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    ‘A Tiny Bit of Math’ Might Improve Your Heart Health, Study Suggests

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    Your average daily heart rate is a useful metric; so is your daily step count. Combining the two might be even better.Many people use a smartwatch to monitor their cardiovascular health, often by counting the number of steps they take over the course of their day, or recording their average daily heart rate. Now, researchers are proposing an enhanced metric, which combines the two using basic math: Divide your average daily heart rate by your daily average number of steps.The resulting ratio — the daily heart rate per step, or DHRPS — provides insight into how efficiently the heart is working, according to a study conducted by researchers at the Feinberg School of Medicine at Northwestern University and published today in the Journal of the American Heart Association.The study found that people whose hearts work less efficiently, by this metric, were more prone to various diseases, including Type II diabetes, hypertension, heart failure, stroke, coronary atherosclerosis and myocardial infarction.“It’s a measure of inefficiency,” said Zhanlin Chen, a third-year medical student at the Feinberg School of Medicine at Northwestern University and lead author of the new study; his coauthors included several Feinberg faculty physicians. “It looks at how badly your heart is doing,” he added. “You’re just going to have to do a tiny bit of math.”Some experts said they saw wisdom in DHRPS as a metric. Dr. Peter Aziz, a pediatric cardiologist at the Cleveland Clinic, said it appeared to be an advance on the information provided by daily steps or average heart rate alone.“What is probably more important for cardio fitness is what your heart does for the amount of work it has to do,” he said. “This is a reasonable way to measure that.”The metric does not look at heart rate during exercise. But, Dr. Aziz said, it still provided an overall sense of efficiency that, importantly, was shown by researchers to have an association with disease.The size of the study added validity to the findings, Dr. Aziz said. The scientists mapped Fitbit data from nearly 7,000 Smartwatch users against electronic medical records.Mr. Chen said that a simple way to grasp the value of the new metric was to compare two hypothetical individuals. Both take 10,000 steps a day, but one has an average daily resting heart rate of 80 — in the middle of the healthy range — while the other’s daily resting heart rate is 120.The first person would have a DHRPS of 0.008, the second 0.012. The higher the ratio, the stronger the signaling of cardiac risk.In the study, the 6,947 participants were divided into three groups based on their ratios; those with the highest showed a stronger association with disease than other participants did. The D.H.R.P.S. metric was also better at revealing disease risk than were step counts or heart rates alone, the study found.“We designed this metric to be low-cost and to use data we’re already collecting,” Mr. Chen said. “People who want to be in charge of their own health can do a little bit of math to figure this out.” More

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      Heart-Valve Patients Should Have Earlier Surgery, Study Suggests

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      The results of a new clinical trial have overturned the “wait and see” approach that cardiologists have long favored for symptom-free patients.For decades, people with failing heart valves who nevertheless felt all right would walk out of the cardiologist’s office with the same “wait and see” treatment plan: Come back in six or 12 months. No reason to go under the knife just yet.A new clinical trial has overturned that thinking, suggesting that those patients would be much better off having their valves replaced right away with a minimally invasive procedure.The trial, whose results were published this week in The New England Journal of Medicine, could change the way doctors treat severe aortic stenosis, a narrowing of the valve that controls blood flow from the heart. The disease, which has a prognosis worse than that of most cancers, afflicts more than 3 percent of people ages 65 and older. It is expected to become more common as people live longer.Replacing people’s heart valves, even if they were not yet experiencing any ill effects, appeared to roughly halve their risk of being unexpectedly hospitalized for heart problems over at least two years, the trial found.Patients who were put on the more conservative treatment plan overwhelmingly ended up needing surgery anyway: Roughly 70 percent of them developed symptoms and needed to have their valves replaced within two years, suggesting that the disease worsens more quickly than previously understood.“You may be able to at least prevent that progression and perhaps improve patient outcomes by treating earlier,” said Dr. Gregg Stone, a professor of medicine at the Icahn School of Medicine at Mount Sinai, describing the implications of the trial. The findings, he said, “will have a major effect on practice.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Time to Say Goodbye to the B.M.I.?

