Blood-brain barrier repair after stroke may prevent chronic brain deficits

Following ischemic stroke, the integrity of the blood-brain barrier (BBB), which prevents harmful substances such as inflammatory molecules from entering the brain, can be impaired in cerebral areas distant from initial ischemic insult. This disruptive condition, known as diaschisis, can lead to chronic post-stroke deficits, University of South Florida researchers report.

In experiments using laboratory rats modeling ischemic stroke, USF investigators studied the consequences of the compromised BBB at the chronic post-stroke stage. Their findings appear in a recent issue of the Journal of Comparative Neurology.

"Following ischemic stroke, the pathological changes in remote areas of the brain likely contribute to chronic deficits," said neuroscientist and study lead author Svitlana Garbuzova-Davis, PhD, associate professor in the USF Health Department of Neurosurgery and Brain Repair. "These changes are often related to the loss of integrity of the BBB, a condition that should be considered in the development of strategies for treating stroke and its long-term effects."

Edward Haller of the USF Department of Integrative Biology, the coauthor who performed electron microscopy and contributed to image analysis, emphasized that "major BBB damage was found in endothelial and pericyte cells, leading to capillary leakage in both brain hemispheres." These findings were essential in demonstrating persistence of microvascular alterations in chronic ischemic stroke.

While acute stroke is life-threatening, the authors point out that survivors often suffer insufficient blood flow to many parts of the brain that can contribute to persistent damage and disability. Their previous investigation of subacute ischemic stroke showed far-reaching microvascular damage even in areas of the brain opposite from the initial stroke injury. While most studies of stroke and the BBB explore the acute phase of stroke and its effect on the blood-brain barrier, the present study revealed the longer-term effects in various parts of the brain.

The pathologic processes of stroke-induced vascular injury tend to occur in a "time-dependent manner," and can be separated into acute (minutes to hours), subacute (hours to days), and chronic (days to months). BBB incompetence during post-stroke changes is well-documented, with some studies showing the BBB opening can last up to four to five days after stroke. This suggests that harmful substances entering the brain during this prolonged BBB leakage might increase post-ischemic brain injury.

In this study, the researchers used laboratory rats modeling ischemic stroke and observed injury not only in the primary area of the stroke, but also in remote areas, where persistent BBB damage could cause chronic loss of competence.

"Our results showed that the compromised BBB integrity detected in post-ischemic rat cerebral hemisphere capillaries -- both ipsilateral and contralateral to initial stroke insult -- might indicate chronic diaschisis," Garbuzova-Davis said. "Widespread microvascular damage caused by endothelial cell impairment could aggravate neuronal deterioration. For this reason, chronic diaschisis poses as a therapeutic target for stroke."

The primary focus for therapy development could be restoring endothelial and/or astrocytic integrity towards BBB repair, which may be "beneficial for many chronic stroke patients," senior authors Cesar V. Borlongan and Paul R. Sanberg suggest. The researchers also recommend that cell therapy might be used to replace damaged endothelial cells.

"A combination of cell therapy and the inhibition of inflammatory factors crossing the blood-brain barrier may be a beneficial treatment for stroke," Garbuzova-Davis said.

Story Source:

The above story is based on materials provided by University of South Florida (USF Innovation). Note: Materials may be edited for content and length.

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Many countries lack capacity to prevent and treat hearing loss

28 February 2014 | GENEVA - Many of the countries who responded to a new WHO survey lack the capacity to prevent and care for hearing loss, according to a report published on International Ear Care Day, 3 March.

Results of the survey

“The results of this survey are a clear call to action for governments and partners to invest in hearing care especially at community and primary level.”

Dr Etienne Krug, Director of the WHO Department of Violence and Injury Prevention and Disability

WHO estimates that over 5% of the world’s population – 360 million people - has disabling hearing loss. The highest prevalence is found in the Asia Pacific, South Asia and sub-Saharan Africa. About half of all cases of hearing loss worldwide are easily prevented or treated.

A leading cause for hearing loss in younger ages, particularly in low- and middle-income countries, is untreated ear infections, which often presents with discharge from the ear. Vaccine-preventable infectious diseases such as rubella, meningitis, measles, or mumps can also lead to hearing loss.

