Fatty muscles raise the risk of serious heart disease regardless of overall body weight

 People with pockets of fat hidden inside their muscles are at a higher risk of dying or being hospitalised from a heart attack or heart failure, regardless of their body mass index, according to research published in the European Heart Journal today (Monday).

This 'intermuscular' fat is highly prized in beef steaks for cooking. However, little is known about this type of body fat in humans, and its impact on health. This is the first study to comprehensively investigate the effects of fatty muscles on heart disease.The new finding adds evidence that existing measures, such as body mass index or waist circumference, are not adequate to evaluate the risk of heart disease accurately for all people.

The new study was led by Professor Viviany Taqueti, Director of the Cardiac Stress Laboratory at Brigham and Women's Hospital and Faculty at Harvard Medical School, Boston, USA. She said: "Obesity is now one of the biggest global threats to cardiovascular health, yet body mass index -- our main metric for defining obesity and thresholds for intervention -- remains a controversial and flawed marker of cardiovascular prognosis. This is especially true in women, where high body mass index may reflect more 'benign' types of fat.

"Intermuscular fat can be found in most muscles in the body, but the amount of fat can vary widely between different people. In our research, we analyse muscle and different types of fat to understand how body composition can influence the small blood vessels or 'microcirculation' of the heart, as well as future risk of heart failure, heart attack and death."

The new research included 669 people who were being evaluated at the Brigham and Women's Hospital for chest pain and/or shortness of breath and found to have no evidence of obstructive coronary artery disease (where the arteries that supply the heart are becoming dangerously clogged). These patients had an average age of 63. The majority (70%) were female and almost half (46%) were non-white.

All the patients were tested with cardiac positron emission tomography/computed tomography (PET/CT) scanning to assess how well their hearts were functioning. Researchers also used CT scans to analyse each patient's body composition, measuring the amounts and location of fat and muscle in a section of their torso.

To quantify the amount of fat stored within muscles, researchers calculated the ratio of intermuscular fat to total muscle plus fat, a measurement they called the fatty muscle fraction.

Patients were followed up for around six years and researchers recorded whether any patients died or were hospitalised for a heart attack or heart failure.

Source: ScienceDaily

Exposure to aircraft noise linked to worse heart function

 People who live close to airports and are exposed to high aircraft noise levels could be at greater risk of poor heart function, increasing the likelihood of heart attacks, life-threatening heart rhythms and strokes, according to a new study led by UCL (University College London) researchers.

The study, published in the Journal of the American College of Cardiology (JACC), looked at detailed heart imaging data from 3,635 people who lived close to four major airports in England.

Within this group, the research team compared the hearts of those who lived in areas with higher aircraft noise with those who lived in lower aircraft noise areas.They found that those who lived in areas with higher than recommended aircraft noise levels had stiffer and thicker heart muscles* that contracted and expanded less easily and were less efficient at pumping blood around the body.

This was especially the case for people exposed to higher aircraft noise at night, potentially due to factors such as impaired sleep and the fact that people are more likely to be at home at night and therefore exposed to the noise.

The researchers found in separate analyses of people not exposed to aircraft noise, that these types of heart abnormalities could result in two- to four-fold increased risks of a major cardiac event such as a heart attack, life-threatening heart rhythms, or stroke when compared to the risk of persons without any of these heart abnormalities.

Senior author Dr Gaby Captur (UCL Institute of Cardiovascular Science and consultant cardiologist at the Royal Free Hospital, London) said: "Our study is observational so we cannot say with certainty that high levels of aircraft noise caused these differences in heart structure and function.

"However, our findings add to a growing body of evidence that aircraft noise can adversely affect heart health and our health more generally.

"Concerted efforts from government and industry are needed to reduce our exposure to aircraft noise and mitigate its impact on the health of millions of people who live close to airports or under flight paths."

Professor Anna Hansell from the University of Leicester added: "We are concerned that the type of abnormalities we saw with night-time aircraft noise might result in increased risk of heart problems and stroke. Aircraft noise at night has been shown to affect sleep quality and this may be an important factor affecting health.

"The role of noise on heart health is currently under investigation. However, there are many established ways to look after your heart. These include eating a healthy and balanced diet, keeping physically active, maintaining a healthy weight, giving up smoking if you smoke, reducing alcohol consumption, keeping conditions such as high blood pressure and diabetes under control, and taking medication including cholesterol-lowering drugs if prescribed by your doctor."

Source: ScienceDAily

Researchers make breakthrough in bioprinting functional human heart tissue

 Researchers at University of Galway have developed a way of bioprinting tissues that change shape as a result of cell-generated forces, in the same way that it happens in biological tissues during organ development.

The breakthrough science focused on replicating heart tissues, bringing research closer to generating functional, bioprinted organs, which would have broad applications in disease modelling, drug screening and regenerative medicine.The research was led by a team at the School of Engineering and CÚRAM Research Ireland Centre for Medical Devices at University of Galway and has been published in the journal Advanced Functional Materials.

Bioprinting technology uses living cells within specialised "bioink" materials -- a substance or material which can support living cells, and due to its characteristics, it can aid cell adhesion, proliferation and differentiation during maturation. The technology offers immense promise for creating lab-grown organs that closely resemble the structure of their human equivalent.

However, bioprinting fully functional organs remains a significant hurdle. For instance, while bioprinted heart tissues can contract, their force of contraction is often considerably weaker than that of a healthy adult heart.