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      The body mass index has long been criticized as a flawed indicator of health. A replacement has been gaining support: the body roundness index.Move over, body mass index. Make room for roundness — to be precise, the body roundness index.The body mass index, or B.M.I., is a ratio of height to weight that has long been used as a medical screening tool. It is one of the most widely used health metrics but also one of the most reviled, because it is used to label people overweight, obese or extremely obese.The classifications have been questioned by athletes like the American Olympic rugby player Ilona Maher, whose B.M.I. of 30 technically puts her on the cusp of obesity. “But alas,” she said on Instagram, addressing online trolls who tried to shame her about her weight, “I’m going to the Olympics and you’re not.”Advocates for overweight individuals and people of color note that the formula was developed nearly 200 years ago and based exclusively on data from men, most of them white, and that it was never intended for medical screening. Even physicians have weighed in on the shortcomings of B.M.I. The American Medical Association warned last year that B.M.I. is an imperfect metric that doesn’t account for racial, ethnic, age, sex and gender diversity. It can’t differentiate between individuals who carry a lot of muscle and those with fat in all the wrong places.“Based on B.M.I., Arnold Schwarzenegger when he was a bodybuilder would have been categorized as obese and needing to lose weight,” said Dr. Wajahat Mehal, director of the Metabolic Health and Weight Loss Program at Yale University.“But as soon as you measured his waist, you’d see, ‘Oh, it’s 32 inches.’”So welcome a new metric: the body roundness index. B.R.I. is just what it sounds like — a measure of how round or circlelike you are, using a formula that takes into account height and waist, but not weight.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Are Some Ultraprocessed Foods Worse Than Others?

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      A new study may offer the biggest clues yet.Name a common condition — heart disease, Type 2 diabetes, cancer, dementia, irritable bowel syndrome — and chances are good that following a diet high in ultraprocessed foods has been linked to it.But the ultraprocessed food category is large and wide-ranging. It makes up an estimated 73 percent of the U.S. food supply, and contains stereotypically “unhealthy” products like sodas, candies and hot dogs as well as seemingly “healthy” ones like whole grain breads, breakfast cereals, flavored yogurts and plant milks.It’s a “hodgepodge of foods,” some of which are likely more harmful than others, said Josiemer Mattei, an associate professor of nutrition at the Harvard T.H. Chan School of Public Health.On Monday, Dr. Mattei and her colleagues published one of the largest and longest studies on ultraprocessed foods and heart health to date. In it, they analyzed the risks of consuming these foods, and teased out the worst offenders.An Overall Risk of Ultraprocessed FoodsThe new study, published in a Lancet journal, included more than 200,000 adults in the United States. They filled out detailed diet questionnaires beginning in the 1980s and early 1990s, and completed them again every two to four years for about 30 years. Most of the participants in the study were white and worked as health professionals. The researchers looked at how the participants’ ultraprocessed food consumption related to their chances of developing cardiovascular disease.After adjusting for risk factors like smoking, family health history, sleep and exercise, the researchers found that those who consumed the most ultraprocessed foods were 11 percent more likely to develop cardiovascular disease and 16 percent more likely to develop coronary heart disease during the study period, compared with those who consumed the least ultraprocessed foods. The highest consumers also had a slightly, but not significantly, elevated risk of stroke.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How Your Body and Mind Change in Midlife

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      Midlife, typically defined as ages 40 to 60, is an inflection point. It’s a time when our past behaviors begin to catch up with us and we start to notice our bodies and minds aging — sometimes in frustrating or disconcerting ways. But it’s also an opportunity: What our older years will look and feel […] More

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      Akira Endo, Scholar of Statins That Reduce Heart Disease, Dies at 90

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      The Japanese biochemist found in the 1970s that cholesterol-lowering drugs lowered the LDL, or “bad” cholesterol, level in the blood.Akira Endo, a Japanese biochemist whose research on fungi helped to lay the groundwork for widely prescribed drugs that lower a type of cholesterol that contributes to heart disease, died on June 5. He was 90.Chiba Kazuhiro, the president of Tokyo University of Agriculture and Technology, where Dr. Endo was a professor emeritus, confirmed the death in a statement. The statement did not give a cause or say where he died.Cholesterol, mostly made in the liver, has important functions in the body. It is also a major contributor to coronary artery disease, a leading cause of death in the United States, Japan and many other countries.In the early 1970s, Dr. Endo grew fungi in an effort to find a natural substance that could block a crucial enzyme that is part of the production of cholesterol. Some scientists worried that doing so might threaten cholesterol’s positive functions.But by 1980, Dr. Endo’s team had found that a cholesterol-lowering drug, or statin, lowered the LDL, or “bad” cholesterol level, in the blood. And by 1987, after other researchers in the field had published additional research on statins, Merck was manufacturing the first licensed statin.Such drugs have proven effective in reducing the risk for cardiovascular disease, and millions of people in the United States and beyond now take them for high levels of LDL.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      What to Know About CKM, the Link Between Heart Health, Diabetes and Kidney Disease

