Friday, December 26, 2008


Heart disease, as the proverb goes, is always better prevented than treated. The end of yr2008 medical journals, is full of studies that shed new light into how we can better look after ourselves. I spend my Christmas hols studying these little studies.
The first that I would like to highlight is that if young people sleep an extra hour every night, you can reduce the incidence of heart by 33%. This findings was published in the Christmas eve edition of the Journal of the American Medical Association. It is part of the CARDIA study. The CARDIA ( Coronary Risk Development in Young Adults ) study is a study of 495 young adults with no heart disease, followed over 5 years with serial EBCT scan to detect coronary calcium. They reported that the scans of young adults who sleeeep on an average 1 hour more, showed less coronary calcification. And if you believe that less coronary calcium means less CAD, then sleeping more results in less CAD. I suppose a possible mechanism is that people who sleep well and longer has better basal blood pressure, thereby resulting in less CAD. In fact the authors claim that a 1 hour more sleep is equivalent to a systolic BP reduction of 16.5mmHg.
The second study that interest me was a small Italian study, published in, which showed that taking care of your gums ( yes dental gums ) can also prevent heart disease. The study was a small cohort. Scaling, removing tartar from gums, and just generally keeping the gums clean and healthy, resulted in less carotid artery intimal thickening. And if you believe like many do, that less carotid artery thickening correlate with less CAD, than keeping good gum hygiene results in less CAD. There is some truth mechanistically, because our gums contain a certain bacteria called Porphyromonas gingavalis, which can stimulate chronic inflammation, resulting in a rise in hs-CRP. The continuing inflammation, with resulting increase in lymphocytic reaction, is presumable the reason why. Well we certainly look forward to a larger study to support this hypothesis. This study only involve 35 subjects. Abit too small to form a firm conclusion.
The lessons that I would like to highlight is that simple lifestyle awareness can help your heart. Do not neglect sleep and also oral hygiene.
The second point that I would like to highlight is that clinical trials and studies sometimes do not look into this and so some of the conclusion may not be as accurate as it is often made out to be. Seldom do we see clinical trials adjusting for dental hygiene and sleep patterns, although they do adjust for BP.
But the important thing is that we keep learning. Sleep 1 hour more and take care of your gums.

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