- If you’re shelling out money for vitamin D pills or are considering doing so for better health, you may want to reconsider.
- guvendemir/Getty Images
- A recent meta-analysis of vitamin D supplements found that the pills don’t protect against heart disease risk like some believe they may.
- Like some prior research, the study suggests vitamin D supplements are unnecessary for healthy people.
- Other research has found vitamin D supplements can cause kidney damage and increase a person’s risk of death.
- Visit INSIDER’s homepage for more.
If you’re shelling out money for vitamin D pills or are considering doing so for better health, you may want to reconsider.
A meta-analysis published June 19 in JAMA Cardiology looked at over 83,000 people in 21 previous studies, about half of whom took vitamin D supplements for over one year. Specifically, the researchers wanted to find out if the study subjects who took the supplements had a lower risk of heart disease, stroke, or heart attack than the subjects who didn’t take vitamin D supplements, since some studies have suggested a link between low vitamin D levels and poor heart health.
Read more: Everything you need to know about vitamin D supplements – and whether you should be taking them
The researchers found, however, that people who were taking vitamin D supplements didn’t have a decreased risk of heart disease, stroke, or heart attack, nor were they any less likely to die of any cause. It’s important to note, however, that many of the studies the researchers included weren’t trying to find a specific link between heart disease and vitamin D consumption.
Still, the researchers write, “the findings suggest that vitamin D supplementation does not confer cardiovascular protection and is not indicated for this purpose.”
This isn’t the first study to show vitamin D supplements are unnecessary and even potentially dangerous
The meta-analysis isn’t the first time researchers have found vitamin D supplements to be ineffective for various health gains.
An April study from researchers at Tufts University looked at multiple supplements, including vitamin A, vitamin K, and zinc, and determined taking them offered no health benefits or risks, making them essentially a waste of money. But when they looked at vitamin D, they found people who took the supplement in 10 milligram daily doses, versus getting vitamin D through foods in a balanced diet, increased their overall risks for cancer and death.
“The potential harm of vitamin D supplement use among individuals without vitamin D deficiency needs to be further evaluated,” Dr. Fang Fang Zhang, a co-author of the study, said in a press release.
Although uncommon, there have also been reports of vitamin D supplements causing kidney damage.
A case report in Canadian Medical Association Journal, for example, looked at a man who told doctors he had been taking between eight and 12 drops of vitamin D daily for the past 2.5 years. As a result, he had kidney problems that landed him in the hospital, and he sustained permanent kidney damage, even after treatment.
Doctors said his overconsumption of the vitamin caused his calcium blood levels to skyrocket. If a person has too much calcium in their blood, it can cause their kidneys, heart, and brain to stop working properly and make their bones weak.
The Mayo Clinic reports that consuming 60,000 IUs of vitamin D daily for multiple months can lead to toxicity, which causes nausea, vomiting, bone pain, and kidney problems. The man who overdosed had 8,000 to 12,000 IUs of vitamin D every day for years, leading to similar consequences.
Together, these recent studies and case reports suggest most people who take vitamin D supplements don’t need it. If you currently take vitamin D or are considering it, talk with your doctor.
According to the Mayo Clinic, elderly folks, people with darker skin, and those who live in places with little sunlight may benefit from vitamin D supplementation, but they too should get a professional opinion first.
- A trio of new studies show that too little or too much sleep is associated with an increased risk for cardiovascular disease.
- Sleeping less than five hours per night raises the risk for a heart attack or stroke by about the same degree as smoking does, according one study in older men.
- This adds to a significant body of evidence that suggests regular sleep is essential for health.
Most of us know that not getting enough sleep is bad for us.
Yet many people believe their busy lives require that they skimp on sleep. As Elon Musk recently posted on Twitter at 2:30 a.m. (after being criticized by Ariana Huffington for working so many hours and sleeping so few), “I just got home from the factory. You think this is an option. It is not.”
But the lengthy list of negative ways that lack of sleep affects your body and brain continues to grow. According to several new studies presented Sunday at a meeting of the European Study of Cardiology, getting too little – or too much – sleep is associated with significant increased risk for cardiovascular problems including hardened arteries, heart attacks, strokes, heart failure, and more.