Just 32 of the 76 countries who responded have developed plans and programmes to prevent and control ear diseases and hearing loss. According to the report, many lack trained health personnel, educational facilities, data and national plans to address the needs of those living with ear and hearing problems. The information received also indicates that the gap between need and services is greatest in sub-Saharan Africa.

“The results of this survey are a clear call to action for governments and partners to invest in hearing care especially at community and primary level,” says Dr Etienne Krug, Director of the WHO Department of Violence and Injury Prevention and Disability. “The programmes must aim to benefit all, including disadvantaged parts of the population who are least able to access hearing services.”

Prevention and treatment of hearing loss at primary level

Good ear care practices, such as reducing exposure to noise and avoiding insertion of objects into the ears, can prevent many from developing ear and hearing problems. A large percentage of people living with hearing loss can benefit from early identification and appropriate treatment.

For example, screening programmes for infant hearing can minimize the impact of hearing loss on a child’s development.

“Ear and hearing problems and the use of hearing aids are often associated with myths and misconceptions”, says Dr Shelly Chadha of the WHO unit for the Prevention of Blindness and Deafness. “National programmes should therefore not only focus on prevention and service provision but also on awareness raising.”

The national plans that already exist in some countries can serve as a model for countries that still lack strategies to better address disabling hearing loss. However, each country needs to develop a unique plan based on its specific situation, the prevalent causes of hearing loss as well as the available health infrastructure.

For more information please contact:

Tarik Jasarevic
WHO, Geneva
Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 79367 6214
E-mail:jasarevict@who.int

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Big Cigarette Tax Hikes Might Prevent 200 Million Deaths in a Century

Study authors suggest that nations triple tobacco taxes

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How common chemotherapy drugs in bone marrow transplantation graft prevent rejection.

Johns Hopkins and Kimmel Cancer porting people to results of a study from the Center for bone marrow transplantation, chemotherapy drug called cyclophosphamide pieces can prevent (GVHD) versus host disease may explain why. Point the immune cells to protect patients from fatal form of evasion cyclophosphamide toxicity, GVHD is experimental. In the journal Science Translational Medicine Online 11/13 published findings may pave the way for preventative treatment of recurrence of cancer or prevent GVHD and new treatment, bone marrow transplant rejection, transplant after underlying improvement.

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Could dog food additive prevent disabling chemo side effect?

Sep. 19, 2013 — Working with cells in test tubes and in mice, researchers at Johns Hopkins have discovered that a chemical commonly used as a dog food preservative may prevent the kind of painful nerve damage found in the hands and feet of four out of five cancer patients taking the chemotherapy drug Taxol.

The Food and Drug Administration-approved preservative, an antioxidant called ethoxyquin, was shown in experiments to bind to certain cell proteins in a way that limits their exposure to the damaging effects of Taxol, the researchers say.

The hope, they say, is to build on the protective effect of ethoxyquin's chemistry and develop a drug that could be given to cancer patients before taking Taxol, in much the same way that anti-nausea medication is given to stave off the nausea that commonly accompanies chemotherapy. While half of Taxol users recover from the pain damage, known as peripheral neuropathy, the other half continue to have often debilitating pain, numbness and tingling for the rest of their lives.

"Millions of people with breast cancer, ovarian cancer and other solid tumors get Taxol to treat their cancer and 80 percent of them will get peripheral neuropathy as a result," says Ahmet Hoke, M.D., Ph.D., a professor of neurology and neuroscience at the Johns Hopkins University School of Medicine and director of the Neuromuscular Division. "They're living longer thanks to the chemotherapy, but they are often miserable. Our goal is to prevent them from getting neuropathy in the first place."

A report on Hoke's research is published online in the Annals of Neurology.

Hoke and his team knew from previous experiments that adding Taxol to a nerve cell line growing in a petri dish would cause neurodegeneration. In a series of experiments, they set out to hunt for compounds that might interrupt the degenerative process by adding Taxol to nerve cells along with some 2,000 chemicals -- one at a time -- to see which, if any, could do that.

Ethoxyquin did so, Hoke says, apparently by making the cells resistant to the toxic effects of the Taxol.

Once they identified ethoxyquin's effects, they gave intravenous Taxol to mice, and saw nerves in their paws degenerate in a couple of weeks. But when they gave ethoxyquin to the mice at the same time as the Taxol, it prevented two-thirds of the nerve degeneration, which Hoke says would have a big impact on quality of life if the same effects were to occur in humans.

