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Alert Number 105

Special Care for Your Heart

Date: July 14, 2005

For a change, here is something that you can do to protect your health that is also pleasurable. As CLL patients we get so fixated on this darned disease that we forget we are also vulnerable to all the other ills that plague the rest of humanity. That includes cardiac disease.

It is important for you to realize that treating your CLL becomes a lot harder if there are "co-morbid complications". There is little doubt that you will handle therapy a lot better if you are in fighting trim to begin with, and your chances of good recovery are a lot worse if you go into therapy with a boat load of other problems. Right up there at the top of the co-morbid conditions to watch out for: skin cancer, heart disease, pulmonary disease, inadequate kidney and liver function. One of the experts that I talked to told me that most of the treatment related mortality associated with stem cell transplants happens in patients with these co-morbid complications. Makes sense to me!

We have discussed many times on our website the links between chronic inflammation and CLL. Here is a link in case you need a refresher course on this very important subject, it may make the difference between life and death: Chronic Inflammation. Inflammation can trigger a number of serious problems, which include pulmonary disease and congestive heart failure. Did you know chronic inflammation has serious consequences for inflammation of the heart and consequential cardiac disease? The bottom line is this: the majority of patients with CLL do not die of the CLL itself: they die while they are hospitalized on account of pneumonia and/or heart disease.

I like potato chips and junk food, just like the rest of you. But I also love chocolate, especially the dark and rich European variety. Below is an interesting report that says eating dark chocolate is good for your heart. So, if you are a CLL patient and a "chocoholic" like me, indulge without feeling guilty. If you are a caregiver to a CLL patient, you know what to get him / her on that special occasion! Remember, cheap chocolate with tons of sugar is kid stuff, go for the real thing: dark, strong, potent and full of the flavonoids that are good for your heart. And for an additional kick, why not make some "Harvey's chocolates", with the added benefit of EGCG (green tea extract)? Here is the link to the recipe: Harvey's Chocolates. Feel free to modify the recipe, reduce the sugar levels, etc. I am more an engineer than a gourmet cook and my recipes are designed for efficiency of operation, not subtle gourmet touches.

Hope you guys are having a great summer. PC and I were away on a long delayed and much needed vacation. But we are back on the job now and you can expect a flurry of new activity on the website. I hope you are ready as well to get back to the serious business of managing your CLL.

Be well,

Chaya
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Press Report

Dark Chocolate May Protect Cardiovascular System

Reuters Health Information 2005. © 2005 Reuters Ltd.

NEW YORK (Reuters Health) Jun 24 - The results of a study published in the June issue of the American Journal of Hypertension suggest that consumption of dark chocolate may exert a protective effect on the cardiovascular system in healthy subjects.

"Epidemiological studies suggest that high flavonoid intake confers a benefit on cardiovascular outcome," Dr. Charalambos Vlachopoulos, of Athens Medical School in Greece, and colleagues write. "Endothelial function, arterial stiffness, and wave reflection are important determinants of cardiovascular performance and are predictors of cardiovascular risk."

In a randomized, sham-procedure-controlled, crossover study, the researchers examined the effects of flavonoid-rich dark chocolate on the endothelial function, aortic stiffness, wave reflections, and oxidant status of 17 young, healthy volunteers over a 3-h period. The subjects consumed 100 g of a commercially available, procyanidin-rich dark chocolate.

Flow-mediated dilation of the brachial artery, aortic augmentation index, and carotid-femoral pulse wave velocity were measured, along with plasma levels of malondialdehyde and total antioxidant capacity to evaluate plasma oxidant status.

A significant increase was observed in the flow-mediated dilation of the brachial artery at 60 min (absolute increase 1.43%, p < 0.5), the authors report.

Chocolate consumption led to a significant decrease in the aortic augmentation index throughout the study (maximum absolute decrease 7.8%, p < 0.001). This indicated a decrease in wave reflections.

No significant change in pulse wave velocity was observed.

The team also found no significant changes in plasma total antioxidant capacity or malondialdehyde values during chocolate consumption or control session, indicating no alteration in the oxidant status.

"The predominant mechanism appears to be dilation of small and medium-sized peripheral arteries and arterioles," Dr. Vlachopoulos and colleagues suggest.

"The dilatory effect of chocolate under resting conditions (dilation of brachial artery, decrease in wave reflections) can be attributed to improved nitric oxide bioavailability, prostacyclin increase, direct effect on chocolate in smooth muscle cells, or activation of central mechanisms."

Am J Hypertens 2005;18:785-791.

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