Traditional bioprinting methods often aim to directly recreate the final anatomical shape of an organ, like the heart -- therefore overlooking the crucial role of dynamic shape changes during natural embryonic development. For example, the heart begins as a simple tube that undergoes a series of bends and twists to form its mature four-chambered structure. These shape-morphing behaviours are essential for sculpting heart cell development and maturation.

The University of Galway research team recognised this and developed a novel bioprinting technique that incorporates crucial shape-changing behaviours.

Ankita Pramanick, lead author of the study and CÚRAM PhD Candidate at University of Galway, said: "Our work introduces a novel platform, using embedded bioprinting to bioprint tissues that undergo programmable and predictable 4D shape-morphing driven by cell-generated forces. Using this new process, we found that shape-morphing improved the structural and functional maturity of bioprinted heart tissues."

The research showed that cell-generated forces could guide the shape-morphing of bioprinted tissues, and it was possible to control the magnitude of the shape changes by modifying factors such as the initial print geometry and bioink stiffness. Morphing was found to sculpt cell alignment and enhance the contractile properties of the tissues. The research team also developed a computational model that could predict tissue shape-morphing behaviour.

Source: ScienceDaily

While most Americans use a device to monitor their heart, few share that data with their doctor

 Advances in technology have made it increasingly easier for people to self-monitor their heart health whether it's via a smart device on their wrist or finger or a blood pressure monitor. However, a new national survey commissioned by The Ohio State University Wexner Medical Center found that while many Americans use a device to monitor their heart, few share that data with their doctor.

The survey of 1,008 Americans found nearly two-thirds use a device on a regular basis to monitor their heart health with the most popular being a smartwatch (32%), portable blood pressure machine (31%), fitness app (19%) and wearable fitness/movement tracker (13%). Of those who use a device, only 1 in 4 use that data to prompt a conversation about their heart health with their doctor.

"These self-monitoring devices are really helpful to patients and their healthcare providers because they can potentially catch things early. For example, if patients are monitoring their blood pressure at home and notice it's been going up over time, they may want to discuss it with their doctor sooner rather than waiting for their annual visit. Or they may capture some irregular heart rhythms on their devices, like atrial fibrillation, much sooner than would be diagnosed at the doctor's office," said Laxmi Mehta, MD, director of Preventative Cardiology and Women's Cardiovascular Health at the Ohio State Wexner Medical Center and Sarah Ross Soter Endowed Chair for Women's Cardiovascular Health Research.

Mehta said patients have increasingly been asking her about the pros and cons of self-monitoring health devices. One of those patients is Sue VanWassenhove, 78, of Upper Arlington, whose children got her a smartwatch to track her health after she fell a couple of times. VanWassenhove has sleep apnea, which affects her heart rate and breathing, and she keeps a close eye on what the device is capturing. When her smartwatch showed a pattern of her heart rate dropping, she set up an appointment with Mehta.

"A normal heart rate is between 60 to 100 beats per minute without exercise. Heart rates can vary due to heart conditions or a variety of non-heart related reasons such as infection, dehydration, anxiety or thyroid disorders. When someone's heart rate or rhythm seems different than usual, it's best for them to speak with their doctor," Mehta said.

When it comes to exercise, the maximum heart rate can be calculated by subtracting a person's age from 220. With moderate intensity exercise, the goal is to hit 50-75% of that number and 70-85% for vigorous exercise, Mehta said. The American Heart Association recommends 150 minutes of moderate intensity aerobic exercise per week or 75 minutes of vigorous exercise per week for maintaining a healthy heart.

During an appointment with Mehta, VanWassenhove learned her smartwatch could do an EKG, which records the electrical signals in the heart, and she could send the results to Mehta through her electronic medical chart.

Source:ScienceDaily

Study shows anti-clotting drug reduced bleeding events in patients with atrial fibrillation

 Patients with atrial fibrillation are typically prescribed an anticoagulant, or blood thinner, to reduce the risk of stroke, but many may discontinue them or never receive a prescription due to concerns of increased risk of bleeding complications. Researchers from Mass General Brigham evaluated a drug that represents a new class of anticoagulants known as Factor XI inhibitors for treating patients with atrial fibrillation as part of the AZALEA-TIMI 71 Study. The trial was stopped early by the recommendation of the Data Monitoring Committee due to an overwhelming reduction in bleeding compared to standard-of-care treatment. The researchers report in the New England Journal of Medicinethat abelacimab, a Factor XI inhibitor, significantly reduced bleeding compared to a standard-of-care anticoagulant, rivaroxaban.

"It should be enormously satisfying to the cardiovascular field, patients and providers that Factor XI inhibitors live up to their promise of superior safety," said Christian Ruff, MD, MPH, director of General Cardiology within the Cardiovascular Division at Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, senior investigator in the TIMI Study Group and principal investigator of the AZALEA-TIMI 71 Study.

"Atrial fibrillation is a common medical condition, and bleeding with currently available anticoagulants resulting in significant undertreatment is still one of the greatest shortcomings in cardiovascular disease."

About 1-in-3 people will develop atrial fibrillation, making it one of the most common cardiovascular conditions in the world.

The risk of stroke increases significantly in patients with atrial fibrillation because blood clots form in the heart chambers and can be pumped to the brain, causing a stroke.

The AZALEA-TIMI 71 Study is the largest and longest trial examining a Factor XI inhibitor compared to standard of care direct oral anticoagulants to date.

The team enrolled 1,287 participants in 95 study sites across the globe.

