August 27, 2008, 7:25 PM CT

Heart attack patients who stop statin risk death

Patients discontinuing statin medicine following an acute myocardial infarction (AMI) increase their risk of dying over the next year, say scientists at McGill University and the McGill University Health Centre (MUHC). Their study was published in a recent issue of the European Heart Journal

Using data on British patients who survived an AMI and were still alive three months later, Dr. Stella Daskalopoulou and his colleagues observed that those who discontinued their statin medicine were 88% more likely to die during the following year in comparison to those who had never been on the medication.

"Statins were found to be beneficial drugs," said Dr. Daskalopoulou, of McGill's Faculty of Medicine and the Department of Medicine and the Division of Clinical Epidemiology at the MUHC. "Patients who used statins before an AMI and continued to take them after were 16% less likely to die over the next year than those who never used them. So even if it appears that the statins failed to prevent your AMI, it is beneficial to continue taking them and potentially quite harmful to stop."

The large, population-based cohort study was conducted using UK data to take advantage of the medical records kept in the General Practice Research Database (GPRD), which collects information on the health of more than three million patients across the UK......... Posted by: Daniel      Read more         Source

August 20, 2008, 6:28 PM CT

How to stop a new type of heart attack

PACEMAKERS are supposed to protect people from heart attacks. But to do that they have to provide digital as well as biological security.

Earlier this year, a team led by William Maisel at Harvard Medical School demonstrated how a commercial radio transmitter could be used to modify wireless communications from a pacemaker (New Scientist, 22 March, p 23). Doctors normally use these signals to monitor and adjust the implanted device, but a malicious hacker could reprogram the pacemaker to give its wearer damaging shocks, or run down its batteries.

Such irresponsible attacks might seem inconceivable, but Tamara Denning, a computer scientist at the University of Washington in Seattle, points out that in 2007 hackers posted flashing images to the Epilepsy Foundation's website, apparently with the aim of triggering attacks in people with photosensitive epilepsy.

Pacemaker users could be similarly targeted, and there are a growing number of other implantable medical devices (IMDs) - such as drug pumps, neural stimulators, swallowable cameras and prosthetics - which could also be undermined by pranksters or even killers. Scientists like Denning believe it's worth being prepared. "We wanted to draw attention not to a prevalent threat, but to a possible future one," she says......... Posted by: Daniel      Read more         Source

July 29, 2008, 11:50 PM CT

Fat around the heart

When it comes to risk for a heart attack, having excess fat around the heart may be worse than having a high body mass index or a thick waist, as per scientists from Wake Forest University Baptist Medical Center and his colleagues reporting in the recent issue of the journal Obesity

The study was among the first to explore whether there is a link between fat deposits around the heart, known according toicardial fat, and the development of hard, calcified plaque in the arteries. Calcified plaque itself is not considered risky, but it is linked to the presence of less stable fatty deposits that can lead to heart attack and stroke.

"The distribution of body fat may be as important as the amount of body fat in determining risk of heart attacks," said Jingzhong Ding, M.D., lead author and an assistant professor of gerontology. "Even a thin person can have fat around the heart".

The scientists examined data from the Multi-ethnic Study of Atherosclerosis (MESA), a $68 million study involving 6,800 participants nationwide, to explore their hypothesis that fat around the arteries in the heart contributes to inflammation and to increased risk of fatty deposits in the vessels.

In addition to its role as energy storage, fat is considered to be an "organ" that produces proteins and hormones that affect metabolism and health. Ding's study is based on a new idea in medicine that excess fat around the heart and other organs may impair their function. Pericardial fat, or stores of fat around the heart, is known to have a higher secretion of inflammatory cytokines, proteins that regulate inflammation, than fat stored just under the skin. The researchers suspect that constant exposure of inflammatory proteins produced by fat around the heart may accelerate the development of atherosclerosis......... Posted by: Daniel      Read more         Source

July 23, 2008, 4:34 PM CT

Exercise could be the heart's fountain of youth

Absence may make the heart grow fonder, but endurance exercise seems to make it younger. As per a research studyconducted at Washington University School of Medicine in St. Louis, older people who did endurance exercise training for about a year ended up with metabolically much younger hearts. The scientists also showed that by one metabolic measure, women benefited more than men from the training.

