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Asymptomatic valve disease in seniors and health risks of air travel · Morning Medical with Dr. Chow

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Good morning, everyone, and welcome to another episode of Morning Medical with Doctor Chiao.
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I am your host, Doctor Ching Chiao.
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In today's episode, We are diving into some of the most pressing health and medical news from
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around the globe.
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We will explore the prevalence of asymptomatic valve disease and seniors.
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The growing role of cardiovascular health and dementia, the health risks associated with air
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travel, and the latest findings on daily multivitamin use.
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Let's get started.
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Our first topic today is a significant finding in the field of cardiology.
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A recent study has revealed that more than 1 in 4 seniors have asymptomatic valve disease.
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This study conducted by researchers at the University of East Anglia in Norwich, England
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highlights the high prevalence of undiagnosed heart valve disease among otherwise healthy
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older adults in the United Kingdom.
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The study found that 28.2 percent of older adults with no previously known heart disease
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and no prior indication for echocardiography had mild, moderate, or severe asymptomatic
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valvular heart disease.
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The prevalence of this condition increases with age starting at 21.2% in the 60 to 60 4 age
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group, rising to 31.5% in those age 70 to 70 4, and reaching a staggering 53.6 percent in
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individuals aged 85 and older.
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According to doctor Vasilos Vasilio Vasilio, the lead researcher older age was identified as
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the most significant risk factor for valve disease.
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The odds of having valve disease increased by 7% with each additional year of age.
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Doctors Vasilio and his colleagues reported their findings in the European Heart Journal
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Cardiovascular Imaging.
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They estimated that for people over 60 years old, the number needed to scan to diagnose 1
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clinically significant case of valvular heart disease was 42.
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This number dropped to 15 for individuals aged 75 and older.
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These findings underscore the importance of age as a predictor of valve disease and suggest
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that routine screening could play a crucial role in early diagnosis and management.
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The study also pointed out that in the current medical practice, referrals for
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echocardiographic screening of valve disease are typically based on symptoms or abnormal
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cardiac auscultation.
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However, this approach may not be effective for older adults, as mild symptoms can be masked by
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reduced physical activity and impaired mobility.
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Furthermore, Cardiac Auscultation has shown limited accuracy in detecting valvular heart
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disease in asymptomatic elderly patients.
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Making it a poor diagnostic tool in primary care settings.
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It's worth noting that the study excluded trivial regurgitation and aortic sclerosis in
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its definition of valve disease, and it also did not include individuals with atrial
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fibrillation.
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This differs from previous studies such as the ox valve study, which reported a higher
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prevalence of asymptomatic and previously undiagnosed valve disease.
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Despite these differences, the data from this study provide valuable insights into the burden
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of valvular heart disease in the community.
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And highlight the potential benefits of echocardiographic screening in the elderly
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population.
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The prospective cohort study involved 10, 000 people recruited from general practices in
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England's West Midlands and Norfolk areas, as well as Aberdeenshire in Scotland between
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20072016.
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Out of these 4237 asymptomatic volunteers with no prior indication for echocardiography and no
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known cardiac disease were included in the study.
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The average age of the participants was 69.1 years, with 54.2% being women and 97.7%
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reporting white race.
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The median blood pressure was a 142.8 over 79.5 millimeters of mercury, and the mean body mass
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index was 26.9 with 70.8% of participants being overweight.
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The study identified the most common, modifiable cardiovascular risk factors among
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the participants as hypertension, hypercholesterolemia, smoking, and diabetes.
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Specifically, 36.4% had hypertension, 24.4% had high cholesterol levels, 9.7% were smokers, and
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7.8% had diabetes.
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The participants underwent clinical examinations and transthoracic echocardiography
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with most scans performed by 2 experienced sonographers.
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The most frequently encountered valve conditions were tricuspid regurgitation found
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in 13.8 percent of cases, mitral regurgitation in 12.8% and aortic regurgitation in 8.3%.
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Interestingly, 63.6 percent of the flagged cases involved isolated single valve disease.
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There were no cases of pulmonary or tricuspid stenosis detected.
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However, the study did incidentally find a few cases of cardiac tumors including 2 atrial
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myxomas and 1 aortic fibroelastoma.
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While the study provides critical insights, It is important to consider its limitations.
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Selection bias is a potential issue given the observational nature of the study.
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Additionally, the findings may not be generalizable to other communities with
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different ethnic compositions.
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The authors also noted that they were unable to incorporate BNP or NT pro BNP values, which are
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important biomarkers in the assessment of heart disease.
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In conclusion, this study funded by a grant from the British Heart Foundation reveals a
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significant burden of asymptomatic valve disease among older adults in the United
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Kingdom.
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It emphasizes the need for health care providers to consider routine echocardiographic
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screening in this population to facilitate early diagnosis and intervention.