Participants were randomized and administered monthly injections of 150 mg abelacimab, 90 mg abelacimab, or standard dosing of rivaroxaban (20 mg or 15 mg in dose reduced patients). The team found that the 150 mg dose of abelacimab reduced bleeding that required hospitalization or medical attention by 62%, compared with rivaroxaban.

The 90 mg dose of abelacimab reduced the same types of bleeding by 69%. In addition, the team found that both doses of abelacimab almost eliminated gastrointestinal bleeding compared to rivaroxaban, which is the most common type of bleeding that occurs in patients on currently available anticoagulants.

The team notes that in the AZALEA-TIMI 71 Study, the rates of stroke were low and there were not any significant differences between patients in the abelacimab groups compared to those taking rivaroxaban, although the trial was not powered for ischemic events.

The TIMI Study Group is leading an ongoing phase 3 trial of the study, LILAC-TIMI 76, which will compare the 150 mg dose of abelacimab to placebo in high-risk atrial fibrillation patients who have been deemed ineligible for current anticoagulants for the prevention of ischemic stroke and systemic embolism.

Source: ScienceDaily

Heart disease remains leading cause of death as key health risk factors continue to rise

 Heart disease kills more people than any other cause as many of the risks factors that contribute to it remain on the rise, according the data reported in the 2025 Heart Disease and Stroke Statistics: A Report of U.S. and Global Data From the American Heart Association. The annual update published today in Circulation, the peer-reviewed, flagship journal of the American Heart Association, the leading global voluntary health organization devoted to changing the future of health care for a world of healthier lives for all.

"Did you know that in the U.S., someone dies of cardiovascular disease every 34 seconds? Nearly 2,500 people in the U.S. die from cardiovascular disease every day. Those are alarming statistics to me -- and they should be alarming for all of us, because it's likely many among those whom we lose will be our friends and loved ones," said Keith Churchwell, M.D., FAHA, the volunteer president of the American Heart Association. "Too many people are dying from heart disease and from stroke which remains the 5th leading cause of death. Together, they kill more people than all cancers and accidental deaths -- the #2 and #3 causes of death -- combined."

According to the Association's 2025 statistical report, in 2022 (the most recent year for which final data is available), the overall number of cardiovascular disease (CVD) related deaths in the U.S. was 941,652, an increase of more than 10,000 from the 931,578 CVD deaths in 2021. The age-adjusted death rate attributable to CVD was 224.3 per 100,000 people, a slight decrease from 233.3 per 100,000 reported in 2021.

The report indicates the overall number of cardiovascular-related deaths appears to be leveling out after a major uptick during the COVID pandemic. In fact, the age-adjusted death rates dropped for all but one of the ten leading causes of death. The kidney disease age-adjusted death rates increased 1.5%.

"Kidney disease has actually been on the rise over the past decade. In our report, we noted a significant increase in the prevalence of chronic kidney disease among Medicare beneficiaries from 9.2% in 2011 to 14.2% in 2021. Additionally, the global prevalence of kidney disease has increased more than 27% in relative terms since 2010," said American Heart Association volunteer and chair of the Association's statistical update writing committee Seth S. Martin, M.D., M.H.S., FAHA, a professor of medicine and cardiologist at Johns Hopkins School of Medicine in Baltimore, Maryland. "The reason this is important is that, first, cardiovascular disease is a major contributor to kidney disease. Second, the risk factors of these diseases are closely interrelated. These include high blood pressure, obesity and diabetes -- all health conditions that are rising substantially across the U.S. and the world."

According to the Association's 2025 Statistics Update:

• Nearly 47% of U.S. adults have high blood pressure.
• More than 72% of U.S. adults have unhealthy weight (currently defined as body mass index ≥25, with nearly 42% having obesity (currently defined as body mass index ≥30).
• More than half of U.S. adults (57%) have type 2 diabetes or prediabetes.

In a 2023 presidential advisory and scientific statement, the American Heart Association recognized cardiovascular-kidney-metabolic (CKM) syndrome as a health disorder due to the risk factor connections among heart disease, kidney disease, diabetes and obesity leading to poor health outcomes.

In the editorial accompanying the 2025 Statistics Update, American Heart Association volunteer Dhruv S. Kazi, M.D., M.Sc., M.S., FAHA, who is head of health economics and associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School in Boston, noted the prevalence of cardiovascular risk factors is projected to worsen over the coming decades.

"Although we have made a lot of progress against cardiovascular disease in the past few decades, there is a lot more work that remains to be done. If recent trends continue, hypertension and obesity will each affect more than 180 million U.S. adults by 2050, whereas the prevalence of diabetes will climb to more than 80 million. And over the same time period, we expect to see a 300% increase health care costs related to cardiovascular disease," said Kazi, who was the volunteer vice-chair of the advisory writing group of the American Heart Association's 2024 presidential advisories: Forecasting the Burden of Cardiovascular Disease and Stroke in the United States Through 2050: Prevalence of Risk Factors and Disease and Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States through 2050. "And it is important to acknowledge that, although cardiovascular disease affects us all, it doesn't affect us all equally. For instance, there is wide variation in the prevalence of obesity, diabetes and high blood pressure by sex and race/ethnicity."

