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Women may be at greater risk for developing diabetes, heart disease and stroke in the years before menopause, rather than afterward, a U.S. study suggests. This may mean that the higher cardiovascular risk seen among post-menopausal women could be related to changes in that time before menopause and less so to the changes after menopause has occurred," said lead study author Dr. Mark DeBoer, a researcher at University of Virginia School of Medicine in Charlottesville. While the reasons for this are unclear, the findings suggest that women may need to pay especially close attention to cardiovascular risk factors in the years leading up to menopause and consider lifestyle changes like improved diet and exercise habits that can make problems like diabetes and heart disease less likely, DeBoer added by email.
Menopause typically happens between ages 45 and 55. As the ovaries curb production of estrogen and progesterone, menstruation stops, and women can experience symptoms such as hot flashes, night sweats and vaginal dryness. Certain treatments for menopause symptoms that contain man-made versions of the hormones estrogen and progestin have also been linked to an increase risk of heart attack and stroke.Previous research has also linked menopause to an increased risk of what's known as metabolic syndrome, a constellation of conditions that increase the risk of heart disease, diabetes and stroke. Obesity, inactivity and a history of smoking appear to make these problems more likely.
For the current study, researchers examined data on 1,470 white and African-American women participating in a national study of the causes and health effects of hardening of the arteries.All of the women went through menopause during the ten-year study period.Researchers focused on five things that contribute to metabolic syndrome: expanding waist circumference, elevated fats in the flood, declines in so-called "good" HDL cholesterol, spikes in blood pressure and increased levels of sugar in the blood. After taking into account whether women used hormone-replacement therapy, researchers still found bigger changes in triglycerides (fats in the blood), cholesterol and glucose (blood sugar) before menopause than afterwards.For white women, waist size spiked more after menopause, however.African-American women experienced larger increases in blood pressure after menopause than before, the researchers report in the Journal of the American Heart Association.
One limitation of the study is that researchers defined the timing of menopause based on whether women said they had a menstrual period in the previous two years, the authors note. Menopause is commonly diagnosed after women cease menstruation for one year, which means the study may have categorized some women as going through this transition who had already completed it. Researchers also lacked data on hormone levels for individual women, even though these can fluctuate and influence the risk for metabolic problems, said Dr. Robert Eckel, of the University of Colorado Anschutz Medical Campus in Aurora.
Not all types of hormone-replacement therapy carry the same risks, and the study also didn't account for the way hormones were administered, Eckel, who wasn't involved in the study, said by email. "Cardiovascular disease screening remains important for all adults including men and women," Eckel said. "Perhaps the frequency of evaluation should be more emphasized in this important peri-menopausal interval (between ages 45-55) in women - more science needed here."

There comes a phase when women think towards having a child. Unfortunately, not all are lucky enough to sail by the process smoothly. Different women may face different changes in terms of fertility or growth and development of the foetus. There has been a growing rise in cases of women facing fertility problems, inhibiting them from getting pregnant. Thus there are fertility therapies, popularly known as IVF, that cater to the needs of such women. However, a recent study conducted by Women's College Hospital in Ontario, Canada, states that women who undergo fertility therapy, but do not get pregnant, may be at a higher risk of developing long-term cardiovascular disease, compared to women who become pregnant.
According to researchers, the drugs used for the fertility treatments could be dangerously affecting the blood pressure levels as well as increase the risk of blood clots.

"We found that two-thirds of women never became pregnant after being managed for fertility treatment and these women also had worse long-term cardiovascular risk, specifically higher risks of stroke and heart failure, compared to the remaining third of women who did become pregnant and delivered a baby," said lead author Jacob Udell.

The findings showed that fertility therapy failure was associated with a 19 per cent increased risk of adverse cardiovascular events, in particular, heart failure. Only about ten in 1,000 suffered heart problems after failed fertility therapy, compared to six in 1,000 for those who had successful treatment, the researchers stressed.

"These findings are consistent with the hypothesis that fertility therapy may represent an early indication for future cardiovascular disease because it represents a unique cardiometabolic stress test," Udell said.

For the study, published in the Canadian Medical Association Journal, the team looked at data on 28,442 women under age 50 who underwent fertility therapy in Ontario. However, the results should be interpreted with caution, the researchers suggested.

