July 2, 2008, 10:19 PM CT

Coronary arterial calcium scan and death risk in the elderly

Measuring calcium deposits in the heart's arteries can help predict overall death risk in American adults, even when they are elderly, as per a new study reported in the recent issue of Journal of the American College of Cardiology

Matthew J. Budoff, M.D., one of the study's authors and a researcher at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), said prior studies had found measuring coronary arterial calcium with computed tomography (CT) heart scans could predict overall death risks in most American adults.

He said the latest study is the first extensive examination of coronary arterial scans of the elderly.

"This study indicates calcium scans can be the best predictor currently available to detect who is likely to suffer a heart attack and who is not," said Dr. Budoff. "Prior studies found coronary arterial calcium scans were effective tools for determining the overall death risk in young adults, diabetics, smokers and those suffering from renal failure. This study indicates coronary arterial scans are effective in measuring overall death risk in the elderly".

A calcium scan looks for calcification or a hardening of the arteries caused by high blood fats and calcium deposits in the arteries leading to and from the heart. These calcifications can block blood vessels and cause heart attacks, strokes or other health issues......... Posted by: April      Read more         Source

July 1, 2008, 9:33 PM CT

Invasive treatment for certain coronary syndromes

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

Although 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, according to 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) prior to hospital discharge. A conservative treatment 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: April      Read more         Source

June 18, 2008, 8:41 PM CT

First gene therapy for heart failure offered at NewYork-Presbyterian

Could injecting a gene into a patient with severe heart failure reverse their disabling and life-threatening condition? Physician-researchers are setting out to answer that question in a first-ever clinical trial of gene treatment to treat severe heart failure.

NewYork-Presbyterian Hospital/Columbia University Medical Center is the only center in the New York City area where the treatment is currently available.

Patients enrolled in the multicenter CUPID trial (Calcium Up-Regulation by Percutaneous Administration of Gene Therapy in Cardiac Disease) will undergo a minimally invasive cardiac catheterization procedure that will introduce a specially engineered gene that stimulates production of an enzyme necessary for the heart to pump more efficiently.

"This new treatment seeks to replenish the levels of this enzyme by introducing the gene for SERCA2a, which is depressed in these patients. If proven effective, this approach could be an alternative to heart transplant for patients without any other options," says Dr. Donna Mancini, the study's principal investigator at NewYork-Presbyterian Hospital/Columbia University Medical Center, where she is medical director of cardiac transplantation. She also is professor of medicine at Columbia University College of Physicians and Surgeons......... Posted by: April      Read more         Source

April 13, 2008, 9:35 PM CT

Macadamia nuts for healthy heart

Macadamia nuts included in a heart healthy diet reduced low-density cholesterol (bad cholesterol) and should be included among nuts with qualified health claims, as per researchers.

"We looked at macadamia nuts because they are not currently included in the health claim for tree nuts, while other tree nuts are currently recommended as part of a heart healthy diet," says Dr. Amy E. Griel, a recent Penn State Ph.D. recipient in nutrition and now senior nutrition scientist at The Hershey Company. "Macadamia nuts have higher levels of monosaturated fats, like those found in olive oil compared with other tree nuts".

Along with Brazil nuts and cashews, macadamia nuts are not included in the U.S. Food and Drug Administration's list of nuts with qualified health claims because the cut-off point is 4 grams of saturated fat per 50 grams of nuts. Macadamia nuts have 6 grams of saturated fat per 50 grams, cashew nuts have 4.6 grams and Brazil nuts have 7.6 grams of saturated fat per 50 grams of nuts.

"Epidemiological studies showed that people who are frequent nut consumers have decreased risk of heart disease," says Penny Kris-Etherton, co-author and distinguished professor of nutritional sciences.

