I JUST DID A TWO-HOUR GYM WORKOUT, including aerobic and resistance training activities. The first exercise form helps to keep my blood pressure low. Today, we look at new evidence that exercises engaging muscles without movement — such as wall squats and planks — may be best for lowering your blood pressure.

Approximately one in three adults in the United States has high blood pressure (hypertension). High blood pressure is like having a pipe with too much pressure, which can cause leaks and damage over time.

Many with hypertension don’t know that they have it. For this reason, some refer to high blood pressure as a “silent killer.” The condition can lead to heart attack and stroke, and there are usually no warning signs.

“Hypertension is a leading risk factor for death and disability worldwide,” says Dr. Paul Whelton, an expert in hypertension and kidney disease at Tulane University. “High blood pressure raises the risk of having a heart attack, heart failure, stroke, or kidney disease.”

Fortunately, we can often prevent or effectively manage high blood pressure. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health.

Before we jump into the new findings about exercise types and lowering blood pressure, here’s one of my favorite authors:

“Listening to the music while stretching her body close to its limit, she was able to attain a mysterious calm. She was simultaneously the torturer and the tortured, the forcer and the forced. This sense of inner-directed self-sufficiency was what she wanted most of all. It gave her deep solace.”
― Haruki Murakami, 1Q84

Today’s Exercise

I began my day with a 60-minute walk. After breakfast, my wife and I headed to the gym for a couple-hour workout. Here’s what we did in our “Push” program:

1. Barbell bench press, four sets of 8
2. Dumbell incline bench press, three sets of 12
3. A superset of dumbbell include bench chest fly (3 x 12) + push-ups (3 x 10)
4. Dumbell seated shoulder press, 4 x 8
5. A superset of machine-assisted dips (4 x 10)
6. Dumbbell overhead tricep extension (3 x 10)
7. Cable straight bar tricep pushdown 3 x 15

We separated the sets by 30 seconds (except for supersets, in which the two exercises were followed by 30 seconds of rest before repeating the superset).

Next came an abdominal workout (including planks and more), with a treadmill walk and stretching to finish. I love being in the gym, surrounded by others working hard.

The downside? In two days, I will be sore. But a good kind of sore.

Isometric (Static) Exercise

Before we turn to the study, I want to talk briefly about isometric exercises. These exercises can help you maintain strength (but you could be better at building it).

Isometric exercises are tightening (contractions) of a specific muscle or group of muscles. During isometric exercises, the muscle doesn’t noticeably change length. The affected joint also doesn’t move.

The Mayo Clinic offers that isometric (static) muscle action occurs when muscles contract but do not visibly change length. The involved joints do not move, facilitating body stability.

Isometric exercises can be done with weights or without, relying on the body’s weight.

I do isometric exercises in many places, including at home, work, the gym, and others. If you have ever done a plank, you have engaged in an isometric exercise.

At the end of this piece, I will provide examples of isometric exercises.

Exercise and Blood Pressure — A New Study

To understand two optimal exercises for lowering blood pressure, let’s look at a recent study published in the British Journal of Sports Medicine.

Researchers examined 270 randomized clinical trials that reported the effects of exercise interventions. All lasted at least two weeks and measured blood pressure between 1990 and 2023.

Systolic blood pressure measures arterial maximum pressure as the heart contracts and relaxes, while diastolic blood pressure denotes what the arterial pressure is when the heart rests between beats, according to the US Centers for Disease Control and Prevention.

Best Two Exercises to Lower Your Blood Pressure

Here are the results of the meta-analysis of 270 trials with 15,827 participants.

Among HIIT, isometric, aerobic, dynamic resistance, and a combination of the latter two exercises, isometric exercise led to the greatest reductions in blood pressure.

More specifically, wall squats led to the biggest drop in systolic blood pressure. Running (aerobic exercise) was most beneficial for decreasing diastolic pressure. For lowering both systolic and diastolic pressure, isometric exercise was best.

Here are the findings in graphic form:

Meta-analyses have potential problems. Below is a reference outlining some of these issues:

https://drive.google.com/viewerng/viewer?url=https%3A//www.meta-analysis.com/downloads/criticismsofmeta-analysis.pdf&embedded=true

Isometric Exercise to Drop Blood Pressure — My Take

I am delighted you have many ways to exercise to lower your blood pressure. Find something you enjoy and be consistent.

Of course, I will continue to pursue other lifestyle interventions to benefit my blood pressure. This focus means I will continue to strive to keep a healthy weight, eat a balanced diet (including limiting my salt intake), not drink excessive alcohol, not smoke, and check my blood pressure regularly.

So far, I have dodged blood pressure medicines. I want to continue to do so.

Finally, I hope scientists will figure out why isometric exercises are better at lowering blood pressure than other physical activity forms. Let’s end with two of my go-to isometric exercise, with explanations from Healthline.com.

Isometric Exercises

1. High plank hold. The high plank hold effectively engages many muscles. This exercise requires no equipment, although I prefer a yoga mat. High planks work your abdominals, glutes, quadriceps, arm muscles, shoulders, and chest. Here is what you need to do:

• Begin with a kneeling push-up. Put your hands shoulder-distance apart.
• Push your hands into the floor and straighten your knees. Push down into the balls of your feet to lift your body into a high plank position. You should appear as if you’re in the upward position of a push-up. Ensure your shoulders and hands are aligned, your legs straight, and your core engaged.
• Hold the position for about 20 to 60 seconds (or as long as you can with proper form). Repeat two more times.

I’m not particularly eager to get all the way up (shoulder discomfort, alas), so I do the exercise with my lower arms on the mat.

