News and Insights in the scope of Cardiovascular

News and Insights of Prof. Valerio Sanguigni

Cardiovascular News Office Prof. Valerio Sanguigni Cardiologist salario nomentano

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Today it was published online click here on the international scientific journal Nutrition: click here
My study of the effects of a natural antioxidant ice cream. For the first time it has been demonstrated that a completely natural food mixture with powerful antioxidant effect can improve cardiovascular function and physical performance. In my opinion this is the way to achieve the "first natural food medicine" that can prevent cardiovascular diseases and slow the aging process:

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MISUSE OF ENERGY DRINKS


In young people it is a constantly growing phenomenon. Risk of sudden arrhythmic death: an underestimated problem?
Energy drinks are soft drinks, commonly found on the community market and are characterized by high levels of caffeine and taurine. With nearly 200 brands available in more than 140 countries, they represent a booming market. In the US, 31% of teenagers between 12 and 17 years have declared a regular consumption of these drinks. The regulation and the amount of caffeine allowed varies from country to country (from 50 to 505 mg/can). The amount of caffeine present in a cup of coffee are highly variable depending on the type and unfortunately this makes it difficult to compare the amount with that present in a can. A cup of espresso, depending on the mixture that is used, contains between 53.8 and 141.3mg of caffeine; a can of energy drink, then, would correspond more or less to a cup of coffee. Caffeine (mainly extracted from coffee, Coffee arabica, Rubiaceae family) is in a group of purine alkaloids such as theophylline (from tea, Camellia sinensis, Theaceae family) and theobromine (cocoa, Theobroma, Sterculiaceae family). Caffeine is not only in coffee but is also found in other plants and foods. This is the case, for example, Coca Cola, mate tea, chocolate, energy drinks, herbal products such as guarana, and in some pharmaceutical products such as certain painkillers, anti-cellulite cosmetics or nasal vasoconstrictor drugs. Caffeine is the most widely used psychoactive drug in the world, and its chemical conformation makes it, in fact, suitable to interact with specific receptors that regulate the biological function of the cardiovascular system, endocrine and nervous systems. The intestinal tract absorbs caffeine very quickly and peak plasma concentrations are observed after approximately one hour from ingestion. Its metabolism is, however, faster and much higher than other stimulants like amphetamines. Just 3-6 hours after administration, plasma caffeine levels are reduced by 50%. Being lipophilic, caffeine has the ability to rapidly pass through the blood-brain barrier. It manages to cross the placenta and may be present in breast milk. Caffeine acts by releasing calcium into the heart on a massive scale, which can cause fatal arrhythmias. Athletes, in particular, should be aware of the fact that energy drinks are to be avoided during or immediately after exercise, and that consumption with alcohol worsens the damage of both types of substances. At the European Congress of Cardiology in Barcelona in 2014, the researcher Milou-Daniel Drici presented data from a study in France. From the data collected, it was found that, between 2009 and the end of 2012, 257 cases were reported, 212 of them with enough information to make a full evaluation. The study results showed a total of 95 people with cardiovascular symptoms. There were 8 deaths, while 46 people have accused arrhythmias, 13 have angina and 3 hypertension. The main side effect, observed in 60 subjects, was the caffeine syndrome, which is a tachycardia accompanied by tremors, anxiety and headache. In addition, there have been some cases of sudden and unexplained deaths, severe arrhythmias and heart attacks that may be associated with excessive consumption of energy drinks. Researcher Fabian Sanchis Gomar published in the Canadian Journal of Cardiology (May 2015) that he experienced an abuse of energy drinks among teenagers in which he reported the danger of the combination of caffeine, theophylline and guarana (Paullinia cupana) and mateina (Yerba Mate) for their very similar chemical structure and potential combined effects on strengthening of these substances on the pro-arrhythmic effects. In particular, the abuse of these substances could lead to SADS (Sudden Arrhythmia Death Syndrome).


Most exposed to arrhythmic risk would be children and young people suffering from cardiomyopathy and those undergoing corrective cardiac surgery for congenital heart disease. In 2013 the EFSA (European Food Safety Authority) published a report on the consumption of energy drinks in Europe for specific population groups, including children and adolescents. The goal was to assess the exposure of these categories to the active ingredients present in energy drinks, especially caffeine. From the report the following habits emerged:
Adults (18 to 65 years): about 30% of the surveyed adults said they regularly consume energy drinks. Among these, 12% consume it regularly 4-5 days or more per week, with an average consumption of 4.5 litres per month.
Adolescents (10 to 18): 68% of adolescents between 10 and 18 years of age declare to consume energy drinks. Among these, 12% represent so-called “chronic” drinkers, with an average consumption of 7 litres per month while another 12% related to acute consumer.
Children (aged 3 to 10 years): 18% of children of this age group consumes energy drinks. Among these, 16% consume an average of 0.95l a week (at least 4 litres per month).
Consumption associated with sports activity: approximately 52% of adult consumers and 41% of teenagers have reported drinking energy drinks before starting a sport. The Italian standard of reference is the Legislative Decree no. 81/2003 on the labelling of foodstuffs which lays down the requirement to specify, among the list of ingredients contained in these drinks, the presence of "caffeine", often referred to as simple "aroma". Article. 6 also states that "the use of caffeine more than 150 mg/l carries the obligation to report to the designation of the product, the indication of ‘High caffeine content’." This limit is easily exceeds by drinking only 2 drinks, given that in 1 drink from 250 mg doses of caffeine are contained between 80 and 140 mg/l, a little below the limit set by law.

The key issue is the clarity of the information on the content of energy drinks to avoid health risks, especially of young people. Comparing the label of four energy drinks you buy at the supermarket, it is noted that all signal the evato and caffeine content, and they respect the limits allowed, but only identify certain at-risk groups (children, pregnant women, and people particularly sensitive to caffeine) and recommend avoidance of simultaneous exposure to alcohol and tobacco. The Italian Society of Pharmacology had already denounced this in 2007 and, to date, is still unresolved. In our view it would be least desirable that all labels report the required information to facilitate proper and safe use of the products in question and to limit abuse. In parallel, it is important that parents are aware of the possible adverse health effects related to the abuse of energy drinks in order to limit access to their children. The solution would be an obligation to add specific warning labels to counter the marketing strategies that revolves around these products. To increase the risk perception related to the content and the boomerang effect of these drinks, it should be mandatory (as provided in Art 6 D.Legvo No 184/2003 for smoking) to add the words "Strongly recommended not to be consumed by children and adolescents who practice sport" in addition to “Energy drinks can cause damage to women during pregnancy ".


INTENSIVE REDUCTION?


At the American Heart Association there is a clear message: intensive lowering of blood pressure below the currently recommended targets provides increased vascular protection, particularly in people at high cardiovascular risk.
It sparks the debate
Intensive lowering of blood pressure below the currently recommended targets provides increased vascular protection, particularly in people at high cardiovascular risk! These are the results of a new meta-analysis produced by Dr. Xie Xinfang of Peking University and published online in the Lancet. The review of 19 studies involving about 45,000 participants showed that intensive lowering of blood pressure obtained in trials has enabled a significant reduction in the composite of major cardiovascular events such as stroke, myocardial infarction, reduced albuminuria and progression of retinopathy, but it has not had a significant impact on heart failure, cardiovascular death, and all-cause mortality or end stage renal disease compared to less intensive regimens. The new data call into question the recent "easing" of the targets for certain high-risk populations suggested by the Eighth Joint National Committee guidelines (JNC8) and the European Society of