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Asthma cause heart palpitations: Persistent asthma linked to increased risk for heart rhythm disorder

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Persistent asthma linked to increased risk for heart rhythm disorder


Please note: This article was published more than two years ago, so some information may be outdated. If you have questions about your health, always contact a health care professional.




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People with persistent asthma could be at 1.5 times higher risk of developing a heart rhythm disorder called atrial fibrillation than those without asthma, new research shows.

The study used data collected on 6,615 people in six areas around the country who were followed for nearly 13 years. When the study started, none of the participants had heart disease. Researchers concluded that the 150 participants with persistent asthma – those who required medication daily to control their condition – were more likely to be diagnosed with AFib than those without asthma.

Inflammation is a risk factor for both asthma and AFib, and the study found people with persistent asthma had the highest levels of inflammation. But the research also suggests there may be more than inflammation connecting asthma to an irregular heartbeat.

“We initially suspected that the link between asthma and atrial fibrillation may be explained by high levels of common inflammation markers in the blood at the baseline of the study,” said study author Dr. Matthew Tattersall, an assistant professor of cardiovascular medicine at the University of Wisconsin in Madison. “These inflammation markers are higher in asthmatics and independently predict atrial fibrillation.”

But when he and his colleagues adjusted for those inflammation blood markers, the relationship between asthma and AFib did not significantly change, Tattersall said. That led them to believe “there may be specific unique patterns of inflammation not identified or even other non-inflammatory pathways that may be driving an increased risk.”

Previous studies done in other countries also have found a link between asthma and AFib. One study in Norway, with 54,567 adults, found having asthma was associated with a 38% increased risk of AFib.

The new study is the first in the U.S., according to study authors, and the first to include a racially diverse group of people; 27% of participants were African American, 12% Chinese and 22% Hispanic. The research was published Tuesday in the American Heart Association journal Circulation: Arrhythmia and Electrophysiology.

At least 5.2 million Americans are living with atrial fibrillation. The condition is marked by a quivering or irregular heartbeat called an arrhythmia. It can cause heart failure and other heart-related complications, as well as blood clots. If a clot leaves the heart and travels to the brain, it can cause a stroke.

People with untreated AFib are nearly five times more likely to have a stroke than those who do not have this heart problem.

Over 25 million Americans have asthma, a chronic disease caused by inflammation in the bronchial tubes, or airways, in the lungs. People with persistent asthma are prescribed daily controller medications to keep their airways from tightening up and prevent coughing, wheezing, shortness of breath or chest tightness.

Patients and doctors need to know about the association between asthma and AFib, said Dr. Marc Miller, a cardiac electrophysiologist and an assistant professor of cardiology at Icahn School of Medicine at Mount Sinai in New York City. But he cautioned the study doesn’t show asthma is causing AFib.

“The theory is they both have a common origin – systemic inflammation,” said Miller, who was not involved with the study. “But we don’t know if that is the reason asthma patients get atrial fibrillation or if it’s the therapies being used to treat the asthma that are inducing the atrial fibrillation.”

Tattersall said the connection between the two conditions suggests doctors should be talking to their asthma patients about the importance of heart-healthy behaviors, such as exercise, maintaining a healthy weight and eating a heart-healthy, low-sodium diet.

“Being aware there is this association means we need to help patients focus on these primary prevention things we know we should be doing but that are often the hardest things to do,” Tattersall said. “But they can help with asthma and they can also reduce risk for atrial fibrillation.”

If you have questions or comments about this story, please email [email protected].



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Can Asthma Cause Heart Palpitations? Understanding the Link and Seeking Treatment at Nao Medical

Asthma is a chronic respiratory condition that affects millions of people worldwide. It is characterized by inflammation and narrowing of the airways, which can cause symptoms such as wheezing, coughing, and shortness of breath. While asthma primarily affects the lungs, it can also have an impact on other parts of the body, including the heart.

Heart palpitations are a common symptom of asthma, and they can be a cause for concern for many patients. Palpitations are sensations of a racing, fluttering, or pounding heart, and they can be accompanied by other symptoms such as dizziness, lightheadedness, and shortness of breath. While palpitations can be a normal response to physical activity or stress, they can also be a sign of a more serious underlying condition.