2. Wall sit

I use wall sits to strengthen my thighs (quadriceps, hamstrings, and butt muscles). This activity helps me rehab from a torn right patellar tendon. Fortunately, no equipment is needed.

1. Stand roughly two feet away from a sturdy wall, leaning against it.
2. Bend your knees and lower your butt. Your knees should form a 90-degree angle. Your body position should look as if you are sitting in a chair.
3. Hold the position for at least 15 seconds. Be sure to keep your hips and shoulders in contact with the wall. Also, keep your knees over your ankles. Don’t lower so much that you put too much pressure on your knees.
4. Perform two or three rounds.

Trust me: Your thighs will get tighter and fatigued.

Optimizing Your Isometric Exercise

Here are some tips for you to get the most out of your isometric exercises:

• Focus on good form. Watch your form to reduce your risk of injury and target your muscles effectively. Once you can’t perform the exercise with proper form, stop.
• Actively contract your muscles. As you perform the exercise, notice your muscles contracting. This attention should help you maintain good form and better muscle activation.
• Breathe. I have to remind myself to breathe during isometric exercises. Makes sure you breathe throughout the activity.
• Please don’t overdo it. Overdoing can lead to injury. Instead, focus on proper form.

Finally, adjust the isometric exercise to your current fitness level. Is 20 seconds too long for your plank? Try ten. You should improve over time.

I will regularly incorporate isometric exercises into my exercise program while tracking my blood pressure. I hope to keep you posted on my anecdotal experience.

The post This Exercise Type May Be Best for Lowering Your Blood Pressure appeared first on Medika Life.

Before you leap to chocoholic status (for hypertension risk reduction), you probably want evidence that previously reported laboratory results translate well into the real world.

Enter a new study from the University of Surrey that illustrates the power of cocoa to reduce high blood pressure. I want to wander a bit through the known health benefits of this nectar of the gods before exploring the provocative new study from the United Kingdom.

The new study has this unwieldy title: “Assessing Variability in Vascular Response to Cocoa With Personal Devices: A Series of Double-Blind Randomized Crossover n-of-1 Trials,” but I hope to analyze it with more accessible language.

Dark chocolate is chock full of nutrients that may benefit your health. Created from cacao tree seeds, it is a potent source of antioxidants. Let’s explore three science-based health benefits of dark chocolate or cocoa.

1. Chocolate can improve cholesterol.

Dark chocolate positively impacts cholesterol by lowering “bad” LDL and improving insulin sensitivity. Let’s look at the evidence, admittedly not high-level.

As reported in a small randomized study in 2014, dark chocolate consumption (supplemented with the flavanol lycopene) significantly reduced levels of total cholesterol, LDL (“bad”) cholesterol, and triglycerides.

The results seem logical. Some types of LDL cholesterol are more likely to oxidize (when contacting free radicals in our body). This oxidation renders the LDL particle reactive, damaging other tissues, including the heart’s artery lining.

Cocoa lowers oxidation-prone types of LDL. With its antioxidants, the food substance enters our bloodstream to protect lipoproteins. We need to be mindful that dark chocolate also contains health-harming sugar.

2. Chocolate might protect your skin from the sun.

You read that correctly: The bioactive substances in dark chocolate may reduce sun-induced skin damage.

One well-done 6-month study involved subjects who consumed a flavanol-rich cocoa beverage. The beverage consumers significantly improved facial wrinkles and skin elasticity compared with the control group.

Before we open a cocoa stand, we should note that not all studies have demonstrated such positive results. Still, when I recently traveled to Kauai (Hawaii), I got in daily dark chocolate, aiming for at least 70 percent cocoa solids with little added sugar.

Of course, I recognize that dark chocolate is no replacement for other forms of sun protection, including sunscreen.

3. Chocolate may boost your brain.

Did you know that dark chocolate may improve your brain functioning? Cocoa rich in flavanols improves brain blood flow, at least in young adults. Consume cocoa, and you may witness improvements in memory, attention, and verbal learning, according to a systematic review from Madrid (Spain).

What about older adults? Can cocoa flavonoids help us maintain cognitive function? The answer is maybe. Lower level evidence comes in the form of a retrospective study showing the substance helped older adults maintain cognitive function (and dropped the chances of progression to dementia). This research study is by no means definitive.

Here is what I previously wrote about the dark chocolate/brain connection:Dark Chocolate and CognitionDark chocolate is chock full of nutrients that can positively affect your health.medium..com.

In the short term, we may get a brain function bump through cocoas compatriots, theobromine, and caffeine. Perhaps these substances are the reason I get a jump-start in brain function.

In summary, cocoa and dark chocolate may improve brain function by increasing blood flow or through the stimulants in the food (such as caffeine and theobromine). Fortunately for me, compared with regular coffee, the caffeine content of dark chocolate is relatively low.

“The greatest tragedies were written by the Greeks and Shakespeare…neither knew chocolate.”
― Sandra Boynton

L’AMUSE-BOUCHE
Chocolate Parmesan Tapioca with a Pan-Seared Scallop

L’ENTREE
Salad with Chèvre Chaud, Honey, and Mint Dressing
Roasted Butternut Squash and Cacao Soup
Oysters with a Mignonette Sauce

LE PLAT PRINCIPAL
Armagnac-and-Chocolate-Infused Daube de Bœuf à la Gascogne
Sweet Potato Curry with Mussels
Chocolate Pasta with a Gorgonzola Cheese Sauce

LA SALADE ET LE FROMAGE
Moules à la Plancha with Chorizo served over a bed of Arugula

Selection of the Château’s Cheeses

LE DESSERT
Mousse au Chocolat spiced with Pimento Chili Peppers and Chocolate Flakes, garnished with Mint.

