Is Heart Disease in ME/CFS and FM Patients Future?

What risk factors do you have for heart disease?

  • Obesity

    Votes: 24 23.5%
  • Smoking

    Votes: 9 8.8%
  • Past menopause

    Votes: 65 63.7%
  • High LDL (bad cholesterol) or low HDL (good cholesterol) or high c-reactive protein levels

    Votes: 32 31.4%
  • Physical inactivity

    Votes: 92 90.2%
  • High alcohol intake

    Votes: 0 0.0%
  • Sleep apnea

    Votes: 29 28.4%
  • Family History of heart disease

    Votes: 47 46.1%
  • Stress

    Votes: 58 56.9%
  • Poor Diet (high saturated fats/processed foods)

    Votes: 5 4.9%

  • Total voters
    102

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Coronary heart disease (CHD) occurs when plaque builds up on the arteries that supply blood to the heart. The plaque buildup can reduce blood flows to the heart causing chest pain - particularly during strenuous activity. If the plaque bursts a clot can form which can block blood flows to the heart causing a heart attack.

CHD is the leading cause of death in the U.S. Despite the fact that it typically shows up about ten years later in women than men it is the leading cause of death in the U.S. for women. This is the second Taiwanese study to find an increased risk of coronary heart disease in people with fibromyaliga. The increased risk of CHD (almost 50%) found was not as high as for diabetes or hypertension, and was described as "moderate".

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[/fright]FM patients with diabetes, hypertension, hyperlipidemia, congestive heart failure, cerebral vascular diseases, depression or anxiety had more significantly increased risks of CHD. The risk for CHD was higher, interestingly in FM patients with out depression than in people with depression but not FM.

The authors proposed several hypotheses to explain the increased CHD. They rejected the idea that the high use of NSAIDS, antidepressants and pain killers were contributing to it. Instead they suggested that chronic stress, including in some patients early lifetime stressors, increaseid sympathetic nervous system activity and reduced parasympathetic nervous system activity. They noted the reduced heart variability results found in FM, which are a known risk factor for heart disease.

People with chronic fatigue syndrome should note that similar autonomic nervous system findings are found in ME/CFS.

Several studies have found "unfavorable lipid profiles" that could increase the risk of atherosclerosis in ME/CFS. A small 2012 study of women with ME/CFS found high triglyceride and malondialdehyde levels and low levels of the healthy cholesterol (HDL-C). HDL-C is anti-inflammatory agent that prevents cholesterol accumulations on the cell walls and reduces lipid peroxidation.

The authors proposed that these factors may predispose ME/CFS patients to vascular (blood vessel) damage and suggested antioxidant supplement and LDL lowering strategies be employed. A 2005 study found increased levels of oxidized lipids and decreased HDL-C in ME/CFS patients with risk factors (high blood pressure and/or obesity).

High levels of overweight and obesity in fibromyalgia may contribute to the problem although they may not be higher than in the population at large. One study suggested that negative lipid profiles in FM were associated with increased weight - suggesting one possible way to reduce them.

Risk Factors for CHD

A look at the risk factors for CHD finds a mixed bag for people with ME/CFS/FM. Some are probably high (triglycerides, lack of physical activity, sleep apnea, stress) while some major ones (unhealthy diet, smoking, alcohol consumption, high blood pressure) are probably low.
Reduced Physical Activity

Reduced physical activity is important risk factor but the authors of the paper did not suggest it was a factor. The US Guidelines for the amount of aerobic exercise needed to maintain health and ward off illness, however, are probably rarely met by people with fibromyalgia and almost never by people with ME/CFS.

The U.S. breaks activity levels into four categories:
  • Inactive is no activity beyond baseline activities of daily living.
  • Low activity is activity beyond baseline but fewer than 150 minutes (2 hours and 30 minutes) of moderate-intensity physical activity a week or the equivalent amount (75 minutes, or 1 hour and 15 minutes) of vigorous-intensity activity.
  • Medium activity is 150 minutes to 300 (5 hours) minutes of moderate-intensity activity a week (or 75 to 150 minutes of vigorous-intensity physical activity a week). In scientific terms, this range is approximately equivalent to 500 to 1,000 metabolic equivalent (MET) minutes a week.
  • High activity is more than the equivalent of 300 minutes of moderate-intensity physical activity a week.
Aerobic Activity

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[/fleft]The U.S. Guidelines state the following amounts of aerobic activity are needed to maintain health and ward off illness. Moderate (such as brisk walking or tennis) or intense (jogging or swimming) should be done in episodes of at least 10 minutes and, if possible, spread out through the week.
  • 150 minutes (2 hours and 30 minutes) each week of moderate-intensity aerobic physical activity (such as brisk walking or tennis)
  • 75 minutes (1 hour and 15 minutes) each week of vigorous-intensity aerobic physical activity (such as jogging or swimming laps)
  • An equivalent combination of moderate- and vigorous-intensity aerobic physical activity
For even greater health benefits, they recommend
  • Increase moderate-intensity aerobic physical activity to 300 minutes (5 hours) each week
  • Increase vigorous-intensity aerobic physical activity for 150 minutes (2 hours and 30 minutes) each week
Is Coronary Heart Disease in ME/CFS and FM Patients Future?

