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By Jeffrey Kopman


There’s nothing funny about heart attacks, but patients being prepped for surgery can now have a good, albeit slightly inappropriate, laugh at them anyway. Contrary to previous concerns, nitrous oxide -- also known as laughing gas -- does not increase a patient’s risk of heart attack, according to a study from Washington University in St. Louis published in the journal Anesthesiology.


Researchers studied 500 surgery patients who had been diagnosed with heart attack risk factors -- such as coronary artery disease and heart failure. Patients were only considered if they were not undergoing heart surgery. All patients were given laughing gas.


Some of the patients were given intravenous vitamin B12 and folic acid to reduce their heart attack risk after surgery. The other patients were not given any vitamins.


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Previous research suggested that laughing gas caused homocysteine levels to rise, which could lead to heart attacks. However, while vitamin B12 kept homocysteine levels in check, there was no effect on heart attack risk, according to the study.


“There were no differences between the groups with regard to heart attack risk,” said lead author Peter Nagele, MD, assistant professor of anesthesiology and genetics, in a press release. “The B vitamins kept homocysteine levels from rising, but that didn’t influence heart attack risk.”


The study authors believe that practitioners should have no reservations towards using laughing gas – due to fear of perioperative cardiac events -- if they believe it can help their patients.


The Heart Health Risks of Surgery


Even if nitrous oxide and other anesthesia do not increase your risk of heart attack, surgery still carries some risk. You should always weigh the risks and benefits with your doctor before deciding on a serious surgical procedure.


Laughing gas may not be linked to heart attacks anymore, but recent research did show that general anesthesia can increase dementia risk, memory and cognitive problems.


While the University of Washington study did not focus on heart surgery patients, there are risks associated with heart surgery, including bleeding, infection, irregular heartbeats, stroke and even death. These complications are generally higher in emergency situations or if the patient has other health conditions, such as diabetes, according to the National Institutes of Health.


“Surgery increases blood pressure, so being active and maintaining good heart health is necessary to undergo surgery,” said Brian Kahn, MD, cardiologist at The Heart Center at Overlea at Mercy Medical Center in Baltimore, Md. “Because anesthesia puts stress on the body it can increase the risk of heart attack. Fitness can help with blockages and limit the effects of anesthesia.”


Deciding on Heart Surgery


Many patients, and doctors, might struggle with the decision to undergo surgery. Making the right choice can be very personal, but new methods are constantly being developed to help make the correct option clearer.


In April, a new method from the Stanford University School of Medicine used “big data” to determine which treatment option was best for heart disease patients. Researchers believe they can come up with the best treatment plan for patients by comparing the outcomes and characteristics of previous patients and historical information from their database.


Big data is just one of the tools available to help doctors and patients weigh the risks and rewards associated with heart surgery. For many patients, surgery might be the answer.


“[Surgery risks] depend on if the patient had prior risk factors," Dr. Kahn said. "There’s little risk for healthy, young 20-year olds, but there is risk for a 70-year old patient with high blood pressure. [These patients] need some sort of stress test, but if the test is normal they can be cleared for surgery. You need to decide if the heart needs to be treated before surgery.”


Surgery Patients Can Laugh Off Nitrous Oxide Heart Attack Risk, Study Says originally appeared on Everyday Health.


Also on HuffPost:






  • 1. Not Smoking


    While not entirely surprising, it doesn't make the message any less important: <a href="http://www.nhlbi.nih.gov/health/health-topics/topics/smo/" target="_hplink">Smoking kills</a>. The habit is considered the No. 1 cause of preventable death and sickness in the U.S.

    Specifically, <a href="http://www.nhlbi.nih.gov/health/health-topics/topics/smo/" target="_hplink">smoking cigarettes harms the heart</a> in that it damages heart and blood vessel function, thereby upping the risk of atherosclerosis (where your arteries harden), according to the National Institutes of Health.




  • 2. Being Physically Active


    Aerobic exercise is good for the heart in that it makes you take in more oxygen, helps you <a href="http://www.mayoclinic.com/health/aerobic-exercise/EP00002/NSECTIONGROUP=2" target="_hplink">keep to a healthy weight</a>, reduces plaque buildup in the arteries and helps to lower blood pressure, according to the Mayo Clinic.