I spun around on one heel, excited to get prepping. Unbeknownst to me, the rest of the kitchen staff had arrived, their jaws agape as they stared at the menu. As usual, Phillipa was the first to speak up. “That menu looks wicked incredible.”
“I don’t know about adding hot peppers to the mousse au chocolat,” said Jane, and the granny brigade nodded in agreement.
I was so sick of her know-it-all attitude. I knew a thing or two, and I was going to stand by my decision. “The combination has Aztec roots. To honor the fertility goddess, they drank xocolāt, a chocolate concoction spiced with chili pepper and vanilla. It’s delicious and unexpected.”
Jane rolled her eyes. “You’re the chef.”
“I am,” I said, wanting to challenge her. “And this is the menu.”
― Samantha Verant, The Secret French Recipes of Sophie Valroux

Chocolate and the heart — New findings

Back to our original question: Can cocoa — or chocolate act as a medicine for high blood pressure? A new study from the United Kingdom provides real-world evidence that the answer is yes.

The study authors observe that cocoa flavanols can lower blood pressure and arterial stiffness as much as some prescribed medicines. But here’s the rub: The great results have been obtained only in tightly controlled experimental settings.

Commenting in Medscape UK, lead study author Christian Heiss, professor of cardiovascular medicine at the University of Surrey, explains that:

“High blood pressure and arterial stiffness increase a person’s risk of heart disease and strokes, so it is crucial that we investigate innovative ways to treat such conditions.”

“Before we even consider introducing cocoa into clinical practices, we need to test if the results reported in laboratory settings safely translate into real-world settings, with people going about their everyday lives.”

Here’s what the scientists did: The team randomized 11 healthy volunteers (under age 45 years) who consumed either cocoa flavanol capsules or placebo capsules (containing brown sugar) on alternate days. They did one of two randomized sequences over eight consecutive days, with capsules taken each morning before breakfast.

Here are the results of this novel double-blind, randomized cross-over trial, published in Frontiers in Nutrition:

• Both 12-hour systolic blood pressure and pulse wave velocity decreased, the former by an average of 1.4 mm Hg.
• There appeared to be much inter-individual variation in responses and considerable between-day variation in individual responses.
• Blood pressure and arterial stiffness dropped when they had been high at baseline. Those with a low blood pressure measurement in the morning had no benefit from cocoa flavanols.
• The effectiveness peaked within three hours of cocoa flavanol ingestion (with a second, smaller peak about eight hours after consumption).

My take — Chocolate and the new study results

This study showed a small drop in blood pressure and arterial stiffness in everyday life, but only for those with elevations within the normal range. At first, I thought the 1.4 mm Hg drop in blood pressure seemed remarkably small until I noted this observation of the study authors:

“The magnitude of effects, in particular within the first 3 hours, is similar to what standard antihypertensive medications achieve in clinical trials, highlighting the clinical relevance and potential of flavanols for use in clinical practice.”

According to the researchers, the amounts of cocoa flavanols in the study are high but achievable through a regular diet.

Regrettably, the researchers did not obtain blood samples that would have allowed for an analysis of flavanol metabolites. Finally, whether a regular dark chocolate consumption habit results in long-term blood pressure decreases is unknown.

I will close with the usual caveats: Chocolate is rich in calories, sugars, and fat. I consume it in small amounts to dodge extra calories. Of course, dark chocolate alone is not going to be enough.

Don’t forget to move, maintain a healthy weight, watch your salt intake, and check your blood pressure. Hopefully, you will not need medicines to keep your blood pressure healthy.

Do you eat dark chocolate? If yes, what is your favorite? Thank you for joining me today.

The post A Ridiculous Way to Improve Your Heart Health appeared first on Medika Life.

Many of us struggle to get the optimal nightly seven to nine hours of sleep. The American Academy of Sleep Medicine and Sleep Research Society recommends that adults (ages 18 to 60) sleep seven or more hours regularly for optimal sleep health.

The National Sleep Foundation consensus report recommends seven to nine hours for adults aged 18 to 64 and seven to eight hours for those 65 and older.

Getting insufficient sleep puts your physical and mental health at risk. According to the US Centers for Disease Control (CDC), more than one-third of adults in the United States report sleeping fewer than six hours daily. The rates are even higher among younger adults and those with a low socioeconomic status.

Short sleep can increase our risks of cardiovascular disease, obesity, and premature mortality. Poor sleep takes a toll on the mind and the body.

Sleep, ambient light, and cardiovascular risk

Sleep researchers at Northwestern University (USA) report that exposure to even small amounts of ambient light at night can negatively affect cardiovascular function.

We already have some evidence that too much evening light may negatively impact our metabolism. Light exposure is associated with a drop in glucose (sugar) tolerance and decreased insulin resistance.

Light exposure before bedtime has perils.

Insulin resistance occurs when cells in your muscles, fat, and liver don’t respond well to insulin and cannot use blood glucose for energy. To make up for this change, your pancreas makes more insulin. With time, your blood sugar levels rise.

Expose yourself to pre-bedtime light, and you may put your sleep and some physiological functions at risk.

Light exposure during bedtime also is dangerous.

Does that muted television threaten you and your sleep? According to a new study of healthy young adults, the answer appears to be yes.

Researchers examined heart rate, sleep quality, glucose levels, and other variables during one night of sleeping in a dark room (three lux) and one night in a moderately lit room (100 lux).

