High Smog Levels Tied to Serious Heart Problems

High levels of particulate air pollution - commonly known as smog - raise the risk of heart attack and other serious heart problems, according to a new study.

Particulate air pollution refers to tiny particles in the air known as PM10. The European Union's PM10 safety threshold is 50 micrograms per cubic meter (mcg/m3), but this study suggests that the harmful effects of PM10 may occur below that level.

The researchers compared data on average daily concentrations of PM10 in Brescia, Italy, between 2004 and 2007 and daily hospitalizations for cardiac events during that period. They found a significant association between PM10 levels and the number of admissions for heart attack and other acute coronary syndromes (an umbrella term for conditions where blood supply to the heart muscle is suddenly blocked), heart failure, worsening heart failure and heart rhythm disorders. For every 10-microgram increase in PM10 levels, there was a 3 percent increase in hospital admissions for serious heart problems, according to the study.

The researchers also found that men and people older than 65 were especially vulnerable to having acute coronary syndromes or heart rhythm disorders with increasing PM10 levels. In addition, people who had previously been hospitalized for heart problems were more likely to be admitted to the hospital with heart problems when PM10 levels were higher. "We need to pay particular attention to protecting patients who are older and who have had a previous heart attack or other heart problem, as they are more vulnerable to having another cardiac event," study author Dr. Savina Nodari said.

"Previous studies support the hypothesis that air pollution may increase cardiovascular-event rates because PM10 can induce processes that are bad for the heart, including inflammation and coagulation," she added.

Nodari said the current PM10 threshold is too high, and the cutoff should be reduced to 20 to 30 mcg/m3 or less, "because, like cholesterol, the risk is continuous -- the higher the levels the greater the risk. If we can obtain a lower level of PM10 probably we will lower the risk of heart disease."

Secondhand smoke really does cause heart attacks

Even legislation declaring only some public places off-limits to smoking reduced the rate of heart attacks by 11 percent, researchers have found. The greatest benefits were seen among women, all adults between the ages of 65 and 74, and non-smokers.

Coronary heart disease is the number one killer in the world, and was responsible for 9.2 percent of all deaths in Spain in 2011. More than 50,000 people were hospitalized in that year for heart attacks (acute myocardial infarctions) alone. Researchers estimate that 20 percent of all heart disease in European countries is caused by tobacco smoke.

"Smoking and second-hand smoke are major and preventable public health hazards and risk factors for coronary heart disease, the single most common cause of death and morbidity worldwide," the researchers wrote.

Ban provides immediate benefits

In 2006, a law went into effect in Spain banning smoking in the workplace or in any hospitality establishment larger than 100 square meters. It also imposed new regulations on the advertisement and sale of tobacco, but did not regulate smoking in hospitality establishments smaller than 100 square meters. Smoking in such establishments was finally banned in 2011.

To assess whether the partial ban had reduced the rate of heart attacks in the intervening years, the researchers analyzed information on 3,703 heart attacks that occurred in the province of Girona between the years of 2002 and 2008. Heart attacks occurring between 2002 and 2004 (before the implementation of the partial ban) were analyzed separately from those occurring between 2006 and 2008 (after the implementation).

Prior studies on the connection between second-hand smoke and heart attacks have typically used data from hospitals. The limitation of such studies; however, is that only one-third of all heart attacks occur in hospitals. In the current study, researchers used a population-wide database to gather more accurate results.

They found that the total heart attack rate in the province dropped by 11 percent following the law's implementation, even among those not treated at a hospital. Among nonsmokers, the rate of heart attacks was reduced by 15 percent, whereas among those over age 65, it was reduced by 18 percent.

The researchers believe that "the population group that has benefited the most from the law passed in 2006 is that of non-smokers, since their passive exposure to tobacco smoke has decreased."

The researchers were unable to study the effects of the more complete public smoking ban implemented in 2011, but they believe that it is likely to reduce heart attack rates even further.

Coronary heart disease is characterized by an insufficient blood supply to the heart. This may eventually starve the heart of oxygen, causing the cell death known as a heart attack. Coronary heart disease is estimated to cost the Spanish public approximately 1.46 billion Euros per year. 

Vitamin D deficiency linked to childhood obesity

The role of vitamin D is increasingly recognized as important for maintaining health, not only for metabolism of calcium in bone health, but also for other conditions as well. This fact makes the current widespread vitamin D deficiency all the more compelling, and a study published in the May issue of Journal of Adolescent Health has found that serious deficiency and insufficiency of vitamin D exist among obese adolescents.