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As our population continues to age, understanding, and addressing the prevalence of
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valve disease will be crucial in managing the overall cardiovascular health of our
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communities.
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Our next topic delves into the intricate relationship between cardiovascular health and
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dementia.
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A groundbreaking study led by researchers at University College London has shed light on how
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cardiovascular health has become an increasingly significant factor in dementia
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risk over time.
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Pubished in the Lancet Public Health, the study explored the changing prevalence of various
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dementia risk factors and their potential impact on future dementia rates.
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Currently, it is estimated that there are 944, 000 people living with dementia in the United
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Kingdom and a staggering 52% of the UK public, which is approximately 34, 500, 000 people know
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someone who has been diagnosed with a form of the disease.
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Dementia remains 1 of the nation's biggest killers and has been the leading cause of death
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in women in the United Kingdom since 2011.
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The study funded by the National Institute for Health And Care Research 3 schools dementia
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research program, analyzed data from 27 papers involving people with dementia worldwide.
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The data was collected between 1947 2015, and the latest paper included in the analysis was
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published in 2020.
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The researchers extracted information about dementia risk factors from each paper and
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calculated the proportion of dementia cases attributable to each risk factor over time.
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Dementia typically develops due to a combination of genetic and environmental
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factors, including hypertension, obesity, diabetes, education, and smoking.
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The study found that the prevalence of certain risk factors such as having less education and
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smoking has decreased over time which correlates with a decline in dementia rates.
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However, the prevalence of obesity and diabetes has increased as has their contribution to
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dementia risk.
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The study highlighted hypertension as the greatest risk factor for dementia in most of
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the reviewed studies.
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Interestingly, the proactive management of hypertension has also increased over time,
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suggesting that while hypertension remains a significant risk factor, Its impact on dementia
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may be mitigated by better management practices.
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Lead author doctor Naayahid Mukadam from University College London's psychiatry
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department noted that cardiovascular risk factors might have contributed more to dementia
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risk over time.
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Warranting more targeted action for future dementia prevention efforts.
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The study's findings suggest that population level interventions could significantly impact
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the occurrence of dementia risk factors.
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For example, increasing education levels and implementing restrictions on smoking have
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already shown positive trends.
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Doctor Madam emphasized that as education levels have risen in many higher income
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countries, this has become a less critical dementia risk factor.
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Meanwhile, smoking levels have declined in Europe and the United States as it has become
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less socially acceptable and more expensive.
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These patterns indicate that governmental policies and public health initiatives can
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significantly influence the prevalence of dementia risk factors.
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While the study provides valuable insights, It is essential to consider its limitations.
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The reported levels of cardiovascular risk factors may have increased over time.
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But so has their proactive management, which could neutralize or reduce their overall impact
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on dementia risk.
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Additionally, all studies analyzed were from 2015 and earlier, so the findings may not
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reflect more recent trends.
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In summary, this research underscores the growing importance of cardiovascular health in
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dementia risk.
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As we continue to understand and address these risk factors, targeted prevention efforts could
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play a crucial role in reducing dementia rates in the future.
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The study's findings highlight the potential benefits of prioritizing cardiovascular health
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through public health initiatives and policy changes.
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The transportation security administration has just reported an all time high for the number
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of airline travelers screened, and major United States airlines expect to transport 271, 000,
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000 passengers this summer, marking a 6.3% increase from last year.
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Given these figures, it is crucial to understand the health risks associated with air
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travel.
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Doctor Carl Abraham, a board certified infectious disease physician and assistant
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professor at the New York Institute of Technology College of osteopathic medicine
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offers valuable insights on how to stay healthy at 35, 000 feet.
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Doctor Abraham, who practices at the medical school's Arkansas location, notes that some
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people may be surprised about the risk of germs spread on most airplanes.
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Commercial airplanes are equipped with high efficiency particulate air filter systems,
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which rapidly exchange the air.
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Generally, the risk of spreading an airborne pathogen is lower in an airplane than in other
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indoor public settings.
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However, studies suggest that sitting within 2 rows of an infected passenger does increase the
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risk of acquiring an airborne infection.
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Given this, doctor Abraham urges anyone with a possible respiratory tract infection to wear an
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n 95 mask, as well as those with compromised immune systems.
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He also recommends disinfecting touched objects, like seat belts or trays, Although
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airlines are supposed to ensure these areas are cleaned thoroughly between flights.
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While disinfecting surfaces is important, Doctor Abraham points out that the real hotspot
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for germ transmission might be the airplane laboratory.
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Transmission can occur either by coming into contact with surfaces contaminated by bacteria
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or by inhaling air contaminated with certain viruses such as influenza, SARS Cove 2, and
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measles after the lavatory has been used by a contagious passenger.
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Transmission of norovirus The common cause of diarrhea outbreaks on cruise ships has also
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been reported.