Here are the findings:

Sleeping in a moderately lit room increased heart rate and activated the sympathetic nervous system during sleep. The practice also impaired the next morning’s glucose regulation.

Sleep specialist Dr. Nilong Nyas explains:

“Your eyes are your direct connection to the part of the brain that controls the circadian rhythm. [Light exposure] is interpreted by the brain to allow the chemical reactions to take place for healthy (or unhealthy) sleep cycles.”

Dr. Nyas adds that “if there’s a significant amount of light interference at a time when your body’s trying to sleep, it can cause poor sleep or unhealthily programmed sleep cycles, which can lead to a significant number of other medical issues.”

For me, the research findings mean sleeping in as dark a room as possible to optimize my sleep quality and health.

Sleep struggles? Try these strategies.

Here are some ways you may be able to improve your sleep, courtesy of the Sleep Foundation:

• Cover your windows. Consider investing in blackout curtains if your blinds or curtains don’t sufficiently block light.
• Mind the gap. Turn off any hallway lights before bedtime, or place a rolled-up towel against the door gap to stop light from entering.
• Wear an eye mask. Light can penetrate our eyelids, potentially inhibiting the sleep hormone melatonin.
• Ditch the electronics. Put away light sources such as computers, cell phones, charging stations, digital clocks, and other electronics. Cover their lights or put them outside your bedroom.
• Dim the lights. In the hours pre-bedtime, try transitioning to dim ambient light.
• Consider your nighttime needs. I sometimes need to use the bathroom in the middle of the night. I try to avoid exposure to high-volume light. Still, be safe: You may need motion-sensor nightlights, but try to minimize your light exposure if it is safe to do so.

Other strategies include:

• Avoiding alcohol.
• Cutting off caffeine early in the day.
• Avoiding vigorous exercise in the late evening.

In summary, light exposure during sleep impairs cardiometabolic function. Are you prioritizing high-quality sleep of adequate duration?

The post Is Your Bedroom Dark Enough? appeared first on Medika Life.

Do you eat chocolate? I avoid commercial milk chocolate with its milk, sugar, cocoa butter, and small volumes of cacao. My preferred chocolate form, dark chocolate, has much more cacao and less sugar than its milk chocolate counterpart.

Let’s explore some of the potential cardiovascular upsides of consuming dark chocolate. We’ll look at some nutritional information and how much dark chocolate you should eat (and no, the answer is not all of it).

Chocolate and blood pressure

Regular consumption of dark chocolate may lower your chances of suffering from cardiovascular disease. For example, regularly eating dark chocolate can lower your blood pressure.

How does dark chocolate work its magic to lower blood pressure? Dark chocolate contains flavonoids, a substance that can stimulate nitric oxide production in your body.

The upside of this nitric oxide production? Nitric oxide results in widening blood vessels, which translates to better blood flow and lower blood pressure.

Here are the results of a small study from Iran looking at the effects of eating dark chocolate on 60 subjects with high blood pressure and type 2 diabetes.

Those who consumed 25 grams of dark chocolate daily for eight weeks had significantly lower blood pressure than individuals who ate the same amount of white chocolate.

Chocolate and cholesterol

“Your hand and your mouth agreed many years ago that, as far as chocolate is concerned, there is no need to involve your brain.”
― Dave Barry

Other compounds in dark chocolate target cholesterol; polyphenols and theobromine can lower “bad” low-density lipoprotein (LDL) cholesterol levels and increase “good” high-density lipoprotein (HDL) cholesterol.

Here’s some evidence: A 2017 clinical trial discovered that adding almonds, cocoa, and dark chocolate to the usual American diet (taking care not to exceed recommended daily calorie totals) improves lipid profiles.

The study authors volunteer that putting almonds, dark chocolate, and cocoa into your diet (without exceeding energy needs) may drop your heart disease risk. Together, almonds and dark chocolate lowered the number of small LDL particles.

Thank you for joining me today.

The post Three Heart Benefits of Dark Chocolate appeared first on Medika Life.

Afterwards she was fine but two months later, when getting out of bed to go to the bathroom, her heart rate jumped up to about 130 bpm. She laid back down but it persisted. Episodes like this occurred nearly every time she moved about and were very scary. On one occasion her heart rate got up to about 200 bpm. “I thought I was going to die.”

She saw her primary care physician at a time when her heart rate was normal. The physician did a history, exam, electrocardiogram and all was normal. She had no idea of what had happened and had no further suggestions. “If it recurs, come on back.” The symptoms did recur the next day and she went back to see the physician. This time she was sent for a cardiac echo and a CAT scan. Both were normal. [The history of recent Covid-19 should have suggested a Long Covid syndrome such as inappropriate tachycardia syndrome, postural orthostatic tachycardia syndrome (POTS) or some of the other arrhythmia syndromes associated with Long Covid. Unfortunately, relatively few doctors are aware.] The symptoms continued to occur and so she was finally referred to a cardiologist.

The cardiologist, also not familiar with Long Covid cardiac issues, was baffled by the symptoms and had her wear a Holter monitor (this device records the electrocardiogram continuously over a day or more) during the weekend. She returned on Monday and was told that she would hear the results within 24 hours. But despite frequent calls to the office, she didn’t hear for almost 10 days.

When finally called, it was a different doctor who said that on one occasion her heart rate had jumped up to 170 bpm and “this is very concerning.” She said “Yes, I agree. I know because I took my pulse then.” The cardiologist had no particular suggestions and was completely unaware of cardiac issues post Covid despite the fact that the patient had brought in references.

