New York, Nov 9 (IANS) Increasing rates of food insecurity are independently associated with an increase in cardiovascular death rates among adults between the ages of 20 and 64, say researchers.

According to the study, about 10 per cent of adults in the US are considered food insecure, meaning they lack immediate access to fresh, healthy and affordable food.

In addition, the stress from not knowing where their next meal will come from or regularly consuming cheap, processed foods may have an adverse impact on cardiovascular health.

“This research shows food insecurity, which is a particular type of economic distress, is associated with cardiovascular disease,” study author Sameed Khatana from University of Pennsylvania in the US.

“It illustrates that cardiovascular health is tied to many things,” Khatana added.

Researchers accessed county-level data on cardiovascular death rates and food insecurity rates that occurred from 2011 to 2017, among adults age 20 to 64, and those 65 years old and older.

In their analysis, researchers examined cardiovascular mortality trends in the US by average annual percent change in food insecurity.

They assessed the relationship between changes in food insecurity and cardiovascular death rates, after adjusting for variables including changes in demographics, employment, poverty, income, health insurance and other factors already known to affect cardiovascular risk.

Overall, food insecurity rates for the entire country declined significantly (from 14.7 per cent to 13.3 per cent) between 2011 and 2017.

The level in which food insecurity changes was a significant predictor of death for people between the ages of 20 and 64.

The findings showed that cardiovascular death rates remained much higher among the elderly than younger people.

According to the researchers, for every one per cent increase in food insecurity, there was a similar increase in cardiovascular mortality among non-elderly adults.

The study is scheduled to be presented at the American Heart Association’s Scientific Sessions 202, virtually from November 13-17.

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Obesity and race are additive, multiplicative mediators or confounders influencing COVID-19 outcomes among American adults, and the disparities have substantial implications for medical and public health responses, according to a speaker.

“Due to the complexity of the relationship between COVID-19, obesity and race/ethnicity, studies show conflicting results with regard to the reasons behind the greater morbidity and mortality noted in communities of color in the U.S.,” Fatima Cody Stanford, MD, MPH, MPA, FAAP, FACP, FAHA, FTOS, an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School, told Healio. “Almost 8 months into this pandemic, we have learned that there is no clear answer as to why these disparities exist. However, it does appear that better health at baseline lends itself to the best outcomes with COVID-19. We need more studies to ascertain this relationship.”

Disproportionate outcomes

There is still much to be learned about the pathophysiology of COVID-19, but it has become clear that Black Americans are disproportionately affected by the novel coronavirus and are far more likely to experience its more severe outcomes, including ICU admission, mechanical ventilation and death, Stanford said during an online presentation at ObesityWeek Interactive.

“When we look at the pandemic’s racial disparity … COVID-19 deaths per 100,000 people, we can see that Black Americans share a large burden,” Stanford said during the presentation. “I can tell you, talking to my parents who lost ten of their friends to this pandemic, my best friend who lost her father, and my mentee who is an internal medicine physician and has lost both parents, that this is indeed real.”

In a study published in June in The New England Journal of Medicine, researchers showed that among 3,481 patients with COVID-19, Black adults were nearly twice as likely to be hospitalized as their white counterparts, with an OR of 1.96 after adjustments for multiple variables (95% CI, 1.62-2.37). Obesity, as well as residence in a low-income area, were also associated with increased odds for hospital admission in the study, Stanford said.

In another analysis published in Clinical Infectious Diseases in August, researchers demonstrated that Hispanic men and women with COVID-19 were significantly more likely to be admitted to the ICU and require mechanical ventilation compared with Black and white adults, Stanford said.

A ‘complex relationship’

The inflammatory state that typically accompanies obesity is associated with several disease processes, including impaired adipogenesis, oxidative stress and insulin resistance, Stanford said. Those processes can lead to metabolic syndrome, type 2 diabetes and cardiovascular disease. Stress — including post-traumatic stress disorder and depression — acts through the brain to further affect eating and exercise behaviors, Stanford said.

“It is important for us to recognize that these are intertwined,” Stanford said.

Adding to the burden, a person’s economic status, underlying health conditions and actual pathophysiological differences in inflammation may lead to the health disparities observed among underrepresented adults, Stanford said.

The additive effects create perfect storm for worse COVID-19 outcomes, she said.

“We need to be cognizant of the fact the people who are disproportionately impacted are those that have less power to deal with these issues,” Stanford said. “Better chronic disease management, particularly surrounding obesity, which has borne itself out to be one of the major risk factors for COVID-19, is necessary for the treatment of obesity across the age spectrum, particularly in those communities that look like mine.”

Stanford said the COVID-19 story “has not yet been completely written.”

