Stress and the heart: Lessons from the pandemic – Harvard Health Blog

The effects of COVID-19 have been extensive, with more than seven million confirmed cases and more than 200,000 deaths in the US alone. COVID-19 has caused additional impacts on healthcare; for example, patients have delayed seeking care for serious symptoms over fears of exposure to COVID-19. But the consequences of COVID-19 have reached beyond healthcare alone, with daily impacts on our financial, social, and emotional well-being.

As we attempt to cope and settle into this new normal, we will learn about the long-term effects of these hardships. Doctors have already begun to study the effects of COVID-related stress and anxiety on people around the world.

Physical effects of stress

Stress can have real physical effects on the body, and it has been linked to a wide range of health issues. Stress directly activates our sympathetic nervous system, initiating a fight-or-flight response that can elevate blood pressure and blood sugar. Though potentially useful in the short term from an evolutionary standpoint, stress can worsen hypertension and diabetes when it occurs chronically. Stress can disrupt our sleep, and can lead us to make unhealthy food choices, as we seek comfort foods or abandon portion control.

A recent study suggests that stress due to the pandemic may already be affecting our heart health.

The link between stress and heart health

Stress cardiomyopathy, also called Takotsubo cardiomyopathy and broken-heart syndrome, is a cardiac disorder characterized by a sudden onset of chest pain and heart dysfunction that mimics a heart attack. But, in contrast with what is seen during a heart attack, doctors are unable to find evidence of a blood clot or abnormalities with cardiac blood flow.

Typical stress cardiomyopathy patients are postmenopausal women experiencing sudden onset of chest pain and shortness of breath. The link between stress and stress cardiomyopathy is well documented;

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When the corporate announced its electrocardiogram for the Apple Watch in the fall of 2018, some doctors and others within the medical industry outdoors of Apple reacted negatively to the information This pissed off some folks internally who had argued for a small and focused product launch, which involved the medical neighborhood getting to weigh in and ask questions to scale back any potential pushback. The company compromised by secretly convening teams of medical experts, including cardiologists, at its headquarters each six months or so, and by introducing content material developed with the assist of doctors at Apple specifically for doctors.

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Stopping osteoarthritis: Could recent heart research provide a clue? – Harvard Health Blog

Here’s a recent headline that I found confusing: Could the first drug that slows arthritis be here?

It’s confusing because it depends on which of the more than 100 types of arthritis we’re discussing. We’ve had drugs that slow rheumatoid arthritis for decades. In fact, more than a dozen FDA-approved drugs can reduce, or even halt, joint damage in people with rheumatoid arthritis. We also have effective medications to slow or stop gout, another common type of arthritis.

But the headline refers to osteoarthritis, the most common type of arthritis. And currently, no medications can safely and reliably slow the pace of this worsening joint disease. That’s one reason so many knee and hip replacements are performed: more than 1.2 million each year in the US alone.

A drug that can slow down joint degeneration in osteoarthritis has long been the holy grail of arthritis treatments, because it could

  • relieve pain and lessen suffering for millions of people
  • help prevent the loss of function that accompanies osteoarthritis
  • reduce the need for surgery, along with its attendant risks, expense, and time needed for recovery.

And, needless to say, such a drug would generate enormous profits for the pharmaceutical company that comes up with it first.

A study of heart disease might have identified a new treatment for osteoarthritis

According to new research published in Annals of Internal Medicine, it’s possible that such a treatment exists, and is already in use to treat other conditions. The researchers reanalyzed data on more than 10,000 people that originally looked at whether the drug canakinumab was beneficial for people with a previous heart attack — yes, heart attack, not arthritis.

Canakinumab inhibits interleukin-1, a substance closely involved with inflammation. And increasing evidence suggests that inflammation raises risk for cardiovascular disease, and may

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Early, tight control of Crohn’s disease may have lasting benefits – Harvard Health Blog

The gastrointestinal (GI) tract is a remarkable organ: it resides on the inside of our bodies, but is regularly in contact with the outside world by virtue of what we ingest. It is quite incredible that the immune cells of the GI tract are not activated more regularly by the many foreign products it encounters every day. Only when the GI tract encounters an intruder that risks causing disease do the immune cells of the GI tract spring into action.

That is, of course, under normal circumstances. In people with Crohn’s disease, the normally tolerant immune cells of the GI tract are activated without provocation, and this activation leads to chronic or relapsing — but ultimately uncontrolled — inflammation.

Crohn’s disease: A primer

First described by Dr. Burrill B. Crohn and colleagues in 1932, Crohn’s disease is a complex inflammatory disorder that results from the misguided activity of the immune system. It can involve any part of the GI tract from the mouth to the anus, but most commonly involves the end of the small intestine.

Depending on the precise location of GI inflammation, Crohn’s disease may cause any number of symptoms including abdominal pain, diarrhea, weight loss, fever, and sometimes blood in the stool.

Treatment options for Crohn’s disease have evolved dramatically since Dr. Crohn and colleagues first described the condition, but the basic principle has remained the same: reduce the uncontrolled inflammation. Early approaches to treatment involved nonspecific anti-inflammatory medications such as corticosteroids, which have many potentially serious side effects outside the intestines.

Today, a number of newer therapies exist that act more specifically on the immune system to target inflammatory pathways known to be active in Crohn’s disease. These newer drugs, termed biologics, are antibodies that block proteins involved in specific inflammatory pathways relevant to Crohn’s disease.

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