She is now seeing a specialist in Long Covid syndromes and who is quite competent in dealing with heart and vascular problems after Covid.

As outlined in my previous article, Long Covid occurs in 10 to 30% of individuals with mild Covid-19 infection. Some of these people develop various cardiovascular symptoms. I want to emphasize here that I am not referring to patients who have had severe Covid-19 with hospitalization and perhaps ventilator support. Instead, the focus is on individuals with mild Covid. As you will see, these individuals can develop various heart and blood vessel syndromes that can range from asymptomatic, to minor annoyances to quite severe, to death.

Heart damage is just one more aspect of Long Covid. It is known that the coronavirus can infect the cells of all three layers of the heart plus the outer lining of the heart, the pericardium. Coronavirus also infects the endothelial (lining) cells of the coronary arteries and other blood vessels. So there’s plenty of opportunity for the coronavirus to cause some level of damage to the heart and blood vessels. It also can attack the nervous system either directly or via autoantibodies.

It is a concern that this damage is occurring or can occur in young previously very healthy individuals. They are just the ones that typically have mild disease or asymptomatic infection. Fairly early in the pandemic there was a study of 26 college competitive athletes who had tested positive for Covid-19. Most of them were asymptomatic and none were hospitalized. Yet on MRI, 12 to 53 days following their initial diagnosis, 46% demonstrated evidence of myocarditis (inflammation of the heart muscle cells) or other cardiac injury. This was a wakeup call that even those who had mild disease could have some form of heart damage including those who were very healthy and young.

The question is — will the pandemic result in many individuals with damaged hearts, individuals that will need long term care?

My friend Eleanor in the opening story above has post exertion tachycardia or a related arrhythmia syndrome.

POTS has been known to be a rare syndrome since long before the pandemic. Most affected individuals, usually young women, report a “viral illness” that preceded onset. POTS can have associated fatigue and brain fog, memory difficulty and headaches, even nausea and vomiting. It is a form of “dysautonomia” that occurs in an estimated one to three million Americans. Dysautonomia refers to an imbalance in the autonomic nervous system, the sympathetic and parasympathetic systems that control heart rate, breathing, GI motility, blood pressure and other automatic functions of the body. Just what causes this imbalance is unclear.

Now POTS is being seen in increased numbers after mild Covid. Certainly not common but very disabling.

Inappropriate tachycardia syndromes including post exertion are being recognized with increasing regularity, sufficient that the term has been suggested as a distinct group of syndromes following Covid-19.

There is evidence that the vagus nerve, the long nerve that operates the parasympathetic system, is damaged by the coronavirus. This damage may be in part the cause of fatigue and other generalized symptoms. But there is also evidence that the tiny nerve endings throughout the body are damaged. Those that surround blood vessels can result in an inability of the smooth muscles around these vessels to contract normally and hence impacting blood pressure. It is likely that this damage is not directly from the virus. Rather, evidence points to the development of autoantibodies that damage nerve endings.

The patient’s history is the key to diagnosis of POTS but the confirmatory test is to lie flat for five minutes, then stand and compare the pulse before and after. If it rises by more than 30 bpm, the diagnosis is confirmed. In some individuals with POTS, the pulse will continue to rise even further over the next 5–10 minutes. Normally, the pulse should increase minimally after arising and then subside within a few minutes at most.

Pre-pandemic, doctors found that POTS could persist for long time frames or subside over weeks to months yet reoccur months later in some. It can be a lifetime of waxing and waning of varying severity. There is no cure. The usual treatment is to drink plenty of fluids, eat a salty diet, and wear full-length compression stockings. These can help but not fully alleviate the symptoms. It appears that post Covid POTS follows the same patterns.

One study of 20 patients, mostly female, with autonomic dysfunction after Covid-19 found (see image) that 6- eight months after diagnosis, 60% could not return to work, 25% could work with accommodations and the remainder were able to eventually return to work.

A series of 27 post Covid patients referred to the Mayo Clinic found a spectrum of autonomic dysfunction after Covid-19 including POTS, lightheadedness, fainting, headache on standing, excessive sweating and burning pains.

Inappropriate tachycardia syndromes including post exertion tachycardia and POTS are not common after Covid-19 but they occur enough that given some 80 million cases in America so far, there are or will be a vast number of individuals with inappropriate tachycardia syndromes and other autonomic disturbances seeking care. As noted above, most doctors including most cardiologists do not seem to be aware.

A major report of heart damage from the Veteran’s Affairs was published in early February, 2022. Epidemiologists looked at the long-term cardiovascular outcomes of individuals seen at any VA health setting during the first 10 ½ months of the pandemic. Using Veterans Affairs electronic health databases, the investigators found 153,760 individuals who had tested positive for COVID-19. Essentially none had received a vaccine as they were not yet available. There were also about 5.5 million during that time who never had a positive test who served as a concurrent control group. They also looked at another 5 ½ million veterans who visited the VA in the year before the pandemic — the historical control group.

The Covid positive individuals were evaluated for cardiovascular outcomes from 30 days after the positive test until 12 months later. They found a substantial number of individuals with cardiovascular disease such as irregularity of the heartbeat, damaged heart muscle, angina and heart attacks, heart failure, and various blood clotting problems, including strokes. The frequency of these diagnoses was compared to the two control groups to determine if they were occurring at the same or greater frequency, i.e., the controls represented the “expected” frequency among these veterans.

Covid-19 positive patients were divided into those never hospitalized for Covid, those hospitalized, and those requiring ICU care.