"We know that the heart deteriorates as people get older, and that's largely because they don't stay as active as they used to," says first author Pablo F. Soto, M.D., instructor in medicine in the Cardiovascular Division. "Past research has suggested that exercise can reverse some effects of aging, and we wanted to see what effect it would have specifically on the heart."

The scientists measured heart metabolism in sedentary older people both at rest and during administration of dobutamine, a drug that makes the heart race as if a person were exercising vigorously. At the start of the study, they observed that in response to the increased energy demands produced by dobutamine, the hearts of the study subjects didn't increase their uptake of energy in the form of glucose (blood sugar).

But after endurance exercise training which involved walking, running or cycling exercises three to five days a week for about an hour per session the participants' hearts doubled their glucose uptake during high-energy demand, just as younger hearts do......... Posted by: Daniel      Read more         Source

July 21, 2008, 9:36 PM CT

Beijing pollution may trigger heart attacks

Olympic athletes aren't the only ones who need to be concerned about the heavily polluted air in Beijing. The dirty air may trigger serious cardiovascular problems for some spectators.

Two scientists in pulmonary medicine and critical care at Northwestern University's Feinberg School of Medicine warn that for people in certain risk groups, breathing high levels of pollution can cause heart attacks and strokes within 24 hours of exposure and increase the possibility of having blood clots in their legs on the plane home.

The people who are vulnerable include those who already have known cardiovascular disease or risk factors for cardiovascular disease such as high blood pressure, high cholesterol, diabetes, obesity, lung disease, a current smoking habit or a family member diagnosed with heart disease before age 55.

"If the air quality is bad, you are more likely to have serious heart disease related events," said Gokhan Mutlu, MD, assistant professor of medicine at the Northwestern's Feinberg School and a doctor at Northwestern Memorial Hospital. "Being exposed to higher levels of pollution may unmask heart disease even if you've never had any symptoms."



WHY POLLUTION CAUSES HEART ATTACKS, STROKES AND BLOOD CLOTS

Mutlu published research in 2007 that showed how pollution triggers heart attacks and strokes. He discovered that microscopic air pollution -- particles less than one-tenth of the diameter of a human hair -- makes the blood thicker and sticky. He found when lungs are inflamed by pollution, they secrete a substance, interleukin-6, which causes an increased tendency for blood to clot......... Posted by: Janet      Read more         Source

July 17, 2008, 9:41 PM CT

Too much, too little sleep increases ischemic risk

Postmenopausal women who regularly sleep more than nine hours a night may have an increased risk of ischemic stroke, scientists reported in Stroke: Journal of the American Heart Association.

In comparison to women sleeping seven hours, the risk of ischemic stroke was 60-70 percent higher for those sleeping nine hours or more, said lead author Jiu-Chiuan Chen, M.D., Sc.D., assistant professor of epidemiology at the University of North Carolina's School of Public Health in Chapel Hill.

"After accounting for all common clinical conditions predictive of stroke, we found this increase was statistically significant: sleeping nine hours or more is strongly linked to increased risk of ischemic stroke," he said.

Scientists also observed that women who slept six hours or less were at 14 percent greater stroke risk than those who slept seven hours a night. Nearly twice as a number of women reported sleeping less than six hours (8.3 percent) than those who reported sleeping nine hours or more (4.6 percent).

"The prevalence in women of having long sleep duration is much lower than having sleep duration less than six hours. So the overall public health impact of short sleep is probably larger than long sleep," Chen said. "This study provides additional evidence that habitual sleep patterns in postmenopausal women could be important for determining the risk of ischemic stroke"......... Posted by: Daniel      Read more         Source

July 14, 2008, 9:43 PM CT

Coronary heart disease patients live longer, but not always happier

Better therapys have improved survival in people with coronary heart disease, but the quality of those extra years may be less than ideal, as per research reported in Circulation: Journal of the American Heart Association.

Compared with adults without coronary heart disease (CHD), adults with CHD scored up to 9 percent lower on four scales measuring "quality of life." Patients with coronary heart disease were more likely to say they had poorer quality of life, or describe themselves as sick, said lead author Jipan Xie, M.D., Ph.D., former health scientist in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention in Atlanta, Ga.

