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A recent NY Times article cited a number of recent long-term studies that linked greater optimism to a lower risk of developing cardiovascular disease and other chronic ailments, and to fostering "exceptional longevity." (https://www.nytimes.com/2020/01/27/well/mind/optimism-health-longevity.html)


Optimism, the psychological attribute characterized as the general expectation that good things will happen, or the belief that the future will be favorable because one can control important outcomes, may be as important as a good diet and ample exercise when it comes to factoring into your heart's health.


Historically, many studies have indicated that more optimistic individuals are less likely to suffer from chronic diseases or die prematurely. An increasing number of recent long-term studies have linked greater optimism to a lower risk of developing cardiovascular disease and other chronic ailments, and to fostering what they identify as "exceptional longevity," a term that refers to people who live to 85 and beyond. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2752100)


One research article published by Dr. Julia K. Boehm, a psychologist at Chapman University in Orange, California, in the American Heart Association Journal, found that positively-thinking people have a reduced risk of cardiovascular disease and cardiovascular-related deaths when compare to their more pessimistic counterparts. One possible explanation for this is that optimistic people may be more likely to engage in healthy behaviors like exercising, eating fruits and vegetables, and avoiding smoking. (https://www.ahajournals.org/doi/full/10.1161/circresaha.117.310828)


A second research article published in the Proceedings of the National Academy of Sciences suggested that "optimism is specifically related to 11 to 15% longer life span, on average," and to greater odds of achieving “exceptional longevity”. These connections were independent of socioeconomic status, health conditions, depression, social integration, and health behaviors such as smoking, poor diet, and alcohol use. Overall, their findings led them to believe that optimism may be an important psycho-social resource for extending life span in older adults.


The MayoClinic.org has some great guidelines and advice that help one identify both positive and negative thinking. They include:


Identifying negative thinking Not sure if your self-talk is positive or negative? Some common forms of negative self-talk include:
  1. Filtering. You magnify the negative aspects of a situation and filter out all of the positive ones. For example, you had a great day at work. You completed your tasks ahead of time and were complimented for doing a speedy and thorough job. That evening, you focus only on your plan to do even more tasks and forget about the compliments you received.

  2. Personalizing. When something bad occurs, you automatically blame yourself. For example, you hear that an evening out with friends is canceled, and you assume that the change in plans is because no one wanted to be around you.

  3. Catastrophizing. You automatically anticipate the worst. The drive-through coffee shop gets your order wrong and you automatically think that the rest of your day will be a disaster.

  4. Polarizing. You see things only as either good or bad. There is no middle ground. You feel that you have to be perfect or you're a total failure.

Focusing on positive thinking You can learn to turn negative thinking into positive thinking. The process is simple, but it does take time and practice — you're creating a new habit, after all. Here are some ways to think and behave in a more positive and optimistic way:
  1. Identify areas to change. If you want to become more optimistic and engage in more positive thinking, first identify areas of your life that you usually think negatively about, whether it's work, your daily commute or a relationship. You can start small by focusing on one area to approach in a more positive way.

  2. Check yourself. Periodically during the day, stop and evaluate what you're thinking. If you find that your thoughts are mainly negative, try to find a way to put a positive spin on them.

  3. Be open to humor. Give yourself permission to smile or laugh, especially during difficult times. Seek humor in everyday happenings. When you can laugh at life, you feel less stressed.

  4. Follow a healthy lifestyle. Aim to exercise for about 30 minutes on most days of the week. You can also break it up into 10-minute chunks of time during the day. Exercise can positively affect mood and reduce stress. Follow a healthy diet to fuel your mind and body. And learn techniques to manage stress.

  5. Surround yourself with positive people. Make sure those in your life are positive, supportive people you can depend on to give helpful advice and feedback. Negative people may increase your stress level and make you doubt your ability to manage stress in healthy ways.

  6. Practice positive self-talk. Start by following one simple rule: Don't say anything to yourself that you wouldn't say to anyone else. Be gentle and encouraging with yourself. If a negative thought enters your mind, evaluate it rationally and respond with affirmations of what is good about you. Think about things you're thankful for in your life.