The retrospective study, done at Hasbro Children's Hospital in Providence, RI, looked at blood levels of 25(OH) D for 68 obese adolescents, and found that all of the girls had low vitamin D, with 72 percent deficient and 28 percent insufficient. Among the boys, 91 percent had low levels, with 69 percent deficient and 22 percent insufficient.

Pediatrician Zeev Harel, lead author of the study, said, "It is possible that the association between obesity and low vitamin D status is indirect, arising from obese individuals having fewer outdoor activities than lean individuals, and therefore, less exposure to sun. Likewise, is it also possible that obese individuals do not consume enough foods that contain vitamin D." Other studies have also found a link between obesity and vitamin D deficiency, possibly from storage of vitamin D in fat tissue

The Hasbro Children's Hospital study also found a disturbing difficulty in treating the problem. About two thirds of the patients had follow-up measurements of vitamin D after treatment, and of that group, only 28 percent reached normal levels. The other patients did not attain a normal level even after multiple treatments.

Harel said of this problem, "The prevalence of low vitamin D status among obese adolescents in this study is greater than previously reported for this age group. It is concerning to us that only 28 percent of the adolescents were able to reach normal vitamin D levels through one course of treatment of the recommended dose of vitamin D, while the other 72 percent failed to normalize their levels even with repeat treatments."

All individuals with low vitamin D are at increased health risks. There is evidence linking healthy levels of vitamin D to protection against certain types of cancer, cardiovascular disease, and autoimmune disorders, as well as other diseases. Vitamin D is also thought to help boost the immune system to protect against infections. Adverse health conditions in adolescents have been found linked to low levels of vitamin D

Tamoxifen Citrate

For on cycle Gynecomastia prevention and post cycle therapy (PCT) needs Tamoxifen (Nolvadex) often fills the role of both for many performance enhancers across the board. For decades Tamoxifen (Nolvadex) has been a staple in many cycles in both men and women and for good reason; it works, it works well and is in most cases very well-tolerated.

By its mode of action Tamoxifen (Nolvadex) functions of the basis of two hormones; estrogen and testosterone; discouraging one while promoting the other. Belonging to a class of medications known as Selective Estrogen Receptor Modulators (SERM’s) Tamoxifen (Nolvadex) is not an anabolic steroid in any shape form or fashion; it does not perform in the traditional anabolic nature; although it can provide a secondary anabolic effect by its method of testosterone stimulation.

For its testosterone stimulating properties this will be and is the main reason any anabolic steroid user will supplement with Tamoxifen (Nolvadex) and this will occur during the PCT period for men. When we supplement with anabolic steroids our natural testosterone production is suppressed and once the cycle is complete it is imperative that we once again stimulate natural testosterone production. This is very important to our overall health, as a well-functioning endocrine system is more than necessary; however, it is also imperative to maintaining the gains made while on a cycle of anabolic steroids. While Tamoxifen (Nolvadex)therapy will not return natural testosterone production to its normal state during PCT use it will send you well on your way. A common misconception is that with a good PCT program our natural testosterone levels are normalized by this simple 3-4 week process; unfortunately this simply isn’t true. Assuming no more anabolic steroids are applied it can take several months for normal levels to be obtained even withTamoxifen (Nolvadex) therapy; however, without therapy such normalization can take up to as much as a year or more depending on the individual at hand.

Beyond PCT needs Tamoxifen (Nolvadex) is often used as a means of Gynecomastia prevention while on a cycle of anabolic steroids. Many anabolic steroids of an androgenic nature, such as testosterone will convert into estrogen after administration. Estrogen is an essential hormone for proper bodily function in-terms of sexual function, immune system and muscle growth, we do need some; however, as these levels increase it can become quite problematic. Many of the most commonly associated side-effects of anabolic steroid use are due to this conversion process brought on by the aromatase enzyme and as levels increase side-effects rear their head. A very common misconception is that Tamoxifen (Nolvadex) decreases estrogen in the body in the same fashion as many aromatase inhibitors; this is not true. While it will not reduce estrogen Tamoxifen (Nolvadex) will block it from binding to the receptors thereby preventing side-effects such as Gynecomastia. Generally 10mg every day of the medication will prove to be useful for this end; however, for many no amount will be enough and only an aromatase inhibitor will prove to be effective.

While Tamoxifen (Nolvadex) was not created with performance enhancing in mind it is just that for which it is used most commonly and without question it has proven to be one of the most useful tools in the arsenal of any performance enhancer. Available in both tablet and liquid forms you simply drink there really aren’t too many downsides to this medication; in-fact, most well-planned cycles, be it for on cycle or PCT use will include Tamoxifen (Nolvadex) in them at some point and time as it is a highly necessary medication for most any athlete.