Quality of life, which includes physical functioning, psychological functioning, social functioning, overall life satisfaction, and perceptions of health status, can be used to measure effectiveness of therapy and predict the long-term mortality after a cardiac event.

Those most likely to report poorer quality of life in this study were:

• age 18 to 49;
• women; and
• black or Hispanic.

The age-related difference, Xie said, probably reflects a difference in age-related expectations.

"Younger people may feel more pressure - particularly younger men - in the workplace and may be more threatened by limitations imposed by their disease," she said......... Posted by: Daniel      Read more         Source

July 9, 2008, 9:16 PM CT

How food affects the brain

In addition to helping protect us from heart disease and cancer, a balanced diet and regular exercise can also protect the brain and ward off mental disorders.

"Food is like a pharmaceutical compound that affects the brain," said Fernando Gmez-Pinilla, a UCLA professor of neurosurgery and physiological science who has spent years studying the effects of food, exercise and sleep on the brain. "Diet, exercise and sleep have the potential to alter our brain health and mental function. This raises the exciting possibility that changes in diet are a viable strategy for enhancing cognitive abilities, protecting the brain from damage and counteracting the effects of aging." .

Gmez-Pinilla analyzed more than 160 studies about food's affect on the brain; the results of his analysis appear in the recent issue of the journal Nature Reviews Neuroscience and are available online at www.nature.com/nrn/journal/v9/n7/abs/nrn2421.html.

Omega-3 fatty acids found in salmon, walnuts and kiwi fruit provide a number of benefits, including improving learning and memory and helping to fight against such mental disorders as depression and mood disorders, schizophrenia, and dementia, said Gmez-Pinilla, a member of UCLA's Brain Research Institute and Brain Injury Research Center......... Posted by: JoAnn      Read more         Source

July 7, 2008, 9:34 PM CT

Pregnancy and risk of heart attack

Eventhough acute myocardial infarction (AMI) is rare in women of child-bearing age, pregnancy can increase a woman's risk of heart attack 3- to 4-fold, as per a research studyreported in the July 15, 2008, issue of the Journal of the American College of Cardiology Since women today may delay having children until during the later part of life, and advances in reproductive medicine enable older women to conceive, the occurrence of AMI linked to pregnancy is expected to increase.

The study, authored by Arie Roth, M.D., Tel Aviv University in Israel, and Uri Elkayam, M.D., University of Southern California (USC), is a follow up to their initial report released in 1995. The report is based on a review of 103 women with pregnancy-related AMI in the last decade and outlines key recommendations for the diagnosis and therapy of this condition in pregnant women that also considers the health and safety of the developing baby.

"It's extremely important that physicians who take care of women during pregnancy and after delivery be aware of the occasional occurrence of AMI in pregnancy and not overlook symptoms in these young patients," said Dr. Elkayam, who is a professor of Medicine and Obstetrics and Gynecology at USC. "Eventhough a number of of the standard principles for diagnosing and treating AMI in non-pregnant patients also apply to pregnant women, two patients need to be treatedthe mother and her babyand the health status of both should play a major role in the selection of diagnostic and therapeutic strategies"......... Posted by: Emily      Read more         Source

July 3, 2008, 9:11 PM CT

Red wine ingredient wards off effects of age on heart

Large doses of a red wine ingredient can ward off a number of of the vagaries of aging in mice who begin taking it at midlife, as per a new report published online on July 3rd in Cell Metabolism, a Cell Press publication. Those health improvements of the chemical known as resveratrolincluding cardiovascular benefits, greater motor coordination, reduced cataracts and better bone densitycome without necessarily extending the animals' lifespan.

Sinclair and de Cabo's team further show evidence that resveratrol mimics the beneficial effects of eating fewer calories. In mice, they observed that resveratrol induces gene activity patterns in multiple tissues that parallel those induced by dietary restriction and every-other-day feeding.

" From a health point of view, the quality of life of these mice at the end of their days is much better," said Rafael de Cabo of the National Institute on Aging. It suggests that resveratrol may "extend productive independent life, rather than just extending life span".