The Link Between Asthma and Heart Palpitations

The exact mechanism behind the link between asthma and heart palpitations is not fully understood. However, there are several theories that have been proposed by medical experts. One theory is that the inflammation and narrowing of the airways in asthma can cause a decrease in oxygen levels in the blood, which can lead to an increase in heart rate and palpitations. Another theory is that the stress and anxiety associated with asthma can trigger the release of adrenaline, which can also cause palpitations.

Regardless of the exact cause, it is clear that there is a strong link between asthma and heart palpitations. Studies have shown that patients with asthma are more likely to experience palpitations than those without asthma, and that the severity of asthma symptoms is correlated with the frequency and intensity of palpitations.

Seeking Treatment at Nao Medical

If you are experiencing heart palpitations in conjunction with your asthma symptoms, it is important to seek medical attention. At Nao Medical, we offer a range of services to help you manage your asthma and reduce your risk of heart palpitations and other complications.

Our team of experienced healthcare providers specializes in urgent care, primary care, multi-specialty care, mental health, women’s health, nutrition services, and more. We take a comprehensive approach to healthcare, focusing not just on your immediate health concerns, but also on your overall well-being and quality of life.

When you visit Nao Medical, you can expect same-day appointments, minimal wait times, exceptional and empathetic staff, stunning clinic environments, a technologically driven approach with a comprehensive app, and extensive after-hours virtual care. We will work with you to develop a personalized treatment plan that addresses your unique needs and helps you achieve your health goals.

Take Control of Your Health Today

If you are experiencing heart palpitations in conjunction with your asthma symptoms, don’t wait to seek treatment. Book an appointment with Nao Medical today and take control of your health. Our team of experts is here to help you manage your symptoms, reduce your risk of complications, and improve your quality of life.

For more information about asthma and heart health, visit the CDC and NHLBI websites.

Disclaimer: The information presented in this article is intended for general informational purposes only and should not be considered, construed or interpreted as legal or professional advice, guidance or opinion.

Pulmonologist Natalya Yuryevna Kopovaya spoke about the symptoms and causes of bronchial asthma — FSBI “NMIC TPM” of the Ministry of Health of Russia

Bronchial asthma is a chronic disease of the bronchi. Currently, the disease is manageable, and with adequate treatment, periods of remission can last for several years. We talked about bronchial asthma with Natalya Yurievna Kopova, a pulmonologist at the National Medical Research Center for TPM of the Russian Ministry of Health.

How does bronchial asthma manifest itself?

The main manifestations include an attack of suffocation, with predominant difficulty in exhaling, wheezing, paroxysmal cough, dry or with sputum (more often at night), shortness of breath. With an exacerbation of bronchial asthma, these symptoms may be accompanied by bloating of the chest, difficulty in speaking, drowsiness and palpitations. In atopic bronchial asthma, asthma attacks are often accompanied by a runny nose (stuffiness or watery discharge, sneezing) and skin itching, especially when in contact with an allergen (for example, when staying in a dusty room, as well as during the flowering period).

Asthma bronchospasm is reversible, an asthma attack can be stopped after dissociation from the “guilty allergen” and under the influence of drugs. After the cessation of an asthma attack, the disease itself does not go away.

How common is this condition?

Bronchial asthma affects about 6% of the world’s adult population. In Russia, the prevalence of bronchial asthma ranges from 2.6% to 20.3% in different regions.

Why does asthma occur?

The main role is assigned to an excessively strong response to various factors: allergens (house dust mites, pollen, mold fungi, food products) and non-specific irritants (pungent odor, tobacco smoke, physical activity, cold air, viruses, bacteria, stress). Chronic inflammation develops in the bronchial mucosa and a tendency to bronchospasm is formed. This feature of the response of the bronchi to allergens can be inherited and is called atopy. The allergen causes the formation of antibodies. When exposed to the allergen + antibody complex on the cells of the bronchial mucosa, histamine and other biologically active substances are released, which cause an asthma attack. This form of bronchial asthma is called atopic, it is often combined with allergic rhinitis. There is also an infection-dependent form of bronchial asthma, in which there is no clear influence of the external aspect. This form is often combined with chronic bronchitis, has a more severe course, and is more difficult to treat. Sometimes seizures can be triggered by medications (eg, aspirin, non-steroidal anti-inflammatory drugs).

How dangerous is bronchial asthma?

