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Marital Stress Linked to Heart Disease

(HealthDay News) -- When married couples lose their cool with one another, it may take a toll on their hearts, too, researchers have found.

What's more, the damage that's wrought may depend on how they lose it, according to study leader Tim Smith, a professor of psychology at the University of Utah.

For women, hostility appears to be the culprit. Wives who were hostile in disagreements with their spouses were more likely to have atherosclerosis, often referred to as hardening of the arteries, Smith and his colleagues discovered. Levels of calcification were particularly high among those women whose husbands also were hostile.

Among husbands, atherosclerosis was more common when either they or their wives acted in a controlling manner, the research team said.

Whether it's social conditioning or some other factor that causes women to be influenced by hostility and men by issues of control is uncertain, Smith said. It's hard to separate biological, psychological, and social/cultural processes, he explained, but social conditioning "would certainly play a role."

Smith and his colleagues first presented their research at a meeting of the American Psychosomatic Society.

"There are well-documented differences in the ways that men and women talk and relate to one another, so finding gender-linked differences related to heart risks makes sense to me," said Janice Kiecolt-Glaser, professor and director of the Division of Health Psychology at Ohio State University College of Medicine.

She and husband Ronald Glaser, an Ohio State professor of molecular virology, immunology and medical genetics, have collaborated on a series of studies over the years examining the ways stress can affect the human immune system. Some of their work has focused on the body's ability to heal from wounds after exposure to stressful situations.

One study, for instance, found that a married couple's typical argument can delay wound healing by at least a day. Highly hostile couples healed at rates that were 60 percent lower than those with lesser hostility levels. Blood samples take from those highly hostile couples showed increased levels of certain "cytokines," or proteins, including interleukin-6, which stimulates the healing process but also has been linked to long-term inflammation.

"And sustained elevated levels of pro-inflammatory cytokines have been linked to a variety of age-related diseases, including cardiovascular disease, so our data support their [Smith and colleagues] findings," Kiecolt-Glaser said.

Smith's study involved 150 healthy married couples between 60 and 70 years of age who were paid $150 to participate and received free CT scans of their coronary arteries to check for any calcification that could lead to future risk of heart attack. Couples were recruited through newspaper advertisements and a polling firm.

The couples were videotaped while discussing a sensitive subject in their marriage, such as money, children, vacations or household duties. Graduate students later coded those conversations to reflect how friendly or hostile the couples were and how submissive or controlling.

Two days after the discussions, the couples had CT scans yielding a score for each person indicating the amount of plaque build-up in the arteries that supply the heart.

The finding: "In our data, it [marital discord] was as large an effect [for atherosclerosis], statistically, as traditional risk factors like smoking, cholesterol, blood pressure, activity level, etcetera, but smaller than the effect for age and sex," Smith said.

So, add marital stress to the risk factors people should be aware of as they consider their overall risk for heart disease, Smith explained.

"Besides all the usual and very important biomedical and behavioral risk factors people should consider in evaluating their level of risk, and any possible risk-reducing plan, they should consider chronic stress and negative emotions," he advised.


Broccoli sprout extract protects skin from UV rays

CHICAGO (Reuters) - Most people know eating broccoli is good for you but it also can help skin cells fend off damage from harmful ultraviolet radiation, U.S. researchers said on Monday.

The extract, derived from newly sprouted broccoli seeds, reduced skin redness and damage by more than one third compared with untreated skin, they said. The extract already has been shown to help skin cells fight UV damage in mice.

"This is a first demonstration that a human tissue can be protected directly against a known human carcinogen," said Dr. Paul Talalay of Johns Hopkins University, whose study appears in the Proceedings of the National Academy of Sciences.

"This is not a sunscreen," Talalay said in a telephone interview. Instead, the extract helped fortify skin cells to fight the effects of UV radiation.

Unlike sunscreens, which provide a physical barrier against UV rays by absorbing, blocking or scattering the light, the extract helped boost the production of protective enzymes that defend against UV-related damage, Talalay said.

He has been studying sulforaphane -- a compound in broccoli sprout extract -- for more than 15 years. It has been shown to prevent tumor development in a number of animals treated with cancer-causing agents.

Talalay and colleagues tried it on six people, testing different doses of the extract on several small patches of skin, which was then exposed to a short pulse of UV radiation sufficient to cause varying degrees of sunburn.