Specifically, Hoke and his team discovered that molecules of ethoxyquin were binding to Hsp90, one of the so-called heat shock proteins that cells defensively make more of whenever they are stressed. Hsp90 acts as a cell's quality control officer, determining whether a protein is properly formed before sending it out where it is needed. When ethoxyquin binds to Hsp90, two other proteins -- ataxin-2 and Sf3b2 -- can't bind to Hsp90. When they can't bind, the cell senses that these two proteins are flawed, so they are degraded and their levels in the cell diminished.

Hoke says his team is not certain why too much of those two proteins appears to have a negative effect on nerves, but reducing their levels clearly appears in their studies to make cells more resistant to Taxol toxicity.

Hoke and his colleagues are looking into whether this medication could also make nerves more resistant to damage in peripheral neuropathy caused by HIV and diabetes, two other major causes of the pain. A previous study, Hoke says, showed that ataxin-2 may cause degeneration in motor neurons in a rare form of ALS, commonly known as Lou Gehrig's disease, suggesting that ethoxyquin or some version of it might also benefit people with this disorder.

Twenty to 30 million Americans suffer from peripheral neuropathy. Hoke says it's a "huge public health issue" that doesn't get much attention because it is not fatal.

Hoke's team is hoping to conduct safety studies with ethoxyquin in animals in advance of possible testing in people. He says that while too much ethoxyquin is thought to be potentially harmful to dogs, the needed dose for humans would likely be 20-to-30-fold lower than what is found in dog food. Ethoxyquin was developed in the 1950s as an antioxidant, a compound to prevent pears and other foods from becoming discolored and spoiling.

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Colonoscopy screening every ten years could prevent 40% of colorectal cancers

Sep. 18, 2013 — According to a large, long-term study from Harvard School of Public Health (HSPH), 40% of all colorectal cancers might be prevented if people underwent regular colonoscopy screening. The new research also supports existing guidelines that recommend that people with an average risk of colorectal cancer should have a colonoscopy every 10 years.

The new study helps address previous uncertainty about the effectiveness of colonoscopy in reducing colorectal cancer incidence and mortality -- particularly among people with cancer that originates in the proximal, or upper part of the colon.

The study appears in the September 19, 2013 edition of the New England Journal of Medicine.

"Colonoscopy is the most commonly used screening test in the U.S. but there was insufficient evidence on how much it reduces the risk of proximal colon cancer and how often people should undergo the procedure," said Shuji Ogino, co-senior author and associate professor in the Department of Epidemiology at HSPH. "Our study provides strong evidence that colonoscopy is an effective technique for preventing cancers of both distal and proximal regions of the colorectum, while sigmoidoscopy alone is insufficient for preventing proximal cancer."

According to the most recent statistics from the Centers for Disease Control and Prevention, nearly 137,000 people in the U.S. were diagnosed with colorectal cancer in 2009, and nearly 52,000 died that year from the disease. Colorectal cancer is the second-leading cause of cancer-related death in the nation.

The researchers analyzed data from 88,902 participants in two long-term studies: the Nurses' Health Study and the Health Professionals Follow-up Study. Based on data from questionnaires that participants filled out every two years between 1988 and 2008, the researchers obtained information on colonoscopy and sigmoidoscopy procedures. They documented 1,815 cases of colorectal cancer and 474 deaths from the disease.

They found that both colonoscopy and sigmoidoscopy -- which screens for tumors in the distal, or lower part of the colorectum -- were associated with decreased risk of either getting colorectal cancer or dying from it. Only colonoscopy decreased the risk for cancers originating in the proximal colon, but not to the degree of its protective effect against distal colorectal cancers. The researchers suggested that colonoscopy's smaller effect in reducing risk for tumors in the proximal colon might be due in part to molecular or biological differences in those cancers.

Other findings include:

• The researchers estimated that if all participants in the study had undergone colonoscopies, 40% of colorectal cancers -- including 61% of distal cancers and 22% of proximal cancers -- would have been prevented.
• Sigmoidoscopy alone is likely insufficient for reducing the incidence or death risk of colorectal cancer that originates in the upper colon.
• People who get a clean bill of health after a colonoscopy have a significantly reduced risk of colorectal cancer for up to 15 years after the procedure, although the data support repeat screening at shorter intervals among individuals with a personal history of adenoma -- a benign tumor of glandular origin that can become malignant over time -- or a family history of colorectal cancer.
• Colorectal cancers diagnosed within five years of a colonoscopy had different molecular characteristics compared with cancers diagnosed more than five years after a colonoscopy, and they may be difficult to detect or completely remove.