Prevalence rates for major risk factors vary widely across specific sex and race/ethnicity populations. Below are comparisons of the highest rates to the lowest rates of key risk factors among all of the population groups. Rates for each individual population group can be found in the report:

• For overall prevalence of obesity, Black women had the highest rate of obesity at 57.9%, compared to the lowest rate of 14.5% which was among Asian women.
• For overall prevalence of diabetes, Hispanic men had the highest rate of diabetes at 14.5% compared to the lowest rate of 7.7% which was among white women.
• For the overall prevalence of high blood pressure, Black women had the highest rate of high blood pressure at 58.4% compared to the lowest rate of 35.3% which was among Hispanic women.

Source: ScienceDaily

Largest genetic study of migraine to date reveals new genetic risk factors

 An international consortium of leading migraine scientists identified more than 120 regions of the genome that are connected to risk of migraine. The groundbreaking study helps researchers better understand the biological basis of migraine and its subtypes and could speed up the search for new treatment of the condition, which affects over a billion individuals worldwide.

In the largest genome study of migraine yet, researchers have more than tripled the number of known genetic risk factors for migraine. Among the identified 123 genetic regions are two that contain target genes of recently developed migraine-specific drugs.

The study involved leading migraine research groups in Europe, Australia and the United States working together to pool genetic data from more than 873,000 study participants, 102,000 of whom had migraine.

The new findings, published on February 3, 2022 in the journal Nature Genetics, also uncovered more of the genetic architecture of migraine subtypes than was previously known.

Neurovascular mechanisms underlie migraine pathophysiology

Migraine is a very common brain disorder with over a billion patients worldwide. The exact cause of migraine is unknown, but it is believed to be a neurovascular disorder with disease mechanisms both within the brain and the blood vessels of the head.

Previous research has shown that genetic factors contribute significantly to the migraine risk. However, it has long been debated whether the two main migraine types -- migraine with aura and migraine without aura -- share similar genetic background.

To gain more insight into the specific risk genes, researchers from the International Headache Genetics Consortium assembled a large genetic dataset to conduct a genome-wide association study (GWAS), looking for genetic variants that were more common in those who had migraine in general, or one of the two main migraine types.

The results demonstrated that migraine subtypes have both shared risk factors and risk factors that appear specific to one subtype. The analyses highlighted three risk variants that appear specific to migraine with aura and two that appear specific to migraine without aura.

"In addition to implicating tens of new regions of the genome for more targeted investigation, our study provides the first meaningful opportunity to evaluate shared and distinct genetic components in the two main migraine subtypes," said the first author of the study, Heidi Hautakangas from the Institute for Molecular Medicine Finland, University of Helsinki.

Furthermore, the results supported the concept that migraine is brought about by both neuronal and vascular genetic factors, strengthening the view that migraine truly is a neurovascular disorder.

Potential to point to new therapies against migraine

As migraine is globally the second largest contributor to years lived with disability, there is clearly a large need for new treatments.

A particularly interesting finding was the identification of genomic risk regions containing genes that encode targets for recently developed migraine-specific therapeutics.

One of the newly identified regions contains genes (CALCA/CALCB) encoding calcitonin gene-related peptide, a molecule involved in migraine attacks and blocked by the recently introduced CGRP inhibitor migraine medications. Another risk region covers the HTR1F gene encoding serotonin 1F receptor, also a target for new migraine-specific medications.

Dr. Matti Pirinen, a group leader from the Institute for Molecular Medicine Finland, University of Helsinki, who led the study, commented: "These two new associations near genes that are already targeted by effective migraine drugs suggest that there could be other potential drug targets among the new genomic regions, and provide a clear rationale for future genetic studies with even larger sample sizes."

The study was a joint effort between research groups from Australia, Denmark, Estonia, Finland, Germany, Iceland, Netherlands, Norway, Sweden, UK and USA.

sources-science daily

Cheap medicines prevented migraine as well as expensive ones

 Migraine is more than just a headache. Often the pain is accompanied by nausea, vomiting, light sensitivity, and sound sensitivity. Chronic migraine can be disabling and may prevent many, especially women, from contributing to working life.

Still, it often takes a long time for migraine patients to find a treatment that works well for them. Researchers at the Norwegian Center for Headache Research (NorHead) have used data from the Norwegian Prescription Register to look at which medicines best prevent migraine in people in Norway:

"There has now been done a lot of research on this subject before. This may weaken the quality of the treatment and increase the cost of treatment for this patient group," says the leader of the study, Professor Marte-Helen Bjørk at the Department of Clinical Medicine, University of Bergen.

Three medicines had better effect than the first choice of medicines

The researchers used national register data from 2010 to 2020 to estimate treatment effect. They measured this by looking at the consumption of acute migraine medicines before and after starting preventive treatment, and investigated how long the people with migraine used the different preventive treatments. A total of over one hundred thousand migraine patients were in the study.

"When the withdrawal of acute migraine medicines changed little after starting preventive medicines, or people stopped quickly on the preventive medicines, the preventive medicine was interpreted as having little effect. If the preventive medicine was used on long, uninterrupted periods, and we saw a decrease in the consumption of acute medicines, we interpreted the preventive medicine as having good effect," Bjørk explains.

As a rule, so-called beta blockers are used as the first choice to prevent migraine attacks, but the researchers found that especially three medicines had better preventive effect than these: CGRP inhibitors, amitriptyline and simvastatin.

"The latter two medicines are also established medicines used for depression, chronic pain and high cholesterol, respectively, while CGRP inhibitors are developed and used specifically for chronic migraine," says the professor.

Can have great significance for the cost of health care

CGRP inhibitors are more expensive than the other medicines. In 2021 their reimbursement amounted to 500 million NOK (not including discounts given by pharma companies).