“We spend one-third of our lives sleeping yet we know little about the impact of this biological need on the cardiovascular system,” Dr. Epameinondas Fountas, one of the authors of a meta-analysis about the best amount of sleep for heart health, said in a news release.
Fountas’ team looked at 11 studies with more than 1 million participants, and their findings shed more light on the impacts of sleep deprivation. The results give us even more reasons to try to fit enough sleep into our lives.
- Etienne Oliveau/Getty Images
What happens if you don’t get enough sleep
Although individual needs may vary, sleep researchers generally say people should get seven to nine hours of shut-eye per night. That’s considered the amount that’s optimal for good cognitive performance, safety, and brain health, and for lower risk of cancer and death.
When it comes to cardiac disease, the authors of the meta-analysis found that the sweet spot for lowest risk was six to eight hours of sleep per night. Averaging less than that was associated with an 11% increased risk for dying from coronary heart disease or stroke at some point in the follow-up period of approximately 9.3 years, and getting more than that was associated with a 33% increase in risk.
Another study on sleep, conducted by a different team of scientists, was also presented at the European Society of Cardiology conference. Those researchers had people wear a waist-band monitor for one week to track their sleep patterns. The results suggested that people who got less than six hours of sleep per night or woke up frequently had about 27% more atherosclerosis: hardening in the arteries that can lead to blockage or narrowing and contribute to heart failure, stroke, or aneurysm.
Yet another new study presented at the cardiology conference reported on a group of 798 men from Gothenburg, Sweden, who provided information on how long they slept in a 1993 survey, when all participants were 50 years old. Twenty years later, the men who had said they slept less than five hours per night were found to have double the risk of a serious cardiovascular event. That increased risk for a heart attack or stroke is comparable to the effects of smoking or having diabetes.
- Andrew Burton/Reuters
Good reasons to get regular sleep
All of these new studies show an association, not a cause-and-effect relationship.
Pinpointing exact causal mechanisms is difficult, since a lack of sleep messes with our bodies in a number of ways that increase disease risk. One recent study, for example, found that not getting enough sleep changes genes in ways that promote obesity and impair metabolism. Other research has shown that sleep deprivation leads to inflammation, which may contribute to cardiovascular disease risk.
“More research is needed to clarify exactly why, but we do know that sleep influences biological processes like glucose metabolism, blood pressure, and inflammation – all of which have an impact on cardiovascular disease,” Fountas said.
Overall, the new research gives us even more good reasons to make sure we sleep enough (but not too much) on a regular basis.
“Having the odd short night or lie-in is unlikely to be detrimental to health, but evidence is accumulating that prolonged nightly sleep deprivation or excessive sleeping should be avoided,” Fountas said.
- The true effects of e-cigarettes on human health are just beginning to emerge.
- Risks of vaping include inhaling toxic metals like lead and potentially doubling one’s risk of a heart attack, according to a new study published by UCSF researchers.
- Despite these emerging health concerns, e-cig companies like Juul, the Silicon Valley startup recently valued at $15 billion, are booming.
Smoking kills. No other habit has been so strongly tied to death.
In addition to inhaling burned tobacco and tar, smokers breathe in toxic metals like cadmium and beryllium, as well as metallic elements like nickel and chromium – all of which accumulate naturally in the leaves of the tobacco plant.
It’s no surprise, then, that much of the available evidence suggests that vaping, which involves puffing on vaporized liquid nicotine instead of inhaling burned tobacco, is at least somewhat healthier. But vaping is linked with its own set of health risks, a spate of new research is beginning to reveal. Those risks include inhaling toxic metals like lead, becoming addicted to nicotine, and now, potentially doubling one’s risk of a heart attack.
That latest finding comes from a large study out of the University of California, San Francisco. The study suggests that people who vape every day may face twice the risk of a heart attack compared with people who neither vape nor smoke at all. The research also suggests that daily conventional cigarette smokers face three times the risk of a heart attack, while people who both vape and smoke (so-called “dual users”) face nearly five times the risk.
That should be a significant concern for e-cig users who also smoke cigarettes, Stanton Glantz, the lead author on the paper and the director of the Center for Tobacco Control Research and Education at the University of San Francisco, told Business Insider. It also adds to a growing list of health concerns faced by e-cig companies like Juul, the booming Silicon Valley startup recently valued at $15 billion.