The scientists used a controlled feeding study to compare a heart-healthy diet with 1.5 ounces a small handful of macadamia nuts to a standard American diet. The participants had slightly elevated cholesterol levels, normal blood pressure and were not taking lipid-lowering drugs. Scientists randomly assigned participants to either the macadamia nut diet or the standard American diet and provided all meals for the participants for five weeks. The participants then switched diets and continued eating only food provided by the scientists for another five weeks......... Posted by: April      Read more         Source

April 9, 2008, 10:07 PM CT

Neuroprotective effect of lovastatin

High cholesterol levels are considered to be a risk factor for cardiovascular disease including stroke. Therefore, a number of cholesterol lowering drugs have been developed by pharmaceutical companies in recent years. One class of these drugs, statins, has been found to reduce the occurence rate of stroke and progression of Alzheimers disease when prophylactically administered.

In a recent paper reported in the Journal of Alzheimers Disease, Amalia Dolga and co-workers from the University of Groningen show that the statin lovastatin, in addition to lowering cholesterol, can also prevent nerve cells from dying in conditions that occur in Alzheimers disease. Amalia Dolga discovered a previously unknown cascade of cellular signals in nerve cells that are responsible for this neuroprotective mechanism. This is an important finding because in a number of diseases such as Alzheimers or Parkinsons, death of nerve cells is generally believed to be a major cause of the dramatic symptoms that we find in these diseases.

Amalia Dolga observed that statins stimulate nerve cells to produce a specific receptor molecule for a protein which plays a central role in the bodys immune response: Tumor Necrosis Factor-alpha (TNF-). Prior studies conducted by Dr. Ulrich Eisels group in the Department of Molecular Neurobiology (headed by Prof. Paul Luiten) have demonstrated that this specific TNF- signaling pathway has a strong beneficial effect on nerve cells and can protect nerve cells against death. This finding now demonstrates that a widely given drug like a statin can activate this protective pathway......... Posted by: April      Read more         Source

April 6, 2008, 8:11 PM CT

Rare genetic mutations protect against hypertension

Howard Hughes Medical Institute (HHMI) scientists have observed that rare mutations in three genes contribute to blood pressure variation in the general population.

Typically the researchers had previously shown that mutations in the three salt handling genes cause several rare diseases that are characterized by low blood pressure. By sequencing DNA samples obtained from 3,125 people who are participating in the Framingham Heart Study, the scientists identified new functional mutations in these three genes that are likely to be carried by an estimated 100 million people worldwide.

The Framingham Heart Study was begun in 1948 in an effort to identify common factors or characteristics that contribute to cardiovascular disease by following its development over a long period of time in a large group of participants who had still not developed overt symptoms of cardiovascular disease or suffered a heart attack or stroke.

We find that about two percent of the population has mutations in at least one of these three genes eventhough all of the identified mutations are individually very rare, said senior author Richard P. Lifton, a Howard Hughes Medical Institute researcher at Yale University School of Medicine. Mutation carriers have reduced blood pressure, with a 60 percent reduction in the risk of high blood pressure at age 60......... Posted by: April      Read more         Source

March 27, 2008, 9:19 PM CT

Normal weight obesity: An emerging risk factor

More than half of American adults considered to have normal body weight in America have high body fat percentages -- greater than 20 percent for men and 30 percent for women -- as well as heart and metabolic disturbances, new Mayo Clinic research shows. The finding conflicts with the widely held belief that maintaining a normal weight automatically guards against disorders such as high levels of circulating blood fats and a tendency to develop metabolic syndrome, which often leads to type 2 diabetes.

The researchers defined normal weight by body mass index (BMI). They found that people with normal BMI who had the highest percentage of body fat were also those who had metabolic disturbances linked to heart disease. The researchers use the phrase normal weight obesity to describe this new type of patient at risk for metabolism problems and risk factors for heart disease, but who rates as normal on standard weight charts. They defined normal weight obesity as a condition of having a normal BMI with high body fat percentage. The Mayo team will present its study results at the American College of Cardiologys Annual Scientific Session next week in Chicago.