"Our analysis shows that some established and cheaper medicines can have a similar treatment effect as the more expensive ones. This may be of great significance both for the patient group and Norwegian health care" says Bjørk.

The researchers at NorHead have already started work on a large clinical study to measure the effect of established cholesterol-lowering medicines as a preventive measure against chronic and episodic migraine.

Facts:

The study was done in collaboration with Aud Nome Dueland (Headache Norway, Sandvika Neurocenter), Frank Sørgaard (former medical advisor at Novartis) and Solveig Borkenhagen with several from Oslo Economics. The results are published in the  journal European Journal of Neurology.

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Do your headaches happen at the same time of day?

 Both cluster headache and migraine have strong links to the circadian system, the internal clock that regulates body processes, according to a meta-analysis published in the March 29, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The meta-analysis included all available studies on cluster headache and migraine that included circadian features. This included information on the timing of headaches during the day and during the year as well as studies on whether genes associated with the circadian clock are more common in people with these headaches

The researchers also looked at studies on cluster headache and migraine and hormones related to the circadian system, including cortisol and melatonin.

"The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache," said study author Mark Joseph Burish, MD, PhD, of the University of Texas Health Science Center at Houston in Texas and a member of the American Academy of Neurology. "This reinforces the importance of the hypothalamus -- the area of the brain that houses the primary biological clock -- and its role in cluster headache and migraine. It also raises the question of the genetics of triggers such as sleep changes that are known triggers for migraine and are cues for the body's circadian rhythm."

For cluster headache, the meta-analysis found a circadian pattern of headache attacks in 71% of people. Attacks peaked in the late hours of the night to early hours of the morning. During the year, people had more attacks in the spring and fall. On the genetic level, cluster headache was associated with two main circadian genes, and five of the nine genes that increase the likelihood of having cluster headache are genes with a circadian pattern of expression.

People with cluster headache also had higher cortisol levels and lower melatonin levels than people without cluster headache.

For migraine, the meta-analysis showed a circadian pattern of attacks in 50% of people. While the peak for attacks during the day was broad, ranging from late morning until early evening, there was a circadian low point during the night when few attacks happened. Migraine was also associated with two core circadian genes, and 110 of the 168 genes associated with migraine were genes with a circadian pattern of expression.

People with migraine had lower levels of melatonin in their urine than people without migraine. In addition, melatonin levels were lower during a migraine attack.

"These results raise the potential for using circadian-based treatments for headache disorders," Burish said. "This could include both treatments based on the circadian rhythm -- such as taking medications at certain times of the day -- and treatments that cause circadian changes, which certain medications can do."

A limitation of the study was that researchers did not have information on factors that could influence the circadian cycle, such as medications, other disorders such as bipolar disorder or circadian rhythm issues such as night shift work.

The study was supported by the Will Erwin Headache Research Foundation.

sources-science daily

Are cardiovascular risk factors linked to migraine?

 Having high blood pressure, specifically high diastolic blood pressure, was linked to a slightly higher odds of ever having migraine in female participants, according to a new study published in the July 31, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. Diastolic pressure is when the heart is resting between beats. However, the study did not find an increased risk between other cardiovascular risk factors and migraine.

"Previous research shows that migraine is linked to a higher risk of cardiovascular events such as stroke, heart disease and heart attack, but less is known about how risk factors for cardiovascular events relate to having migraine," said study author Antoinette Maassen van den Brink, PhD, of Erasmus MC University Medical Center in Rotterdam, the Netherlands. "Our study looked at well-known risk factors for cardiovascular disease, such as diabetes, smoking, obesity and high cholesterol and found an increased odds of having migraine only in female participants with higher diastolic blood pressure."

The study involved 7,266 people, male and female, with a median age of 67 years, of whom 15% had previous or current migraine.

All participants had physical exams and provided blood samples. They were also asked questions about migraine, including if they had ever experienced a headache with severe pain that affected their daily activities.

After adjusting for multiple cardiovascular risk factors such as physical activity, as well as education level, researchers found female participants with higher diastolic blood pressure had 16% increased odds of having migraine per standard deviation increase in diastolic blood pressure. An increase per standard deviation is a measure to compare the diastolic blood pressure with other cardiovascular risk factors. No associations were found for systolic blood pressure. Maasen van den Brink said this contributes to the theory that migraine is associated with a slightly reduced function of the small blood vessels rather than a reduced function of the large blood vessels.

There were no associations for female participants with high cholesterol or obesity, and current smoking was associated with 28% lower odds of having migraine and diabetes with 26% lower odds of having migraine. Maassen van den Brink said, "These results should be interpreted with caution, as they do not prove that smoking causes a lower risk of migraine. Instead, smoking might trigger migraine attacks and therefore, people who choose to smoke are less likely to be people who have migraine."

In male participants, researchers found no associations between cardiovascular risk factors and migraine.

"Our study suggests that overall, migraine is not directly related to traditional risk factors for cardiovascular disease," said Maassen van den Brink. "Because we looked at people who were middle-age and older, future studies are needed in younger groups of people who are followed for longer periods of time."

A limitation of the study was the small number of male participants with migraine. Maassen van den Brink said this could help explain why they found no associations for male participants between cardiovascular risk factors and migraine.

The study was funded by the Dutch Research Council

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Lipton noted that participants showed that based on their headache warning symptoms, they could reliably predict impending migraine headaches. These findings apply only to those with reliable warning symptoms. A limitation of the study was that participants recorded their symptoms and medication use in electronic diaries, so it is possible some people may not have recorded all information accurately. The study was funded by AbbVie, the maker of ubrogepant.