Despite some negative risk factors - not necessarily. The CDC estimates that about 7% of the entire population and about 17% of people over 65 have it. Women have lower rates of CHD (@ 5%) than men but may be more severely affected by it when it does occur.

[fleft]
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[/fleft]That suggests that even a 50% increase in the risk factor for CHD would leave the vast majority of middle-aged women with FM (>90%) without it. FM and ME/CFS patients with increased risk factors (depression, anxiety, obesity, increased blood pressure, sleep apnea) would have a higher incidence.

Coronary heart disease is something to think about given the reports of decreased heart rate variability, increased oxidative stress, the high triglyceride findings, the lack of activity, etc. in ME/CFS/FM but it's certainly not a forgone outcome. More study is clearly needed regarding the long term effects of these diseases.

In the meantime a heart healthy diet, stress reduction, whatever exercise can be done, strategies to reduce inflammation and sleep studies to assess sleep apnea are probably good ideas.
 
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h3ro

Active Member
I'm curious to know how common obesity actually is in ME/CFS and Fibromyalgia.

From observation it seems to be more common in Fibromyalgia and in particular in women. From what I've noticed a lot of men with ME/CFS tend to be quite thin at best and underweight, or even emaciated at worst. I'm not actually sure I've seen a man with ME/CFS that is obese?
 

GracieJ

Active Member
My 58yo female cousin passed away this summer, very unexpectedly. She had a heart attack with no history of heart issues. She also had fibromyalgia. Of course I strongly suspect the true cause of her death should actually be attributed to complications of fibromyalgia.

Sharing this with my kids made them concerned for me. Although I, too, feel a sense of heads-up on the possibility, I also feel there is a strong component of self-care in this, finding the highest level of function possible. Maybe it will head off complications.

So I tell them not to worry... joking that I will probably outlive THEM.

What the truth is the next decades will show. Our population is aging and mostly untreated or poorly treated.
 

GracieJ

Active Member
I'm curious to know how common obesity actually is in ME/CFS and Fibromyalgia.

From observation it seems to be more common in Fibromyalgia and in particular in women. From what I've noticed a lot of men with ME/CFS tend to be quite thin at best and underweight, or even emaciated at worst. I'm not actually sure I've seen a man with ME/CFS that is obese?
My brother-in-law has this, is overweight, and has high blood pressure. He is around 60.
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
I'm curious to know how common obesity actually is in ME/CFS and Fibromyalgia.

From observation it seems to be more common in Fibromyalgia and in particular in women. From what I've noticed a lot of men with ME/CFS tend to be quite thin at best and underweight, or even emaciated at worst. I'm not actually sure I've seen a man with ME/CFS that is obese?
From anecdotal reports you may be right.

I checked out the general rate of obesity in the US though and it looked as it was about as high as in the FM study I checked out. It was hard to compare the two though. I don't know if the rate of obesity is higher or just a bit higher in FM or just normal :). Over 60% of the women in the FM study I looked at were overweight or obese but the rate of obesity in the US is in the mid-thirty percentile...

We're a big country!
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
My 58yo female cousin passed away this summer, very unexpectedly. She had a heart attack with no history of heart issues. She also had fibromyalgia. Of course I strongly suspect the true cause of her death should actually be attributed to complications of fibromyalgia.

Sharing this with my kids made them concerned for me. Although I, too, feel a sense of heads-up on the possibility, I also feel there is a strong component of self-care in this, finding the highest level of function possible. Maybe it will head off complications.

So I tell them not to worry... joking that I will probably outlive THEM.

What the truth is the next decades will show. Our population is aging and mostly untreated or poorly treated.
I think the next decades will show a lot. I think we're going to get more attention and some of that will focus on epidemiology...It's going to be interesting..
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
As expected the rates of some major risk factors for heart disease: smoking, alcohol intake and poor diet - are very low...Maybe that's enough to offset the lack of physical activity and stress to some extent...
 

ElaineC

New Member
I don't know about everyone else with fibromyalgia and/or me/cfs (I have both) but it's really tough to even get to a low activity level. Just this week I have resumed walking after a year's hiatus but even going a short distance won't put me in their category of low activity. I was diagnosed with me/cfs 5 years ago and fibromyalgia 25 years ago and have recovered to about 70% after years of intensive effort with multiple treatments. However based on their activity levels maybe I haven't recovered as much as I thought. The thought of also having high heart disease risk is enough to make a person want to give up.
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
I don't know about everyone else with fibromyalgia and/or me/cfs (I have both) but it's really tough to even get to a low activity level. Just this week I have resumed walking after a year's hiatus but even going a short distance won't put me in their category of low activity. I was diagnosed with me/cfs 5 years ago and fibromyalgia 25 years ago and have recovered to about 70% after years of intensive effort with multiple treatments. However based on their activity levels maybe I haven't recovered as much as I thought. The thought of also having high heart disease risk is enough to make a person want to give up.
I want to be careful with the high heart disease risk. I was quite pleased to find that even with increased risk most people are not likely to have it.