"We don't want to alarm women who undergo fertility therapy. We are instead suggesting that as women age, they should stay mindful of their health and remind their physician about any fertility therapy years earlier," explained Donald Redelmeier, scientist at the Institute for Clinical Evaluative Sciences - a Canada-based health care research organisation.

Hot flashes are one of the most common side effects of menopause. These are periods of intense heat, warm skin and excessive sweating can be really uncomfortable. For most women, these episodes of hot flashes are frequent and sever. According to a new study, published in the journal Menopause, hot flashes in pre-menopausal women may be a sign of heart disease.

As per scientists, the occurrence of hot flashes could be a warning sign of an emerging vascular dysfunction that can lead to heart disease. They have been linked to cardiovascular changes that occur early during the menopause transition. For the study, the team analysed 272 non-smoking women aged between 40 and 60 years. They tested the relationship between physiologically assessed hot flashes and the endothelial cell (the inner lining of the blood vessels) function.

Interestingly, the results show that hot flashes often start earlier than previously thought and persist for longer. The effect of hot flashes on the ability of blood vessels to dilate was documented only in the younger women in the sample. In older women, no such association was observed indicating indicating that early occurring hot flashes may be those most relevant to heart disease risk.

Certain things like stress, alcohol, spicy food and smoking may trigger hot flashes and make it even worse. You can't really avoid hot flashes if they occur but you can certainly deal with the situation by staying cool, deep breathing can help and so can having light meals. According to Macrobiotic Nutritionist Shilpa Arora, foods rich in phytoestrogen like soy, broccoli, cabbage and herbs like shatavri and maca can help in easing the symptoms of menopause.

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What Is Congenital Heart Disease?
Congenital heart disease, or a congenital heart defect, is a heart abnormality present at birth. The problem can affect:

the heart walls

the heart valves

the blood vessels

There are numerous types of congenital heart defects. They can range from simple conditions that don’t cause symptoms to complex problems that cause severe, life-threatening symptoms.

According to the Centers for Disease Control and Prevention, there are currently 1 million adults and 1 million children in the United States living with congenital heart defects. Treatments and follow-up care for defects have improved drastically over the past few decades, so nearly all children with heart defects survive into adulthood. Some need continuous care for their heart defect throughout their lives. However, many go on to have active and productive lives despite their condition.

Types of Congenital Heart Disease

Though there are many different types of congenital heart defects, they can be divided into three main categories:

In heart valve defects, the valves inside the heart that direct blood flow may close up or leak. This interferes with the heart’s ability to pump blood correctly.

In heart wall defects, the natural walls that exist between the left and right sides and the upper and lower chambers of the heart may not develop correctly, causing blood to back up into the heart or to build up in places where it doesn’t belong. The defect puts pressure on the heart to work harder, which may result in high blood pressure.

In blood vessel defects, the arteries and veins that carry blood to the heart and back out to the body may not function correctly. This can reduce or block blood flow, leading to various health complications.

Cyanotic and Acyanotic Congenital Heart Disease
Many doctors classify congenital heart disease as either cyanotic congenital heart disease or acyanotic congenital heart disease. In both types, the heart isn’t pumping blood as efficiently as it should. The main difference is that cyanotic congenital heart disease causes low levels of oxygen in the blood, and acyanotic congenital heart disease doesn’t. Babies with reduced oxygen levels may experience breathlessness and a bluish tint to their skin. Babies who have enough oxygen in their blood don’t display these symptoms, but they may still develop complications later in life, such as high blood pressure.

What Are the Symptoms of Congenital Heart Disease?
A congenital heart defect is often detected during a pregnancy ultrasound. If your doctor hears an abnormal heartbeat, for instance, they may further investigate the issue by performing certain tests. These may include an echocardiogram, a chest X-ray, or an MRI scan. If a diagnosis is made, your doctor will make sure the appropriate specialists are available during delivery.

In some cases, the symptoms of a congenital heart defect may not appear until shortly after birth. Newborns with heart defects may experience:

bluish lips, skin, fingers, and toes
breathlessness or trouble breathing
feeding difficulties
low birth weight
chest pain
delayed growth

In other cases, the symptoms of a congenital heart defect may not appear until many years after birth. Once symptoms do develop, they may include:

abnormal heart rhythms
dizziness
trouble breathing
fainting
swelling
fatigue

What Causes Congenital Heart Disease?