Here are some examples of negative self-talk and how you can apply a positive thinking twist to them:

Putting Positive Thinking Into Practice:

Negative self-talk

I've never done it before.

It's too complicated.

I don't have the resources.

I'm too lazy to get this done.

There's no way it will work.

It's too radical a change.

No one bothers to communicate with me.

I'm not going to get any better at this.


vs.


Positive thinking

It's an opportunity to learn something new.

I'll tackle it from a different angle.

Necessity is the mother of invention.

I wasn't able to fit it into my schedule, but I can re-examine some priorities.

I can try to make it work.

Let's take a chance.

I'll see if I can open the channels of communication.

I'll give it another try.


(https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950)


It's turning out that cannabis may not be the panacea many once had professed it to be. While recreational consumption still appears to have a fairly low level of health risk for the average person, a new study suggests that there's a potential cardiovascular impact for those managing heart disease. We know that tobacco smoking leads to almost one in every four cardiovascular disease-related deaths. Studies on cannabis-related cardiovascular events have been primarily observational and self-reported, often pulling from small population samples without differentiation of consumption method. Some of those "studies" have suggested that marijuana can be the inducer for triggering heart attacks and strokes. Now there's something more concrete after a new report was published in the Journal of the American College of Cardiology, “Marijuana Use in Patients With Cardiovascular Disease.”


One of the authors of that report, Ersilia DeFilippis, MD, a cardiology fellow at Columbia University Irving Medical Center and New York-Presbyterian, said the study started looking into marijuana's effect on the heart a few years ago while studying heart attacks in people under 50.


“Some observational studies have suggested an association between marijuana and a range of cardiovascular risks,” said another author, Muthiah Vaduganathan, MD, MPH, of Brigham and Women’s Hospital’s Heart and Vascular Center in Boston. “We also know that marijuana is becoming increasingly potent. Our review suggests that smoking marijuana carries many of the same cardiovascular health hazards as smoking tobacco. While the level of evidence is modest, there’s enough data for us to advise caution in using marijuana for our highest-risk patients, including those who present with a heart attack or new arrhythmia, or who have been hospitalized with heart failure.”


Dr. DeFilippis stated, "We noted that 10% of patients in a registry of young heart attack patients had used marijuana and/or cocaine." She and her colleagues recently went through the medical literature to find out about the substance and limitations to previous studies. What they found, based on the responses to a National Health and Nutrition Examination Survey from 2016, was that over 2 million people with heart disease have used or continue to use marijuana.


Marijuana is an incredibly highly abused drug in the US. Approximately 90 million American adults have admitted to using it at least once in their lives, and over 39 million admit to having used marijuana in the past year.


"In addition to the 2 million marijuana users with diagnosed cardiovascular disease, many more may be at risk," Dr. DeFilippis says, "With many adolescents and young adults turning to marijuana, it is important to understand the cardiovascular implications they may face years down the line."


There is a common belief among researchers that cannabinoids may have the ability to increase the activity of some prescription drugs that are already in one's body. The review found that certain cardiovascular medications, including statins and blood thinners, could possibly be affected by marijuana use. However, there is limited data available to help direct physicians when adjusting dosages to compensate for marijuana use.


THC is the psychoactive chemical that one can ingest from smoking marijuana, but marijuana contains more than 100 other compounds, called cannabinoids, that are chemically related to THC and THCA. The percentage of THC that one can get from marijuana plants has steadily increased over the past 30 years mostly due to the evolution of the marijuana growing business and the technology around creating more potent marijuana.


"Higher potency may translate into greater effects on the conduction system, the vasculature, and the muscle of the heart," Dr. DeFilippis mentions. "It also highlights the need for real-world data given the variety of marijuana products and formulations available for purchase."


“Vaping marijuana is becoming more and more common, and we know vaping marijuana increases the pharmacological effects of the drug,” Dr. Vaduganathan said.

There are now many new ways now to ingest THC as well, which have also evolved with the advent of the legal marijuana business. Marijuana is now legal in 11 US states. Aside from smoking marijuana, users can now consume edible THC in candy and cookies. There is also more concentrated form of THC called "wax," which is a wax-like substance that is distilled from the marijuana plant and can be smoked but is most often vaped. The myriad of delivery methods have also evolved in their ability to elevate cannabinoid potency to even higher levels than simply smoking the plant.


