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Living in poor neighborhoods could increase heart failure risks

Raghu Kshitiz

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KATHMANDU — People living in the poorest neighborhoods have a higher risk of heart failure regardless of their socioeconomic status, the US study has suggested.

In addition to people’s income and education level, the neighborhood in which they lived helped predict their risk, according to the researchers.

Previous research has linked heart failure with a person’s individual socioeconomic status, a general term which includes income, education and occupation. But this new study, published Tuesday in Circulation: Cardiovascular Quality and Outcomes, shows that deprived neighborhoods themselves may play a role in higher heart failure rates.

The study suggested that the availability of gyms, places to buy healthy foods and medical facilities accounted for nearly 5 percent of the increased heart failure risk in low-income areas. The researchers also noted that improving access to these resources could benefit people living in these neighborhoods.

“It simply matters where you live,” said the study’s lead author Dr Elvis Akwo, a postdoctoral research fellow at Vanderbilt University Medical Center in Nashville, adding, “Improving a person’s individual condition isn’t enough.”

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Dr Akwo and fellow researchers at Vanderbilt looked to find out if a neighborhood deprivation index — a cluster of 11 social and economic factors — can predict the risk of heart failure beyond individual socioeconomic status in a low-income population.

The study included 27,078 whites and blacks living in low-income neighborhoods who were recruited as part of the Southern Community Cohort Study, a study of chronic diseases in the southeastern United States.

Participants were predominantly middle-aged and poor: 70 percent earned less than $15,000 a year. They were put into three groups, ranging from the least-deprived to the most-deprived neighborhoods.

Most of the participants were underinsured and lived in areas with limited resources. More than half lived in the most deprived neighborhoods and 75 percent earned less than $15,000 a year. Around 39 percent did not have a high school diploma, and 44 percent were obese.

“There is existing evidence suggesting strong, independent associations between personal socioeconomic status — like education, income level and occupation — and risks of heart failure and many other chronic diseases,” said study author Loren Lipworth, who is an associate professor of epidemiology at Vanderbilt University Medical Center in Nashville, in a news release from the American Heart Association.

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During an average follow-up period of more than five years, 4,300 people were diagnosed with heart failure. Those living in low-income areas were at highest risk for heart failure. The researchers noted that as socioeconomic status dropped from one community to the next, the risk for the condition increased 12 percent.

After taking other contributing factors into account, the researchers concluded that 4.8 percent of the disparity in heart failure risk was attributable to neighborhood factors.

But the study did not prove that living in a poor area actually caused heart risk to rise, just that there was an association.

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Drinking 3 cups of coffee or tea daily may keep stroke risk at bay

Raghu Kshitiz

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KATHMANDU — There have been several conflicting studies on the health benefits of drinking coffee and tea and their various varieties. But drinking up to three cups of coffee or tea in a day is safe because it reduces irregular heartbeat and stroke risk, according to a new study published in the journal JACC: Clinical Electrophysiology.

Coffee has previously been believed to worsen abnormal heart rhythms, as doctors generally discourage patients suffering from the condition. However, the results of this particular study say that a daily consumption of upto 300 mg of caffeine may be safe for arrhythmic patients.

This is because the caffeine acts as a stimulant to the central nervous system and blocks the effect of adenosine. Adenosine is a chemical which causes Atrial Fibrillation (AFib).

A single cup of coffee contains about 95 mg of caffeine. It acts as a stimulant to the central nervous system and works to block the effects of adenosine — a chemical that causes AFib.

AFib is the most common heart rhythm disorder, causes the heart to beat rapidly and skip beats, and if left untreated, can cause strokes.

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“There is a public perception, often based on anecdotal experience, that caffeine is a common acute trigger for heart rhythm problems,” said lead author Peter Kistler, Director at Melbourne’s Alfred Hospital.

But, “caffeinated beverages such as coffee and tea have long-term anti-arrhythmic properties mediated by antioxidant effects and antagonism of adenosine,” he added.

A meta-analysis of 228,465 participants showed that AFib frequency decreasing by 6 per cent in regular coffee drinkers, and an analysis of 115,993 patients showed a 13 per cent reduced risk.

Another study of 103 post-heart attack patients who received an average of 353 mg of caffeine a day showed improvement in heart rate and no significant arrhythmias — or abnormal heart rhythms, that cause the heart to beat too fast, slow or unevenly.

However, in two studies, where patients drank at least 10 cups and nine cups of coffee per day, showed an increased risk for ventricular arrhythmias (VAs) – a condition in which the lower chambers of the heart (ventricles) beat very quickly.

On the other hand, patients with pre-existing heart conditions who consumed two or more energy drinks — that contains concentrated caffeine — per day reported palpitations within 24 hours.

With Agency Inputs

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