Those with severe Covid had many cases of persisting or new cardiovascular disorders. But what was more interesting were those with mild Covid who, although having many fewer episodes, the number of cases was very real. It boils down to about 20 more cases per thousand then would be expected based on the control groups.

The authors observe that Covid was “an equal opportunity offender” meaning that the risk was the same for old versus young, diabetes or not, obesity or not, and smoker or not.

It is important to note that these veterans do not represent a full cross section of Americans as they were mostly older white males.

So yes, the risk of cardiovascular disease for a non-hospitalized individual with mild Covid-19 is relatively low but can be a very serious problem for a substantial number of people. In this article I have noted damage to heart muscle from asymptomatic and mild Covid-19 in young healthy college students; autonomic dysfunction with inappropriate tachycardias and POTS after mild Covid; and more serious cardiovascular diseases also after mild Covid.

The total known number of COVID-19 infected people in United States is nearing 80 million. This implies a huge number of individuals with mild Covid will develop autonomic dysfunction like inappropriate tachycardias and multiple cardiovascular diseases during the first year after infection. This is sobering.

Please join me next time for a discussion of mental health/neuro-psychiatric syndromes after mild Covid-19.

The post Cardiovascular Disease Even After Mild COVID-19 Is Real appeared first on Medika Life.

Twenty minutes of physical activity on a treadmill improved attention, action monitoring, and inhibitory control (more on that in a bit). The benefits accrued to both anxious and non-anxious individuals.

Today we explore the research investigation “The effect of acute exercise for reducing cognitive alterations associated with individuals high in anxiety.” First, though, let’s look at some of the other known benefits of physical activity and exercise.

Exercise benefits

Physical activity has many upsides, ranging from muscle preservation to cardiovascular health optimization. Exercise,,, and you are more likely to avoid premature death and dodge chronic diseases such as diabetes and cardiovascular disease. While there are some risks associated with exercise, the benefits outweigh the risks for most individuals.

While we lack high-quality randomized clinical trials of exercise for the prevention of early death in a healthy population, there is an abundance of observational studies suggesting this:

Regular exercise drops the risk of mortality for most men and women, younger and older individuals, and those with high blood pressure.

Do you exercise? The drops in risk are associated with recreational and non-recreational physical activity and are observed in countries of varying income levels.

While the benefits of exercise have some dose dependency, even so-called weekend warriors get improvements in cancer death risk, heart health, and early death compared with sedentary individuals.

Somewhat surprisingly to me, doses of moderate-intensity physical activity greater than 100 minutes daily for healthy individuals are not associated with additional drops in mortality rates.

Exercise and cognition

I have written about my approaches to optimizing my mental functioning:How I Keep My Brain Ridiculously FitPHYSICAL ACTIVITY, adequate sleep, flavonoids (more about that in a bit), and more. These are essential elements for me…medium.com

Today, we focus on exercise and its association with improvements in cognitive functioning. First, an aside about how exercise may be working its magic — among other things, regular physical activity:

• stimulates physiological changes that reduce inflammation and insulin resistance;
• promotes the growth of new blood vessels in the brain;
• improves the number and overall health of our brain cells.

Study authors Dr. Matthew Pontifex and his team aimed to see how exercise might help with anxiety-related cognitive impairments. Anxiety affects attentional resources, impairing attentional control.

Here’s what they did: Researchers conducted a brain imaging study to see how exercise impacts students’ performances on an inhibitory control task. They compared the reactions of anxious and non-anxious participants.

The study included 37 college-aged women with generalized anxiety (high anxiety group) and 33 who fell below the cut-off for generalized anxiety (low anxiety).

All participants did two lab sessions on two separate days. For one of the sessions, participants completed the Eriksen flanker task before and after 20 minutes of moderate exercise on a treadmill. Individuals did no exercise for the other lab session but completed the inhibitory control task before and after 20 minutes of sitting.

What is the inhibitory control task? The test required participants to avoid responding to irrelevant stimuli. As the subjects performed the task, researchers recorded brain activity using electroencephalography (EEG), a process that involves leads placed on the scalp to measure brain electrical activity.

Here are the results in a nutshell:

Exercise offered cognitive benefits for both anxious and non-anxious people.

The study authors acknowledge that more research is needed to explore how exercise type, duration, and intensity influence cognition. Other forms of exercise may be better for acute bouts of anxiety among the highly anxious.

My takeaway? Move and you will likely reap both physical and psychological benefits. Join a friend to walk around your block, get out in the garden, take the stairs, park far away from your grocery store.

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There is no shortage of people who carry excess weight but have impeccable blood pressure and cholesterol levels and no known health problems. Consider the example of professional athletes whose livelihoods are dependent on being heavy, such as football linemen or sumo wrestlers.

At first glance, it is easy to notice their rotund shape, but they also possess greater physical endurance and strength than the average person. On the other hand, some maintain a thin figure but eat poorly, seldom exercise, and have a host of health issues.  Granted, most of us don’t train like professional athletes but it gets to the heart of the question: What matters more when it comes to health– weight or fitness?

Some studies do suggest that regular physical activity can mitigate some of the negative effects of being overweight, which does lend credibility to the idea of being both. Regardless of your weight, exercising regularly is sure to be a good thing. However, even when controlling for physical activity level, those who are overweight tend to be at higher risk of disease than their normal-weight peers.