" I was most surprised by how broad the effects were in the mice," added David Sinclair of Harvard Medical School. "Usually, you focus on slowing down or ameliorating one disease at a time. In this case, resveratrol influences a whole series of seemingly unrelated diseases linked to aging." Sinclair said he expects some of the effect seen in the mice would have even greater impact if they hold in humans. That's because, unlike people, mice commonly don't die as a result of heart disease, or suffer from weakening bones......... Posted by: Daniel      Read more         Source

July 3, 2008, 9:03 PM CT

Statins have unexpected effect on brain cells

Cholesterol-lowering drugs known as statins have a profound effect on an elite group of cells important to brain health as we age, researchers at the University of Rochester Medical Center have found. The new findings shed light on a long-debated potential role for statins in the area of dementia.

Neuroresearchers observed that statins, one of the most widely prescribed classes of medicine ever used, have an unexpected effect on brain cells. Scientists looked at the effects of statins on glial progenitor cells, which help the brain stay healthy by serving as a crucial reservoir of cells that the brain can customize depending on its needs. The team observed that the compounds spur the cells, which are very similar to stem cells, to shed their flexibility and become one particular type of cell.

The new findings come at a time of increasing awareness among neurologists and heart specialists of the possible effects of statins on the brain. Several studies have set out to show that statins provide some protection against dementia, but the evidence has been inconclusive at best. Meanwhile, there is some debate among physicians about whether statins might actually boost the risk of dementia. The new research reported in the recent issue of the journal Glia by Steven Goldman, M.D., Ph.D., and first author Fraser Sim, Ph.D., provides direct evidence for an effect of statins on brain cells......... Posted by: Daniel      Read more         Source

July 1, 2008, 9:31 PM CT

Invasive treatment for certain coronary syndromes

An analysis of prior studies indicates that among men and high-risk women with a certain type of heart attack or angina an invasive therapy strategy (such as cardiac catheterization) is linked to reduced risk of rehospitalization, heart attack or death, whereas low-risk women may have an increased risk of heart attack or death with this therapy, as per an article in the July 2 issue of JAMA

Eventhough an invasive strategy is frequently used in patients with unstable angina and nonST-segment elevation myocardial infarction (NSTEMI; a type of heart attack with certain findings on an electrocardiogram), data from some trials suggest that this strategy may not benefit women, with a possible higher risk of death or heart attack, as per background information in the article. "Thus, the benefit of an invasive strategy in women remains unclear. However, individual trials have not been large enough to explore outcomes reliably within subgroups," the authors write.

For this study, an invasive strategy was defined as the referral of all patients with heart attacks and unstable angina for cardiac catheterization (a procedure that allows physicians to find and open potential blockages in the coronary arteries to help prevent heart attacks and death) previous to hospital discharge. A conservative therapy strategy was defined as a primary strategy of medical management and subsequent catheterization only for those patients with ongoing chest pain or a positive stress test......... Posted by: Daniel      Read more         Source

June 23, 2008, 7:13 PM CT

Anticancer agents on patients with heart disease

A set of promising new anticancer agents could have unforeseen risks in individuals with heart disease, suggests research at Washington University School of Medicine in St. Louis. The anticancer drugs which go by the strange name of hedgehog antagonists interfere with a biochemical process that promotes growth in some cancer cells. But the scientists showed that interfering with this biochemical process in mice with heart disease led to further deterioration of cardiac function and ultimately death.

"This finding should serve as a warning that these drugs might have adverse effects on the heart and that it could be very important to monitor patients' cardiovascular health when using this type of anticancer drug," says senior author David Ornitz, M.D., Ph.D., the Alumni Endowed Professor and head of Developmental Biology. The research was reported June 20, 2008, in advance online publication in the Journal of Clinical Investigation

Hedgehog antagonists are drugs that inhibit the hedgehog signaling pathway, a chain of biochemical signals that regulate cellular growth and differentiation. The odd term hedgehog has little to do with the small, spiny mammals it originated when researchers noted the spiky, hedgehog-like appearance of fly embryos with abnormal hedgehog genes. Every organism in the animal kingdom has hedgehog genes, which play an essential role in guiding cells to mature into the appropriate form for proper function......... Posted by: Janet      Read more         Source

June 18, 2008, 8:55 PM CT

Failure to bridle inflammation spurs atherosclerosis

When a person develops a sore or a boil, it erupts, drawing to it immune system cells that fight the infection. Then it resolves and flattens into the skin, often leaving behind a mark or a scar.