Congenital heart disease occurs as a result of an early developmental problem in the heart’s structure. The defect typically interferes with the normal flow of blood through the heart, which may affect breathing. Although researchers aren’t exactly sure why the heart fails to develop correctly, suspected causes include the following:

The heart defect may run in families.
Taking certain prescription drugs during pregnancy puts a child at a higher risk for a heart defect.
Using alcohol or illegal drugs during pregnancy can increase a child’s risk of having a heart defect.
Mothers who had a viral infection during the first trimester of pregnancy are more likely to give birth to a child with a heart defect.
Increased blood sugar levels, such as occurs with diabetes, may affect childhood development.

How Is Congenital Heart Disease Treated?
The treatment for a congenital heart defect depends on the type and severity of the defect. Some babies have mild heart defects that heal on their own with time. Others may have severe defects that require extensive treatment. In these cases, treatment may include the following:

Medications

There are various medications that can help the heart work more efficiently. Some can also be used to prevent blood clots from forming or to control an irregular heartbeat.

Implantable Heart Devices

Some of the complications associated with congenital heart defects can be prevented with the use of certain devices, including pacemakers and implantable cardioverter defibrillators (ICDs). A pacemaker can help regulate an abnormal heart rate, and an ICD may correct life-threatening irregular heartbeats.

Catheter Procedures

Catheterization techniques allow doctors to repair certain congenital heart defects without surgically opening the chest and heart. During these procedures, the doctor will insert a thin tube into a vein in the leg and guide it up to the heart. Once the catheter is in the correct position, the doctor will use small tools threaded through the catheter to correct the defect.

Open-Heart Surgery

This type of surgery may be needed if catheter procedures aren't enough to repair a congenital heart defect. A surgeon may perform open-heart surgery to close holes in the heart, repair heart valves, or widen blood vessels.

Heart Transplant

In the rare cases in which a congenital heart defect is too complex to fix, a heart transplant may be needed. During this procedure, the child's heart is replaced with a healthy heart from a donor.

Consuming fatty fish four times a week may help increase the amount of good cholesterol and prevent the risk of heart disease, finds a study.

The findings showed that fatty fish increases the size and lipid composition of high-density lipoprotein (HDL) particles, also known as good cholesterol, in people with impaired glucose metabolism.

Morever, using daily 30 ml of camelina oil -- rich in alpha-linolenic acid, which is an essential omega-3 fatty acid -- was also found to decrease the number of harmful Intermediate-density lipoprotein (IDL) particles.


The IDL lipoprotein is the precursor of (low-density lipoprotein) LDL, which is also known as the bad cholesterol. Previous studies have shown that long-chain omega-3 fatty acids found in fish have a beneficial effect on lipoprotein size and composition.

Both of these changes can reduce the risk of cardiovascular diseases, said researchers from the University of Eastern Finland.

For the study, published in the journal Molecular Nutrition & Food Research, the team involved nearly 100 Finnish men and women aged between 40 and 72, with impaired glucose metabolism.

Study participants were randomly divided into four groups for a 12-week intervention: the camelina oil group, the fatty fish group, the lean fish group, and the control group.

While people in the camelina oil group, fatty fish group, showed potentially higher HDL and lower IDL cholesterol level, eating lean fish, was not associated with changes in the number, size or composition of lipoprotein particles, the researchers said.

Dr. Suhas Sodal
Dr. Suhas Sodal
MBBS, Pediatrician, 8 yrs, Pune
Dr. Sandeep Mengade
Dr. Sandeep Mengade
BAMS, Family Physician General Physician, 17 yrs, Pune
Dr. Mangesh Khandave
Dr. Mangesh Khandave
DNB, Pediatrician, 17 yrs, Pune
Dr. Krishnath Dagade
Dr. Krishnath Dagade
BAMS, General Physician Family Physician, 28 yrs, Pune
Dr. Hemant Damle
Dr. Hemant Damle
MD - Allopathy, Gynaecologist Obstetrics and Gynecologist, 25 yrs, Pune
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