Asthma flare-ups can be very severe and life-threatening. In an acute attack of suffocation, which is characterized by rapidly progressive shortness of breath, coughing, wheezing, a feeling of tightness in the chest, respiratory failure may develop, leading to severe oxygen starvation of all organs, including the brain. If treatment is not started in a timely manner, a severe life-threatening condition may develop – a prolonged attack of suffocation, which cannot be relieved within a few hours with the use of conventional anti-asthma drugs. This condition requires emergency medical attention.

You can make an appointment with a pulmonologist at the National Medical Research Center for TPM of the Russian Ministry of Health by calling 8(495) 790-71-72.

symptoms, causes and treatments

  • 1 Asthma : causes, symptoms and effective treatments
    • 1.1 Asthma: symptoms, causes and treatments
      • 1.1.1 What is asthma?
    • 1.2 Related videos:
    • 1.3 Asthma: symptoms, causes and treatments
      • 1.3.1 Main symptoms of asthma:
    • 1.4 Causes of asthma
    • 90 065 1.5 Asthma diagnosis: what you need to know

      • 1. 5. 1 Analysis of symptoms and medical history
      • 1.5.2 Functional tests
      • 1.5.3 Allergy tests
    • 1.6 Basic asthma management
      • 1.6.1 Inhaled medicines
      • 1.6.2 Systemic medicines
      • 1.6.3 Vaccination
      • 1.6.4 Steroids
      • 1.6.5 Trigger removal

      90 070

    • 1.7 Inhalation medicines for asthma
      • 1.7.1 What is inhalation drugs?
      • 1.7.2 How do inhalants work?
      • 1.7.3 Which inhalers are used to treat asthma?
      • 1.7.4 How to use the inhaler correctly?
    • 1.8 Asthma folk remedies
    • 1.9 Key recommendations for patients with asthma
    • 1.10 The role of nutrition in the treatment and prevention of asthma
      • 1.10.1 The impact of diet on asthma

      900 70

    • 1.11 Sports and exercise are an important component of treatment asthma
    • 1.12 How can I prevent an asthma attack?
      • 1.12.1 Take preventive measures
      • 1. 12.2 Know how to deal with an asthma attack
    • 1.13 Q&A:
        • 1.13.0.1 What is asthma?
        • 1.13.0.2 What are the symptoms of asthma?
        • 1.13.0.3 What factors contribute to the development of asthma?
        • 1.13.0.4 How is asthma treated?
        • 1.13.0.5 Can asthma be completely cured?
        • 1.13.0.6 Is it possible to get asthma at any age?
  • Find out what asthma is, its symptoms and causes, and what treatments are available. How to take medicines correctly and what measures will help prevent exacerbation of asthma. Useful information for those who have experienced this disease or are worried about the health of their loved ones.

    One of the most common diseases of the respiratory system is asthma. This disease is characterized by airway obstruction caused by inflammation and bronchial constriction. Patients with asthma experience attacks of difficulty breathing, rapid heart rate, coughing, and shortness of breath.

    Asthma is latent, and many of its symptoms can be interpreted as signs of other diseases. Therefore, recognizing asthma is quite difficult. However, knowledge of the causes and risk factors, as well as the symptoms of this disease, can help to identify its presence in time and prescribe effective treatment.

    In this article we will talk about the causes of asthma, the main symptoms and methods of its treatment. You will also learn about prevention of this disease and how to reduce the risk of developing and exacerbating asthma. Careful study of this information will help maintain the health of the respiratory system for many years.

    Asthma: symptoms, causes and treatments

    What is asthma?

    Asthma is a chronic disease that affects the bronchi of the lungs. It causes the bronchi to become more sensitive and react to various irritants such as allergens, smoke, cold air or excessive physical activity.

    The main symptom of asthma is shortness of breath, which can occur during exercise or at rest. Other symptoms may include coughing, especially at night, and wheezing in the chest.

    Asthma can have a variety of causes, including heredity, environmental exposure, and even certain foods. However, most people with asthma can manage their symptoms with appropriate treatment.

    • Asthma treatment usually includes the use of inhalers to make breathing easier and medicines to reduce inflammation in the bronchi.
    • It is also very important to pay attention to the environment. For example, you can avoid smoke, use air conditioners or air purifiers, and watch out for foods that may trigger an allergic reaction.
    • It is important to remember that asthma treatment must be individualized and prescribed by a physician. Patients can receive advice and guidance from a specialist to manage their symptoms and prevent disease progression.