"Each year, more than 1.2 million people are diagnosed with colorectal cancer worldwide. Our findings could help improve and strengthen the current guidelines for colorectal cancer screening," said Reiko Nishihara, lead author and research fellow in the Department of Nutrition at HSPH.

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Exercise, vitamin D may prevent falls: guidelines

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NEW YORK (Reuters Health) - Older adults who are at high risk of falls should have physical therapy and take vitamin D supplements to reduce their chance of injury, according to new recommendations from a government-backed panel.

Falling is "a common problem and it's often overlooked because doctors may not be aware of their patients' fall risk," said Dr. Albert Siu, a professor at Mount Sinai School of Medicine in New York and vice co-chair of the U.S. Preventive Services Task Force (USPSTF), which came out with the recommendations on Monday.

"By asking about falls and by observing the patient in terms of walking, we might be able to asses who might be at risk and who can benefit from preventive measures," Siu told Reuters Health.

Falls are a leading cause of injury among older adults, he added.

According to the new guidelines, published in the Annals of Internal Medicine, 30 to 40 percent of people age 65 or older fall at least once each year, and five to 10 percent of them will have a serious injury such as a hip fracture.

The USPSTF makes recommendations on a range of prevention and treatment issues, and its guidelines on reducing the risk of falls in the elderly had not been updated since 1996.

There has been considerable research done since then on what seniors can do to prevent falls -- and what doesn't seem to work. For instance, correcting vision, wearing a shield called a hip protector, stopping some medications or taking protein supplements do not reduce the risk that someone will have a fall, according to the guidelines.

Vitamin D, exercise and physical therapy, however, are moderately beneficial, reducing the risk of falling by 13 to 17 percent (see Reuters Health report of December 21, 2010).

A 13 percent reduction in falls would mean that instead of 30 out of 100 older adults having a fall each year, that number would drop to 26.

In the USPSTF's review of the evidence on vitamin D, the panel found that to prevent one elderly person from falling, 10 would have to take vitamin D supplements.

Siu said the usual dose is 800 international units (IUs) per day, and studies suggest people should take vitamin D for one year to see any benefit.

For exercise or physical therapy, one person would be spared a fall among every 16 people who participate in a program for 12 weeks.

Siu said there's not one particular exercise regimen that works best for preventing falls, and that people should talk to their doctors about finding an exercise or physical therapy program they'll stick to over the long run.

"I know from experience, if you recommend something someone had very little interest in, it's not going to get done," he said.

Siu said doctors can pick out patients who are at a higher risk of falling by informal assessments, such as watching how steady they are on their feet and asking them whether they've had a fall recently.

Physicians can also use a more formal test that includes timing how quickly people can get up from a chair, walk a few paces and return to the same spot.

The USPSTF recommends against more detailed assessments of these higher risk patients, such as evaluating their balance and if their homes have tripping hazards.

There seems to be only a minor benefit from doing an in-depth examination of risks and how to manage them, according to Siu -- and such an undertaking should be reserved for just those patients that a doctor feels would truly benefit, rather than widely applied to all patients at risk of falling.

SOURCE: http://bit.ly/L9cPi0 Annals of Internal Medicine, May 28, 2012.

Common Painkillers May Help Prevent Skin Cancer: Study

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TUESDAY, May 29 (HealthDay News) -- Taking nonsteroidal anti-inflammatory drugs (NSAIDs) -- which include medicine cabinet staples such as aspirin, Motrin and Aleve -- appears to significantly lower the risk for developing several major forms of skin cancer, a new Danish study reveals.

What's more, the apparent protective impact of both prescription and nonprescription NSAIDs on skin cancer risk seems to be stronger the longer someone takes them.

Over-the-counter NSAIDs are used to control pain, fever and swelling. NSAIDs also include prescription medicines called COX-2 enzyme inhibitors, such as Celebrex (celecoxib).

"Our study showed that users of common painkillers, known as NSAIDs, have a lower risk of the three major types of skin cancer, [including] malignant melanoma, basal cell carcinoma and squamous cell carcinoma," said study lead author, Sigrun Alba Johannesdottir, at the department of clinical epidemiology at Aarhus University Hospital in Aarhus, Denmark.

