Day: July 13, 2022

Categories : Ageing Cardiovascular DiseaseTags : Leave a comment

Type of Macular Degeneration Linked to Cardiovascular Disease

On By ModernMedia
Credit: National Eye Institute

Patients with a certain subtype of age-related macular degeneration (AMD) are at significant risk for cardiovascular disease and stroke, according to new research published in Retina.

“For the last three decades researchers have suggested an association between AMD and cardiovascular disease, but there has been no conclusive data on this until now. Our retinal team answered this important question by focusing on two different varieties of AMD that can be seen with advanced retinal imaging. We discovered that only one form of AMD, that with subretinal drusenoid deposits, is tightly connected to high-risk vascular diseases, and the other form, known as drusen, is not,” explained lead author R. Theodore Smith, MD, PhD, Professor at Mount Sinai. “If ophthalmologists diagnose or treat someone with the specific subretinal drusenoid deposits form of AMD, but who otherwise seems well, that patient may have significant undetected heart disease, or possibly carotid artery stenosis that could result in a stroke. We foresee that in the future, as an improved standard of care, such patients will be considered for early referral to a cardiologist for evaluation and possibly treatment.”

AMD is the leading cause of visual impairment and blindness over the age of 65. Drusen is one major form of early AMD: small yellow cholesterol deposits form in a layer under the retina, depriving it of blood and oxygen, leading to vision loss. Drusen formation can be slowed by appropriate vitamin supplementation.

The other major form of early AMD is the presence of subretinal drusenoid deposits (SDD), which is lesser known, which needs advanced retinal imaging to detect. These deposits are also made of fatty lipids and other materials, but form in a different layer beneath the light sensitive retina cells, where they are also associated with vision loss. There is no known treatment for SDD at present.

Mount Sinai researchers analysed 126 patients with AMD, using optical coherence tomography (OCT) which captures high-resolution cross-sectional scans of the retina. Patients also answered health history questionnaires. Of the patients on the study, 62 had SDD and 64 had drusen; 51 of the 126 total patients (40%) reported having cardiovascular disease or a past stroke, and most (66%) of those patients had SDD. By contrast, of the 75 patients who did not have known heart disease or stroke, relatively few (19%) had SDD. The odds of patients with cardiovascular disease or stroke having SDD was three times than in patients without.

The researchers suggested that the underlying cardiovascular disease likely compromises blood circulation in the eye, leading to the SDDs beneath the retina.

“We believe poor ocular circulation that causes SDDs is a manifestation of underlying vascular disease. This has important public health implications and can facilitate population screening and disease detection with major impact,” explained author Jagat Narula, MD, PhD, Associate Dean of Global Affairs and Professor of Medicine (Cardiology), and Radiology, at the Icahn School of Medicine at Mount Sinai. “Seen in an eye clinic, such patients should be prompted to see a cardiologist. On the other hand, if clinically substantiated in prospective studies, SDDs could emerge as a risk marker for underlying vascular disease in asymptomatic patients in primary care or a cardiology clinic. The temporal relationship between SDDs and macrovascular disease will also need to be established in prospective studies which are currently in progress.”

Analysis of patient blood samples revealed genetic risk factors may also play a role in SDD cases in addition to vascular causes. Specifically, they found that the ARMS2 gene acted independently of vascular disease to cause SDD in some patients.

“This study further demonstrates that AMD is not a single condition or an isolated disease, but is often a signal of systemic malfunction which could benefit from targeted medical evaluation in addition to localised eye care,” noted Richard B. Rosen, MD, Chief of the Retina Service for the Mount Sinai Health System. “It helps bring us one step closer to unraveling the mystery of this horrible condition which robs so many patients of the pleasure of good vision during their later years. “

Source: The Mount Sinai Hospital / Mount Sinai School of Medicine

Categories : General InterestTags : Leave a comment

Social Media Viewing of Tobacco Content Linked to Use

On By ModernMedia
Photo by Freestocks on Unsplash

People who have viewed tobacco content on social media are more than twice as likely than non-viewers to report using tobacco and, among those who have never used tobacco, more predisposed to use in the future.

A meta-analysis of 29 studies published in JAMA Pediatrics analysed data from a total of 139 624 participants. The study draws on data across age groups, countries, content types and platforms and is the first large-scale effort linking social media content to tobacco use.

“We casted a wide net across the tobacco and social media literature and synthesised everything into a single association summarising the relationship between social media exposure and tobacco use,” said Scott Donaldson, PhD, the study’s first author. “What we found is that these associations are robust and have public health implications at the population level.”