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Doctor Abraham explains that the surfaces of public restrooms are frequently contaminated
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with fecal flora, bacteria found in stool, and airplane restrooms are no exception.
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Although airlines clean the laboratory between flights, They're used during the flight results
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in contamination of the toilet, sink handles, door handles, both inside and outside, and
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especially the floors.
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Bacteria from the bathroom can also track into the cabin on the bottom of passenger's shoes.
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To avoid coming into contact with these germs, Doctor Abraham advises passengers to open and
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close laboratory door handles with a sanitizing wipe, use toilet seat covers and close the lid
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before flushing.
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He emphasizes the importance of hand hygiene, recommending that everyone should always wash
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their hands or practice some form of hand hygiene before putting clothes back in place
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and before and after eating.
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Our final topic today addresses a common belief held by many individuals regarding the benefits
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of daily multi vitamins.
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A significant new study has found that taking daily multi vitamins might not help you live
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longer.
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Researchers from the National Institutes of Health analyzed over 20 years of data from 400,
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000 healthy adults in the United States and concluded that multivitamins do not reduce
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mortality risk.
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The study, published in JAMA Network Open, revealed that people who took daily
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multivitamins did not have a lower risk of death from any cause compared to those who did
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not take multi vitamins.
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The researchers stated in a press release from the National Institutes of Health, the analysis
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showed that people who took daily multivitamins did not have a lower risk of death from any
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cause than people who took no multivitamins.
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Additionally, the study found no differences in mortality rates from cancer, heart disease or
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cerebral vascular diseases between those who took multivitamins and those who did not.
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In fact, those who took daily multivitamins were found to have a 4% higher mortality risk.
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The participants in the study had an average age of 61 and a half years, and a 164, 162
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deaths occurred during the follow-up period.
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The researchers noted that while multivitamin users might generally lead healthier
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lifestyles, sicker individuals are also more likely to increase their use of multivitamins.
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Results were adjusted for factors such as race, ethnicity, education, and nutrition to account
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for potential biases.
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This study follows a 2022 analysis by the United States preventive services task force,
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which concluded there was insufficient evidence to determine if multivitamin use improved
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mortality.
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By including a large number of participants and extending the follow-up period, the researchers
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aimed to address potential biases that could influence the findings.
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They acknowledge that people who use multivitamins might have healthier lifestyles
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in general and sicker patients may be more likely to increase their use of multivitamins.
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This adjustment was crucial to ensure the findings were as accurate as possible.
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Doctor Peter Cohen, an associate professor of medicine at the Cambridge Health Alliance in
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Massachusetts, who was not involved in the study provided his perspective.
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He told Fox News Digital, this study provides further evidence that taking multi vitamins,
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even for 20 years or more, will not extend your life.
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For healthy adults, there is no reason to add on a multivitamin unless your doctor
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specifically recommends it.
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Doctor, Brett Osborne, a Florida neurologist and longevity expert, who was also not involved
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in the study, pointed out some limitations.
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He noted the observational nature of the study, the absence of a control group, and the
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variability in multivitamin formulations used by participants.
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Doctor.
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Why Osborne stated observational studies like this 1 can suggest associations or
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correlations, but cannot prove causation due to the potential for confounding variables
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influencing both multivitamin use and mortality outcomes.
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Doctor Osborne emphasized that without a control group, it is challenging to separate
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the effects of multivitamins from other health behaviors or baseline health conditions that
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could influence mortality.
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Specific formulation or dosage of multivitamins taken by participants.
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Most multi vitamins contain a broad spectrum of vitamins and minerals but the concentrations
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can vary Osborne highlighted the importance of rigorous scientific inquiry into the health
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benefits of multivitamins.
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He mentioned that vitamin usage is just 1 aspect of longevity.
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Alongside genetics, lifestyle, socio economic status, and access to health care among other
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factors.
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The multifactorial nature of longevity means that isolating the impact of multivitamins
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alone is complex and challenging, if not impossible, Doctor Osborne added.
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The study's findings underscore the necessity of evaluating multivitamin use and mortality
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risk across diverse populations with varying medical conditions and dietary habits.
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The researchers emphasize the importance of measuring the impact multivitamins on mortality
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in different kinds of populations, such as those with documented nutritional deficiencies.
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They also highlighted the potential impact of regular multivitamin use on other health
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conditions associated with aging.
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In summary, while the study suggests that daily multivitamins may not extend longevity, it also
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highlights the need for further research to fully understand their impact on different
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populations and health conditions.
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As always, it is essential to consult with health care providers before making any changes
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to your supplement regimen.
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That brings us to the end of today's episode.
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Thank you for joining us on morning medical with doctor Chow.
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Stay tuned for more updates on the latest health and medical news from around the world.
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Have a wonderful day, and stay healthy.