Receptors for cannabinoids are highly concentrated in the nervous system but research shows that they also can be found in blood cells, muscle cells, and other tissues and organs. There has been a small experimental study that had found that THC ingestion could bring on angina, or chest pain, more quickly in people with coronary heart disease compared with smoking a placebo.


And while the current evidence for a link between marijuana and heart attacks is still emerging, many in the medical community feel that smoking marijuana may increase cellular stress and inflammation. All of which are known to be precipitating factors for coronary artery disease and heart attacks. There is also a belief that there is an association between marijuana use and cerebrovascular events, including strokes. The theory is that marijuana may induce changes in the inner lining of blood vessels or alter blood flow.


For patients who wish to continue to use marijuana, or who have other medically indicated reasons for use, the reviewers recommend limiting use as much as possible and for clinicians to inform patients that vaping or ingesting certain synthetic forms of cannabinoids, which are particularly potent, may have increased adverse effects.


The reviewers recommend that for some patients, cardiologists should test for marijuana use by urine toxicology screening. These include patients being considered for heart transplantation or those who present with early-onset heart attacks or heart failure at a young age.


"Although we need more data, the evidence we do have indicates that marijuana use has been associated with coronary artery disease, arrhythmia, cardiomyopathy, and more," Dr. DeFilippis says. "Therefore, asking patients about marijuana use may help in risk assessment. In addition, we know that marijuana use affects the metabolism of many common cardiac drugs. In order to make sure patients are getting therapeutic doses without untoward side effects, it is important for cardiologists to talk to their patients about marijuana use," she concludes.


Dr. Vaduganathan added, “Now that we have seen marijuana use become more popular than tobacco smoking, we need more rigorous research, including randomized clinical trials, to explore the effects of marijuana on cardiovascular health."


Reference: “Marijuana Use in Patients With Cardiovascular Disease” by Ersilia M. DeFilippis, Navkaranbir S. Bajaj, Amitoj Singh, Rhynn Malloy, Michael M. Givertz, Ron Blankstein, Deepak L. Bhatt and Muthiah Vaduganathan, 20 January 2020, Journal of the American College of Cardiology.


DOI: 10.1016/j.jacc.2019.11.025


In 2017, Stanford University researchers began a study sponsored by Apple that looked at the effectiveness of cardiac apps installed in the Apple Watch. Last month, those researchers published their paper in the New England Journal of Medicine. Previously, though, they had released the study's preliminary results which concluded that, indeed, the Apple Watch was able to accurately detect atrial fibrillation, a condition that can lead to stroke, blood clots and heart failure.


The study enlisted 400,000 volunteers and monitored heart rhythms. Participants who registered an irregular heartbeat were sent ECG patches so the researchers could get a week's worth of data to confirm the condition. Those patches confirmed that 84% of the detected cases were accurate. As the study conclusion stated, "84% is not absolute, but it's certainly high enough to be trustworthy." One can read more about the study here.


In that article, Marco Perez, the study's lead author, said in a statement, "The performance and accuracy we observed in this study provides important information as we seek to understand the potential impact of wearable technology on the health system. What the Apple Heart Study shows us is that atrial fibrillation is just the beginning. We can look ahead to other areas of preventive medicine. Further research will help people make more informed health decisions."


Not all of the heart healthy apps available pertain to ECG, many are fitness apps, which are numerous. Others involve diet and wellness. These apps and their devices could make great gifts this year to the right people. Without unpacking all the fitness apps, here's a rundown of some of the better reviewed other heart healthy apps out this year.



1. KardiaMobile

iOS: Here

Android: Here

Price: App is free, device is $84


KardiMobile is an app that actually comes with an external EKG measurement device ($84). It bills itself as "the most clinically‑validated personal EKG in the world." While many heart healthy apps don't come with external devices, and certainly an Apple Watch can be used as that device for some, for those looking for more accuracy, the KardiaMobile system may be a great solution. The system stores EKG's on one's phone and can email those results to one's healthcare provider. The app is good for both iOS and Android. Out of almost 1,300 reviews, consumers have given the system a 4.4 out of 5 stars, and it looks like the most recent reviews are consistently 5 stars, which means the maker AliveCor has been attentive to fine-tuning their product.



