Health

When measuring heart attack risk, one important red flag is often overlooked, doctors say

Published

1 year ago

November 27, 2023

When measuring heart attack risk, one important red flag is often overlooked, doctors say

Heart disease kills more people in the U.S. than any other cause of death — yet many Americans aren’t aware of one major genetic risk factor.

Lipoprotein(a), or Lp(a), is a protein that can greatly increase the chances of a heart attack when it’s present in high levels in the blood.

Fox News Digital spoke with Dr. Seth Baum, a cardiologist and chief scientific officer at Flourish Research in Boca Raton, Florida, about the importance of this often overlooked red flag.

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What is Lp(a)?

Along with low-density lipoprotein (LDL) and high-density lipoprotein (HDL), Lp(a) carries cholesterol through the blood.

The higher your levels of Lp(a), the more likely that cholesterol will build up in your blood vessels, increasing the risk of a heart attack or stroke.

Heart disease kills more people in the U.S. than any other cause of death — killing one person every 33 seconds. (iStock)

“Lp(A) contains a particle that leads to cardiovascular disease when it’s in higher concentrations,” Baum said.

There are three main elements of Lp(A) that put people at risk, the cardiologist said.

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The first is that it causes atherosclerosis, which is the buildup of fats and cholesterol in the arteries.

“Another is that it causes inflammation, which is a really important aspect of plaque progression and the risk of creating a heart attack,” Baum said.

The third component, which is also vital in the genesis of a heart attack or a stroke, is that Lp(a) increases the risk of clotting, the doctor said — which could block off the artery.

“We call it a triple threat,” Baum said.

Along with low-density lipoprotein (LDL) and high-density lipoprotein (HDL), Lipoprotein(a) carries cholesterol through the blood. (iStock)

Brett Sealove, M.D., chief of cardiology at Jersey Shore University Medical Center, agreed that Lp(a) is an indicator of a serious threat.

“These ‘bad cholesterols’ result in plaque build-up in the arteries and reduced blood flow to vital organs, including the brain, heart, kidneys and legs,” he told Fox News Digital.

“The evidence is irrefutable — Lp(a) is considered an independent risk factor in addition to classic heart disease risk factors.”

Who is at risk?

Approximately 20% of the population is at risk because of Lp(a).

“These are very, very big numbers,” Baum said. “And it’s even higher than that in certain genetic groups.”

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Black and South Asian Americans are at particularly high risk.

Despite that high prevalence, only a negligible share of Americans know their Lp(a) levels, the doctor pointed out.

“Probably fewer than 1% of the population has had their Lp(a) levels checked,” he estimated.

The higher your levels of Lp(a), the more likely that cholesterol will build up in your blood vessels, increasing the risk of a heart attack or stroke. (iStock)

Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution, a Cincinnati, Ohio-based company that offers cardiovascular and anesthesiology services to hospitals nationwide, noted that the cost and limited access to Lp(a) testing can be a problem.

“When trying to assess heart health risk, we often use risk screening tools that estimate an individual’s 10-year risk for developing significant cardiovascular disease,” he told Fox News Digital.

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“These calculators take into consideration age, gender, blood pressure, cholesterol levels and smoking history — but they do not include Lp(a),” he went on.

“Since these nationally accepted tools do not include the lipoprotein(a) in their score calculation, some insurance companies do not cover the cost of the testing.”

What can be done?

While LDL is genetically driven in a small subset of the population, Baum said, that type of lipoprotein is heavily influenced by diet and exercise.

Lp(A), however, cannot be controlled by lifestyle factors.

“There’s no therapeutic currently available that will reduce Lp(a),” Baum said.

Lp(A) levels can be tested through a simple blood sample. (iStock)

So why check the levels if there’s nothing that can be done?

“Even though we can’t directly reduce Lp(a), we can reduce other cardiovascular risk factors,” Baum said. “You’ll still have the Lp(a) risk, but you won’t have all the other stuff floating around — so you can mitigate some of the overall risk.”

In Europe and Canada, the doctor noted, there are guidelines in place that state everyone should have universal screening for Lp(a) levels.

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“In America, we’re a little behind the times — we still only check Lp(a) in patients who are at a higher risk,” he said.

Some doctors, like Baum, recommend testing Lp(a) levels for everyone, with the idea that if patients know they are more susceptible to heart attacks, they will be much more likely to reduce other cardiovascular risks.

Lp(A) levels can be tested through a simple blood sample.