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    Asthma: symptoms, causes and treatments

    Main symptoms of asthma:

    9 0002 Asthmatic cough is one of the most common symptoms of asthma. It can appear both at night and during the day, and is accompanied by difficulty breathing.

    In addition, patients with asthma may experience chest pressure, palpitations, and chest discomfort.

    Large amounts of mucus are also common, which can also cause breathing difficulties.

    In some cases, asthma may present with occasional attacks triggered by environmental factors.

    • Difficulty breathing. One of the most obvious signs of asthma is a disturbance in the normal functioning of the respiratory system.
    • Severe cough. Asthmatic cough worse at night and may disturb sleep.
    • Chest pressure. Some patients notice a feeling of pressure or constriction in the chest.
    • Large amount of mucus. Asthma may have difficulty clearing mucus from the airways.

    Causes of Asthma

    Asthma is a chronic disease that can be caused by various causes. One of the main reasons is genetic predisposition. If someone from close relatives has asthma, then you are much more likely to have it.

    Allergens such as pollen, dust, pets, pollen mites, etc. can also cause asthma. Having allergies can also increase the risk of asthma.

    Some people may develop asthma as a result of occupational activities that involve chemicals and other harmful substances such as paints, solvents and smoke.

    Being overweight can also increase the risk of asthma and make it worse. Smoking can also lead to the development of chronic obstructive pulmonary disease, which increases the risk of asthma.

    Diagnosis of asthma: what you need to know

    Analysis of symptoms and medical history

    Diagnosis of asthma begins with a thorough analysis of the patient’s symptoms and medical history. The doctor needs to know when and how often the signs of the disease appear, how severe they are, what medications the patient has taken in the past.

    It is also important to find out if the patient’s relatives have asthma or other allergic diseases such as eczema or allergic rhinitis. This will allow the doctor to determine the risk group and adjust the choice of diagnostic method.

    Functional tests

    Functional tests are special tests that allow you to determine the degree of impairment of the respiratory system. With their help, you can determine the presence of asthma and assess its severity.

    One of the most common functional tests is peak flowmetry, which measures the flow of exhaled air. Spirometry can also be done, which measures the volume and speed of air passing through the lungs. These tests allow you to compare the results with healthy people and determine the presence of asthma.

    Allergy testing

    Allergy testing is done when an allergic disease is suspected. Their goal is to identify substances that can cause an allergic reaction and, accordingly, provoke an asthma attack.

    The initial phase of allergy testing consists in applying a special solution containing the allergen to the skin. In case of a positive reaction at the stage of application and analysis of the result, patients are prescribed additional studies.

    Diagnosing asthma is a complex process that involves several steps, but it can help doctors treat the disease faster and more accurately and improve the patient’s quality of life. Early diagnosis makes treatment more effective and helps patients live active and fulfilling lives.

    Basic asthma treatment

    Inhalation medicines

    Inhalation is a method of taking medicines through inhalers. This method is the most effective and safest way to treat asthma. Inhalation drugs act directly on the lungs, ensuring the rapid penetration of the drug into the body.

    Systemic drugs

    This method of asthma treatment is based on the use of drugs in the form of tablets or injections. It is prescribed in the case when the indicators of the disease worsen, and inhalants do not work.

    Vaccination

    Patients who are frequently exposed to allergens are usually given a specific vaccination to desensitize the body to the allergen and make it less susceptible to asthmatic attacks. Vaccines are usually given based on a test that looks for allergens that cause asthma.

    Steroids

    Standard asthma treatment protocol includes steroids such as prednisone and beclomethasone. Steroids help reduce inflammation and swelling of the bronchial tubes, which reduces the chance of an asthma attack.

    Removal of triggers

    An important method of treating asthma is the removal of triggers that cause asthma attacks. This may include regular cleaning or an air purification system to help avoid allergens that trigger attacks.

    Asthma inhalers

    What are inhalers?

    Inhaled asthma medicines are medicines that are taken into the body through the respiratory system. Inhalation is the most effective way to deliver drug components directly to the lungs. Medicines of this type allow you to clear the airways and reduce the risk of negative side effects.

    How do inhalers work?