‘We’re the first people to show a long term impact of e-cigarettes’
- Eduardo Munoz/Reuters
Glantz’ recent paper, published on Wednesday in the American Journal of Preventive Medicine, is one of the first studies of its kind to show a long-term health impact of e-cigarettes.
Business Insider spoke with Glantz in February when the peer-reviewed summary of his study was first made public.
He and his research team presented those findings early in an attempt to get the word out about the research – which he found deeply concerning – as soon as possible.
“We’re the first people to show a long term impact of e-cigarettes, and given that it’s consistent with what we know biologically about how vaping effects the heart, we wanted to get this out there,” he said.
Still, the study has a number of limitations, most notably the fact that it could not conclude that vaping (or even smoking, for that matter) caused heart attacks – only that the two were linked.
To arrive at the findings, Glantz and his research team looked at national survey data on 70,000 Americans which asked people about their use of e-cigarettes and regular cigarettes. It also asked if they’d ever suffered a heart attack. After controlling for factors that could muddle their results, like hypertension, the researchers found that people who vaped every day were twice as likely to have suffered a heart attack as people who didn’t vape or smoke at all. Daily smokers were three times as likely as non-smokers to have suffered a heart attack.
The people most at risk, however, are “dual users,” or people who both vape and smoke. Dual users faced approximately five times the risk of a heart attack as those who took up neither habit, the study suggested.
Other studies in animals and cells have suggested that vaping could stiffen the heart and blood vessels, potentially creating an increased risk of heart disease and heart attacks, but this was the first to line up those limited findings with actual health impacts in humans.
People who vape and smoke are most at risk
- Spencer Platt/Getty
Many e-cig manufacturers promote their devices as a tool for either quitting smoking or for “switching” from smoking conventional cigarettes to vaping, which is generally seen as less harmful. Juul, the San Francisco-based startup behind the most popular e-cig in America, encourages consumers to “make the switch” from traditional cigarettes to the Juul.
But the new study suggests that the people most vulnerable to an increase in heart attacks are those who make both smoking and vaping a daily habit. Glantz said this group of people also represent the largest population of e-cig users.
“E-cigarettes are widely promoted as a smoking cessation aid but for some, they actually make it harder to quit, so most people end up doing both,” Glantz said. “This is the dominant use.”
Juul, which was recently valued at $15 billion and is already rapidly expanding both in the US and internationally, has come under fire for a range of other health issues, namely its popularity among teens who are particularly susceptible to nicotine addiction.
“At Juul Labs, our definition of switching is aligned with the American Cancer Society, National Academy of Science, and Public Health England: Smokers should switch completely away from combustible tobacco,” a representative for the company told Business Insider.
“We are committed to helping current adult smokers who want to end their relationship with combustible cigarettes.”
Snowballing evidence of health concerns tied to vaping
- California Department of Public Health
Evidence still suggests that inhaling vapor is healthier than breathing in burned tobacco. Still, researchers urge people to recognize that e-cigs come with their own set of health concerns.
Chief among those issues is the high concentration of nicotine in e-cig fluid. This may be part of the reason why teens who vape are seven times more likely to smoke regular cigarettes than young people who never use e-cigs.
Ana Rule, a professor of environmental health and engineering at Johns Hopkins University, said the makers of these devices fail to address “the increased risk to this huge market they are creating among teenagers and young adults that never have smoked, and would have never even considered smoking” had they not vaped.
Researchers are also not convinced that e-cigs actually help adult smokers quit.
So far, the evidence suggests they don’t. In January, a study in the journal The Lancet found that e-cigs were linked with “significantly less quitting” among smokers. Several months later, a study in the Annals of Internal Medicine found that e-cig users were less likely than non-vapers to abstain from tobacco use over six months. And a study published in the journal PLOS One this month found no evidence that vaping helped adult smokers quit.
Nicholas Chadi, a clinical pediatrics fellow at Boston Children’s Hospital, spoke about the Juul at the American Society of Addiction Medicine’s annual conference in April.
“After only a few months of using nicotine, [these teens] describe cravings, sometimes intense ones. Sometimes they also lose their hopes of being able to quit,” Chadi said.
For these reasons, several nonprofit anti-tobacco agencies strongly oppose Juul, including the nonprofit Campaign for Tobacco-Free Kids and the California Department of Public Health. On Tuesday, Israel became the first country to ban Juul devices entirely, citing health concerns linked with the their high nicotine content. In a statement, Israel’s Health Ministry said the devices pose “a grave risk to public health.”