At a minimum, Baum recommends getting Lp(a) levels checked at least once, and then again in the event of certain health changes. (iStock)

The levels tend to be relatively stable throughout the patient’s lifetime, the doctor said, but some elements can shift the Lp(a) a little in either direction.

“For example, going through menopause can dramatically increase Lp(a) levels, as can low thyroid or kidney disease,” Baum noted.

At a minimum, the doctor recommends getting Lp(a) levels checked at least once, and then again in the event of certain health changes.

“Probably fewer than 1% of the population has had their Lp(a) levels checked.”

Sealove agreed that patients should have their Lp(a) checked at least once as a screening test — “especially for those with a family history of heart disease and in conjunction with other laboratory parameters, including the standard lipid panel and other metabolic tests.”

In Serwer’s opinion, the decision of whether to test Lp(a) levels is a personal one that should be discussed with a medical provider.

“Before any medical test is ordered, it is important to know what you’re going to do with that information,” he told Fox News Digital.

Researchers are working to better understand Lp(a) and its role in diagnosis, risk assessment and potential therapeutics. (iStock)

“If knowing the Lp(a) level will make a difference or alter medical decisions, then it may be beneficial to measure.”

Regardless of the Lp(a) level, Serwer strongly recommends reducing cardiovascular risk factors with lifestyle, diet and exercise.

“The best way to combat atherosclerotic disease is to avoid it entirely — and the best way to do that is to start a healthy lifestyle as early as possible.”

Future of Lp(a) therapy

There is one therapy, called lipoprotein apheresis, that involves removing Lp(a) from the blood using IVs.

“It’s a technique we use to basically cleanse the blood of bad lipoprotein,” Baum said.

There are some drugs in development to treat high Lp(a).

Baum has a lipoprotein apheresis center in South Florida, and there are more than 40 other centers around the country.

This therapy is only available to a small number of patients, however.

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“We pretty much limit these for people who are very, very high risk,” Baum noted.

There are some drugs in development to treat high Lp(a), said Baum, who is heavily involved in clinical research.

“Those of us who know about these studies are very excited, because there is a real possibility that we’re going to do something significant in the not-too-distant future — that we’re going to have a therapeutic drug to reduce the risk of elevated Lp(a),” Baum said.

Regardless of the Lp(a) level, Serwer strongly recommends reducing cardiovascular risk factors with lifestyle, diet and exercise. (iStock)

Sealove reiterated that researchers are working to better understand Lp(a) and its role in diagnosis, risk assessment and potential therapeutics.

“Currently, several clinical trials are underway that target Lp(a), with more long-term outcome trials to come,” he told Fox News Digital.

“Until these treatments become available, patients and doctors should focus on optimizing traditional risk factors and educating themselves about the impact of Lp(a) on cardiovascular health.”

For more Health articles, visit www.foxnews.com/health.

Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital.

Health

Nutritionists react to the red food dye ban: 'Took far too long'

Published

33 minutes ago

January 16, 2025

Press Room

Nutritionists react to the red food dye ban: 'Took far too long'

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The U.S. Food and Drug Administration (FDA) announced a ban this week on red dye No. 3, or erythrosine, from foods and oral medications due to a potential cancer risk.

Food manufacturers have until Jan. 2027 to remove the dye (Red 3) from their products, and drug manufacturers have until Jan. 2028, the Associated Press reported.

The dye was removed from cosmetics nearly 35 years ago for the same cancer-related concerns.

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Following the Wednesday announcement of the new ban, nutritionists and other health experts applauded the removal of the additives from America’s food supply.

Los Angeles-based registered dietitian nutritionist Ilana Muhlstein shared excitement about the FDA “finally” banning the synthetic dye that has been in candy, cereals and strawberry-flavored drinks for “far too long.”

Red 3 can be found in a variety of food products, most commonly candies and colorful sweets. (iStock)

“What is wild is that this decision comes over three decades after the same dye was banned in cosmetics like lipstick because there was enough evidence linking it to cancer in animals,” she told Fox News Digital.

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“For years, consumer advocacy groups and researchers have pushed for this change, citing not only cancer risks but also potential links to hyperactivity and ADHD in kids.”

Certified holistic nutritionist and The Power of Food Education founder Robin DeCicco, based in New York, commented that “it’s about time” Red 3 was banned.