 Contrary to previous research, a new study of female participants finds no link between migraine and the risk of developing Parkinson's disease. The study is published in the August 21, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"These results are reassuring for women who have migraine, which itself causes many burdens, that they don't have to worry about an increased risk of Parkinson's disease in the future," said study author Tobias Kurth, MD, ScD, from the Institute of Public Health at Charité -- Universitätsmedizin Berlin in Germany.

The study involved 39,312 female participants with an average age of 55 at the start of the study.

A total of 7,321 of the participants reported current or past migraine at the start of the study.

The participants were then followed for an average of 22 years.

During that time, 685 people reported physician-diagnosed Parkinson's disease.

Of those, 128 were people who reported a history of migraine or active migraine, and 557 were people with no migraine.

After adjusting for other factors that could affect risk of developing Parkinson's disease as well as migraine, such as age, physical activity, alcohol use and smoking status, researchers found that people with migraine were no more likely to develop Parkinson's disease than those who did not have migraine.

This result did not change based on how frequently people had a migraine or whether they experienced an aura before the migraine.

An aura is a visual or other sensory disturbance that occurs before the migraine starts, such as seeing bright lights.

"Since this study involved only female health professionals who were primarily white people, more research is needed to determine whether the results will apply to other groups, including men, women and other races, ethnicities and gender identities," Kurth said.

Another limitation of the study is that participants self-reported information on migraine and Parkinson's disease, so it is possible that some information was not accurate. In addition, since Parkinson's disease is often not diagnosed until symptoms are advanced, it's possible that some participants may have developed Parkinson's disease after the end of the study.

The study involved 39,312 female participants with an average age of 55 at the start of the study.

A total of 7,321 of the participants reported current or past migraine at the start of the study.

The participants were then followed for an average of 22 years.

During that time, 685 people reported physician-diagnosed Parkinson's disease.

Of those, 128 were people who reported a history of migraine or active migraine, and 557 were people with no migraine.

After adjusting for other factors that could affect risk of developing Parkinson's disease as well as migraine, such as age, physical activity, alcohol use and smoking status, researchers found that people with migraine were no more likely to develop Parkinson's disease than those who did not have migraine.

This result did not change based on how frequently people had a migraine or whether they experienced an aura before the migraine.

An aura is a visual or other sensory disturbance that occurs before the migraine starts, such as seeing bright lights.

"Since this study involved only female health professionals who were primarily white people, more research is needed to determine whether the results will apply to other groups, including men, women and other races, ethnicities and gender identities," Kurth said.

Another limitation of the study is that participants self-reported information on migraine and Parkinson's disease, so it is possible that some information was not accurate. In addition, since Parkinson's disease is often not diagnosed until symptoms are advanced, it's possible that some participants may have developed Parkinson's disease after the end of the study.

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Drug may stop migraines before headache starts

 When taken at the first signs of a migraine, before headache pain begins, a drug called ubrogepant may be effective in helping people with migraine go about their daily lives with little or no symptoms, according to a new study published in the August 28, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study focused on people with migraine who could tell when an attack was about to happen, due to early symptoms such as sensitivity to light and sound, fatigue, neck pain or stiffness, or dizziness.

Ubrogepant is a calcitonin gene-related peptide receptor antagonist, or CGRP inhibitor. CGRP is a protein that plays a key role in the migraine process.

"Migraine is one of the most prevalent diseases worldwide, yet so many people who suffer from this condition do not receive treatment or report that they are not satisfied with their treatment," said study author Richard B. Lipton, MD, of Albert Einstein College of Medicine in Bronx, New York, and Fellow of the American Academy of Neurology. "Improving care at the first signs of migraine, even before headache pain begins, can be a key to improved outcomes. Our findings are encouraging, suggesting that ubrogepant may help people with migraine function normally and go about their day."

The study involved 518 participants who had migraine for at least one year and two to eight migraine attacks per month in the three months before the study. All of the participants regularly experienced signs that a migraine would be starting within the next few hours. Participants were asked to treat two attacks during a two-month period.

Researchers divided participants into two groups. The first group received a placebo for their first set of pre-headache symptoms of migraine, followed by taking 100 milligrams (mg) of ubrogepant for their second instance of symptoms. The second group took ubrogepant for the first instance and placebo for the second instance.

Participants evaluated limitations on their activity in their diary using a scale ranging from zero to five, with 0 meaning "not at all limited -- I could do everything"; 1, "a little limited"; 2, "somewhat limited"; 3, "very limited"; or 4, "extremely limited."

Twenty-four hours after taking the drug or a placebo, 65% of people who took ubrogepant reported themselves as "not at all limited -- I could do everything," or "a little limited," compared to 48% of those who took the placebo.

Researchers found that as early as two hours post-medication, people who took the drug were 73% more likely to report that they had "no disability, able to function normally," than those who took the placebo.

"Based on our findings, treatment with ubrogepant may allow people with migraine who experience early warning signs before a migraine occurs to quickly treat migraine attacks in their earliest stages and go about their daily lives with little discomfort and disruption," said Lipton. "This could lead to an improved quality of life for those living with migraine."

Lipton noted that participants showed that based on their headache warning symptoms, they could reliably predict impending migraine headaches. These findings apply only to those with reliable warning symptoms.

A limitation of the study was that participants recorded their symptoms and medication use in electronic diaries, so it is possible some people may not have recorded all information accurately.