- REUTERS/Andrew Burton
- Bankers in their 20s and 30s are being admitted to the hospital more frequently with cardiac conditions and heart attacks, cardiologists in the UK told Business Insider.
- One doctor estimated he’s seen a 10% rise in bankers under 30 being admitted to the hospital in the last decade.
- One former banker shared her experience with Business Insider in which she suffered a cardiac event in her early-20’s after frequently working until 4 a.m.
- This all comes even as big banks are trying to reduce stress for junior employees.
As a second-year analyst at a major European bank, Laura frequently worked until 4 a.m., suffered a cardiac event, and was hospitalized three times in two years. She said she was told by doctors “if you keep working, you will die.”
Laura isn’t the finance professional’s real name. She asked Business Insider not to name her or the bank for fear of retribution. In describing her time at the bank, she said she worked day and night, and was stopped from taking sick days off even after getting a throat infection which eventually spread to her heart in a case of infective endocarditis.
In the early hours one Monday morning in 2015, she shot up in bed with pain in her chest. “I was having basically a heart attack,” she said. She previously had good health and didn’t take drugs.
She left the bank soon after.
“My husband told me to get out [saying] ‘the money’s not worth it,’” she said.
Young bankers are facing health issues
Young bankers in their 20’s and 30’s are being admitted to the hospital more frequently with heart conditions and heart attacks, cardiologists in the UK told Business Insider
Dr. Arjun Ghosh, a consultant cardiologist at Barts Heart Centre in London estimated that in the last decade, he’s seen a 10% rise in heart attacks among bankers under the age of 30. Around one in ten of his patients in this age range work in finance.
This is happening even as banks have put in measures to reduce the workload and stress of their junior staff, such as requiring Saturdays be taken off, following the death of a Bank of America intern in 2013.
Despite the recent efforts of big banks to reduce the working hours of their employees, Dr. Syed Ahsan, a cardiologist with a clinic in Canary Wharf, said he hasn’t seen evidence of change.
“In investment banking, I think whatever they [the banks] say… the hours and the pressure that is put on these guys is huge. So as much as they may be doing things to improve – I don’t think it’s changed at all,” he said.
To be sure, the increase in heart attacks among young bankers reflects similar trends in the population at large, the cardiologists say, although there hasn’t yet been formal research published to reflect this.
“It’s so common now – young people getting a heart attack. This is common enough not to be shocking… It’s not ‘Oh my god, they’re only 25!’,” Dr. Ahmed Elghamaz, a consultant cardiologist at London North West University Hospital said. “We are not shocked anymore.”
The increase is perhaps a result of an unhealthy, busy lifestyle with people working longer hours then they have in the past, Dr. Elghamaz said.
Doctors say they regularly see young bankers with two types of heart conditions – cardiac arrhythmia and myocarditis, both of which can lead to a fatal heart attack and can be made more likely by excessive work, stress, and drug use.
Myocarditis is an inflammation of the heart, which can be caused by stress or a viral infection that spreads through the body eventually infecting the heart, and arrhythmia is an uneven heart rhythm that can be brought on by tension and drug use.
The most common of the two heart conditions in bankers under 30 is myocarditis, Business Insider was told, and some of the cardiologists said they see it most in people that have a weakened immune system due to fatigue and unhealthy living.
The Whitehall Study, conducted by University College London’s Department of Epidemiology and Public Health, followed more than 10,000 British civil servants since the mid-1980s and showed that workers under 50 who were chronically stressed were 68% more likely to suffer a heart attack or chest pain.
There’s a culture of drug taking
A culture of drug taking in corporate environments also plays a factor.
Dr. Ashan said he recently treated a banker with heart problems in his late-20s. “He was using increasing amounts of cocaine working 12 to 14 hour a day, barely sleeping and he came in with episodes of blacking out and palpitations,” he said.
Trends that the three cardiologists shared with BI are anecdotal, but they called for more research to be done into cardiac conditions in young people, and their relationship to stress and the work environment.
Professor Alexandra Michel, a scholar in organizational and behavioral research at the University of Pennsylvania, has studied the health and psychology of investment bankers for over 15 years.