A certified holistic nutritionist (not pictured) warned that red dye No. 3 appears in some products that “you’d never expect.” (iStock)

“It never made sense to me why the dye was taken out of lipsticks and blushes 30 years ago but has been allowed to be in our food supply,” she reiterated to Fox News Digital. “There has been evidence of the dye causing cancer in rats for decades.”

“Our kids deserved better, and it’s frustrating that it took this long for action to be taken.”

While the ban is an “obvious win for public health,” she still feels “frustrated” that it took so long, she said.

“The FDA became aware of the risks in the 1980s, and other countries, like those in the EU, banned red dye No. 3 years ago,” she noted. “Yet big food manufacturers lobbied hard to delay this decision because these artificial dyes are cheap, convenient and profitable.”

Red dye No. 3 is often used in strawberry flavoring, according to experts. (iStock)

The dye was commonly used in products that are primarily marketed to children, she noted, such as colorful lollipops, candies and breakfast cereals.

“Our kids deserved better, and it’s frustrating that it took this long for action to be taken,” Muhlstein added.

‘Stay informed’

The ban is a “step forward,” but Muhlstein said it’s also a reminder to “stay informed about what we’re feeding our families.”

Red dye No. 3 is included in other products that aren’t so obvious, including some pre-packaged vegan meats, fruit cups, mini muffin snacks, mashed potatoes, yellow rice and sugar-free water flavors, according to experts.

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DeCicco encouraged consumers to always read the ingredient label and to look for natural replacements for these products.

The dye was commonly used in products that are primarily marketed to children, such as colorful lollipops, candies and breakfast cereals. (iStock)

“It’s not about deprivation or restriction – I always say it’s about eating foods with high-quality ingredients,” she said. “The ingredients matter more than anything else, and they’re out there.”

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“I have worked with many families with kids who have ADHD, and removing sugar and artificial food dyes and additives can in some cases lessen symptoms (as one part of treatment),” DeCicco added.

Colorful food without carcinogens

While nutritionists recommend that consumers stay away from foods that contain red dye or erythrosine on the label, there are healthier, natural alternatives to keep food fun.

Using alternatives for red dye like pomegranate juice or fruit powder can keep food fun, according to nutritionists. (iStock)

Muhlstein recommended adding 1 to 2 tablespoons of pomegranate juice to a baking recipe, such as vanilla cake, to give the batter a natural red hue.

She also suggested mixing crushed-up, freeze-dried strawberries into white frosting or whipped cream.

“Beetroot powder, hibiscus powder and even mashed raspberries are great alternatives, too,” she added.

Fox News Digital’s Melissa Rudy contributed reporting.

Health

Mom’s Gripes About Sister-in-Law Put Daughter in a Bind

Published

8 hours ago

January 16, 2025

Press Room

Mom’s Gripes About Sister-in-Law Put Daughter in a Bind

My mother is hypercritical of my brother’s wife, to the point that she blames my sister-in-law for my brother’s “failings” (not getting a better job, not taking better care of his health, etc.). It has gotten worse now that there are grandchildren. My mother constantly criticizes how my sister-in-law is raising the kids, who are lovely and adore their grandparents.

Although my mother will occasionally raise criticisms with my sister-in-law and brother, I am mostly her audience.

I have a great relationship with my sister-in-law, and when my mother goes off on one of her rants, I defend her. I tell my mother how lucky she is to have such wonderful grandchildren, and point out that my brother is an adult who makes his own decisions. This just leads to an argument between my mother and me.

When I finally told my mother how much it hurts me to hear her say these things about my sister-in-law, she said that she needed to air her frustrations with someone. I want to be there for my mother, but I don’t like being put in this position. How do I navigate this?

From the Therapist: The short answer to your question is that you can navigate this by no longer engaging in these conversations. But I imagine you already know this. What you might be less aware of is that you aren’t being “put in this position” of supportive daughter, protective sister-in-law and unwilling confidante. You’ve chosen it, and it’s worth examining why you’ve signed up for a job you don’t want — and what makes it hard to resign.

Usually when we find ourselves repeatedly engaging in uncomfortable family patterns, it’s because they echo familiar roles from our childhood. It sounds as if you’re struggling with enmeshment, a relationship pattern in which boundaries between family members become blurred or are nonexistent.

Think of enmeshment as being like two trees that have grown so close together that their branches have become intertwined. While this might look like closeness, it actually prevents either tree from growing in a healthy way. In your case, your mother’s emotions and grievances have become so entangled with your own emotional life that it’s hard to distinguish where her feelings end and yours begin.