Using the term normal weight obesity is really a way of being more precise about the changing conceptualization of obesity, because the real definition of obesity is excess body fat, says Francisco Lopez-Jimenez, M.D., a cardiologist on the Mayo research team. Our study demonstrates that even people with normal weight may have excessive body fat, and that these people are at risk for metabolic abnormalities that lead to diabetes and, eventually, to heart disease......... Posted by: April      Read more         Source

March 16, 2008, 9:51 PM CT

ECG standards should be revised for elderly

Scientists at Mayo Clinic suggest that the established normal ranges for evaluating electrocardiograms for persons over 80 years old should be revisited. The recommendation comes as per a research findings published recently in the American Journal of Geriatric Cardiology.

After analyzing readings from more than 700 patients 80 or older, the scientists discovered that the average cutoffs (beginning and end points) for measuring all three ECG intervals -- PR, QRS and QT -- were greater than the current established norms. The findings also showed that the intervals, while greater in general, were significantly higher in men. The intervals refer to the times between recorded peaks of the specific motions in a heartbeat as represented on an electrocardiogram.

What is normal for a population of middle-aged individuals may not be the same for the steadily increasing elderly population in this country, says Latha Stead, M.D., lead author of the study and chair of the Division of Emergency Medicine Research at Mayo Clinic.



Significance of the Findings

Americas boomer generation is quickly aging into a geriatric generation. In 1994 one person in eight was elderly; by 2030, that figure will be one in five. As these individuals age, physicians need to have appropriate standards to evaluate their cardiac health, whether they have a routine checkup or appear in an emergency department. Mayo is seeking the best information about how to treat each individual, no matter what the age......... Posted by: April      Read more         Source

March 9, 2008, 5:21 PM CT

Cannabis based medicines may help smokers to quit

Smokers trying to quit in the future could do it with the help of cannabis based medicines, according to research from The University of Nottingham.

Teams of pharmacologists, studying the cannabis-like compounds which exist naturally in our bodies (endocannabinoids), are exploring the potential for medical treatment. This includes treating conditions as diverse as obesity, diabetes, depression and addiction to substances like nicotine.

Scientists have known about endocannabinoids since the mid-1990s. This led to an explosion in the number of researchers looking into the future medical uses of cannabinoids and cannabis compounds.

Dr Steve Alexander, Associate Professor in the School of Biomedical Sciences, focused on a number of these projects in editing the first themed podcast for the British Journal of Pharmacology.

Dr Alexander said: "It is clear that there is very realistic potential for cannabinoids as medicines. Scientists are looking at a range of possible applications".

One of these researchers is Professor David Kendall, a cellular pharmacologist at the University: "The brain is full of cannabinoid receptors. And so, not surprisingly with diseases like depression and anxiety, there's a great deal of interest in exploiting these receptors and in doing so, developing anti-depressant compounds"......... Posted by: April      Read more         Source

March 4, 2008, 6:06 PM CT

Quantity and frequency of drinking influence mortality risk

How much and how often people drink not just the average amount of alcohol they consume over time independently influence the risk of death from several causes, as per a new study by scientists at the National Institutes of Health (NIH).

"Taken together, our results reinforce the importance of drinking in moderation. In drinkers who are not alcohol dependent, the majority of U.S. drinkers, alcohol quantity and frequency might be thought of as modifiable risk factors for mortality, the scientists conclude.

These findings underscore the importance of looking at drinking patterns when investigating alcohol-related health outcomes, says Ting-Kai Li, M.D., Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the NIH.

Rosalind A. Breslow, Ph.D., M.P.H., an epidemiologist in NIAAAs Division of Epidemiology and Prevention Research, and Barry I. Graubard, Ph.D., a statistician in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, examined data from a nationwide health survey conducted in 1988. Almost half of the nearly 44,000 people who participated in the survey identified themselves as current drinkers who had at least 12 drinks of alcohol during the prior year. By the end of 2002, more than 2,500 of these individuals had died. Drs. Breslow and Graubard compared their causes of death with the alcohol consumption patterns they published in the survey. A report of their findings appears in the March, 2008 issue of Alcoholism: Clinical and Experimental Research......... Posted by: April      Read more         Source