“There is still a lot for us to learn as we conduct research that will hopefully go beyond this jump to publish,” Stanford said. “We can make an impact. We know that issues related to structural racism and related to the history of this country have made it that certain groups are disproportionately impacted by chronic and acute diseases like COVID-19.”

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LONDON, Sept 3 — New European research has found that individuals with high blood pressure could lower their risk of death during flu season by getting the influenza vaccine.

Carried out by researchers at the University of Copenhagen, Denmark, the new study looked at 608,452 patients aged 18 to 100 years with hypertension (high blood pressure) during nine consecutive flu seasons.

The researchers recorded how many patients had received a flu vaccine before the start of each flu season and then followed them through the season, noting how many died from all causes, from any cardiovascular cause, and from heart attack or stroke.

The findings, presented on Sunday at ESC (European Society of Cardiology) Congress 2019 together with the World Congress of Cardiology, showed that after taking into account potentially influencing factors such as age, medications, and socioeconomic status, high blood pressure patients who received the flu vaccine appeared to benefit from an 18 percent reduced risk of death from all causes during flu season.

In addition, those who received the vaccine had a 16 per cent reduced risk of death from any cardiovascular cause, and a 10 per cent reduced risk of dying from heart attack or stroke.

“Given these results, it is my belief that all patients with high blood pressure should have an annual flu vaccination,” commented first author Daniel Modin. “Vaccination is safe, cheap, readily available, and decreases influenza infection. On top of that, our study suggests that it could also protect against fatal heart attacks and strokes, and deaths from other causes.”

Previous research has suggested that the stress the flu infection puts on the body could trigger heart attacks and strokes, with Modin adding that the strong immune response to the infection can also cause inflammation which could lead to heart attacks and strokes.

“Heart attacks and strokes are caused by the rupture of atherosclerotic plaques in the arteries leading to the heart or the brain. After a rupture, a blood clot forms and cuts off the blood supply. It is thought that the high levels of acute inflammation induced by influenza infection reduce the stability of plaques and make them more likely to rupture,” explained Modin.

Those with high blood pressure already have a higher risk of heart attack and stroke, and so preventing a flu infection through vaccination may help to protect against cardiovascular events.

“We show that influenza vaccination may improve cardiovascular outcomes in patients with hypertension. During the nine flu seasons we studied, vaccine coverage ranged from 26 per cent to 36 per cent, meaning that many patients with high blood pressure were not vaccinated. If you have high blood pressure, it would be worth discussing vaccination with your doctor,” advised Modin. — AFP-Relaxnews

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A new study suggests that middle-aged people with surgically confirmed endometriosis have a slightly lower mortality rate than their peers who don’t have endometriosis. The reasons for this aren’t totally clear, but researchers suggest they are likely related to differences in lifestyle and medical attention and care.

The study, “Mortality of midlife women with surgically verified endometriosis — a cohort study including 2.5 million person-years of observation,” was published in the journal Human Reproduction.

Endometriosis has been linked to an increased risk of life-threatening diseases, including heart disease and cancer. As such, one might assume that people with endometriosis have a higher mortality rate (a greater likelihood of death from any cause). However, there isn’t much data directly assessing this.

Thus, researchers used a combination of national databases from Finland to obtain information on 49,956 people with endometriosis verified through surgery. The patient data covered 1987 to 2012; the average patient age was 36.4 years at the beginning of follow-up and 53.6 years at the end of follow-up.

Data for a control (without endometriosis) cohort of 98,824 age-matched individuals was also obtained. In total, the study accounted for 2.5 million person-years’ worth of data.

The overall mortality rate was slightly, but significantly, lower in the endometriosis cohort than in the control cohort: 19.6 versus 25.9 per 1,000 people over 10 years.

This included 12% fewer deaths from cancer and 45% fewer deaths from heart disease in the endometriosis cohort. Deaths related to alcohol, violence, and respiratory and digestive diseases were also less common in the endometriosis cohort, but rates of death from nervous system diseases such as Alzheimer’s were similar in both groups, as were rates of suicide.

“We speculate that the decreased mortality is significantly due to different characteristics and factors related to women’s lifestyle and/or increased medical attention and care received among women with surgically verified endometriosis,” the researchers stated in their paper. They stressed, however, that this was strictly speculation; a major limitation of this study is that data on lifestyle factors that also greatly affect diseases such as cancer (e.g. smoking) were not included in the analysis.

The researchers also noted that “the present results can be applied only to midlife women with surgically verified endometriosis, and caution is needed when interpreting the results in terms of causality.” In other words, this paper only shows that two things are associated; it makes no claim that having endometriosis has a direct effect of decreasing the chance of death — and this paper only applies to a particular population of a particular age. “There is a need for more studies on this issue,” the researchers concluded.

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