    According to the Centers for Disease Control and Prevention, adults are recommended to get at least <a href="http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html" target="_hplink">150 minutes of aerobic exercise</a> a week (moderate to intense level), and also do muscle-strengthening at least twice a week.




  • 3. Maintaining Normal Blood Pressure Levels


    <a href="http://www.nhlbi.nih.gov/hbp/bp/bp.htm" target="_hplink">Blood pressure measurements</a> are written in terms of systolic over diastolic. Systolic pressure is "as the heart beats," according to the National Institutes of Health, while diastolic pressure is the relaxation of the heart between heartbeats.

    A person with a normal blood pressure level has a systolic blood pressure reading of 120 millimeters of mercury or less, and a diastolic blood pressure reading of 80 millimeters of mercury or less.

    A person is <a href="http://www.nhlbi.nih.gov/hbp/detect/categ.htm" target="_hplink">considered hypertensive</a> (has high blood pressure) when the systolic blood pressure is between 140 and 159, and the diastolic blood pressure is between 90 and 99.




  • 4. Maintaining Normal Blood Glucose Levels


    Having chronically <a href="http://diabetes.webmd.com/blood-glucose" target="_hplink">high levels of glucose</a>, a kind of sugar, in the blood can lead kidney and blood vessel damage, according to WebMD.

    Insulin, a hormone in the body, is responsible for helping the body's cells to <a href="http://www.medicinenet.com/insulin/article.htm" target="_hplink">use glucose in the blood</a>. However, if the body doesn't have enough insulin or isn't able to use it properly, then <a href="http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html" target="_hplink">blood sugar levels may rise</a>, according to the American Diabetes Association. High blood sugar is considered a diabetes complication.

    Tests to check for high blood glucose can help show whether a person has diabetes, and are used to <a href="http://diabetes.webmd.com/blood-glucose" target="_hplink">monitor someone with diabetes</a> over time, WebMD reported.




  • 5. Maintaining Normal Total Cholesterol Levels


    <a href="http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm" target="_hplink">High cholesterol</a> is a known risk factor for heart disease, because it causes hardening of arteries going to the heart, according to the National Institutes of Health. When part of the heart is deprived of blood, it could trigger a heart attack.

    The <a href="http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm" target="_hplink">optimum total cholesterol level</a> is 200 or fewer milligrams of cholesterol per deciliter of blood, while having a total cholesterol level of 200 to 239 milligrams per deciliter is considered borderline high. High total cholesterol is having 240 milligrams of cholesterol per deciliter of blood, or more, according to the National Institutes of Health.




  • 6. Having A Healthy Weight


    Calculating your body mass index (BMI, a ratio of weight to height) is a good starting point for knowing if you're at a <a href="http://www.cdc.gov/healthyweight/assessing/index.html" target="_hplink">healthy weight</a>, according to the Centers for Disease Control and Prevention. According to the BMI chart, having a BMI of 18.5 or below is considered "underweight" and a BMI of 18.5 to 24.9 is considered "normal" or healthy weight. A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 and above is considered obese.

    <a href="http://www.nhlbisupport.com/bmi/" target="_hplink">Click here to calculate your BMI</a>.

    <a href="http://www.cdc.gov/healthyweight/assessing/index.html" target="_hplink">Waist circumference</a> can also give clues to your weight; a man may be at risk for health problems from obesity if his waist circumference is more than 40 inches, the CDC reported. For a non-pregnant woman, it's more than 35 inches.




  • 7. Eating A Healthy Diet


    While there are obviously differences in opinion depending on who you ask as to what you should or shouldn't eat for optimal health, there are some <a href="http://www.mayoclinic.com/health/heart-healthy-diet/NU00196" target="_hplink">heart-healthy nutrition rules</a> that remain true across the board. The Mayo Clinic reports that eating a diet low in cholesterol and "bad" fats (saturated and trans fats), with low-fat proteins (like lean meats, fish and beans), whole grains (with lots of fiber), and little sodium is good for your heart.

    For more nutrition advice, <a href="http://www.mayoclinic.com/health/healthy-diet/NU00200" target="_hplink">click over to the Mayo Clinic</a>.




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