The findings come amid growing concerns about the potential harms of social media use, particularly among young people. They build a compelling argument that online tobacco content has the power to influence viewers’ offline tobacco use.

“The proliferation of social media has offered tobacco companies new ways to promote their products, especially to teens and young adults,” said Assistant Professor Jon-Patrick Allem, the paper’s senior author. “Our hope is that policymakers and other stakeholders can use our study as a basis for decision making and action.”

Effects across age, content type and platform

Compared to those not reporting exposure tobacco content, people who did report exposure were more than twice as likely to use tobacco in their lifetime, to have used it in the past 30 days, or to be susceptible to future tobacco use if they had never used tobacco before.

“Of particular importance is the fact that people who had never before used tobacco were more susceptible,” Prof Allem said. “This suggests that exposure to tobacco-related content can pique interest and potentially lead nonusers to transition to tobacco use.”

The sample included populations from across the United States, India, Australia, and Indonesia. Adolescents made up 72% of the participants, while young adults and adults accounted for 15% and 13%, respectively.

Tobacco content included both ‘organic’ or user-generated posts, such as videos of friends smoking or vaping, and promotional material, including advertising or sponsorships from tobacco companies. Items depicted in posts ranged from cigarettes and e-cigarettes to cigars, hookah and smokeless tobacco products. Tobacco content appeared on a range of social media platforms, including Facebook, Instagram, Twitter, YouTube, Snapchat, Pinterest and Tumblr.

Both active engagement with tobacco content (eg commenting or liking) and passive engagement (just viewing) were associated with lifetime use, recent use and susceptibility to future use. People who saw content on two or more social media platforms faced even higher odds of use or susceptibility to use than those who saw tobacco-related content on just one platform.

The researchers suggest that future research should use longitudinal or experimental designs to determine whether exposure to tobacco content on social media directly leads to tobacco use. As the data in meta-analysis was drawn mostly from surveys conducted at a single point in time, a causal relationship between viewing and use could not be established.

Preventing harm from tobacco content

The study’s authors point to three levels of action that can help address the abundance of tobacco content on social media.

“First of all, we can work on designing and delivering interventions that counter the influence of pro-tobacco content, for example by educating teens about how the tobacco industry surreptitiously markets its products to them,” Allem said.

Social media platforms can also implement safeguards to protect users, especially young people, from tobacco content, for instance by including warning labels on posts that include tobacco-related terms or images. At the federal level, regulators might also choose to place stricter limits on the way tobacco companies are permitted to promote their products online.

The researchers next plan to explore the effectiveness and reach of social media tobacco prevention campaigns. They also aim to delve deeper into specific platforms used by young people, such as TikTok, and investigate how tobacco-related videos can impact susceptibility.

Source: University of Southern California

Categories : Diet and NutritionTags : Leave a comment

You Can’t Outrun a Poor Diet, Large Study Shows

On By ModernMedia
Tired woman after exercise
Photo by Ketut Subiyanto on Pexels

New research reported in the British Journal of Sports Medicine has found that the detrimental effects of a poor diet on mortality risk are not counteracted by exercise, showing that you cannot ‘outrun’ a poor diet.

Study participants with both high levels of physical activity and a high-quality diet were found to have the lowest mortality risk.

The University of Sydney-led researchers analysed the independent and joint effects of diet and physical activity with all-cause, cardiovascular disease and cancer mortality using a large population-based sample of 360 600 adults from the UK Biobank.

High quality diets were defined as including at least five portions of fruit and vegetables every day, two portions of fish per week and lower consumption of red meat, particularly processed meat.

The study revealed that for those who had high levels of physical activity and a high-quality diet, their mortality risk was reduced by 17% from all causes, 19% from cardiovascular disease and 27% from selected cancers, as compared with those with the worst diet who were physically inactive.

Lead author Associate Professor Melody Ding at the University of Sydney said: “Both regular physical activity and a healthy diet play an important role in promoting health and longevity.

“Some people may think they could offset the impacts of a poor diet with high levels of exercise or offset the impacts of low physical activity with a high-quality diet, but the data shows that unfortunately this is not the case,” said Associate Professor Melody Ding, the study’s lead author.

A small collection of studies have previously found that high-intensity exercise may counteract detrimental physiological responses to over-eating.

However, the long-term effects on how diet and physical activity interact with each other remained less explored. The study findings confirm the importance of both physical activity and quality diet in all-cause and cause-specific mortality.

“This study reinforces the importance of both physical activity and diet quality for achieving the greatest reduction in mortality risk,” said Assoc Prof Ding.

“Public health messages and clinical advice should focus on promoting both physical activity and dietary guidelines to promote healthy longevity.”

Source: The University of Sydney