You mention wanting to “be there” for your mom even though these conversations hurt you. Many adult children who struggle to say no to their parents grew up serving as their parents’ emotional support system, or absorbing their parents’ feelings, even at the expense of their own. When you told your mother how much her venting hurt you, she responded not by acknowledging your feelings, but by asserting her need to “air her frustrations.” Her response reveals something important: She sees you as a vessel for her emotional overflow rather than as someone with valid feelings of your own. And yet, despite your hurt, you’re still more concerned about her feelings than yours.

You’re asking how to navigate this situation, but I think the deeper question is: How can you begin to value your own emotional needs?

You can start by reframing what it means to make a reasonable request, which is essentially what setting a boundary is. A boundary isn’t about pushing someone away. Instead, it’s about making a bid for connection. It’s saying: “I want to feel good being close to you, but when you do X, it makes me want to avoid you. Help me come closer.”

Establishing a boundary consists of three steps:

State the issue and the desire to come closer (what will make this possible): “Mom, I love you and want to support you, but these conversations about my sister-in-law put me in an impossible position and make me want to avoid talking with you, which I know isn’t what either of us wants. I’m happy to talk about other things together, but in order to keep our relationship strong, I need this topic to be off limits.”
Set the boundary (what you will do): “If you’re struggling with their choices, I’m happy to support you in finding a therapist who can help you work through these feelings. But if you bring up these frustrations with me, I’m going to end the conversation and we can talk another time about other things.”
Hold the boundary (do what you say): A boundary isn’t about what the other person will or won’t do. A boundary is a contract with yourself. If you say you’ll end the conversation when your mom brings up your sister-in-law, you need to hold that boundary every single time. If you end the conversation only 90 percent of the time, then why would the other person honor your request when 10 percent of the time, you can’t honor it yourself? Honoring your request might sound like: “Mom, I’m going to end the conversation now because I’m not comfortable talking about my sister-in-law. I love you, and we’ll talk later.”

If you start to feel guilty, remember that just because someone sends you guilt doesn’t mean you have to accept delivery. Remind yourself that when you become your mother’s outlet for criticism of your sister-in-law, you’re participating in a cycle that strains loyalties and causes you personal distress. And keep in mind that being a good daughter means setting boundaries that encourage our parents to grow, rather than enabling patterns that harm our family relationships.

Want to Ask the Therapist? If you have a question, email askthetherapist@nytimes.com. By submitting a query, you agree to our reader submission terms. This column is not a substitute for professional medical advice.

Health

Cancer death rates decline yet new diagnoses spike for some groups, says report

Published

9 hours ago

January 16, 2025

Press Room

Cancer death rates decline yet new diagnoses spike for some groups, says report

Alcohol linked to 7 types of cancer

Dr. Nicole Saphier joins ‘America’s Newsroom’ to discuss the surgeon general pushing for cancer warning labels on alcohol and the CDC warning of norovirus cases surging in parts of the U.S.

A major annual cancer report has revealed a mix of good news and points of concern.

Cancer diagnoses are expected to exceed two million in 2025, with approximately 618,120 deaths predicted, according to the American Cancer Society’s annual cancer trends report, which was published today in CA: A Cancer Journal for Clinicians.

ACS researchers compiled data from central cancer registries and from the National Center for Health Statistics.

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While mortality rates have declined, certain groups are seeing a spike in diagnoses, the report noted.

Cancer diagnoses are expected to exceed two million in 2025, with approximately 618,120 deaths predicted. (iStock)

“Continued reductions in cancer mortality because of drops in smoking, better treatment and earlier detection is certainly great news,” said lead author Rebecca Siegel, senior scientific director of surveillance research at the ACS in Georgia, in a press release.

“However, this progress is tempered by rising incidences in young and middle-aged women, who are often the family caregivers, and a shifting cancer burden from men to women, harkening back to the early 1900s, when cancer was more common in women.”

Overall decline in death rates

Cancer death rates dropped 34% between 1991 and 2022, according to the ACS report.

That equates to approximately 4.5 million deaths avoided due to early detection, reductions in smoking, and improvements in treatment, the report stated.

Cancer death rates dropped 34% between 1991 and 2022.

Several factors likely contributed to this decline, noted John D. Carpten, Ph.D., chief scientific officer at City of Hope, a national cancer research and treatment organization in California.