A similar scenario plays out in the blood vessels. However, when there is a defect in the resolution response the ability of blood vessels to recover from inflammation atherosclerosis or hardening of the arteries can result, said scientists at Baylor College of Medicine in Houston and Harvard Medical School in Boston in a report that appears online today in The Journal of the Federation of American Societies for Experimental Biology The major factor in this disease is a deficiency in the chemical signals that encourage resolution (pro-resolution signals). These signals are produced in the blood vessel where the inflammation occurs, the scientists said.

Chronic inflammation of the artery wall can cause atherosclerosis, a major risk factor for heart disease and heart attack. However, said Dr. Lawrence C.B. Chan, professor of medicine and molecular and cellular biology and chief of the division of division of diabetes, endocrinology and metabolism at BCM, in a number of instances, the lesions or little sores inside the artery arise and then resolve, often from a very young age. The mystery is why some lesions do not heal......... Posted by: Daniel      Read more         Source

June 16, 2008, 10:13 PM CT

Why some don't respond to cholesterol-lowering drugs

A variation in the way the body processes a single protein may explain why some people don't respond well to drugs that lower "bad" cholesterol, as per a report in Circulation: Journal of the American Heart Association

The gene variation, called alternative splicing, explained 9 percent of the drugs' decreased power to reduce low-density lipoprotein (LDL) in study participants in comparison to people with the standard processing pathway.

The study is the first to show that a change in a biological process contributes substantially to the effectiveness of cholesterol-lowering drugs known as statins.

"Nine percent is a large number," said Ronald Krauss, M.D., senior author of the study and director of atherosclerosis research at the Children's Hospital Oakland Research Institute in California. "When we look at individual variations in genes affecting cholesterol metabolism, we can commonly explain only a few percent of the variability in statin response."

The discovery could lead to improved cholesterol therapy and new treatment for other chronic ailments.

"The implications could go well beyond the efficacy of statins by helping us to understand the differences among individuals in how cholesterol is metabolized," Krauss said......... Posted by: Daniel      Read more         Source

June 4, 2008, 11:04 PM CT

Brief, intense exercise benefits the heart

Short bursts of high intensity sprints known to benefit muscle and improve exercise performancecan improve the function and structure of blood vessels, in particular arteries that deliver blood to our muscles and heart, as per new research from McMaster University.

The study, lead by kinesiology doctoral student Mark Rakobowchuk, is published online in the journal American Journal of Physiology. Regulatory, Integrative & Comparative Physiology.

The findings support the idea that people can exercise using brief, high-intensity forms of exercise and reap the same benefits to cardiovascular health that can be derived from traditional, long-duration and moderately intense exercise.

"As we age, the arteries become stiffer and tend to lose their ability to dilate, and these effects contribute to hypertension and cardiovascular disease," says Maureen MacDonald, academic advisor and an associate professor in the Department of Kinesiology. "More detrimental is the effect that blood vessel stiffening has on the heart, which has to circulate blood".

The research compared individuals who completed interval training using 30-second "all-out" sprints three days a week to a group who completed between 40 and 60 minutes of moderate-intensity cycling five days a week......... Posted by: Daniel      Read more         Source

June 4, 2008, 10:59 PM CT

Substance in red wine keep hearts young

How do the French get away with a clean bill of heart health despite a diet loaded with saturated fats? Researchers have long suspected that the answer to the so-called "French paradox" lies in red wine. Now, the results of a new study bring them closer to understanding why.

Writing this week in the online, open-access journal Public Library of Science (PLoS) ONE, scientists from industry and academia, including the University of Wisconsin-Madison and the University of Florida, report that low doses of resveratrol -- a natural constituent of grapes, pomegranates, red wine and other foods -- can potentially boost the quality of life by improving heart health in old age.