"The greatest effect," she noted, "was found for squamous cell carcinomas and malignant melanoma, especially when [these painkillers were] taken frequently and over a long time period."

The study appears in the May 29 online issue of the journal Cancer.

The authors noted that prior work supported the notion that NSAIDs may offer some measure of protection against cancer (most notably colorectal cancer), by specifically impeding the cancer-causing activities of COX-2 (cyclooxygenase) enzymes.

However, the team suggested that past investigations into how NSAIDs may affect skin cancer risk, in particular, had key design problems that undercut efforts to nail down any NSAID-skin cancer connection.

For the new study, the researchers analyzed prescription databases and health information registries including the Danish Cancer Registry and the Danish Civil Registration System.

The team focused on diagnostic and death records concerning nearly 2,000 cases of squamous cell carcinoma, about 13,300 cases of basal cell carcinoma and nearly 3,250 cases of malignant melanoma diagnosed between 1991 and 2009 when the patients were at least 20 years old.

In turn, prescription histories were gathered for both the cancer patient group and almost 179,000 healthy Danes. Records covered the use of both low- and high-dose aspirin (ranging from 75 milligrams to 500 milligrams), so-called "nonselective" NSAIDs (such as ibuprofen [Advil] and naproxen [Aleve]), and both older and newer types of COX-2 inhibitors. Researchers noted the number of prescriptions issued per patient and their length of use, with short-term use defined as fewer than seven years.

The result: The relative risk for squamous cell carcinoma was found to have dropped by 15 percent among those Danes who had filled more than two NSAID prescriptions, compared to those who had filled two or less.

Similarly, malignant melanoma risk fell by nearly as much (13 percent) among those filling more than two NSAID prescriptions.

However, the same dynamic was generally not seen with regards to basal cell carcinoma. But taking NSAIDs for long periods of time, and at relatively high doses, was associated with a reduced risk (between 15 and 21 percent), specifically for basal cell cases that manifested in skin regions that typically experience relatively little sun exposure (areas other than the neck or head).

On that front, long-term users and those who took NSAIDs at relatively higher doses appeared to benefit from the strongest protective effect, suggesting that when it comes to skin cancer risk reduction, more NSAID use is better.

The researchers pointed out that the NSAID-cancer connection could be affected by a range of lifestyle factors they did not account for, such as an individual's specific skin type or sun exposure patterns.

But Johannesdottir added that "we hope that our finding will inspire more research on skin cancer prevention. Also, the potential cancer-protective effect should be taken into account when discussing benefits and harms of NSAID use," she noted.

However, "other studies need to detail the association further and to examine benefits versus risks," she cautioned. "Meanwhile, the most important prevention against skin cancer remains sun protection."

Meanwhile, Dr. William Ting, a private practice dermatologist in San Ramon, Calif., praised the study despite agreeing that many factors are at play when it comes to skin cancer formation.

"Now we have a better understanding that inflammation also plays a significant role in cancer formation and even skin cancers," he said.

And, "this exciting article gives physicians and consumers a relatively simple way of diminishing one's risk of skin cancer by doing what most of us are doing already for heart health," Ting added. Ting also advised that people consult with their doctor before starting on any blood thinner.

While the study found an association between skin cancer risk and NSAIDs, it did not prove a cause-and-effect relationship.

More information

For more on NSAIDs and cancer, visit the U.S. National Cancer Institute.

Copyright c 2012?HealthDay. All rights reserved.

Antibiotics prevent UTIs better than probiotics

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NEW YORK (Reuters Health) - Antibiotics are still better than probiotics at preventing urinary tract infections, but at least "good bacteria" don't add to a person's antibiotic resistance, a new study concludes.

Recurring UTIs are common among some women and low-dose antibiotics are sometimes used to prevent them. The worry is that overuse of the drugs also reduces their effectiveness by making disease-causing bacteria like E. coli resistant.

"This is an increasing worldwide problem, resulting into less and less treatment options for (severe) bacterial infections in all countries of the world," Dr. Suzanne Geerlings, from the Academic Medical Center at the University of Amsterdam in The Netherlands and one of the new study's authors, wrote in an email to Reuters Health.

Geerlings and her colleagues recruited 252 women between January 2005 and September 2007 for a trial to compare the use of antibiotics and probiotics to prevent UTIs.