I guess, though, that you were feeling pretty good until you started walking more and found your limits were worse than you'd imagined.

I walk every day but slowly... I'm not even close to the recommended guidelines.
 
I have preload failure, a vascular problem, with intermittent episodes of orthostatic intolerance (they go together and are treated the same way.) The last has been tricky because I have hypertension, which is well controlled with a small amount of medication: 5mg of lisinopril. However, I seem to be finding a balance and have normal b/p. My lipids are excellent. I am 71 and female. I never smoked and have a normal BMI. I have a healthy diet.

Family history is irrelevant because my father was morbidly obese and a heavy smoker until he was 52 when he got diabetes. He had a fatal heart attack when he was seventy. Also this was thirty seven years ago when very little was known how to treat someone at such significant risks for heart disease. E.g. his job required really heavy exercise; he was told to rest. There was little known about diet and diabetes. It was not uncommon for men to have fatal heart attacks at seventy. My mother did everything right and died at ninety three from various causes.

I am now in a slow but promising exercise program. The too vigorous one I was in last spring raised my heart and lung function on a step test from 68% to 97%. I probably lost that progress due a flare I'm having this fall. (change of seasons are hard for me.) However, I know it's possible to get back up to optimum. However, I have to be at it for the rest of my life.

The reason I include all of this is because I asked the cardiopulmonary specialist I see if preload failure and OI could shorten my life due to heart disease. He said they simply don't know and he's in academic medicine. I didn't discuss other risks with him but he is aware I don't smoke,have a normal BMI, and have hypertension.

I'm glad you mentioned stress. I've been extremely stressed the last month and decided I have to do something about it. I can't change my world but I can live in it better. I've started relaxation exercises and am seeing a therapist to guide me. The anxiety has sometimes been unbearable. I did relaxation exercise and meditation years ago so I have the tools; I just have to start using them again.

You don't have to have CFS to be stressed. I'm seeing it all around me. Friends and family; some of my doctors I've seen for many years admit to it. The NYTimes has articles on toxic stress in the workplace, etc. It does seem like everyone is working harder and longer.( Living in a world of stressed out people doesn't help those of us who have CFS and FMS.)
 

Strike me lucky

Well-Known Member
For me i would say the inactivity is most likely why im carrying extra baggage as well as cholesterol increasing. I also think the hpa axis and hormone problems can be a significant factor in high cholesterol . I think many of us cant convert the cholesterol into the hormones we need .
 

J William M Tweedie

Well-Known Member
Interesting timing of the article as I just came back from having an echo cardiogram done. The reason, oddly enough, is swelling in my ankles and lower legs. Lasix didn't help so my Dr thought it might be a malfunctioning heart. Results later this week.
 

Seeksassy

Active Member
As expected the rates of some major risk factors for heart disease: smoking, alcohol intake and poor diet - are very low...Maybe that's enough to offset the lack of physical activity and stress to some extent...
Ha-ha! Let's hope so
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Interesting timing of the article as I just came back from having an echo cardiogram done. The reason, oddly enough, is swelling in my ankles and lower legs. Lasix didn't help so my Dr thought it might be a malfunctioning heart. Results later this week.
Good luck with that.....I do know of someone with heart issues whose energy was quite improved when they got taken care of.
 

dee

Active Member
how does one exercise with M.E.??? does getting out of bed count? :>( I would LOVE to be able to exercise, like a walk, but would I remember to come home and remember where? HUFF-PUFF, HUFF-PUFF! i'm EXHAUSTED just washing my hair!

Dr. Lerner said its CARDIOMYOPATHY!
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
how does one exercise with M.E.??? does getting out of bed count? :>( I would LOVE to be able to exercise, like a walk, but would I remember to come home and remember where? HUFF-PUFF, HUFF-PUFF! i'm EXHAUSTED just washing my hair!

Dr. Lerner said its CARDIOMYOPATHY!
I hope he's wrong - but I guess he's think a viral infection. I believe he had one and he has those holter monitor tests. For some people I'm sure that it is....Unfortunately in the US despite the fact that there are many cases of idiopathic cardiomyopathy they test for viruses hardly at all.
 

Seeksassy

Active Member
Interesting timing of the article as I just came back from having an echo cardiogram done. The reason, oddly enough, is swelling in my ankles and lower legs. Lasix didn't help so my Dr thought it might be a malfunctioning heart. Results later this week.
Fingers crossed that something good comes from it.
 

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