The researchers included small amounts of resveratrol in the diets of middle-aged mice and observed that the compound has a widespread influence on the genetic causes of aging. Specifically, the scientists observed that low doses of resveratrol mimic the heart-healthy effects of what is known as caloric restriction, diets with 20 to 30 percent fewer calories than a typical diet. The new study is important because it suggests that resveratrol and caloric restriction, which has been widely studied in animals from spiders to humans, may govern the same master genetic pathways correlation to aging......... Posted by: Daniel      Read more         Source

June 4, 2008, 10:35 PM CT

Heart patients fare better in 3-year program

People recovering from acute heart problems such as heart attack and heart surgery are more likely to develop habits to control heart attack risk factors when they meet regularly with cardiac "disease managers," as per scientists at Mayo Clinic in Rochester. These managers are nondoctor cardiac rehabilitation specialists who lead long-term follow-up programs that last three years. With these risk factors under control, heart patients are likely to live longer and have fewer heart problems, the Mayo scientists conclude.

The Mayo Clinic scientists studied the effects of a long-term cardiac disease manager model on 503 patients involved in cardiac rehabilitation. Their findings are published in The Journal of Cardiopulmonary Rehabilitation and Prevention. The disease manager's role was to monitor the patient's status, and to coach the patients in adopting heart attack prevention behaviors. At each meeting, the following factors were assessed and management strategies were discussed: blood lipid levels, blood pressure and body weight, tobacco use, cardiac medicine compliance, exercise regimen and physical activity, nutrition and cardiopulmonary symptoms. After initial rehabilitation training about risk factor management, each patient met with a trained disease manager every three to six months for three years......... Posted by: Daniel      Read more         Source

May 26, 2008, 8:35 PM CT

Many patients have poor knowledge of heart attack symptoms

Nearly half of patients with a history of heart disease have poor knowledge about the symptoms of a heart attack and do not perceive themselves to have an elevated cardiovascular risk, as per a report in the May 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Individuals with heart disease have five to seven times the risk of having a heart attack or dying as the general population, as per background information in the article. Survival rates improve following heart attack if therapy begins within one hour. However, most patients are admitted to the hospital 2.5 to three hours after symptoms begin. Barriers to seeking appropriate care quickly are both cognitive and emotional, the authors write. If patients do not know the symptoms of acute myocardial infarction (heart attack) and other acute coronary syndromesincluding nausea and pain in the jaw, chest or left armthey will not seek therapy for them. If they do not perceive themselves to be at risk for heart attack, they will look for another explanation when they experience these symptoms.

Kathleen Dracup, D.N.Sc., of the University of California, San Francisco, School of Nursing, and his colleagues surveyed 3,522 patients (average age 67) who had a history of heart attack or an invasive procedure for treating narrowed arteries. The patients were asked to identify possible symptoms of heart attack and responded to true-false questions about heart disease. Participants also were asked whether they were more or less likely than other individuals their age to have a heart attack in the next five years......... Posted by: Daniel      Read more         Source

May 26, 2008, 7:56 PM CT

Increased screening for those at higher risk for heart disease

Adding noninvasive imaging to current risk-assessment protocols may identify more people at risk of developing heart disease, UT Southwestern Medical Center scientists have found.

Scientists used data from the UT Southwestern-led Dallas Heart Study to determine whether using computed tomography (CT) to scan patients hearts for calcium deposits and blockages could identify more people at high risk for heart disease and who could benefit from cholesterol-lowering treatment.

The recommendations by the Screening for Heart Attack Prevention and Education (SHAPE) task force are a proposed update to the current guidelines, were updated by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) in 2004.

In findings published in todays edition of Archives of Internal Medicine, scientists observed that the additional imaging proposed by the SHAPE task force did indeed increase the number of patients classified at high risk.

We added imaging of coronary artery calcium, as recommended by the SHAPE task force, to determine if this strategy would augment current risk assessment, said Dr. Jason Lindsey, an author of the paper and cardiology fellow at UT Southwestern.

The efficiency of calcium screening as per the SHAPE recommendations was determined by the number of people who had to be scanned before a single participant was reclassified as either meeting or not meeting individual cholesterol goals......... Posted by: Daniel      Read more         Source