heart failure were 80{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} more likely to develop dementia, while a meta-analysis of 14 studies found that females with diabetes had a 62{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} higher risk of developing dementia, and males had a 58{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} higher risk.

In terms of the risk of dementia linked to obesity, a meta-analysis of studies with up to 42 years of follow-up showed that people with midlife obesity had a 33{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of developing dementia.

Smoking also remains an important risk factor. A meta-analysis of 37 studies demonstrated that people who smoked at the time had a 30{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of dementia, a 40{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} higher risk of Alzheimer’s disease, and a 38{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of vascular dementia.

The risk of cognitive dysfunction or dementia can vary depending on race, ethnicity, sex, education, occupation, and geography.

The 2022 Update highlights an analysis of 2016 Behavioral Risk Factor Surveillance System data that showed that Black adults were about three times more likely and Hispanic adults about four times more likely than white adults to need assistance with daily activities due to memory loss.

Additionally, Alzheimer’s disease and related dementias disproportionately affects females. According to GBD data from 2020, about 20 million males and 35 million females worldwide had a diagnosis of Alzheimer’s disease and related dementias, with a death rate of 1.28 million for females and 0.61 million for males.

Dr. Elkind commented:

“Because nearly half of all adults in the U.S. have elevated blood pressure, and 40{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} are obese, these data provide an inkling of what we can expect to see in the future as the population ages, and the impact of these risk factors begins to be felt. Recent data suggest that globally, dementia cases may triple over the next 3 decades, even as heart disease declines.”

Decreasing risk by modifying lifestyles and behavioral risk factors may help protect people from developing cardiovascular disease, stroke, and dementia. Dr. Elkind stated that a system-wide approach is necessary to achieve long-term behavioral change.

He explained: “Researchers are now testing technologies to see if they can improve our success rates with behavioral risk factors; some of these approaches involve moving the focus of care from the doctor’s office to the home and involving nonphysician providers in management to improve efficiency. For example, can in-home blood pressure monitoring with real-time connection to a doctor or nurse help improve blood pressure?”

Dr. Elkind also wondered: “Can we use nonclinical settings, such as barbershops, to reach Black men and women to detect high blood pressure and make changes in their lifestyles? […] These types of approaches may ultimately lead to bigger benefits than doctors prescribing specific medications or trying to convince individual patients to change their behaviors.”

Dr. Jason Tarpley — a stroke neurologist and director of the Stroke and Neurovascular Center for Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA — went on to comment, in an interview with MNT, that “the take-home message is that a lot of this is preventable” through a combination of a healthy diet, exercise, and medications.

He added: “The information age is helping people […] [P]atients know their cholesterol number, they know their LDL, they know their hemoglobin A1C — which is a long-term measurement of their blood sugar — and they know [their] blood pressures. I […] see that behaviors are changing, and I think that people are […] taking more their health into their own hands, and that’s really good.”

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Long COVID may affect how women recover from exercise

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New research explores the link between long COVID and women’s ability to exercise. Artur Widak/NurPhoto via Getty Images
  • Long COVID or post-acute COVID syndrome is characterized by a multitude of symptoms that persist beyond the acute phase of 3–4 weeks after getting the SARS-CoV-2 virus.
  • Women hospitalized with COVID-19 are more likely to experience persistent deficits in cardiovascular and lung function than men in the months following discharge.
  • A new study found that even women with mild-to-moderate COVID-19 may experience slower declines in their resting heart rate after physical activity in the post-acute phase of the SARS-CoV-2 infection.
  • Such deficits in cardiovascular function during exercise are associated with reduced capacity for physical exercise and, potentially, activities of daily life.
  • Women presenting with specific long COVID symptoms, namely shortness of breath or joint or muscle aches, were also more limited in their ability to do a walking test than people who had had a SARS-CoV-2 infection but experienced no lingering symptoms.

Although the majority of individuals recover within the first 3–4 weeks after contracting COVID-19, a considerable number continue to experience lingering symptoms for weeks or months after this initial or acute phase of the disease.

These symptoms, which people refer to collectively as long COVID or post-acute COVID-19, include shortness of breath, loss of smell and taste, brain fog, headaches, and fatigue.

Studies have shown that more than half of the individuals hospitalized with COVID-19 during the initial phase of the SARS-CoV-2 infection show persistent impairments in cardiovascular and lung function several months after discharge. Furthermore, women hospitalized with severe COVID-19 are more likely than men to present with such persistent deficits in cardiovascular and lung function after discharge.

Individuals may present with persistent symptoms during the post-acute phase of COVID-19, regardless of the severity of symptoms during the acute phase of the illness. The effects of mild-to-moderate COVID-19 on lung and cardiovascular function and, subsequently, on daily physical functioning during the post-acute phase is not well-understood.

Researchers at Indiana University, Bloomington, recently examined how mild-to-moderate COVID-19 affected exercise capacity or tolerance during the post-acute phase in women. Exercise tolerance or capacity refers to the ability of an individual’s cardiovascular system to sustain physical activity.

The researchers used an exercise test called the 6-minute walk test to assess the persistent effects of SARS-CoV-2 infection on cardiovascular function in women during the post-acute phase of the infection.

They found that women with COVID-19 who had mild-to-moderate illness during the acute phase showed a slower decline in their heart rate after the 6-minute walk test than the participants in the control group. This difference was more pronounced in women actively experiencing long COVID symptoms.