2. Qardio Blood Pressure Monitoring Made Easy

iOS: Here

Android: Here

Price: App is free, QardioArm is $79


QardioArm is a very compact cuff that pairs with an iOS or Android app. One simply puts the device on one's arm, fastens the Velcro strap, and hits the Start button in the app. QardioArm's app does the rest. The reading takes less than 30 seconds, and one's results appear instantly. The app has a few other features, such as reminders one can adjust to be daily or just a few times a week, history, and the ability to integrate with some health data apps. One issue some users may have is that Qardio's app and device isn't compatible with Microsoft HealthVault and some other platforms one might use to log one's other health and medical statistics.



3. Instant Heart Rate+ HR Monitor

iOS: Here

Android: Here

Price: $4.99 for iPhone; free for Android, both with in-app purchases

Subscriptions are $9.99 USD per month or $59.99 USD per year.


Instant Heart Rate transforms one's phone’s camera lens into a heart rate monitor. It can display a reading in less than 10 seconds. Its trusted accuracy makes it a favorite with researchers and cardiologists. One can take one's heart rate in any situation and create a pulse waveform graph, or one can take the app’s StandUp test to measure fatigue and fitness. The app records one's beats-per-minute and let's one annotate the readings so one can track what one is were doing at the time of the test.



4. CardioVisual

iOS: Here

Android: Here

Price: Free download with in-app purchases

Monthly: $0.99 per month, Annual: $9.99 per year


CardioVisual is not a monitoring app as much as it is an educational one. The app has 2 versions, one for for everyday users and another for medical professionals, but both feature bountiful libraries of health information for almost every heart condition. It was created by cardiologists as a one-stop destination for learning or sharing everything one needs to know about heart health, from structure to function, condition overviews to treatments, and surgical procedures to heart-healthy lifestyle choices. The Favorite function allows one to bookmark and curate the graphics and videos one may want to revisit.



5. DASH Diet: Doctor Recommended

iOS: Here

Price: Free with in-app purchases

Paleo Meal Plan Subscription $0.99, Paleo Meal Plan Subscription $1.99, Paleo Meal Plan Subscription $9.99, Dash Diet Annual Plan $49.99


DASH Diet Plan

Android: Here

Price: Free


Diet apps are nothing new, but the ability to combine a record of one's eating with tips to stay on course with one's DASH diet is something that can be of use to almost anyone who's struggling with keeping one's blood pressure in check. DASH Diet: Doctor Recommended for iOS features the ability to subscribe to much more extensive guidance and meal options while the android version is more limited, however both are free to try.



6. Calm

iOS: Here

Android: Here

Price: Free with in-app purchases - Subscriptions range from $14.99 for a month to $299.99 for a lifetime subscription.


One of the things that's become synonymous with heart health are lifestyle choices that promote stress management and Calm will help one “sleep more, stress less, and live better.” This is accomplished through guided meditation, relaxing music and sounds for sleep, videos on mindful movement and stretching, mindfulness classes, and images of nature. The app includes hundreds of programs for beginner, intermediate and advanced users. Guided meditation sessions are available in lengths of 3, 5, 10, 15, 20 or 25 minutes. There are over 100 sleep stories that help lull one into a deep and restful slumber.




BONUS PulsePoint Respond

iOS: Here

Android: Here

Price: Free


This app not only makes a great gift, but it can also give the gift of life in the right situation. One may not always be in the right place to get fast help when cardiac problems arise. PulsePoint Respond connects one with CPR-trained people in one's community who are ready to act in a cardiac emergency. It uses one's GPS to notify people in one's area who can respond quickly and put their life-saving skills to use before EMS may arrive. It can help responders find people in distress and also gives directions to the nearest external defibrillator. It's an interesting concept, but so far one that has proven a life saver for some of it's consumers.

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