MONDAY, Nov. 19 (HealthDay News) -- A new study shows that lowered income actually has an inflammatory effect on the body, which may explain why people of lower socioeconomic status are at higher risk of heart disease, researchers report.

The link between higher levels of inflammatory molecules in the blood and lower income is weight gain, spurred by poor diet and lack of exercise, the study suggests.

"Lack of physical activity could be a factor, but it is less likely than diet," said study author Nalini Ranjit, an investigator at the University of Michigan School of Public Health.

The findings are published in the Nov. 20 issue of Circulation.

Ranjit and her colleagues studied data on more than 6,800 U.S. adults in the Multi-Ethnic Study of Atherosclerosis. With an average income of $51,000, 38 percent of the participants were white, 28 percent black, 22 percent Hispanic and 12 percent Chinese-American.

The researchers measured levels of two molecules found in the blood that are associated with inflammation -- interleukin-6 and C-reactive protein.

They found a direct relationship between levels of these inflammatory biomarkers and income.

Some people in the study made as much as $140,000 a year, Ranjit said, and people whose income was $41,300 below that figure had levels of IL-6 and CRP that climbed 6 percent to 9 percent higher compared to the top earners. The strongest association between income levels and inflammatory markers was seen among whites, she added.

Inflammation has long been linked to cardiovascular disease. It causes damage to blood vessels that can lead to blockage that results in heart attack, stroke or other cardiovascular problems.

While overweight was the singlemost important explanation for the link between lower socioeconomic status and a greater inflammatory burden, other factors did play a role, Ranjit said. "In an earlier paper, we showed that a general attitude of cynical distrust was associated with higher inflammatory molecule levels", she said. In addition, among blacks, smoking was associated with higher inflammatory molecule levels and lower levels of education, she added.

Diet is well known to affect other risk markers for cardiovascular disease, notably blood cholesterol levels, but levels of the inflammatory molecules "are more sensitive markers than serum [blood] cholesterol," Ranjit said.

Among both whites and blacks, a link between education level and inflammatory markers was also found. For example, a drop of 4.6 fewer years of education was associated with 6 percent to 14 percent higher levels of IL-6 and CRP.

"Our results suggest that persons of lower socioeconomic position have greater inflammatory burden than those of higher socioeconomic position because of the cumulative effects of multiple behavioral, psychological and metabolic characteristics," the researchers concluded. "If the role of inflammation in the origin of multiple chronic diseases is confirmed, inflammation may represent a common element through which socioeconomic position is related to cardiovascular disease and other chronic disease common in aging."

More information

There's more on C-reactive protein at the American Heart Association  .

WEDNESDAY, Nov. 21 (HealthDay News) -- Soaring temperatures and high ozone levels work together to boost death risks from heart disease and stroke, researchers report.

They believe that global warming -- which brings more heat and more ozone -- may further increase the number of people who die of cardiovascular events.

"Temperature and ozone are strong factors in cardiovascular mortality during June to September in the Unites States," noted the study's lead author, Cizao Ren, from the Department of Epidemiology in the School of Medicine at the University of California, Irvine. "Temperature and air pollution combine to affect the health of large populations," he added.

Ren expects the problem will get worse as the earth becomes hotter. "Increases in temperature and air pollution will have a strong affect on health," he said.

His team based its findings on data on almost 100 million people living in 95 different areas across the United States from June to September.

These Americans were included in the National Mortality and Air Pollution Study, which tracked links between health and air pollution for the years 1987 to 2000.

Four million deaths from heart attacks or strokes occurred during the study period. Ren's team compared death rates against changes in temperature during one day.

Ozone was a common link, they found.

In fact, the higher the ozone level, the greater the risk of cardiovascular death attributable to high temperatures, Ren's team concluded.

Ozone levels ranged from an average of 36.74 parts per billion to 142.85 parts per billion, while daily temperatures ranged from 68 to around 107 degrees Fahrenheit.

When the ozone level was at its lowest, a 10-degree increase in temperature was associated with about a 1 percent increase in deaths from heart disease and stroke. However, when the ozone level was at its highest, there was a more than an 8 percent increase in deaths from heart disease and stroke, Ren's group found.

The findings are published Nov. 21 in the online edition of the journal Occupational and Environmental Medicine.

Ozone is a pollutant strongly linked to weather conditions, particularly the amount of ultraviolet light in the atmosphere. Ozone is generated by a reaction between airborne nitrogen oxides, volatile organic compounds, and oxygen in sunlight.