Here are three reasons why being overweight does not always harmonize with being fit:

1. Fat is a hormonally and metabolically active tissue – Fat cells do more than just add inches. They can influence the balance of hormones and energy systems in our bodies. For example, fat cells can increase cortisol levels, which can further contribute to weight gain, and can promote insulin resistance, which can lead to diabetes.   It can also release substances that contribute to a steady level of chronic inflammation in the body – which increases risk of some cancers.
2. Excess weight, irrespective of fitness level, can be a risk factor for development of disease. While some people may be overweight but still maintain healthy blood pressure, cholesterol, and glucose levels, it is important to recognize that they are a snapshot of their present health status. The reality is that being chronically overweight carries the risk of developing other health problems in the future, although there is no way to predict exactly when that might occur.  Health is about the long-term strategy. Some of these health problems include diabetes, high blood pressure, heart disease, and stroke. Certainly, maintaining a regular physical activity regimen to keep fit may delay the development of these conditions, but losing body fat is another important way to reduce the risk of developing them.
3. Carrying extra fat can put undue stress on various body structures. Many discussions about fitness focus on cardiovascular health and reducing the risk of some cancers, but being overweight can also worsen back and joint pain. Chronic back and joint pains are significant causes of disability as we get older.  Extra fat around the neck can also contribute to the development of obstructive sleep apnea by causing the airway to collapse while sleeping.

The COVID pandemic has taught us important lessons about the importance of self-care. It’s not just about our lifespan, but also our health span.  That requires each of us to do our part in striving for a healthier lifestyle, whether that means eating more healthfully, exercising more consistently, or implementing better stress reduction techniques. While it’s possible to achieve good health despite being overweight, reducing excess body fat is yet another way to further optimize health and fitness and reduce the development of chronic disease.

The post How Many Pounds You Weigh vs How Fit You Are… appeared first on Medika Life.

I am blessed: The sheer number of jaw-dropping hikes in the Pacific Northwest region of the United States is staggering. Today, I want to explore some of my favorites before turning to how you can use hiking to burn some serious calories.

Hiking in the Pacific Northwest

Hurricane Ridge is one of my favorite places to hike. Perhaps it is because I discovered the Ridge as one of my first explorations of the Pacific Northwest in 1993.

Do you want to see extraordinary sunrises or sunsets? Have a young child and don’t want a very challenging hike? Hurricane Ridge may be for you. Located in the Olympic National Park, it has easy-to-access trailheads and is fabulous for an entire family.

Go to Port Angeles (Washington State, USA) and drive about 40 minutes into the mountains. Here’s a view:

Ambitious? Given the ease of access to the Hurricane Ridge Mountain area, you might make it a stop on your Olympic Peninsula Road Trip.

Ruby Beach is next. Positioned on the Washington coast, you can get to the beach reasonably quickly by foot. Prepare yourself for towering rock formations, lots of driftwood, and your beach picnic. Here’s a peek at Ruby Beach:

Number three on my list is one I discovered earlier this year. Can you guess what it is if I tell you that it gets as much as 14 feet of rain annually? If you are from the Seattle area, you probably know that I am talking about the Hoh Rainforest in the Olympic National Park.

Here’s a pic of this wondrous, stress-dropping place:

Hiking to burn calories

I walk. On the treadmill, on the blocks around my suburban hospital, or at Seattle’s Pike Place Market. This simple exercise promotes my physical health and gives my mind a boost, too.

Walking is a low-impact cardiovascular exercise that helps me maintain a blood pressure of 110/70 and good cholesterol levels. Hiking has similar benefits. But what if you want to burn more calories than you can with walking?

Walk, and you may burn approximately 100 calories for each mile. Hiking can easily double that number, depending on the difficulty of the activity. For the ambitious of us who take on challenging and steen terrain with a heavy backpack, you may burn well over 500 calories per hour.

I sometimes do an urban or suburban hike. You can, too — find a hilly (and safe) neighborhood, load up your backpack, and go. Perhaps you can add some trekking poles.

Hiking can be strenuous and can introduce uneven terrain, so don’t hesitate to fall back to my go-to form of exercise: Walking on an even surface.

Thank you for joining me today. I hope you have a health- and joy-filled 2022. Looking forward to the acute phase of the pandemic burning out over the next two to three months, fingers crossed.

The post How You Can Use Hiking to Burn Calories appeared first on Medika Life.

Do it right, and you may discover your blood pressure goes down, your cholesterol improves, and you can experience memory improvements. In addition, you can reduce your risk for diabetes, heart disease, cancer, and more.

Walking can be central to losing weight, dropping blood pressure and cholesterol, and boosting memory, as well as lowering your risk for diabetes, cancer, and heart disease.

I prescribe walking to my patients, a “wonder drug” with health and wellness benefits we often underestimate. Moreover, it’s free, and there are no side effects.

Longevity benefit

Every minute counts. A 2014 University of Utah study discovered this:

For every single minute of brisk walking performed, women dropped their risk of obesity by five percent.

The same institution looked at the power of walking in combating being sedentary. Low-intensity activities (for example, standing) may not be enough to offset the health hazards of sitting for long periods.

The scientists found no benefit in decreasing sitting by two minutes each hour and adding two minutes more of low-intensity activities. However, they noted this:

Trade sitting for light intensity activities for two minutes each hour, and there appears to be a 33 percent lower risk of dying.

Perhaps we focus too much on the benefits of moderate or vigorous activity. Light activity appears associated with a lower chance of premature death. Of course, we need large, randomized, interventional trials to definitively answer whether exchanging sitting for light activities leads to better overall health.

But what about heart health? Fifteen minutes of activity is associated with a 22 percent lower risk of early mortality, according to research presented EuroPRevent 2016 meeting. Walking appeared associated with a 43 percent reduced risk of stroke and heart attack, irrespective of heart rate.