The study was funded by AbbVie, the maker of ubrogepant.

sources-science daily

New drug to prevent migraine may start working right away

 A drug recently approved to prevent migraine may start working right away, according to a study published in the December 23, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study looked at the drug atogepant, which is a calcitonin gene-related peptide (CGRP) receptor antagonist taken by mouth.

"With many current drugs to prevent migraine, it takes time to find the right dosage for the individual and it can take weeks or even months for it to be most effective," said study author Richard B. Lipton, MD, of Albert Einstein College of Medicine in the Bronx, New York, and a Fellow of the American Academy of Neurology. "Some people give up and stop taking the drugs before they reach this point. Plus, many people experience side effects with current treatments. Developing a drug that works both effectively and quickly is critical."

In the study, people taking the drug atogepant were less likely to have a migraine on the first day of taking the drug compared to those taking a placebo. They also had fewer migraines per week during each of the first four weeks of the study and fewer migraines during the study overall than those taking a placebo.

For this study, researchers looked at the data from three trials on the safety and effectiveness of atogepant over 12 weeks to focus on how rapidly improvements appeared. The ADVANCE trial, which enrolled people with episodic migraine, had 222 people taking the drug and 214 taking placebo. The ELEVATE trial, which enrolled people with episodic migraine who had previously not responded well to other oral preventive treatments, had 151 on the drug and 154 on placebo. The PROGRESS trial, which enrolled people with chronic migraine, had 256 on the drug and 246 on placebo.

People with episodic migraine experience up to 14 migraine days per month. People with chronic migraine experience at least 15 days with headache per month, with at least eight days being characteristic of migraine.

On the first day of the study, 12% of those taking the drug in the first trial, the ADVANCE trial had a migraine, compared to 25% of those taking placebo. In the second trial, the ELEVATE trial, the numbers were 15% and 26%. For the third trial, the PROGRESS trial, the numbers were 51% and 61%.

When researchers adjusted for other factors that could affect the rate of migraine, they found that people taking the drug were 61% less likely to have a migraine in the first trial, 47% less likely in the second trial, and 37% less likely in the third trial.

For the first two trials, the people taking atogepant had an average of one fewer day with migraine per week, compared to an average of less than one-half day fewer per week for those taking the placebo. For the third trial, average migraine days per week declined by about 1.5 days for those taking the drug compared to about one day for those taking the placebo.

The people taking atogepant also showed improvement on assessments of how much migraine impaired their activities and their overall quality of life compared to people taking the placebo.

"Migraine is the second-leading cause of disability in the overall population and the leading cause of disability in young women, with people reporting negative effects on their relationships, parenting, career and finances," Lipton said. "Having a treatment that can act quickly and effectively addresses a key need."

A limitation of the study is that it involved mostly female and white participants, so the results may not apply to the overall population.

The study was supported by AbbVie, the maker of atogepant.

sources-science daily

Ghrelin: All about the hunger hormone

 Ghrelin is a hormone that is produced and released in the stomach. People often refer to it as the “hunger hormone” because it increases appetite. It also promotes blood sugar regulation, prevents muscle breakdown, and protects the heart. In this Honest Nutrition feature, we explore what ghrelin is, its functions, and how a person can manage levels in their body.

Ghrelin is a hormone mainly produced in the stomach when it is empty. It is also produced in the small intestine, brain, and pancreas.

Ghrelin travels through the bloodstream to the brain, where it acts on the hypothalamus. The hypothalamus is a part of the brain, which produces hormones that regulate hunger, mood, thirst, and many other important functions within the body.

Ghrelin is often referred to as the hunger hormone because its primary role is to regulate appetite. When ghrelin activates its receptor — growth hormone secretagogue receptor — it causesTrusted Source a person to eat more food and store extra fat.

In people who are trying to lose weight or who have recently lost weight, ghrelin levels are often higher, making it challenging to maintain weight loss.

For example, one studyTrusted Source from 2020 looked at people with diabetes who participated in a 2-year weight management program. Participants who initially lost weight slowly regained it over the study duration. Researchers found that weight loss was associated with increased ghrelin levels and increased hunger, which might make it difficult to keep weight off.

Ghrelin can also signal the body to decrease brown fat thermogenesis. When this happens, the body burns less fat at rest. Brown fat is known for its thermogenic propertiesTrusted Source and ability to increase overall calories burned.

Studies show that ghrelin also affects a person’s sleep/wake cycle, taste sensation, and reward-seeking behavior.

As it plays a role in reward processing, many expertsTrusted Source believe higher ghrelin levels can contribute to food and alcohol misuse.

Recently, researchersTrusted Source have discovered that ghrelin also has many functions in the body, including improving heart health, preventing muscle atrophy, and influencing bone metabolism.

It can also stimulate gastric acid secretion and accelerate gastric emptying.

What causes ghrelin levels to rise?

Levels of ghrelin frequently change throughout the day and are primarily controlled by food intake. Ghrelin levelsTrusted Source usually rise when the stomach is empty and decrease once a person has eaten.

Some studiesTrusted Source show that people who have obesity have higher levels of ghrelin circulating. This can lead to a continuous state of hunger and make it difficult to lose weight.

However, research remains conflicted on this point. Yet a 2015 review suggests that ghrelin levels are low in people with obesity and even lower in people with obesity who also have a binge-eating disorder.

DietingTrusted Source also has been known to stimulate ghrelin secretion. What is more, diets can also decreaseTrusted Source leptin levels, which is known as the “satiety hormone.” Combined, this may make it difficult to lose weight and keep it off long term.