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      And they’re increasingly common. Here’s what to know about the shared risk factors for these diseases.Heart disease, diabetes and kidney disease are among the most common chronic illnesses in the United States — and they’re all closely connected.Adults with diabetes are twice as likely to have heart disease or a stroke compared with those who don’t have diabetes. People with diabetes — Type 1 and Type 2 — are also at risk of developing kidney disease. And when the kidneys don’t work well, a person’s heart has to work even harder to pump blood to them, which can then lead to heart disease.The three illnesses overlap so much that last year the American Heart Association coined the term cardiovascular-kidney-metabolic syndrome to describe patients who have two or more of these diseases, or are at risk of developing them. A new study suggests that nearly 90 percent of American adults already show some early signs of these connected conditions.While only 15 percent of Americans meet the criteria for advanced stages of C.K.M. syndrome, meaning they have been diagnosed with diabetes, heart disease or kidney disease or are at high risk of developing them, the numbers are still “astronomically higher than expected” said Dr. Rahul Aggarwal, a cardiology fellow at Brigham and Women’s Hospital in Boston and co-author of the study.The research suggests that people should pay attention to shared risk factors for these diseases early on — including excess body fat, uncontrolled blood sugar, high blood pressure and high cholesterol or triglyceride levels.A Dangerous CycleYour kidneys, heart and metabolic system (which helps process the food you eat into energy and maintains your blood sugar levels) work closely together. If something goes awry with one, it can lead to problems with the others.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      What Is VO2 Max?

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      VO2 max has become ubiquitous in fitness circles. But what does it measure and how important is it to know yours?Fitness is full of numbers meant to help you become faster and stronger. There’s your mile run time, your resting heart rate and measures of strength and flexibility. But perhaps the gold standard is VO2 max.A handful of years ago, the test — which tracks how much oxygen your body absorbs — was an obscure tool mainly used by elite athletes. Today, it’s touted by fitness professionals and wellness experts like Peter Attia as being a useful measure for all exercisers.But getting an accurate number requires an expensive and exhausting lab evaluation. And estimates provided by wearable devices might not tell you much. So how useful is it to invest time and money in the full work-up, and how important is knowing your VO2 max?For everyday people who want to be healthy and live a long time, the measurement is “the best piece of empirical information we have on health and longevity,” said Kate Baird, a clinical exercise physiologist and the coordinator of running and metabolic services at Hospital for Special Surgery in New York.The key, she said, is acting on what the data tells you.What is VO2 Max?“VO2 max” is a two-digit number that expresses how effectively your body metabolizes oxygen. The measurement itself is the milliliters of oxygen consumed in a minute per kilogram of body weight.As you exercise, your body needs ever more oxygen. The more you can efficiently consume, the more energy your muscles will have, increasing the time and intensity you can exercise. Generally speaking, someone with a higher VO2 max will be able to sustain a run or an aerobic activity at a given pace longer than someone with a lower VO2 max.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Death of David Gail, ‘Port Charles’ Star, Was Drug Related, Publicist Says

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      The 58-year-old actor, who was also on “Beverly Hills, 90210,” died last month in a Tampa, Fla., hospital days after going into cardiac arrest.David Gail, the “Port Charles” and “Beverly Hills, 90210” actor who died in a Tampa, Fla. hospital on Jan. 16, had been intoxicated from a mix of drugs and alcohol that caused him to go into cardiac arrest, his publicist said on Tuesday.A number of drugs were found in Mr. Gail’s system, including amphetamines, cocaine, alcohol and fentanyl, according to a statement from the publicist, Linda Brown. The cardiac arrest led to a brain injury, which ultimately caused his death days later, she said.The Hillsborough County Medical Examiner did not immediately respond to a request for Mr. Gail’s autopsy report on Tuesday evening.The family previously said that Mr. Gail, 58, had died from complications from a sudden cardiac arrest.Paramedics who found Mr. Gail after he went into cardiac arrest performed CPR and used a defibrillator to try to revive him, but he ultimately wound up on life support at the hospital, according to Ms. Brown.Mr. Gail’s mother, Mary Painter, said in the statement that her son had for years been reliant on medication to manage pain from hand and wrist surgeries that kept him out of work for nearly a decade.“It breaks my heart to learn my son died this way,” Ms. Painter said, adding, “I can only assume that his former dependence played a part in self-medicating from uncontrolled sources.”Her son’s death, she said, highlighted victims of pharmaceutical addiction and the fentanyl epidemic.Mr. Gail had a bountiful television acting career in the mid- to late 1990s, including his most prominent role, as Dr. Joe Scanlon on the “General Hospital” spinoff show “Port Charles.” Mr. Gail played Dr. Scanlon in 216 episodes in one season, which ran in 1999 and 2000, according to IMDb.Years before that, Mr. Gail appeared on eight episodes of “Beverly Hills, 90210,” playing a minor part in an episode in the first season and returning to the show for the fourth season in a more established role.“When I came back it was such a shock, I was asking, ‘How could I possibly come back?’” Mr. Gail said about his return on the “Beverly Hills Show Podcast” in 2021.“But it worked,” he added.He also made dozens of appearances in a variety of television shows throughout the 1990s and several films in the 2000s. More