However, encouragingly, they found no statistically significant differences in a range of other measures, including pre- and post-test oxygen saturations, pre- and post-test heart rate, ratings of perceived exertion, and ratings of perceived breathlessness.

The study’s lead author, Dr. Stephen Carter, a professor at Indiana University, told Medical News Today: “A puzzling feature of post-acute COVID-19 syndrome is the variable presentation of symptoms that appear to be independent of initial illness severity. The present work shows even those with mild-to-moderate initial symptoms can be affected with underlying cardiac-related irregularities with the potential to affect exercise tolerance and/or activities of daily living.”

“It’s also plausible that lingering symptoms, particularly muscle/joint pain and/or shortness of breath, may trigger a maladaptive pattern that accelerates systemic deconditioning. However, further research is needed.”

Dr. Ziyad Al-Aly, chief of research and education service at Veterans Affairs St. Louis Health Care System, also spoke with MNT. Dr. Al-Aly, who was not involved with the study, said, “Studies like this are important to help us understand why some people with long COVID experience profound exertional fatigue that may limit their ability to exercise and their ability to carry out activities of daily living.”

The study appears in the journal Experimental Physiology.

The study included 29 women who had experienced mild or moderate illness due to COVID-19. These women had received a positive SARS-CoV-2 diagnosis at least 4 weeks prior to the study, with the average time of diagnosis being 94 days before the study. The control group consisted of 16 women who had never tested positive for a SARS-CoV-2 infection.

Out of the 29 participants in the test group, 17 women reported experiencing at least one long COVID symptom at the time of the study. These long COVID symptoms included shortness of breath, fatigue, cough, muscle or joint pain, loss of smell or taste, and skin irritation.

The researchers administered pulmonary function tests to assess various aspects of lung function. They found that the women who had tested positive for SARS-CoV-2 exhibited reduced total lung capacity compared with those in the control group.

The researchers then evaluated changes in cardiovascular function during and after the 6-minute walk test. The test measures the distance that participants walk in 6 minutes at their normal pace, and researchers use it to assess exercise tolerance. The team adjusted the results for age, sex, and body mass index (BMI) to prevent these variables from influencing the test results.

There was no significant difference between the distances that the two groups covered during the test.

However, women with SARS-CoV-2 who experienced shortness of breath or joint or muscle pain had a lower adjusted distance value than those with SARS-CoV-2 who did not experience these long COVID symptoms.

The researchers assessed the blood pressure, heart rate, and blood oxygen or oxygen saturation levels before and immediately after the 6-minute walk test. They calculated the heart rate response during exercise by subtracting the heart rate at rest from the heart rate after the completion of the test.

The heart rate response during exercise is a measure of cardiovascular function, with a lower heart rate response being a predictor of reduced exercise capacity and cardiovascular disease-associated mortality.

The women in the SARS-CoV-2 group showed a lower heart rate response than those in the control group.

Moreover, the participants in the SARS-CoV-2 group who reported shortness of breath as a long COVID symptom at the time of the study had a lower heart rate response during the test than those in the SARS-CoV-2 group who did not have this symptom.

The researchers also measured heart rate recovery, which is another indicator of cardiovascular health and all-cause mortality.

Heart rate tends to drop immediately after strenuous exercise. Heart rate recovery measures the decrease in heart rate after the cessation of exercise. Specifically, heart rate recovery quantifies the decrease in heart rate at a predefined time interval — generally 1 minute — from the end of the physical activity.

In the current study, the researchers measured the participants’ heart rate at the end of each minute during the 5-minute recovery period after the 6-minute walk test.

The SARS-CoV-2 group participants showed a less significant decrease in heart rate at 1 minute after the completion of the test than those in the control group. This suggests that the decline in heart rate occurred more gradually in the women in the SARS-CoV-2 group. Such a delay in heart rate recovery is associated with reduced exercise capacity.

Furthermore, women in the SARS-CoV-2 group who exhibited specific long COVID symptoms at the time of the study had decreased heart rate recovery compared with the SARS-CoV-2 group participants without these symptoms.

Specifically, women in the SARS-CoV-2 group with symptoms such as fatigue, loss of taste or smell, joint and muscle aches, or shortness of breath had decreased heart rate recovery compared with women who had not had SARS-CoV-2.

“A lot of long COVID-19 patients are placed into rehabilitation programs that are designed for non-COVID-19 patients. These programs may not be suitable for long COVID patients. It is important to understand that people with long COVID need programs designed for them (pacing, etc.). Findings from this study and others should be taken into account when designing rehabilitation programs for people with long COVID,” said Dr. Al-Aly.

Dr. Carter noted: “SARS-CoV-2 participants and [people without the infection] were matched for age, BMI, smoking status, and history of cardiopulmonary disease. As such, we have better assurance that reported differences were attributed to SARS-CoV-2, as opposed to another comorbidity.”

“A strength of the work is that comparisons were performed among women — who appear to be susceptible to persistent SARS-CoV-2-related symptoms — during and following a 6-minute walk test.”

Dr. Carter acknowledged that the study had a few limitations. He said: “Indeed, the 6-minute walk test is a widely used clinical tool that offers insight into exercise capacity and walking autonomy. However, it should be noted we cannot disregard the possibility of undiagnosed pulmonary abnormalities and/or autonomic dysfunction that existed prior to a SARS-CoV-2 infection. Additionally, it is conceivable some controls may have had an asymptomatic SARS-CoV-2 infection and/or a previous false-negative diagnostic test for SARS-CoV-2.”

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