    Inhalation drugs act directly on the lungs, and not on the organs and systems of the body as a whole. They help relax smooth muscles that can contract, causing airway obstruction, and reduce the amount of secretions that can build up in the lungs, making breathing easier.

    Which inhalers are used to treat asthma?

    Asthma inhalers fall into two categories: fast-acting and long-acting. Rapid-acting drugs (bronchodilators) work in a few minutes and help relieve asthma attacks of shortness of breath. Long-acting drugs are used to prevent asthma attacks and increase the duration of the intervals between them.

    • Bronchodilators: salibutamol, terbutaline, albuterol and others.
    • Glucocorticosteroids: beclomethasone, bulesonide, fluticasone and others.
    • Combined preparations: symbicort, duaklir glucoside, seretide.

    How to use the inhaler correctly?

    Inhalers can be of different types, so before you start taking the drug, you must carefully read the instructions and follow their recommendations. Usually, a special inhaler is used, which converts the drug into small particles, which then pass through the mouth and reach the lungs. After use, the inhaler should be rinsed with warm water to remove any medication residue and prevent contamination.

    Asthma folk remedies

    Asthma is a serious condition that can lead to life-threatening situations. Although scientists have developed many different treatments, some patients use traditional folk remedies to relieve symptoms and reduce the risk of flare-ups.

    1. Garlic. This simple and affordable spice can help improve lung function and reduce airway inflammation. It is best consumed fresh, adding to salads and dishes.

    2. Turmeric. This spicy root contains curcumin, a substance with anti-inflammatory properties that may help reduce the severity of asthma attacks. It is recommended to add turmeric to meals or take it as a supplement in the form of capsules.

    3. Eucalyptus leaf tea. Eucalyptus leaves contain eucalyptus oil, which can help relieve coughing, one of the most bothersome symptoms of asthma. Eucalyptus leaf tea can also relieve tension and reduce the risk of flare-ups.

    4. Oak bark smoke. If you feel the onset of an asthma attack, try lighting and inhaling oak bark smoke. It can help expand the bronchi and reduce inflammation in the airways.

    While home remedies can help relieve asthma symptoms, it’s always a good idea to check with your doctor before using any new treatments or supplements.

    Key recommendations for patients with asthma

    Asthma is a chronic bronchial disease that severely limits the lives of patients. At the same time, proper treatment and following a few simple recommendations helps to control symptoms and live a fulfilling life.

    • Regular health check-ups – Patients with asthma should have regular check-ups and tests. This helps prevent exacerbations and correct treatment in time.
    • Avoid recurring allergens and irritants – It’s important to know what triggers your asthma attack and try to minimize exposure to these substances. Determine what your triggers are and avoid them.
    • Regular medication use – the use of drugs should be regular and agreed with the doctor. This reduces symptoms and reduces the risk of asthma exacerbation.
    • Organize a healthy lifestyle – As with any disease, physical activity and a healthy diet can help control symptoms and strengthen the body.
    • Be prepared for unexpected flare-ups – It’s important to know how to respond quickly to asthma flare-ups and what to do in certain situations. Follow your healthcare provider’s instructions and keep your asthma medications with you at all times.

    The role of nutrition in the treatment and prevention of asthma

    The impact of nutrition on asthma

    Proper nutrition plays an important role in the treatment and prevention of asthma. Excess weight can increase the risk of exacerbation of the disease. Therefore, it is recommended to control your weight.

    To reduce the number of asthma attacks, include in your diet foods rich in magnesium, such as nuts, beans, spinach and bananas. Magnesium helps to relax the airways and improve bronchial patency.

    Vitamin C foods such as citrus fruits, red peppers and strawberries are also recommended. Vitamin C improves immunity and reduces the risk of developing asthma.

    • Do not abuse products containing histamine. It can be alcohol, canned food, chocolate and red fruits. Histamine can trigger an allergic reaction, making asthma symptoms worse.
    • Dairy products, fatty meats and fried foods can also aggravate asthma symptoms. It is recommended to reduce the amount of these foods consumed in favor of healthier and lighter meals.
    • Food allergens that can exacerbate asthma should be avoided whenever possible. These foods include eggs, scallops, shellfish, nuts, and many others.

    However, before changing your diet, you need to consult a specialist and find out which foods can be useful or harmful for a particular patient.