They compared the redness of the skin in the treated and untreated areas. "That redness is a measure of a series of processes that go on in the skin which are harmful, including DNA damage," Talalay said.

At the highest doses, the extract reduced redness and swelling by an average of 37 percent.

The effect was long-lasting, Talalay said. "Two days after we stopped treatment, there was still an effect," he said.

The effect varied widely among the volunteers, ranging from 8 percent to 78 percent protection, due to genetic differences.

"What we have shown is important because it works in humans," Talalay said. "How it should be applied to humans -- that requires further work."

The extract might be useful as a means of protecting against exposure to UV radiation, especially in people with suppressed immune systems who are most at risk for skin cancer, such as transplant patients, Talalay said. But it is no substitute for sunscreen.

"It does not prevent the radiation from penetrating into skin cells," he said.

Skin cancer is the most common cancer in the United States, affecting more than 1 million Americans every year, according to the National Cancer Institute. It kills more than 10,000 people each year, representing about 4 percent of all cancer deaths.

The ABCs of CPR

More than 900 Americans die because of sudden cardiac arrest every day, according to the American Heart Association (AHA). Between 75 percent and 80 percent of all sudden cardiac arrests occur at home, and survival does depend on how quickly defibrillation, either through CPR or an automated external defibrillator (AED), can be administered. With every minute that passes an individual's rate of survival drops by seven to ten percent. After several minutes of no treatment, resuscitation is almost impossible.

CPR is as simple as ABC, as you'll see from a review of the procedures recommended by the AHA below.

First, of course, check to see if the person is responsive. Gently shake the victim and shout, "Are you okay?" If you get a response, you don't need to perform CPR. If you get no response, dial 9-1-1 or point to a bystander and ask that individual to call 9-1-1.

Then begin the ABCs of CPR.

A: Airway
If the person is unresponsive, open the airway. If the person has no head or neck injuries, lift the chin with one hand and push down on the forehead with your other hand to tilt the head back. Place your ear near the mouth and listen and feel for breath; at the same time, look at the chest to see if it's rising and falling.

B: Breathing
If the person isn't breathing normally, give two rescue breaths by keeping the head tilted, pinching the nose closed, and placing your mouth around the victim's mouth. Give the victim two slow, full breaths (about two seconds each) while watching to see that the chest rises with each breath. After giving those two breaths, check for signs of circulation, including breathing, coughing, movement or response to gentle shaking. Continue keeping the head tilted while you place your ear near the mouth. Look, listen and feel for signs of breathing while watching for movement. The AHA doesn't recommend trying to find a pulse.

C: Circulation
If you don't detect circulation, begin chest compressions. Place the heel of one hand in the center of the chest between the victim's nipples with the heel of your second hand on top. Position your body directly over your hands, elbows locked. For an adult victim, apply 15 compressions, pushing the breastbone down about two inches with each thrust. Allow the chest to return to normal between compressions. Use the full weight of your body-don't be scared about cracking ribs-and don't bend your elbows. After 15 compressions, give two more rescue breaths. Repeat this pump-and-blow cycle three more times for a total of 60 compressions. Recheck for signs of circulation. If you don't see any, resume the pump-and-blow cycle until circulation resumes or help arrives.

Remember these three things when administering CPR:
  1. Breathe at a normal rate
  2. Compress hard
  3. Try not to let too much time lapse between compression cycles
How an AED Can Save Lives
While CPR is still the most common method to resuscitate victims after cardiac arrest, using an automated external defibrillator (AED) in conjunction with CPR may prove to be more effective. An AED is a computerized device that delivers an electric shock to the heart. Numerous public facilities, including health clubs, airports and shopping malls, are now putting AEDs on site. As with CPR, training is required to use an AED, but because the device uses voice prompts, lights and text messages to walk a rescuer through the process, it's easy to learn. With CPR alone, survival rates hover around five percent. Yet add an AED to the scenario and survival rates rise significantly.

That doesn't mean you should underestimate the power and contribution of CPR. Start CPR immediately and if possible, send someone else to call 9-1-1 and get the AED. Then continue CPR until the AED is ready.

Getting Certified in CPR and AED

If you're looking for certification options, ACE has an American Heart Association course for you. The eight-hour Heartsaver First Aid with CPR and AED course is offered four times a year at select cities throughout the country and is taught by ACE-certified instructors. The certificate is valid for two years.

The complete ABCs of CPR first appeared in the April/May 2005 issue of ACE Certified News.

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