In one piece of research published in 2012 by Administrative Science Quarterly, she followed four groups of investment bankers at two different banks from the start of their careers and tracked their progression over 10 years. At their fourth year, every banker involved in the study had developed a mental or physical health problem.
“Not only are there are new types of illnesses, many of them having to do with burn-out, but also illness that people typically get later in life, they now get earlier in life. And so I’m observing in these young bankers a whole cluster of health issues,” Michel told Business Insider.
The work practices on Wall Street, which involve a super fast-paced environment in which employees are tied to their electronic devices 24/7, are spreading to other industries as well. This may bring about a whole new set of health issues to workers outside finance, Michel said.
The doctors called for more research to be done and action to be taken.
“There’s got to be more research into the direct impact of working conditions, working hours, work stress and how that correlates with cardiac events,” Dr. Ashan said.
An older man suddenly clutches at his chest, his face set in a grimace of pain. He reaches out for support, maybe falls to the ground.
Most of us witnessing this are likely to leap to the conclusion that this man is having a heart attack, and we probably would not be wrong.
Many of us – inured by depictions on television and cinema – are used to this dramatic presentation of what happens when part of our heart muscle dies due to lack of blood supply.
However, consultant cardiologist Dr Timothy Watson notes that Asians tend to present a bit differently when they have a heart attack.
“From the patient’s perspective, what the textbook says is they will get central, crushing chest pain, up to the jaw, down the left arm.
“The reality though is that Asians present differently. It can be profound sweating; sometimes it can be syncope, or sudden collapse,” he says.
The HSC Medical Centre, Kuala Lumpur, medical director explains: “Some of that may be cultural, but it may also be due to the high rate of diabetes (in the region).
“Patients with diabetes can have what we call, silent heart attacks, where they don’t get the same dramatic symptoms.”
While the end result may seem sudden, a heart attack is usually really an event that is years in the making.
Says Dr Watson: “Various things can cause a heart attack.
“The primary cause though, is the heart’s blood supply developing a cholesterol build-up.
“And that cholesterol build-up, called artherosclerosis, forms plaques within the heart’s blood supply, and over time, those can erode.
“When the plaques erode, exposing the cholesterol to the blood – they mix together, but they don’t mix together very well, resulting in the formation of blood clots.
“And those blood clots grow, and they suddenly occlude (block) the heart’s blood supply, causing a heart attack.”
The result of that, he says, is that the heart muscle supplied by that particular blood vessel is deprived of oxygen and nutrients.
Most people have three main arteries serving the heart muscles, along with their various sub-branches. “It only takes one branch to block to cause a heart attack,” he explains.
“So the heart muscle starts to suffer – it generates some pain, it contracts less well – and if that process occurs for more than a few minutes, you start to damage the heart cells – the myocytes – causing an infarction.”
An infarction means the death of cells or tissues due to blockage of their blood supply. A heart attack is medically known as a myocardial infarction.
And Dr Watson notes: “Heart cells can’t regenerate – once they’re dead, they’re dead.”
Improvements in treatment
Dr Watson poses for a photo in his hospital’s cardiac catheterisation lab. He emphasises that heart attack patients need to come in as early as possible for treatment, as after 12 hours, damage to the heart muscle is almost complete and the efficacy of treatment is dramatically reduced.
This is why it is crucial to get medical care as soon as possible once a heart attack has started.
“Outcome relates to how quickly treatment is instigated,” he says. “Because heart muscle damage is irreversible, the quicker you come to hospital, the quicker the treatment is given, the better the outcome.”
According to Dr Watson, about 100 years ago, medical professionals could already recognise a heart attack, but there was no treatment for it. Patients were just put to bed and fate would take its course.
Then, about the 1950s, things started to improve.
“We recognised that complications of heart attacks include heart rhythm disturbances, and that they were often fatal.
“Around that time, we developed the defibrillator – big box of tricks that shocks the heart – and we developed coronary care units (CCUs),” he says.
These developments went hand-in-hand. The CCUs, still in existence today, are specific wards where heart attack patients are placed, which are staffed with cardiac nurses who are able to recognise heart rhythm abnormalities and use the defibrillator to treat them.
“Because outcome for heart rhythm disturbances relate to time – give the shock of electricity (via the defibrillator) very quickly, and you have a very high survival rate.