    Foods useful for asthmaticsProduct Benefits

    Nuts Rich in magnesium, relaxes the respiratory tract
    Beans Contains magnesium and vitamin C, improves immunity
    Spinach Rich in magnesium, improves bronchial patency 9039 2
    Bananas Contains magnesium, improves bronchial patency
    Citrus fruits Contains vitamin C, improves immunity
    Red pepper Contains vitamin C, improves immunity
    strawberries Contains vitamin C, improves immunity

    Sports and physical exercises – an important component of asthma treatment

    It seems that sports and physical exercises can be a difficult test for people suffering from people suffering stma. Nevertheless, according to doctors and experts in the field of healthy lifestyle, regular physical activity is an important condition for improving the quality of life of patients.

    One of the reasons why life can be so difficult for people with asthma is that they may suffer from limited breathing. However, regular exercise in the gym, running, swimming and other forms of physical activity can increase capillaries and improve oxygen supply to the body, which will positively affect lung function and the body as a whole.

    • Lung strengthening . Sports and exercise help to improve respiratory function and strengthen lung function, which is especially important for people suffering from bronchial asthma.
    • Improvement of the heart and blood circulation . Sports help to strengthen the heart and maintain healthy circulation, which is especially beneficial for people with asthma because it improves oxygen supply.
    • Strengthening the immune system . Physical activity helps to strengthen the immune system, increase the level of endorphins (hormones of happiness), which have a beneficial effect on the activity of proteins and blood enzymes. It helps prevent the development of various diseases, including asthma.

    It is important to remember that physical activity should not be too intense and the patient should not be more stressful than he can bear. It is always recommended to consult a doctor and gradually increase the load in order to avoid possible complications.

    Sports recommended for people with asthma: Sports that may be contraindicated for people with asthma 2

    Athletics Gymnastics Football YOGA Hockey

    How to prevent asthma attack?

    Take preventive measures

    You can prevent an asthma attack by following a number of preventive measures:

    • Avoid triggers . These can be allergens (pollen, dust, pet hair), chemicals (exhaust fumes, varnishes, paints), dust and tobacco smoke.
    • Avoid physical activity if possible . Exercise and sports can trigger asthma attacks. However, if you have the opportunity to take a course of therapeutic exercises, this will not only help prevent attacks, but also strengthen the lungs and improve overall health.
    • Wear natural materials and use hypoallergenic cosmetics to avoid contact with substances that can trigger an allergic attack.
    • Get treated and take medicines prescribed by your doctor. Some medicines help prevent asthma attacks, reduce the frequency of them, and improve overall well-being.

    Know how to deal with an asthma attack

    It is not always possible to prevent an asthma attack. Therefore, it is important to know how to act if it occurs:

    1. Do not panic . First, try to calm down and breathe slowly, deeply.
    2. Use the inhaler, if available, as directed and directed by your doctor.
    3. If you don’t have an inhaler, follow this algorithm :
    Step 1: Sit in a comfortable position and open a window or door for fresh air.
    Step 2: Place your hands on your stomach and breathe slowly, deeply through your nose.
    Step 3: Inhale as far as you can through your nose, then exhale quickly, pursing your lips.
    Step 4: Repeat step 3 until the seizure resolves or medical attention is provided.

    Q&A:

    What is asthma?

    Asthma is a chronic respiratory disease characterized by dyspnoea, coughing, redness of the face and neck. It occurs due to constriction of the bronchi and increased mucus production, which makes breathing difficult and leads to suffocation.

    What are the symptoms of asthma?

    Asthma symptoms may include coughing, sneezing, shortness of breath, chest itching, chest pain, heavy breathing, reduced lung capacity, and others. They can worsen at certain periods of life or when exposed to various factors, such as allergens, air pollution levels and physical activity.

    What factors contribute to the development of asthma?

    There are many factors that can contribute to the development of asthma, such as genetic predisposition, passive smoking, allergies, environmental conditions, increased emotional stress, and others. It is often important to identify a specific cause in order to choose the right therapy.

    How is asthma treated?

    Treatment of asthma may include the use of inhaled drugs such as corticosteroids, adrenomimetics and anticholinergics, oxygen, treatment of allergies and other conditions that can exacerbate attacks. Often, in addition to deep therapy, it is important to avoid allergens, monitor the daily routine, allocate time for sports and a healthy lifestyle.