The participants, who lived in communities surrounding the medical center, were all postmenopausal -- a time when vulnerability to UTIs increases because of hormonal changes, according to the researchers.

All the participants reported having had at least three UTIs in the year before the trial began, and the average number was seven.

The women were separated into two groups of about the same size. One group took a single dose of the antibiotic co-trimoxazole (Bactrim, Septra and others) every day for twelve months, while the other group took two capsules containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, both types of beneficial bacteria, daily.

All the participants also took placebo pills so the patients and the people dispensing the pills wouldn't know who received which treatment -- to minimize any influence on the study's results.

The researchers then tracked how many UTIs occurred in each group of women over a year. They also collected vaginal swabs and samples of the women's urine and feces every month to test for the presence of good bacteria and infection-causing bacteria like E. coli.

In addition, women took a monthly survey asking about symptoms of UTIs, side effects, other infections and antibiotic use.

Overall, the antibiotics were slightly better at keeping UTIs at bay.

About 69 percent of the women in the group taking the antibiotic had one or more UTIs within the year. On average, the antibiotic group had 2.9 UTIs per woman.

As for the probiotic group, about 79 percent had a UTI within the year, with an average of 3.3 UTIs per woman.

The women taking the antibiotic also seemed to go twice as long without a UTI -- six months, compared with three months among women taking the probiotics.

Based on the women's urine and feces samples, however, resistance to a range of antibiotics seemed to increase within the first month in the antibiotic group.

Before the study, about 20 percent to 40 percent of E. coli in samples from all the women's bodies were resistant to co-trimoxazole.

At the 12-month mark, between 80 percent and 95 percent of the bacteria were resistant in the women taking the antibiotic.

Rates of resistant E. coli were slightly lower at 12 months in women taking the probiotics than when the study began.

Similar changes in antibiotic resistance were seen for a range of other antibiotics, including ciprofloxacin and gentamicin, among both groups of women -- which the researchers speculate might be because the same mechanism in certain bacteria allows them to resist several different drugs.

The absence of increased resistance among women taking the probiotics means that "lactobacilli may be an acceptable alternative for prevention of UTIs, especially in women who dislike taking antibiotics," the researchers wrote in the Archives of Internal Medicine.

The study, however, had several limitations.

More than 80 women dropped out of the study by the end of the year because of side effects and other reasons. A greater number of those taking the probiotics had diarrhea compared to those taking the antibiotics, for instance. Other reasons for dropping out included the participant not thinking the treatment was working, or she couldn't adhere to study's directions.

As a result, the researchers did not have the number of participants in each group they would have liked to give the findings statistical weight.

Despite the study's weaknesses, a commentary published in the same journal called the findings "exciting and compelling."

"I think we need to appreciate that the normal flora in our body is another system we need for good health and antibiotics disrupt it and leave lasting effects… We need to think of antibiotics as a situation that has some risk," Dr. Barbara Trautner, one of the commentary's authors, told Reuters Health.

Trautner, of the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, said that probiotics may be an acceptable alternative but they need further exploration.

Topical estrogen creams are sometimes used to prevent UTIs in menopausal women, but many women prefer to avoid using hormones.

In her commentary, Trautner wrote that 60 percent of women in the United States experience UTIs or bladder infections during their lifetimes, and they recur in about a third of those women.

"We don't have terrific preventive strategies so a probiotic approach would be beneficial and promising," Trautner said.

For right now, she said most women with recurring UTIs have exhausted any type of behavioral changes that might help prevent the infections, and are left with low-dose antibiotics as their only recourse.

SOURCE: http://bit.ly/JUywUA and http://bit.ly/JUyDzE Archives of Internal Medicine, May 2012.

Health Tip: Help Prevent Heart Disease

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(HealthDay News) -- You can't control all risk factors for heart disease, but living a healthy lifestyle and taking medication prescribed by your doctor can help prevent many of its dangerous risk factors.

The Womenshealth.gov website suggests these steps to help reduce your risk of heart disease:

Maintain healthy cholesterol and blood pressure.Quit or avoid smoking and drinking too much alcohol.Take steps to control diabetes.Maintain a healthy body weight.Get plenty of regular exercise and adhere to a regular sleep schedule.Control conditions such as sleep apnea and metabolic syndrome.

Copyright c 2012?HealthDay. All rights reserved.