“Wait 20 minutes, the survival rate goes down quickly,” says Dr Watson.
Over the following 50 years, research found that aspirin could “thin” the blood and that streptokinase could break down blood clots.
“In the early 1980s, we did trials testing aspirin and testing streptokinase in people that presented in hospitals with big heart attacks,” he explains.
Those trials showed that both aspirin and streptokinase individually improved survival rates, but given together, their effects were even better.
“So, that quickly became the standard of care for the large, Stemi (ST-elevation myocardial infarction) heart attacks,” he says.
However, there was a risk of increased bleeding when taking streptokinase, which could be fatal if it occurred in the head, as well as allergies to the drug and low blood pressure (hypotension).
Because of this, streptokinase was slowly replaced over the next few years with other clot-busting drugs that had less of its dangerous side effects.
These drugs all come under the category of tissue plasminogen activators (tPAs); their generic names typically ending with the suffix “-plase”.
“It interferes with the blood clot mechanism, helping the body break down the blood clot essentially,” explains Dr Watson.
However, he adds, that about a third of patients fail to respond to tPAs and continue to have a heart attack.
Even in the majority of patients in whom tPAs and streptokinase do work, he explains that the cholesterol plaques that cause the narrowing of the heart, or coronary, artery are still there.
“This is why we moved on to things that are better, which is primary angioplasty.”
- Angiogram stills of a heart attack patient’s right coronary artery before (top) and after an angioplasty that treated the blocked artery. — DR TIMOTHY WATSON
An angioplasty is a minimally-invasive procedure using a balloon-tipped catheter to enlarge a narrowing in an artery by blowing up the balloon once it is in place. It is typically used in coronary artery disease to enlarge narrowed coronary arteries.
Primary angioplasty means that the angioplasty is the main treatment given to the patient.
Originally conceptualised as an alternative to coronary bypass surgery, primary angioplasty was shown to have lower rates of death and subsequent heart attacks, as well as decreased risk of bleeding, compared to tPA treatment alone, in the Primary Angioplasty in Myocardial Infarction (Pami) trial published in 1993.
A subsequent study, published in 1999, that followed the patients for two years after their treatment, confirmed these rates held true after two years.
Dr Watson explains the procedure: “In primary angioplasty, the patient comes into the emergency department, they get given aspirin and a secondary blood-thinner tablet, which these days is either clopidogrel or ticagrelor.
“They are then very quickly moved to the cardiac catheter laboratory, where we do a coronary angiogram.
“There we introduce a plastic tube called a catheter, either through the wrist or the groin, and we take it up to the heart and take pictures of the heart’s blood supply with an injected iodine-based dye to see where the occlusion is.”
After that, the cardiologist will pass a very thin wire up to the heart the same way and through the blood clot that is blocking the artery. This wire serves as a means to introduce and guide other equipment to the blockage.
“Over the wire, you then have different strategies you can take.
“You can try and suck out the blood clot. But increasingly, we use a balloon – put a balloon across the blockage, blow it up, and then deflate the balloon and pull it back.
“And usually, that mechanical trauma you have caused to the blood clot is enough to restore blood flow,” he says.
He adds that the cardiologist may also put in a stent directly, but “usually after ballooning, you’d put a stent in anyway, because you’re still left with that residual cholesterol plaque”.
A stent is a tube-shaped device placed in an artery to hold it open and prevent it from narrowing again.
There are a few types of stents, including bare metal stents, which function solely as a scaffold to hold the artery open; bioresorbable stents, which are made of materials that will naturally dissolve after some time; and drug-eluting stents, which contain drugs that help prevent the artery from being blocked again.
Aside from avoiding the side effects of tPA treatment, Dr Watson says that a primary angioplasty has a success rate of about 95%-97%, with very good blood flow restored and a quicker effect, compared to medication.
The trick is that an interventional cardiologist and a cardiac catheterisation team needs to be on standby to do the procedure at any time of the day – something that is not currently practiced in Malaysia as far as Dr Watson knows.
However, he notes that the National Heart Association of Malaysia committee has been pushing for this service to be implemented – “this is something all the cardiologists feel very passionately about”.
The main obstacles, he says, are funding and infrastructure issues, as not all hospitals are equipped with the personnel and equipment to perform angioplasties.