Commenting on his research, Dr. David Hupin, of the University Hospital of Saint-Etienne in Saint-Etienne, France, observes:

Commenting on his research, Dr David Hupin, a physician in the Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne in Saint-Etienne, France observes:

“Age is not an excuse to do no exercise. Regular physical activity has a better overall effect on health than any medical treatment. But less than half of older adults achieve the recommended minimum of 150 minutes moderate-intensity or 75 minutes vigorous-intensity exercise each week.”

For those of you who have not gotten on the physical activity train, the most significant reduction in mortality occurs when we go from being sedentary to becoming moderately active. A study of U.S. veterans is illustrative. Researchers divided subjects into five categories based on their level of fitness.

The least fit healthy adults have an early death risk that is 4.5-times that of the fittest. You may find it surprising that an individual’s fitness level represented a more important predictor of early death than established risk factors such as smoking, high blood pressure, high cholesterol, and diabetes.

What a remarkable reminder that fitness and daily activity have a tremendous influence on the incidence of cardiovascular disease and early mortality.

Such studies underscore that fitness and daily activity levels can strongly influence your chances of suffering from heart disease and improve your overall longevity.

Risks

Fortunately, the risks of cardiac-related complications (such as a heart attack or a severe heart rhythm problem) are extremely low. For adults without heart disease, the risk of a cardiac event is as low as 1 in 400,000 to 800,000 hours of exercise.

For those with known heart disease, the event rate is about one in 62,000 hours. For regular exercisers, the risk is nearly 50 times lower than for a sedentary person.

Even though the risk of exercise is low, please check with your healthcare provider before beginning an exercise program.

Move

If you cannot commit to a half-hour of physical activity on a particular day, try to insert small bits of movement into your routine. Need some ideas? Here you go:3 Small Ways I Move MoreHOW MANY TIMES have you heard me advocate for physical activity? You already know the perils of being sedentary. I try…medium.com

Get started. Increasing evidence shows us that physical activity has a powerful influence on a host of chronic diseases. Just put those shoes on, walk outside, and enjoy your walk.

Thank you for joining me today.

The post Does Walking Extend Life? appeared first on Medika Life.

What does heart related back pain feel like?

This symptom, usually occurs in your upper back and is more likely to affect women. The pain can originate in your chest and then “move” to your back. Although most often felt in the upper back, it can also occasionally cause pain in the lower back.

Onset can be sudden and pain can wake you at night. The pain is most often described as originating between the shoulder blades. As there are many non-heart related causes for back pain, its important to consider any of the other heart attack symptoms that would indicate your pain is heart related. If you find it difficult to pinpoint the pain, this could be an indicator of heart related pain.

Why does your heart cause this symptom?

It’s a case of crossed wires. Our bodies are normally very specific when they send out pain signals. Close your finger in the door and you know which part of your body isn’t impressed with you. The heart is a little bit more complicated as it shares nerves that send out signals to our arms, head and upper body.

As a result heart related symptoms like back pain are called referred pain. In other words, although that area feels painful, it isn’t the problem. Your heart is the issue and the signals have simply gotten mixed up. The source of origin for referred pain is also more diffuse and difficult for patients to pinpoint.

Accompanying symptoms

Back pain can occur as an isolated symptom or be accompanied by pain in your neck, jaw, shoulder or chest and you may experience nausea, sweating, shortness of breath, dizziness, or lightheadedness. If your back pain is accompanied by any these symptoms, seek immediate medical help.

If you’ve recently noticed any of the following, you should also seek medical attention if your back pain is unexplained.

• feeling tired or out of breath from your normal day to day routine
• struggling for breath from activities that don’t normally tax you
• feeling tired and listless but struggling to sleep
• sudden feelings of dread or anxiousness (panic attack)

Gender prevalence for back pain

Women experience this symptom far more than men do and many women report the pain as having started in their chests and then moving to the upper back area. For women, it is a typical red flag, but men may not experience any back pain at all. Women are also more likely than men to feel their back pain while they’re resting or sleeping.

Alternate Causes of back pain

Even if you suffer from any of the conditions listed below, you may still experience back pain as a result of a heart condition. The pain may not feel the same as the pain you normally experience from an existing condition.

The most common causes of upper back pain are muscular, related to poor posture, trapped nerves or degenerative conditions of the spine and bones. These include some of the following

• Back muscle spasm, sprain or strain
• Cancers
• Degenerative disc disease
• Herniated (bulged or ruptured) disc
• Lung Cancer
• Osteoarthritis
• Osteomyelitis
• Osteoporosis
• Spinal stenosis
• Spondylitis

A life-threatening cause of back pain is an aortic dissection, a condition in which the biggest artery in your chest tears.

Are there clear signs it’s your heart?

There are a few tell tale signs that would indicate the pain in your back is related to your heart.

• Sharp pain that wakes you but you are unable to pinpoint the source of the pain
• Pain is most often described as occurring between the shoulder blades
• If the pain is accompanied by sudden excessive sweating not related to menopause
• If you find yourself suddenly short of breath from normal activities
• If your back pain is accompanied by one or more of the other heart related symptoms seek immediate medical attention

When to call your Doctor or 911

If you are experiencing upper back pain, especially pain that travels to your jaw, neck or down your arm, and are having associated symptoms of nausea, dizziness, sweating, or shortness of breath, call 911 right away.

If you are in an at risk group for heart disease (elderly, diabetic, obese, overweight, smoker or high blood pressure) then you should treat any back pain seriously. The more prolonged the discomfort or pain is, the faster you should seek medical care. Dial 911 or visit your nearest ER

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