“I think a big one is smoking cessation and the battle against lung cancer, which has always been the most common form of cancer and is tied to tobacco use,” Carpten told Fox News Digital in an on-camera interview.

“Screening programs are a critical component of early detection, and expanding access to these services will save countless lives.” (iStock)

“But without a doubt, I think new and better methods for early detection, and screening for colorectal cancer and other forms of the disease, have also allowed us to see a decrease.”

Lifestyle improvements have also helped to decrease mortality, he said, along with the development of new and better therapies for cancer.

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Despite overall declines in mortality, the report revealed that death rates are rising for cancers of the oral cavity, pancreas, uterine corpus and liver (for females).

Some common cancers have also seen an increase in diagnoses, including breast (female), prostate, pancreatic, uterine corpus, melanoma (female), liver (female) and oral cancers associated with the human papillomavirus, the report stated.

Increased diagnoses among certain groups

Diagnoses for many cancer types are increasing among certain groups.

Cancer rates for women 50 to 64 years of age have surpassed those for men, the report revealed. For women under 50, rates are 82% higher than males in that age group.

The report revealed that diagnoses of colorectal cancer in men and women under 65 and cervical cancer in women between 30 and 44 years of age has increased. (iStock)

As far as what is influencing the “disconcerting trend” in women’s cancers, Carpten said it is likely “highly nuanced” and will require additional research.

“The decrease in fertility and increases in obesity that we’ve seen are risk factors for breast cancer, especially in postmenopausal middle-aged women,” he said.

“But there could be other modifiable risk factors at play, like alcohol and physical activity.”

Cancer rates for women 50 to 64 years of age have surpassed those for men.

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Another trend in the increase in early cancers is occurring in individuals under the age of 50, Carpten noted.

In particular, the report revealed that diagnoses of colorectal cancer in men and women under 65 and cervical cancer in women between 30 and 44 years of age has increased.

The report also discusses inequities in cancer rates among certain ethnic groups, with Native American and Black people experiencing higher diagnoses of some cancer types.

“Progress against cancer continues to be hampered by striking, wide static disparities for many racial and ethnic groups,” said senior author Dr. Ahmedin Jemal, senior vice president of surveillance and health equity science at the ACS, in the release.

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The report shows mixed trends for children, with diagnoses declining in recent years for patients 14 years of age and younger, but rising for adolescents between 15 and 19.

“Mortality rates have dropped by 70% in children and by 63% in adolescents since 1970, largely because of improved treatment for leukemia,” the ACS stated in the release.

Pancreatic cancer a growing concern

The ACS report also warns about “lagging progress” against pancreatic cancer, the third-leading cause of cancer death in the U.S.

The ACS report also warns about “lagging progress” against pancreatic cancer, the third-leading cause of cancer death in the U.S. (iStock)

Rates of diagnoses and deaths from the disease type are on the rise.

“Pancreatic is an incredibly deadly form of cancer,” Carpten said.

One of the main issues with pancreatic cancer, he said, is that it sometimes can grow in an individual for up to 10 years before it’s detected.

“If we can identify those cancers when they’re at at a curable stage, we can improve outcomes.”

One of the best opportunities for beating pancreatic cancer is early detection, Carpten said.

“By the time those cancers have advanced, they’ve spread to the liver or other organs, and they’re almost impossible to cure at that stage,” he said.

“If we can identify those cancers when they’re at a curable stage, we can improve outcomes.”

‘It takes a village’

Making progress in fighting cancer “takes a village,” Carpten told Fox News Digital.

“It will require partnerships between the community, the health care system, cancer researchers, government, industry — we all have to work together if we want to continue to see a decrease and an ultimate increase in cures,” he said.

“We all have to work together if we want to continue to see a decrease and an ultimate increase in cures,” a cancer researcher said. (iStock)

Dr. Wayne A. I. Frederick, interim chief executive officer of the American Cancer Society and the American Cancer Society Cancer Action Network (ACS CAN), stated that the report highlights the need to “increase investment in both cancer treatment and care, including equitable screening programs.”

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“Screening programs are a critical component of early detection, and expanding access to these services will save countless lives,” he said in the release.

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“We also must address these shifts in cancer incidence, mainly among women. A concerted effort between health care providers, policymakers and communities needs to be prioritized to assess where and why mortality rates are rising.”

Fox News Digital reached out to the ACS for further comment.

Melissa Rudy is senior health editor and a member of the lifestyle team at Fox News Digital. Story tips can be sent to melissa.rudy@fox.com.