Interestingly, experts believe people who have undergone weight loss surgery have lower levels of ghrelin, which may make it easier to keep weight off.

In particular, one recent reviewTrusted Source found that ghrelin levels fall significantly following sleeve gastrectomy. Researchers believe this is because part of the stomach — the gastric fundus — where most ghrelin is produced is completely removed. However, the results of other studies are inconsistent for other weight loss procedures such as roux-en-y gastric bypassTrusted Source.

People with certain health conditions also tend to have elevated ghrelin levels.

People with obesity and Prader-Willi syndrome (PWS) have very high levels of ghrelin circulating, which may play a role in their constant sense of hunger and difficulty controlling weight.

Additionally, people with Hashimoto’s thyroiditis, anorexia nervosa, bulimia, and cachexia from illness tend to have higher hunger hormone levels.

Ghrelin levels also may be higher during periods of stress. Higher ghrelin levels are thought to have an anxiolyticTrusted Source effect on the body.

How to increase ghrelin levels

Although elevated ghrelin levels are commonly perceived as unfavorable and associated with increased appetite, certain individuals may benefit from higher ghrelin levels.

For instance, someone struggling to gain weight or with wasting syndrome may benefit from the appetite-stimulating effects of ghrelin.

Newer studies suggest ghrelin administration may potentially be helpful in patients with cancer cachexia because it can help reverse weight loss and protein breakdown in catabolic states. Although short-term ghrelin administration appears to be safe and well-tolerated, we need more studies on its effectiveness and safety before recommending it.

Animal research on how cannabis increases appetite by stimulating ghrelin production also appears to be promising to support its use in treating illness-induced anorexia.

Additionally, one human studyTrusted Source in men with HIV found that tetrahydrocannabinol (THC), the psychoactive compound in cannabis, can stimulate ghrelin release.

How to decrease ghrelin levels

Ghrelin levels may increaseTrusted Source following weight loss. Decreasing levels of ghrelin in the body may help decrease a person’s appetiteTrusted Source, prevent weight regain, or promote weight loss.

However, it is important to note that other studiesTrusted Source highlight monitoring changes in ghrelin alone are not sufficient to predict weight gain following weight loss in most people. Behavioral, physiological, and environmental factors also play a role in weight regain.

A person who wants to naturally decrease ghrelin levels may want to try some of the following interventions.

Follow a healthy diet

People’s ghrelin levels tend to increase when on a diet and not eating enough calories. Avoiding an empty stomach and eating a nutrient-rich diet may help limit ghrelin secretion.

According to the Dietary Guidelines for Americans, 2020–2025Trusted Source, the main elements that make up a healthy dietary pattern include:

• vegetables of all types
• fruits, especially whole fruit
• grains, at least which half are whole grains
• low fat dairy
• lean protein
• oils, such as olive oil and those naturally occurring in nuts and fatty fish

Some foods may also decrease ghrelin levels. In one older studyTrusted Source, researchers discovered that fiber-rich foods could reduce ghrelin levels.

Another studyTrusted Source looked at 21 men who were either given a bagel or eggs for breakfast. The group who ate eggs for breakfast had decreased ghrelin levels than those who ate bagels.

Get adequate sleep

Poor sleep patterns are tied to increased ghrelin levelsTrusted Source and decreased leptin levels, leading to increased appetite and hunger. For better sleep, aim to get a minimum of 7 hours of sleepTrusted Source in a 24-hour period.

Eat more protein

Consuming high protein meals and snacks can help promote satiety and reduce ghrelin levels. In fact, many meal-related studies have shown significant reductions in hunger and increased fullness following high protein meals.

ResearchersTrusted Source suggest getting between 1.2-1.6 grams of protein per kilogram of body weight per day or 25–30% of daily calories to promote weight management and appetite suppression. Most people can follow a high protein diet by eating chicken breast, beans, lentils, low fat dairy, and shellfish.

Limit stress

Although removing stress altogether is near impossible, studies show that high levels of chronic stressTrusted Source can lead to elevated ghrelin levels. In addition to signaling hunger, ghrelin may affect brain function. The exact mechanism remains unclear, and mixed findings make it difficult to draw conclusions about ghrelin’s role in stress.

Some animal studies suggest it may reduce anxiety and have antidepressant-like properties, while other studies suggest it may promote these behaviors.

Regular physical activity, adequate sleep, and practicing yoga or meditation can help minimize stress.

Exercise

Research surrounding the effect of exercise on ghrelin levels remains conflicting. In one 2021 reviewTrusted Source, researchers found that acute exercise suppresses ghrelin production. However, they also found that long-term exercise programs may have the opposite effect and increase ghrelin production.

The exact mechanism behind these effects remains unclear, but researchers believe it is likely due to elevated blood flow redistribution and weight loss from exercise.

Summary

Ghrelin is known as the hunger hormone due to its key role in appetite regulation. High levels of ghrelin lead to an increase in appetite and food intake. However, the body needs ghrelin because it is involved in many processes. These include improving heart health, influencing bone metabolism, and preventing muscle breakdown.

A person who wishes to naturally reduce ghrelin levels in the body may consider eating a healthy, fiber-rich diet, consuming adequate protein, exercising, getting enough sleep, and minimizing stress.

In contrast, someone with illness-induced anorexia or difficulty gaining weight may benefit from higher ghrelin levels to promote hunger and weight gain.

Source - Medical News Today