Exposure to high levels of ozone can affect the airways and the autonomic nervous system, making people more susceptible to the effects of temperature changes, Ren's team explained.

One expert agreed with the team's conclusions.

"This paper reinforces what we know -- that both temperature and ozone affect health, even to the extent that they affect mortality," said George Thurston, an associate professor of environmental medicine at New York University.

Global warming will increase both temperatures and pollution, Thurston added, because higher temperatures are conducive to the production of ozone. "This will be a growing problem," he said.

For the general public, the study raises questions about pollution and climate change, Thurston said. "The health effects may be even worse than thought," he said. "There are health benefits to reducing climate change."

Cutting back on the use of fossil fuels will help, Thurston said. "Reducing fossil fuel combustion will reduce climate change and pollution," he said. "We have seen the problem, and it's fossil fuel combustion. Now, all we have to do is come up with an alternative," he said.

More information

For more on heart disease, stroke and pollution, visit the American Heart Association  .

SUNDAY, Nov. 18 (HealthDay News) -- Doctors call them transient ischemic attacks, but they're more commonly known as "mini-strokes."

But make no mistake -- they can be deadly.

What's worse, many people who suffer such an attack rarely seek medical help. Just one in 10 people who experienced symptoms of a transient ischemic attack (TIA) sought the proper emergency care, a recent study published in the journal Stroke found.

Urgent care is critical, because some people who suffer TIAs will have a major stroke as soon as a day or two after the mini-stroke.

"People need urgent medical attention not for the symptoms that have passed but for what might be coming. Many people don't have a TIA before they have a stroke, so, in a sense, it's fortunate to have one. Now you have a chance to intervene," said Dr. Keith Siller, medical director of the Comprehensive Stroke Care Center at New York University Medical Center.

A transient ischemic attack occurs when blood flow to a part of the brain is temporarily blocked. When this occurs, symptoms come on suddenly and last anywhere from a few minutes to many hours. Symptoms may include:

• Sudden loss of speech or the ability to understand others.
• Rapid onset of weakness or numbness of the face, arm or leg, especially if it occurs on only one side of the body.
• Sudden loss of, or change in, vision that may occur in one or both eyes.
• Sudden difficulty walking or maintaining balance.

One thing you may not feel with a stroke is pain.

"Pain is not the right thing to look for in stroke," said Dr. Christian Schumacher, a neurologist at the Stern Stroke Center at Montefiore Medical Center in New York City. "People expect that like a heart attack, which is often painful, that stroke will cause pain. But stroke symptoms are, in most cases, without pain."

One exception, Siller added, is what's known as a hemorrhagic stroke. In this instance, you would likely experience a sudden, severe, unexplained headache. If you have such a headache or any of the above symptoms, Siller said, you should get to the hospital immediately.

Unfortunately, not many people realize the need for urgent care. In the Stroke study, British researchers surveyed 241 people who had experienced a transient ischemic attack. Just 44.4 percent sought medical care within a few hours of experiencing TIA symptoms, and only 10 percent sought any emergency medical care for their symptoms.

Another 44 percent waited longer than a day after their symptoms to seek care. People who had symptoms that lasted more than one hour -- and those with motor symptoms, such as difficulty walking -- were more likely to seek care. If the TIA symptoms occurred on a weekend, people were more likely to delay seeking treatment.

People "want to wait until they feel better, and most TIAs get better within an hour. If it gets better, people just think, 'Oh, that was weird,' and then they may call their doctor later," Schumacher said.

Or, they may just forget the symptoms altogether, Siller said. "When symptoms are gone, and they feel better, people forget. But, it's a misconception that if it went away, it doesn't mean anything," he said.

"Although TIA is called a mini-stroke; it's like having a real stroke. It's a warning sign for a major disabling stroke," Schumacher said.

Getting to the hospital as soon as possible after TIA or stroke symptoms begin is critical. The reason: Clot-busting drugs that can spare you many of stroke's worst effects -- including paralysis -- have to be administered within several hours after the onset of symptoms to be effective, Siller explained.

"If you wait, we can't do as much to help you," he said.

Siller also recommends discussing your risk factors with your physician. The most common risk factor for stroke is a past history of a stroke or a TIA. People with high blood pressure, high cholesterol, diabetes and those with heart disease also have an increased risk of stroke, making it even more important for them to act quickly if they have any TIA symptoms.

More information

The American Heart Association has more on transient ischemic attacks  .

FRIDAY, Nov. 9 (HealthDay News) -- People diagnosed with rheumatoid arthritis run a greater risk of developing heart disease.

But that risk can be spotted and hopefully modified by using the same criteria used to identify heart-disease risk in the general population, a new study suggests.

Those screening checks include high blood pressure, high cholesterol, older age, and family history of cardiovascular illness. And people diagnosed with rheumatoid arthritis (RA) should be screened using those risk factors as soon as possible following their diagnosis of RA, the study authors said.

"The bottom-line is that RA patients are at increased risk of heart disease," said lead researcher Dr. Hilal Maradit Kremers, a research associate with the Mayo Clinic Department of Health Sciences Research in Rochester, Minn.

"But we need to know how can we predict which RA patients are at a higher risk than others, so that we can then put more effort in the prevention of heart disease in these people," she added. "And so, here we attempted to do just that, by using a typical cardiovascular risk profile to predict heart disease among these patients."

Kremers and her colleagues presented their findings this week at the American College of Rheumatology annual meeting, in Boston.

The study findings follow a 2005 Mayo Clinic report that suggested that the increase in heart disease risk among RA patients may be due to the systemic inflammation brought on by the disease, which, in turn, prompts arterial plaque to form blood clots. The new findings also come on the heels of a Mayo Clinic study released last month that said RA patients are more than twice as likely to develop heart failure over a 15-year period than people who don't have the disease.

According to the Arthritis Foundation, rheumatoid arthritis is a chronic and often disabling disease with no known cause or cure that affects just over 2 million Americans. It's characterized by inflammation of the lining of the joints and, over time, can lead to joint damage, severe pain, and immobility.

Treatments -- such as nonsteroidal anti-inflammatories, analgesics and physical therapy -- focus primarily on controlling pain and limiting inflammation and joint destruction.

For the new study, Kremers and her colleagues set out to predict the onset of heart disease over the course of a 10-year period among more than 1,100 people, approximately half of whom had just been diagnosed with RA. The patients were 57 years old, on average, and nearly three-quarters were women.

The patients were evaluated on standard indicators for heart disease risk, as detailed by the American Heart Association. The indicators included: gender; having a family history of heart disease; having diabetes; and/or being black. Patients were also examined for other risk factors, such as high cholesterol and high blood pressure. Risky lifestyle habits -- including smoking, lack of exercise, and being overweight -- were also considered, the researchers said.

Based on the risk-assessment scores, the researchers assigned the patients to one of five different risk categories for heart disease -- ranging from very low to very high risk. Then the patients were tracked for an average of 12 to 14 years, during which time all incidences of heart attack, heart failure, heart surgeries, and cardiovascular-related deaths were noted.

The researchers found that while 85 percent of the RA patients between the ages of 50 and 59 had an intermediate or high risk for developing heart disease within 10 years of diagnosis, just 27 percent of comparable non-RA patients did. Among patients between the ages of 60 and 69 at the start of the study, 100 percent of the RA patients had an intermediate or high risk for heart disease, compared with 79 percent of non-RA patients.

When looking at just "high risk" among the 60 to 69 age group, the difference was even more dramatic: 85 percent for RA patients, compared to just 40 percent for non-RA patients.

The researchers concluded that more than half of RA patients 50 to 59, and all RA patients over the age of 60, had a 10 percent or greater risk of developing heart disease within 10 years of an RA diagnosis.

In light of the findings, the Mayo researchers are encouraging doctors to conduct heart-disease assessment screenings similar to the ones used in the study for each of their RA patients. These screenings should be done as soon as possible following an RA diagnosis and prevention strategies put into place, the researchers said.

"By simply doing the things that we already know, such as measuring blood pressure, blood sugars, and cholesterol -- all the standard things that we look at for the general population -- we can help identify the risk for a major cardiovascular event among the RA population," Kremers said.

Dr. Hayes Wilson, chief of rheumatology at Piedmont Hospital in Atlanta, said he endorsed the Mayo researchers' work.

"Anything that helps us characterize and categorize risk factors helps us in the treatment of the disease," he said. "And, until we can figure out what the smoking gun is, hopefully this advice will help us prevent cardiovascular disease or related diseases by helping RA patients better appreciate the risks they face."

More information

To learn more about rheumatoid arthritis, visit the Arthritis Foundation  .